DISEASES OF TRINUCLEOTIDE REPEATS
A number of human loci have trinucleotide repeats. Expansion
of some of these loci is harmless, however, expansion of many
loci has grave consequences and leads to a variety of
disorders such as Huntington's disease, myotonic dystrophy
and some ataxias.These repeats have included the CGG, CAG and
CTG sequences (Table 1). In the March 8, 96 issue of Science,
Capmpuzano et al report a new type of repeat, GAA, that is
associated with Friedrich's ataxia.There is a distinct
difference in the diseases associated with the other repeats
as compared with that associated with the Friedrich's ataxia.
The former group of repeats are found in part of exons that
may or may not code for an amino acid and result in disorders
that are inherited as a dominant trait. The length of these
repeats shows instability in the siblings of the family
member who exhibits such an expanded repeat sequences. This
so-called "dynamic mutations" gain additional repeats through
generations. Friedrich's ataxia (FRDA) is distinct from the
group of diseases with trinucleotide repeats that have so far
been identified. This disease is transmitted as an autosomal
recessive disorder that involves the central and peripheral
nervous system. A gene, X25 was identified in the FRDA locus
on chromosome 9q13 that encodes a 210 amino acid protein that
is designated frataxin. A few FRDA patients had point
mutations in the X25 gene, however, the majority of patients
were homozygous for unstable GAA repeats in the first intron
rather than the exon of the involved gene. The individuals
who are heterozygotes for the disease carry the expanded
alleles but are phenotypically normal. As compared with the
carriers or normal controls, FRDA patients show either
undetectable or low amounts of X25 transcript.
The expanded trinucleotide sequences in the coding region of
the genes of ataxias and the 5' untranslated region of FMR1
gene in the fragile X syndrome, and the intron of the gene
implicated in the Friedrich's ataxia produce functional
changes. It is likely that soon we will witness the discovery
of other genetic disorders due to the repeat of the
trinucleotide sequences as well as the mechanism that lead to
the lengthening of such repeats.