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10.4 A Comprehensive Example: The Hemoglobin Genes   357


                       fundamental insights into the mechanisms that change   Figure 10.20  Effects of deletions in the β-globin gene
                         globin expression during normal development from   cluster. (a) Normal situation. The locus control region (LCR)
                         embryonic to fetal to adult forms. Furthermore, the DNA   sequentially turns on the transcription of the ε gene in embryos: the
                       sequence of these clusters reveals how various mutations   two γ genes during fetal development, and the β and δ genes in
                                                                           adults. (b) Loci with a deletion of the β and δ genes cannot switch
                       give rise to a range of globin-related disorders. Hemoglo-  gene expression at birth, so the γ fetal polypeptides are still
                       bin disorders are the most common genetic diseases in the   produced in adults. This hereditary persistence of fetal hemoglobin
                       world and  include sickle-cell anemia, which arises from an   is benign. (c) Deletion of the LCR prevents the expression of all
                       altered β chain, and  thalassemia, which results from   genes in the cluster, causing severe β-thalassemia.
                         decreases in the amount of either α or β chain production.  (a) Normal   cluster

                                                                              LCR                 G   A     1
                       The Order of the Hemoglobin Genes in
                       the α and β Clusters Reflects the Timing
                       of Their Expression                                    (b) Hereditary persistence of fetal hemoglobin
                                                                                                      X
                       For the α-like chains, the temporal order of protein   LCR                 G   A     1
                         expression is ζ-globin during the first five weeks of em-
                       bryonic life, followed by α-globin (encoded by both the
                       α1 and α2 genes) during fetal and adult life. For the β-like                              -  deletion-  deletion
                       chains, the order of protein production is ε-globin during
                       the first five weeks of embryonic life; then γ-globin   (c) Severe  -thalassemia
                         (encoded by the Aγ and Gγ genes) during fetal life; and   Loss of gene expression
                       finally, within a few months of birth, mostly β but also                   G   A     1
                       some δ chains (see Fig. 10.19c).
                          If you compare Figs. 10.11 and 10.19c, you will note   LCR
                       that within each cluster, the order of globin genes on the   Deletion
                       chromosomes parallels the order of their expression during
                       development. Furthermore,  all  the genes in the α-globin
                       locus are oriented in the same direction relative to chromo-  have certain deletions extending across the β and δ genes
                       some 16; that is, they all use the same strand of DNA as the   (compare Fig. 10.20a and b). Because of these specific
                       template for transcription. The genes in the β-globin locus   deletions, the LCR can’t switch, as it normally would near
                       are also all oriented in the same direction, here relative to   the time of birth, from γ-globin production to β- and
                       chromosome 11. The organization of these globin-gene-  δ-globin production. People with this rare condition,
                       containing regions contrasts with most regions of the   called hereditary persistence of fetal hemoglobin, continue
                         genome, where adjacent genes appear to be oriented ran-  to produce large enough amounts of fetal γ-globin through-
                       domly. These  facts  taken  together  suggest that  whatever   out adulthood to maintain near-normal health.
                       mechanism turns the globin genes on and off during differ-
                       ent stages of development takes advantage of their relative
                         positions and orientations.                       Globin-Related Diseases Result from a
                          We now understand what that mechanism is: Each of
                       the two globin loci contains a  locus control region (or   Variety of Mutations
                       LCR) at one end that controls sequential gene expression   By comparing DNA sequences from affected individuals
                       from that locus (Fig. 10.11). The LCR at each locus is a col-  with those from healthy individuals, researchers have
                       lection of regulatory elements called enhancers that are dis-  learned that two general classes of disorders arise from
                       cussed in detail in Chapter 17. Through their interactions     alterations in the hemoglobin genes.
                       with proteins called  transcription factors, the enhancers   In one class, mutations change the amino acid  sequence
                         activate transcription of each gene in the right cells at the   and thus the three-dimensional structure of the α- or
                       appropriate time.                                   β-globin chain. These structural changes result in an altered
                          One interesting consequence of the β-globin locus’s   protein whose malfunction causes the destruction of red
                       organization and its control through the LCR is seen in a   blood cells. Diseases of this type are known as hemolytic
                       rare medical condition with a surprising prognosis. In   anemias. An example is sickle-cell anemia, caused by an
                       some adults, the red blood cell precursors express neither   A-to-T substitution in the sixth codon of the β-globin chain.
                       the β nor the δ genes. Although this should be a lethal situ-  This simple change in DNA sequence alters the sixth amino
                       ation, these adults remain healthy. Sequence analysis of   acid in the chain from glutamic acid to valine. Red blood
                       the β-globin locus from affected adults shows that they   cells carrying these altered molecules often have abnormal
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