Week 13 Flashcards
What are the modes of inheritance for single gene disorders?
Autosomal or Sex-linked
Name some examples of single gene disorders?
Sickle cell anaemia
Cystic fibrosis
Familial Hypercholesterolaemia
Huntington disease
Haemophilia
Duchenne Muscular Dystrophy
What are single gene disorders caused by? What % of population do they affect?
Point mutations in single genes,
affecting 1-5% of the population, with high morbidity and mortality in children. Most are currently incurable, despite treatments improving
What is the difference between autosomal or sex-linked?
Autosomes are all chromosomes apart from X and Y
Autosomal Recessive disease example: Cystic fibrosis. What are characteristics?
Most common life-shortening genetic disorder.
Carrier frequency: 1 in ~25
CF births: 1 in ~2500
If untreated, sufferers die before 5th birthday
What are symptoms of CF?
A disorder originating in secretory epithelial tissue
Accumulation of mucus in lungs, pancreas, digestive tract and other organs
Affects include: chronic bronchitis, recurrent bacterial infections
How does a defect in Cystic Fibrosis Transmembrane conductance Regulator (CFTR) cause Cystic Fibrosis?
How is this patient life prolonged?
Defect in Cl- transport causes extracellular mucus to become thicker and stickier.
Treatment: life is prolonged by antibiotics and by daily massage to clear mucus from airways
Autosomal recessive example: Sickle cell Anaemia. Summarise symptoms, treatment, cure?
Affects 1 in 625 Afro-Caribbean or Afro-American births
Symptoms: anaemia, joint pain, swollen spleen, frequent severe infections
Treatment: regular blood transfusions
Cure: Bone marrow transplant
What is causes sickle cell anaemia?
A single nucleotide substitution in B-chain of haemoglobin has a large negative effect leading to incorrect folding of the protein.
The defective haemoglobin forms long chains of rigid polymers (after 02 is released) which deforms the red blood cell
What is a positive trait of having sickle cell?
Carriers of the sickle cell disease or the patients; are resistant to Malaria Therefore selection for malaria resistance in carriers maintains the sickle cell allele in the population due to heterozygote advantage
What is heterozygote advantage?
Where the heterozygote is fitter than either of the homozygotes
What are the main symptoms of the Autosomal Dominant disease: Huntington’s disease?
Late-onset degeneration of the brain resulting in:
Jerky movements,
Personality changes,
Deterioration of walking, speaking and swallowing abilities,
Death will result from complications such as choking, infection or heart failure
What is the molecular cause of Huntington’s?
Large gene mapping studies showed defect on chromosome 4.
Narrowed down to abnormalities in the HD gene.
HD gene contains CAG repeats (encoding glutamine)
11 - 34 repeats = normal
36 - 125 repeats = Disease
Autosomal dominant disease example: Familial Hypercholesterolaemia. Symptoms and treatment?
Symptoms:
- High levels of cholesterol in blood
- Cholesterol deposits build up on joints
- Cardiovascular disease
Treatment:
- Cholesterol-lowering drugs
- Low cholesterol diet
Familial Hypercholesterolaemia is an example of Incomplete dominance, why?
Homozygotes (hh) have a 6-fold increase in blood cholesterol - heart attacks at age of 2 (1 in 1million births)
Heterozygotes (Hh) have a 2-fold increase in blood cholesterol - heart attacks by age of 35 (1 in 500 births)
Dominant phenotype is caused by haploinsufficiency
Pedigree of a sex-linked recessive trait?
Females are carriers, mostly males affected
Carrier female will transmit to 50% of sons (affected) and to 50% of daughters (carriers)
Affected male cannot transmit to sons but will transmit to 100% of daughters (carriers)
Sex-linked recessive example: Haemophilia, What is it? What are the symptoms?
Blood clotting disorder, symptoms include: uncontrolled bleeding, tendency to extensive bruising, bleeding into joints
What is the difference between haemophilia A and B?
A - Mutation in the gene for factor VIII (on x chr). Incidence is 1 in 5,000males
B - (or christmas disease) Mutation in the gene for factor IX (on X chr), Incidence 1 in 30,000 males
Pedigree of an autosomal recessive disease?
Males and females affected,
Disease absent from most genertations,
Consanguinity (sexual relationship with a blood relative) increases frequency of affected individuals,
Carriers have 25% chance of having an affected child
What CF gene codes for a chloride channel, what does it regulate?
CFTR = Cystic fibrosis transmembrane conductance regulator
Regulates the flow of Cl- across the membrane
What is the most common mutation causing CF? How does the mutation occur?
∆F508
Deletion of 3 base pairs (bp) results in loss of a Phe (F) residue at position 508. Protein does not fold normally and is more quickly degraded. There are >800 different CFTR mutations that cause CF
Sequencing of the chloride channel gene in patients allows healthcare professionals to determine exactly what mutation a patient has. This information can then be used to offer suitable “precision medicines”.
What are these precision medicines?
- Drugs aiming to improve function of mutated ion channel, the drug used depends on the mutation (for example: 1) Gating mutations treated with drugs to help open gates 2) Other mutations treated by using combination therapies, etc)
- Gene therapy to provide patients with a copy of the correct chloride channel (clinical trials are underway)
Name an example consequence of a base pair substitution point mutation?
Sickle Cell Anaemia
What are a few pleiotropic effects of sickle cells?
(don’t need to name all, just some!)
Breakdown of blood cells leading to weakness, anaemia, heart failure
Clumping of cells and clogging small blood vessels leading to heart failure, fever and pain, brain damage, organ damage which could result in paralysis, pneumonia, impaired mental function, kidney failure, rheumatism
Accumulation of sickled cells in spleen leading to spleen damage