sickle-cell anaemia

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Related to sickle-cell anaemia: Sickle cell crisis, sickle cell syndrome

sickle-cell anaemia (SCA)

a human abnormality in which defective HAEMOGLOBIN molecules (Hbs) cause the red blood cells to have a twisted ‘sickle’ shape resulting in major circulatory problems and eventually death. The condition is controlled by a single autosomal gene on chromosome 11, with two alleles, S and s . The mutant haemoglobin has one amino acid alteration in its beta chain, number six having changed from GLUTAMIC ACID to VALINE possibly as a result of SUBSTITUTION MUTATION. Sickle-cell anaemics have an s/s genotype, while heterozygotes (S/s) have a condition called sickle-cell ‘trait’ with a tendency for their blood to sickle at low oxygen tension. Although SELECTION operates strongly against individuals with SCA the mutant allele has remained at fairly high frequency in some populations (e.g. in Central Africa), probably because the heterozygotes are at an advantage relative to the normal (S/s) types in terms of resistance to the MALARIA PARASITE, producing a GENETIC POLYMORPHISM. In North America, however, SCA is a transient polymorphism amongst blacks of African descent since the malarial selection pressure has been removed and its frequency in the population is expected to fall, although the success of modern medical treatment in reducing mortality has the effect of preserving the gene in the population.