In this lesson, students will analyze an informational text that describes recent research into the underlying factors affecting rheumatoid arthritis. The text describes how epigenetic analysis in knee and hip joints revealed unique patterns that suggest the disease may differ from joint to joint. The findings may allow for the development of more effective, personalized treatment for those who suffer with RA. This lesson is designed to support reading in the content area. The lesson plan includes a note-taking guide, a vocabulary handout, text-dependent questions, a writing prompt, answer keys, and a writing rubric.
Subject(s): Science, English Language Arts
Grade Level(s): 11, 12
Document Camera, Computer for Presenter, Computers for Students, Internet Connection, LCD Projector, Speakers/Headphones
Resource supports reading in content area:Yes
Keywords: epigenetic, methylation, DNA, gene, genetics, immune, autoimmune, synovial, joint, rheumatoid arthritis, FLS, text complexity, informational text
Lesson Plan Template: General Lesson Plan
Learning Objectives: What should students know and be able to do as a result of this lesson?
Students should be able to:
- Describe the mechanisms that cause the disease rheumatoid arthritis.
- Explain the problems with treating rheumatoid arthritis.
- Describe the study of epigenetics in general terms.
- Describe the research identified in the article on how genetic markers may now identify RA triggers.
- Explain what FLS are and how they contribute to RA.
- Cite specific and relevant text evidence to support analysis of the text.
- Determine the meaning of selected academic and domain-specific words in the text.
- Construct a written response that clearly establishes the main point(s), contains relevant textual evidence to support the main point, uses transitions to maintain flow, effectively uses domain-specific vocabulary, and provides an appropriate conclusion.
Prior Knowledge: What prior knowledge should students have for this lesson?
In regards to science:
- Students need to know the structure and function of joints within our bodies to understand the issues with rheumatoid arthritis. They shouldunderstandthesynovial fluid acts as a lubricant around the joint, and this iswheretheFLS or fibroblast-likesynoviocytes reside and contribute to joint destruction in RA.
- The free, OpenStax open resource, , gives a good overview.
- Students need to have someunderstandingofDNA and how the genome isourindividualDNA fingerprint. They should know that our genome consists of an ordered pattern of genes that direct all cell activities, even those that are harmful.
- To increase students' background knowledge, teachers may want to use this TEDEd video lesson titled "The Twisting Tale of DNA."
- Students need to have some understanding of the immune system and how it works—knowing that our body's immune system is a highly specialized system whose function is to tackle foreign invaders. Students should know that inflammation is evidence of the immune system at work and what processes were involved to cause the inflammation. This video titled "The Immune System Explained - Bacteria Infection" (6:48, uploaded by YouTube user Kurzgesagt - In a Nutshell) simplifies the concepts, but it also does a good job of highlighting how the immune system works.
In regards to literacy skills:
- Students should have prior experience utilizing various vocabulary strategies to determine the meaning of unknown words in a text, including use of context clues, word parts, and dictionary skills.
- Based on the writing rubric provided with this lesson, students should be able to respond to a writing prompt in a clear, organized manner that includes use of an introduction to establish the main point(s), a body paragraph(s) that supports the main point(s) and includes relevant and specific textual evidence, and a conclusion that supports the main point(s).
- Students should have some awareness that use of transition words or phrases can help a piece of writing flow smoothly from one point or idea to the next. Teachers might wish to provide students with a sheet of transitions to help them. This site provides transitions teachers might provide to students.
Guiding Questions: What are the guiding questions for this lesson?
- What is rheumatoid arthritis and how does it affect the human body?
- How does the human body's immune system target a foreign invader?
- What is epigenetics and how is it used in this research study?
- What are FLS and how are they used in causing harm to those with rheumatoid arthritis?
- What is DNA methylation and why is it so vital in understanding the mechanisms for RA?
- What has the recent research found as a possible way to more effectively target treatment for those afflicted with RA?
Teaching Phase: How will the teacher present the concept or skill to students?
- To begin the lesson, ask students a few opening questions. Have you ever injured your knee or another joint in your body? If so, how did it feel? What did you have to do to let it heal? What was some of the treatment that was used?
- Student athletes may have firsthand knowledge of knee injuries and may talk about how they had a meniscus tear or an ACL injury. Ask them to describe the structure if they can.
- If possible, have a model of a knee or other joint so students can see the ligaments and cartilage in the model. Your school may already have a sample, but you could also order one from a science catalog such as this from Carolina Biological Supply Company.
- Show this video titled "Cartilage Science Explained" (4:17, uploaded by YouTube user Sportology).
- Tell students that there are diseases that actually attack cartilage, and these attacks don't spring from an injury, for example, from playing sports. Ask students, "Does anyone know what these diseases are called?" Students may bring up RA or osteoarthritis, and if so, let them explain what they know about it. Then, show this short video (5:08) from Covenant Health on rheumatoid arthritis.
- Next, discuss with students that we have an awesome immune system, but sometimes it works too well or it doesn't recognize that it is attacking our own bodies. That is a problem and one reason these autoimmune diseases are such a concern. But due to recent research, scientists' understanding of how these diseases work and how our cells respond has improved now that we have started really looking at the genome and epigenetics—the study of how our genes are activated. It really is a new field and one you will be hearing a lot about in the next decade.
- Show the diagram of DNA methylation (Wikimedia Commons), which is an example of epigenetics. Students can see how the additions of a methyl group to the DNA strand can then change the DNA but only in that it can trigger a gene to turn on or off.
- Finally, show this SciShow video (9:28) on epigenetics.
- Tell students that what we will be doing today is reading an article about some research into RA and what scientists found in a new epigenetics study.
Guided Practice: What activities or exercises will the students complete with teacher guidance?
- Provide each student with a copy of the article "Rheumatoid Arthritis Mechanisms May Vary by Joint" (National Institutes of Health). For class discussions that will follow, it might be helpful to have students number each paragraph.
- Provide each student with a note-taking guide and vocabulary handout.
- Before students begin reading, direct them to pay attention to the text features of the article to help them learn and locate information:
- Title: Rheumatoid Arthritis Mechanisms May Vary by Joint
- Pull out section/summary: At a Glance: An epigenomic analysis of rheumatoid arthritis in knee and hip joints revealed unique patterns that suggest disease mechanisms may differ from joint to joint. The findings could open the door to development of more effective, personalized therapies for rheumatoid arthritis.
- Caption: Located next to the illustration of the human body.
- Have students fill out the note-taking guide and the vocabulary worksheet during and/or after their first reading of the text. This work can be done individually, in pairs, or in a small group. The teacher should monitor students as they work and provide support and guidance as needed.
- Note: Based on the needs and skills of the students, teachers can decrease the number of academic or domain-specific vocabulary students will define on the vocabulary handout.
- For academic vocabulary, students will likely be able to use a variety of vocabulary strategies to define the meaning of the words, including use of context clues, word parts, and dictionaries. For domain-specific (in other words, subject-specific) vocabulary, students will typically need to draw on prior knowledge and use a dictionary to define the words.
- If students struggle with determining the meaning of the selected academic vocabulary, teachers might use the following tips to help them:
- Mechanism: the way something works; a system of parts that operate or interact like those of a machine. This word is used in the title, "At a Glance" section, and also in paragraph 2. The best context clue probably comes in paragraph two where the phrase "at work in the disease" immediately follows use of the word "mechanisms." The more that scientists can learn about how RA works in the body, how it affects joints, and how it may work differently from joint to joint, it will help researchers come up with better methods and plans to treat patients suffering with RA.
- Tendency: an inclination, bent, or predisposition to something. This word is used in paragraph two. Students may want to break the word apart and focus on "tend." You might provide an example of the word used in a sentence: I tend to sleep in on Saturdays and stay up late on Saturday nights. In this context, "tend" means you are inclined to do something. Explain to them that tendency can mean an inclination to do something, but it can also mean a predisposition to something. Predisposition means to make susceptible. An example might be: Genetic factors may predispose human beings to certain metabolic diseases. Now have students look again at "tendency" as used in paragraph two. Scientists have discovered that several genes involved in the immune system have been associated, or connected with, a tendency to develop RA. This means that people with these genes may have a predisposition or are more susceptible to developing RA.
- Triggering: causes something to occur; to initiate or precipitate (a chain of events, scientific reaction, psychological process, etc.). In genetics this term is used a lot. Ask students to think of the word "trigger" as in trigger finger or trigger on a gun. It is a cause of something. In paragraph two, this word is used to explain that environmental factors may play a role in triggering, in other words, causing or setting off, RA.
- Promising: shows promise, favorable; likely to turn out well. This word is used in paragraph seven. Have students break the word apart and focus on the "promise" part of the word. Give them an example of this word used in a sentence: After a great deal of training and a better nutritional plan, Mark, a relatively new long-distance runner, believed that the competitions in the fall held much promise for him. In this context, the word "promise" means positive, favorable, or likely to turn out well. Have them look at the word used in paragraph seven. The last two sentences in this paragraph may provide some context clues. The text uses the phrase "promising drugs" and then also says that "this analytical method could form the basis for developing precision medicine approaches to RA." In the past, certain drugs have shown promise or seemed like they could help those suffering with RA, but joint-specific biological pathways weren't taken into account. (In paragraph eight it goes on to say this might explain why some joints improved with certain medicine while others did not, even though they were exposed to the same drug.) With using new methods of assessment and analysis, now researchers might be able to make even better, more accurate medicines that could help those with RA.
- Assessed: to judge worth, value, or importance; to look at something and evaluate it closely. Ask students to think about how the term "assess" is used in their lives—they may think a test or something similar. With the information scientists are learning through this study, they can look back and see that drugs that looked favorable in helping patients with RA might have been evaluated differently if the joint-specific biological pathways had been factored into the evaluation. Now with this information, they can take this information into account and hopefully develop medicines that will more effectively help treat RA.
- Precision: being precise; with accuracy or scientific exactness. Have students break the word apart and focus on "precise." With the new analytical method, researchers might be able to make medicine that will be more precise in treating various joints that are each affected differently by RA.
- Approaches: different methods; the method used or steps taken in setting about a task, problem, etc. With the information scientists have learned in this study, they are hoping a different analytical method will help them develop better methods, or a better approach, to creating and using precise medicines that will more effectively treat those suffering with RA.
Formative Assessment (How will teachers check for student understanding?):
- Teachers can check students' understanding by collecting students' completed handouts, checking their work, providing written feedback, or grading the assignment. Or, teachers can have students share out their responses and the teacher can provide verbal corrective feedback, allowing students to make corrections to their work during the discussion.
- Teachers can use this sample answer key for the note-taking guide and this sample answer key for the vocabulary handout to help them assess students' answers.
- For discussion on students' answers to the defined vocabulary words, teachers are encouraged to not only ask students to explain the meaning they determined for a word, but the strategy they used to arrive at that meaning. This will allow the teacher to provide alternative suggestions as to how the student could have arrived at the correct meaning of the word.
Common errors/misconceptions to anticipate and how to respond:
- DNA is the only way you inherit information on your genome.
- With epigenetics we are finding that this is not the case. While your DNA is inherited from your parents and it is a fixed set of directions, we are finding out that the triggers of the genes on your genome can be caused by environmental factors. The patterns of DNA methylation can trigger changes to how the genes work—either turning on or off by this process. It can have profound effects on the organism, such as triggering rheumatoid arthritis (which this article focuses on). We do not inherit a disease, instead we inherit susceptibility factors that increase risk for a disease.
- A gene and the expression of the gene is the same thing.
- Again, the science of what triggers a gene to activate is key here. A gene or a section of your DNA is inherited but whether or not the gene is activated may be due to environmental factors.
- Single genes code for most traits.
- Many genes in combination can cause a trait, and that is what is so challenging about curing diseases. There are so many factors, not just in the DNA but the triggers that activate them.
- Cells all have the same DNA so the genes work the same way in each cell.
- Cells are differentiated because the genes within that cell are activated to work. White blood cells have different directions than muscle cells and epithelial cells. Genes are activated or turned off so that a cell can do its specialized function.
Independent Practice: What activities or exercises will students complete to reinforce the concepts and skills developed in the lesson?
Provide each student with a copy of the text-dependent questions to complete. Students should be reminded to continually refer back to the text and to use relevant and specific evidence from the text to support their answers.
Formative Assessment (How will teachers check for understanding?):
Teachers can check students' understanding by collecting students' answers to the text-dependent questions, checking their work, providing written feedback, and maybe grading the assignment. Or, teachers can have students share out their responses and the teacher can provide verbal corrective feedback, allowing students to make corrections to their work during the discussion.
Common errors/misconceptions to anticipate and how to respond: Please see the text-dependent questions sample answer key.
Closure: How will the teacher assist students in organizing the knowledge gained in the lesson?
- Before students complete the writing prompt for the summative assessment be sure to review responses to the text-dependent questions as a class, including covering the misconceptions and key points described in the sample answer key.
- After students' written responses for the summative assessment have been graded and returned with feedback, teachers might wish to use the provided sample response with the class. Students who are struggling writers can benefit greatly from seeing a well-organized, detailed written response. The teacher could show the sample response on an overhead or withanLCD projector and discuss some of the following:
- Have students examine each of the three body paragraphs and identify textual evidence from the article that explains what RA is, explains the research studies that were conducted by the team at the University of California, and explains how their findings may help lead to better treatment for those suffering with RA.
- Have students identify the effective and accurate use of domain-specific vocabulary (e.g., joints, autoimmune, inflammation, environmental, FLS, immune system, genes, DNA sequence, DNA methylation, genome) and academic vocabulary (e.g, mechanism, trigger).
- Students will individually respond to the writing prompt. They should be directed to respond with a multi-paragraph response, with a clear introduction, body section, and conclusion. They can refer back to the text as they construct their response.
- Provide students with a copy of the rubric and go over the rubric with them so they will know how their written response will be assessed.
- Go over the writing prompt with students and make sure students understand what the prompt is asking them to address.
The prompt: Explain how the immune system works against someone with rheumatoid arthritis. Then, explain the research conducted by the team from the University of California and how their findings may lead to better treatment for victims of this disease. Use evidence from the text to support your response.
- Teachers will use the rubric to assess students' written responses.
Specific suggestions for conducting Formative Assessment can be found in the Guided Practice and Independent Practice phases of the lesson.
Feedback to Students
Specific suggestions for providing Feedback to Students can be found in the Guided Practice and Independent Practice phases of the lesson where it says, "Common errors/misconceptions to anticipate and how to respond."
Accommodations & Recommendations
For students struggling with the science concepts:
- Background: Check out this resource from Biology Reference called This can help students understand about the synovial fluid and how these cells work. This will relate to the building of cartilage and how the breakdown occurs over time.
- If students need extra support on understanding the concept of epigenetics, the NIH's Genetics Home Reference page titled "What is the epigenome?"
- Here is an excellent explanation video on the epigenome called "The Epigenome at a Glance" from Learn.Genetics.
- Students can manipulate and test out gene control and how it works in this resource from Learn.Genetics.
For struggling readers:
- It might benefit students to chunk the text. Have students independently read the first four paragraphs, and then have several strong readers read these paragraphs aloud. Then repeat this process for the last four paragraphs.
- Then, have students highlight the selected vocabulary that falls in the first four paragraphs of the article. The teacher can select several of these words, both academic and domain-specific vocabulary, to model for students ways to determine the meaning of the words. Students can then define the remaining words for the first four paragraphs, share out their answers, and receive feedback on their work. This process could repeat for words in the last four paragraphs of the article. For academic vocabulary (words that are seen across subjects and often have multiple meanings), students really need to pay attention to how the word is used in the context of the article when working to define the word. If they are looking up the meaning in a dictionary, they need to continually refer back to the text to see how the word is used so they can select the most appropriate meaning from the dictionary entry.
- Students can then work in pairs or small groups to answer the questions on the note-taking guide. Or, the teacher could work with the class as a whole group to answer the questions, making sure that students identify the textual evidence in the article that can help them answer each question.
For struggling writers: It might help struggling writers to provide them with an outline to help them structure their written response for the summative assessment. The outline might include places for them to record:
- Ideas on how to introduce the topic
- A few specifics from the text they might want to use to support or explain the topic
- A place to write down their main point(s)
- Topic sentence (the first sentence of each body paragraph that will reveal the point of the paragraph and will connect to the paper’s overall main point)
- Specific evidence from the text for support in each body paragraph
- Ideas for transition words
- Ideas for use of selected vocabulary
- Ideas on how to wrap up their piece and connect back to the main point(s)
- Have students research other from MedlinePlus and share out how they function and what the current treatments include. Autoimmune diseases might include:
- Celiac's disease
- Grave's disease
- Multiple Sclerosis
- Type 1 diabetes
- Autoimmune hepatitis
- Students can read about current research with autoimmune diseases from the NIH. Students could conduct research, write a summary and share out what they learned. They could also compare and contrast what they learned in their research with the research described in the main article for this lesson.
- Students can delve further into the joints of the skeleton, specifically synovial joints. Students can build working models of a selected synovial joint and explain how they work and and where they are located in the body.
- Hinge joints
- Pivot joint
- Ball and socket joint
- Condyloid joints
- Saddle joints
- Gliding joints
- Students can delve further into the newer science of epigenetics. Students can learn how understanding our genome and how DNA methylation works may be a key to unlocking information on all sorts of things from curing diseases, preventing illness and more.
- Students can continue with the study of epigenetics and read this recent Discover article titled "DNA Is Not Destiny: The New Science of Epigenetics." The class could have a discussion on the article and relate back to what was read in the main article for this lesson.
Suggested Technology: Document Camera, Computer for Presenter, Computers for Students, Internet Connection, LCD Projector, Speakers/Headphones
Special Materials Needed:
If possible, secure a model of a knee joint or something similar. The anatomy/physiology teacher or health teacher at your school may have a model for you to borrow. If not, and if funds are available, order one from a science supply company.
- For teachers who would like more support in understanding and implementing Reading Standards for Literacy in Science and Technical Subjects into their science curriculum, please see the teacher tutorials featured in the section of this lesson's CPALMS resource page labeled "Attached Resources."
- For more information on epigenetics, see the NIH's Genetics Home Reference page titled ""
- This video from Learn.Genetics titled "The Epigenome at a Glance" helps explain the epigenome.
- This is a valuable Ted Talk video by Courtney Griffins titled "Epigenetics and the Influence of Our Genes" (18:40, uploaded by TEDx Talks).
The text's grade band recommendation reflects the shifts inherent in the standards and is based on a text complexity analysis of a quantitative measure, qualitative rubric, and reader and task considerations.
Source and Access Information
Name of Author/Source: Maggie Molledo
District/Organization of Contributor(s): Brevard
Access Privileges: Public
* Please note that examples of resources are not intended as complete curriculum.