Factors Influencing Disease Incidence

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Questions and Answers

What is the primary role of a driver gene in tumorigenesis?

  • To promote cell division without restriction (correct)
  • To provide insight into cancer prevention strategies
  • To undergo somatic mutations that have no effect on growth
  • To interact with T cells for immune response

How do passenger genes differ from driver genes during tumorigenesis?

  • Passenger genes promote immune responses, whereas driver genes do not.
  • Passenger genes can lead to familial clustering of cancers unlike driver genes.
  • Passenger genes do not confer a growth advantage to cells. (correct)
  • Passenger genes directly contribute to uncontrolled cell growth, unlike driver genes.

Which gene is commonly associated with retinoblastoma?

  • Insulin gene
  • Retinoblastoma gene (correct)
  • APC gene
  • HLA class II gene

What percentage of familial clustering of type 1 diabetes is attributed to inherited genetic variation in the insulin region?

<p>10% (A)</p> Signup and view all the answers

Which gene is considered a logical candidate for susceptibility to type 1 diabetes?

<p>Insulin gene (D)</p> Signup and view all the answers

What is the effect of Class 2 mutations in the LDL receptor gene?

<p>They result in the LDL receptor being stuck in the endoplasmic reticulum. (B)</p> Signup and view all the answers

What is a consequence of Class 3 mutations in the LDL receptor gene?

<p>They enhance the uptake of LDL cholesterol. (C)</p> Signup and view all the answers

What contributes to the variation in blood pressure observed in families?

<p>Complex interactions between genes and environmental factors. (C)</p> Signup and view all the answers

Which of the following is NOT considered an important environmental risk factor for hypertension?

<p>High fiber diet. (C)</p> Signup and view all the answers

What percentage of systemic hypertension’s prevalence is estimated worldwide?

<p>25% to 30% (C)</p> Signup and view all the answers

What is one reason MZ twins may develop personality differences?

<p>To assert their individuality (B)</p> Signup and view all the answers

How do adoption studies help estimate genetic contributions to diseases?

<p>By observing whether adopted children develop diseases of their biological parents (D)</p> Signup and view all the answers

What percentage of adopted children with a schizophrenic parent develop schizophrenia?

<p>8% to 10% (D)</p> Signup and view all the answers

In the context of the discussed studies, what does a comparative control population refer to?

<p>Adopted children born to unaffected parents (B)</p> Signup and view all the answers

What is a key precaution when interpreting the results of adoption studies?

<p>Neglecting the backgrounds of adoptive parents (B)</p> Signup and view all the answers

What kind of trait are adoption studies often used to estimate?

<p>Multifactorial traits (C)</p> Signup and view all the answers

Which of the following diseases is specifically mentioned as being studied in relation to genetic contributions in adopted children?

<p>Schizophrenia (D)</p> Signup and view all the answers

What happens to children born to parents with a disease, who are later adopted by unaffected parents?

<p>They may still develop the disease at a higher rate (C)</p> Signup and view all the answers

What is suggested by the dissimilar concordance rates for schizophrenia and bipolar affective disorder?

<p>There is a significant genetic component for these diseases. (C)</p> Signup and view all the answers

What does a concordance rate close to 1.0 for dermatoglyphics indicate?

<p>They are determined mainly by genetic influences. (B)</p> Signup and view all the answers

Which of the following conditions exemplifies a gene-environment interaction?

<p>α1-antitrypsin deficiency exacerbated by smoking. (B)</p> Signup and view all the answers

What is a common misconception about the relationship between genetics and common diseases?

<p>They result from an interaction of genetic and nongenetic factors. (D)</p> Signup and view all the answers

Which statement about α1-antitrypsin deficiency is true?

<p>It affects approximately 1 in 2500 individuals among whites. (A)</p> Signup and view all the answers

What role did twins historically play in understanding genetics and environment?

<p>They were viewed as ideal for assessing the relative influences of both genetics and environment. (D)</p> Signup and view all the answers

What challenge arose when using twins in genetic research?

<p>Factors influencing concordance were often overlooked. (A)</p> Signup and view all the answers

What is the primary synthesis location of α1-antitrypsin in the body?

<p>Liver (B)</p> Signup and view all the answers

What is the estimated lifetime risk of developing breast cancer for women who inherit a mutation in BRCA1 or BRCA2?

<p>50% to 80% (C)</p> Signup and view all the answers

Which cancer risk is associated with a mutation in BRCA1?

<p>Ovarian cancer and breast cancer (C)</p> Signup and view all the answers

Familial adenomatous polyposis is caused by mutations in which gene?

<p>APC (A)</p> Signup and view all the answers

What percentage of males with a BRCA2 mutation will develop breast cancer?

<p>6% (A)</p> Signup and view all the answers

Hereditary nonpolyposis colorectal cancer is attributed to mutations in which aspect?

<p>DNA repair genes (D)</p> Signup and view all the answers

What is the role of the BRCA1 and BRCA2 gene products?

<p>DNA repair (A)</p> Signup and view all the answers

What percentage of all colon tumors are associated with somatic mutations of the APC gene?

<p>About 85% (B)</p> Signup and view all the answers

Which of the following genes is not typically associated with inherited breast cancer?

<p>VHL (A)</p> Signup and view all the answers

What is the male to female ratio observed in studies of autism spectrum disorders?

<p>4 : 1 (C)</p> Signup and view all the answers

How does the sibling recurrence risk for males with congenital heart defects compare to that of females?

<p>It is higher for females. (D)</p> Signup and view all the answers

What does the term 'isolated' refer to when discussing conditions like cleft lip and/or palate?

<p>The condition is the only observed disease feature. (A)</p> Signup and view all the answers

What is the implication of having two affected siblings in terms of familial risk for multifactorial disorders?

<p>The family has more information about their true risk. (D)</p> Signup and view all the answers

Which of the following conditions is NOT described as multifactorial?

<p>Duchenne muscular dystrophy (A)</p> Signup and view all the answers

Which statement about recurrence risk in multifactorial disorders is accurate?

<p>Recurrence risk increases with the number of affected family members. (C)</p> Signup and view all the answers

What types of diseases are characterized as multifactorial?

<p>Congenital malformations and adult diseases influenced by genetics and environment. (A)</p> Signup and view all the answers

What is the correct approach to understanding the risk for congenital heart defects when one sibling is affected?

<p>The risk is approximately 3% for another sibling. (C)</p> Signup and view all the answers

Flashcards

Multifactorial Inheritance

The inheritance pattern of diseases influenced by multiple genetic and environmental factors, resulting in a complex interplay of influences.

Recurrence Risk

The likelihood of a disease occurring within a family, often expressed as a percentage, indicating the probability of a sibling developing the same condition.

Sex Ratio

The proportion of males versus females affected by a disease. It can indicate potential sex-specific genetic or environmental factors.

Multifactorial Disease with 4:1 Sex Ratio

A disease with a sex ratio of 4:1 suggests that males are four times more likely to be affected than females.

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Reversed Sex Ratio Effect

If a disease affects more females than males, the recurrence risk is expected to be higher when the proband (affected individual) is male.

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Recurrence Risk Increases with Multiple Affected Family Members

Diseases influenced by multifactorial inheritance exhibit an increasing recurrence risk as more family members are affected, suggesting a greater concentration of susceptibility factors.

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Constant Recurrence Risk in Single-Gene Disorders

The recurrence risk of a single-gene disorder remains constant regardless of the number of affected siblings, indicating a distinct inheritance pattern.

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Increased Recurrence Risk Reflects Family Liability Distribution

The observed increase in recurrence risk with more affected siblings reflects a greater likelihood of the family having a higher number of susceptibility factors, placing them higher on the liability distribution.

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Twin Studies in Genetics

Studies that involve comparing the traits of identical twins raised together and apart, helping researchers understand the influence of nature (genes) and nurture (environment) on a given trait.

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Adoption Studies in Genetics

One of the types of studies used to estimate the genetic contribution to a multifactorial trait, focusing on the development of traits in adopted children compared to their biological and adoptive parents.

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Personality Differences in MZ Twins

The differences observed in personality traits between genetically identical twins, often attributed to their individual experiences and environmental influences.

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Schizophrenia in Adoption Studies

A disorder characterized by severe mental health issues, often involving hallucinations, delusions, and disorganized thinking. The study of this disorder in adopted children indicates a potential genetic component.

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Spina Bifida

This term refers to a condition where the spinal cord fails to close completely during fetal development, often leading to various physical disabilities.

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Anencephaly

This refers to a birth defect involving the incomplete closure of the skull during fetal development, potentially causing severe neurological impairments.

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Precautions in Interpreting Twin and Adoption Studies

When examining the results of twin and adoption studies, it's crucial to consider and address potential contributing factors. For example, adoptive parents of children with a specific genetic predisposition may share similar environments or lifestyles that can influence the children's outcomes.

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Class 2 mutation in LDL receptor

A type of mutation in the LDL receptor gene that produces a receptor that cannot leave the endoplasmic reticulum and is degraded.

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PCSK9 mutations

Mutations in the PCSK9 gene lead to the production of a protein that regulates LDL receptor activity. Inhibiting PCSK9 can lower cholesterol levels.

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Hypertension

A genetic condition that increases the risk of developing heart disease, stroke, and kidney disease.

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Genetic factors and blood pressure

Genetic factors contribute between 20% and 40% of the variation in blood pressure.

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Environmental factors and hypertension

Environmental factors like increased sodium intake, decreased physical activity, stress, and obesity contribute to developing hypertension.

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Driver Genes

Genes that directly promote uncontrolled cell growth and contribute to tumor formation. Think of them as the "accelerator" in cell division.

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Passenger Genes

Genes that undergo mutations during tumorigenesis, but don't directly cause cancer. They are "passengers" in the tumor-forming process.

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Carcinogenesis

The process by which cancer develops, involving a series of genetic alterations.

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Insulin Gene Polymorphisms

Inherited variations in the insulin gene that contribute to the increased risk of developing Type 1 diabetes.

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Familial Clustering

The influence of genetic factors on a disease's susceptibility within a family.

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Concordance Rate

The degree to which a trait or disease shared by two individuals is influenced by genes.

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MZ vs. DZ Twins

Identical (monozygotic) twins share 100% of their genes, while fraternal (dizygotic) twins share 50% of their genes. Comparing the concordance rate in these twins helps us understand the relative contribution of genes and environment to a particular trait.

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Gene-Environment Interaction

When genes and environmental factors work together to increase the risk of a disease beyond what either factor could do alone.

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α1-Antitrypsin Deficiency

A genetic condition where the body produces less α1-antitrypsin, a protein that protects the lungs. This makes individuals more susceptible to lung damage, especially when they smoke.

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Pulmonary Emphysema

A chronic lung disease characterized by damage to the tiny air sacs in the lungs. It can be caused by genetic factors, environmental exposures (like smoking), or a combination of both.

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Genetic Predisposition

When an individual has a genetic predisposition to a disease, meaning they're more likely to develop it, but the disease may not manifest unless certain environmental factors also exist.

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Twin Studies

The study using twins to determine the relative contributions of genes (nature) and environment (nurture) to a trait or disease.

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Genetically Determined Traits

Traits or diseases that are determined almost entirely by genes, leading to very high concordance rates in identical twins.

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What is BRCA1?

A gene that, when mutated, increases the risk of developing breast, ovarian, and other cancers. It plays a role in DNA repair.

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What is BRCA2?

A gene that, when mutated, increases the risk of developing breast, ovarian, and other cancers. It also participates in DNA repair.

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What is familial adenomatous polyposis (FAP)?

A genetic disorder characterized by the development of numerous polyps in the colon, which can lead to colorectal cancer. It is caused by mutations in the APC gene.

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What is APC?

A gene that acts as a tumor suppressor, meaning it helps prevent the uncontrolled growth of cells. Mutations in this gene are associated with familial adenomatous polyposis (FAP) and colorectal cancer.

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What is hereditary nonpolyposis colorectal cancer (HNPCC)?

A type of cancer that accounts for a significant portion of colorectal cancer cases. It is caused by mutations in several genes involved in DNA repair, leading to an increased risk of the disease.

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What is DNA repair?

The process by which cells repair damaged DNA. This process is essential for preventing the accumulation of mutations that can lead to cancer.

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What is a gene mutation?

A change in the DNA sequence of a gene, which can lead to a variety of effects, including increased risk of disease. Mutations in genes involved in DNA repair can increase cancer risk.

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What are tumor suppressor genes?

A type of gene that normally prevents cells from growing uncontrollably. When these genes are mutated, they lose their function, allowing cancer cells to proliferate.

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Study Notes

Factors Influencing Disease Incidence

  • Incidence rate is the number of new cases reported during a specific period (often 1 year) divided by the number of people in the population (often expressed as person-years).
  • Prevalence rate is the proportion of the population affected by a disease at a specific point in time. It depends on both the incidence rate and the length of survival.
  • Prevalence varies among populations. For example, cystic fibrosis is more common in Europeans than Asians.
  • Environmental factors can significantly influence prevalence, especially in common adult diseases. For instance, colon cancer rates have increased in Japan as their diet has become more Westernized.
  • Analysis of risk factors often uses relative risk, which is the ratio of the incidence rate in those exposed to a risk factor to the incidence rate in those not exposed.
  • Cigarette smoking is strongly linked to a significantly increased risk of lung cancer.
  • Relative risks help quantify the effect of individual factors in common diseases like cancer, diabetes, or high blood pressure. These various factors can interact.

Principles of Multifactorial Inheritance

  • Multifactorial traits are influenced by multiple genes and environmental factors.
  • Quantitative traits, like blood pressure, typically have a continuous distribution.
  • Multifactorial traits are assumed to follow a normal (bell-shaped) distribution.
  • The more factors influencing a trait, the more closely its distribution resembles the normal distribution.
  • Genes involved in multifactorial traits follow Mendelian principles of segregation and independent assortment.

Threshold Model

  • Some diseases aren't distributed normally. Instead, they are either present or absent, but don't follow single-gene inheritance patterns.
  • This is explained by individual liability to a disease, with thresholds in the population.
  • Individuals below a threshold are unaffected, while above it they exhibit the disease.
  • Pyloric stenosis is an example. The recurrence risk depends on the sex of the initial affected family member. Higher risk is observed for siblings of the less commonly affected sex.
  • The increased recurrence risk of more than one affected family member means the family is likely higher on the liability curve.
  • The severity of the disease in the proband can also increase recurrence risks for relatives.

Nature and Nurture: Genes and Environment

  • Family resemblance in traits involves both nature (genes) and nurture (environment).
  • Traits are rarely influenced solely by one or the other.
  • Twin studies compare monozygotic (identical) and dizygotic (fraternal) twins to assess the influence of genetics and environment, respectively.
  • Similar environments can inflate the appearance of a trait's genetic influence among MZ twins.
  • Adoption studies assess whether traits in adopted children resemble those of their biological or adoptive parents, providing estimates of genetic influence. Studies are often complicated because of prenatal or early-life environmental effects, and often adopted candidates are carefully matched with their adoptive parents in background, and socioeconomic status.

Common Diseases

  • Coronary Heart Disease: Genetic and environmental factors like diet, exercise, smoking, obesity, family history, and cholesterol levels contribute to CHD.
  • Hypertension: Many genes, though not all, influence blood pressure. Genetics interact with environment factors like salt intake, activity, and stress.
  • Cancer: Breast cancer, colorectal cancer, and prostate cancer have heritable components. Environmental factors, like diet, exercise, and smoking, are also influential.
  • Diabetes Mellitus (Type 1 and 2): Type 1 diabetes is often an autoimmune disorder, while type 2 results from insulin resistance. Genes and environmental factors like obesity and lifestyle significantly impact both types.
  • Obesity: Genes interact with lifestyle and environmental factors to influence body weight.
  • Alzheimer Disease: Although most cases are multifactorial, some early-onset cases follow a single-gene inheritance pattern, likely related to amyloid-β deposition.
  • Alcoholism: Genetic predispositions exist. Environmental factors such as social environment and access to alcohol also significantly affect its development.
  • Psychiatric disorders (e.g., schizophrenia, bipolar disorder): Genetics and environment interact; twin and adoption studies have revealed a substantial genetic contribution.
  • Congenital Malformations: Numerous factors and genes are involved. These disorders show multifactorial inheritance patterns.

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