Gaucher disease 3/22/2009. Mendelian pedigree patterns. Autosomal-dominant inheritance

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Mendelian pedigree patterns Autosomal-dominant inheritance Autosomal dominant Autosomal recessive X-linked dominant X-linked recessive Y-linked Examples of AD inheritance Autosomal-recessive inheritance Neurofibromatosis Achondroplasia (short-limbed dwarfism) Gaucher disease Multiple mutations in gene (chrs 1) which encodes the enzyme GLYCOCEREBROZIDASE 1

Age of appearance Duration of life Type 1 In any age 6-80 Type 2 In childhood 2 years Type 3 In childhood 6-80 Gaucher disease Type 1 Type 2 Type 3 Primary deffects of CNS - ++ Hepatosplenomegaly +++ Hematological abnormalities ++ Skeletal abnormalities - +++ - - +++ Nonmendelian inheritance Nonmendelian monogenic characters Genetic heterogeneity Mitochondrial inheritance Polygenic characters Monogenic characters Mendelian Have biallele determinism Follow mendelian patterns Correspond to one of the basic pedigree patterns Have bimodal distribution in population (normal phenotype/pathologic) Nonmendelian Have biallele or monoallele determinism Do not follow mendelian patterns Do not correspond to basic pedigree patterns Show variable manifestation in phenotype: nonpenetrance, variable expression Phenomena which influence the expression of AD genes Nonpenetrance Nonpenetrance Variable expression Tissue specificity Sporadic cases by de novo mutations 2

Variable expression Polydactily Phenomena which influence the expression of AR genes Single allele expression (genome imprinting, lyonization, allele exclusion) Uniparental disomy Compound heterozygotes Expression of genes is controlled by patterns of methylation that differ according to the parental origin of gene Genome Imprinting Uniparental disomy Angelman and Prader-Willi syndromes Compound heterozygotes 3

Mechanisms involved in variable expression of pathological genes Allele and non-allele interactions Allele and locus heterogeneity Pleiotropy Unstable expanding repeats Environmental factors Genetic heterogeneity Genetic heterogeneity Locus heterogeneity Heterogeneity is a phenomenon when different mutation produce the similar phenotype There are two types: Locus heterogeneity different nonallele gene mutations produce the similar phenotype different allelic mutation in the same locus produce the similar (but not identical) phenotype Allele 1 Trait 1 Allele 2 Trait 2 Allele 3 Trait 3 Mutant Gene 1 or Mutant Gene 2 or Mutant Gene 3 Abnormal trait Numerous mutations in gene which encode Cl - channel produce the cystic fibrosis (cystic fibrosis=mucoviscidosis) 4

Locus heterogeneity 35 different A-D, R-D, X-R mutant genes are manifested as Retinitapigmentosum Retinita pigmentosum Pleiotropy one gene determine many different traits Marfan Syndrome Marfan Syndrome Unstable expending repeats Paul Rose CTG repeats 350 520 Appearance After 30 years After 20 years Pathological traits Myotony; muscle weakness Myotony; muscle weakness Dylan >3000 prenatal Sever muscle weakness; pulmonary insufficiency 5

Some diseases caused by unstable expanding repeats Fragile- X-syndrome Disease Location of gene Repeat sequence Stable repeat no. Unstable repeat no. Fragile-Xsyndrome Myotonic dystrophy Xq27.3 19q13.3 CGG/CCG CTG/CAG 5-50 5-35 200 50-4000 Huntington disease 4p16.3 CAG/CTG 6-35 42 Freidreich ataxia 9p13 CAG/CTG 7-22 200-1700 Mitochondrial inheritance Matrilineal inheritance, giving a recognizable pedigree pattern Disease is caused by mutation in mtdna energy metabolism defects Mutations usually produce nervous and muscle systems diseases, but can affect any other organ Mitochondrial diseases have a early appearance, progressive evolution and variable expression Mitochondrial diseases CPEO chronic progressive external ophthalmoplegy Ocular myopathy Hereditary cardiomyopathy MELAS (Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes ) Leber s hereditary optic atrophy MERFF (myoclonic epilepsy with ragged-red-fibers ) Mitochondrial disease MELAS Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes 6

Multifactorial inheritance Characters depend on many genetic loci, with greater or smaller contributions from environmental factors The genetic determination may involve a small number of loci (oligogenic) or many loci each of individually small effect (polygenic) Most human normal traits, such as height, weight, eye and skin color, intelligence and metabolic rate are governed by the cumulative effects of many genes Pedigree pattern of multifactorial transmission Polygenic diseases Are determined by many genes; Have familial aggregation; Have bimodal or multimodal distribution; Recurrence risk depends on severity of disease, grade of relationship with sick person, number of affected relatives, coefficient of heredity, Ex.:common diseases; isolated congenital diseases; cancer; some forms of mental retardation. 7