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Human Genetic Disorders - Mendelian Disorders in Humans

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Estimated time: 24 minutes
CBSE: Class 12
CISCE: Class 12

Introduction

Mendelian disorders are genetic disorders caused by mutations or alterations in a single gene (monogenic disorders). They follow the classical Mendelian patterns of inheritance - autosomal dominant, autosomal recessive, or sex-linked - and can be traced through family pedigrees.​

Key Characteristics:

  • Caused by alteration/mutation in one gene locus​
  • Can be identified by pedigree analysis of family history​
  • Either inherited from one or both parents or arise due to new mutations​
  • Relatively rare - may affect one in every thousand or million individuals​
CBSE: Class 12
CISCE: Class 12

Classification of Mendelian Disorders

CBSE: Class 12
CISCE: Class 12

Autosomal Recessive Disorders: Sickle-Cell Anaemia

An autosomal recessive blood disorder caused by a point mutation in the β-globin gene, leading to structurally abnormal haemoglobin (HbS) and sickle-shaped red blood cells.

Micrograph of the red blood cells and the amino acid composition of the relevant portion of β-chain of haemoglobin: (a) From a normal individual; (b) From an individual with sickle-cell anaemia

Gene & Chromosome:

  • Gene: HBB (β-globin gene) on Chromosome 11 (short arm)​
  • Alleles: HbA (normal) and HbS (mutant)

Molecular Mechanism:

Level Normal Mutant (Sickle-cell)
DNA (codon) GAG GTG (or GUG at mRNA level)
mRNA codon GAG GUG
Amino acid (Position 6, β-chain) Glutamic acid (polar, hydrophilic) Valine (non-polar, hydrophobic)
Haemoglobin HbA (normal) HbS (defective)

Genotypes & Phenotypes:

Genotype Condition Phenotype
HbA HbA Normal Normal RBCs
HbA HbS Carrier (Sickle-cell Trait) Mostly normal, mild anaemia under stress
HbS HbS Affected (Sickle-cell Disease) Severe anaemia, sickle-shaped RBCs

Pathophysiology:

  • Under low oxygen conditions, HbS molecules polymerise due to hydrophobic valine forming tactoids (crystalline structures)​
  • Tactoids distort RBCs into crescent/sickle shapes
  • Sickled RBCs adhere to blood vessel walls → vaso-occlusion → tissue damage​
  • Sickled RBCs are fragile → rupture → haemolytic anaemia​
CBSE: Class 12
CISCE: Class 12

Autosomal Recessive Disorders: Phenylketonuria (PKU)

An autosomal recessive inborn error of metabolism caused by a deficiency of the enzyme phenylalanine hydroxylase (PAH), leading to the accumulation of phenylalanine and its toxic derivatives.

Gene & Chromosome:

  • Gene: PAH on Chromosome 12q (long arm)​
  • PAH enzyme deficiency accounts for ~95% of PKU cases​

Mechanism:

 

Key Features:

  • Mental retardation, if untreated
  • Reduced hair and skin pigmentation (less tyrosine → less melanin)​
  • Phenylpyruvate and phenylacetate are excreted in urine​
  • Ferric chloride test → green discolouration of urine (diagnostic)​
  • Newborn screening (Guthrie test / Tandem Mass Spectrometry within 24–48 hours of birth) allows early dietary intervention​
CBSE: Class 12
CISCE: Class 12

Autosomal Recessive Disorders: Thalassaemia

An autosomal recessive blood disorder characterised by reduced synthesis (quantitative defect) of α or β globin chains of haemoglobin, resulting in severe anaemia.​

Gene & Chromosome:

  • α-Thalassaemia → mutations in HBA1 and HBA2 genes on Chromosome 16​
  • β-Thalassaemia → mutations in HBB gene on Chromosome 11​

Types Comparison:

Type Affected Chain Gene Locus Key Feature
α-Thalassaemia α-globin chain HBA1, HBA2 (Chr 16) Deletions common; severity varies by number of deleted genes
β-Thalassaemia β-globin chain HBB (Chr 11) Point mutations; β-Thalassaemia Major (Cooley's anaemia) is most severe

Symptoms: Severe anaemia, bone deformities, facial deformities, enlarged spleen/liver, jaundice, poor growth​.
Treatment: Regular blood transfusions, bone marrow transplant in severe cases.

CBSE: Class 12
CISCE: Class 12

Autosomal Recessive Disorders: Albinism

An autosomal recessive disorder characterised by the absence of melanin in skin, hair, and eyes due to non-functional or absent tyrosinase enzyme.

Gene & Chromosome:

  • TYR gene on Chromosome 11q14 (tyrosinase gene) for OCA type 1​
  • Inheritance: Autosomal recessive - sex of individual does NOT affect occurrence

Mechanism:

Key Features:

  • Very pale/white skin, hair, and eyes​
  • Photosensitivity - high risk of sunburn and skin cancer​
  • Vision problems - lack of melanin in retina​
  • Carriers (Aa) are normal in appearance; only aa individuals are affected​
  • Real-Life Note: Approximately 1 in 20,000 people globally are affected by oculocutaneous albinism (OCA)
CBSE: Class 12
CISCE: Class 12

X-Linked Recessive Disorders: Haemophilia

An X-linked recessive disorder in which blood clotting is impaired due to a deficiency of clotting factors (Factor VIII in Haemophilia A; Factor IX in Haemophilia B).​

Gene & Chromosome:

  • Gene located on the X chromosome (sex chromosome)
  • Males (XY): Only one X → if defective, disease manifests (hemizygous)
  • Females (XX): Need two defective copies to be affected; one copy = carrier

Genotype Table:

Genotype Individual Status
XH XH Female Normal
XH Xh Female Carrier (normal phenotype)
Xh Xh Female Affected (very rare)
XH Y Male Normal
Xh Y Male Affected (haemophilic)

Key Features:

  • Prolonged / uncontrolled bleeding even from minor cuts​
  • Internal bleeding in joints (haemarthrosis) is common​
  • Transmitted from carrier mother to son (criss-cross inheritance)​
  • Haemophilic father → all daughters are carriers; all sons are normal (if mother is normal)
CBSE: Class 12
CISCE: Class 12

X-Linked Recessive Disorders: Colour Blindness

An X-linked recessive disorder in which the individual cannot distinguish between red and green colours, due to defective or absent cone pigments in the retina.​

Gene & Chromosome:

  • Genes for red-sensitive (OPN1LW) and green-sensitive (OPN1MW) cone pigments on X chromosome​
  • Dominant allele X^C → normal vision; Recessive allele X^c → colour blind

Key Features:

  • Affected individuals see red and green as shades of grey​
  • Approximately 8% of males and 0.4% of females are colour blind (higher in males because males are hemizygous)​
  • Shows criss-cross inheritance: colour-blind father passes the trait to all daughters (as carriers), not to sons​

Cross: Carrier Female × Normal Male

CBSE: Class 12
CISCE: Class 12

Key Points: Mendelian Disorders in Humans

Disorder Inheritance Type Chromosome Involved Main Defect Key Features
Haemophilia X-linked recessive X-chromosome Defective blood-clotting protein Excessive bleeding from minor cuts; mainly affects males
Colour Blindness X-linked recessive X-chromosome Defect in red/green cone pigments Inability to distinguish red and green colours
Sickle-Cell Anaemia Autosomal recessive Autosome (Chr 11) Valine replaces glutamic acid in β-globin Sickle-shaped RBCs, anaemia, reduced oxygen transport
Phenylketonuria (PKU) Autosomal recessive Autosome Lack of enzyme converting phenylalanine to tyrosine Mental retardation due to phenylalanine accumulation
Thalassaemia Autosomal recessive Autosomes (Chr 11 / 16) Reduced synthesis of α or β globin chains Severe anaemia, fragile RBCs
Albinism Autosomal recessive Autosome Absence of tyrosinase enzyme → no melanin Very pale skin, hair and eyes; sun sensitivity
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