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Human genetics of infectious diseases: between proof of principle and paradigm
Alexandre Alcaïs, … , Laurent Abel, Jean-Laurent Casanova
Alexandre Alcaïs, … , Laurent Abel, Jean-Laurent Casanova
Published September 1, 2009
Citation Information: J Clin Invest. 2009;119(9):2506-2514. https://doi.org/10.1172/JCI38111.
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Human genetics of infectious diseases: between proof of principle and paradigm

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Abstract

The observation that only a fraction of individuals infected by infectious agents develop clinical disease raises fundamental questions about the actual pathogenesis of infectious diseases. Epidemiological and experimental evidence is accumulating to suggest that human genetics plays a major role in this process. As we discuss here, human predisposition to infectious diseases seems to cover a continuous spectrum from monogenic to polygenic inheritance. Although many studies have provided proof of principle that infectious diseases may result from various types of inborn errors of immunity, the genetic determinism of most infectious diseases in most patients remains unclear. However, in the future, studies in human genetics are likely to establish a new paradigm for infectious diseases.

Authors

Alexandre Alcaïs, Laurent Abel, Jean-Laurent Casanova

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Figure 2

Schematic representation of the continuous genetic models underlying human infectious diseases.

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Schematic representation of the continuous genetic models underlying hum...
The spectrum of genetic susceptibilities predisposing individuals to infectious diseases is summarized. Different situations may be distinguished according to the number of genes with an additive impact on genetic susceptibility (in green) or resistance (in red), the marginal effect of each of these genes, and the number of pathogens to which the individual is susceptible. Six textbook examples are shown: SCID-associated infections (a unique gene with complete penetrance conferring predisposition to a large spectrum of infectious agents); HSE (a single gene with high penetrance conferring predisposition to a single infectious agent); malaria caused by P. vivax (a single gene with high penetrance conferring resistance to a single infectious agent); severe malaria caused by P. falciparum (a small number of genes with HbS conferring resistance to the disease); leprosy (a small number of genes with intermediate penetrance conferring predisposition to a single infectious agent); diseases in which HLA alleles have been shown to play a role (HLA-associated infections). Examples of common infectious diseases favored by multiple predisposing alleles in a given individual (truly multigenic inheritance) may be revealed by future GWA studies.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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