Lesson 2 Genetic Testing (See accompanying CD or website or Restriction Enzymes PowerPoint) Background: Students have learned that Gena Karbowski has a breast cancer tumor and have decided to test Gena to see if there is a chance that she has a genetic version of the disease. Goal: To introduce students to methods of DNA extraction, sequencing and testing in order to solve medical issues. Objectives: Students will… Collect a human DNA sample Look at restriction enzymes and complete a paper electrophoresis lab activity Look at bioinformatics and explore how it is used in medical situations Materials: 91% COLD Isopropyl alcohol – 1 bottle (rubbing alcohol) Salt ( Non-Iodized) Liquid soap 1 ml Plastic pipettes – 2 per student 10 - 20 ml test tubes – 1 per student DNA extraction student sheet – 1 per student DNA sequence strips Restriction Enzymes Activity student worksheet LCD projector (optional) Scissors – 1 per student Access to the Internet Time required: 1 x 45-60 minute class period National Standards Met: S1, S3, S6, S7 Prep: For Cheek DNA extraction-Prepare a stock solution of salt water by adding 8 grams of sodium chloride to a beaker and dissolving with 92 ml of distilled water. Prepare a stock solution of soap solution by adding 25 ml of liquid soap to 75 ml of distilled water. Procedure: Day 1 Explain to students that you have gotten Gena’s physical exam results from the Doctor’s office and there is a lot more information. Pfizer and Beyond Benign Page 1 Explain that you also received another e-mail from Gena – handout the e-mail. Hand out the physical results and discuss with the students. Explain to students that today they are going to do some genetic testing to determine if Gena’s breast cancer was caused by genetics. Explain that first they will learn how a DNA sample is collected by collecting their own DNA. Hand out the DNA extraction student sheet Review students sheet and answer any questions Have students complete the activity. Explain that this is one way that the lab would collect Gena’s DNA for testing. So now what happens next? Explain that the students will now be looking at restriction enzymes and the role that they play in DNA. Show the Restriction Enzymes PowerPoint Presentation(instead of using the presentation you may have the students use the background information hand out) Check for student understanding Hand out the Restriction Enzymes Student Worksheet, the DNA sequence strips and the restriction enzymes examples sheet Review activity and check for understanding Ask students to complete the activity Day 2 Explain to the students that now that they have an understanding of what restriction enzymes do, they are going to model how restriction enzymes are used in the lab in a process called gel electrophoresis and that gel electrophoresis can be used to identify specific genes that cause disease. Review the background information about gel electrophoresis with students. Hand out the worksheets for the gel electrophoresis activity. Have students complete the activity Explain to the students that they have to use one more decoding process to get meaningful results from Gena’s DNA. Handout the Human genome Background information sheet Review the content and check for understanding Take your students to the computer lab or somewhere where they can access the Internet. Hand out the bioinformatics student activity sheet. Explain that they are going to utilize the same database that geneticists use to research DNA Have students follow the directions and complete the activity Pfizer and Beyond Benign Page 2 Fine Family Physicians Medical Center Full Physical Exam Patient Name: Gena Karbowski D.O.B.: 4/17/1963 ■ Today’s date: 6/20/2007 SS#:886-54-0000 Day Phone: 755-289-9999 CBC (Complete Blood Count) Results: Test Name What the test shows Gena Karbowski WBC White Blood Cell May be increased with infections, inflammation, some cancers. Within normal range RBC Red Blood Cell Decreased with anemia; increased when too many made and with fluid loss due to diarrhea, dehydration, burns Normal %Eos Eosinophil Shows parasitic infection present, None Inflammation Platelet Platelet Decreased or increased with conditions that affect platelet production; blood clotting normal/abnormal ■ Urinalysis results: Test Clotting normal results show no glucose excretion, indicating patient does not have diabetes. Pfizer and Beyond Benign Page 3 ■ IgE (Immunology) Test Results: Slightly elevevated Allergen Explanation Results for Gena Karbowski Seasonal Rhinitis or Asthma Allergen to plants Negative Oral Allergy Syndrome Food Allergies Negative Perennial Rhinitis or Asthma Pet Allergens Negative Eczema Dust mites, Animals, airborne allergens positive Anaphylaxis Caused by nuts and shellfish and constricts airways Negative Drug Allergy There are limited tests available for drugs and antibiotics. N/A No current medications Bee and Many individuals stung by these insects N/A No sting reported Wasp Venom will develop severe reactions Allergy ■ Chest X-Ray: Results show no signs of tumors, pathogens, or fluid in lungs. This indicates patient does not have lung cancer, emphysema, pneumonia, and bacterial infection in lungs Pfizer and Beyond Benign Page 4 Physical examination (no problems) (Left, Right, or Bilateral) o Change to diagnostic or add ultrasound if indicated. Indicate Area of Concern on Graphic Right Left Notes: Box above indicates the position of the lump examined during the physical exam. Gena is a 44 year old woman with three children Elizabeth 22, Eric 16 and Ariel 14. She has been coming to see me for annual screening exams for five years. She has never had abnormal results in her previous exams. Gena came to see me with concerns about a lump on the upper right side of her right breast. She has also been having skin irritation, with redness around the same area. During her physical exam I noticed that the lump appeared to have an irregular shape (not round) and a pebbly surface, somewhat like a golf ball. It is very hard, like a slice of raw carrot. Gena complains of no other symptoms. I performed a biopsy of the lump and found it to be cancerous. I have referred Gena to an oncologist for radiation treatment and a surgeon for removal of the lump. PHYSICIAN SIGNATURE: Dr. Devi Singh Pfizer and Beyond Benign DATE: 06/20/2007 Page 5 Gena’s E-mail – Student/Teacher Sheet INSERT YOUR NAME HERE (If you want to) From: Karbowski, Gena (gkarbowski@peoplerpc.com) Sent: Friday June 22nd, 2008 10.15 am To: Insert your name here (if you want to) Subject: Update on my life Hello insert your name here (if you want to), Well it seems that I do indeed have breast cancer but don’t worry; I’m going to be fine. I will be having surgery tomorrow to remove the lump and then I will be having radiation just to make sure all the cancerous cells are dead. Don’t worry about me though, the doctor said they caught it early and I should make a full recovery. I wondered for a while if I got this because of all those chemicals I worked with in the lab in college but now I’m wondering if this is genetic. Can you run some tests for me? Take care, Gena Pfizer and Beyond Benign Page 6 Genetic Testing, cheek DNA extraction – Student Sheet DNA extraction is the first step in DNA analysis. In order for Gena’s doctors to determine if her breast cancer is due to a faulty gene (or genes) they must first obtain a sample of Gena’s DNA. The epithelial cells lining the insides of the mouth are a great source of DNA since they are very easy to obtain. In this activity you will use several household chemicals to extract your own cheek cell DNA. In order to extract DNA from a human cell the cellular and nuclear membranes of a cell must be ruptured, allowing DNA to escape into the surrounding environment. IMPORTANT NOTE: MAKE SURE YOU HAVE NOT EATEN ANYTHING PRIOR TO THIS LAB AND IF YOU HAVE, BE SURE TO RINSE YOUR MOUTH OUT WITH PLENTY OF WATER. FOOD PARTICLES WILL INHIBIT A GOOD EXTRACTION. Follow the procedure below to extract DNA from your own body. Collect the following materials from the supply area: 1 1 8 1 2 1 4 ml of non iodized sodium chloride solution ml liquid soap solution ml of bottled or distilled water plastic test tube with cap plastic pipettes paper cup ml COLD 91% isopropyl alcohol 1. Use a plastic test tube and place 8 ml of water (bottled or fountain) into the tube and cap with screw top. 2. Gently chew the insides of your cheeks for 30 seconds. This step is necessary to harvest enough cheek cells for a good DNA extraction. 3. Place water from plastic tube into your mouth and swish for 30-45 seconds. DO NOT SWALLOW THE WATER! 4. Spit water into a small cup and pour the contents back into your plastic test tube. 5. Add 1 ml of the sodium chloride solution to your plastic tube and cap with cover. Gently mix by inverting the test tube several times. 6. Add 1 ml of liquid soap to your plastic tube and cap. Gently mix contents by slowly turning the test tube upside down and right side up 5 times. Try not to create bubbles!! 7. Add 3-4 ml of the ice-cold 91 % isopropyl alcohol to the test tube at a 45°angle down the side of the test tube. 8. Let tube sit for 5 minutes and observe as DNA floats to the surface. It will look like tiny bubbles. Pfizer and Beyond Benign Page 7 9. There you have it, your own genetic code. Since DNA is insoluble in alcohol this DNA can be stored for a long time in a small screw top or snap top vial. 10. If you wish to keep your DNA you may use a plastic disposable pipette to remove some of your DNA from your plastic test tube and transfer it to a small plastic microtube and top off with some alcohol. Post Lab Questions: 1. When you look at your DNA sample are you looking at a single DNA molecule or many? Explain. 2. What traits would you expect to find encoded in your DNA? 3. What trait is the most prevalent in your class? Pfizer and Beyond Benign Page 8 Restriction Enzymes Background Information In the previous activity you extracted DNA from your cheek cells. DNA extraction is the first step towards DNA analysis. In order for Gena’s DNA to be analyzed for the presence of cancer genes her extracted DNA must be prepared, or “chopped up”, into pieces with proteins called restriction enzymes. These pieces of DNA are then tested and the results are interpreted. It may seem very complicated but, as you will learn, it’s fairly simple. So, what are restriction enzymes? Restriction enzymes, sometimes called “molecular scissors”, cut a DNA molecule at specific sites to create smaller fragments of DNA. Restriction enzymes scan the DNA code until they find a very specific sequence of nucleotides, called a restriction site, and make a specific cut in that point. Restriction enzymes typically identify DNA sequences that are palindromes. Palindromes are words that read the same forward as backwards. For example, the words “mom” and “dad” are palindromes. The phrase “never odd or even” also reads the same forwards as backwards and is considered a palindrome. Genetic palindromes are similar to verbal palindromes. A palindromic sequence in DNA is one in which the 5’ to 3’ base pair sequence is identical on both strands (the 5’ and 3’ ends refers to the chemical structure of the DNA). Each of the double strands of the DNA molecule is complimentary to the other; thus adenine pairs with thymine, and guanine with cytosine. Restriction enzymes (also known as restriction endonucleases) recognize and make a cut within specific palindromic sequences, known as restriction (or recognition) sites, in the genetic code. In general, a recognition site is a 46 base pair sequence found in the genetic code. HaeIII is an example of a restriction enzyme that searches the DNA molecule until it finds this specific sequence of four nitrogen bases: 5’ GGCC 3’ 3’ CCGG 5’ Once HaeIII finds, or recognizes, the GGCC sequence, it cleaves (cuts) the DNA between the GG and CC bases. Look at the DNA sequence below. Can you spot the HaeIII recognition site? Once the recognition site was found HaeIII would go to work cleaving the DNA. 5’ TGACGGGTTCGAGGCCAG 3’ 3’ ACTGCCCAAGGTCCGGTC 5’ Pfizer and Beyond Benign Page 9 HaeIII would cut the DNA into two pieces or fragments, right in the middle of the GGCC recognition site: 5’ TGACGGGTTCGAGG 3’ ACTGCCCAAGGTCC CCAG 3’ GGTC 5’ These straight cuts produce what scientists call blunt ends. NAMES Restriction enzymes come from bacteria and the name of a particular restriction enzyme is related to the type of bacteria in which the enzyme is found, as well as the order in which the restriction enzyme was identified and isolated. For example, EcoRI gets its name from the R strain of E. Coli bacteria. Since EcoRI was the first restriction enzyme discovered in E. Coli, “I” is used in its name. Remember how HaeIII produced a blunt end? Well, other restriction enzymes can make uneven, staggered cuts. (Think of a zigzag pattern.) EcoRI, for instance, searches for the DNA for following palindromic sequence: 5’ GAATTC 3’ 3’ CTTAAC 5’ Once the restriction enzyme recognizes this site it will cut between the G and A on both the top and bottom strands of the DNA molecule. Do you notice what happens when DNA is cut in that location? Instead of making a blunt cut, EcoRI results in fragments that are uneven or staggered. The example below shows that action of EcoRI: 5’ GAATTC 3’ 3’ CTTAAG 5’ EcoRI cuts between the G and A on the top and bottom strands: 5’ G 3’ CTTAA AATTC 3’ G 5’ Because the enzyme produces a jagged cut, the ends of the DNA fragments are called “sticky ends”. Sticky ends are useful in the field of recombinant DNA technology since different DNA fragments with complimentary sticky ends can be combined in different ways to create new molecules. You will encounter recombinant DNA technology when you insert a foreign gene into a bacterial plasmid. The restriction sites of several different restriction enzymes, with their cut sites, are shown below: Pfizer and Beyond Benign Page 10 Pfizer and Beyond Benign Page 11 Restriction Enzymes Activity – Student Worksheet Cut the DNA sequence strips along their borders. These strips represent a double stranded DNA molecule. Each sequence of letters represents the DNA backbone, while the vertical lines between each base pair represent the hydrogen bonds between nitrogen bases. 1. You will model the activity of EcoRI. Scan the DNA sequences of strip 1 until you find the EcoRI restriction site (refer to the list above for the sequence). Make cuts through the DNA backbone by cutting between the G and the first A of the restriction site through both strands. Be sure not to cut all the way through the strip! Remember that EcoRI cleaves the backbone of each DNA strand separately and also separates the hydrogen bonds between the base pairs. 2. Now separate the hydrogen bonds between the cut sites by cutting through the vertical lines that connect the nitrogen bases. Separate the two pieces of complimentary DNA. Look at the new DNA ends produced by EcoRI. Are they blunt or sticky? Write “EcoRI” on these cut ends. Place them on your desk in front of you. 3. Repeat the procedure with strip 2, this time simulating the activity of SmaI. Find the SmaI site, and cut the DNA backbones at the restriction cut sites. Are there any bonds that are cut between the cut sites? Are the resulting ends blunt or sticky? Label the new ends SmaI, and place them on your desk in front of you. 4. Simulate the activity of HindIII with strip 3. Are these ends sticky or blunt? Label the new ends HindIII, and place them on your desk in front of you. 5. Repeat the produce one more time with strip 4, simulating EcoRI once again. 6. Pick up the “front-end” DNA fragment from strip 4 (an EcoRI fragment) and the “back-end” HindIII fragment from strip 3. Both fragments have single stranded ends that are 4 bases long. Write down the base sequences of the two ends, and label them EcoRI and HindIII. Label the 5’ and 3’ ends. Are the base sequences of the HindIII and EcoRI tails complimentary? 7. Put the HindIII fragments down. Now, pick up the back-end DNA fragment from strip 1 (cut with EcoRI) and Compare the single stranded tails of the EcoRI fragment from strip 1 to the EcoRI Pfizer and Beyond Benign Page 12 fragment from strip 4. Write down the base sequences of the single stranded tails, and label the 3’ and 5’ ends. Are they complimentary? 8. Imagine that EcoRI has cut a completely unknown DNA fragment. Do you think the single stranded tails of these fragments would be complimentary to the single stranded tails of the fragments from strip 1 and strip 4? Justify your answer. 9. An enzyme called DNA ligase re-forms the bonds between nucleotides. In order for DNA ligase to work, two nucleotides must come close enough together in the proper orientation for a bond to form. Do you think it would be easier for DNA ligase to reconnect two DNA fragments produced by the action of EcoRI or one fragment cleaved by EcoRI with one cleaved by HindIII? What is your reason? Pfizer and Beyond Benign Page 13 DNA Sequence Strips – Student Sheet COPY SINGLE SIDED! Pfizer and Beyond Benign Page 14 Restriction Enzyme Examples – Student Sheet Pfizer and Beyond Benign Page 15 Gel Electrophoresis Background Information You have already learned about restriction enzymes and how they cut DNA. When you perform an actual restriction digest, you place the DNA and restriction enzyme into a small tube and let the enzyme begin cleaving the DNA. Before the reaction starts, the mixture in the tube looks like a clear fluid. Guess what? After the reaction is complete, it still looks like clear fluid! Just by looking at it, you can’t tell that anything special has happened. In order for the restriction digestion to mean much to you, you have to be able to see the different DNA fragments that are produced. Gel electrophoresis takes advantage of the chemical nature of DNA to separate the fragments. The phosphate groups in the backbone of DNA are negatively charged. In electrical terms DNA molecules will be attracted to anything that is positive charged. In gel electrophoresis, DNA molecules are placed in an electric field (which has a positive and negative pole) so that they will migrate (or move) toward the positive pole. The electric field in electrophoresis makes the different DNA fragments move and causes them to separate. This whole process is carried out in a gel made of agarose. If you have ever made or eaten Jell-O or Jelly, you have had experience with a gel. One gel material that is often used for electrophoresis of DNA is agarose, derived from seaweed. To make a gel for DNA electrophoresis (called pouring or casting a gel), you dissolve some agarose powder in some boiling buffer solution, pour in into a dish, and let it cool. As the gel cools it hardens. Since the plan for agarose gels is to add DNA to them, scientists place a comb in the liquid agarose after it has been poured into the desired dish and let the agarose harden around the comb. When the comb is removed from the hardened agarose gel, a row of holes in the gel remains. The holes made by the comb are called sample wells. DNA is placed into the wells with a micropipette before electrophoresis is begun. Pfizer and Beyond Benign Page 16 For agarose gel electrophoresis, the gel is placed in a tank or chamber of salt water solution (not table salt) called buffer that balances the pH. An electric current is then applied across the tank so that it travels through the buffer and agarose gel. When the electric current is applied, the DNA molecules begin to migrate (move) through the gel from the negative toward the positive pole of the electric field. Why? Because DNA is negative and is attracted to the positive. The electricity is applied for between 20-30 minutes, during which time the gel does its most important work. All of the DNA fragments in the gel migrate toward the positive pole, but the agarose makes it more difficult for larger DNA fragments to move than smaller ones. So in the same amount of time, smaller DNA fragments migrate much farther than a large ones. You can think of agarose gel electrophoresis as a DNA footrace, where the “runners” (the DNA fragments being separated) separate like the runners in a real race. The smaller the molecule, the faster it will run. In electrophoresis races, the small DNA always wins! After 20-30 minutes, the electric current is turned off, and the entire gel is placed into a cationic (positively charged) DNA staining solution. After staining the DNA can be visualized. The DNA fragments now look like a series of stripes (bands) in the gel; each separate band composed of one size DNA fragment. There are millions of actual molecules in each band, but they are all approximately the same size. Pfizer and Beyond Benign Page 17 Paper Electrophoresis - Student Activity You will be provided with three linear models of Gena’s DNA (base pairs are not shown) and an outline of a gel electrophoresis gel. The models show where Gena’s DNA would be cut with three different restriction endonucleases. You will model the digestion of three of Gena’s DNA molecules with three different restriction enzymes and then simulate agarose gel electrophoresis of the restriction fragments. Materials Needed: Scissors Tape or glue stick 1. Cut out the three pictures of Gena’s 15,000 Base Pair DNA Fragment Sequence Molecules 2. Model the activity of EcoRI on Gena’s DNA by cutting the strip at the vertical lines representing the EcoRI sites. You have now “digested” Gena’s DNA molecule. Put your “restriction fragments” in a pile away from the other two DNA strips. 3. “Digest” Gena’s second DNA model with BamHI. Put the BamHI fragments in a separate pile. 4. “Digest” Gena’s third DNA molecule with the restriction enzyme HindIII. Put these fragments in a third pile. 5. You will separate the EcoRI, BamHI, and HindIII fragments in a model gel as if you had really loaded them into sample wells. Arrange Gena’s fragments in the way that they would be separated by agarose gel electrophoresis. Designate a place on your desk as the end of the gel with the sample wells. Starting with the EcoRI fragments, place them from longest to shortest, with the longest one closest to the well. 6. Next, separate the BamHI fragments from each other and place them adjacent to the EcoRI fragments on your desk. Be sure to order each fragment correctly by size with respect to the other BamHI fragments and to the EcoRi fragments that you have already laid out on your desk. 7. Repeat the same procedure for the HindIII restriction fragments. You should now have all three of fragments lengths arranged in order on your desk in front of you. 8. Check with your teacher at this point for accuracy before going further. 9. Look at the outline of the gel electrophoresis gel provided by your teacher. Do you notice that it has a size scale in base pairs on the left-hand side and that sample wells are drawn? Using the outline and the size scale as a guide, draw the pattern that your restriction digest for Gena’s DNA would make on an actual gel. Use the EcoRI sample well for the EcoRI fragments and so on. 10. After drawing the bands representing Gena’s restriction fragments, use the size information on the paper strips to label each band on your gel with the sizes, in base pairs, of each fragment. Post Activity Questions: 1. Are all the smaller fragments across the gel “lanes” in front of all the larger fragments? 2. Does the size scale have regular intervals? Pfizer and Beyond Benign Page 18 3. What is the size (in base pairs) of Gena’s largest fragment? 4. Analysis of DNA electrophoresis has revealed that DNA fragments smaller than 300 base pairs may indicate the presence of genes that have been associated with cancer. BRCA 1, p53, and CHEK2 are three genes that have been identified in cancer research. Does it appear from your electrophoresis model that Gena may have a cancer gene? Explain your answer. 5. Would you recommend that Gena’s 160 base pair fragment be sent to the laboratory for DNA sequencing analysis? Below are three representatives of a 15,000 base pair DNA molecule. Each representation shows the locations of different types of restriction sites, with vertical lines representing the cut site. The numbers between, show the sizes (in base pairs) of the fragments that would be generated by digesting the DNA with that enzyme. EcoRI sites 4,000 3,500 2,500 5,000 BamHI Sites 6,000 4,000 3,000 1,840 160 HindIII 8,000 Pfizer and Beyond Benign 4,500 2,500 Page 19 Gena’s Gel Electrophoresis EcoRI Size scale in base pairs HindIII BamHI Sample wells 8,000 -- 6,000 -- 4,000 -- 3,000 -- 2,000 -- 1,000 -500 -400 -300 300 ---200 200 --100 -50 -25 -- Pfizer and Beyond Benign Page 20 Bioinformatics and the Human Genome Project Background Information: Since the elucidation of the structure of DNA by James Watson and Francis Crick in the mid 20th century the world has seen an explosion in genetic knowledge. With the development of computer processing and technology the ability to study DNA was taken to new heights. The Human Genome Project, begun in 1986, with the cooperation of public and private companies set about the monumental task of sequencing all 3 billion base pairs in the human genome. It was no small task and many problems were encountered. With the help of high speed computers and state of the art DNA technology the Human Genome Project was completed in 1996. With the Human Genome sequence now complete, scientists were faced with the additional task of making sense of the enormous amounts of genetic information now available to them. The explosion of data produced by the Human Genome Project led to the creation of a new scientific disciple: Bioinformatics. Bioinformatics focuses on the acquisition, storage, analysis, modeling and distribution of the many types of information embedded in DNA. A variety of bioinformatics software has been developed. Gene prediction software, for example, attempts to identify genes within a long DNA sequence while sequence alignment software uses computers to determine if a sequence of DNA is similar to that of a known gene. One of the most popular and widely used sequence alignment programs is called BLAST, Basic Local Alignment Search Tool. This program searches a nucleic acid (or protein) sequence database for matching or similar sequences. The BLAST search engine allows scientists to determine if a DNA or protein sequence is part of a known gene. If the BLAST search shows that a particular DNA sequence is part of a known gene it allows the scientists to continue with their efforts to determine the function of that gene. It also provides a way for scientists to confirm the identity of unknown DNA sequences, thereby saving much time, energy, and money in the process. Pfizer and Beyond Benign Page 21 Bioinformatics Student Activity: Mining the Genome In this activity you will use a government funded bioinformatics website, the National Center for Biotechnology Information (NCBI), to conduct a sequence alignment search to determine if Gena’s smallest fragment, 160 base pairs, visualized by gel electrophoresis, matches any known DNA sequences in the database. Instructions: 1. Log onto the following website: http://www.ncbi.nlm.nih.gov 2. Click on BLAST 3. Under BLAST Assembled Genomes, choose the word “human”. 4. In the large box enter the first 30 bases pairs of Gena’s DNA sequence obtained from the electrophoresis activity. 5. Scroll down and click “Begin Search” 6. You will advance to a screen that gives you information of Query, Database, Job Title, etc. At this point you should click “View Report” adjacent to Request ID. 7. A new screen will appear showing the results of your search. The important information on this screen is found under the “Descriptions” heading. Here you should read the following words: “Sequences producing significant alignments”. You should see information concerning the species and chromosome number that Gena’s DNA sequence search matched. (You don’t have to worry about the Score and E Value.) 8. Scroll down to the word “Alignments” just below descriptions. 9. Under the words “Features flanking this part of subject sequence:” you should find an important piece of information for determining if Gena’s 160 base pair sequence matches any known DNA sequences. Do you see what that important clue is? If so, write it down here:_____________________________ 10. Congratulations you have just completed your first DNA sequence alignment search in the emerging scientific field of Bioinformatics. Post Activity Question: 1. What do you conclude about Gena’s DNA sequence from this activity? Pfizer and Beyond Benign Page 22 Gena’s 160 Base Pair DNA Fragment Sequence Molecules: TTCCCATCAAGCCCTAGGGCTCCTC GTGGCTGCTGGGAGTTGTAGTCTG AACGCTTCTATCTTGGCGAGAAGCG CCTACGCTCCCCCTACCGAGTCCC GCGGTAATTCTTAAAGCACCTGCAC CGCCCCCCCGCCGCCTGCAGAGGG CGCAGCAGGTCTT Pfizer and Beyond Benign Page 23 Gena’s Genetic Testing Results Department of Genetics Yale University School of Medicine 333 Cedar Street New Haven, CT 06520 License # State of CT.CL-00084 Report Re: Karbowski, Gena Reason For Study: Carrier Analysis for BRCA1 and 2 mutations General genetic screen Med. Rec. #: Lab #: 00000-0 Source: BLOOD Referring Provider 1 Referring Provider 2 Dr. Devi Singh Fine Family Physicians Mystic, CT 02020 Fax: (203) 764-8401 Family #: 00000 Birth Date: 4/17/1963 Referring Provider 3 Interpretation: Two OF THE MOST COMMON Breast Cancer MUTATIONS, BRCA1--185delAG, and P53 WERE screened IN THIS PATIENT. Gene Mutation Screened BRCA1 P53 Interpretation 185delAG Protein No Mutation Detected Mutation Detected Females with mutations in P53 are high risk for aggressive breast cancer and ovarian cancer. Males with this mutation are at increased risk for prostate cancer and possibly breast cancer. Interpretation: THE CARRIER GENE CNGA3 for ACHROMATOPSIA WAS FOUND IN THIS PATIENT. Interpretation: THE CARRIER GENE FOR MALE PATTERN BALDNESS WAS FOUND ON THE X CHROMOSOME OF THIS PATIENT. Signed: Date: Allen E. Bale, M.D. Director, DNA Diagnostics Laboratory Signed: Date: Michael R. Rossi, Ph.D. Molecular Diagnostics Fellow NOTE: While results obtained from this type of testing are usually highly accurate, infrequent laboratory errors may occur. NOTE: PCR-based tests are performed pursuant to a license agreement with Roche Molecular Systems, Inc. The results of this testing and its implications should be interpreted and conveyed by a professional trained in genetics. Pfizer and Beyond Benign Page 24 Condition Pattern of prevalence Gene (s) in which mutations cause the condition Chromosome on which the gene is found – if known Treatment Alzheimer’s Disease Achromatopsia 1 : 2,500 1 : 40,000 #1, #14, #19, #21 #2, #14 None None Asthma 5% of the population PS1, PS2, APP CNGA3, CGNB3 and GNAT2 Unknown Inhaler, medication Breast Cancer Breast Cancer 5% of the 182,000 breast cancer cases reported each year BRCA - 2 BRCA - 1 #5, #6, #11, #14, and #12 #13 #17 Cystic Fibrosis 1 : 2,500 CFTR #7 Fragile X Mental Retardation Haemophilia A Huntington Disease Male pattern baldness 1 : 4,000 boys 1: 2,000 girls 1 : 10,000 boys 1 : 20,000 No data FMR1 X Factor 8 c IT15 AR X #4 X Where is the BRCA1 gene located? Cytogenetic Location: 17q21 Molecular Location on chromosome 17: base pairs 38,449,839 to 38,530,993 Pfizer and Beyond Benign Page 25 Lumpectomy, radiation, chemotherapy, mastectomy etc. based upon severity Physiotherapy, antibiotics, enzymes to digest food and diet Educational and behavioral support Factor 8 Supportive therapy None Disorder student information sheet BRCA-1 Recently, scientists have begun to isolate genes responsible for hereditary breast cancer. In 1994 the gene, named Breast Cancer 1 (BRCA-1), was finally isolated in Chromosome #17, one of the 23 pairs of chromosomes found in most human cells. An altered BRCA-1 has been linked to the development of breast and ovarian cancer. In 1995, scientists developed experimental tests for detecting several recently discovered cancer genes, including BRCA-1. However preliminary studies have shown that testing positive for an altered BRCA-1 gene does not necessarily mean a woman will develop breast cancer. At least 15% of the women who carry the altered gene will never develop the disease. Scientists have no way of knowing yet which women fall into that category. In addition, because BRCA-1 alterations occur in many different places scattered throughout the gene, developing an accurate test will be very difficult to do. The altered BRCA-1 gene appears in only 5% of the 182,000 breast cancer cases that develop. If a woman tests negative (that is, she does not have the altered gene), this does not necessarily mean she will be free of breast cancer during her lifetime. BRCA-2 Scientists also have recently located the gene BRCA-2 on Chromosome #13. Like BRCA-1, BRCA-2 appears to be a cancer-causing gene when altered. BRCA-2 appears to account for as many cases of breast cancer as does BRCA-1. BRCA-2 apparently triggers breast cancer in males as well as in females. P53 There are specific genes in the cells of our bodies that normally help to prevent tumors from forming. One of these tumor-suppressor genes, called P53 ("p" for protein and "53" for its weight) was recently named "Molecule of the Year" by the editors of the journal Science. This protein plays a major role in cell growth. The job of P53 is to prevent (suppress) cells from growing. When it has been damaged or altered, P53 loses its ability to block cell growth. Changes to the gene result in an increased risk of cancer. Almost 50% of all human cancer cells contain a P53 mutation. These cancers are more aggressive and more often fatal. Since P53 is so important for normal cell growth in humans, researchers are continuing to look for ways to diagnose, prevent, and treat cancer associated with P53. Pfizer and Beyond Benign Page 26 ATM After more than a decade of intensive searching, researchers have isolated a recessive gene that increases the risk for people to develop some kinds of cancer (as well as a rare genetic disease). The gene, ataxia telangiectasia mutated (ATM) may be involved in many cancers, including breast cancer. The normal role of the ATM gene is to control cell division. Although researchers do not know why an altered ATM causes cancer, 1% of Americans (more than 2 million people) carry at least one copy of the defective form of the gene. By examining the role of altered ATM genes, scientists are hoping to shed some light on what makes cells live, grow, and die. Besides being associated with cancers, the ATM gene may also identify those individuals who are sensitive to radiation. The altered form of the ATM gene is closely linked to a childhood disorder of the nervous system called Ataxia Telangiectasia, or AT. AT afflicts 1 in 40,000 children in the U.S. and 1 in 200,000 worldwide each year. P65 With the recent discovery of the gene called P65, scientists are hoping to develop a blood test to detect cancers of the breast and prostate at a much earlier stage than is now possible. The altered form of P65 is linked to the overproduction of certain hormones that may help to cause both breast and prostate cancers. The new blood test, called the tumor blood marker, hopefully will allow doctors to monitor a patient's response to cancer treatment. The level of the P65 protein marker in the blood decreases as tumors are destroyed during therapy. A study is being performed to determine if the tumor marker blood test is suitable for widespread use Achromatopsia, the complete inability to distinguish color, is an autosomal recessive disease of the retina. This means that both parents have one copy of the altered gene but do not have the disease. Each of their children has a 25% chance of not having the gene, a 50% chance of having one altered gene (and, like the parents, being unaffected), and a 25% risk of having both the altered gene and the condition. In 1997, the achromatopsia gene was located on chromosome 2. A total inability to distinguish colors (achromatopsia) is exceedingly rare. These affected individuals view the world in shades of gray. They frequently have poor visual acuity and are extremely sensitive to light (photophobia), which causes them to squint in ordinary light. What causes Achromatopsia? Achromatopsia is caused by an abnormality of the retina, that portion of the eye responsible for “making the picture”. It is analogous to the film in a camera. In the retina, there are three types of cells (cones) that are responsible for normal color vision. These are the red cones, the green cones, and the blue cones. A balanced distribution of these cells is necessary for normal color vision. If a child is born with non-functioning cones, they will have achromatopsia. Sometimes children have a reduced complement of the cones, in which case they will have partial or incomplete achromatopsia. Achromatopsia is an inherited condition and so far three genes (genetic markers found on chromosomes) are known to be associated with this Pfizer and Beyond Benign Page 27 condition: CNGA3, CGNB3 and GNAT2. The three chromosomes that may have changes associated with achromatopsia are chromosome 14, chromosome 8q21- q22 and chromosome 2q11. Male Pattern Baldness – The most common form of baldness is a progressive hair thinning condition called androgenic alopecia or 'male pattern baldness' that occurs in adult male humans and other species. The severity and nature of baldness can vary greatly; it ranges from male and female pattern alopecia (androgenetic alopecia, also called androgenic alopecia or alopecia androgenetica), alopecia areata, which involves the loss of some of the hair from the head, and alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body. too many androgen receptors make you bald. The genetic reason for Pattern Baldness is linked to your mother's X-Chromosome. Everyone gets one-half of their genetic make-up from their mother and their father. The final chromosome pair of the 23 pairs is the sex determining set. While males are XY and females are XX the determination of an individual’s sex is made by the father. It is the father who gives either the X chromosome, which matches with the woman’s X resulting in XX and a female child or the Y chromosome which joins with the woman’s X resulting in an XY match and a male child. It is the X chromosome or female sex chromosome that contains the gene for Male Pattern Baldness. Pfizer and Beyond Benign Page 28