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Detection of point mutation in gene for LDL receptor -an inherited metabolic disorder -caused by a lack or malfunction of receptors for the low-density lipoproteins (LDL) that activate removal of cholesterol from the blood. LDL receptors on the cell membrane take cholesterol into the cell and break it down, so that the HDL (high density lipoproteins) can carry the cholesterol to the liver to be excreted from the body People with FH have fewer receptors on their cell membranes Elevated cholesterol in their blood (because the cholesterol cannot get into the cell to be carried to the liver). Fewer receptors lead to elevated cholesterol which causes plaque formation and coronary artery disease = increased risk of early death secondary to heart disease. Levels of LDL-cholesterol in familial hypercholesterolemia: Age LDL cholesterol > 20 years 6,2 mmol/l and more 20-29 years 6,7 mmol/l and more 30-39 years 7,2 mmol/l and more > 39 let 7,8 mmol/l and more physiological level of LDL-cholesterol < 3,4 mmol/l Gene for LDL receptor is lokated on chromosome 19, in position p3.1 -p3.3. 700 mutations were detected in gene for LDL receptor, all with low frequence. Mutation R395W, is one of the most frequent mutations in LDL receptor gene. Mutation is due to single nucleotide substitution of G to T, which leads to substitution of arginine (R) to thyrozine (W) in position 395 (GGG TGG). A key aspect of research in genetics is associating sequence variations with heritable phenotypes. The most common variations are single nucleotide polymorphisms (SNPs), which occur approximately once every 100 to 300 bases. Because SNPs are expected to facilitate large-scale association genetics studies, there has recently been great interest in SNP discovery and detection. SNP - single nuclotide polymorphism Human blood - DNA isolation leukocytes trombocytes erytrocytes Cells in ml 4-7 x 106 3- 4 x 108 5 x 109 DNA 30- 60 g/ml (6 pg/cell) RNA 1- 5 g/ml blood Hemoglobine - Plasma proteins - - - - 60- 80 mg/ml 150 mg/ml - -carried on chromosomes -basic physical and functional units of heredity -specific sequences of bases that encode instructions on how to make proteins – the genetic information. There are three types of genes : 1) Protein-coding genes : these are transcribed into RNA and then translated into proteins. 2) RNA-specifying genes : these are only transcribed into RNA. 3) Regulatory genes : these include only untranscribed sequences. translation="MDTKHFLPLDFSTQVNSSLTSPTGRGSMAAPSLHPSLGPGIGSP GQLHSPISTLSSPINGMGPPFSVISSPMGPHSMSVPTTPTLGFSTGSPQLSSPMNPVS SSEDIKPPLGLNGVLKVPAHPSGNMASFTKHICAICGDRSSGKHYGVYSCEGCKGFFK RTVRKDLTYTCRDNKDCLIDKRQRNRCQYCRYQKCLAMGMKREAVQEERQRGKDRNEN EVESTSSANEDMPVERILEAELAVEPKTETYVEANMGLNPSSPNDPVTNICQAADKQL FTLVEWAKRIPHFSELPLDDQVILLRAGWNELLIASFSHRSIAVKDGILLATGLHVHR NSAHSAGVGAIFDRVLTELVSKMRDMQMDKTELGCLRAIVLFNPDSKGLSNPAEVEAL REKVYASLEAYCKHKYPEQPGRFAKLLLRLPALRSIGLKCLEHLFFFKLIGDTPIDTF LMEMLEAPHQMT" BASE COUNT 1010 a 1643 c ORIGIN 1 gcgccggggg ccgccgcgcc 61 tcgcagacat ggacaccaaa 121 ccctcacctc cccgacgggg 181 ggcctggcat cggctccccg 241 tcaacggcat gggcccgcct 301 cggtgcccac cacacccacc 361 tgaaccccgt cagcagcagc 421 aggtccccgc ccacccctca 481 gcggggaccg ctcctcaggc 541 tcttcaagcg gacggtgcgc 601 tgattgacaa gcggcagcgg 661 tgggcatgaa gcgggaagcc 721 atgaggtgga gtcgaccagc 781 ctgagctggc cgtggagccc 841 ccagctcgcc gaacgaccct 901 ccctggtgga gtgggccaag 961 tcatcctgct gcgggcaggc 1021 tcgccgtgaa ggacgggatc 1081 acagcgcagg ggtgggcgcc 1645 g 1151 t cgccgcccgc catttcctgc cgaggctcca ggacagctgc ttctcggtca ctgggcttca gaggacatca ggaaacatgg aagcactatg aaggacctga aaccggtgcc gtgcaggagg agcgccaacg aagaccgaga gtcaccaaca cggatcccac tggaatgagc ctcctggcca atctttgaca tgcctgcgcc cgctcgattt tggctgcccc attctcccat tcagctcccc gcactggcag agccccccct cttccttcac gagtgtacag cctacacctg agtactgccg agcggcagcg aggacatgcc cctacgtgga tttgccaagc acttctcaga tgctcatcgc ccgggctgca gggtgctgac gccggccggg ctccacccag ctcgctgcac cagcaccctg catgggcccc cccccagctc gggcctcaat caagcacatc ctgcgagggg ccgcgacaac ctaccagaag tggcaaggac ggtggagagg ggcaaacatg agccgacaaa gctgcccctg ctccttctcc cgtccaccgg ggagcttgtg catgagttag gtgaactcct ccgtccctgg agctccccca cactccatgt agctcaccta ggcgtcctca tgcgccatct tgcaagggct aaggactgcc tgcctggcca cggaacgaga atcctggagg gggctgaacc cagcttttca gacgaccagg caccgctcca aacagcgccc tccaagatgc (Polymerase Chain Reaction) The purpose of a PCR is to make a huge number of copies of a specific DNA sequence. There are three major steps in a PCR, which are repeated for 20 to 30 cycles on an automated cycler. The tubes with the reaction mixture are heated and cooled in a very short time. Denaturation at 94°C : During the denaturation, the double strand melts open to single stranded DNA. Annealing at 50-65°C : The primers are annealed. extension at 72°C : This is the ideal working temperature for the polymerase. The polymerase adds dNTP's from 5' to 3', reading the template from 3' to 5' side. PCR - reaction mixture DNA RFLP refers to the variation among individuals in the lengths of DNA fragments between normal and mutant allels. Restriction endonucleases are enzymes that cleave DNA molecules at specific nucleotide sequences depending on the particular enzyme used. Enzyme recognition sites are usually 4 to 6 base pairs in length. Gel electrophoresis is a procedure for separating a mixture of molecules through a stationary material (gel) in an electrical field. DNA is negatively charged (the phosphates that form the sugar-phosphate backbone of a DNA molecule have a negative charge). Samples containing DNA mixed with loading buffer are pipeted into the sample wells. DNA will migrate towards the anode. When adequate migration has occured, DNA fragments are visualized by staining with ethidium bromide. To visualize DNA, the gel is placed on a ultraviolet transilluminator. After restriction analysis - fragments on gel Molecular diagnostics research and clinical research applications Bacteria Pathogenic enteric bacteria detection in stool by multiplex PCR Chlamydia trachomatis in swabs and histological sections detected by PCR and sequencing Chlamydia pneumoniae analysis in monocytes by RT-PCR Bordetella pertussis detection in nasopharyngeal swabs by PCR followed by immunoassay Legionella pneumophila detection in bronchoalveolar lavage by PCR Periodontal bacteria identification of bacteria implicated in gingivitis by multiplex PCR Pneumocystis carinii genotyping studies using samples isolated from bronchoalveolar specimens Various bacteria identification from 16S-rRNA gene fragments by RT-PCR and sequencing Mycobacteria detection and identification in paraffin-embedded lung samples by PCR Viruses Influenza A virus molecular characterization of strains Human adenovirus subgenera detection in clinical samples by multiplex PCR Enteroviruses and HSV detection of viral nucleic acids in cerebrospinal fluid by multiplex PCR Viral genotyping manual and automated isolation from plasma Viral load monitoring highly sensitive quantification in peripheral blood mononuclear cells and biopsies Fungi, parasites Candida and Aspergillus species isolation of DNA from cultures and blood Leishmania species detection in tissue biopsies by PCR Trichomonas vaginalis detection in cervical swabs and urine by PCR Minimal Residual Disease after Stem-Cell Transplants Monitoring of follicular lymphoma by PCR Two methods - one detects an associated t(14:18) translocation, - the other a tumor- specific CDRIII sequence. Bone marrow and peripheral blood samples were collected from 15 patients with disseminated follicular lymphoma following autologous stem-cell transplantation Blood-group incompatibilities between mother and fetus Detection in amniotic cell DNA by PCR Fetal DNA was isolated from two amniotic-fluid samples using the QIAamp Viral RNA Mini Kit. Individual PCRs contained primer sets specific for the RH sequences (83–158 bp) indicated, as well as hGH (434 bp) as internal control. D2–D10 refer to the specific exons targeted within the RHD gene. c(cyt48) refers to a sequence variant of the RHc allele. A RH genotype: CCD.ee; B RH genotype: ccddee. M: DNA molecular weight marker V (Boehringer Mannheim).