Chapter 2 Peter S. Vickers To introduce the student to the fascinating and very important subject of genetics, so that a knowledge of genetics will enable them to understand many of the illnesses that have a genetic foundation. Fig. 2.1 provides an overview of the cell nucleus and DNA. Genetics is an increasingly important field of specialist healthcare about which all nurses need to have knowledge and understanding. Indeed, it is so important that many scientists and doctors are describing this present century as ‘the century of genetics’ as we learn more about the subject and are able to manipulate human, animal and plant genes in an attempt to eradicate disease and hunger. Clinical genetic services were first established in the United Kingdom in the 1950s, although services for affected families were very limited initially (Patch & Skirton, 2009). It is a very important subject for you to know and understand, because many health problems that you will meet in practice are linked to genes. Genes are subdivisions of DNA that are carried within chromosomes. These genes contain sets of instructions related to our bodies and how they function. Almost all the genes that we possess have been inherited from our parents (apart from any spontaneous mutations), who in turn inherited theirs from their parents, and so on. Here are some technical definitions that will help you to understand this chapter on genetics. The double helix was identified in the 1950s by James Watson and Francis Crick (Patch & Skirton, 2009). The double helix is made up of two strands of DNA and phosphate. It is a spiral‐shaped molecule, resembling a corkscrew ladder, whose rungs are pairs of bases. Within the double helix, the genetic information is encoded in a linear sequence of chemical subunits, called nucleotides (see Fig. 2.2). Deoxyribonucleotides consist of three molecules: The bases are those elements of the double helix that carry the genetic code. They are arranged in different sequences along the deoxyribose–phosphate strands of the double helix. Each deoxyribonucleotide comprises three parts: a nitrogenous base, a deoxyribose sugar, and one phosphate group. There are four different bases found in DNA, namely: The order in which the bases are organised along the length of the DNA molecule provides the variation that allows for the storage of genetic information. Look again at the drawing of the double helix; each strand carries different bases. These bases join together and make the molecule stable. However, these bases do not just pair off haphazardly; they can only pair up with bases that match them so that they will fit together (like jigsaw pieces). Because of this, the bases are limited as to which other base they will pair with, and there is a golden rule to remember with this pairing: So, if one half of the DNA has a base sequence AGGCAGTGC then the opposite side of the DNA will always have the complementary base sequence TCCGTCACG The bases join together by means of hydrogen/polar bonding, and the individual bases are connected to the deoxyribose of the strands by means of covalent bonds. This is important because hydrogen bonds are not as strong as covalent bonds, and thus can separate more easily. The importance of this will become apparent when DNA replication and protein synthesis are discussed (Jorde et al., 2015). A chromosome does not just consist of DNA. Rather, the nuclear DNA (known as nucleic acid) of cells is combined with protein molecules (known as histones). Together, the DNA and histones make up the nucleosomes contained within the cell nucleus. This nucleic acid–histone complex is known as chromatin. If we unravelled all the chromatin from every cell in a human adult body, its length would be equivalent to nearly 70 trips from the Earth to the Sun and back, and, on average, a single human chromosome consists of a DNA molecule that is almost 5 cm in length (Cell, 1966). We only manage to package that amount of DNA and histone molecules in our bodies because they are so neatly folded that they fit into each cell of the body. The chromatin cannot just be pushed into the cell haphazardly – it would never fit and there would be a high possibility of things going wrong (Vickers, 2011). Consequently, the chromosomes twist on one another before being arranged into loops and superloops, until they assume the shape that is recognisable as a chromosome – i.e., the X‐shape that can be seen in a human cell (Fig. 2.3) (Jorde et al., 2015). Each chromosome is made up of two chromatids joined by a centromere to make an ‘X’ shape. Each half of the chromosome is a chromatid, and where they join near the top of the X, that is the centromere (Fig. 2.3). In most humans, each nucleated body cell (i.e., each body cell with a nucleus) has 46 chromosomes, arranged in 23 pairs. Of those 23 pairs, one pair determines the gender of the person. These sex chromosomes are designated as X and Y chromosomes (all the others have numbers from 1 to 22), as can be seen in Fig. 2.4. One of each pair of a chromosome that we inherit comes from our mother and one comes from our father, and the position a gene occupies on a chromosome is called a locus. There are different loci for colour, height, hair, etc. Think of the locus as the address of that particular gene on Chromosome Street – just like your address signifies that that is where you live. Genes that occupy corresponding loci and code for the same characteristic are called alleles. Alleles are found at the same place in each of the two corresponding chromatids, and an allele determines an alternative form of the same characteristic, whether it be hair colour, eye colour, or propensity for certain diseases, and so forth. Example: Look at the colour of a person’s hair – the gene that determines hair colour is found at the same place on each of the two chromatids of one particular chromosome. One gene will come from the father and the other from the mother. If parents of a child have different coloured hair from each other – perhaps the mother has red hair and the father brown hair, the child may have red or brown hair, depending upon factors that will be discussed later in this chapter. This principle applies to each of a person’s characteristics, for example, eye colour, or height. A person with a pair of identical alleles for a particular gene locus is said to be homozygous for that gene, whilst someone with a dissimilar pair is said to be heterozygous for that gene. There are two other very important facts to mention about genes: some genes are ‘recessive’ and some genes are ‘dominant’. This is a very important concept to grasp because of the significance that it brings to bear on hereditary disorders. Returning to the biology of genetics, as was explained earlier in this chapter, nuclear acids are components of DNA and they have two major functions: Synthesis means ‘production’, for example, the production of protein from raw materials. All the genetic instructions for making proteins are found in DNA, but in order to synthesise these proteins, the genetic information encoded in the DNA has first to be translated into RNA and then into a protein. Initially, all of the genetic information in a region of DNA has to be copied in order to produce a specific molecule of RNA (ribonucleic acid). Then, through a complex series of procedures, the information contained in RNA is translated into a corresponding specific sequence of amino acids in a newly produced protein molecule. There are two parts to this procedure: transcription and translation. In transcription, the DNA has to be transcribed into RNA because protein cannot be synthesised (produced) directly from DNA. By using a specific portion of the cell’s DNA as a template, the genetic information stored in the sequence of bases of that DNA is rewritten so that the same information appears in the bases of RNA. To do this, the two strands of the DNA first have to separate (Fig. 2.5), and the bases that are attached to each strand then pair up with bases that are attached to strands of RNA. As with the two strands of DNA, the bases of DNA can only join up with a specific base of mRNA. As with DNA, guanine can only join up with cytosine in RNA, but in RNA, the adenine in DNA can only join to uracil (U) in the RNA, because there is no thymine in RNA: For example, Fig. 2.5 shows how the DNA separates and makes more DNA. This same process occurs during transcription, except that the new strand with its bases is RNA rather than DNA. Thus, DNA acts as a template for mRNA (Vickers, 2011). However, in addition to serving as the template for the synthesis of mRNA, DNA also synthesises two other kinds of RNA: rRNA and tRNA. Once ready, mRNA, rRNA and tRNA leave the nucleus of the cell and in the cytoplasm of the cell commence the next step in protein synthesis, namely translation (Fig. 2.6). It is during these stages of transcription, translation and protein synthesis that mistakes (mutations) can occur, due particularly to the extreme speed and complication of the processes. The mistakes can lead either to cell death or to a malfunctioning gene, which, in turn, can have varying effects on health and development. The effect on the body of these mutations depends on where they occur and whether they alter the function of essential proteins (US National Library of Medicine, 2016). The DNA sequence of a gene can be changed in several different ways, of which a few are discussed in the following sections. This occurs when there is a change in one DNA base pair, which leads to the replacement of one amino acid for another in the protein for which that gene is an important component. If, in the above gene sequence, one of the nucleotides is altered so that the sequence becomes: Then that change in the sequence causes that triplet to code for a different amino acid, and hence a different protein is formed. So the gene does not make sense – hence ‘missense’. An example of a genetic disorder caused by a missense mutation is sickle cell anaemia. When a nonsense mutation occurs, there is also a change in one DNA pair. However, rather than substituting one DNA base pair for another, this type of mutation sends a signal for the sequence to be prematurely concluded. This leads to a shortened protein which may, or may not, function properly, or even may not function at all. If, in the above gene sequence, one of the nucleotides is altered so that the sequence becomes: Then the sequence for this gene is altered in such a way that the production of the protein is terminated prematurely. The subsequent resulting shortened protein may not function as it should or may not even function at all. Cystic fibrosis is an example of a disease caused by a nonsense mutation. A deletion mutation occurs when the numbers of DNA bases are reduced by the removal of a piece of DNA. The resultant problems may occur as a result of just one or two base pairs within a gene or the removal of a complete gene or even several genes. When this occurs, the function of the resulting protein (or proteins) may be altered. 22q11.2 deletion syndrome is one such disease caused by this mutation. It is caused by the deletion of just a small section of chromosome 22. There are many health problems with this deletion mutation including cleft palate, heart defects, autoimmune disorders, to name just a few. The symptoms vary considerably from child to child, but they can also be accompanied by learning disabilities and mental illness. Other problems caused by genes occur following:
Genetics
Aim
The cell nucleus and DNA
Introduction
Genes
The double helix
Deoxyribonucleotides
Bases
Chromosomes
From DNA to proteins
Protein synthesis
Transcription
DNA
mRNA
guanine (G)
–
cytosine (C)
cytosine (C)
–
guanine (G)
thymine (T)
–
adenine (A)
adenine (A)
–
uracil (U)
Genetic mutations
Missense mutation
DNA bases
T A G
T T C
A G C
T A G
Amino acids
1
2
3
1
DNA bases
T A G
T G C
A G C
T A G
Amino acids
1
4
3
1
Nonsense mutation
DNA bases
T A G
T T C
A G C
T A G
Amino acids
1
2
3
1
DNA bases
T A G
T G C
A G C
T A T
Amino acids
1
2
3
end
Deletion