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Genetics and Sports

Medicine and Sport Science Vol. 54 Series Editors J. Borms Brussels M. Hebbelinck Brussels A.P. Hills Brisbane T. Noakes Cape Town

Genetics and Sports Volume Editor Malcolm Collins Cape Town 11 figures, and 12 tables, 2009 Basel Freiburg Paris London New York Bangalore Bangkok Shanghai Singapore Tokyo Sydney

Medicine and Sport Science Founded 1968 by E. Jokl, Lexington, Ky. Malcolm Collins, PhD MRC/UCT Research Unit for Exercise Science and Sports Medicine (ESSM) South African Medical Research Council (MRC) and the Department of Human Biology, University of Cape Town (UCT) Sports Science Institute of South Africa Boundary Road Newlands 7700, Cape Town (South Africa) This book was generously supported by Library of Congress Cataloging-in-Publication Data Genetics and sports / volume editor, Malcolm Collins. p. ; cm. -- (Medicine and sport science, ISSN 0254-5020 ; v. 54) Includes bibliographical references and indexes. ISBN 978-3-8055-9027-3 (hard cover : alk. paper) 1. Sports--Physiological aspects. 2. Human genetics. I. Collins, Malcolm, 1965- II. Series: Medicine and sport science, v. 54. 0254-5020 ; [DNLM: 1. Genetic Phenomena. 2. Sports. 3. Athletic Injuries--genetics. 4. Athletic Performance--physiology. 5. Exercise--physiology. 6. Genetic Techniques. W1 ME649Q v.54 2009 / QT 260 G3285 2009] RC1235.G46 2009 599.93 5--dc22 2009024000 Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents and Index Medicus. Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 2009 by S. Karger AG, P.O. Box, CH 4009 Basel (Switzerland) www.karger.com Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel ISSN 0254 5020 ISBN 978 3 8055 9027 3 e-isbn 978 3 8055 9028 0

Contents VII Preface Collins, M. (Cape Town) 1 Key Concepts in Human Genetics: Understanding the Complex Phenotype Gibson, W.T. (Vancouver, B.C.) 11 Nature versus Nurture in Determining Athletic Ability Brutsaert, T.D. (Albany, N.Y.); Parra, E.J. (Mississauga Ont.) 28 Genetics and Sports: An Overview of the Pre-Molecular Biology Era Peeters, M.W. (Leuven/Brussels); Thomis, M.A.I.; Beunen, G.P. (Leuven); Malina, R.M. (Austin, Tex./Stephenville, Tex.) 43 Genes, Athlete Status and Training An Overview Ahmetov, I.I. (St. Petersburg/Moscow); Rogozkin, V.A. (St. Petersburg) 72 Angiotensin-Converting Enzyme, Renin-Angiotensin System and Human Performance Woods, D. (Newcastle upon Tyne) 88 α-actinin-3 and Performance Yang, N.; Garton, F.; North, K. (Sydney, NSW) 102 East African Runners: Their Genetics, Lifestyle and Athletic Prowess Onywera, V.O. (Nairobi) 110 Gene-Lifestyle Interactions and Their Consequences on Human Health Pomeroy, J. (Phoenix, Ariz./Umeå); Söderberg, A.M.; Franks, P.W. (Umeå) 136 Genetic Risk Factors for Musculoskeletal Soft Tissue Injuries Collins, M. (Cape Town); Raleigh, S.M. (Northampton) 150 Innovative Strategies for Treatment of Soft Tissue Injuries in Human and Animal Athletes Hoffmann, A.; Gross, G. (Braunschweig) 166 Gene Doping: Possibilities and Practicalities Wells, D.J. (London) V

176 Genetic Testing of Athletes Williams, A.G. (Alsager); Wackerhage, H. (Aberdeen) 187 The Future of Genetic Research in Exercise Science and Sports Medicine Trent, R.J.; Yu, B. (Camperdown, NSW) 196 Author Index 197 Subject Index VI Contents

Preface Athletic performance and the occurrence of sports-related injuries are both multifactorial conditions which are determined by the complex and poorly understood interactions of both environmental and genetic factors. Although much work has been done to identify the non-genetic components that are associated with performance and susceptibility to injuries, there is an ever growing body of research investigating the genetic contribution to these phenotypes. This book, which contains contributions by a broad range of scientist and clinicians from several disciplines including, but not limited to, human molecular genetics, clinical genetics and exercise science covers a number of topics in an attempt to obtain an integrated and holistic understanding of the field. The recent sequencing of the human genome and development of several tools and methodologies have successfully been used to investigate the genetic contribution to many complex diseases. This area of research has more recently been applied to the fields of exercise science and sports medicine. This publication reviews past, current and future applications, as well as the ethical concerns, of genetic research in the fields of exercise science and sports medicine. The introductory chapter of this book highlights current and key concepts in human genetics, in particular with respect to its application to understanding multifactorial conditions. This is followed by a chapter exploring the often misunderstood relationship between nature (genetics) and nurture (common environmental effects such as training, diet, etc.) in determining athletic ability. The third chapter summarises the methodologies initially used during the pre-molecular biology era and the estimates obtained for gene and environmental contributions for performancerelated phenotypes. The molecular genetics of performance is specifically investigated in the subsequent four chapters. These chapters include a review of the specific DNA sequence variants currently believed to be associated with athletic performance and response to training, critical reviews of the roles of the much investigated variants within the angiotensin-converting enzyme and α-actinin-3 genes and performance, and finally an exploration of the genetic and lifestyle of the East African runners who have dominated distance running events for the last half century. VII

This book also contains a chapter exploring the interaction of lifestyle, such as physical active or sedentary, with genetic make-up and its implications on human health, in particular understanding mechanisms underlying specific diseases, such as obesity, and its prevention. This is followed by a chapter summarising the recent developments in the identification of genetic risk factors for musculoskeletal soft tissue injuries. The current and possible application of gene therapy as well as other novel therapeutic strategies such as stem cell and growth factor therapies in injured athletes is also reviewed. This is followed by a chapter exploring the potential abuse of genetic information and technologies, together with other developments in molecular biology, (gene doping) to enhance performance. The ethical framework in which genetic research is done and its application is not straightforward. Exercise scientists and sports physicians need to keep abreast of advances in medical ethics broadly and customise them efficiently to the field. These issues are discussed in the second last chapter, which is followed by a review on the new technologies and paradigms which will influence future genetic research in exercise science and sports medicine. Malcolm Collins, Cape Town VIII Preface