Sickle-cell anemia Sickle-cell anemia (SCA) is a
genetic disorder caused by the presence of two incompletely recessive alleles. When a sufferer's
red blood cells are exposed to low-
oxygen conditions, the cells lose their healthy round shape and become sickle-shaped. This deformation of the cells can cause them to become lodged in capillaries, depriving other parts of the body of sufficient oxygen. When untreated, a person with SCA may suffer from painful periodic bouts, often causing damage to
internal organs,
strokes, or
anemia. Typically, the disease results in premature death. Because the genetic disorder is incompletely recessive, a person with only one SCA allele and one unaffected allele will have a "mixed"
phenotype: The sufferer will not experience the ill effects of the disease, yet will still possess a
sickle cell trait, whereby some of the red blood cells undergo benign effects of SCA, but nothing severe enough to be harmful. Those afflicted with sickle-cell trait are also known as carriers: If two carriers have a child, there is a 25% chance their child will have SCA, a 50% chance their child will be a carrier, and a 25% chance that the child will neither have SCA nor be a carrier. Were the presence of the SCA allele to confer only negative traits, its allele frequency would be expected to decrease generation after generation, until its presence were eliminated by selection and by chance. However, convincing evidence indicates, in areas with persistent
malaria outbreaks, individuals with the heterozygous state have a distinct advantage (and this is why individuals with heterozygous alleles are far more common in these areas). Those with the benign sickle trait possess a resistance to malarial infection. The pathogen that causes the disease spends part of its cycle in the red blood cells and triggers an abnormal drop in oxygen levels in the cell. In carriers, this drop is sufficient to trigger the full sickle-cell reaction, which leads to infected cells being rapidly removed from circulation and strongly limiting the infection's progress. These individuals have a great resistance to infection and have a greater chance of surviving outbreaks. However, those with two alleles for SCA may survive malaria, but will typically die from their genetic disease unless they have access to advanced medical care. Those of the homozygous "normal" or wild-type case will have a greater chance of passing on their genes successfully, in that there is no chance of their offspring's suffering from SCA; yet, they are more susceptible to dying from malarial infection before they have a chance to pass on their genes. This resistance to infection is the main reason the SCA allele and SCA disease still exist. It is found in greatest frequency in populations where malaria was and often still is a serious problem. Approximately one in 10 African Americans is a carrier, as their recent ancestry is from malaria-stricken regions. Other populations in Africa, India, the Mediterranean and the Middle East have higher allele frequencies, as well. As effective antimalarial treatment becomes increasingly available to malaria-stricken populations, the allele frequency for SCA is expected to decrease, so long as SCA treatments are unavailable or only partially effective. If effective sickle-cell anemia treatments become available to the same degree, allele frequencies should remain at their present levels in these populations. In this context, 'treatment effectiveness' refers to the reproductive fitness it grants, rather than the degree of suffering alleviation.
Cystic fibrosis Cystic fibrosis (CF) is an autosomal recessive hereditary monogenic disease of the
lungs,
sweat glands and
digestive system. The disorder is caused by the malfunction of the
CFTR protein, which controls inter
membrane transport of
chloride ions, which is vital to maintaining equilibrium of water in the body. The malfunctioning protein causes viscous mucus to form in the lungs and intestinal tract. Before modern times, children born with CF would have a life expectancy of only a few years, but modern medicine has made it possible for these people to live into adulthood. However, even in these individuals, CF typically causes male
infertility. It is the most common genetic disease among people of
European descent. The presence of a single CF mutation may influence survival of people affected by diseases involving loss of body fluid, typically due to diarrhea. The most common of these maladies is
cholera, which only began killing Europeans millennia after the CF mutation frequency was already established in the population. Another such disease that CF may protect against is
typhoid. Those with cholera would often die of dehydration due to intestinal water losses. A mouse model of CF was used to study resistance to cholera, and the results were published in
Science in 1994 (Gabriel, et al.). The heterozygote (carrier) mouse had less secretory diarrhea than normal, noncarrier mice. Thus, it appeared for a time that resistance to cholera explained the selective advantage to being a carrier for CF and why the carrier state was so frequent. This theory has been called into question. Hogenauer, et al. have challenged this popular theory with a human study. Prior data were based solely on mouse experiments. These authors found the heterozygote state was indistinguishable from the noncarrier state. Another theory for the prevalence of the CF mutation is that it provides resistance to
tuberculosis. Tuberculosis was responsible for 20% of all European deaths between 1600 and 1900, so even partial protection against the disease could account for the current gene frequency. The most recent hypothesis, published in the Journal of Theoretical Biology, proposed having a single CF mutation granted respiratory advantage for early Europeans migrating north into the dusty wasteland left by the
Last Glacial Maximum. As of 2016, the selective pressure for the high gene prevalence of CF mutations is still uncertain, and may be due to an unbiased genetic drift rather than a selective advantage. Approximately one in 25 persons of European descent is a carrier of the disease, and one in 2500 to 3000 children born is affected by Cystic fibrosis.
Triosephosphate isomerase Triosephosphate isomerase (TPI) is a central enzyme of
glycolysis, the main pathway for cells to obtain energy by metabolizing
sugars. In humans, certain mutations within this
enzyme, which affect the dimerisation of this protein, are causal for a rare disease,
triosephosphate isomerase deficiency. Other mutations, which inactivate the enzyme (=
null alleles) are lethal when inherited
homozygously (two defective copies of the TPI gene), but have no obvious effect in
heterozygotes (one defective and one normal copy). However, the frequency of heterozygous null alleles is much higher than expected, indicating a heterozygous advantage for TPI null alleles. The reason is unknown; however, new scientific results are suggesting cells having reduced TPI activity are more resistant to
oxidative stress.
Resistance to hepatitis C virus infection There is evidence that genetic heterozygosity in humans provides increased resistance to certain viral infections. A significantly lower proportion of HLA-DRB1 heterozygosity exists among HCV-infected cases than uninfected cases. The differences were more pronounced with alleles represented as functional supertypes (P = 1.05 × 10−6) than those represented as low-resolution genotypes (P = 1.99 × 10−3). These findings constitute evidence that heterozygosity provides an advantage among carriers of different supertype HLA-DRB1 alleles against HCV infection progression to end-stage liver disease in a large-scale, long-term study population.
MHC heterozygosity and human scent preferences Multiple studies have shown, in double-blind experiments, females prefer the scent of males who are heterozygous at all three
MHC loci. The reasons proposed for these findings are speculative; however, it has been argued that heterozygosity at MHC loci results in more alleles to fight against a wider variety of diseases, possibly increasing survival rates against a wider range of infectious diseases. The latter claim has been tested in an experiment, which showed outbreeding mice to exhibit MHC heterozygosity enhanced their health and survival rates against multiple-strain infections.
BAFF and autoimmune disease B-cell activating factor (BAFF) is a cytokine encoded by the TNFSF13B gene. A variant of the gene containing a deletion (GCTGT—>A) renders a shorter mRNA transcript that escapes degradation by
microRNA, thus increasing expression of BAFF, which consequently up-regulates the humoral immune response. This variant is associated with
systemic lupus erythematosus and
multiple sclerosis, but heterozygote carriers of the variant have decreased susceptibility to malaria infection.
Cardiometabolic disease Variants of the kinase-related
MAP3K5 are associated with lifespan. In a study among Japanese-Americans, homozygous individuals have a longer lifespan than heterozygous individuals, indicating a homozygote advantage. ==See also==