news feature Altered states Changes to the genome that don’t affect DNA sequence may help to explain differences between genetically identical twins. Might these ‘epigenetic’ phenomena also underlie common diseases? Carina Dennis investigates. arie and Jo — not their real names — are twins, genetically identical Mand raised in a happy home. Grow- ing up, both enjoyed sport and art, were equally good at school, and appeared simi- H. KING/CORBIS lar in almost every respect. But as adults, their lives and personalities diverged: in her early twenties, following episodes of hallucinations and delusions, Marie was diagnosed with schizophrenia. Such examples have long baffled geneti- cists. Despite sharing the same DNA and often the same environment, ‘identical’ twins can sometimes show striking differ- ences. Now some researchers are beginning to investigate whether subtle modifications to the genome that don’t alter its DNA sequence, known as epigenetic changes, may provide the answer. In doing so, they hope to shed light on the mysterious roots of com- mon diseases — such as schizophrenia and diabetes — that burden society as a whole. The idea that epigenetics underpins many of the world’s health scourges is still highly speculative. “Most geneticists believe that the essence of all human disease is related Spot the difference: colour-coded epigenetic microarrays could show why ‘identical’ twins aren’t the same. to DNA-sequence variation,” says Arturas Petronis, a psychiatrist at the University of important epigenetic mechanism. Inside the stumbled into the subject from conventional Toronto in Canada. But with the genomics nucleus, strands of DNA wrap around pro- genetics, discovering that the mutated gene revolution having yet to yield the hoped-for teins called histones, and then coil up for a rare condition exerts its effect by avalanche of genes that confer susceptibility again into a densely packed structure called influencing epigenetic modifications else- to common diseases, Petronis is not alone in chromatin. Chemical modification of the where in the genome, for instance. Children believing that it’s time to revisit the problem protruding histone tails — by the addition of born with mutations in a gene called MECP2, under the spotlight of epigenetics. acetyl, methyl or phosphate groups — can which influences chromatin remodelling, Each of our cells carries the genes for alter chromatin structure, which in turn influ- gradually lose their ability to speak and walk1. making all the building blocks of the body, ences the activity of adjacent genes. There are People with a mutant form of a gene for an but only some of them are active. Epigenetic some predictable patterns — for example, important DNA-methylating enzyme suffer modifications act like switches, helping to genes associated with acetylated histones are from immune-system deficiencies and facial control gene activity so that only those that usually switched on. But the consequences of deformities2. And mutations in a gene called are required in a particular cell are actually the many different combinations of histone ATRX cause mental retardation, urogenital turned on. They constitute a ‘memory’ of modifications — known as the histone code abnormalities and a form of anaemia — gene activity that can be passed on each time — have yet to be fully deciphered. apparently the result of changes in both chro- a cell divides, ensuring that liver cells beget Together, these mechanisms modulate matin structure and DNA methylation3. more liver cells, and so on. gene expression throughout the genome, Among oncologists, the idea that epi- The best-known epigenetic signal is DNA and underpin several unusual phenomena, genetic changes might be linked to disease is methylation, which tags cytosine, one of the including the shutting down of one copy of already well established. “Epigenetic changes four chemical bases that make up the genetic the X chromosome that occurs in female are terribly important in cancer,” says Andrew code, with a methyl group. Although not mammals, and parental ‘imprinting’ — in Feinberg, a geneticist at Johns Hopkins Uni- a hard-and-fast rule, DNA methylation is which a gene’s activity depends on whether it versity in Baltimore, Maryland. Two decades generally associated with silencing of gene is inherited from the mother or the father. ago, Feinberg and his colleague Bert Vogelstein expression, whereas active genes are usually Over the past few years, some researchers were among the first to show that cancer cells unmethylated. studying rare diseases have found themselves may exhibit unusual patterns of DNA methyl- Chromatin remodelling is another delving into epigenetics. In some cases, they ation4. Since then, similar reports of epigenetic 686 © 2003 Nature Publishing Group NATURE | VOL 421 | 13 FEBRUARY 2003 | www.nature.com/nature news feature Keep it in the family You are what you eat, or so we are told. But how could what your grandmother ate make S. KUMAR/R. ROBERTS any difference? That’s the mystery posed by the grandchildren of women who were pregnant during the famine that hit the Netherlands at the end of the Second World War. Not only were the babies born to malnourished women smaller than normal, but the next generation also had unusually low birth weights13. A similarly perplexing finding emerged last November, in a study of the grandchildren of Swedish men born in 1890–1920. From crop records, Gunnar Kaati and his colleagues at the University of Umeå calculated how much the grandparents had eaten just before puberty. They found that the grandchildren of well-fed adolescents had a greater risk of dying from diabetes, whereas those descended from famine survivors were less likely to die of heart disease14. How can this be? It smacks of lamarckism, the discredited theory that evolution occurs by A methylating enzyme (white) binds to its target site (red) on DNA; the methyl donor is shown in green. the inheritance of acquired characteristics. Now some researchers argue that the answer lies in abnormalities in cancer have proliferated5. it’s the new frontier,” claims Feinberg. epigenetics. “Changes in diet could activate Yet researchers who are interested in other That frontier is still a fairly lonely place, but certain pathways that then leave an imprint that common diseases — such as diabetes, obesity, pioneers are starting to explore. “Eight years is passed to the next generation,” says Alexander heart disease and a host of psychiatric dis- ago, I didn’t even know what the word ‘epi- Olek of the Berlin-based company Epigenomics. orders — have shown relatively little interest genetics’ meant,” says Petronis. Today, he feels It’s a contentious idea — biologists have in epigenetics. Whereas tumours arise from that some features of complex diseases are eas- long thought that the genome is reprogrammed aberrant cells, making it easy to imagine how ier to explain in terms of epigenetic changes around the time of fertilization. But recently, an epigenetic mix-up might be involved, the than through conventional genetics. Some evidence has emerged that some epigenetic origins of other conditions are more com- conditions, such as multiple sclerosis, fluctu- changes survive this process. plex, which made the idea seem less plausible ate in severity as they progress. Although the At the University of Sydney in Australia, for these diseases. “It’s not been on people’s case is far from cut-and-dried, Petronis researchers led by Emma Whitelaw have studied radar screens,” says Feinberg. believes this to be more consistent with shift- a strain of genetically identical mice whose fur ing epigenetic profiles than with the constant ranges in colour from yellow to black, depending Disease by descent nagging presence of a susceptibility gene6. on the methylation of a single gene. They found Besides, many common diseases seem to be Factors such as lifestyle and diet undoubt- that coat colour tends to pass from mothers to inherited within families, which is incompati- edly influence our susceptibility to disease, their pups15. And now a study of fruitflies is ble with the long-standing idea that the epi- and there is mounting speculation that they generating a similar stir. Douglas Ruden, of the genetic slate is wiped clean in the embryo leave a trail of epigenetic footprints across University of Alabama at Birmingham, and his shortly after fertilization, except for parentally our genome. Alexander Olek, chief executive colleagues found evidence that reductions in imprinted genes. Only now is evidence officer of Epigenomics, a Berlin-based com- the activity of a protein called Hsp90 cause emerging that other epigenetic changes can pany that aims to hunt down the epigenetic heritable changes in eye structure that are the be inherited (see ‘Keep it in the family’, right). markers of disease, is hot on the trail of result of epigenetic changes in chromatin16. The lure of genomics has also been instru- changes associated with diet. Olek hopes that If similar phenomena occur in humans, it is mental in keeping medical geneticists focused this will lead him to an epigenetic fingerprint possible that epigenetic modifications, and not on DNA sequence rather than what goes on for diabetes7. Epigenetics may also help to just mutations in DNA sequence, could lie at the around it. One consequence of the Human explain why many diseases only appear late in root of inherited diseases. Genome Project has been the mapping of life. “Age is accompanied by changes in DNA more than a million single-nucleotide poly- methylation,” Olek points out. morphisms (SNPs) — positions in the While Olek’s firm is launching a wide- NIOD genome at which the sequence varies between ranging effort to study disease epigenetics, individuals by a single letter in the genetic Petronis was drawn to the subject by his code. By seeing which SNPs are inherited long-standing quest to understand the most alongside common, complex diseases, it debilitating conditions that haunt the human should be possible to pin down the locations of mind, including bipolar disorder — popularly genes that make some people particularly sus- known as manic depression — and schizo- ceptible to certain conditions.