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» 首页 » Genetics » 课堂讲稿
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Author: Laurie Ann Demmer, M.D.
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Mendelian Genetics (Part 1)
Readings
Jorde, Carey, Bamshad & White: Medical
Genetics, 3rd edition, C.V. Mosby Publishing, 2005.
- Mitochondrial genetics, chapter 5, 101-105
- Multifactorial inheritance, chapter 12, 248-277
Objectives
- Understand that mitochondrial inheritance is maternal, and
understand the concept of heteroplasmy.
- Understand the concept of multifactor inheritance
including threshold effect, liability, and recurrence risk.
Mitochondrial Inheritance
In Mendelian inheritance, abnormal phenotypes result
from the transmission of mutant genes located in the nucleus of the cell.
However, not all DNA coding for genes necessary for cellular function resides
in the nucleus. Each cell contains hundreds of mitochondria, each of which
contains multiple copies of a 16.5 Kb circular DNA molecule. The entire
human mitochondrial chromosome has been cloned and sequenced.
It consists of 16,569 base pairs of
DNA and encodes 37 genes, of which 2 are for ribosomal
RNAs, 22 transfer RNAs, and 13 for polypeptides involved in oxidative
respiration. Although most proteins functioning in
the mitochondria are encoded by nuclear genes, some are encoded by
mitochondrial genes, and mutations can lead to energy failure.
In humans, at fertilization, the ovum contributes
significantly more cytoplasm to the zygote than does the sperm. The sperm
mitochondria degenerate upon penetration of the ovum. Thus, mitochondria in
offspring are exclusively maternal in origin. This phenomenon results in a
maternal transmission of the phenotype.
Another important concept that results from
mutations in the mitochondrial genome is heteroplasmy.
(Heteroplasmy: the mtDNA is a mixture of normal and mutant
forms. Homoplasmy: the mtDNA is all the same type, ie. all
normal or all mutant). There are hundreds of copies of mitochondrial DNA
molecules in each cell, in contrast with nuclear genes where there are only two
copies per cell. During cell division, each mitochondrial DNA molecule
replicates, but unlike nuclear genes, the newly synthesized mitochondrial
molecules segregate passively to the daughter cells. As a result, some daughter
cells may have many copies of the mutant mitochondrial DNA, while other cells
may have only a few (or none).
When eggs are formed in a female carrying mutant
forms of mitochondria, some of her eggs may have many copies of the mutant
mitochondria, while some of her eggs may carry only a few. The offspring
accordingly may be severely affected by the resulting disease, or may have only
mild evidence of the disease. In addition, the proportion of mutant mtDNA
molecules may change over time through replicative segregation as mitochondria
proliferate and cells divide. The percentage of mutant mtDNA can increase or
decrease over time due to either chance variation (genetic drift) or because of
a selective advantage of one mtDNA molecule over another.
Human disorders that are the result of mutations in
mitochondrial DNA include: Leber's optic atrophy, Kearns-Sayre syndrome, MELAS
syndrome (mitochondrial myopathy, lactic acidosis, and stroke-like episodes),
MERRF syndrome (myoclonus epilepsy and ragged red fibers syndrome), Alpers
progressive infantile poliodystrophy, and Leigh subacute necrotizing
encephalomyelopathy. Most of these syndromes affect cell types that are
especially susceptible to chronically decreased synthesis of ATP, such as
skeletal, muscle, heart and brain.
For many of the above conditions, the DNA mutations
are known and prenatal diagnosis is theoretically possible. However, because of
the presence of heteroplasmy, and the fact that different tissues can be
affected to different degrees, predicting severity of disease by prenatal
diagnosis can be extremely difficult.
Multifactorial Inheritance
A multifactorial trait is a is a phenotypic
characteristic that is caused by the sum of effects from many different genetic
and environmental factors. Multifactorial traits can be expressed as "normal"
human features, such as variable height, intelligence and skin color, or may
result in abnormal disorders and malformations.
Quantitative Traits: caused by the
additive effects of many genetic and environmental factors and can be measured
on a numerical scale (i.e., height, weight, blood pressure).
Tend to follow a normal, or
'bell-shaped' distribution in
populations.
Threshold Traits: a trait is either
present or absent (club foot, diabetes, cleft lip). Here there is thought to be
a normal or bell-shaped distribution in the population with respect to
liability to a trait, but only those individuals exceeding the
threshold on the liability scale will actually exhibit the
trait.
Because multifactorial traits are not the result of
a single gene defect, they do not follow the patterns of single gene
inheritance. Many common human disorders are inherited as so called "complex"
traits, implying that more than one gene, and/or a combination of genetic and
environmental factors are responsible for the conditions. Examples of complex
traits in humans includes: hypertension, asthma, Alzheimer's disease,
autism, diabetes, multiple sclerosis, glaucoma, neural tube defects, club foot,
congenital heart disease, cleft lip and/or palate, pyloric stenosis, and
schizophrenia. In total frequency, multifactorial
disorders are much more common than genetic disorders known to be caused by
single genes.
Evidence of a Genetic Contribution to a Disorder
Comes from Observations of Familial Aggregation:
- The disease is more common in biologic relatives (who
share a portion of genes) than in spouses (or other family members sharing the
environment).
- Monozygotic twins are more frequently concordant than
dizygotic twins.
- Monozygotic twins reared separately have greater
concordance than expected by chance.
- Adopted children more closely resemble biologic than
adoptive parents in disease frequency.
Multifactorial Disorders are Characterized
by:
- Familial concentration without a set pattern of
inheritance.
- Absence of clear biochemical defects resulting from a
single abnormal gene
- Considerable variation in severity and expression of
the phenotype.
- Often sex differences in the frequency of occurrence.
Recurrence risks in multifactorial traits are
based upon population and family studies and are called "empiric risks". Risk
of occurrence and recurrence is often different for males and females.
Recurrence risk is less than in single gene disorders, but is not
insignificant. The actual recurrence risks vary substantially for a given
disorder, but a good general number to remember is 49.
Rules of Multifactorial Inheritance:
- The recurrence risk is higher if more than one family
member is affected.
- The greater the severity of disease in the proband,
the higher the recurrence risk.
- The recurrence risk is greater if the proband is of
the less commonly affected sex.
- The recurrence risk usually decreases rapidly in more
remotely related individuals.
- The recurrence risk for first-degree relatives is
approximately the square root of the population incidence of the trait.
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