Academic journal article Social Work

Epigenetics and the Social Work Imperative

Academic journal article Social Work

Epigenetics and the Social Work Imperative

Article excerpt

Historically, social workers have been suspicious of the study of genetics, in part because of the malicious use of genetic knowledge in the eugenics movement, in which the profession played an unfortunate collaborative role (Kennedy, 2008). A partial rapprochement between social work and genetics occurred in the 1980s and 1990s, however, as new understanding of genetic diseases has highlighted the importance of the specialty practice area of genetic counseling (Rauch, 1988).

Knowledge about human genetics has grown at an astonishing rate, particularly since completion of the Human Genome Project (HGP) (National Human Genome Research Institute, 2010). The goal of the HGP was breathtaking: to map the entire human genetic code. The project was completed in 2003, and results demonstrate that humans have between 20,000 and 25,000 genes. Specific functions of many of those genes were identified, but it is not possible to identify the specific genes for most diseases, as most diseases are complex and related to the functioning of many genes. The most interesting findings of the HGP, however, turn out to be what it did not tell us: how and why specific genes are expressed.

THE HUMAN EPIGENOME

The human genome--that is, an individual's entire genetic code-is not a perfect predictor of his or her actual physiology (called the phenotype). Why do identical twins become less and less identical as they grow older (Gilbert, 2009)? Why do some women who carry the now well-known BRCA1 and BP, CA2 genetic mutations for breast cancer not develop breast cancer (Antoniou et al., 2003)? Why do only some members of monozygotic (identical) twin pairs develop schizophrenia and bipolar disorder, though a genetic connection is clear (Rosa et al., 2008)?

The answer to the above questions is epigenesis. Epigenesis is the transmission of information to new cells during cell division that determines how genes are expressed: which genes present are "turned on" and which are silenced. Experience and the environment (in the broadest sense) are major determinants of which genes are expressed and which are silenced, and as the environment changes, so may the epigenome, the system that regulates gene expression. Attention to the effects of the environment is, of course, social work's claim to fame, an attention we often cite (somewhat unfairly) as setting us apart from other professions. Nevertheless, our emerging understanding of epigenesis provides a new mandate and potential opportunity for social workers to focus on the environment.

EXPLAINING EPIGENESIS

Epigenesis occurs through biochemical processes, to which other genes, environmental exposures, experiences, and other factors contribute. Because it occurs during cell division, epigenesis may be most critical during periods of rapid growth: gestation, infancy, and puberty, as well as possibly during old age, when cells have divided many times and may be "wearing out" (Gilbert, 2009). Epigenesis causes changes in the structure of an organism (that is, the phenotype) without changing the underlying DNA (the double strand of nucleic acid that contains the genetic instructions) by altering gene expression. This point deserves emphasis: Epigenetic changes in the organism are not due to changes in the genes themselves, such as occur through mutation. Khan (2010) asserted that "epigenetics blurs the distinction between 'nature' and 'nurture' as experiences (nurture) become a part of intrinsic biology (nature)" (p. 259).

Genes direct development by determining which proteins are produced in the cells; although all cells have the same DNA, some produce proteins that direct them to become part of the eye, whereas others are directed to be liver or skin cells (Nafee, Farrell, Carroll, Fryer, & Ismail, 2007). Directions are transmitted primarily (though not exclusively) through two biochemical processes: methylation and chromatin remodeling. …

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