Epigenetics and Global Health Duke Universitys Role

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Epigenetics and Global Health Duke
Universitys Role

• Ralph Corey, M.D.
• Gary Hock Professor of Global Health
• Hubert/Yeargan Center for Global Health

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Epigenetics and Global Health

• Assume
• The phenotypic expression of the genetic profile
  (e.g. susceptibilities and behavior) of children
  are profoundly influenced by parental
  behavior/exposure/diet during fetal gestation and
  postpartum development.

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Epigenetics and Global Health

• Then consider
• How the environment toxins, nutrition, trauma,
  infections - in the developing world affects the
  phenotypes of OUR children and their offspring
  for generations to come

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Epigenetics and Global Health

• Toxins
• Smoking, alcohol, drugs
• Big problems in the DW
• Chemical exposures
• Few environmentalists in Tanzania, western China
• Antibiotics
• Result in resistant bacteria which are
  transmitted to humans E. coli in our meat,
  salmonella in our poultry/eggs

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Epigenetics and Global Health

• Did his mothers cigarette smoking change this
  boys life?
• Will his sons life be changed by his addiction?

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Epigenetics and Global Health

• Clean Water
• 50 of the worlds population have to travel over
  1 mile to get their daily water
• Contaminated Water
• Primary cause of diarrheal illnesses and infant
  mortality

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Epigenetics and Global Health
Arsenic Poisoning from contaminanted surface
water in Bangladesh has resulted in untold
suffering Lead poisoning throughout the world
has lead to mental retardation in many of our
children
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Epigenetics and Global Health

• Nutrition
• STARVATION
• During pregnancy can lead to
• stunted body and brain development
• future diabetes
• In general
• Loss of productivity
• Loss of moral structure
• Les Miserables

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Epigenetics and Global Health

• Vitamins
• Folate deficiency in pregnancy leads to poorly
  developed fetal brains
• Scurvy, Beri-beri, rickets can cause both fetal
  and adult disease
• Micronutrients
• Arginine deficiency may predispose to recurrent,
  severe malaria

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A Masai child grows up in a mud/dung hut filled
with animals and smoke (to keep the flies
out). Poor nutrition, no education, and
no health care.
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Epigenetics and Global Health
Nutrition
Diet of carbohydrates, fat, and sodium Obesity,
diabetes, and hypertension are epidemic
throughout the world
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Epigenetics and Global Health

• Trauma to children
• Physical
• Prostitution
• Abuse/Slavery
• Environmental exposures

Post-Tsunami
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Epigenetics and Global Health

• Trauma to Children
• Mental
• 12 yr old caring for her dying mother

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Do not be fooled by the Hollywood images of Rio
de Janeiro.
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Just Up the Hill from the Beaches-a Bit of Hidden
Reality
These abandoned children will soon be parents
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Epigenetics and Global Health

• Infections
• Think global
• Influenza -1918
• Started in Europe
• 40-100 Million People died worldwide
• 1 Million Americans died

New York City 1918
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Epigenetics and Global HealthAnimal Exposures

• Chickens
• New Type(s) of Influenza
• Asia-Bird Flu - poorly transmitted to humans but
  highly lethal (63)
• Human influenza is highly infectious but more
  benign
• THE PIG is the mixer can be infected with both
  human and bird flu at the same time
• Very Scary

Chickens awaiting slaughter in Hong Kong
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Epigenetics and Global Health

• HIV
• Started in Africa
• Death of young workers (e.g. farmers)
• Starvation for the family
• Orphans! 3 million and rising

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Epigenetics and Global Health

• Malaria
• Kills primarily babies 2 million each year!
• Has changed the genetics of the human race.
• Sickle cell disease more resistant to malaria
  infection

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Exposure to sandflies can occur while playing or
fighting in Iraq or Brazil. And the diseases they
produce can be brought back home.
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Epigenetics and Global Health
Contamination with human excrement leads to
cholera, salmonella, parasites.
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Epigenetics and Global Health

• What can we do? You, I, Duke University
• Our Vision
• To create a future generation that is globally
  experienced, socially responsible, and
  service-oriented

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Epigenetics and Global Health

• We want to educate our students through
  Action
• and with them change the future.

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Epigenetics and Global Health

• Create longterm relationships with communities
  in the Developing World
• Develop a comprehensive program environmental
  researchers, physicians, engineers, agricultural
  experts, and others.

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Epigenetics and Global Health

• Leadership
• The Nicholas School
• of the Environment
• The Institute for Global Health
• The Hubert/Yeargan
• Center for Global Health
• Engineering World Health
• The Center for Health Disparities
• Many many others

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Megan
Maria
We can and must do better
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