genetics, human

▪ biology

Introduction

      study of the inheritance of characteristics by children from parents. Inheritance in humans does not differ in any fundamental way from that in other organisms.

      The study of human heredity occupies a central position in genetics. Much of this interest stems from a basic desire to know who humans are and why they are as they are. At a more practical level, an understanding of human heredity is of critical importance in the prediction, diagnosis, and treatment of diseases that have a genetic component. The quest to determine the genetic basis of human (human body) health has given rise to the field of medical genetics. In general, medicine has given focus and purpose to human genetics, so that the terms medical genetics and human genetics are often considered synonymous.

The human chromosomes (chromosome)

      A new era in cytogenetics, the field of investigation concerned with studies of the chromosomes, began in 1956 with the discovery by Jo Hin Tjio and Albert Levan that human somatic cells contain 23 pairs of chromosomes. Since that time the field has advanced with amazing rapidity and has demonstrated that human chromosome aberrations rank as major causes of fetal death and of tragic human diseases, many of which are accompanied by mental retardation. Since the chromosomes can be delineated only during mitosis, it is necessary to examine material in which there are many dividing cells. This can usually be accomplished by culturing cells from the blood or skin, since only the bone marrow cells (not readily sampled except during serious bone marrow disease such as leukemia) have sufficient mitoses in the absence of artificial culture. After growth, the cells are fixed on slides and then stained with a variety of DNA-specific stains that permit the delineation and identification of the chromosomes. The Denver system of chromosome classification, established in 1959, identified the chromosomes by their length and the position of the centromeres. Since then the method has been improved by the use of special staining techniques that impart unique light and dark bands to each chromosome. These bands permit the identification of chromosomal regions that are duplicated, missing, or transposed to other chromosomes.

      Micrographs showing the karyotypes (i.e., the physical appearance of the chromosome) of a male and female have been produced. In a typical micrograph the 46 human chromosomes (the diploid number) are arranged in homologous pairs, each consisting of one maternally derived and one paternally derived member. The chromosomes are all numbered except for the X and the Y chromosomes, which are the sex chromosomes. In humans, as in all mammals, the normal female has two X chromosomes and the normal male has one X chromosome and one Y chromosome. The female is thus the homogametic sex, as all her gametes normally have one X chromosome. The male is heterogametic, as he produces two types of gametes—one type containing an X chromosome and the other containing the Y chromosome. There is good evidence that the Y chromosome in humans, unlike that in Drosophila, is necessary (but not sufficient) for maleness.

fertilization, sex determination, and differentiation

      A human individual arises through the union of two cells, an egg (ovum) from the mother and a sperm from the father. Human egg cells are barely visible to the naked eye. They are shed, usually one at a time, from the ovary into the oviducts (fallopian tubes), through which they pass into the uterus. Fertilization, the penetrance of an egg by a sperm, occurs in the oviducts. This is the main event of sexual reproduction and determines the genetic constitution of the new individual.

      Human sex determination is a genetic process that depends basically on the presence of the Y chromosome in the fertilized egg. This chromosome stimulates a change in the undifferentiated gonad into that of the male (a testicle). The gonadal action of the Y chromosome is mediated by a gene located near the centromere; this gene codes for the production of a cell surface molecule called the H-Y antigen. Further development of the anatomic structures, both internal and external, that are associated with maleness is controlled by hormones produced by the testicle. The sex of an individual can be thought of in three different contexts: chromosomal sex, gonadal sex, and anatomic sex. Discrepancies among these, especially the latter two, result in the development of individuals with ambiguous sex, often called hermaphrodites (hermaphroditism). The phenomenon of homosexuality is of uncertain cause and is unrelated to the above sex-determining factors. It is of interest that in the absence of a male gonad (testicle) the internal and external sex anatomy is always female, even in the absence of a female ovary. A female without ovaries will, of course, be infertile and will not experience any of the female developmental changes normally associated with puberty. Such a female will often have Turner's syndrome.

      If X-containing and Y-containing sperm are produced in equal numbers, then according to simple chance one would expect the sex ratio at conception (fertilization) to be half boys and half girls, or 1 : 1. Direct observation of sex ratios among newly fertilized human eggs is not yet feasible, and sex-ratio data are usually collected at the time of birth. In almost all human populations of newborns there is a slight excess of males; about 106 boys are born for each 100 girls. Throughout life, however, there is a slightly greater mortality of males; this slowly alters the sex ratio until, beyond the age of about 50 years, there is an excess of females. Studies indicate that male embryos suffer a relatively greater degree of prenatal mortality, so that the sex ratio at conception might be expected to favour males even more than the 106 : 100 ratio observed at birth would suggest. Firm explanations for the apparent excess of male conceptions have not been established; it is possible that Y-containing sperm survive better within the female reproductive tract, or that they may be a little more successful in reaching the egg in order to fertilize it. In any case, the sex differences are small, the statistical expectation for a boy (or girl) at any single birth still being close to one out of two.

      During gestation—the period of nine months between fertilization and the birth of the infant—a remarkable series of developmental changes occur. Through the process of mitosis, the total number of cells changes from one (the fertilized egg) to about 2 × 10¹¹. In addition, these cells differentiate into hundreds of different types with specific functions (liver cells, nerve cells, muscle cells, etc.). A multitude of regulatory processes, both genetically and environmentally controlled, accomplish this differentiation. Elucidation of the exquisite timing of these processes remains one of the great challenges of human biology.

Immunogenetics

      Immunity is the ability of an individual to recognize the “self” molecules that make up one's own body and to distinguish them from such “non-self” molecules as those found in infectious microorganisms and toxins. This process has a prominent genetic component. Knowledge of the genetic and molecular basis of the mammalian immune system has increased in parallel with the explosive advances made in somatic cell and molecular genetics.

      There are two major components of the immune system, both originating from the same precursor “stem” cells. The bursa component provides B lymphocytes (B cell), a class of white blood cells that, when appropriately stimulated, differentiate into plasma cells. These latter cells produce circulating soluble proteins called antibodies or immunoglobulins (antibody). Antibodies are produced in response to substances called antigens, most of which are foreign proteins or polysaccharides. An antibody molecule can recognize a specific antigen, combine with it, and initiate its destruction. This so-called humoral immunity is accomplished through a complicated series of interactions with other molecules and cells; some of these interactions are mediated by another group of lymphocytes, the T lymphocytes, which are derived from the thymus gland. Once a B lymphocyte has been exposed to a specific antigen, it “remembers” the contact so that future exposure will cause an accelerated and magnified immune reaction. This is a manifestation of what has been called immunological memory.

      The thymus component of the immune system centres on the thymus-derived T lymphocytes. In addition to regulating the B cells in producing humoral immunity, the T cells also directly attack cells that display foreign antigens. This process, called cellular immunity, is of great importance in protecting the body against a variety of viruses as well as cancer cells. Cellular immunity is also the chief cause of the rejection of organ transplants. The T lymphocytes provide a complex network consisting of a series of helper cells (which are antigen specific), amplifier cells, suppressor cells, and cytotoxic (killer) cells, all of which are important in immune regulation.

The genetics of antibody formation

      One of the central problems in understanding the genetics of the immune system has been in explaining the genetic regulation of antibody production. Immunobiologists have demonstrated that the system can produce well over 1,000,000 specific antibodies, each corresponding to a particular antigen. It would be difficult to envisage that each antibody is encoded by a separate gene—such an arrangement would require a disproportionate share of the entire human genome. Recombinant DNA analysis has illuminated the mechanisms by which a limited number of immunoglobulin genes can encode this vast number of antibodies.

      Each antibody molecule consists of several different polypeptide chains—the light chains (L) and the longer heavy chains (H). The latter determine to which of five different classes (IgM, IgG, IgA, IgD, or IgE) an immunoglobulin belongs. Both the L and H chains are unique among proteins in that they contain constant and variable parts. The constant parts have relatively identical amino acid sequences in any given antibody. The variable parts, on the other hand, have different amino acid sequences in each antibody molecule. It is the variable parts, then, that determine the specificity of the antibody.

      Recombinant DNA studies of immunoglobulin genes in mice have revealed that the light-chain genes are encoded in four separate parts in germline DNA: a leader segment (L), a variable segment (V), a joining segment (J), and a constant segment (C). These segments are widely separated in the DNA of an embryonic cell, but in a mature B lymphocyte they are found in relative proximity (albeit separated by introns). The mouse has more than 200 light-chain variable region genes, only one of which will be incorporated into the proximal sequence that codes for the antibody production in a given B lymphocyte. Antibody diversity is greatly enhanced by this system, as the V and J segments rearrange and assort randomly in each B-lymphocyte precursor cell. The mechanisms by which this DNA rearrangement takes place are not clear, but transposons are undoubtedly involved. Similar combinatorial processes take place in the genes that code for the heavy chains; furthermore, both the light-chain and heavy-chain genes can undergo somatic mutations to create new antibody-coding sequences. The net effect of these combinatorial and mutational processes enables the coding of millions of specific antibody molecules from a limited number of genes. It should be stressed, however, that each B lymphocyte can produce only one antibody. It is the B lymphocyte population as a whole that produces the tremendous variety of antibodies in humans and other mammals.

      Plasma cell tumours (myelomas (multiple myeloma)) have made it possible to study individual antibodies since these tumours, which are descendants of a single plasma cell, produce one antibody in abundance. Another method of obtaining large amounts of a specific antibody is by fusing a B lymphocyte with a rapidly growing cancer cell. The resultant hybrid cell, known as a hybridoma, multiplies rapidly in culture. Since the antibodies obtained from hybridomas are produced by clones derived from a single lymphocyte, they are called monoclonal antibodies.

The genetics of cellular immunity

      As has been stated, cellular immunity is mediated by T lymphocytes that can recognize infected body cells, cancer cells, and the cells of a foreign transplant. The control of cellular immune reactions is provided by a linked group of genes, known as the major histocompatibility complex (MHC). These genes code for the major histocompatibility antigens (human leukocyte antigen), which are found on the surface of almost all nucleated somatic cells. The major histocompatibility antigens were first discovered on the leukocytes (white blood cells) and are, therefore, usually referred to as the HLA (human leukocyte group A) antigens.

      The advent of the transplantation (transplant) of human organs in the 1950s made the question of tissue compatibility between donor and recipient of vital importance, and it was in this context that the HLA antigens and the MHC were elucidated. Investigators found that the MHC resides on the short arm of chromosome 6, on four closely associated sites designated HLA-A, HLA-B, HLA-C, and HLA-D. Each locus is highly polymorphic—i.e., each is represented by a great many alleles within the human gene pool. These alleles, like those of the ABO blood group system, are expressed in codominant fashion. Because of the large number of alleles at each HLA locus, there is an extremely low probability of any two individuals (other than siblings) having identical HLA genotypes. (Since a person inherits one chromosome 6 from each parent, siblings have a 25 percent probability of having received the same paternal and maternal chromosomes 6 and thus of being HLA matched.)

      Although HLA antigens are largely responsible for the rejection of organ transplants, it is obvious that the MHC did not evolve to prevent the transfer of organs from one person to another. Indeed, information obtained from the histocompatibility complex in the mouse (which is very similar in its genetic organization to that of the human) suggests that a primary function of the HLA antigens is to regulate the number of specific cytotoxic T killer cells, which have the ability to destroy virus-infected cells and cancer cells.

Arthur Robinson

The genetics of human blood

      More is known about the genetics of the blood than about any other human tissue. One reason for this is that blood samples can be easily secured and subjected to biochemical analysis without harm or major discomfort to the person being tested. Perhaps a more cogent reason is that many chemical properties of human blood (blood group) display relatively simple patterns of inheritance.

Blood types

      Certain chemical substances within the red blood cells (such as the ABO and MN substances noted above) may serve as antigens. When cells that contain specific antigens are introduced into the body of an experimental animal such as a rabbit, the animal responds by producing antibodies in its own blood.

      In addition to the ABO and MN systems, geneticists have identified about 14 blood-type gene systems associated with other chromosomal locations. The best known of these is the Rh system (Rh blood group system). The Rh antigens are of particular importance in human medicine. Curiously, however, their existence was discovered in monkeys. When blood from the rhesus monkey (hence the designation Rh) is injected into rabbits, the rabbits produce so-called Rh antibodies that will agglutinate not only the red blood cells of the monkey but the cells of a large proportion of human beings as well. Some people (Rh-negative individuals), however, lack the Rh antigen; the proportion of such persons varies from one human population to another. Akin to data concerning the ABO system, the evidence for Rh genes indicates that only a single chromosome locus (called r) is involved and is located on chromosome 1. At least 35 Rh alleles are known for the r location; basically the Rh-negative condition is recessive.

      A medical problem may arise when a woman who is Rh-negative carries a fetus that is Rh-positive. The first such child may have no difficulty, but later similar pregnancies (pregnancy) may produce severely anemic newborn infants. Exposure to the red blood cells of the first Rh-positive fetus appears to immunize the Rh-negative mother, that is, she develops antibodies that may produce permanent (sometimes fatal) brain damage in any subsequent Rh-positive fetus. Damage arises from the scarcity of oxygen reaching the fetal brain because of the severe destruction of red blood cells. Measures are available for avoiding the severe effects of Rh incompatibility by transfusions to the fetus within the uterus; however, genetic counselling before conception is helpful so that the mother can receive Rh immunoglobulin immediately after her first and any subsequent pregnancies involving an Rh-positive fetus. This immunoglobulin effectively destroys the fetal red blood cells before the mother's immune system is stimulated. The mother thus avoids becoming actively immunized against the Rh antigen and will not produce antibodies that could attack the red blood (serum) cells of a future Rh-positive fetus.

Serum proteins

      Human serum, the fluid portion of the blood that remains after clotting, contains various proteins that have been shown to be under genetic control. Study of genetic influences has flourished since the development of precise methods for separating and identifying serum proteins. These move at different rates under the impetus of an electrical field (electrophoresis), as do proteins from many other sources (e.g., muscle or nerve). Since the composition of a protein is specified by the structure of its corresponding gene, biochemical studies based on electrophoresis permit direct study of tissue substances that are only a metabolic step or two away from the genes themselves.

      Electrophoretic studies have revealed that at least one-third of the human serum proteins occur in variant forms. Many of the serum proteins are polymorphic, occurring as two or more variants with a frequency of not less than 1 percent each in a population. Patterns of polymorphic serum protein variants have been used to determine whether twins are identical (as in assessing compatibility for organ transplants) or whether two individuals are related (as in resolving paternity suits). Whether or not the different forms have a selective advantage is not generally known.

      Much attention in the genetics of substances in the blood has been centred on serum proteins called haptoglobins (haptoglobin), transferrins (transferrin) (which transport iron), and gamma globulins (a number of which are known to immunize against infectious diseases). Haptoglobins appear to relate to two common alleles at a single chromosome locus; the mode of inheritance of the other two seems more complicated, about 18 kinds of transferrins having been described. Like blood-cell antigen genes, serum-protein genes are distributed worldwide in the human population in a way that permits their use in tracing the origin and migration of different groups of people.

hemoglobin

      Hundreds of variants of hemoglobin have been identified by electrophoresis, but relatively few are frequent enough to be called polymorphisms. Of the polymorphisms, the alleles for sickle-cell and thalassemia hemoglobins produce serious disease in homozygotes, whereas others (hemoglobins C, D, and E) do not. The sickle-cell polymorphism confers a selective advantage on the heterozygote living in a malarial environment; the thalassemia polymorphism provides a similar advantage.

Influence of the environment

      As stated earlier in this article, gene expression occurs only after modification by the environment. A good example is the recessively inherited disease called galactosemia, in which the enzyme necessary for the metabolism of galactose—a component of milk sugar—is defective. The sole source of galactose in the infant's diet is milk, which in this instance is toxic. The treatment of this most serious disease in the neonate is to remove all natural forms of milk from the diet (environmental manipulation) and to substitute a synthetic milk lacking galactose. The infant will then develop normally but will never be able to tolerate foods containing lactose. If milk were not a major part of the infant's diet, however, the mutant gene would never be able to express itself, and galactosemia would be unknown.

      Another way of saying this is that no trait can exist or become actual without an environmental contribution. Thus, the old question of which is more important, heredity or environment, is without meaning. Both nature (heredity) and nurture (environment) are always important for every human attribute.

      But this is not to say that the separate contributions of heredity and environment are equivalent for each characteristic. Dark pigmentation of the iris of the eye, for example, is under hereditary control in that one or more genes specify the synthesis and deposition in the iris of the pigment (melanin). This is one character that is relatively independent of such environmental factors as diet or climate; thus, individual differences in eye colour tend to be largely attributable to hereditary factors rather than to ordinary environmental change.

      On the other hand, it is unwarranted to assume that other traits (such as height, weight, or intelligence) are as little affected by environment as is eye colour. It is very easy to gather information that tall parents tend, on the average, to have tall children (and that short parents tend to produce short children), properly indicating a hereditary contribution to height. Nevertheless, it is equally manifest that growth can be stunted in the environmental absence of adequate nutrition. The dilemma arises that only the combined, final result of this nature–nurture interaction can be directly observed. There is no accurate way (in the case of a single individual) to gauge the separate contributions of heredity and environment to such a characteristic as height. An inferential way out of this dilemma is provided by studies of twins.

Fraternal twins

      Usually a fertile human female produces a single egg about once a month. Should fertilization occur (a zygote is formed), growth of the individual child normally proceeds after the fertilized egg has become implanted in the wall of the uterus (womb). In the unusual circumstance that two unfertilized eggs are simultaneously released by the ovaries, each egg may be fertilized by a different sperm cell at about the same time, become implanted, and grow, to result in the birth of twins.

      Twins formed from separate eggs and different sperm cells can be of the same or of either sex. No matter what their sex, they are designated as fraternal twins. This terminology is used to emphasize that fraternal twins are genetically no more alike than are siblings (brothers or sisters) born years apart. Basically they differ from ordinary siblings only in having grown side by side in the womb and in having been born at approximately the same time.

Identical twins

      In a major nonfraternal type of twinning, only one egg is fertilized; but during the cleavage of this single zygote into two cells, the resulting pair somehow become separated. Each of the two cells may implant in the uterus separately and grow into a complete, whole individual. In laboratory studies with the zygotes of many animal species, it has been found that in the two-cell stage (and later) a portion of the embryo, if separated under the microscope by the experimenter, may develop into a perfect, whole individual. Such splitting occurs spontaneously at the four-cell stage in some organisms (e.g., the armadillo) and has been accomplished experimentally with the embryos of salamanders, among others.

      The net result of splitting at an early embryonic stage may be to produce so-called identical twins. Since such twins derive from the same fertilized egg, the hereditary material from which they originate is absolutely identical in every way, down to the last gene locus. While developmental and genetic differences between one “identical” twin and another still may arise through a number of processes (e.g., mutation), these twins are always found to be of the same sex. They are often breathtakingly similar in appearance, frequently down to very fine anatomic and biochemical details (although their fingerprints are differentiable).

Diagnosis of twin types

      Since the initial event in the mother's body (either splitting of a single egg or two separate fertilizations) is not observed directly, inferential means are employed for diagnosing a set of twins as fraternal or identical. The birth of fraternal twins is frequently characterized by the passage of two separate afterbirths. In many instances, identical twins are followed by only a single afterbirth, but exceptions to this phenomenon are so common that this is not a reliable method of diagnosis.

      The most trustworthy method for inferring twin type is based on the determination of genetic similarity. By selecting those traits that display the least variation attributable to environmental influences (such as eye colour and blood types), it is feasible, if enough separate chromosome loci are considered, to make the diagnosis of twin type with high confidence. HLA antigens, which, as stated above, are very polymorphic, have become most useful in this regard.

Inferences from twin studies

Metric (quantitative) traits

      By measuring the heights of a large number of ordinary siblings (brothers and sisters) and of twin pairs, it may be shown that the average difference between identical twins is less than half the difference for all other siblings. Any average differences between groups of identical twins are attributable with considerable confidence to the environment. Thus, since the sample of identical twins who were reared apart (in different homes) differed little in height from identicals who were raised together, it appears that environmental–genetic influences on that trait tended to be similar for both groups.

      Yet, the data for like-sexed fraternal twins reveal a much greater average difference in height (about the same as that found for ordinary siblings reared in the same home at different ages). Apparently the fraternal twins were more dissimilar than identicals (even though reared together) because the fraternals differed more among themselves in genotype. This emphasizes the great genetic similarity among identicals. Such studies can be particularly enlightening when the effects of individual genes are obscured or distorted by the influence of environmental factors on quantitative (measurable) traits (e.g., height, weight, and intelligence).

      Any trait that can be objectively measured among identical and fraternal twins can be scrutinized for the particular combination of hereditary and environmental influences that impinge upon it. The effect of environment on identical twins reared apart is suggested by their relatively great average difference in body weight as compared with identical twins reared together. Weight appears to be more strongly modified by environmental variables than is height.

      Study of comparable characteristics among farm animals and plants suggests that such quantitative human traits as height and weight are affected by allelic differences at a number of chromosome locations: that they are not simply affected by genes at a single locus. Investigation of these gene systems with multiple locations (polygenic systems) is carried out largely through selective-breeding experiments among large groups of plants and lower animals. Human beings select their mates in a much freer fashion, of course, and polygenic studies among people are thus severely limited.

      Intelligence (intelligence, human) is a very complex human trait, the genetics of which has been a subject of controversy for some time. Much of the controversy arises from the fact that intelligence is so difficult to define. Information has been based almost entirely on scores on standardized IQ tests constructed by psychologists; in general such tests do not take into account cultural, environmental, and educational differences. As a result, the working definition of intelligence has been “the general factor common to a large number of diverse cognitive (IQ) tests.” Even roughly measured as IQ, intelligence shows a strong contribution from the environment. Fraternal twins, however, show relatively great dissimilarity in IQ, suggesting an important contribution from heredity as well. In fact, it has been estimated that on the average between 60 and 80 percent of the variance in IQ test scores could be genetic. It is important to note that intelligence is polygenically inherited and that it has the highest degree of assortative mating of any trait; in other words, people tend to mate with people having similar IQ's. Moreover, twin studies involving psychological traits should be viewed with caution; for example, since identical twins tend to be singled out for special attention, their environment should not be considered equivalent even to that of other children raised in their own family.

      Since the time of Galton, generalizations have been repeatedly made about racial differences in intelligence, with claims of genetic superiority of some races over others. These generalizations fail to recognize that races are composed of individuals, each of whom has a unique genotype made up by genes shared with other humans, and that the sources of intraracial variation are more numerous than those producing interracial differences.

Other traits

      For traits of a more qualitative (all-or-none) nature, the twin method can also be used in efforts to assess the degree of hereditary contribution. Such investigations are based on an examination of cases in which at least one member of the twin pair shows the trait. It was found in one study, for example, that in about 80 percent of all identical twin pairs in which one twin shows symptoms of the psychiatric disorder called schizophrenia, the other member of the pair also shows the symptoms (that is, the two are concordant for the schizophrenic trait). In the remaining 20 percent, the twins are discordant (that is, one lacks the trait). Since identical twins often have similar environments, this information by itself does not distinguish between the effects of heredity and environment. When pairs of like-sexed fraternal twins reared together are studied, however, the degree of concordance for schizophrenia is very much lower—only about 15 percent.

      Schizophrenia thus clearly develops much more easily in some genotypes than among others; this indicates a strong hereditary predisposition to the development of the trait. Schizophrenia also serves as a good example of the influence of environmental factors since concordance for the condition does not appear in 100 percent of identical twins.

      Studies of concordance and discordance between identical and fraternal twins have been carried out for many other human characteristics. It has, for example, been known for many years that tuberculosis is a bacterial infection of environmental origin. Yet identical twins raised in the same home show concordance for the disease far more often than do fraternal twins. This finding seems to be explained by the high degree of genetic similarity among the identical twins. While the tuberculosis germ is not inherited, heredity does seem to make one more (or less) susceptible to this particular infection. Thus, the genes of one individual may provide the chemical basis for susceptibility to a disease, while the genes of another may fail to do so.

      Indeed, there seem to be genetic differences among disease germs themselves that result in differences in their virulence. Thus, whether a genetically susceptible person actually develops a disease also depends in part on the heredity of the particular strain of bacteria or virus with which he or she must cope. Consequently, unless environmental factors such as these are adequately evaluated, the conclusions drawn from susceptibility studies can be unfortunately misleading.

      The above discussion should help to make clear the limits of genetic determinism. The expression of the genotype can always be modified by the environment. It can be argued that all human illnesses have a genetic component and that the basis of all medical therapy is environmental modification. Specifically, this is the hope for the management of genetic diseases. The more that can be learned about the basic molecular and cellular dysfunctions associated with such diseases, the more amenable they will be to environmental manipulation.

Hampton L. Carson Arthur Robinson

Additional Reading

Curt Stern, Principles of Human Genetics, 3rd ed. (1973), is a classic work thoroughly covering the field. Alan E.H. Emery and David L. Rimon (eds.), Principles and Practice of Human Genetics, 2 vol. (1983), presents an up-to-date, thorough treatment of medical genetics. Victor A. McKusick, Mendelian Inheritance in Man: Catalogue of Autosomal Dominant, Autosomal Recessive, and X-Linked Phenotypes, 6th ed. (1983), is an informative source. Aubrey Milunsky and George J. Annas (eds.), Genetics and the Law II (1980), presents papers on ethics, eugenics, genetics, and the law. See also such symposium and conference proceedings as Ernest B. Hook and Ian H. Porter (eds.), Population Cytogenetics: Studies in Humans (1977); and Charles J. Epstein et al. (eds.), Risk, Communication, and Decision Making in Genetic Counseling (1979).Arthur Robinson

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