Principles of Molecular Pathology

Principles of Molecular Pathology

Principles of Molecular Pathology

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Principles of Molecular Pathology - Gene & Genome Basics

  • DNA vs. RNA Structure:
    • DNA: Deoxyribose sugar, Thymine base, Double helix.
    • RNA: Ribose sugar, Uracil base, Single strand. DNA vs RNA structure
  • Gene: Basic hereditary unit; a DNA segment coding for a functional product (RNA/protein).
  • Genome: An organism’s complete set of DNA.
  • Chromosome: Structure within cells containing genetic material (DNA).
  • Central Dogma of Molecular Biology:
  • Mutations: Permanent alterations in DNA sequence.
    • Point Mutation: Change in a single nucleotide.
      • Silent: No change in amino acid.
      • Missense: Results in a different amino acid.
      • Nonsense: Creates a premature stop codon.
    • Frameshift Mutation: Insertion or deletion of nucleotides (not in multiples of three); alters the reading frame.
  • Polymorphism: Common variation in DNA sequence within a population.

    ⭐ Single Nucleotide Polymorphisms (SNPs) are the most common type of genetic variation in the human genome.

  • Allele: Variant form of a given gene.
  • Genotype: An individual's collection of genes.
  • Phenotype: Observable characteristics resulting from genotype-environment interaction.

Molecular Techniques - Lab Sleuth Kit

  • Polymerase Chain Reaction (PCR): Amplifies specific DNA segments.
    • Principle: Exponential DNA amplification.
    • Steps: Denaturation, Annealing, Extension.
-   Types: RT-PCR (RNA template), qPCR (quantitative real-time).
  • Blotting Techniques: 📌 SNoW DRoP mnemonic:

    • Southern: DNA detection.
    • Northern: RNA detection.
    • Western: Protein detection.
  • Hybridization: Probes (labeled DNA/RNA) bind to target sequences.

    • In Situ Hybridization (ISH): Detects sequences in cells/tissues.
    • Fluorescent ISH (FISH): Visualizes genes; detects gene amplification (e.g., HER2 in breast cancer), translocations (e.g., BCR-ABL in CML). FISH showing BCR-ABL translocation (Philadelphia chromosome)
  • Microarrays: Analyze expression of thousands of genes simultaneously.

  • Sequencing:

    • Sanger Sequencing: Dideoxy chain termination method for determining nucleotide sequence.
    • Next-Generation Sequencing (NGS): High-throughput, parallel sequencing; faster & cost-effective for large genomes/panels.

⭐ Polymerase Chain Reaction (PCR) can amplify a single copy of DNA by millions of times, enabling detection of minute quantities of genetic material.

Clinical Applications - Disease Detectives

Molecular pathology identifies disease mechanisms:

  • Genetic Disorders:
    • Monogenic: Detects CFTR mutations (Cystic Fibrosis), HBB gene variants (Sickle Cell Anemia).
    • Chromosomal: Identifies Trisomy 21 (Down Syndrome). Karyotype showing Trisomy 21
    • Trinucleotide Repeats: Diagnoses Huntington's Disease (expanded HTT gene repeats).
  • Cancer:
    • Oncogenes (RAS, MYC) & Tumor Suppressors (TP53, RB1) for diagnosis/prognosis.
    • Therapeutic Markers: EGFR mutations (lung cancer), HER2 amplification (breast cancer).
    • Fusion Genes: BCR-ABL (Chronic Myeloid Leukemia - CML).
  • Infectious Diseases:
    • Pathogen ID & Load: HIV viral load monitoring, HPV typing for cancer risk.
    • Antimicrobial Resistance: Detects genes like mecA (MRSA), NDM-1.

⭐ The Philadelphia chromosome, resulting from the t(9;22) translocation creating the BCR-ABL fusion gene, is a hallmark of Chronic Myeloid Leukemia (CML).

Emerging Concepts - Pathology's Future

  • Epigenetics: Heritable changes not altering DNA sequence.
    • DNA Methylation: Gene silencing; aberrant in cancer.
    • Histone Modification: Alters chromatin accessibility. Epigenetic Mechanisms: DNA Methylation and Histone Mod
  • Pharmacogenomics: Tailoring drug therapy to genetic makeup.
    • E.g., CYP enzyme variants (warfarin sensitivity).

    ⭐ Pharmacogenomics aims to tailor drug therapy based on an individual's genetic makeup, improving efficacy and reducing adverse drug reactions.

  • Liquid Biopsy: Non-invasive tumor monitoring via circulating tumor DNA (ctDNA).
    • Applications: Early detection, monitoring response, resistance.
  • Gene Therapy: Introducing genetic material to treat disease.
    • Viral vectors common for delivery.
  • CRISPR-Cas9: Genome editing tool for precise DNA modification (brief mention).

High‑Yield Points - ⚡ Biggest Takeaways

  • Central Dogma (DNA → RNA → Protein) underpins all molecular processes.
  • PCR enables DNA amplification for diagnostics; RT-PCR for RNA.
  • Blotting: Southern (DNA), Northern (RNA), Western (Protein) detect specific macromolecules.
  • FISH visualizes gene loci and chromosomal aberrations directly in cells.
  • NGS provides high-throughput DNA/RNA sequencing for comprehensive genomic analysis.
  • Monoclonal antibodies offer specific targeting in diagnostics and therapeutics.
  • Epigenetics (e.g., DNA methylation) regulates gene expression without altering DNA sequence.

Practice Questions: Principles of Molecular Pathology

Test your understanding with these related questions

Which PCR technique is best suited for identifying a syndrome with multiple causative agents?

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Flashcards: Principles of Molecular Pathology

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_____ is the most commonly mutated gene in sporadic breast carcinomas

TAP TO REVEAL ANSWER

_____ is the most commonly mutated gene in sporadic breast carcinomas

TP53

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