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Genetic
disorders
A
genetic disorder is a condition caused by abnormalities in genes
or chromosomes. While some diseases, such as cancer, are due to
genetic abnormalities acquired in a few cells during life, the term
"genetic disease" most commonly refers to diseases present
in all cells of the body and present since conception. Some genetic
disorders are caused by chromosomal abnormalities due to errors
in meiosis, the process which produces reproductive cells such as
sperm and eggs. Examples include Down syndrome (extra chromosome
21), Turner Syndrome (45X0) and Klinefelter's syndrome (a male with
2 X chromosomes). Other genetic changes may occur during the production
of germ cells by the parent. One example is the triplet expansion
repeat mutations which can cause fragile X syndrome or Huntington's
disease. Defective genes may also be inherited intact from the parents.
This can often happen unexpectedly when two healthy carriers of
a defective recessive gene reproduce, but can also happen when the
defective gene is dominant. Currently about 4,000 genetic disorders
are known, with more being discovered. Most disorders are quite
rare and affect one person in every several thousands or millions.
Cystic fibrosis is one of the most common genetic disorders; around
5% of the population of the United States carry at least one copy
of the defective gene. Some types of recessive gene disorder confer
an advantage in the heterozygous state in certain environments.[1]
Genetic diseases are typically diagnosed and treated by geneticists.
Genetic counselors assist the physicians and directly counsel patients.
The study of genetic diseases is a scientific discipline whose theoretical
underpinning is based on population genetics.
Both environmental and genetic factors have roles in the development
of any disease. A genetic disorder is a disease caused by abnormalities
in an individual's genetic material (genome). The four different
types of genetic disorders are(1) single-gene, (2) multifactorial,
(3) chromosomal, and (4) mitochondrial.
(1) Single-gene (also called Mendelian or monogenic)
This type is caused by changes or mutations that occur in the DNA
sequence of one gene. Genes code for proteins, the molecules that
carry out most of the work, perform most life functions, and even
make up the majority of cellular structures. When a gene is mutated
so that its protein product can no longer carry out its normal function,
a disorder can result. There are more than 6,000 known single-gene
disorders, which occur in about 1 out of every 200 births. Some
examples are cystic fibrosis, sickle cell anemia, Marfan syndrome,
Huntington's disease, and hereditary hemochromatosis.
" Single-gene disorders are inherited in recognizable patterns:
autosomal dominant, autosomal recessive, and X-linked.
(2) Multifactorial (also called complex or polygenic)
This type is caused by a combination of environmental factors and
mutations in multiple genes. For example, different genes that influence
breast cancer susceptibility have been found on chromosomes 6, 11,
13, 14, 15, 17, and 22. Its more complicated nature makes it much
more difficult to analyze than single-gene or chromosomal disorders.
Some of the most common chronic disorders are multifactorial. Examples
include heart disease, high blood pressure, Alzheimer's disease,
arthritis, diabetes, cancer, and obesity. Multifactorial inheritance
also is associated with heritable traits such as fingerprint patterns,
height, eye color, and skin color.
(3) Chromosomal
Chromosomes, distinct structures made up of DNA and protein, are
located in the nucleus of each cell. Because chromosomes are carriers
of genetic material, such abnormalities in chromosome structure
as missing or extra copies or gross breaks and rejoinings (translocations)
can result in disease. Some types of major chromosomal abnormalities
can be detected by microscopic examination. Down syndrome or trisomy
21 is a common disorder that occurs when a person has three copies
of chromosome 21.
3.1
Autosomal dominant
Only
one mutated copy of the gene will be necessary for a person to
be affected by an autosomal dominant disorder. Each affected person
usually has one affected parent. There is a 50% chance that a
child will inherit the mutated gene. Conditions that are autosomal
dominant have low penetrance, which means that, although only
one mutated copy is needed, a relatively small proportion of those
who inherit that mutation go on to develop the disease, often
later in life. Examples of this type of disorder are Huntington's
disease, Neurofibromatosis 1, Marfan Syndrome, Hereditary nonpolyposis
colorectal cancer, and Hereditary multiple exostoses,which is
a high penetrance autosomal dominant disorder.
3.2
Autosomal recessive
Two
copies of the gene must be mutated for a person to be affected
by an autosomal recessive disorder. An affected person usually
has unaffected parents who each carry a single copy of the mutated
gene (and are referred to as carriers). Two unaffected people
who each carry one copy of the mutated gene have a 25% chance
with each pregnancy of having a child affected by the disorder.
Examples of this type of disorder are Cystic fibrosis, Sickle
cell anemia(Also Partial Sickle Cell Anemia), Tay-Sachs disease,
Spinal muscular atrophy, and Dry (otherwise known as "rice-brand")
earwax[2]
3.3
X-linked dominant
X-linked
dominant disorders are caused by mutations in genes on the X chromosome.
Only a few disorders have this inheritance pattern. Males are
more frequently affected than females, and the chance of passing
on an X-linked dominant disorder differs between men and women.
The sons of a man with an X-linked dominant disorder will not
be affected, and his daughters will all inherit the condition.
A woman with an X-linked dominant disorder has a 50% chance of
having an affected daughter or son with each pregnancy. Some X-linked
dominant conditions, such as Aicardi Syndrome, are fatal to boys,
therefore only girls have them (and boys with Klinefelter Syndrome).
Other examples of this type of disorder are Hypophosphatemia,
Aicardi Syndrome, and Chokenflok Syndrome.
3.4
X-linked recessive
X-linked
recessive disorders are also caused by mutations in genes on the
X chromosome. Males are more frequently affected than females,
and the chance of passing on the disorder differs between men
and women. The sons of a man with an X-linked recessive disorder
will not be affected, and his daughters will carry one copy of
the mutated gene. With each pregnancy, a woman who carries an
X-linked recessive disorder has a 50% chance of having sons who
are affected and a 50% chance of having daughters who carry one
copy of the mutated gene.Examples of this type of disorder Hemophilia
A, Duchenne muscular dystrophy, Color blindness, Muscular dystrophy
and Androgenetic alopecia.
3.5
Y-linked
Y-linked
disorders are caused by mutations on the Y chromosome. Only males
can get them, and all of the sons of an affected father are affected.
Since the Y chromosome is very small, Y-linked disorders only
cause infertility, and may be circumvented with the help of some
fertility treatments. Examples are Male Infertility.
(4)
Mitochondrial
This
relatively rare type of genetic disorder is caused by mutations
in the nonchromosomal DNA of mitochondria. Mitochondria are small
round or rod-like organelles involved in cellular respiration
and found in the cytoplasm of plant and animal cells. Each mitochondrion
may contain 5 to 10 circular pieces of DNA. This type of inheritance,
also known as maternal inheritance, applies to genes in mitochondrial
DNA. Because only egg cells contribute mitochondria to the developing
embryo, only females can pass on mitochondrial conditions to their
children. Examples of this type of disorder are Human mitochondrial
genetics, and Leber's Hereditary Optic Neuropathy
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