In the last five years over 1,200 papers have appeared in PubMed with “epigenetics” in their title, and at first glance it seems like it might be related to pharmacogenetics. But epigenetics is actually an emerging field all of its own.

Epigenetics is a scientific discipline studying heritable changes to gene expression that aren’t caused by changes to the DNA sequence. DNA isn’t typically found as a free-floating molecule in cells; it’s surrounded by a framework of structural and support molecules. Changes to these can affect how the DNA is expressed.

Unlike genetics, epigenetic changes can sometimes be triggered by environmental or behavioral circumstances. Researchers are now exploring epigenetics’ role in gene expression, health and evolution.

So what does this mean to the field of pharmacogenetics?

Not much.

When it comes to drug metabolizing enzymes specifically, there isn’t conclusive evidence. Researchers don’t yet understand all the factors that contribute to epigenetic variation and how to predict their precise effect and impact on gene expression. The only factors that seem to conclusively and predictably affect the expression of these genes are mutations to the DNA itself or interactions with medications, herbal compounds or certain foods.

Genelex does not currently test for epigenetic factors because no known epigenetic factors have been shown to change a patient’s drug metabolism. There simply isn’t evidence to make them clinically actionable. An internal Pharmacy & Therapeutics committee continually reviews new scientific literature. If epigenetics ever shows the ability to create concrete predictions, it will be considered for inclusion in YouScript®.

For now, epigenetics is an interesting research subject, similar to where pharmacogenetics was twenty years ago. Whether it eventually develops into a clinically actionable field like pharmacogenetics remains to be seen.