Types of Mutation
Types of Mutation
Types of Mutation
In a few genetic diseases, all affected individuals have the same mutation. In sickle cell
disease, for example, all mutant genes have a single base substitution, changing the sixth
codon of the beta-globin gene from GAG to GTG, resulting in the substitution of valine for
glutamic acid. In Huntington disease, all affected individuals have an expansion of a CAG
trinucleotide repeat expansion. The majority of mendelian disorders are, however, due to
many different mutations in a single gene. In some cases, one or more mutations are
particularly frequent. In cystic fibrosis, for example, over 700 mutations have been described,
but one particular mutation, _F508, accounts for about 70% of all cases in northern
Europeans. In many conditions, the range of mutations observed is very variable. In DMD,
for example, mutations include deletions, duplications and point mutations.
Deletions
Large gene deletions are the causal mutations in several disorders including thalassaemia,
haemophilia A and Duchenne muscular dystrophy. In some cases the entire gene is deleted,
as in -thalassaemia; in others, there is only a partial gene deletion, as in Duchenne muscular
dystrophy.
Duplications and insertions
Pathological duplication mutations are observed in some disorders. In Duchenne muscular
dystrophy, 510% of mutations are due to duplication of exons within the dystrophin gene,
and in CharcotMarieTooth disease type 1a, 70% of mutations involve duplication of the
entire PMP22 gene. In DMD the mutation acts by causing a shift in the translation reading
frame, and in CMT 1a by increasing the amount of gene product produced. Insertions of
foreign DNA sequences into a gene also disrupt its function, as in haemophilia A caused by
insertion
Trinucleotide repeat expansions
Expanded trinucleotide repeat regions represent new, unstable mutations that were
identified in 1991. This type of mutation is the cause of several major genetic disorders,
including fragile X syndrome, myotonic dystrophy, Huntington disease, spinocerebellar
ataxia and Friedreich ataxia. In the normal copies of these genes the number of repeats of the
trinucleotide sequence is variable. In affected individuals the number of repeats expands
outside the normal range. In Huntington disease the expansion is small, involving a doubling
of the number of repeats from 2035 in the normal population to 4080 in affected
individuals.
In fragile X syndrome and myotonic dystrophy the expansion may be very large, and
the size of the expansion is often very unstable when transmitted from affected parent to
child. Severity of these disorders correlates broadly with the size of the expansion: larger
expansions causing more severe disease.
Epigenetic effects
Epigenetic effects are inherited molecular changes that do not alter DNA sequence.
These can affect the expression of genes or the function of the protein product. Epigenetic
effects include DNA methylation and alteration of chromatin configuration or protein
conformation. Methylation of controlling elements silences gene expression as a normal
event during development. Abnormalities of methylation may result in genetic disease.
In fragile X syndrome, methylation of the promotor occurs when there is a large CGG
expansion, inactivating the gene and causing the clinical phenotype. Methylation is also
involved in the imprinting of certain genes, where abnormalities lead to disorders such as
Angelman and PraderWilli syndromes.
Point mutations
Most disease-causing mutations are simple base substitutions, which can have variable effect.
Mis-sense mutations result in the replacement of one amino acid with another in the protein
product and have an effect when an essential amino acid is involved. Non-sense mutations
result in replacement of an amino acid codon with a stop codon. This often results in mRNA
instability, so that no protein product is produced. Other single base substitutions may alter
the splicing of exons and introns, or affect sequences involved in regulating gene expression
such as gene promoters or polyadenylation sites.
Modifier genes
The variation in phenotype between different affected members of the same
family who have identical gene mutations may be due in part to environmental
factors, but is probably also determined by the presence or absence of particular
alleles at other loci, referred to as modifier genes. Modifying genes may for
example, determine the incidence of complications in insulin dependent
diabetes, the development of amyloidosis infamilial Mediterranean fever and
the occurrence of meconium ileus in cystic fibrosis.
Overexpression
Overexpression of a structurally normal gene may occasionally produce an abnormal
phenotype. Complete duplication of the PMP22 gene, with an increase in gene product,
results in CharcotMarieTooth disease type 1a. Interestingly, point mutations in the same
gene produce a similar phenotype by functioning as activating mutations. Although examples
of gene duplication are not common, the abnormal phenotype associated with chromosomal
duplications is probably due to the overexpression of a number of genes.