Molecular Basis of Genetic Diseases

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Foundations of Genetic Disease - Gene Glitches 101

  • Mutation: Permanent DNA alteration; frequency <1%.
  • Polymorphism: Common DNA variation; frequency >1%.
  • Penetrance: Proportion of individuals with a specific genotype who express the expected phenotype. All-or-none.
  • Expressivity: Variation in phenotypic expression (severity/type) among individuals with the same genotype. Variable.
  • Classifications:
    • Monogenic: Single gene defect (e.g., Cystic Fibrosis).
    • Polygenic: Multiple genes + environment (e.g., Type 2 Diabetes).
    • Chromosomal: Numerical/structural anomalies (e.g., Trisomy 21).
    • Mitochondrial: Maternally inherited (e.g., LHON). Molecular basis of genetic diseases and detection

⭐ Pleiotropy refers to a single gene influencing multiple, often seemingly unrelated, phenotypic traits (e.g., Marfan syndrome).

Mutation Mayhem - DNA's Dark Side

  • Point Mutations (Single Base Change):
    • Silent: Different codon, same amino acid (AA).
    • Missense: Different codon, different AA (e.g., Sickle cell: HbS, $GAG \rightarrow GTG$, Glu→Val).
    • Nonsense: Codon becomes STOP (UAA, UAG, UGA). 📌 "U Are Away, U Go Away, U Are Gone". Yields truncated protein.
  • Frameshift Mutations (Insertions/Deletions not multiple of 3 bases):
    • Alters reading frame downstream; often premature STOP.
  • Functional Consequences:
    • Loss-of-Function (LOF): Reduced or absent protein function (typically recessive).
    • Gain-of-Function (GOF): Increased or novel protein function (typically dominant).
    • Dominant Negative: Mutant interferes with wild-type function. Point vs Frameshift Mutations

⭐ Nonsense mutations often trigger nonsense-mediated mRNA decay (NMD), a quality control degrading faulty mRNAs.

Inheritance Patterns & Exemplars - Family Fault Lines

  • Pedigree Analysis: Visualizes gene transmission. Standardized Pedigree Symbols
  • Key Distinctions:
PatternTransmissionRisk (Typical)SexesNotesE.g.
ADVertical50% (1 affected parent)M=FOften structural proteins; Variable expressivity, Incomplete penetranceHuntington's, Marfan, Achondroplasia, Neurofibromatosis T1
ARHorizontal25% (carrier parents)M=FEnzyme deficiencies; Consanguinity ↑ riskCystic Fibrosis ($\Delta$F508), Sickle Cell, PKU, Tay-Sachs, Thalassemia
XLRNo male-to-male50% sons (carrier mom)M >> FSkips generations; Carrier females usually unaffectedDuchenne MD, Hemophilia A/B, G6PD deficiency, Lesch-Nyhan
XLDNo male-to-maleDad→all daughters; Affected mom → 50% offspringF > MOften severe/lethal in malesFragile X, Rett Syndrome, Hypophosphatemic rickets (Vit D-resist)
Mito.Maternal onlyAll (affected mom)M=FHeteroplasmy; Affects high-energy tissues (CNS, muscle)LHON, MELAS, MERRF

Anticipation: Disease worsens or appears earlier in successive generations. Common in trinucleotide repeat disorders (e.g., Huntington's [AD], Myotonic Dystrophy [AD], Fragile X [XLD]).

📌 Mnemonic AD/AR: "Dominant diseases Destroy Generations (Vertical). Recessive diseases Run in sibs (Horizontal)."

Chromosomal Chaos & Diagnostics - Blueprint Blunders

  • Numerical Abnormalities (Aneuploidy): Gain/loss of chromosomes.
    • Down Syndrome: Trisomy 21. 📌 Mnemonic: Voting age 21 (Down for voting).
    • Turner Syndrome: 45,XO (females, short stature).
    • Klinefelter Syndrome: 47,XXY (males, gynecomastia).
  • Structural Abnormalities: Altered chromosome structure.
    • Translocations: e.g., Philadelphia Chromosome t(9;22) in CML.
    • Deletions: e.g., Cri-du-chat syndrome (del 5p).
  • Key Diagnostics:
    • Karyotyping: Visualizes chromosome number & structure.
    • FISH: Detects specific DNA sequences/regions.
    • PCR: Amplifies DNA for mutation detection. Trisomy 21 (Down Syndrome) Karyotype and Phenotype

⭐ The Philadelphia chromosome, t(9;22)(q34;q11.2), creating the BCR-ABL1 fusion gene, is a hallmark of Chronic Myeloid Leukemia (CML).

High‑Yield Points - ⚡ Biggest Takeaways

  • Single-gene disorders follow Mendelian inheritance (AD, AR, X-linked).
  • Trinucleotide repeat expansions cause Huntington's (CAG) & Fragile X syndrome (CGG).
  • Mitochondrial diseases: maternal inheritance, affect high-energy tissues.
  • Genomic imprinting: differential expression by parental origin (e.g., Prader-Willi, Angelman).
  • Loss-of-function mutations: common in recessive diseases; gain-of-function in dominant ones.
  • Epigenetic changes (e.g., methylation) alter gene expression, causing disease without DNA sequence change.

Practice Questions: Molecular Basis of Genetic Diseases

Test your understanding with these related questions

A 25-year-old man presents for a routine examination and is found to have an early diastolic murmur on examination. Clinical findings suggest hypertrophic cardiomyopathy. The family pedigree shows affected individuals in three consecutive generations with both males and females affected, and no generation is skipped. What is the most likely mode of inheritance of this genetic condition?

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Flashcards: Molecular Basis of Genetic Diseases

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BRCA_____ is located on chromosome 17.

TAP TO REVEAL ANSWER

BRCA_____ is located on chromosome 17.

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