12/09/2025
What is sickle-cell anemia?
It is a genetic disorder caused by a mutation in the gene that makes hemoglobin, the protein in red blood cells that carries oxygen. In this disorder, one small change occurs in the β-globin chain: the amino acid glutamic acid is replaced by valine at position 6. This tiny change causes hemoglobin to clump under low oxygen, making red blood cells sickle-shaped.
2. How is it inherited?
Every person has two copies of the hemoglobin gene, one from each parent.
If both copies are normal (HbA/HbA), the person is healthy.
If both copies are mutated (HbS/HbS), the person has sickle-cell disease. Their red blood cells sickle, break easily, and block blood vessels, causing severe anemia, pain, and reduced lifespan.
If one copy is normal and one is mutated (HbA/HbS), the person is called a heterozygote or "carrier." They usually do not have severe disease but may show mild symptoms under stress conditions.
3. Why does this harmful gene still survive?
Normally, nature removes harmful genes over generations. But here, the defective gene is still present in many populations, especially in Africa, India, and parts of the Middle East. Why? Because of heterozygote advantage.
4. What is heterozygote advantage?
A heterozygote is a person with one normal gene and one mutated gene (HbA/HbS). Such people do not get full-blown sickle-cell disease. But their slightly altered red blood cells give them an important protection: they are resistant to malaria, especially the deadly Plasmodium falciparum type.
5. How does it protect against malaria?
The malaria parasite needs to live and multiply inside red blood cells. In heterozygotes, the red blood cells are not completely normal. When infected by the parasite, their hemoglobin tends to sickle under stress, and the infected cells are destroyed faster by the body. This stops the parasite from spreading widely in the blood. So, heterozygotes survive malaria much better than people with normal hemoglobin.