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The Nobel Prize in Physiology or Medicine 1993

Splicing and diseases

Splicing errors cause thalassemia


Thalassemia, a form of anemia common in the Mediterrarean countries, is caused by errors in the splicing process.



Normal red blood cells contain correctly spliced beta-globin, an important component in hemoglobin that takes up oxygen in the lungs.



The red blood cells in thalassemia patients are distorted and sometimes immature, containing a nucleus. This is due to a point mutation in the beta-globin gene, which causes an error in splice site selection. A faulty beta-globin protein is made, leading to severe anemia.

Arrows mark two examples of sites where point mutations causing thalassemia occur in the beta-globin gene.

 

The Philadelphia chromosome and cancer

The small Philadelphia chromosome is present in cancer cells of almost all patients with chronic myeloic leukemia, a form of cancer of the blood. This chromosome is generated by breaks in the long arms of chromosomes 9 and 22 followed by an exchange of the tips of the chromosomes (translocation). This results in the creation of a fusion gene in the Ph chromosome, which then via a spliced mRNA, gives rise to a fusion protein. This abnormal protein is believed to play a key role in causing leukemia.

 

The 1993 Prize in: