The telomere test—are we ready to make health decisions
based on our epigenome?
With companies like Alternity Healthcare1
marketing kits intended to test your epigenome: the non-genetic changes in the
microenvironment controlling heritability like methylation and telomere length,
it is already becoming an option for patients to use information about their
genetics (in this case, epigenetics), to develop treatment plans. It has proven
certainly useful in developing precision medicine plans for cancer patients,
for example knowing whether or not the use BRAF inhibitors would be useful in
melanoma treatment or Imatinib would be useful in treating leukemia2.
But those are based on well-understood pathways and directly impact
interventions. The truth is these epigenetic kits are being tacked-on to the
same old advice and aren’t really being used to specify treatment direction.
They’re billed as being used to determine “biological age,” which is described
as this:
“Everyone knows their chronological age. Chronological age is
the number of candles that are on top of your cake and the birthdays you
celebrate (or sometimes don’t!). However, developments in science have created
another measurement of age called biologic or epigenetic age. Unlike
chronological age, this measurement of age is based on years of statistical
research and provides much more relevant health information. It can tell us how
healthy you are and even when you might pass away. Epigenetic Testing uses
biomarkers on your DNA called methylation.
This test involves providing a small blood sample!
Your biological age is more accurate at predicting health
span (how healthy you are) and lifespan (how long you will live) than any
previous molecular biomarker, and can be correlated to almost any health factor
such as physical fitness, socioeconomic status, and drug use history. Ideally,
everyone would want their biological age to be less than their chronological
age. This means that you are living a lifestyle that is healthy and will help
you stay free of sickness and disease longer! If you could reverse your risk of
age-related disease and avoid sickness, wouldn’t you want to know how1?”
The study of epigenetics is barely two decades old, despite
the term being coined in the 1940s. We aren’t really certain of many of the
findings and don’t know how to apply the findings we are certain of. These kits
are being sold with the hopes of elucidating disease but in reality are simply
marketing add-ons of holistic medicine which encourages better eating habits,
more regular exercise, and reducing environmental toxins—all good advice, but
not something you needed to buy a kit and spend hundreds of dollars to hear.
The man behind the technology these tests use, Steve Horvath
(a bio-statistician at UCLA), was profiled by Wire3 and the piece
covered the question of the tests’ utility3:
“Generally, though, these tests aren’t fortune tellers. You
won’t learn exactly how long you have left to live. For one thing, random
events—a serious infection, a car accident—play a huge role in lifespan. For
another, the test was designed to apply to a population, rather than an
individual. It’s one thing to say that a group of people who share a similar
pattern of methylation changes will, on balance, live longer. It’s quite
another to accurately forecast one specific individual’s lifespan. “It’s not
the case we could nail down the date of death of an individual within plus or
minus one year,” Horvath says.”
In essence these tests are a wake-up call, they’ll telling
you if you’re aging faster than you should if you don’t have a healthy
lifestyle. But we know that, we’re Americans. We don’t need to be exploited by
pharma startups to understand that we aren’t as healthy as we should be. Until
these tests are sensitive and informative enough to cause specific and direct
alterations to treatment plans that aren’t based on wholistic advice that could
be granted without these tests, they’re not worth it.
Written by Jeremiah Ockunzzi, courtesy of Dr. Bart
Rademaker, MD.
1)
https://alternityhealthcare.com/telomere-epigenetic-testing/
3)
https://www.wired.com/story/new-tests-use-epigenetics-to-guess-how-fast-youre-aging/
