The human chromosome 21 has been sequenced1xThe DNA sequence of human chromosome 21. Hattori, M. et al. Nature. 2000; 405: 311–319Crossref | PubMed | Scopus (776)See all References1, a major step in our quest for decoding the blue print of human life. The sequence data covers 99.7% of 21q, the long arm of the chromosome, as well as a portion of 21p, the short arm, and is estimated to be 99.995% accurate. Surprisingly only 225 genes and 59 pseudogenes (genes that are incapable of being expressed as protein products) were identified. Although these estimates may only be considered approximate, they certainly suggest that chromosome 21, and thus perhaps the entire human genome too, contains far fewer genes than was previously thought.More than 43% of the detected genes are novel and 41% of them have no functional attributes. Some functionally related gene clusters (e.g. the interferon receptor family, or the trefoil peptide cluster) were found to be arranged in tandem arrays, suggesting the possibility of rounds of gene duplication during evolution. The sequence also confirmed that compositional features of the chromosome (e.g. guanine and cytosine content, or the presence of Alu repeats) correlate well with gene density. Furthermore, several duplicated regions were detected on the chromosome. The function of these regions is not understood but might be relevant for mechanisms involved in chromosomal rearrangements.The sequencing of chromosome 21 will have significant medical implications: several of its genes have been implicated in a number of human diseases and perhaps one of the most important of these is Down’s syndrome, a disease that affects one in 700 live births. The cause of Down’s syndrome, the duplication of some or all of the, 21st chromosome (leading to three, instead of two copies of genes) has long been known. Nevertheless, the problem of which genes are responsible for the characteristic abnormalities of this disease, ranging from mental retardation to heart problems, has remained elusive. It was suspected that the complex phenotypical alterations of Down’s syndrome could be the result of an interplay between several genes. However, without knowing all potentially relevant genes it was difficult to dissect the mechanisms of the disease. With the sequencing of chromosome 21 this obstacle has now been greatly diminished: for the first time, it has become possible to systematically investigate the role of every resident gene. Understanding the genetic mechanisms of Down’s syndrome will be an enormous scientific achievement in itself. But by doing so, we might also be holding the key to another devastating neurodegenerative disease, Alzheimer’s Disease, which is prevalent in Down’s patients of 35 years or older but which also affects a large proportion of the elderly in the general human population. Clearly, the medical importance of knowing the sequence of the 21st chromosome cannot be overestimated.However, the sequence is only a series of characters, a book written in a secret language whose message we will yet need to understand by translating it to the language of biological function. With the pieces in hand we can now start putting the puzzle together, which will eventually reveal the picture we have long been seeking.