2. Overview and Concepts
• Single-gene (Mendelian) disorders result from pathogenic variants in
one gene.
• Inheritance can be dominant, recessive, or X-linked.
• Family pedigree analysis helps identify the likely mode of inheritance.
• Affected individuals typically show patterns over generations, making
these disorders traceable.
3. Genotype and Phenotype
• Genotype: The genetic makeup (e.g., mutation in a gene like CFTR).
• Phenotype: The observable traits or clinical symptoms.
• Two people with the same genotype may show different phenotypes
due to modifier genes or environment.
• Homozygous = two identical alleles; Heterozygous = two different
alleles.
4. Autosomal Dominant Inheritance
• One mutated allele is sufficient to cause disease.
• Vertical transmission: appears in multiple generations.
• Affected individuals have a 50% chance of passing the mutation to
offspring.
• Examples: Marfan syndrome, Achondroplasia, Neurofibromatosis
type 1 (NF1).
Often due to:
• Haploinsufficiency
• Dominant-negative effect
• Gain-of-function mutations
5. Autosomal Recessive Inheritance
• Two mutated alleles are needed (homozygosity or compound
heterozygosity).
• Parents of affected children are typically asymptomatic carriers.
• Horizontal pattern: disease often seen in siblings, not parents.
• 25% risk of disease in offspring of two carrier parents.
• Examples: Cystic fibrosis, Phenylketonuria (PKU), Tay-Sachs disease.
6. Sex-limited Phenotype in Autosomal
Dominant Diseases
• Gene is autosomal, but phenotype is expressed only in one sex.
• Common in traits tied to sexual physiology (e.g., male-limited
precocious puberty).
• Genotype may be present in both sexes, but only one sex shows the
disease.
7. Penetrance
• Penetrance = proportion of individuals with a mutation who express the
phenotype.
• Complete penetrance = everyone with the mutation shows symptoms.
• Incomplete (reduced) penetrance = some mutation carriers remain
unaffected.
Influenced by:
• Age
• Environment
• Modifier genes
Example: BRCA1 mutations show incomplete, age-dependent penetrance for
breast/ovarian cancer.
8. Expressivity
• Expressivity = variation in disease severity or symptoms among
individuals with the same genotype.
May be:
• Variable expressivity – same mutation, different clinical features.
• Seen in Neurofibromatosis type 1: mild café-au-lait spots vs. severe
tumors.
• Expressivity is influenced by:
• Modifier genes
• Environmental triggers
• Epigenetic factors