Modern genetics

10.2 Modern genetics



A clinical geneticist is a medical specialist who has expert knowledge of human clinical and laboratory genetics. However, because genetic information underlies the development and responses of every individual, an understanding of human genetics is essential for every medical practitioner. This chapter provides a brief overview of the principles of genetics as they pertain to paediatrics, but readers are cautioned that there is much that is both important and fascinating that cannot be covered in the space available. It is strongly recommended that readers utilize other resources that are relevant to this section. Readers should also bear in mind that genetics is a rapidly developing field, and detailed information derived from any source may become outdated within a matter of months.


Many technical terms are used throughout this chapter and readers need to be familiar with these terms. Many will be familiar from courses in genetics or biochemistry.



Genetic information








The function of our genome: DNA, genes and proteins







Our understanding of the function of DNA is changing


Until recently the accepted understanding was that genes occur infrequently along the human genome and that these genes encode RNA, which in turn encodes the amino acid sequence of protein polypeptides. By this view, a gene encodes a single protein polypeptide and is separated from its neighbouring genes by long stretches of intergenic non-coding ‘junk’ DNA. It is now clear that this is a simplified interpretation of the function of DNA, and of what constitutes a gene. Below is a summary of our current understanding of the function of the genome, but readers are again cautioned that this information will rapidly become outdated and that other resources should be consulted.




Gene regulation



The regulation of human gene expression is incompletely understood


Our understanding of the ways the human genome is regulated and integrated within a cell (or an individual) is rudimentary. It is beyond the scope of this chapter to discuss all that is known or hypothesized about gene regulation, but the reader should be familiar with two important concepts: inactivation of genes by methylation, and imprinting.


Genes are controlled by regulatory DNA sequences. These regulatory sequences can be chemically altered by the addition of methyl groups (− CH3) to the nucleotides of the sequence, this is called methylation.



The activation or silencing of a gene is usually independent of whether the gene was inherited paternally or maternally. An exception is genes that are imprinted.



Failure of normal imprinting results in overexpression or underexpression of a gene, which may lead to a clinical disorder.





Genes and networks


A single gene does not produce its effect independent of the action of other genes. All processes within a single cell are regulated by an interacting network of many genes. For example, a network of several hundred different genes is involved in intracellular galactose metabolism. This leads to a degree of biological robustness because a mutation (genetic error) in a single gene will not necessarily result in cellular dysfunction if the remainder of the genetic network is able to compensate for the mutated gene.


This network of genes is embedded within a network of interacting cells within a single tissue or organ, which is embedded in a network of interacting tissues and organs within a single individual. Individuals, in turn, are embedded in social and environmental networks. The interplay and variation within and between these genetic, cellular, biological, social and environmental networks helps explain why the clinical features of a specific disorder can vary from one individual to another.


Aug 4, 2016 | Posted by in PEDIATRICS | Comments Off on Modern genetics

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