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Tay-Sachs Disease

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Genetic Disease Project – Tay-Sachs Disease
Tay-Sachs is an autosomal recessive genetic disorder caused by a mutation in the HEXA gene on chromosome 15 that damages the nerves of the brain and spinal cord. It is also known as GM2 gangliosidosis because of the accumulation of gangliosides (especially and particularly GM2 gangliosides, a component of the cell membrane) in the brains nerve cells which leads to premature death of the cells and is the cause of the deterioration the patient exhibits. The disease is named after two physicians, Waren Tay and Bernard Sachs. Tay was the first to define and discuss the cherry-red spot in on the retina, which is an indicator of the disease. Sachs was a neurologist that studied the Ashkenazi Jew population and noticed the cellular changes of the disease and its increase prevalence in isolated populations.
An individual with the disease will fall into one of three classifications, infantile (the most common), juvenile on-set and adult on-set. Classification of Tay-Sachs depends on the symptoms and the age at which the symptoms occur. The prognosis is not a favorable as the disease is severely degenerative and usually results in death of the infant or juvenile. Adults become wheelchair bound but may not die of the disease. Babies with infantile Tay-Sachs appear normal for the first few months after birth but as the gangliosides begin to accumulate and distend and stress the neurons the mental and physical deterioration begins. This usually starts while the baby is still in utero, but it takes time for the nerve cells to become over run and begin to die. The seemingly normal child will become paralytic, deaf, and blind, lose the ability to swallow and begin to atrophy. Infants usually succumb to the disease by age four or five. While all forms of the disease are rare, the Juvenile onset classification is the rarest of the three. Similar to infantile, Juvenile Tay-Sachs begins with the deterioration of motor and cognitive stills, lose the ability to speak (dysarthria), lose voluntary muscle movements (ataxia) and become rigid/stiff (spasticity). Death normally occurs between the ages of five and fifteen in these patients. In Late-Onset Tay-Sachs, which has its first symptoms appear in the 30’s and 40’s, is not as fatal as the other forms as the effects can stop progressing before death. The neurological deterioration is seen in this form as an unsteadiness of gait, difficulty swallowing, spasticity and decline of cognitive functions. A schizophrenia-like psychosis and psychiatric illness has also been recorded. The need for a wheelchair full time is a frequency with this form.
Tay-Sachs is a HEXA mutation on human chromosome 15. It’s most commonly found in genetically isolated populations like the Ashkenazi Jews, French Canadians and Louisiana Cajuns. The disease has also been found in Jacob’s sheep as well and caused by similar mutations on that animals’ chromosome. As an autosomal recessive disorder, a person with two carrier parents will have a 25% chance of developing the disease. (see punnett square, T = normal, t=Tay-Sachs) A child with one defective gene (50% chance) will become a carrier of the disease and have the potential to pass the disease to his or her children if they have children with another carrier. There is a 25% chance that with two carrier parents, the offspring will inherit the two normal genes and not be a carrier. | T | t | T | TT | Tt | t | Tt | tt |
Hexosaminidase, the protein that helps break down gangliosides, is lacking in individuals with Tay-Sachs. This allows the gangliosides, specifically GM2, to build up in the nerve cells and eventually overtake then kill the cells. The mutation that causes the disease differs between the populations. In Ashkenazi Jews, it is a base pair insertion that causes a reading frame shift which causes the enzyme to not form or not form correctly. In the journal article relating to Tay-Sachs in the Persian population scientist have identified that it is a nonsense mutation. The Cajun and Quebec populations have mutations similar to the Ashkenazi Jews, but it is not identical.
There is no known treatment or cure for this disease nor is there a way to prevent this if both parents are carriers. If one feels he or she is a risk of being a carrier or has a family history, genetic screening can be completed to determine if the gene is present. Once an infant or juvenile is diagnosed, the only measure that can be taken is to make the patient more comfortable. If a person is exhibiting any symptoms, a doctor will take a family history and perform an exam. A cherry-red spot in the macula in the retina of the eye is also an indicator and this will be examined as well as an enzyme analysis for hexosaminidase levels.

References

"Health Guide Tay-Sachs." Tay-Sachs Disease. New York Times, 17 Nov. 2010. Web. 25 Nov. 2012. <http://health.nytimes.com/health/guides/disease/tay-sachs- disease/overview.html>.

"Identification of Two HEXA Mutations Causing Infantile-onset Tay-Sachs Disease in the Persian Population." Journal of Human Genetics 56.9 (2011): 682-84. National Center for Biotechnology Information. U.S. National Library of Medicine, 28 July 2011. Web. 25 Nov. 2012. <http://www.ncbi.nlm.nih.gov/pubmed/21796138>.

"KidsHealth." Tay-Sachs Disease. N.p., May 2011. Web. 25 Nov. 2012. <http://kidshealth.org/parent/medical/genetic/tay_sachs.html>.

Petersen, G. M., J. I. Rotter, R. M. Cantor, L. L. Field, and S. Greenwald. "The Tay-Sachs Disease Gene in North American Jewish Populations: Geographic Variations and Origin." The American Journal of Human Genetics 35.6 (1983): 1258-269. Web. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1685967/>.

T, Kodama, Togawa T, Tsukimura T, Kawashima I, and Matsuoka K. "Lyso-GM2 Ganglioside: A Possible Biomarker of Tay-Sachs Disease and Sandhoff Disease." National Center for Biotechnology Information. U.S. National Library of Medicine, 20 Dec. 2011. Web. 25 Nov. 2012. <http://www.ncbi.nlm.nih.gov/pubmed/22205997>.

"Tay-Sachs Disease: MedlinePlus." U.S National Library of Medicine. U.S. National Library of Medicine, 24 July 2012. Web. 25 Nov. 2012. <http://www.nlm.nih.gov/medlineplus/taysachsdisease.html>.

"Tay-Sachs Disease." Wikipedia. Wikimedia Foundation, 20 Nov. 2012. Web. 25 Nov. 2012. <http://en.wikipedia.org/wiki/Tay-Sachs_disease>.

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