Genetic and geographical variability in cystic fibrosis: evolutionary considerations

We have studied cystic fibrosis from an evolutionary perspective by focusing on three main points: the high frequency of cystic fibrosis; the different spectrum of mutations that cause the disease in different areas of Europe; and the age of the delta F508 mutation. Several hypotheses have been suggested to explain the high frequency of cystic fibrosis. We argue that the most plausible is heterozygote resistance to cholera and to other dehydrating intestinal diseases. Different population sizes in the past could explain the higher diversity among cystic fibrosis mutations found in southern Europe. Three microsatellite loci are found close to the delta F508 mutation. The reconstruction of the original microsatellite haplotype in which delta F508 arose, and of the genealogy of the microsatellite haplotypes bearing the mutation, allowed us to date the mutation event at around 50,000 years ago.