Recent study on Melatonin and Scoliosis

[Karen Ocker]

Scoliosis and polio

When I was treated for scoliosis at age 13 we asked if it could have come from polio--because many children had polio those days. None of us(with scoliosis in my family) had polio. Apparently, my Doctor (John Cobb) could tell by examining us that we did not have curves resulting from polio. I really do not know how they could tell. I had fellow teens with mothers and sisters with scoliosis who did not have polio and I had one fellow patient with scoliosis who had polio and was in a wheelchair. Perhaps the scoliosis from polio arose from muscle weakness and a physical exam could show that.

There is so much we really do not know--and we do not know what we do not know-- but no one could convince me it's not genetically modulated. As a matter of fact, while I was working at Columbia-Presbyterian in the 1970s-1990 we were told it was 85% in girls(the 'idiopathic type') a sex linked genetic expression with mixed dominance.
I do not know if further research has clarified that.

One problem with genetics, that unless we unearth our ancestors, we really do not know who had what gene and what disease because: we do not have their medical history and many people died in infancy,as young adults or middle age. My maternal grandmother-who did not have scoliosis-- could not tell us if her mother had scoliosis because my maternal great-grandmother died from typhus when my grandmother was 4. My maternal first cousin has scoliosis. (Mother's sister's daughter).

How can we really make a correct assumption about a new mutation???

[Dingo]

Genetic predisposition

Karen Ocker

but no one could convince me it's not genetically modulated.

It's absolutely possible that you have a rare genetic disorder that caused your Scoliosis. If hereditary Scoliosis is as common as hereditary deafness that's approximately 1 in 2500 kids. You could be one of those kids.

But the study from Denmark suggests that Scoliosis is probably not a genetic disease for most children.

Scoliosis hits 2% of children around the world. No genetic disorder looks like that, especially one with a 13% MZ concordance rate.

I don't think that Scoliosis is caused specifically by Polio virus. But I wouldn't be surprised to learn that it's caused by a virus or microbe.

In many ways Scoliosis looks like Polio.
Both of these disorders hit millions of children around the globe.

[Dingo]

Anti gunshot genes

concerned dad

I was really hoping you would use the gunshot wound susceptability gene as an example

I considered the gunshot idea but then I realized that the "Humans Stress Disorder Project" was more likely to get government funding.

[Karen Ocker]

Dingo, what are you doing about your child????

Dingo:

What are you doing about your child?? What have you found out about his scoliosis and is it progressing? Does he have any spinal cord issues or are there any vertebral abnormalities??? This should be your priority.

As far as scoliosis genetics/causes go--- all your research about causes in other people will not help your child. One study(Danish) cannot "prove" that scoliosis has no genetic origin. There are different types of scoliosis that manifest themselves at different times in the life cycle-congenital, infantile, childhood, adolescent and de-novo in adults.

A meta analysis-a compiled study of many studies- would hold more validity. It takes time to do this and many years.
Some studies have not been done at all because there is no funding or no interest.

What concerns me about your posts is that you seem to put forth as "proof" citations about a single study, studies which don't necessarily apply(animals), and a discounting of evidence based science when you don't seem to like the results. I'm not sure you have the knowledge or scientific background to do this.
Speaking for myself, as a medical professional and a person with scoliosis, I find this very disturbing.

How in the world is, all this energy put into this, helping your child? Isn't this why you are on this forum???

[PNUTTRO]

For instance people with Gene A don't have Scoliosis at a higher rate than any other group. However if someone with Gene A ends up with Scoliosis their curve will progress very fast. Natural selection can't get rid of Gene A because most children don't get Scoliosis and it offers some other significant benefit to healthy children.

That is NOT how natural selection works. Natural selection doesn't get rid of scoliosis because is does not kill the individual before reproducing. The only way that a scoliosis gene would not transmit is if the curve made people so hideously ugly that no one would ever have sex with them.

So, when you and P say that scoliosis is not a genetic disease, perhaps it would be better to say "Scolioisis is not a Single Gene genetic disease".

See Post #71. Maybe I wasn't clear.

If you had anti-cigarette or anti-radiation genes you wouldn't get cancer from these carcinogens. So I guess looked at from that angle every disease could be considered a type of genetic illness.

Actually, those are different because they are mutagens and cause genetic damage.

I see Angelman's, Cystic Fibrosis, Color Blindness and Haemophilia.... but no mention of arthritis or heart disease.

Those are all single gene disorders. Arthritis and heart disease fall into the complex category. A strong family history is a bigger factor for a heart attack than obesity.

Off the top of my head the only diseases I can think of that aren't multi-factorial are genetic diseases. Sickle Cell is the result of genetic programming pure and simple. Color Blindness and Haemophilia are the same. If you've got the genes you've got the disorder.

That isn't true either. That is why we have genetic testing. It requires two copies of the disease gene to cause disease. You can carry the mutation and never have the disorder. Look up recessive inheritance. This is high school biology.

in girls(the 'idiopathic type') a sex linked genetic expression with mixed dominance.

That I can believe! Don't worry Karen. Dingo won't let go. I just don't want too many people believing he is an expert. Frankly, I don't have the time. I shouldn't be here now, but the kids are still in bed.

[concerned dad]

I just reread the whole thread, especially P's post 71.

Let me try one more time.

All disease, has a genetic component and an environmental component. Geneticists have calculations that allow them to measure the contribution of
genes to a specific phenotype. Everything else is environment. Genetic disorders fall into different categories.

Does this fit your model so far? Maybe we are both saying the same thing. I'm not sure.

The rare and usually fatal disorders affecting children are typically transmitted in a recessive fashion and a person only exhibits a symptoms when two people with the same allele have progeny. And then the two alleles must come together in the same individual. A perfect storm--so to speak. eg Tay Sach's and cystic fibrosis--which can be traced to a founder by the way. It doesn't mean that an allele disappears from a population. It always exists at a low frequency.

Other disorders, such as NF2, have a dominant transmission

Correct me if I am wrong please
Regarding the environmental factor, When P says "all disease", you mean all disease except the very rare single gene genetic diseases like cystic fibrosis. Am I correct to assume that those rare single gene genetic diseases DO NOT have an environmental component. (even with P's broad definition of environment).

And, when Dingo asserts that scoliosis is not genetic, he is referring to that very rare thing P mentions, the single gene scenario.

Scoliosis doesn't fall into either of these categories. It behaves more like Type II diabetes where there are several genes that in combination contribute to the illness. But not every person with Type II diabetes has this predisposition either. Fortunately, we know a lot about sugar metabolism and how to control blood sugar.

The way Karen described her family, there is likely to be a new mutation in her family that causes scoliosis. Your comments implied that a hypothetical scoliosis gene could not exist, simply isn't true. I wanted you to explain what you meant, not make a glib comment.

You have been considering "environment" to be a limit set of factors--mostly pathogens. I think that this is faulty reasoning. I consider "environment" to be "life on this planet". Forgive me if it is vague, but it includes everything that I can't think of. Also, it gives me some leverage when someone tells me I am wrong.

Regarding unique Karens family history, P says it is "likely" that a new mutation is involved, Dingo says it is "possible, but not likely".
This part still has me confused but I am tending to lean towards Dingo's view on that point. Would love to have P's view explained. I didnt think Karens situation was all that unique as (I thought) there were a lot of people who could list a long line of family members w/ scoliosis.

That is NOT how natural selection works. Natural selection doesn't get rid of scoliosis because is does not kill the individual before reproducing. The only way that a scoliosis gene would not transmit is if the curve made people so hideously ugly that no one would ever have sex with them.

This seems extreme, I thought natural selection could act on even the slightest benefit or detriment of a genetic expression.

[Dingo]

You are incorrect about positive selection

PNUTTRO

Natural selection doesn't get rid of scoliosis because is does not kill the individual before reproducing. The only way that a scoliosis gene would not transmit is if the curve made people so hideously ugly that no one would ever have sex with them.

You are incorrect about how natural selection works. For a gene to succeed it has to spread to the next generation at the same rate as other genes. Even a slight reduction in fitness can ensure a gene's extinction over time.

The girl in this photo has Polio. This girl may have gotten married and had a large family. But what about a thousand girls with Polio? Would they average the same success rate? If mild Polio was a genetic disease it wouldn't last long even if it never killed a single child.

[Dingo]

Twin study

Karen Ocker

One study(Danish) cannot "prove" that scoliosis has no genetic origin.

You are correct that one study is never definitive. However the Danish twin study is credible and I doubt it will be overturned. When another study confirms it's findings you won't hear a lot of talk about Scoliosis being a genetic disease any longer.

To be honest I didn't need the Danish twin study in order to form an opinion on this. From the beginning it was very unlikely that a common, childhood disease like Scoliosis would be a genetic disorder.

[txmarinemom]

Dingo,

Like Karen, I'm puzzled how your lay interpretation of a seemingly endless supply of one-of, unproven and questionable studies is going to help your child (or anyone else's for that matter) TODAY. Not only are you not helping, you could be doing harm. Did you join the forum to help your kid (he of the 10° curve that is barely even scoliosis, and for all you know could self-resolve) or blog?

Your continued argument with a researcher who does this for a living (when you've already said you simply "read a lot" and are NOT an expert) is amusing.

At this point I'm tempted to propose a new drinking game for every time you (the non-expert) tell P (the expert) "you're incorrect": I bet I could find some Syrian hamsters who'd eagerly play - and at the current frequency of said statement - stay pretty satisfied .

[concerned dad]

You are going to dissapoint those hamsters

If a person with scoliosis was slightly less fucund and had 3 children and a person w/o had 4, then that would be sufficient for natural selection to work (if the scoliosis was genetic).

The condition actually killing the indivudal before reproduction is not necessary and P is either wrong or made an oversimplification. All that is necessary is a small difference in reproductive success.

On this point, I would guess that P would concede she overstated the issue. (perhaps in an attempt to dumb it down or simplify it).
But, differential reproductive success would not require the extreme situation she put forth (hideously ugly ...).

[Dingo]

This is really easy

Several of you have expressed concern about my son and I'd like to thank you for your thoughts. He has his followup in May and I'll let you know how it goes.

[Dingo]

families hit with disease

concerned dad

I didnt think Karens situation was all that unique as (I thought) there were a lot of people who could list a long line of family members w/ scoliosis.

Some families are prone to cervical cancer (caused by HPV) or multiple sclerosis (caused by Epstein-Barr) or Type 1 Diabetes (caused by Enterovirus) or Alzheimers (caused by Herpes 1) or probably any other health condition no matter what the cause.

Karen's story is sad, but it's also normal. Diseases of every type can hit particular families hard.

[Pooka1]

Scoliosis associated with Marfan's, given that Marfan's is entirely and completely genetic, is entirely and completely genetic, no?

I am having trouble following this thread I must admit.

Love,
NOT a biologist

[Dingo]

Marfan's

Pooka1

That's interesting, I didn't know that Marfan's was associated with Scoliosis. It makes sense because Marfan's distorts the skeleton. Marfan's hits 1 child in 5,000 which makes it approximately 100 times rarer than Scoliosis.

The most readily visible signs are associated with the skeletal system. Many individuals with Marfan Syndrome grow to above average height. Some have long slender limbs with fingers and toes that are also abnormally long and slender (arachnodactyly). This long, slender body habitus and long, slender limbs are known as dolichostenomelia. An individual's arms may be disproportionately long, with thin, weak wrists. In addition to affecting height and limb proportions, Marfan syndrome can produce other skeletal signs. Abnormal curvature of the spine (scoliosis) is common, as is abnormal indentation (pectus excavatum) or protrusion (pectus carinatum) of the sternum. Other signs include abnormal joint flexibility, a high palate, malocclusions, flat feet, hammer toes, stooped shoulders, unexplained stretch marks on the skin and thin wrists. It can also cause pain in the joints, bones and muscles in some patients. Some people with Marfan have speech disorders resulting from symptomatic high palates and small jaws.

[concerned dad]

Alzheimers (caused by Herpes 1) .

Oh no, I really wish you hadnt said that