Finnish Heritage Disease
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A Finnish heritage disease is a genetic disease or disorder that is significantly more common in people whose ancestors were ethnic
Finns Finns or Finnish people ( fi, suomalaiset, ) are a Baltic Finnic ethnic group native to Finland. Finns are traditionally divided into smaller regional groups that span several countries adjacent to Finland, both those who are native to these ...
, natives of
Finland Finland ( fi, Suomi ; sv, Finland ), officially the Republic of Finland (; ), is a Nordic country in Northern Europe. It shares land borders with Sweden to the northwest, Norway to the north, and Russia to the east, with the Gulf of B ...
and Sweden ( Meänmaa) and
Russia Russia (, , ), or the Russian Federation, is a transcontinental country spanning Eastern Europe and Northern Asia. It is the largest country in the world, with its internationally recognised territory covering , and encompassing one-eig ...
( Karelia and
Ingria Ingria is a historical region in what is now northwestern European Russia. It lies along the southeastern shore of the Gulf of Finland, bordered by Lake Ladoga on the Karelian Isthmus in the north and by the River Narva on the border with Esto ...
). There are 36
rare disease A rare disease is any disease that affects a small percentage of the population. In some parts of the world, an orphan disease is a rare disease whose rarity means there is a lack of a market large enough to gain support and resources for discov ...
s regarded as Finnish heritage diseases. The diseases are not restricted to Finns; they are genetic diseases with far wider distribution in the world, but due to founder effects and genetic isolation they are more common in Finns. Within
Finland Finland ( fi, Suomi ; sv, Finland ), officially the Republic of Finland (; ), is a Nordic country in Northern Europe. It shares land borders with Sweden to the northwest, Norway to the north, and Russia to the east, with the Gulf of B ...
these diseases are more common in the east and north, consistent with their higher association with ethnic Finns than with ethnic Swedes. The Finnish disease heritage does not extend to other ethnic groups in the region, the
Sámi The Sámi ( ; also spelled Sami or Saami) are a Finno-Ugric-speaking people inhabiting the region of Sápmi (formerly known as Lapland), which today encompasses large northern parts of Norway, Sweden, Finland, and of the Murmansk Oblast, Ru ...
and
Karelians Karelians ( krl, karjalaižet, karjalazet, karjalaiset, Finnish: , sv, kareler, karelare, russian: Карелы) are a Finnic ethnic group who are indigenous to the historical region of Karelia, which is today split between Finland and Russi ...
other than Finnish Karelians. It is attributed to a population bottleneck among ancestors of modern Finns, estimated to have occurred about 4000 years ago, presumably when populations practicing agriculture and animal husbandry arrived in Finland. In Finland about one in five persons carries a gene defect associated with at least one Finnish heritage disease, and about one in 500 children born is affected. Most of the gene defects are
autosomal An autosome is any chromosome that is not a sex chromosome. The members of an autosome pair in a diploid cell have the same morphology, unlike those in allosomal (sex chromosome) pairs, which may have different structures. The DNA in autosom ...
recessive In genetics, dominance is the phenomenon of one variant (allele) of a gene on a chromosome masking or overriding the effect of a different variant of the same gene on the other copy of the chromosome. The first variant is termed dominant and t ...
s, so that if both the mother and father carry the same defect, the chance that their child will have the associated disease is 1 in 4. The
molecular genetics Molecular genetics is a sub-field of biology that addresses how differences in the structures or expression of DNA molecules manifests as variation among organisms. Molecular genetics often applies an "investigative approach" to determine the ...
of many of these diseases have been determined, enabling genetic testing,
prenatal testing Prenatal testing consists of prenatal screening and prenatal diagnosis, which are aspects of prenatal care that focus on detecting problems with the pregnancy as early as possible. These may be anatomic and physiologic problems with the health o ...
, and counseling. This has raised questions of
bioethics Bioethics is both a field of study and professional practice, interested in ethical issues related to health (primarily focused on the human, but also increasingly includes animal ethics), including those emerging from advances in biology, m ...
and
eugenics Eugenics ( ; ) is a fringe set of beliefs and practices that aim to improve the genetic quality of a human population. Historically, eugenicists have attempted to alter human gene pools by excluding people and groups judged to be inferior o ...
.


Finnish heritage disease types

There are 36 identified Finnish heritage diseases: * Amyloidosis, Finnish type * Lethal arthrogryposis with anterior horn cell disease *
Aspartylglucosaminuria Aspartylglucosaminuria (AGU) is an inherited disease that is characterized by a decline in mental functioning, accompanied by an increase in skin, bone and joint issues. The disease is caused by a defect in an enzyme known as aspartylglucosaminid ...
* Autoimmune polyendocrinopathy syndrome, type I, with or without reversible metaphyseal dysplasia *
Cartilage–hair hypoplasia Cartilage–hair hypoplasia (CHH) is a rare genetic disorder. Symptoms may include short-limbed dwarfism due to skeletal dysplasia, variable level of immunodeficiency, and predisposition to cancer. It was first reported by Victor McKusick in 196 ...
*
Ceroid lipofuscinosis, neuronal Neuronal ceroid lipofuscinosis is the general name for a family of at least eight genetically separate neurodegenerative lysosomal storage diseases that result from excessive accumulation of lipopigments ( lipofuscin) in the body's tissues. These ...
, 1 * Ceroid lipofuscinosis, neuronal, 3 *
Ceroid lipofuscinosis, neuronal Neuronal ceroid lipofuscinosis is the general name for a family of at least eight genetically separate neurodegenerative lysosomal storage diseases that result from excessive accumulation of lipopigments ( lipofuscin) in the body's tissues. These ...
, 5 * Ceroid lipofuscinosis, neuronal, 8, Northern epilepsy variant (Synonyms: Northern epilepsy; Epilepsy, progressive, with intellectual disability) *
Choroideremia Choroideremia (; CHM) is a rare, X-linked recessive form of hereditary retinal degeneration that affects roughly 1 in 50,000 males. The disease causes a gradual loss of vision, starting with childhood night blindness, followed by peripheral vision ...
* Cohen syndrome * Cornea plana 2 * Diarrhea 1, secretory chloride, congenital *
Diastrophic dysplasia Diastrophic dysplasia is an autosomal recessive dysplasia which affects cartilage and bone development. ("Diastrophism" is a general word referring to a twisting.) Diastrophic dysplasia is due to mutations in the ''SLC26A2'' gene. Affected indivi ...
* Epilepsy, progressive myoclonic 1A ( Unverricht–Lundborg) *
Glycine encephalopathy Glycine encephalopathy is a rare autosomal recessive disorder of glycine metabolism. After phenylketonuria, glycine encephalopathy is the second most common disorder of amino acid metabolism. The disease is caused by defects in the glycine cleava ...
(Nonketotic hyperglycinemia) *
GRACILE syndrome GRACILE syndrome is a very rare lethal autosomal recessive genetic disorder, one of the Finnish heritage diseases. GRACILE syndrome has also been found in the UK and Sweden, but not nearly as much as in Finland. It is caused by a mutation in the '' ...
* Gyrate atrophy of choroid and retina *
Hydrolethalus syndrome Hydrolethalus syndrome (HLS) is a rare genetic disorder that causes improper fetal development, resulting in birth defects and, most commonly, stillbirth. HLS is associated with HYLS1 mutations. The gene encoding HYLS1 is responsible for proper ci ...
1 * Infantile-onset spinocerebellar ataxia ( Mitochondrial DNA depletion syndrome 7) * Lactase deficiency, congenital * Lethal congenital contracture syndrome 1 * Lysinuric protein intolerance * Meckel syndrome *
Megaloblastic anemia Megaloblastic anemia is a type of macrocytic anemia. An anemia is a red blood cell defect that can lead to an undersupply of oxygen. Megaloblastic anemia results from inhibition of DNA synthesis during red blood cell production. When DNA synth ...
-1, Finnish and Norwegian type * Mulibrey nanism * Muscular dystrophy-dystroglycanopathy (congenital with brain and eye anomalies), type A, 3 * Nephrotic syndrome, type 1 (Finnish congenital nephrosis) * Ovarian dysgenesis 1 *
Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy Nasu–Hakola disease also known as polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy is a rare disease characterised by early-onset dementia and multifocal bone cysts. It is caused by autosomal recessive loss of functi ...
(Nasu–Hakola disease) * Progressive encephalopathy with Edema, Hypsarrhythmia and Optic atrophy * RAPADILINO syndrome * Retinoschisis 1, X-linked, juvenile * Sialuria, Finnish type (Salla disease) * Tibial muscular dystrophy, tardive *
Usher syndrome Usher syndrome, also known as Hallgren syndrome, Usher–Hallgren syndrome, retinitis pigmentosa–dysacusis syndrome or dystrophia retinae dysacusis syndrome, is a rare genetic disorder caused by a mutation in any one of at least 11 genes result ...
, type 3A Out of these, three are rare causes of dwarfism:
cartilage–hair hypoplasia Cartilage–hair hypoplasia (CHH) is a rare genetic disorder. Symptoms may include short-limbed dwarfism due to skeletal dysplasia, variable level of immunodeficiency, and predisposition to cancer. It was first reported by Victor McKusick in 196 ...
,
diastrophic dysplasia Diastrophic dysplasia is an autosomal recessive dysplasia which affects cartilage and bone development. ("Diastrophism" is a general word referring to a twisting.) Diastrophic dysplasia is due to mutations in the ''SLC26A2'' gene. Affected indivi ...
and Mulibrey nanism. Four genetically distinct subtypes of
neuronal ceroid lipofuscinosis Neuronal ceroid lipofuscinosis is the general name for a family of at least eight genetically separate neurodegenerative lysosomal storage diseases that result from excessive accumulation of lipopigments ( lipofuscin) in the body's tissues. These ...
are found in the Finnish heritage: CLN1,
CLN3 G1/S-specific cyclin Cln3 is a protein that is encoded by the ''CLN3'' gene. The Cln3 protein is a budding yeast G1 cyclin that controls the timing of ''Start'', the point of commitment to a mitotic cell cycle. It is an upstream regulator of t ...
,
CLN5 Ceroid-lipofuscinosis neuronal protein 5 is a protein that in humans is encoded by the ''CLN5'' gene. The neuronal ceroid lipofuscinoses (CLN or NCL) are a group of autosomal recessive, progressive encephalopathies in children. They are characte ...
, and
CLN8 Protein CLN8 is a protein that in humans is encoded by the ''CLN8'' gene. Molecular biology This gene encodes a transmembrane protein that localizes to the endoplasmic reticulum (ER) and recycles between the ER and the Golgi apparatus via COPII- ...
. page 125 Names for conditions associated with these subtypes include infantile neuronal ceroid lipofuscinosis, Jansky–Bielschowsky disease and northern epilepsy syndrome. As of 2001, CLN5 and CLN8 had been reported almost exclusively in Finland. Meckel syndrome type 1 ( MKS1), a lethal condition, is known in 48 Finnish families.


Other genetic diseases

The European Organization for Rare Diseases (EURORDIS) estimates that there are between 5,000 and 7,000 distinct rare diseases, affecting between 6% and 8% of the population of the
European Union The European Union (EU) is a supranational political and economic union of member states that are located primarily in Europe. The union has a total area of and an estimated total population of about 447million. The EU has often been de ...
. The majority of genetic diseases reported in Finland are not part of the Finnish disease heritage and their prevalence is not higher in Finland than worldwide. Some genetic diseases are disproportionately rare in Finns. These include cystic fibrosis and
phenylketonuria Phenylketonuria (PKU) is an inborn error of metabolism that results in decreased metabolism of the amino acid phenylalanine. Untreated PKU can lead to intellectual disability, seizures, behavioral problems, and mental disorders. It may also re ...
. In Finland, about 1 in 80 persons are carriers of a cystic fibrosis mutation, compared with an average of 1 in 25 elsewhere in Europe.


Genetic history

Based on molecular data, a population bottleneck among ancestors of modern Finns is estimated to have occurred about 4000 years ago. This bottleneck resulted in exceptionally low diversity in the
Y chromosome The Y chromosome is one of two sex chromosomes (allosomes) in therian mammals, including humans, and many other animals. The other is the X chromosome. Y is normally the sex-determining chromosome in many species, since it is the presence or abse ...
, estimated to reflect the survival of just two ancestral male lineages. The distribution of Y chromosome haplotypes within Finland is consistent with two separate founding settlements, in eastern and western Finland. The Finnish disease heritage has been attributed to this 4000-year-old bottleneck. The geographic distribution and family pedigrees associated with some Finnish heritage disease mutations has linked the enrichment in these mutations to multiple local founder effects, some associated with a period of "late settlement" in the 16th century (see History of Finland).


Etymology

Although the concept is older, the
English English usually refers to: * English language * English people English may also refer to: Peoples, culture, and language * ''English'', an adjective for something of, from, or related to England ** English national ide ...
term "Finnish disease heritage" first appears in the medical literature in the 1990s. One of the earliest uses is in the translated title of a 1994 medical article, soon followed by others.


See also

*
Leena Peltonen-Palotie Leena Peltonen-Palotie (16 June 1952 – 11 March 2010) was a Finnish geneticist who contributed to the identification of 15 genes for Finnish heritage diseases, including arterial hypertension, schizophrenia, lactose intolerance, arthrosis ...
*
Nine diseases In Finnish mythology, the Nine diseases are the sons of Loviatar, the blind daughter of Tuoni. She is impregnated by wind (some versions of the story tell that Iku-Turso fathered them). According to the version told in the Kalevala they are ''Pistos ...
*
Population genetics Population genetics is a subfield of genetics that deals with genetic differences within and between populations, and is a part of evolutionary biology. Studies in this branch of biology examine such phenomena as Adaptation (biology), adaptation, ...
* BCG disease outbreak in Finland in the 2000s * Medical genetics of Ashkenazi Jews * Finnish Association on Intellectual and Developmental Disabilities (FAIDD) * Finno-Ugrian suicide hypothesis


References

{{DEFAULTSORT:Finnish Heritage Disease Rare diseases Autosomal recessive disorders Health in Finland