Human Genetic Variation by National Institute of Health - HTML preview

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part of the lesson

• 1 copy of Master 3.13 for each Firm B group

89

Student Lesson 3

Human Genetic Variation

Procedure

1. Introduce the lesson by displaying a transparency of Master 3.1,

Molecular Medicine Comes of Age, and asking students what they

think the statement means and whether they can think of any

examples that illustrate or provide evidence for this statement.

Students should be able to explain that understanding human genetic

variation at a molecular level means identifying the specific differences

in the base sequence that distinguish one human from another. Although

Asking students to explain

students will likely not mention pharmacogenomics and targeted drug

the phrase “understand

therapy as examples of healthcare strategies that depend on understanding

human genetic variation

molecular variation, they may mention gene therapy as a strategy.

at a molecular level” will

help you assess what they

Students may have difficulty expressing these ideas in their own words.

learned from the fi rst part

You may wish to help them by asking probing questions such as, “What

does it mean to understand human genetic variation at a molecular

of Lesson 2.

level?” and “Can you think of any way that finding and sequencing the

gene related to a disease could help scientists develop ways to treat it?”

2. Explain that the students’ challenge in this lesson is to investigate

two examples that illustrate and provide evidence for this statement.

Explain further that students will investigate these examples by

acting as groups of employees in two pharmaceutical companies

facing problems that threaten the companies’ futures.

3. Divide the class in half and explain that one-half will act as employees

in Firm A and the other half, as employees in Firm B. Tell students

that the problems the two firms face are different, but both problems

can be solved in ways that relate to the statement on the transparency.

4. Direct students to organize into groups of four. Give one copy each of

Masters 3.2, 3.3, 3.4, and 3.5, Saving Firm A, [Role], to each group in

one-half of the class and one copy each of Masters 3.8, 3.9, 3.10, and 3.11,

Saving Firm B, [Role], to each group in the other half. Also give one copy of Master 3.6, Report Form for Firm A, or Master 3.12, Report Form for

Firm B, to each student and explain that students should use these

forms to organize their discussions and report the results of their work.

For an introduction to the different roles for Firm A,

students can view the Lesson 3 videos on the Human

Genetic Variation Web site. Go to http://science.education.

nih.gov/supplements/genetic/student and click on “Molecular

Medicine Comes of Age” to access the videos.

5. Instruct the groups to decide who will assume each of the four roles

associated with their problem and to distribute the masters accordingly.

Master 3.5, Saving Firm A, Role: Biostatistician, involves somewhat more

challenging analysis than the other roles. You may want to consider

assigning students who have stronger mathematical analysis skills to

the biostatistician role.

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6. Give the groups 30 minutes to complete their reports and to be

ready to defend their analysis of their company’s problem and their

suggested solution to the class. They should use the Report Form

(Master 3.6 or 3.12) to organize their thoughts.

When students reach Step 6 on Master 3.6 or Step 5 on Master 3.12, they

will ask you, as vice president of the company, for additional data (Master

3.7, Some New Genetic Data about Firm A, or Master 3.13, Some New

Information about Firm B). You can give the groups copies of the masters, or you can devise an approach that requires students to search for the data.

Students can also go to the Human Genetic Variation Web

site and view the video “New Data” when they reach Step 6.

Go to http://science.education.nih.gov/supplements/genetic/

student and click on “Molecular Medicine Comes of Age”

to access New Data. Access to the video is password protected.

Give students the password: gene.

7. After 30 minutes, call the class to order. Explain that you will assume

the role of the vice president for research for Firm A first and then

the role of the vice president for research for Firm B, and that you are

calling everyone together to hear the results of the groups’ work.

8. Display a transparency of Master 3.6, Report Form for Firm A, and use it to guide the discussion by asking groups from Firm A to present

their answers to the questions (a different group should answer each

question). After one group has offered an answer, invite questions

and additional comments from the class.

To keep all students involved in both discussions, invite students from

the other firm to contribute to the discussion by asking questions and

even offering suggestions, as appropriate.

An interesting way

to assess students’

Question 1. What is the biological problem facing Firm A with respect

understanding of this

to Drug X?

information is to ask one

group to offer an answer

The response to Drug X among asthma patients is inconsistent, that is,

the drug does not work the same way on all patients.

to a question and a

different group to evaluate

Question 2. Describe asthma in your own words (refer to Master 3.2,

the answer’s accuracy and

Saving Firm A, Role: Team Coordinator , and Master 3.3, Saving Firm

completeness and propose

A, Role: Physiologist ).

corrections or additions as

necessary. This technique

Asthma is a fairly common condition that involves breathing

difficulties. The bronchioles contract abnormally. It is often associated

helps students learn to offer

with an allergic reaction to foreign substances.

feedback in a positive way

and extends accountability

Question 3. What is Drug X designed to do for asthma sufferers (refer to

for acceptable answers to

Master 3.2, Saving Firm A, Role: Team Coordinator , and Master 3.3,

more students than simply

Saving Firm A, Role: Physiologist )?

the group members who

The drug opens up the bronchioles to make breathing easier.

provide the initial answer.

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Student Lesson 3

Human Genetic Variation

Question 4. Look at the preliminary test results (refer to Master 3.5,

Saving Firm A, Role: Biostatistician ). Can you predict which group

will be helped most or least by Drug X? For example, does the sex of

an individual make a difference? Does having pets make a difference?

Explain your answers.

No to all three questions. Students should recognize that the proportion

of children who experience relief from the symptoms of asthma is the

same for males and females and for children who do and do not own

pets. In all cases, about one-third experience significant relief, slightly

more than 40 percent experience some relief, and nearly one-fourth

experience no relief. The constancy of these proportions means that

neither the sex of the individual nor the presence of pet dander makes

a difference in the response.

Question 5. What does the example of ApoE (refer to Master 3.4, Saving

Firm A, Role: Molecular Biologist ) suggest might be happening with

Drug X? Based on this example, what might Firm A investigate?

The data indicate that response to the Alzheimer drug might be based

on variations in the ApoE gene. Perhaps Firm A should explore genetic

differences with respect to response to Drug X.

Question 6. Firm A’s vice president for research (your teacher) will

provide you with some new data. What do the new data reveal

about Drug X?

There is a difference in response to the drug on the basis of the

genetic variations in the patient population.

Question 7. What would be an appropriate way to prescribe Drug X?

It would be appropriate to test each asthma patient’s genotype to

determine whether Drug X will be effective with that individual.

Question 8. Has your group solved the biological problem facing the

company with respect to Drug X? What new problems has it raised?

The group’s work has answered the basic biological question about

response to Drug X. It has raised new questions about the ability to

test all asthma sufferers. For example, how expensive is it to do that?

Will physicians order the test? Will it be covered by health insurance?

Who will have access to the information that results from the genetic

test? How will Firm A educate physicians and other healthcare

professionals so they understand the test and the results and can

explain this information to their patients?

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9. Repeat the same process with the groups from Firm B, but use a

transparency made from Master 3.12 to guide the discussion.

Again, to keep all students involved in the discussion, invite students

from the other firm to contribute to the discussion by asking

questions and even offering suggestions, as appropriate.

Question 1. What is the problem facing Firm B with respect to Drug Y

(refer to Master 3.8, Saving Firm B, Role: Team Coordinator )?

Drug Y is a successful treatment for cystic fibrosis (CF) and the firm’s

leading product. Firm B needs to keep looking ahead, however, and

begin thinking about new treatments for CF that take advantage

of what scientists have learned about the condition and, in the

future, might be able to supplement or even replace income that the

company is now receiving from Drug Y.

Question 2. Describe cystic fibrosis in your own words (refer to

Master 3.9, Saving Firm B, Role: Physiologist ).

CF is a genetic disease that causes the body to produce abnormally

thick, sticky mucus. This mucus clogs the airways and other ducts

and passages in the body and provides an ideal breeding ground

for many microorganisms. CF patients have frequent airway

infections and often show poor weight gain and slowed growth

and development.

Question 3. What have we learned in the past few years about

the cause of CF (refer to Master 3.10, Saving Firm B, Role:

Molecular Biologist )?

The most common CF mutation leads to one missing amino acid

in the CFTR protein. The loss of this single amino acid causes the

protein to be misshapen in such a way that most of it is destroyed

instead of being inserted into the cell membrane. The absence of

properly functioning CFTR protein in the cell membrane leads to

abnormal movement of chloride ions and water into and out of

the cell and the production of thick, sticky mucus.

Question 4. What is Drug Y (and most other current treatments)

designed to do for CF patients (refer to the Master 3.11, Saving Firm

B, Role: Physician , and discuss what goes in the last column of the

table provided)?

Most existing treatments for CF focus on alleviating the symptoms

of the disease—for example, removing airway mucus, reducing

infection, and improving nutrition. Students should discover this

by completing the last column in the table provided on Master 3.11.

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Student Lesson 3

Human Genetic Variation

Question 5. Firm B’s vice president for research (your teacher) will

provide you with some new information. What clue does this new

information provide about how Firm B might approach developing

new treatments for CF?

The important clue that students should gain from this new

information is that understanding the biological basis of CF has

allowed these researchers to propose a way to correct the problem in

CF cells. This approach is different from treating its consequences.

Question 6. What new approaches do you recommend Firm B consider

as it attempts to design and develop one or more new treatments for CF?

Students will not be able to suggest detailed approaches to developing

treatments, but they should be able to propose general approaches

that address each of the items on the flow chart on Master 3.10. For

example, students might suggest developing treatments that would

• correct or replace the defective CF genes,

• replace the missing amino acid in the CFTR protein,

• cause the CFTR protein to fold properly despite the missing

amino acid,

• prevent the defective CFTR protein from being destroyed before

it reaches the cell membrane,

• introduce functional CFTR protein into the cell from another

source, or

• create another mechanism in the cell that would regulate the

movement of chloride ions.

Question 7. Has your group solved the problem facing the company

with respect to Drug Y? What new problems has it raised?

No, the group has not solved the problem facing the company, but it has

You may wish to ask the

suggested several directions that the company may want to investigate

students who worked on

as it develops new CF treatments. New problems that the group’s work

Firm A’s problem to

has raised include problems common to all development of new drugs:

answer the questions

deciding on an approach to try, allocating funds to pay for development

and clinical testing, and going through the process of gaining Food and

related to Firm B’s

Drug Administration (FDA) approval for the new treatment.

problem, and vice versa.

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10. Challenge students to generalize what they have learned by answering

the following questions:

• How is genetic variation related to the use of drugs?

Students should understand that genetic differences between people

may cause them to respond differently to therapeutic drugs. As

scientists begin to detect such genetic differences, physicians will

become more sensitive to individual variation in response to drugs

and may even begin to prescribe drugs based on differences in

genotype.

• How will pharmaceutical companies likely use our increasing

understanding of human genetic variation?

Pharmaceutical companies may begin to design drugs intended

for people who have certain genotypes. They may also resurrect

Refocusing students’

products that were not viable in the past because of their

attention on the opening

unpredictable, negative side effects on certain people.

statement draws them

back to the lesson’s major

• How can discovering the genes associated with genetic disorders

concept.

help scientists develop new approaches to treatment?

As Figure 6 (page 25) shows, mapping and cloning the genes

associated with genetic disorders helps scientists discover their

underlying biochemical mechanisms, and this can suggest new

approaches to treatment.

Another way to raise these issues with students is to display a

transparency made from Figure 6 and ask students to explain

how the lesson they just completed relates to the beginning and

end points of the arrows on the diagram.

11. Display again the transparency you made from Master 3.1, Molecular

Medicine Comes of Age. Ask students to explain what it means, and

provide examples that illustrate or serve as evidence for this point.

12. Close the lesson by asking students what they think the

transparency’s title means.

95

Student Lesson 3

Human Genetic Variation

Lesson 3 Organizer

Procedure

What the Teacher Does

Reference

Display a transparency of Master 3.1. Ask students what they think the

Page 90

statement means and whether they can think of examples that illustrate or

Step 1

provide evidence for this statement.

Explain that to investigate this statement, students will work in groups as

Page 90

employees of two pharmaceutical companies that are facing problems.

Step 2

Have one-half the class act as employees in Firm A and the other half, in

Page 90

Firm B. Tell students that the two companies face different problems, but

Step 3

both problems can be solved in ways that relate to the statement on the

transparency.

Direct students to work in groups of four. Give each group that will work

Page 90

as Firm A a copy of Masters 3.2, 3.3, 3.4, and 3.5. Give each group that will Step 4 *

work as Firm B one copy of Masters 3.8, 3.9, 3.10, and 3.11. Give each student a copy of either Master 3.6 (Firm A) or Master 3.12 (Firm B) and explain that these forms will help them organize their discussions and report their results.

Instruct groups to decide who will play each of the four roles and to

Page 90

distribute the masters accordingly.

Step 5

Allow 30 minutes for groups to complete their reports on Master 3.6 or

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3.12. When students ask for additional data, give them Master 3.7 or 3.13.

Step 6 *

At the end of that time, groups should be ready to defend their analysis

and to present their suggested solution to the class.

Call the class to order. Explain that you will assume the role of vice

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president for research first for Firm A and then for Firm B.

Step 7

Display a transparency of Master 3.6. Use it to guide the discussion about

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Firm A. After Firm A groups share their ideas, ask if other class members

Step 8

have questions or comments.

Display a transparency of Master 3.12. As before, use it to guide the

Page 93

discussion about Firm B.

Step 9

Challenge students to use these questions to generalize what they learned:

Page 95

• How is genetic variation related to the use of drugs?

Step 10

• How will pharmaceutical companies likely use our increasing

understanding of human genetic variation?

• How can discovering the genes associated with genetic disorders help

scientists develop new approaches to treatment?

Display again the transparency of Master 3.1. Ask students to explain the

Page 95

statement and provide examples.

Step 11

Close the lesson by asking students what they think the title on the

Page 95

transparency of Master 3.1 means.

Step 12

= Involves copying a master.

* = Involves optional online

video

vignette.

= Involves making a transparency.

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index-105_1.png

index-105_2.png

L E S S O N 4

Elaborate

Are You

Susceptible?

Focus

Students play a game to explore the relationship between genetic

At a Glance

variation and environmental factors in the onset of heart disease

and consider the implications for disease prevention of increased

knowledge about genetic variation.

Major Concepts

Studying the genetic and environmental factors involved in multifactorial

diseases will lead to better diagnosis, prevention, and treatment.

Objectives

After completing this lesson, students will

• understand that all disease, except perhaps trauma, has both a

genetic and environmental component;

• recognize that certain behaviors can increase or reduce a person’s

risk of experiencing certain medical outcomes; and

• understand that the ability to detect genes associated with common

diseases increases the prospects for prevention.

Prerequisite Knowledge