En Route

"Synapsis: A Health Humanities Journal" was founded in 2017 by Arden Hegele, a literary scholar, and Rishi Goyal, a physician. Its mission is to develop conversations among diverse people thinking about medical and humanistic ways of knowing ... as a “Department Without Walls” that connects scholars and thinkers from different spheres

When Bad Things Happen to Good People: Living Well in the Midst of Suffering

"Synapsis: A Health Humanities Journal" was founded in 2017 by Arden Hegele, a literary scholar, and Rishi Goyal, a physician. Its mission is to develop conversations among diverse people thinking about medical and humanistic ways of knowing ... as a “Department Without Walls” that connects scholars and thinkers from different spheres

Prosody

"Synapsis: A Health Humanities Journal" was founded in 2017 by Arden Hegele, a literary scholar, and Rishi Goyal, a physician. Its mission is to develop conversations among diverse people thinking about medical and humanistic ways of knowing ... as a “Department Without Walls” that connects scholars and thinkers from different spheres

Asthma Discordance in Twins Is Linked to Epigenetic Modifications of T Cells

T cells mediate the inflammatory responses observed in asthma among genetically susceptible individuals and have been suspected to be prone to epigenetic regulation. However, these relationships are not well established from past clinical studies that have had limited capacity to control for the effects of variable genetic predisposition and early environmental exposures. Relying on a cohort of monozygotic twins discordant for asthma we sought to determine if epigenetic modifications in T cells were associated with current asthma and explored whether such modifications were associated with second hand smoke exposures. Our study was conducted in a monozygotic twin cohort of adult twin pairs (n = 21) all discordant for asthma. Regulatory T cell (Treg) and effector T cell (Teff) subsets were assessed for levels of cellular function, protein expression, gene expression and CpG methylation within Forkhead box P3 (FOXP3) and interferon gamma-γ (IFNγ) loci. Comparisons by asthma and current report of exposure to second hand smoke were made. Treg from asthmatic discordant twins demonstrated decreased FOXP3 protein expression and impaired Treg function that was associated with increased levels of CpG methylation within the FOXP3 locus when compared to their non-asthmatic twin partner. In parallel, Teff from discordant asthmatic twins demonstrated increased methylation of the IFNγ locus, decreased IFNγ expression and reduced Teff function when compared to Teff from the non-asthmatic twin. Finally, report of current exposure to second hand smoke was associated with modifications in both Treg and Teff at the transcriptional level among asthmatics. The results of the current study provide evidence for differential function of T cell subsets in monozygotic twins discordant for asthma that are regulated by changes in DNA methylation. Our preliminary data suggest exposure to second hand smoke may augment the modified T cell responses associated with asthma

A Reimagined Healing: A Reflection on “This is Water” by David Foster Wallace

"Synapsis: A Health Humanities Journal" was founded in 2017 by Arden Hegele, a literary scholar, and Rishi Goyal, a physician. Its mission is to develop conversations among diverse people thinking about medical and humanistic ways of knowing ... as a “Department Without Walls” that connects scholars and thinkers from different spheres

A Girl and a Neem Tree: Identity and the Belonging of Not Belonging

"Synapsis: A Health Humanities Journal" was founded in 2017 by Arden Hegele, a literary scholar, and Rishi Goyal, a physician. Its mission is to develop conversations among diverse people thinking about medical and humanistic ways of knowing ... as a “Department Without Walls” that connects scholars and thinkers from different spheres

From Rumi to Herman Hesse, A Contemplation on Optimism: Why Uncertainty is When Hope is Needed Most

"Synapsis: A Health Humanities Journal" was founded in 2017 by Arden Hegele, a literary scholar, and Rishi Goyal, a physician. Its mission is to develop conversations among diverse people thinking about medical and humanistic ways of knowing ... as a “Department Without Walls” that connects scholars and thinkers from different spheres

Why We Tell Stories

"Synapsis: A Health Humanities Journal" was founded in 2017 by Arden Hegele, a literary scholar, and Rishi Goyal, a physician. Its mission is to develop conversations among diverse people thinking about medical and humanistic ways of knowing ... as a “Department Without Walls” that connects scholars and thinkers from different spheres

Subject demographics for twins discordant for asthma.

*<p>Significant differences between asthmatic and non-asthmatic twins, P<0.05.</p

Reduction of FOXP3 and IFNγ is augmented with recent SHS exposure.

<p>Peripheral blood Treg or Teff (CD4+CD25neg) were purified from twin pairs discordant for asthma and concordant for no SHS exposure (n = 15) and discordant for both asthma and SHS exposure (n = 6). In A and B, Treg were assessed for FOXP3 transcript (A) and FOXP3 protein (B). In C and D, Teff were assessed for IFNγ transcript (C) and protein (D). Gene expression was determined by QT-PCR and is shown as relative fold expression of candidate genes to expression of the housekeeping gene β-glucuronidase. Protein levels were determined by intracellular flow cytometry and shown as mean fluorescence intensity (MFI). Data points (circles) represent individuals and individual twin pairs are connected via a line, p<.05 for non-asthmatic vs. asthmatic or asthmatic + SHS for all groups.</p