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Hormone Replacement Therapy in Dogs – WagWalking

Posted: May 26, 2019 at 1:46 pm

Diagnosis of USMI is typically based on signalment (breed, age, sex), history, and lack of other causes of incontinence found during physical examination. Most commonly USMI is seen in spayed dogs of medium to large size. Certain breeds are predisposed to this condition including Boxers, Doberman Pinschers, English Springer Spaniels, German Shepherds, Irish Setters, Old English Sheepdogs, Rottweilers, and Weimaraners. Other factors that predispose to this condition include docked tail and obesity.

The gold standard diagnostic test is a urethral pressure profile. For this test a urinary catheter is placed in an awake or lightly sedated dog and removed at a constant rate while warm sterile water is infused. The pressure generated in the urethra is then measured. This is a 15-30 minute procedure that requires no anesthesia.

Once a diagnosis is made, your veterinarian will prescribe your dog the necessary medicines to treat USMI: Estrogen (DES) and/or Phenylpropanolamine (PPA), an alpha-1 adrenergic agonist. DES is prescribed as a daily pill and then slowly tapered to a low dose maintenance schedule. PPA may be used in addition to DES and will also be tapered to a maintenance schedule from a three time per day dose.

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The Pros & Cons of Hormone Replacement Therapy for Women

Posted: May 26, 2019 at 1:46 pm

The decision to start hormone replacement therapy (HRT) is a big step for many women. Some wonder about the benefits of HRT, while others worry about possible effects from the treatment. Almost every woman who considers hormone replacement therapy appreciates information on the pros and cons of the therapy.

Approximately 80 percent of women who go through menopause experience symptoms and about one-fourth of these women experience severe symptoms of menopause. The symptoms of menopause can be more severe than many women anticipate, and symptoms can last longer than expected too. Night sweats and hot flashes can last for more than seven years in more than half of all women!

Doctors often prescribe hormone replacement therapy to treat moderate to severe menopause symptoms. Despite the benefits of HRT, only a small percentage of women in menopause use hormone replacement therapy.

Menopause is a time that marks the end of menstrual cycles. It means that a woman can no longer bear children because her ovaries, which produce eggs, no longer produce the hormones estrogen and progesterone, and a woman stops ovulating.

Menopause generally begins when a woman is in her late 40s or early 50s. The average age of menopause is 51 in the United States.

Symptoms of menopause can be uncomfortable and inconvenient. These symptoms can often interfere with a womans daily life. Menopause symptoms primarily include hot flashes, sleep problems due to night sweats, and vaginal changes, primarily dryness. Symptoms vary according to the levels of estrogen and progesterone, which tend to fluctuate as the ovaries stop functioning.

Hormone replacement therapy provides a number of benefits for women, especially for women suffering from symptoms of menopause. First, hormone replacement therapy helps women feel better. HRT also protects against bone loss and many other health conditions.

Hormonal fluctuations during peri-menopause cause uncomfortable symptoms HRT can alleviate those symptoms to help women feel more comfortable. Hormone replacement therapy is exceptionally good at relieving hot flashes, particularly at night.

HRT can improve vaginal health. Decreased moisture production can cause vaginal dryness. Loss of elasticity, coupled with vaginal dryness, can cause pain and even slight bleeding during intercourse. Reduced sensation may affect libido as well. Hormone therapy can help relieve dryness and increase moisture and sensation, making sex more pleasurable. Loss of tissue elasticity can affect the vagina and urethra, which is the tube that carries urine from the bladder to the outside world. Loss of elasticity here can cause sudden, frequent and strong urges to urinate. It can even cause urinary incontinence, which is the leaking of urine from the bladder. Women in menopause may even have urinary tract infections (UTIs) more frequently. Hormones help maintain elasticity and muscle tone in the bladder and urethra, helping resolve embarrassing symptoms.

HRT protects bones. Estrogen, produced by the ovaries, helps keep bones strong. Estrogen decreases sharply when a woman reaches menopause and this leaves her vulnerable to osteoporosis, a condition characterized by weak bones. Osteoporosis increases the risk of bone fractures of the hip and spine. In fact, one in every two women over the age of 50 will suffer a bone fracture due to osteoporosis, according to the National Osteoporosis Foundation. Hormone replacement therapy restores estrogen to levels high enough to protect bones from osteoporosis and fractures. Maintaining estrogen levels after menopause essentially stops bone loss.

Hormone replacement therapy can protect women from other health problems too. Estrogen is important to heart health, for example, so when estrogen drops because of menopause, the risk of heart problems increases. HRT can even reduce the risk of colon cancer.

Hormone replacement therapy can even present unexpected benefits that everyone can love. These HRT benefits include boosted collagen production, increased skin thickness, and decreased wrinkles that defy the signs of aging. Hormone replacement therapy even lowers the percentage of body fat and decreases fat around hips and thighs.

As with all medications, hormone replacement therapy does present a risk of side effects. The main concern for women is an increased cancer risk. This is where the type of hormones used is key. Synthetic progesterone, marketed under the brand name Provera, for instance, increases breast cancer risk.

However, bio-identical progesterone actually decreases breast cancer risk as well as an endometrial cancer risk. The use of estrogen therapy may cause the uterus to grow, which increases the risk of uterine cancer; but this is only if a woman does not take progesterone to counter the effects of estrogen on the uterus.

Because of the potential for side effects, the choice to undergo hormone replacement therapy should be done only with a physician trained in bioidentical hormones. Not synthetic hormones, which can be risky. Working with a professional who can provide a personal assessment of healthcare wants and needs is helpful. A doctor can prescribe a personalized hormone replacement therapy to fit a patients needs, reduce their symptoms, improve their quality of life, and decrease their risk for virtually every degenerative disease of aging.

Want to find out if youre at risk for hormone decline? First, take our scientifically based hormone decline risk assessment completely free (takes no more than 5 minutes).

After completing it, you will find out your risk level for hormone decline and, most importantly, how to proceed with beating your symptoms.Click hereto take the male version, andclick hereto take the female version.

Then, if youre interested in learning more about our comprehensive Age Management & Hormone Optimization program,contact us through this formto schedule your free consultation, or call us at323-874-9355.

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Hormone Replacement Therapy | Types of HRT & Alternative …

Posted: May 26, 2019 at 1:46 pm

Hormone replacement therapy (HRT) typically refers to the replacement of sex hormones in menopausal women. Women use HRT to help control the symptoms of menopause. Menopause is the stage in a womans life when sex hormone levels fall and her menstrual period stops.

Symptoms of menopause include hot flashes, night sweats, sleep problems, vaginal dryness, mood swings, anxiety, decreased sexual desire, fatigue, and headaches. Menopause can also cause thinning bones (osteoporosis).

The two main sex hormones that a womans body makes are estrogen and progesterone. Progesterone is primarily produced by the ovaries and, in pregnant women, the placenta. The ovaries also produce estrogen. Estrogen is responsible for the female sexual characteristics. It is also important for many body processes, such as maintaining a healthy heart and bones.

A woman who has had her uterus removed by hysterectomy may receive estrogen alone for HRT. A woman who still has her uterus must receive progesterone in addition to estrogen for HRT. Progesterone signals the uterus to shed its liningsimilar to a menstrual period. This decreases the risk of uterine cancer.

HRT is only one method of controlling the symptoms of menopause. HRT involves some health risks. You may have other treatment options that involve less risk. Discuss all the treatment options with your doctor or healthcare provider to understand which options are right for you.

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Menopause treatment | womenshealth.gov

Posted: May 26, 2019 at 1:46 pm

Many women do not need treatment for their menopause symptoms. You may find that your symptoms go away by themselves. Or you may not find the symptoms uncomfortable. If you are bothered by your symptoms, talk to your doctor or nurse about ways to relieve them. You can work together to find a treatment that is right for you. Some women find that changing their eating habits and getting more physical activity can help. Others may need medicine to help relieve their symptoms.

If your menopause symptoms bother you, talk to your doctor or nurse. Your doctor or nurse can suggest medicines to help with your symptoms. All medicines have risks, and your doctor can help you figure out which medicines are best for you.

Menopausal hormone therapy is prescription medicine to help relieve your menopause symptoms, such as hot flashes and vaginal dryness, if they are severe enough to disrupt your daily life. Menopausal hormone therapy is sometimes called hormone therapy or hormone replacement therapy.

During menopause, your ovaries make very low levels of the hormones estrogen and progesterone. Menopausal hormone therapy replaces some of the hormones no longer made by your ovaries with artificial estrogen and progesterone.

Topical (TOP-ih-kuhl) hormone therapy is usually a low-dose estrogen cream applied directly to the vagina. It relieves vaginal dryness but does not help with other symptoms, such as hot flashes. It also is available as a vaginal ring, insert, and gel. The risks of topical hormone therapy are different from the risks of menopausal or hormone replacement therapy.

Menopausal hormone therapy, sometimes called hormone replacement therapy, is safe for some women, but it also has risks. That is why the FDA advises women who want to try menopausal hormone therapy to use the lowest dose that works for the shortest time needed.

Research shows that:1

Menopausal hormone therapy may not be safe for some women. You should discuss your risks with your doctor if you have:2

The FDA recommends that women take estrogen-only or estrogen plus progesterone menopausal hormone therapy at the lowest dose that works for the shortest time needed.

Talk to your doctor to weigh the risk and benefits of menopausal hormone therapy based on your symptoms, age, and risk factors.

Companies that make bioidentical hormone therapy use the term bioidentical to suggest that their products are exactly the same as natural hormones. Many of these companies also claim that their products are safer than menopausal hormone therapy. However, the FDA does not recognize this term or regulate these products. No studies have been done to evaluate how safe or effective these products are.

Talk to your doctor or nurse before trying any bioidentical hormone therapy.

Some women report relief for hot flashes and other menopause symptoms with complementary or alternative therapies. Talk to your doctor or nurse before taking any herbal or vitamin supplement. The Food and Drug Administration (FDA) does not regulate supplements in the same way they regulate medicines. Many supplements can interfere with medicines and make them work incorrectly or not at all.

Some research studies show relief from premenstrual syndrome (PMS) symptoms with these herbal supplements, but other studies do not. Many herbal supplements should not be used with other medicines. Some herbal supplements women use for menopause symptoms are:3

Research continues on these and other alternative ways of relieving menopause. Talk to your doctor or nurse before trying natural remedies.

This content is provided by the Office on Women's Health.

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Hormone Replacement Therapy Raises Risk Of Death From Breast …

Posted: May 26, 2019 at 1:46 pm

A molecular breast imaging slide shows breast cancer, indicated by the arrow. The Mayo Clinic hide caption

There's another round of bad news today for hormone replacement therapy (HRT).

Women taking a popular drug to alleviate post-menopausal symptoms increase their risk of dying from breast cancer, according to new results from a major government study.

On top of news in recent years that HRT doesn't protect against heart disease and that it increases the risk of breast and lung cancer, more women and their doctors will be taking a long hard look at this today.

It's been eight years since the big study called the Women's Health Initiative knocked the props out from under one of the biggest drug pitches of all time that HRT could allow women undergoing menopause to hold onto their youth, and prevent ills such as heart disease.

The first results from the WHI, back in 2002, showed hormone replacement doesn't prevent heart disease. And it does raise the risk of breast cancer.

But only now can the WHI answer one of the big questions about hormone replacement therapy: Does it cause more women to die from breast cancer? And that answer is yes.

The latest study out of the WHI says women who took a popular combination of estrogen and progestin called PremPro may have twice the risk of dying from breast cancer as women who took a placebo. The report appears in the Journal of the American Medical Association.

The new study an 11-year followup of about 13,000 WHI participants confirms that hormone replacement raises the risk of breast cancer.

Many experts had hoped that the kind of breast cancers caused by hormone replacement would be less aggressive and more curable.

Hugh Taylor, chief of reproductive endocrinology at Yale University, told the Washington Post:

"This really is a paradigm shift. There was a whole group of people, including myself, who had been thinking hormone use was associated with an increased detection of breast cancer but not necessarily an increase risk of death from breast cancer. But this really nails it," he said.

According to the report, the breast cancers diagnosed among those on hormone replacement were more likely to be advanced at the time of diagnosis than those among women on a placebo. This partly because estrogen supplements make breast tumors harder to diagnose.

A note of caution, though: The increased risk of death from breast cancer is small. For every 10,000 women, about three die of breast cancer among hormone replacement recipients versus about two among those who didn't take the supplements, the study shows.

But when you multiply this among the millions of women who once took hormone replacements six million at the peak the impact is sobering.

After the first results of the Women's Health Initiative came out in 2002, about half of the women being followed stopped taking hormone replacement therapy and the nation's breast cancer rate fell sharply.

Some experts think deaths from breast cancer will decline in the next few years as a result of these women abandoning hormone replacement.

But millions of women still take hormones for the bothersome hot flashes and sleepless nights of menopause. Sales of Prempro still total $1 billion a year.

Pfizer, which makes the drug, says the company stands behind Prempro's current labeling, which advises the lowest effective dose for the shortest period of time. Regarding the risk, the statement reads, in part:

... hormone therapy is among the most thoroughly studied medicines and the increased risk of breast cancer compared to placebo has been included in Prempros label since its introduction in 1995. This analysis does not alter that risk, nor does it dispute hormone therapys effectiveness. FDA describes hormone therapy as the most effective FDA approved medicine for relief of hot flashes [and] night sweats."

But in the wake of the new HRT report, some experts wonder if there's any way to tell what a safe course of hormone replacement is.

One of the authors of the new study, Dr. JoAnn E. Manson, a professor of medicine at Harvard Medical School and Brigham and Womens Hospital, said women should not take the hormones unless they really need them.

The data suggest it is cumulative long-term use, Dr. Manson said. Women should avoid long-term use. I think thats the bottom line, she told The New York Times.

But Dr. Peter Bach of Memorial Sloan-Kettering Cancer Center says there are no studies to support the safety of short-course hormone replacement. In a JAMA editorial, Bach says it's all well and good to tell women to talk it over with their doctors.

"But the reality is that informed decisions are not valid," Bach writes, "when the information underlying the decision is itself speculative."

Meanwhile, more than 9,000 lawsuits have been filed against the company by women who claim the drugs caused breast cancer. Recently, the Supreme Court declined to take up an appeal by the company, leaving the matter up to state courts.

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Hormone Replacement Therapy – Baton Rouge, Lafayette

Posted: May 26, 2019 at 1:46 pm

The hormonal changes that come with age can have a significant impact on both men and womens moods, energy levels, and overall health. Fortunately, hormone replacement therapy offers people a safe and easy way to feel like their old selves again.

The Aesthetic Medicine & Anti-Aging Clinics of Louisiana are dedicated to providing the highest quality of hormone replacement therapy to patients in the Baton Rouge and Lafayette areas. Our practices lead physician, Dr. Howell, has 11 years of experience delivering high-quality hormone therapies to his patients. If youd like to learn more about his practice or are interested in scheduling a consultation appointment, contact us today.

Over time, the levels of many essential hormones can begin to deplete. While these changes are a natural part of the aging process, they can cause men and women to look, feel, and act differently than they normally would.

Hormonal imbalances can cause a wide range of adverse side effects, including:

Fortunately, many or all of these side effects are eliminated when a patient begins hormone replacement therapy. This revolutionary new treatment allows both men and women to restore their hormone levels to normal and lead healthy, active lives at any age.

Hormone replacement therapy begins with a blood analysis. This gives our practices lead physician, Dr. Howell, a more precise idea of exactly what hormones each patient is lacking and need to be supplemented through hormone replacement therapy. Our practice offers two primary methods of hormone replacement therapy: testosterone replacement and HGH therapy.

Testosterone plays a vital role in both men and womens overall health and well-being. It plays an important part in maintaining healthy bones, muscles, and sex drive. While testosterone is present in larger amounts in men, women also need it for a wide variety of physical and mental functions. If its found that a patient has low levels of testosterone, testosterone replacement can drastically improve that patients overall health and happiness.

Human growth hormone, or HGH, is vital for regulating body composition, fluids, as well as muscle and bone growth in both men and women. Without it, it can be difficult for patients to sleep or maintain proper immune system functions. Deficiencies in HGH are often caused by complications during surgical or radiation-based procedures.

HGH therapy can help restore a persons HGH levels to normal, restoring proper body functions.

When experience counts, choose Dr. Howell to administer your hormone replacement therapy. Contact the Aesthetic Medicine & Anti-Aging Clinics of Louisiana today to schedule a consultation appointment. We look forward to hearing from you!

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Hormone Replacement Therapy - Baton Rouge, Lafayette

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Hormone Replacement Therapy Atlanta – Erin Everett, NP-C

Posted: May 26, 2019 at 1:46 pm

Transgender FTM & MTF HRT

If youre interested in hormone replacement therapy in Atlanta, you are in good hands. Transitioning is the single-most important decision an individual can make. While transgender hormone replacement therapy (HRT) is a safe treatment that comes with minimal risks and undesirable side-effects, its important to start HRT with a specialist who can help design your program, all the while providing support and advice.

Whether youre making the transition from male-to-female or female-to-male, as a transgender individual, you need to consider the quality of your overall health care. Unfortunately most general physicians and healthcare providers are not properly equipped to care for transgender patients. In turn, you can benefit from having a supportive and experienced specialist by your side as you begin a new chapter in your life.

Erin Everett, NP-C, is a provider of healthcare for transgender patients in Atlanta who offers hormone replacement therapy for both transgender men and women. Erin is committed to providing a safe, nondiscriminatory space for everyone to receive the highest quality healthcare especially those within Atlantas LGBTQ community. For more information about transgender hormone replacement therapy in Atlanta, contact Erin to learn more.

The impact of male to female hormone replacement therapy varies from person to person. However, male to female (MTF) HRT for transgender females will almost always yield the same consistent responses by introducing feminizing hormones. HRT MTF is a long term process that typically requires 2 years before transgender women experience the dramatic transformation they desire. However, most MTF patients will see and feel noticeable changes within the first few months of HRT.

In essence, MTF HRT increases your estrogen levels while lowering your testosterone levels. You may be given a hormone known as anti-androgen which reduces testosterone to a level that is normal for a woman. In just a matter of months, MTF HRT will result in desirable responses, such as reduced body hair, softer skin, genital changes, and redistribution of fat and muscle mass. MTF HRT can also help in developing greater breast size, however the effects of MTF HRT rarely lead to breast development exceeding a size B cup. Another factor that male to female transgender patients often ask about is voice. Unfortunately, feminizing hormones do not change the tone of your voice. This typically requires other interventions, such as voice feminization training, or in some cases, patients may choose to pursue surgery.

Female to male hormone replacement therapy, also generalized as masculinizing hormone therapy or testosterone therapy, has been proven to be both safe and highly effective. However, the rapidity and extent of biological change when undergoing female to male (FTM) HRT will often vary depending on how therapy is administered (i.e. skin patches, gels, injections, etc.) This is why working with an experienced transgender care specialist can have its advantages.

In its every essence, FTM HRT increases levels of testosterone while gradually reducing levels of estrogen. Although it can take over a year to see transformative changes that most transgender men desire, the first three months of starting testosterone therapy can yield many exciting changes. As testosterone levels increase, transgender males will experience profound physical changes. Menstruation typically stops within the first 2 months but may take longer for some. Facial and chest hair will typically begin to grow during the initial months of FTM HRT, and upper body strength and overall muscle mass will start to increase. Clitoral enlargement occurs along with an increased libido. Some patients are satisfied with the clitoral enlargement, while others seek later gender affirming surgeries. At around three months, the voice begins to deepen.

Over the past few years alone, there have been a number of compelling studies that support the safety and efficacy of hormone replacement therapy. In turn, it has become a common form of treatment in the provision of transgender care.

For transgender patients who seek hormone replacement therapy, initiating and monitoring treatment requires a mindful approach in developing a successful program. This why working with an experienced and proficient primary care provider can work to a patients benefit. From the knowledge and experience that goes into a hormone therapy program to providing an autonomous environment that encourages open communication and understanding, transgender patients should feel as though they can fully trust their healthcare provider.

Erin Everett, NP-C is committed to the LGBTQ community, providing a relaxed, supportive, non-judgmental environment where patients can address their health. If you would like to learn more about transgender hormone replacement therapy in Atlanta, such as the cost of HRT or information regarding any of the other primary care services available, visit the contact page.

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Consider Pros and Cons of Hormone Replacement Therapy

Posted: May 26, 2019 at 1:46 pm

When a woman goes through menopause, she stops having menstrual periods, and the process can sometimes lead to a variety of other symptoms, including hot flashes and vaginal dryness.

One option for combating some of the symptoms of menopause is hormone replacement therapy(HRT), according to the National Institutes of Health (NIH).

With HRT, you can relieve menopause symptoms with estrogen and/or progestin, according to the American College of Obstetricians and Gynecologists(ACOG). Women can take estrogen only if they have had a hysterectomy, but if they still have their uterus, need to take estrogen and progestin.

There are two types of hormone therapyavailable systemic and local. With systemic therapy, hormones are released into the bloodstream and go to the organs and tissues that need it, according to the ACOG.

Local therapy is for women who are only suffering from vaginal dryness, according to the ACOG.

HRT can be beneficial, according to the ACOG, by:

There are also risks to HRT, according to the ACOG. Some risks include:

Currently, HRT is recommended to be used to treat symptoms of menopause but only on a limited basis, according to the ACOG. Its recommended that women take time to weigh the risks and benefits and talk with their doctor about the best option for their individual health needs.

The ACOG also recommends that women who do chose to use HRT use the lowest effective dose for the shortest possible amount of time.

Its important also to reevaluate the therapy often to reconsider the benefits and risks, according to the ACOG. Talk with your doctor about how the HRT is working for you, if you have any new symptoms or side effects from the hormones especially vaginal bleeding. Review the HRT at least once a year with your doctor.

For more information about hormone replacement therapy, talk with your doctor or find a physician.

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The Ihrie Lab @ Vanderbilt | Neural stem cells, neural …

Posted: May 23, 2019 at 3:47 am

2019-04: Come see Rebecca speak at the EBC/Stem Cell symposium on campus April 4th.

2019-03: Gabrielle's paper on tumor cell of origin in Tuberous Sclerosis Complex is now out in Life Science Alliance. Congratulations!

2019-02: Mistry's latest paper on V-SVZ-contacting brain tumors is now out in Scientific Reports.

2018-11: Rebecca's minireview (with colleagues) on Shh signaling is now out in J Neurosci.

2018-10: Congratulations Laura - Best Talk award at Pharmacology retreat!

2018-09: Justine wins Runner-Up for Best Presentation at the PDB annual retreat. Way to go!

2018-08: Amanda wins the Outstanding Oral Presentation Award for her summer research project and is featured in the VUMC Reporter. Way to go Amanda!

2018-06: Welcome to our VSSA student Amanda Blythe from U Missouri!

2018-05: Welcome new Pharmacology Ph.D. student Laura Winalski!

2018-04: Congratulations to postdoctoral fellow Todd Bartkowiak on your NCI K00 award!

2018-03: Congratulations to Nalin (comentored with the Irish lab) on your successful Ph.D. defense and residency match (Yale/Pathology)!

2018-01: The Ihrie and Ess labs are awarded pilot funding from the Vanderbilt Brain Institute TiPs program to develop mass based imaging in brain.

2017-10: Congratulations Justine and Bret on your accepted review article for the American Journal of Pathology!

2017-9: Dr. Ihrie and Dr. Irish receive the Ann Faulkenberry Memorial Award at the Southeastern Brain Tumor Foundation Race for Research.

2017-7: The lab is thrilled to have been selected for a research grant from the Southeastern Brain Tumor Foundation. See you at the Race for Research in September!

2017-5: Amanda wins the 2017 Founders Medal, and Divya is Salutatorian for the MLK Jr. Magnet Class of 2017.

2017-4: Current Protocols article now available online for dissociation of solid tumors for analysis using mass cytometry.

2017-3: Congratulations to Mistry on receiving the The Society of Neurological Surgeons/RUNN Resident Award to support your research!

2017-2: Nalin receives the AACR - ABTA Scholar-in-Training Award for her upcoming poster at AACR!

2017-1: Congratulations, Mistry - second accepted article in J Neuro Oncology!

2016-11: Great job, Nalin - oral presentation of collaborative work at the SNO 2016 Meeting

2016-9: Congratulations, Justine - first place poster at the annual PDB retreat!

2016-9: Congratulations to Mistry on his accepted article in J Neuro Oncology!

2016-7: Congratulations to Gabrielle on her recently published review article!

2016-7: Way to go, Divya - nice presentation at the School for Science and Math @ Vanderbilt poster session!

2016-6: Congratulations to Justine on passing her Phase I qualifying exam!

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Epigenetics – National Institute of Environmental Health …

Posted: May 20, 2019 at 7:45 pm

Introduction

For decades, scientists have known the basic structure of our DNA, the building blocks that make up our genes. Although nearly every cell in the human body has the same set of genes, why is it that different types of cells, such as those from brain or skin, look and behave so differently?

The answer is epigenetics, a rapidly growing area of science that focuses on the processes that help direct when individual genes are turned on or off. While the cells DNA provides the instruction manual, genes also need specific instructions. In essence, epigenetic processes tell the cell to read specific pages of the instruction manual at distinct times.

Some epigenetic changes are stable and last a lifetime, and some may be passed on from one generation to the next, without changing the genes.

Several epigenetic processes involve chemical compounds that attach, or bind, to DNA or to proteins that package the DNA within cells called histones. When a chemical compound binds to DNA, certain genes switch on or off, selecting which proteins are made.

For example, the epigenetic process of DNA methylation involves the binding of a chemical compound called a methyl group to certain locations on the DNA. This binding changes the structure of DNA, making genes more or less active in their role of making proteins.

Another process called histone modification involves chemical compounds that bind to histone proteins. Ribonucleic acids, or RNAs, are also present in cells and can participate in epigenetic processes that regulate the activity of genes.

DNA methylation and histone modification are normal processes within cells and play a role in development, by instructing stem cells, or cells capable of turning into more specialized cells, like brain or skin cells.

Epigenetic processes are particularly important in early life when cells are first receiving the instructions that will dictate their future development and specialization. These processes can also be initiated or disrupted by environmental factors, such as diet, stress, aging, and pollutants.

In 2005, a team of Italian researchers provided the first concrete evidence for the role of environmental epigenetics in explaining why twins with the same genetic background can have vastly different disease susceptibilities.1 The researchers showed that, at birth, pairs of identical twins have similar epigenetic patterns, including DNA methylation and histone modifications.

However, over time, the epigenetic patterns of individuals become different, even in twins. Since identical twins are the same genetically, the differences are thought to result from a combination of different environmental influences that each individual experiences over a lifetime.

Investigating the effects of the environment on the epigenetic regulation of biological processes and disease susceptibility is a goal in the NIEHS 2012-2017 Strategic Plan.

NIEHS is currently supporting epigenetics research that is accelerating the understanding of human biology and the role of the environment in disease. These discoveries may lead to the development of new ways to prevent and treat diseases for which the environment is believed to be a factor.

In 2003, NIEHS-supported researchers made an important discovery that demonstrated the role of environmental epigenetics in development and disease.2 They used the agouti mouse in their study. The mouse has an altered version of the agouti gene, which causes them to be yellow, obese, and highly susceptible to developing diseases, such as cancer and diabetes.

The researchers fed the mice a diet rich in methyl groups. Through epigenetic processes, the methyl groups attached to the mothers DNA, and turned off the agouti gene. As a result, most of the offspring were born lean and brown, and no longer prone to disease.

This study was the first to demonstrate that it is not just our genes that determine our health, but also our environment and what we eat.

While researchers have known, for quite some time, the sequence of DNA that make up all human genes, collectively known as the genome, the same could not be said for the human epigenome, until recently. The epigenome refers to all of the chemical compounds added to the genetic material of an organism that regulate its function.

NIEHS and the National Institute on Drug Abuse (NIDA) co-led a national effort, through the NIH Roadmap Epigenomics Program, to create a series of epigenomic maps representing locations on the DNA where chemical compounds attached in more than 100 different tissue and cell types, including blood, lung, heart, gastrointestinal tract, brain, and stem cells. The groundbreaking work was featured in a 2015 article in the journal Nature.3

By comparing the epigenomic map of a healthy cell or tissue, with the map of the same cell or tissue after an environmental exposure or in relation to a specific disease, NIEHS scientists can better understand how the environment affects genes through epigenetic processes. The epigenomic maps are available to the entire scientific community through the Washington University Epigenome Browser.

NIEHS-supported researchers at Harvard T.H. Chan School of Public Health have shown that human exposure to environmental air pollutants and toxic metals, such as arsenic, can cause damage to cells that may lead to cardiovascular disease. The research team has been tracking abnormalities in blood, as well as epigenetic changes, which may serve as indicators, or markers, of exposure to air pollution and toxic metals at levels that can increase the risk of cardiovascular disease, particularly in elderly men. These markers may help in the early detection and prevention of cardiovascular and other diseases.4,5

Grantees at Beth Israel Deaconess Medical Center used epigenetics to define the link between environmental exposure to smoke, mercury, and lead, and reproductive outcomes, such as preterm birth.6,7 Their results are important, since more than one in 10 infants worldwide is born prematurely, increasing their chances of having health problems later in life.8 The study also found that epigenetic changes may serve as markers for maternal chemical exposure during pregnancy.

NIEHS scientists in the Epigenetics and Stem Cell Biology Laboratory are examining how epigenetic mechanisms influence normal cell development, and contribute to biological processes involved in breast cancer and immune function. To date, they have uncovered many details of how the protein complex Mi-2/NuRD controls genes involved in breast cancer. Mi-2/NuRD is found in the nucleus of cells and includes enzymes that affect histone modifications that regulate gene activity.

The research is helping to identify what genes are regulated by the complex and how the complex alters epigenetic processes that may contribute to disease. Understanding the underlying mechanisms of disease may lead to the development of new methods to diagnose, prevent, and treat diseases, such as breast cancer, in the future.

NIEHS-supported researchers have found that early-life exposure to nutritional and dietary factors, maternal stress, and environmental chemicals can increase the likelihood of developing disease and poor health outcomes later in life. In addition, some of the effects of these exposures can be passed down for multiple generations, even after the original exposure has been removed, through a process known as transgenerational inheritance.

Researchers in the NIEHS Transgenerational Inheritance in Mammals After Environmental Exposure (TIME) Program are using mice and rats to investigate how transgenerational inheritance occurs after exposure to environmental exposures, whether the process is different in males and females, and when in development these events are most likely to occur. Understanding how transgenerational inheritance of effects from exposures occur in animals may shed light on similar processes in humans.

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