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Genetic heterogeneity occurs through the production of single or similar phenotypes through different genetic mechanisms. There are two types of genetic heterogeneity:
allelic heterogeneity Allelic heterogeneity is the phenomenon in which different mutations at the same locus lead to the same or very similar phenotypes. These allelic variations can arise as a result of natural selection processes, as a result of exogenous mutagens ...
, which occurs when a similar phenotype is produced by different alleles within the same gene; and ''locus'' heterogeneity, which occurs when a similar phenotype is produced by mutations at different ''loci''.


Role in medical disorders

Marked genetic heterogeneity is correlated to multiple levels of causation in many common human diseases including
cystic fibrosis Cystic fibrosis (CF) is a rare genetic disorder that affects mostly the lungs, but also the pancreas, liver, kidneys, and intestine. Long-term issues include difficulty breathing and coughing up mucus as a result of frequent lung infections. Ot ...
,
Alzheimer's disease Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As ...
, autism spectrum disorders, inherited predisposition to
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or ...
, and non-syndromic hearing loss. These levels of causation are complex and occur through: (1) rare, individual mutations that when combined contribute to the development of common diseases; (2) the accumulation of many different rare, individual mutations within the same gene that contribute to the development of the same common disease within different individuals; (3) the accumulation of many different rare, individual mutations within the same gene that contribute to the development of ''different phenotypic variations'' of the same common disease within different individuals; and (4) the development of the same common disease in different individuals through different mutations.
Increased understanding of the role of genetic heterogeneity and the mechanisms through which it produces common disease phenotypes will facilitate the development of effective prevention and treatment methods for these diseases.


Cystic Fibrosis

Cystic fibrosis Cystic fibrosis (CF) is a rare genetic disorder that affects mostly the lungs, but also the pancreas, liver, kidneys, and intestine. Long-term issues include difficulty breathing and coughing up mucus as a result of frequent lung infections. Ot ...
is an inherited autosomal recessive genetic disorder that occurs through a mutation in a single gene that codes for the
cystic fibrosis transmembrane conductance regulator Cystic fibrosis transmembrane conductance regulator (CFTR) is a membrane protein and anion channel in vertebrates that is encoded by the ''CFTR'' gene. Geneticist Lap-Chee Tsui and his team identified the CFTR gene in 1989 as the gene linked wi ...
. Research has identified over 2,000 cystic fibrosis associated mutations in the gene encoding for the cystic fibrosis transmembrane conductance regulator at varying degrees of frequency within the disease carrying population. These mutations also produce varying degrees of disease phenotypes, and may also work in combinations to produce additive phenotypic effects.


Alzheimer's disease

Alzheimer's disease Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As ...
is a complicated neurodegenerative disorder with multiple phenotypic subtypes, including clinical and preclinical, that result from different genetic origins. Current research on the amyloid cascade hypothesis has identified rare mutations in three genes that encode the amyloid precursor protein (''APP''), presenilin 1 (''PS-1''), and presenilin 2 (''PS-2'') that cause the autosomal dominant, early-onset form of familial Alzheimer's disease. Research has also discovered the association of a fourth allele, apolipoprotein E4 (''ApoE4''), in the development of late-onset and sporadic forms of the disease, although the pathology of its role is still largely unknown.


Autism spectrum disorders

Autism spectrum disorders are among the most highly heritable psychiatric disorders and display high levels of phenotypic variability. Disorders on the Autism spectrum have high levels of genetic heterogeneity and result from multiple genetic pathways including single gene mutation disorders (such as
Fragile X Syndrome Fragile X syndrome (FXS) is a genetic disorder characterized by mild-to-moderate intellectual disability. The average IQ in males with FXS is under 55, while about two thirds of affected females are intellectually disabled. Physical features ma ...
), regional and submicroscopic variations in the number of gene copies (either heritable or de novo), rare and common genetic variants, and chromosomal aberrations.


Inherited predisposition to breast cancer

Mutations in ten different genes have been found to contribute to a heritable increased risk of breast cancer and other cancer syndromes. These genes, when functional, contribute to a pathway that serves to preserve genomic integrity. Mutations in
BRCA1 Breast cancer type 1 susceptibility protein is a protein that in humans is encoded by the ''BRCA1'' () gene. Orthologs are common in other vertebrate species, whereas invertebrate genomes may encode a more distantly related gene. ''BRCA1'' is a ...
and
BRCA2 ''BRCA2'' and BRCA2 () are a human gene and its protein product, respectively. The official symbol (BRCA2, italic for the gene, nonitalic for the protein) and the official name (originally breast cancer 2; currently BRCA2, DNA repair associated) ...
result in a high risk of both breast and ovarian cancers. Mutations in ''p53'' and ''PTEN'' increase risks of breast cancer associated with rare cancer syndromes. Mutations in ''CHECK2'', ''ATM'', ''NBS1'', ''RAD50'', ''BRIP1'', and ''PALB2'' can double the risk of breast cancer development. Biallelic mutations, in which both copies of a particular gene are mutated, in BRCA2, BRIP1, and PALB2 also cause
Fanconi anemia Fanconi anaemia (FA) is a rare genetic disease resulting in impaired response to DNA damage. Although it is a very rare disorder, study of this and other bone marrow failure syndromes has improved scientific understanding of the mechanisms of no ...
, a recessive syndrome that leads to progressive bone marrow failure.


Non-syndromic hearing loss

Non-syndromic hearing loss can occur through multiple pathways including
autosomal dominant 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 ...
,
autosomal 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 an ...
,
X-linked Sex linked describes the sex-specific patterns of inheritance and presentation when a gene mutation (allele) is present on a sex chromosome (allosome) rather than a non-sex chromosome (autosome). In humans, these are termed X-linked recessive, ...
, and
Y-linked Y linkage, also known as holandric inheritance (from Ancient Greek ὅλος ''hólos'', "whole" + ἀνδρός ''andrós'', "male"), describes traits that are produced by genes located on the Y chromosome. It is a form of sex linkage. Y&nbs ...
inheritance patterns. 69 genes and 145 loci have been discovered to be involved in the genetic heterogeneity of non-syndromic hearing loss, and the phenotype of the disorder is largely associated with its pattern of inheritance.


Studying genetic heterogeneity

Initial research on genetic heterogeneity was conducted using genetic linkage analyses, which map genetic loci of related individuals to identify genomic differences. Current research now relies largely on genome-wide association studies which examine the association of
single-nucleotide polymorphisms In genetics, a single-nucleotide polymorphism (SNP ; plural SNPs ) is a germline substitution of a single nucleotide at a specific position in the genome. Although certain definitions require the substitution to be present in a sufficiently larg ...
(SNPs) to a particular disease in a population.


References

{{reflist Classical genetics