Pr
epa
r
ed
by
:
Supe
rvi
sed
by
:
epa edby Yasser Sh. Barhoum
Mohammed Bakeer
Supe sedby
Prof.Abed Nasser Abu shahla
Master Program of Biological Sciences, Al‐Azhar University‐Gaza (December, 2013)
AS
Dfiiti
A
LBINI
S
M
D
e
fi
n
iti
on:
•Is a congenital disorder characterized by
the complete or partial absence of
melanin
p
ig
ment in the skin
, hair and
pg
,
eyes.
Dtbdf tf
ti
•
D
ue
t
o a
b
sence or
d
e
f
ec
t
o
f
t
yros
inase
enzyme involved in the production of
melanin.
i
Aith
17
tht
d
H
i
story
A
man
in
th
e
17
th
cen
t
ury name
d
Balthazar Telez
, who was an explorer,
came up with the name "Albino", which
means white ne
g
ro
, after he saw an
g
,
albino African tribe. Balthazar thought he wasseeingtwodifferentracesofpeople was
seeing
two
different
races
of
people
.
This was the first discovery of albinism.
Albinism also called Hypo‐pigmentation,
achromia, achromasia, or achromatosis
ALBINO: organism with complete absence
of melanin.
ALBINOID or ALBINIC: anorganismwith
onlyadiminished
amount
an
organism
with
only
a
diminished
amount
of melanin.
i
Alll ditliibt
Melan
i
n
•
Al
so ca
ll
e
d
p
igmen
t
, me
lan
in
is a su
b
s
t
ance
that gives the skin
and hair
its natural color.
•It also gives color to the iris of the eye
,
f
eat
h
e
r
s
,
a
n
d
sca
les
.
eat es
,ad
scaes
•Melanin is synthesized from the amino acid tit
yros
ine.
•In the skin
, melanin is formed b
y
cells
,y
called melanocytes.
Therearethreebasictypesofmelanin There
are
three
basic
types
of
melanin
:
1.Eumelanin:
have black
and brown
color.
2.Pheomelanin:
have red
or yellow
color,
responsibleforredhairandfreckles responsible
for
red
hair
and
freckles
.
3.Neuromelanin:is found in the brain,
though its function remains obscure
.
Both pheomelanin and eumelanin are found in human
skin and hair, but eumelaninis the most abundant
liihll
thftlik ltb
me
lan
in
in
h
umans, as we
ll
as
th
e
f
orm mos
t
lik
e
ly
t
o
b
e
deficient in albinism.
Melanin have some benefits
1. Melanin provides a natural protection
againsttheharmfuleffectsof
ultraviolet
against
the
harmful
effects
of
ultraviolet
rays
of the sun.
2. Melanin is also a mechanism for
absorbin
g
heat from the sun.
g
3. Melanin, also important for sharpness of
ii
v
is
ion.
fA ii
1
)OculocutaneousAlbinism(OCA)
Types o
f
A
lb
i
n
i
sm
1
)
Oculocutaneous
Albinism
(OCA)
‐Affecting the eyes, skinand hair.
‐People with this type of albinism have whiteor
pinkhair, skin, and iris color, as well as vision problems.
‐Most severetype.
H
4
t(
1
2
3
4
)
‐
H
ave
4
t
ypes
(
1
,
2
,
3
,
4
)
2) Ocular Albinism (OA)
Aff tith
l
‐
Aff
ec
ti
ng
th
e eyes on
ly
.
‐Skin color is usually normalor slightly lighterthan the
skinofotherfamilymembers. skin
of
other
family
members.
‐Eye color may be in the normalrange but there is no
pigment in the retina.
‐Have 3 types.
GifAii G
enet
i
cs o
f
A
lb
i
n
i
sm
Mosttypesofalbinismareinheritedasan Most
types
of
albinism
are
inherited
as
an
Autosomal recessive but some types are X‐
linkedRecessive linked
Recessive
.
1) Autosomal Recessive:
•Most types of albinism are inherited when an
individual receives the albinism gene from both
parents.
•If parents are carriers, the child has a 25%chance
fbill
l
50
%
hfbi
o
f
b
e
ing comp
lete
ly norma
l, a
50
%
c
h
ance o
f
b
e
ing
a carrier, and a 25%chance of getting albinism.
2) X‐linked Recessive: Theexception:sometypesofocularalbinismwhichis The
exception:
some
types
of
ocular
albinism
,
which
is
passed from mothers to their sons.
What if one gene is normal and one
g
ene
does not
p
roduce the
p
enzyme?
The one functioning gene produces enough
enzyme to make melanin for normal coloration
C
Albi iidbtti
C
auses
•
Albi
n
ism
is cause
d
b
y mu
t
a
ti
on or an
alteration of the gene that makes the
lii
me
lan
in p
igment.
• Albinism is inherited genetically as
previouslystateditis
autosomalrecessive
previously
stated
,
it
is
autosomal
recessive
and some types x‐linked recessive inheritance inheritance
.
Pl dIid P
reva
l
ence an
d
I
nc
id
ence
•
Theinternationalaverageforalbinismisabout
•
The
international
average
for
albinism
is
about
1 in 20,000.
IthUS
1
i
17
000
ht
•
I
n
th
e
U
.
S
.,
1
person
in
17
,
000
h
as some
t
ype
of albinism.
• Research indicates that the first type,
Oculocutaneous Albinism (OCA) happen by 1
per 40,000of the population.
•
Whilethesecondtype,
OcularAlbinism
(OA)
While
the
second
type,
Ocular
Albinism
(OA)
happen by 1 per 15,000 of the population.
Pl dIid P
reva
l
ence an
d
I
nc
id
ence
Hllthld
•
H
appens a
ll
over
th
e wor
ld
.
•
Affects
allvertebrates
•
Affects
all
vertebrates
.
•Affects
p
eo
p
le from all races.
pp
•Effects men and women of all ages. • Albinism has been observed in many animals
also.
SS
ymptoms
kidi
|
Paleskinor
|
Usuallypaleblueorlight
S
ki
n an
d
Ha
ir
Eyes
|
Pale
skin
or
|
patchy skin
|
Whitehair
|
Usually
pale
blue
or
light
brown, but can
sometimes appear pink‐
|
White
hair
red
|
Extremely poor vision
|
Light sensitivity
(Photophobia)
|
Rapid eye movements
(Nystagmus)
b
|
Stra
b
ismus
Ab f l i t i lti i Ab
sence o
f
norma
l
p
i
gmen
t
s
i
n eyes resu
lti
ng
i
n
pale blue, light brown or red eyes
This is not because the iris is red, but because there is so little color that the because
there
is
so
little
color
that
the
blood vessels show through the iris.
Albinism in animals
i
Prognos
i
s
•
Growthdevelopmentandintellectual
•
Growth
,
development
and
intellectual
development in the albino child are normal
.
• Vision is invariably severely impaired
.
• Albinism does not affect
the expected
lifespan
.
•People with albinism may be limited in their
activities
becausetheycan'ttoleratethe
activities
because
they
can't
tolerate
the
sun.
CiiC
ompl
i
cat
i
ons
•
Lackofskinpigmentationmakingmore
•
Lack
of
skin
pigmentation
making
more
susceptible to sunburnand skin cancer.
•Blindness. • Albinism may cause social problems,
blhlblkdff b
ecause peop
le wit
h
a
lb
inism
loo
k
d
iff
erent
from their families, peers and other
members of their ethnic group.
BIOCHEMICAL BIOCHEMICAL
BASIS BASIS BASIS BASIS
ii
Albi iidb
tilkf
B
i
ochem
i
cal Bases
•
Albi
n
ism
is cause
d
b
y a gene
ti
c
lac
k
o
f
melanin.
•
Melaninissynthesizedfromtheamino Melanin
is
synthesized
from
the
amino
acid tyrosine.
•Tyrosinasebreaks down tyrosine.
ii
B
i
osynthet
i
c pathways
•The first step of the biosynthetic pathway for both eumelanins and pheomelanins is
catalyzed by tyrosinase:
Tyrosine → DOPA → dopaquinone
•Dopaquinonecan combine with cysteineby two pathways to form pheomelanins: Dopaquinone + cysteine → 5‐S‐cysteinyldopa→ pheomelanin Dopaquinone + cysteine → 2‐S‐cysteinyldopa→ pheomelanin •Also, Dopaquinonecan be converted to leucodopachromeand follow two pathways
fhli
to
f
orm t
h
e eume
lan
ins:
Dopaquinone → leucodopachrome → dopachrome → 5,6‐dihydroxyindole‐2‐carboxylic acid (DHICA)
→ quinone → eumelanin
Dopaquinone → leucodopachrome → dopachrome → 5,6‐dihydroxyindole (DHI)→ quinone →
eumelanin
Albinism: mutation in tyrosinase, the first enzyme in the pathway that
converts tyrosine to melanin
The result of no melanin is
an
albino
.
an
albino
.
Interestingly, individuals with phenylketonuria can have light skin and hair at birth,
. low levels of tyrosine
because of However, phenylketonuriacs are not albinos,because they obtain sufficient
amounts of tyrosinein their diets to support melanin biosynthesis.
DIAGNOSIS DIAGNOSIS DIAGNOSIS DIAGNOSIS
ii
D
i
agnos
i
s
•
Albinismcanfirstappearatbirthbecauseitisa
•
Albinism
can
first
appear
at
birth
because
it
is
a
physical deformity that never changes.
•
Detectedatbirthbecauseofirregularpigmentation. Detected
at
birth
because
of
irregular
pigmentation.
• Diagnosis is based on careful history of pigment
develo
p
ment and an examination of the skin
,
hair
p,
and eyes.
•
Themostaccuratewaytodeterminealbinismis
•
The
most
accurate
way
to
determine
albinism
is
genetic test, for example : Chorionic Villus Sampling
Test(CVS)
and
Amniocentesis
canidentifyalbinism
Test(CVS)
and
Amniocentesis
can
identify
albinism
during the second trimester of pregnancy
.
ii
D
i
agnos
i
s
•
Hairfromthescalpcanbeusedtoassess
tyrosinase
•
Hair
from
the
scalp
can
be
used
to
assess
tyrosinase
activitybydetermination the DOPAand melanin
concentration.
•DOPAand melaninassessed by a radioactive biochemical
assay
, in which the samples are incubated with a
radiolabelled tyrosine precursor and the amount of
radiolabel released after enzymatic conversion quantified
spectrophotometrically spectrophotometrically
.
•The value of this test is debatable since a negative result
idi t
OCA
1
bt
positi eres lt
tilllth
in
di
ca
t
es
OCA
1
b
u
t
a
positi
v
e
res
u
lt
s
till
leaves
th
e
possibility of OCA1
, OCA2
, OCA3
, or OA1
.
MANEGMENT MANEGMENT MANEGMENT
MANEGMENT
andandand
and
TREATMENT TREATMENT TREATMENT TREATMENT
MANEGMENT and TREATMENT
•
Thereis
nocure
foralbinism
becausealbinismisagenetic
•
There
is
no
cure
for
albinism
,
because
albinism
is
a
genetic
disorder, treatment is limited
.
•Treatments only reduce the symptoms
.
•The skin and eyes must be protected from the sun. SkiSki
n
•The skin can be protected by using sunscreen creams . •Always wear special UV protective clothing to reduce
sunburn risk.
• Children should receive annual skin assessments to screen
for skin cancer or lesions that could lead to cancer.
MANEGMENT and TREATMENT
EE
yes
• Man
y
children will need to wear
p
rescri
p
tion Glassesor
ypp
lenses, which can provide improvements in their vision
.
•Wear dark Sunglasses(UV protected) may relieve
photophobia
.
•Eye muscle surgery is sometimes recommended to correct
abnormaleyemovements(
Nystagmus
)
abnormal
eye
movements
(
Nystagmus
)
.
•For strabismus
, ophthalmologists prefer to treat infants
startin
g
at about six months of a
g
e
,
before the function of
gg,
their eyes has developed fully.
• Children should receive annual examinations
by an
hhl l i
op
h
t
h
a
lmo
log
ist.