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GENETIC VARIATION AND
EVOLUTION AND THEIR
IMPORTANCE TO
MEDICINE
BY: DAVID OSAS ENOMA
1
OUTLINE
 INTRODUCTION
 EVOLUTION AND ITS APPLICATIONS
 GENETIC VARIATION
 SOURCES OF GENETIC VARIATION
 SIGNIFICANCE OF GENETIC VARIATION IN MEDICINE
 SINGLE NUCLEOTIDE POLYMORPHISMS
 PHARMACOGENOMICS
 APPLICATIONS OF GENETIC VARIATION
 GENETIC TESTING AND SCREENING
2
INTRODUCTION
 In the mid-19th century, Charles Darwin formulated the
scientific theory of evolution by natural selection,
published in his book On the Origin of Species (1859).
 The central concept of natural selection is the
evolutionary fitness of an organism.
 Fitness is measured by an organism's ability to survive
and reproduce.
3
INTRODUCTION CONTD.
 An evolutionary perspective challenges the prevalent
but fundamentally incorrect metaphor of the body as a
machine designed by an engineer.
 Understanding the body as a product of natural
selection, not design, offers new research questions and
a framework for making medical education more
coherent. (Nesse & Stearns, 2008)
4
INTRODUCTION CONTD.
 Genetic variation is the driving force of evolution.
(Arber, 2005).
 Evolutionary processes are generally thought of as
processes by which these changes occur.
 Four processes are widely recognized: natural
selection (in the broad sense, to include sexual
selection), genetic drift, mutation, and migration
(Scott‐Phillips et al., 2014)
5
INTRODUCTION CONTD.
 A complete genetic stability would not allow biological
evolution to occur, while a very high genetic instability
would not allow a concerned species to persist(Arber,
2005).
 Instead of phenomena as specific as acid–base
balance, evolution can help doctors make sense of
why a disease exists at all, what environments increase
the risk, and how treatments work (Nesse & Stearns,
2008).
6
EVOLUTIONARY RELATIONSHIP
OF PRIMATES
7
Figure 1: The hominoids are descendants of a
common ancestor.
Comparative studies
across ethnically
diverse human
populations and across
human and nonhuman
primate species is
important for
reconstructing human
evolutionary history
(Tishkoff & Verrelli,
2003)
EVOLUTIONARY QUESTIONS
8
APPLICATIONS OF EVOLUTION
TO MEDICINE
 Phylogenetics is the study of evolutionary relationships
among biological entities - often species, individuals or
genes (which may be referred to as taxa).
 Phylogenetic analysis also was used to falsify the
hypothesis that HIV was introduced into Africa via polio
vaccine.
 Rambaut et al. (2001) performed an evolutionary
analysis of HIV-1 subtypes from Congo.
9
APPLICATIONS OF EVOLUTION
TO MEDICINE CONTD.
 The analysis indicate that the common ancestor to
HIV-1 group M, which gave rise to the pandemic
strains, was present in a human host long before the
first OPV field trials were conducted in the Congo
during the late 1950s.
 Tracing pathogen phylogenies can be very useful.
Influenza phylogenies suggest which strains are likely
to spread in future epidemics (Smith, 2006).
10
APPLICATIONS OF EVOLUTION
TO MEDICINE CONTD.
 The complete genome sequence of the severely
pathogenic Shigella flexneri reveals that it is
phylogenetically indistinguishable from the Escherichia
coli that lives normally in the human gut (Wei et al.
2003).
 Applications of evolutionary biology to infectious
disease are also very direct.
 Antibiotic resistance is an arms race; we invent new
defenses, the enemy quickly finds ways around them,
and we try to find new defenses.
11
GENETIC VARIATION AS DRIVERS
OF MOLECULAR EVOLUTION
12
SOURCES OF GENETIC
VARIATION
 Random mutations are the ultimate source of genetic
variation.
 Polyploidy is an example of chromosomal mutation.
 Crossing over (genetic recombination) and random
segregation during meiosis can result in the production
of new alleles
 Variation and recombination can be facilitated by
transposable genetic elements, endogenous retroviruses,
transposons, etc.
13
SIGNIFICANCE OF GENETIC
VARIATION
14
IMPORTANCE OF GENETIC
VARIATION IN MEDICINE
 Specific gene-disease relationships (variations both
within and between groups in disease susceptibility or
resistance according to genotype).
 Gene-environment interactions—phenotypic variation
and pharmacogenetic implications.
 Complex genetic traits associated with specific aberrant
behavioral characteristics, such as aggressivity and
alcoholism;
15
IMPORTANCE OF GENETIC
VARIATION IN MEDICINE CONTD.
 Genetic factors linked to multivariate non-disease-related
characteristics, such as height, intelligence, and aging.
 Genotype associations—predisposition to particular
cancers, autoimmune disease, and other disorders.
 HLA and other immune-response-related genotypes in
diverse populations and their implications for
transplantation, vaccine development, and related
therapies.
16
GENETIC VARIATION IN
INDIVIDUALS AND POPULATION
 By characterizing genetic variation among individuals
and populations, we may gain a better understanding
of differential susceptibility to diseases.
 We may also gain better understanding of differential
responses to pharmacological agents and the complex
interaction of genetic and environmental factors in
producing phenotypes (Collins et al., 2003).
17
GENETIC VARIATION AND
RACISM
 Populations outside Africa derive from one or more
migration events out of Africa within the last 100,000
years.
 The greatest genetic variation occurs within Africans,
with variation outside Africa representing either a
subset of African diversity or newly arisen variants
(Risch et al., 2002).
 Racial and ethnic groups should not be assumed to be
equivalent, either in terms of disease risk or drug
response.
18
GENETIC VARIABILITY IN RACE
AND DISEASE RISK ASSOCIATION
 Furthermore, a 'race-neutral' approach to biomedical
research is neither equitable nor advantageous, and
would not lead to a reduction of disparities in disease risk
or treatment efficacy.
 Whether each race responds equally to a particular drug
is an empirical question that can only be addressed by
group study.
 Avoid naïve inferences about between racial/ethnic
groups
19
RACE AND GENETICS IN
MEDICINE
 Sickle-cell disease is much more common in African and
Mediterranean populations than in northern European
populations, whereas the reverse is true for cystic fibrosis
and hemochromatosis. (Jorde & Wooding, 2004)
 Ge et al. (2009) report that a genetic polymorphism near
the IL28B gene, encoding interferon-λ-3 (IFN-λ-3), is
associated with difference in response to treatment for
Hepatitis virus between African-Americans and patients of
European ancestry.
20
SINGLE NUCLEOTIDE
POLYMORPHISM
 Each of us is at some genetic risk, and therefore can
benefit, at least theoretically, from the progress
scientists are making in understanding and learning
how to respond to these risks.
 Single nucleotide polymorphism (SNP) is the most
common sequence variation
in coding and noncoding genomes in diverse taxa
across life from viruses and bacteria to humans (Nevo
and Beiles, 2011).
21
SINGLE NUCLEOTIDE
POLYMORPHISM CONTD.
 From the efforts of an international Single Nucleotide
Polymorphism (SNP) consortium, over six million SNPs
have currently been identified, ∼1every 1–2 kilobases (kb)
(http://www.ncbi.nlm.nih.gov/SNP/snp summary.cgi)
 For studies of demographic history, analysis of genetic
variation in noncoding regions (i.e., selectively neutral) will
be most informative.
22
MOLECULAR EVOLUTION OF FOXP2
GENE IN SPEECH
 A work has shown that that human FOXP2 contains
changes in amino-acid coding and a pattern of
nucleotide polymorphism, which strongly suggest that
this gene has been the target of selection during recent
human evolution. (Enard et al., 2002).
 FOXP2 is the first gene relevant to the human ability to
develop language.
23
SINGLE GENE DISORDERS OF
OBESITY
 Some of the single-gene disorders associated with
severe obesity are also characterized by drastic changes
in eating behavior.
 Obese patients with mutations in leptin (LEP),
melanocortin 4 receptor (MC4R), and neurotrophic
tyrosine kinase receptor type 2 (NTRK2) genes have
been also diagnosed with severe hyperphagia (Rankinen
& Bouchard, 2006)
24
RELEVANT SINGLE NUCLEOTIDE
POLYMORPHISMS
 For example, we already know that single base
differences in the APOE gene are associated with
Artherosclerosis and Alzheimer's disease.
 Also that a simple deletion within the chemokine-
receptor gene CCR5 leads to resistance to HIV and AIDS.
(Chakravarti, 2001).
 Evaluating the contributions of individual genes to
diseases that have a complex, multigene basis.
 And gene variants leading to tissue and organ
incompatibility
25
PHARMACOGENETICS OF DRUG
METAB. ENZYMES
26
WIDE ARRAY OF APPLICATION OF
GENETIC MAPPING IN HEALTH
27
GENETIC TESTING AND
SCREENING
 Genetic testing is not a new health care strategy.
Newborn screening for diseases like PKU has been
going on for 30 years in many states. Institutes of
Health (US), 2007)
 The identification of the BRCA1and BRCA2 genes and
variants of these genes are associated with an
increased risk of breast and ovarian cancer have paved
the way for the development of guidelines and
protocols.
28
CONCLUSION
 Advances in molecular biology, genetics, evolutionary
biology, omics technologies have endowed us with
powerful tools to answer important questions- Who we
are, Where we come from and Why we respond the way
we do.
 These questions have impacted the study of our
evolutionary history which has stimulated progress in
medicine.
29
REFERENCES
 Collins, F. S., Green, E. D., Guttmacher, A. E., & Guyer, M. S. (2003). A vision for
the future of genomics research. Nature, 422: 835. doi: 10.1038/nature01626
 Chakravarti, A. (2001). . . .to a future of genetic medicine. Nature, 409: 822.
doi: 10.1038/35057281
 National Research Council (US) Committee on Human Genome
Diversity.(1998). Evaluating Human Genetic Diversity: National Academies
Press. ISBN NO. 9780309184748Arber, W. (2005).
 The theory of molecular evolution and its medical implications. In R. Paton &
L. A. McNamara (Eds.), Studies in Multidisciplinarity (Vol. 3, pp. 31-45):
Elsevier. ISBN NO. 1571-0831
 Evolutionary processes are generally thought of as processes by which these
changes occur. Four such processes are widely recognized: natural selection
(in the broad sense, to include sexual selection), genetic drift, mutation, and
migration
30
REFERENCES
 Smith, D. J. 2006. Predictability and preparedness in influenza
control. Science312:392–394.
 Risch, N., Burchard, E., Ziv, E., & Tang, H. (2002). Categorization of humans in
biomedical research: genes, race and disease. Genome Biology, 3(7):
comment2007.2001-comment2007.2012.
 National Institutes of Health (US); Biological Sciences Curriculum Study. NIH
Curriculum Supplement Series [Internet]. Bethesda (MD): National Institutes of
Health (US); 2007. Understanding Human Genetic Variation. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK20363/
 Eviatar Nevo and Avigdor Beiles (2011) Genetic variation in nature. Scholarpedia,
6(7):8821.
 Rankinen, T., & Bouchard, C. (2006). Genetics of Food Intake and Eating Behavior
Phenotypes in Humans. Annual Review of Nutrition, 26(1): 413-434. doi:
10.1146/annurev.nutr.26.061505.111218
31
THANK YOU FOR
YOUR
ATTENTION
32

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Genetic variation and evolution and their importance to medicine

  • 1. GENETIC VARIATION AND EVOLUTION AND THEIR IMPORTANCE TO MEDICINE BY: DAVID OSAS ENOMA 1
  • 2. OUTLINE  INTRODUCTION  EVOLUTION AND ITS APPLICATIONS  GENETIC VARIATION  SOURCES OF GENETIC VARIATION  SIGNIFICANCE OF GENETIC VARIATION IN MEDICINE  SINGLE NUCLEOTIDE POLYMORPHISMS  PHARMACOGENOMICS  APPLICATIONS OF GENETIC VARIATION  GENETIC TESTING AND SCREENING 2
  • 3. INTRODUCTION  In the mid-19th century, Charles Darwin formulated the scientific theory of evolution by natural selection, published in his book On the Origin of Species (1859).  The central concept of natural selection is the evolutionary fitness of an organism.  Fitness is measured by an organism's ability to survive and reproduce. 3
  • 4. INTRODUCTION CONTD.  An evolutionary perspective challenges the prevalent but fundamentally incorrect metaphor of the body as a machine designed by an engineer.  Understanding the body as a product of natural selection, not design, offers new research questions and a framework for making medical education more coherent. (Nesse & Stearns, 2008) 4
  • 5. INTRODUCTION CONTD.  Genetic variation is the driving force of evolution. (Arber, 2005).  Evolutionary processes are generally thought of as processes by which these changes occur.  Four processes are widely recognized: natural selection (in the broad sense, to include sexual selection), genetic drift, mutation, and migration (Scott‐Phillips et al., 2014) 5
  • 6. INTRODUCTION CONTD.  A complete genetic stability would not allow biological evolution to occur, while a very high genetic instability would not allow a concerned species to persist(Arber, 2005).  Instead of phenomena as specific as acid–base balance, evolution can help doctors make sense of why a disease exists at all, what environments increase the risk, and how treatments work (Nesse & Stearns, 2008). 6
  • 7. EVOLUTIONARY RELATIONSHIP OF PRIMATES 7 Figure 1: The hominoids are descendants of a common ancestor. Comparative studies across ethnically diverse human populations and across human and nonhuman primate species is important for reconstructing human evolutionary history (Tishkoff & Verrelli, 2003)
  • 9. APPLICATIONS OF EVOLUTION TO MEDICINE  Phylogenetics is the study of evolutionary relationships among biological entities - often species, individuals or genes (which may be referred to as taxa).  Phylogenetic analysis also was used to falsify the hypothesis that HIV was introduced into Africa via polio vaccine.  Rambaut et al. (2001) performed an evolutionary analysis of HIV-1 subtypes from Congo. 9
  • 10. APPLICATIONS OF EVOLUTION TO MEDICINE CONTD.  The analysis indicate that the common ancestor to HIV-1 group M, which gave rise to the pandemic strains, was present in a human host long before the first OPV field trials were conducted in the Congo during the late 1950s.  Tracing pathogen phylogenies can be very useful. Influenza phylogenies suggest which strains are likely to spread in future epidemics (Smith, 2006). 10
  • 11. APPLICATIONS OF EVOLUTION TO MEDICINE CONTD.  The complete genome sequence of the severely pathogenic Shigella flexneri reveals that it is phylogenetically indistinguishable from the Escherichia coli that lives normally in the human gut (Wei et al. 2003).  Applications of evolutionary biology to infectious disease are also very direct.  Antibiotic resistance is an arms race; we invent new defenses, the enemy quickly finds ways around them, and we try to find new defenses. 11
  • 12. GENETIC VARIATION AS DRIVERS OF MOLECULAR EVOLUTION 12
  • 13. SOURCES OF GENETIC VARIATION  Random mutations are the ultimate source of genetic variation.  Polyploidy is an example of chromosomal mutation.  Crossing over (genetic recombination) and random segregation during meiosis can result in the production of new alleles  Variation and recombination can be facilitated by transposable genetic elements, endogenous retroviruses, transposons, etc. 13
  • 15. IMPORTANCE OF GENETIC VARIATION IN MEDICINE  Specific gene-disease relationships (variations both within and between groups in disease susceptibility or resistance according to genotype).  Gene-environment interactions—phenotypic variation and pharmacogenetic implications.  Complex genetic traits associated with specific aberrant behavioral characteristics, such as aggressivity and alcoholism; 15
  • 16. IMPORTANCE OF GENETIC VARIATION IN MEDICINE CONTD.  Genetic factors linked to multivariate non-disease-related characteristics, such as height, intelligence, and aging.  Genotype associations—predisposition to particular cancers, autoimmune disease, and other disorders.  HLA and other immune-response-related genotypes in diverse populations and their implications for transplantation, vaccine development, and related therapies. 16
  • 17. GENETIC VARIATION IN INDIVIDUALS AND POPULATION  By characterizing genetic variation among individuals and populations, we may gain a better understanding of differential susceptibility to diseases.  We may also gain better understanding of differential responses to pharmacological agents and the complex interaction of genetic and environmental factors in producing phenotypes (Collins et al., 2003). 17
  • 18. GENETIC VARIATION AND RACISM  Populations outside Africa derive from one or more migration events out of Africa within the last 100,000 years.  The greatest genetic variation occurs within Africans, with variation outside Africa representing either a subset of African diversity or newly arisen variants (Risch et al., 2002).  Racial and ethnic groups should not be assumed to be equivalent, either in terms of disease risk or drug response. 18
  • 19. GENETIC VARIABILITY IN RACE AND DISEASE RISK ASSOCIATION  Furthermore, a 'race-neutral' approach to biomedical research is neither equitable nor advantageous, and would not lead to a reduction of disparities in disease risk or treatment efficacy.  Whether each race responds equally to a particular drug is an empirical question that can only be addressed by group study.  Avoid naïve inferences about between racial/ethnic groups 19
  • 20. RACE AND GENETICS IN MEDICINE  Sickle-cell disease is much more common in African and Mediterranean populations than in northern European populations, whereas the reverse is true for cystic fibrosis and hemochromatosis. (Jorde & Wooding, 2004)  Ge et al. (2009) report that a genetic polymorphism near the IL28B gene, encoding interferon-λ-3 (IFN-λ-3), is associated with difference in response to treatment for Hepatitis virus between African-Americans and patients of European ancestry. 20
  • 21. SINGLE NUCLEOTIDE POLYMORPHISM  Each of us is at some genetic risk, and therefore can benefit, at least theoretically, from the progress scientists are making in understanding and learning how to respond to these risks.  Single nucleotide polymorphism (SNP) is the most common sequence variation in coding and noncoding genomes in diverse taxa across life from viruses and bacteria to humans (Nevo and Beiles, 2011). 21
  • 22. SINGLE NUCLEOTIDE POLYMORPHISM CONTD.  From the efforts of an international Single Nucleotide Polymorphism (SNP) consortium, over six million SNPs have currently been identified, ∼1every 1–2 kilobases (kb) (http://www.ncbi.nlm.nih.gov/SNP/snp summary.cgi)  For studies of demographic history, analysis of genetic variation in noncoding regions (i.e., selectively neutral) will be most informative. 22
  • 23. MOLECULAR EVOLUTION OF FOXP2 GENE IN SPEECH  A work has shown that that human FOXP2 contains changes in amino-acid coding and a pattern of nucleotide polymorphism, which strongly suggest that this gene has been the target of selection during recent human evolution. (Enard et al., 2002).  FOXP2 is the first gene relevant to the human ability to develop language. 23
  • 24. SINGLE GENE DISORDERS OF OBESITY  Some of the single-gene disorders associated with severe obesity are also characterized by drastic changes in eating behavior.  Obese patients with mutations in leptin (LEP), melanocortin 4 receptor (MC4R), and neurotrophic tyrosine kinase receptor type 2 (NTRK2) genes have been also diagnosed with severe hyperphagia (Rankinen & Bouchard, 2006) 24
  • 25. RELEVANT SINGLE NUCLEOTIDE POLYMORPHISMS  For example, we already know that single base differences in the APOE gene are associated with Artherosclerosis and Alzheimer's disease.  Also that a simple deletion within the chemokine- receptor gene CCR5 leads to resistance to HIV and AIDS. (Chakravarti, 2001).  Evaluating the contributions of individual genes to diseases that have a complex, multigene basis.  And gene variants leading to tissue and organ incompatibility 25
  • 27. WIDE ARRAY OF APPLICATION OF GENETIC MAPPING IN HEALTH 27
  • 28. GENETIC TESTING AND SCREENING  Genetic testing is not a new health care strategy. Newborn screening for diseases like PKU has been going on for 30 years in many states. Institutes of Health (US), 2007)  The identification of the BRCA1and BRCA2 genes and variants of these genes are associated with an increased risk of breast and ovarian cancer have paved the way for the development of guidelines and protocols. 28
  • 29. CONCLUSION  Advances in molecular biology, genetics, evolutionary biology, omics technologies have endowed us with powerful tools to answer important questions- Who we are, Where we come from and Why we respond the way we do.  These questions have impacted the study of our evolutionary history which has stimulated progress in medicine. 29
  • 30. REFERENCES  Collins, F. S., Green, E. D., Guttmacher, A. E., & Guyer, M. S. (2003). A vision for the future of genomics research. Nature, 422: 835. doi: 10.1038/nature01626  Chakravarti, A. (2001). . . .to a future of genetic medicine. Nature, 409: 822. doi: 10.1038/35057281  National Research Council (US) Committee on Human Genome Diversity.(1998). Evaluating Human Genetic Diversity: National Academies Press. ISBN NO. 9780309184748Arber, W. (2005).  The theory of molecular evolution and its medical implications. In R. Paton & L. A. McNamara (Eds.), Studies in Multidisciplinarity (Vol. 3, pp. 31-45): Elsevier. ISBN NO. 1571-0831  Evolutionary processes are generally thought of as processes by which these changes occur. Four such processes are widely recognized: natural selection (in the broad sense, to include sexual selection), genetic drift, mutation, and migration 30
  • 31. REFERENCES  Smith, D. J. 2006. Predictability and preparedness in influenza control. Science312:392–394.  Risch, N., Burchard, E., Ziv, E., & Tang, H. (2002). Categorization of humans in biomedical research: genes, race and disease. Genome Biology, 3(7): comment2007.2001-comment2007.2012.  National Institutes of Health (US); Biological Sciences Curriculum Study. NIH Curriculum Supplement Series [Internet]. Bethesda (MD): National Institutes of Health (US); 2007. Understanding Human Genetic Variation. Available from: https://www.ncbi.nlm.nih.gov/books/NBK20363/  Eviatar Nevo and Avigdor Beiles (2011) Genetic variation in nature. Scholarpedia, 6(7):8821.  Rankinen, T., & Bouchard, C. (2006). Genetics of Food Intake and Eating Behavior Phenotypes in Humans. Annual Review of Nutrition, 26(1): 413-434. doi: 10.1146/annurev.nutr.26.061505.111218 31