Recall that hemoglobin is the protein
that is affected in thalassemia. Hemoglobin is made of
heme, alpha globins, and beta globins. At least 9
different genes direct the production of heme. Changes
in these genes may lead to disorders of heme production,
a group of conditions separate from the thalassemias.
Alpha thalassemia occurs when a mutation in the gene
that codes for alpha globin results in reduced or absent
production of alpha globins. Beta thalassemia occurs
with a corresponding change in the beta globin gene.
Therefore, the thalassemias are a result of quantitative
mutations in the globin genes.
Below is a karyotype, a picture of all of an
individual’s genetic information as seen through a
microscope. Notice there are 22 pairs of numbered
chromosomes (autosomes) and one pair of sex-determining
chromosomes. Also notice that a male carries both an X-
and a Y-chromosome, whereas a female has two
X-chromosomes. Because a man can pass down either an X-
or a Y-chromosome, he is the one who randomly determines
the sex of the baby.
The instructions for
alpha globin production are present in duplicate, two
genes on each chromosome 16 for a total of four. The
instructions for beta globin production are on
chromosome 11, one gene on each chromosome for a total
of two.
Half of a woman’s
genetic information goes into each egg, including one
chromosome 11 and one chromosome 16. The same is true in
the formation of sperm. At conception, the total of 46
chromosomes is restored. Which chromosome 11 or 16 is
passed down is determined randomly. There is nothing
that a mother or father does (or does not do) to direct
which chromosome, and therefore which allele, is
transmitted to his or her children.
The Recessive
Inheritance
The thalassemias are a group of recessively inherited
conditions. Recall that genes come in pairs. In
recessive conditions, both members of the pair
associated with the condition must be changed, or
mutated. This is different from a dominant condition, in
which only one copy of the gene need be changed in order
to manifest symptoms.
In recessive conditions, a benign trait or carrier state
can exist in which an individual has both a normal and a
mutated copy of the gene. The term "normal" is a
convention to simply describe the copy of the gene,
called an allele, that is seen most often in the general
population. The normal allele is able to compensate for
the missing or altered function of the mutant allele.
Therefore, the individual with trait does not have the
symptoms seen in the disease. It is generally thought
that each one of us carries 7-8 of these recessive
traits, which would cause disease if present in a
“double dose.”
It is not uncommon for a person with a recessive disease
to be the first individual in his or her family to have
the condition. Typically, this occurs when both parents
are carriers of the trait. This is different from a
dominantly inherited condition in which members of a
family in several consecutive generations are affected.