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Finnish heritage disease

{{Short description|Group of autosomal recessive genetic disorders that affect Finns much more frequently}}

A Finnish heritage disease is any genetic disease or disorder that is significantly more common in people whose ancestors were ethnic Finns, natives of Finland and Northern Sweden (Meänmaa) and Northwest Russia (Karelia and Ingria). There are 36 rare diseases regarded as Finnish heritage diseases.{{Cite journal |last=Norio R |date=May 2003 |title=The Finnish Disease Heritage III: the individual diseases |journal=Human Genetics |volume=112 |issue=5–6 |pages=470–526 |doi=10.1007/s00439-002-0877-1 |pmid=12627297 |s2cid=26741302}} The diseases are not restricted to Finns; they are genetic diseases with far wider distribution in the world, but due to founder effects and genetic isolation they are more common in Finns.

Within Finland these diseases are more common in the east and north, consistent with their higher association with ethnic Finns than with ethnic Swedes.{{Cite journal |vauthors=Palo JU, Ulmanen I, Lukka M, Ellonen P, Sajantila A |date=April 2009 |title=Genetic markers and population history: Finland revisited |journal=European Journal of Human Genetics |volume=17 |issue=10 |pages=1336–46 |doi=10.1038/ejhg.2009.53 |pmc=2986642 |pmid=19367325}} The Finnish disease heritage does not extend to other ethnic groups in the region, the Sámi and Karelians other than Finnish Karelians. It is attributed to a population bottleneck among ancestors of modern Finns, estimated to have occurred about 4000 years ago, presumably when populations practicing agriculture and animal husbandry arrived in Finland.

In Finland about one in five persons carries a gene defect associated with at least one Finnish heritage disease, and about one in 500 children born is affected.{{Cite journal |vauthors=Kallinen J, Heinonen S, Palotie A, Mannermaa A, Ryynanen M |date=May 2001 |title=Antenatal gene tests in low-risk pregnancies: molecular screening for aspartylglucosaminuria (AGU) and infantile neuronal ceroid lipofuscinosis (INCL) in Finland |journal=Prenatal Diagnosis |volume=21 |issue=5 |pages=409–12 |doi=10.1002/pd.82 |pmid=11360285 |s2cid=22368642}} Most of the gene defects are autosomal recessives, so that if both the mother and father carry the same defect, the chance that their child will have the associated disease is 1 in 4. The molecular genetics of many of these diseases have been determined, enabling genetic testing, prenatal testing, and counseling. This has raised questions of bioethics and eugenics.{{Cite book |last=Seppo Poutanen |url=https://books.google.com/books?id=cKxl1JOVQLQC |title=Genetic governance: Health, risk, and ethics in the biotech era |publisher=Routledge |year=2005 |isbn=0-415-35407-2 |editor-last=Robin Bunton |pages=215 |chapter=3: The first genetic screening in Finland: its execution, evaluation, and some possible implications for liberal government |editor-last2=Alan Petersen}}

Finnish heritage disease types

There are 36 identified Finnish heritage diseases:{{Cite web |title=The Finnish Disease Heritage |url=http://www.findis.org/heritage.html |url-status=dead |archive-url=https://web.archive.org/web/20170113050903/http://www.findis.org/heritage.html |archive-date=13 January 2017 |access-date=4 March 2018 |publisher=FinDis}}{{Cite web |title=Diseases |url=http://www.findis.org/diseases.html |access-date=4 March 2018 |publisher=FinDis}}

Out of these, three are rare causes of dwarfism: cartilage–hair hypoplasia, diastrophic dysplasia and Mulibrey nanism.

Four genetically distinct subtypes of neuronal ceroid lipofuscinosis are found in the Finnish heritage: CLN1, CLN3, CLN5, and CLN8.{{Cite book |last=Krystyna E. Wiśniewski |title=Batten disease: diagnosis, treatment, and research |last2=Nanbert Zhong |last3=Jeffrey C. Hall |publisher=Academic Press |year=2001 |isbn=0-12-017645-9 |pages=243}} page 125 Names for conditions associated with these subtypes include infantile neuronal ceroid lipofuscinosis, Jansky–Bielschowsky disease and northern epilepsy syndrome. As of 2001, CLN5 and CLN8 had been reported almost exclusively in Finland.

Meckel syndrome type 1 (MKS1{{Cite journal |vauthors=Consugar MB, Kubly VJ, Lager DJ, Hommerding CJ, Wong WC, Bakker E, Gattone VH, Torres VE, Breuning MH, Harris PC |date=June 2007 |title=Molecular diagnostics of Meckel–Gruber syndrome highlights phenotypic differences between MKS1 and MKS3 |journal=Human Genetics |volume=121 |issue=5 |pages=591–9 |doi=10.1007/s00439-007-0341-3 |pmid=17377820 |s2cid=11815792}}), a lethal condition, is known in 48 Finnish families.{{Cite journal |last=Salonen R. |last2=Opitz |first2=John M. |last3=Reynolds |first3=James F. |date=August 1984 |title=The Meckel syndrome: clinicopathological findings in 67 patients |journal=American Journal of Medical Genetics |volume=18 |issue=4 |pages=671–89 |doi=10.1002/ajmg.1320180414 |pmid=6486167}}

Other genetic diseases

The European Organization for Rare Diseases (EURORDIS) estimates that there are between 5,000 and 7,000 distinct rare diseases, affecting between 6% and 8% of the population of the European Union.{{Cite web |date=November 2005 |title=Rare Diseases: Understanding This Public Health Priority |url=http://www.eurordis.org/IMG/pdf/princeps_document-EN.pdf |access-date=16 May 2009 |publisher=European Organisation for Rare Diseases (EURORDIS)}} The majority of genetic diseases reported in Finland are not part of the Finnish disease heritage and their prevalence is not higher in Finland than worldwide.

Some genetic diseases are disproportionately rare in Finns. These include cystic fibrosis and phenylketonuria. In Finland, about 1 in 80 persons are carriers of a cystic fibrosis mutation, compared with an average of 1 in 25 elsewhere in Europe.{{Cite journal |vauthors=Hytönen M, Patjas M, Vento SI, Kauppi P, Malmberg H, Ylikoski J, Kere J |date=December 2001 |title=Cystic fibrosis gene mutations deltaF508 and 394delTT in patients with chronic sinusitis in Finland |journal=Acta Oto-Laryngologica |volume=121 |issue=8 |pages=945–7 |doi=10.1080/000164801317166835 |pmid=11813900}}

Genetic history

Based on molecular data, a population bottleneck among ancestors of modern Finns is estimated to have occurred about 4000 years ago.{{Cite journal |vauthors=Sajantila A, Salem AH, Savolainen P, Bauer K, Gierig C, Pääbo S |date=October 1996 |title=Paternal and maternal DNA lineages reveal a bottleneck in the founding of the Finnish population |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=93 |issue=21 |pages=12035–9 |bibcode=1996PNAS...9312035S |doi=10.1073/pnas.93.21.12035 |pmc=38178 |pmid=8876258 |doi-access=free}} This bottleneck resulted in exceptionally low diversity in the Y chromosome, estimated to reflect the survival of just two ancestral male lineages.{{Cite journal |vauthors=Kittles RA, Bergen AW, Urbanek M, Virkkunen M, Linnoila M, Goldman D, Long JC |date=April 1999 |title=Autosomal, mitochondrial, and Y chromosome DNA variation in Finland: evidence for a male-specific bottleneck |url=https://zenodo.org/record/1235474 |journal=American Journal of Physical Anthropology |volume=108 |issue=4 |pages=381–99 |doi=10.1002/(SICI)1096-8644(199904)108:4<381::AID-AJPA1>3.0.CO;2-5 |pmid=10229384}}{{Cite journal |vauthors=Lahermo P, Savontaus ML, Sistonen P, Béres J, de Knijff P, Aula P, Sajantila A |year=1999 |title=Y chromosomal polymorphisms reveal founding lineages in the Finns and the Saami |journal=European Journal of Human Genetics |volume=7 |issue=4 |pages=447–58 |doi=10.1038/sj.ejhg.5200316 |pmid=10352935 |doi-access=free}} The distribution of Y chromosome haplotypes within Finland is consistent with two separate founding settlements, in eastern and western Finland.{{Cite journal |vauthors=Kittles RA, Perola M, Peltonen L, Bergen AW, Aragon RA, Virkkunen M, Linnoila M, Goldman D, Long JC |date=May 1998 |title=Dual origins of Finns revealed by Y chromosome haplotype variation |journal=American Journal of Human Genetics |volume=62 |issue=5 |pages=1171–9 |doi=10.1086/301831 |pmc=1377088 |pmid=9545401}} The Finnish disease heritage has been attributed to this 4000-year-old bottleneck. The geographic distribution and family pedigrees associated with some Finnish heritage disease mutations has linked the enrichment in these mutations to multiple local founder effects, some associated with a period of "late settlement" in the 16th century (see History of Finland).{{Cite journal |vauthors=Peltonen L, Jalanko A, Varilo T |year=1999 |title=Molecular genetics of the Finnish disease heritage |journal=Human Molecular Genetics |volume=8 |issue=10 |pages=1913–23 |doi=10.1093/hmg/8.10.1913 |pmid=10469845 |doi-access=free}}

Etymology

Although the concept is older, the English term "Finnish disease heritage" first appears in the medical literature in the 1990s. One of the earliest uses is in the translated title of a 1994 medical article,{{Cite journal |vauthors=de la Chapelle A, Hästbacka J, Lehesjoki AE, Sulisalo T, Kere J, Tahvanainen E, Sistonen P |year=1994 |title=[Linkage and linkage disequilibrium in the Finnish disease heritage] |journal=Duodecim; Lääketieteellinen Aikakauskirja |language=Finnish |volume=110 |issue=7 |pages=654–64 |pmid=8542820}} soon followed by others.{{Cite journal |last=Perheentupa J |date=October 1995 |title=The Finnish disease heritage: a personal look |journal=Acta Paediatrica |volume=84 |issue=10 |pages=1094–9 |doi=10.1111/j.1651-2227.1995.tb13501.x |pmid=8563216 |s2cid=29999767}}

See also

{{Portal|Medicine|Finland}}

References

{{Reflist|2}}

{{DEFAULTSORT:Finnish Heritage Disease}}

Category:Rare diseases

Category:Autosomal recessive disorders

Category:Health in Finland