"

4.5 Polygenic Disorders

Phenotype Variability

The phenotypes described thus far correlate nearly perfectly with their associated genotypes. In other words, an individual with a particular genotype always has the expected phenotype. However, most phenotypes are not determined entirely by genotype alone. Instead, they are determined by an interaction between genotype and environmental factors and can be conceptualized in the following relationship:

Genotype + Environment 

  Phenotype (G + E  ⇒  P)

Or:

Genotype + Environment  + InteractionGE

  Phenotype (G + E + IGE  ⇒ P)

*GE = Genetics and Environment

This interaction is especially relevant in studying economically important phenotypes, such as human diseases or agricultural productivity. For example, a particular genotype may predispose an individual to cancer, but cancer may only develop if the individual is exposed to certain DNA-damaging chemicals or carcinogens. Therefore, not all individuals with a particular genotype will develop the cancer phenotype; only those who experience a particular environment will. The terms penetrance and expressivity are also helpful to describe the relationship between certain genotypes and their phenotypes.

Penetrance

Penetrance is the proportion of individuals with a particular genotype that display a corresponding phenotype (see figure below). It is usually expressed as a percentage of the population. Because all pea plants are homozygous for the allele for white flowers, this genotype is entirely (100%) penetrant. In contrast, many human genetic diseases are incompletely penetrant since not all individuals with the disease genotype develop symptoms associated with the disease (less than 100%).

Ovals of various shades of black, grey and white, used to demonstrate penetrance
Figure 4.15 Relationship Between Penetrance and Expressivity in Eight Individuals With a Mutant Genotype. Penetrance can be complete (all eight have the mutant phenotype) or incomplete (only some have the mutant phenotype). Among those individuals with the mutant phenotype, the expressivity can be narrow (minimal variation) to broad (lots of variation). Source: Original by Locke (2017), CC BY-NC 3.0, Open Genetics Lectures.

Expressivity

Expressivity describes the variability in mutant phenotypes observed in individuals with a particular phenotype (see figure below). Many human genetic diseases provide examples of broad expressivity since individuals with identical genotypes may vary significantly in the severity of their symptoms. Incomplete penetrance and broad expressivity are due to random chance, non-genetic (environmental), and genetic factors (mutations in other genes).

Mutations in wings of Drosophila melanogaster showing weak to strong expressivity.
Figure 4.16 Five different mutations demonstrated in the wings of Drosophila show weak to strong expressivity, which describes the variability in mutant phenotypes observed in individuals with a particular phenotype, which can be due to random chance, environment and/or other genetic factors. Source: Original by Locke (2017), CC BY-NC 3.0, Open Genetics Lectures

Concept in Action

Watch the video Penetrance vs. Expressivity (3 mins) by The Excel Cycle (2020) on YouTube which discusses the difference between expressivity and penetrance.

Video source: The Excel Cycle. (2020, June 6). Penetrance vs. Expressivity [Video]. YouTube. https://www.youtube.com/watch?v=nurrFUIDBHc

Read

Wright, F., & Fessele, K. (2017). Primer in genetics and genomics, article 5 further defines the concepts of genotype and phenotype and explores genotype-phenotype associations. Biological Research for Nursing19(5), 576–585. https://doi.org/10.1177/1099800417725190

Read Wright, F., & Fessele, K. (2017) online for free

 

Genotype as a predictor for the development of disease

This unit taught us that our genotype can predispose us to disease development, but multiple factors influence it, including polygenic contributions and epigenetic mechanisms. While some individuals may inherit genetic variants that increase susceptibility, the expression of these genes can be significantly modified by epigenetic changes, which are often influenced by environmental and lifestyle factors.

This illustration represents pleiotropy - when one gene influences two or more seemingly unrelated phenotypic traits. The image has the word "genotype" at the top and "phenotype" at the bottom. Three circles, red G1, blue G2, and yellow G3 lie in a row representing genotypes of three individuals. Below this are three circles, red P1, brown P2, and green P3 in a row representing phenotypes. There are arrows going from G1 to P1 and P2, G2 to P2 and P3, and G3 to P2 and P3 to represent the complexity of mapping from genotype to phenotype.
Figure 4.17 Image result for pleiotropy. Pleiotropy occurs when one gene influences two or more seemingly unrelated phenotypic traits. This relationship between genes and phenotypes is demonstrated by mapping one genotype; e.g., G1 to multiple phenotypes; e.g.; P1 and P2. Source: Simple Genotype Phenotype Map by Alphillips6, CC BY-SA 4.0

Usually, no one-to-one correspondence between a gene and a physical characteristic exists. Often, a gene is responsible for several phenotypic traits and is said to be pleiotropic. Pleiotropy occurs when one gene influences two or more seemingly unrelated phenotypic traits. Such a gene that exhibits multiple phenotypic expression is called a pleiotropic gene. For example, mutations in Drosophila’s vestigial gene (vg) result in an easily visible short-wing phenotype. However, mutations in this gene also affect the number of egg strings, the position of the bristles on the scutellum, and the lifespan of Drosophila. Therefore, the vg gene is said to be pleiotropic in that it affects many different phenotypic characteristics. During his study of inheritance in pea plants, Mendel made several interesting observations regarding the colour of various plant components. Specifically, Mendel noticed that plants with coloured seed coats always had coloured flowers and coloured leaf axils — axils are the parts of the plant that attach leaves to stems. Mendel also observed that pea plants with colourless seed coats always had white flowers and no pigmentation on their axils. In other words, in Mendel’s pea plants, seed coat colour was always associated with specific flower and axil colours. We know that Mendel’s observations resulted from pleiotropy, or the phenomenon in which a single gene contributes to multiple phenotypic traits. In this case, the seed coat colour gene, denoted a, was responsible for seed coat colour and flower and axil pigmentation.

On the other hand, single characteristics can be affected by mutations in multiple, different genes. This implies that many genes are needed to make each characteristic. For example, if we return to the Drosophila wing, there are dozens of genes that, when mutant, alter the normal shape of the wing, not just the vg locus. Thus, many genes are needed to make a normal wing; the mutation of any one causes an abnormal, mutant phenotype. This type of arrangement is called polygenic inheritance.

Image result for polygenic traits shown in a bar graph form and exemplifies a bell shaped curve
Figure 4.18 Typical Distribution of Phenotypes in Polygenic Inheritance. Traits that display a continuous distribution, such as height or skin colour, are polygenic. A bell curve showing the typical distribution of phenotypes in Polygenic Inheritance. On the extreme left and the extreme right of the curve, a small frequency of outlier genotypes are represented. As the curve approaches the middle, the frequency of more common genotypes increases. At the very centre of the curve, a maxima is achieved, producing the typical bell shaped graph. Source: Polygene00 by Maulits, CC BY-SA 4.0

What are complex or multifactorial disorders?

Researchers are learning that nearly all conditions and diseases have a genetic component. Some disorders, such as sickle cell disease and cystic fibrosis, are caused by variants (also known as mutations) in single genes. The causes of many other disorders, however, are much more complex. Common health problems such as heart disease, type 2 diabetes, and obesity do not have a single genetic cause—they are influenced by multiple genes (polygenic) in combination with lifestyle and environmental factors, such as exercise, diet, or pollutant exposures. Conditions caused by many contributing factors are called complex or multifactorial disorders.

Although complex disorders often cluster in families, they do not have a clear-cut inheritance pattern. Identifying the role of genetics in these disorders may be challenging, mainly because families often share environments and have similar lifestyles. This makes it difficult to determine a person’s risk of inheriting or passing on these disorders. Complex disorders are also difficult to study and treat because the specific factors that cause most of these disorders have not yet been identified. Researchers continue to look for major contributing genes for many common, complex disorders.

Continuous Variation

Most of the phenotypic traits commonly used in introductory genetics are qualitative. This means the phenotype exists in only two (or possibly a few more) discrete, alternative forms, such as purple or white flowers, or red or white eyes.  These qualitative traits are, therefore, said to exhibit discrete variation.  On the other hand, many interesting and important traits exhibit continuous variation, meaning they exhibit a continuous range of phenotypes that are usually measured quantitatively, such as intelligence, body mass, blood pressure in animals (including humans), and yield, water use, or vitamin content in crops.   Traits with continuous variation are often complex, and do not show the simple Mendelian segregation ratios (e.g., 3:1) observed with some qualitative traits.  The environment heavily influences many complex traits; nevertheless, complex traits can often have a heritable component, which must involve one or more genes.

How can genes, which are inherited (in the case of a diploid) as, at most, two variants each, explain the wide range of continuous variation observed for many traits?  The lack of an immediately obvious explanation to this question was one of the early objections to Mendel’s explanation of the mechanisms of heredity. However, upon further consideration, it becomes clear that the more loci that contribute to the trait, the more phenotypic classes may be observed for that trait (see figure below).

(left) Punnett square showing an 8x8 trihybrid cross. (right top) Punnett square showing typical monohybrid cross 2x2. (lower right) Punnett square showing a typical dihybrid cross 4x4.
Figure 4.19 Punnett Squares for One, Two, or Three Loci.  This is a simplified example of up to three semi-dominant genes, and in each case, the effect on the phenotype is additive, meaning the more “upper case” alleles present, the stronger the phenotype.  A comparison of the Punnett squares and the associated phenotypes shows that the larger the number of genes that affect a trait, the more intermediate phenotypic classes will be expected under these conditions. Source: Original by Deyholos (2017), CC BY-NC 3.0, Open Genetics Lectures

If the number of phenotypic classes is sufficiently large (as with three or more loci), individual classes may become indistinguishable (particularly when environmental effects are included), and the phenotype appears as a continuous variation (see figure below). Thus, quantitative traits are sometimes called polygenic traits, because it is assumed that the combined activity of many genes controls their phenotypes. Note that this does not imply that each of the individual genes has an equal influence on a polygenic trait — some may have a major effect, while others are only minor.  Furthermore, any single gene may influence more than one trait, whether these traits are quantitative or qualitative traits.

 

4 graphs showing increasing number of phenotypic classes as more loci affect a single trait.
Figure 4.20 The More Loci that Affect a Trait, the Larger the Number of Phenotypic Classes Can Be Expected. The number of contributing loci is so large that the phenotypic classes blend in apparently continuous variation for some traits. Bar charts and bell curves demonstrate that the more loci that are affecting a trait, the larger the number of phenotypic classes can be expected. For some traits, the number of contributing loci is so large that the phenotypic classes blend together in apparently continuous variation. Source: Original by Deyholos (2017), CC BY-NC 3.0, Open Genetics Lectures

Concept in Action

Watch the video, Polygenic Inheritance (13 mins) by AK Lectures (2015) on YouTube, which discusses the genetic basis of Polygenic Inheritance.

Video source: Andrey K. (2015, January 13). Polygenic inheritance [Video]. YouTube. https://www.youtube.com/watch?v=tKnOvPtwZL4

Attribution & References

Except where otherwise noted, this page is adapted from:

References

Deyholos, M. (2017). Figures: 15. Punnett Squares for one, two, or three loci; and 16. The more loci that affect a trait… [digital images]. In Locke, J., Harrington, M., Canham, L. and Min Ku Kang (Eds.), Open Genetics Lectures, Fall 2017 (Chapter 26, p. 8). Dataverse/ BCcampus. http://solr.bccampus.ca:8001/bcc/file/7a7b00f9-fb56-4c49-81a9-cfa3ad80e6d8/1/OpenGeneticsLectures_Fall2017.pdf

Locke, J. (2017). Figures: 18. Relationship between penetrance and expressivity; and 19. Mutations in wings of Drosophila melanogaster… [digital images]. In Locke, J., Harrington, M., Canham, L. and Min Ku Kang (Eds.), Open Genetics Lectures, Fall 2017 (Chapter 26, p. 11). Dataverse/ BCcampus. http://solr.bccampus.ca:8001/bcc/file/7a7b00f9-fb56-4c49-81a9-cfa3ad80e6d8/1/OpenGeneticsLectures_Fall2017.pdf

License

Icon for the Creative Commons Attribution-NonCommercial 4.0 International License

Precision Healthcare: Genomics-Informed Nursing Copyright © 2025 by Andrea Gretchev, RN, MN, CCNE is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.