51
|
Itzhaki RF, Klapper P. Comment on "cytomegalovirus infection and risk of Alzheimer disease in older black and white individuals," journal of infectious diseases, 8 august 2014. J Infect Dis 2015; 211:2023-4. [PMID: 25635119 DOI: 10.1093/infdis/jiv051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 01/22/2015] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Paul Klapper
- Faculty of Medical and Human Sciences, University of Manchester, United Kingdom
| |
Collapse
|
52
|
D’Aiuto L, Prasad KM, Upton CH, Viggiano L, Milosevic J, Raimondi G, McClain L, Chowdari K, Tischfield J, Sheldon M, Moore JC, Yolken RH, Kinchington PR, Nimgaonkar VL. Persistent infection by HSV-1 is associated with changes in functional architecture of iPSC-derived neurons and brain activation patterns underlying working memory performance. Schizophr Bull 2015; 41:123-32. [PMID: 24622295 PMCID: PMC4266288 DOI: 10.1093/schbul/sbu032] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Herpes simplex virus, type 1 (HSV-1) commonly produces lytic mucosal lesions. It invariably initiates latent infection in sensory ganglia enabling persistent, lifelong infection. Acute HSV-1 encephalitis is rare and definitive evidence of latent infection in the brain is lacking. However, exposure untraceable to encephalitis has been repeatedly associated with impaired working memory and executive functions, particularly among schizophrenia patients. METHODS Patterns of HSV-1 infection and gene expression changes were examined in human induced pluripotent stem cell (iPSC)-derived neurons. Separately, differences in blood oxygenation level-dependent (BOLD) responses to working memory challenges using letter n-back tests were investigated using functional magnetic resonance imaging (fMRI) among schizophrenia cases/controls. RESULTS HSV-1 induced lytic changes in iPSC-derived glutamatergic neurons and neuroprogenitor cells. In neurons, HSV-1 also entered a quiescent state following coincubation with antiviral drugs, with distinctive changes in gene expression related to functions such as glutamatergic signaling. In the fMRI studies, main effects of schizophrenia (P = .001) and HSV-1 exposure (1-back, P = 1.76 × 10(-4); 2-back, P = 1.39 × 10(-5)) on BOLD responses were observed. We also noted increased BOLD responses in the frontoparietal, thalamus, and midbrain regions among HSV-1 exposed schizophrenia cases and controls, compared with unexposed persons. CONCLUSIONS The lytic/quiescent cycles in iPSC-derived neurons indicate that persistent neuronal infection can occur, altering cellular function. The fMRI studies affirm the associations between nonencephalitic HSV-1 infection and functional brain changes linked with working memory impairment. The fMRI and iPSC studies together provide putative mechanisms for the cognitive impairments linked to HSV-1 exposure.
Collapse
Affiliation(s)
- Leonardo D’Aiuto
- Department of Psychiatry, WPIC, University of Pittsburgh, School of Medicine, Pittsburgh PA;,These authors contributed equally to the article
| | - Konasale M. Prasad
- Department of Psychiatry, WPIC, University of Pittsburgh, School of Medicine, Pittsburgh PA;,These authors contributed equally to the article
| | - Catherine H. Upton
- Department of Psychiatry, WPIC, University of Pittsburgh, School of Medicine, Pittsburgh PA
| | - Luigi Viggiano
- Department of Biology, University of Bari “Aldo Moro”, Bari, Italy
| | - Jadranka Milosevic
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Giorgio Raimondi
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lora McClain
- Department of Psychiatry, WPIC, University of Pittsburgh, School of Medicine, Pittsburgh PA
| | - Kodavali Chowdari
- Department of Psychiatry, WPIC, University of Pittsburgh, School of Medicine, Pittsburgh PA
| | - Jay Tischfield
- Department of Genetics and The Human Genome Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ
| | - Michael Sheldon
- Department of Genetics and The Human Genome Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ
| | - Jennifer C. Moore
- Department of Genetics and The Human Genome Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ
| | - Robert H. Yolken
- Stanley Division of Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Paul R. Kinchington
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA;,Department of Molecular Genetics & Biochemistry, University of Pittsburgh, Pittsburgh, PA
| | - Vishwajit L. Nimgaonkar
- Department of Psychiatry, WPIC, University of Pittsburgh, School of Medicine, Pittsburgh PA;,Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA,*To whom correspondence should be addressed; Western Psychiatric Institute and Clinic, TDH 441, 3811 O’Hara St, Pittsburgh, PA 15213, US; tel: 412-246-6353, fax: 412-246-6350, e-mail:
| |
Collapse
|
53
|
Gutiérrez-Fernández J, Luna Del Castillo JDD, Mañanes-González S, Carrillo-Ávila JA, Gutiérrez B, Cervilla JA, Sorlózano-Puerto A. Different presence of Chlamydia pneumoniae, herpes simplex virus type 1, human herpes virus 6, and Toxoplasma gondii in schizophrenia: meta-analysis and analytical study. Neuropsychiatr Dis Treat 2015; 11:843-52. [PMID: 25848282 PMCID: PMC4384747 DOI: 10.2147/ndt.s79285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In the present study we have performed both a meta-analysis and an analytical study exploring the presence of Chlamydia pneumoniae, herpes simplex virus type 1, human herpes virus 6, and Toxoplasma gondii antibodies in a sample of 143 schizophrenic patients and 143 control subjects. The meta-analysis was performed on papers published up to April 2014. The presence of serum immunoglobulin G and immunoglobulin A was performed by enzyme-linked immunosorbent assay test. The detection of microbial DNA in total peripheral blood was performed by nested polymerase chain reaction. The meta-analysis showed that: 1) C. pneumoniae DNA in blood and brain are more common in schizophrenic patients; 2) there is association with parasitism by T. gondii, despite the existence of publication bias; and 3) herpes viruses were not more common in schizophrenic patients. In our sample only anti-Toxoplasma immunoglobulin G was more prevalent and may be a risk factor related to schizophrenia, with potential value for prevention.
Collapse
Affiliation(s)
| | | | | | | | - Blanca Gutiérrez
- Department of Psychiatry, Institute of Neurosciences and CIBERSAM, School of Medicine and Biohealth Research Institute (Instituto de Investigación Biosanitaria) IBS-Granada, University of Granada, Granada, Spain
| | - Jorge A Cervilla
- Department of Psychiatry, Institute of Neurosciences and CIBERSAM, School of Medicine and Biohealth Research Institute (Instituto de Investigación Biosanitaria) IBS-Granada, University of Granada, Granada, Spain
| | | |
Collapse
|
54
|
Cook TB, Brenner LA, Cloninger CR, Langenberg P, Igbide A, Giegling I, Hartmann AM, Konte B, Friedl M, Brundin L, Groer MW, Can A, Rujescu D, Postolache TT. "Latent" infection with Toxoplasma gondii: association with trait aggression and impulsivity in healthy adults. J Psychiatr Res 2015; 60:87-94. [PMID: 25306262 DOI: 10.1016/j.jpsychires.2014.09.019] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 09/03/2014] [Accepted: 09/19/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Latent chronic infection with Toxoplasma gondii (T. gondii), a common neurotropic pathogen, has been previously linked with suicidal self-directed violence (SSDV). We sought to determine if latent infection with T. gondii is associated with trait aggression and impulsivity, intermediate phenotypes for suicidal behavior, in psychiatrically healthy adults. METHODS Traits of aggression and impulsivity were analyzed in relationship to IgG antibody seropositivity for T. gondii and two other latent neurotropic infections, herpes simplex virus 1 (HSV1) and cytomegalovirus (CMV). One thousand community-residing adults residing in the Munich metropolitan area with no Axis I or II conditions by SCID for DSM-IV (510 men, 490 women, mean age 53.6 ± 15.8, range 20-74). Plasma samples were tested for IgG antibodies to T. gondii, HSV-1 and CMV by ELISA. Self-reported ratings of trait aggression scores (Questionnaire for Measuring Factors of Aggression [FAF]) and trait impulsivity (Sensation-Seeking Scale-V [SSS-V]) were analyzed using linear multivariate methods. RESULTS T. gondii IgG seropositivity was significantly associated with higher trait reactive aggression scores among women (p < .01), but not among men. T. gondii-positivity was also associated with higher impulsive sensation-seeking (SSS-V Disinhibition) among younger men (p < .01) aged 20-59 years old (median age = 60). All associations with HSV-1 and CMV were not significant. CONCLUSIONS Aggression and impulsivity, personality traits considered as endophenotypes for SSDV, are associated with latent T. gondii infection in a gender and age-specific manner, and could be further investigated as prognostic and treatment targets in T. gondii-positive individuals at risk for SSDV.
Collapse
Affiliation(s)
- Thomas B Cook
- Department of Public Health, Mercyhurst Institute for Public Health, Mercyhurst University, Erie, PA, USA
| | - Lisa A Brenner
- Veterans Integrated Service Network (VISN) 19, Mental Illness Research Education and Clinical Center (MIRECC), Denver, CO, USA; Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA; Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - C Robert Cloninger
- Department of Psychiatry, Sansone Centre for Well-Being, Washington University, St. Louis, MO, USA
| | - Patricia Langenberg
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ajirioghene Igbide
- DC Department of Behavioral Health, Saint Elizabeths Hospital, Psychiatry Residency Program, Washington, DC, USA
| | - Ina Giegling
- Department of Psychiatry, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Annette M Hartmann
- Department of Psychiatry, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Bettina Konte
- Department of Psychiatry, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Marion Friedl
- Department of Psychiatry, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Lena Brundin
- Division of Psychiatry and Behavioral Medicine, College of Human Medicine, Michigan State University, Van Andel Research Institute, Grand Rapids, MI, USA
| | | | - Adem Can
- Department of Psychiatry, University of Maryland-Baltimore School of Medicine, Baltimore, MD, USA
| | - Dan Rujescu
- Department of Psychiatry, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Teodor T Postolache
- Veterans Integrated Service Network (VISN) 19, Mental Illness Research Education and Clinical Center (MIRECC), Denver, CO, USA; Department of Psychiatry, University of Maryland-Baltimore School of Medicine, Baltimore, MD, USA; Veterans Integrated Service Network (VISN) 5, Mental Illness Research Education and Clinical Center (MIRECC), Baltimore, MD, USA.
| |
Collapse
|
55
|
Itzhaki RF. Herpes simplex virus type 1 and Alzheimer's disease: increasing evidence for a major role of the virus. Front Aging Neurosci 2014; 6:202. [PMID: 25157230 PMCID: PMC4128394 DOI: 10.3389/fnagi.2014.00202] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/23/2014] [Indexed: 12/15/2022] Open
Abstract
Herpes simplex virus type 1 (HSV1), when present in brain of carriers of the type 4 allele of the apolipoprotein E gene (APOE), has been implicated as a major factor in Alzheimer's disease (AD). It is proposed that virus is normally latent in many elderly brains but reactivates periodically (as in the peripheral nervous system) under certain conditions, for example stress, immunosuppression, and peripheral infection, causing cumulative damage and eventually development of AD. Diverse approaches have provided data that explicitly support, directly or indirectly, these concepts. Several have confirmed HSV1 DNA presence in human brains, and the HSV1-APOE-ε4 association in AD. Further, studies on HSV1-infected APOE-transgenic mice have shown that APOE-e4 animals display a greater potential for viral damage. Reactivated HSV1 can cause direct and inflammatory damage, probably involving increased formation of beta amyloid (Aβ) and of AD-like tau (P-tau)-changes found to occur in HSV1-infected cell cultures. Implicating HSV1 further in AD is the discovery that HSV1 DNA is specifically localized in amyloid plaques in AD. Other relevant, harmful effects of infection include the following: dynamic interactions between HSV1 and amyloid precursor protein (APP), which would affect both viral and APP transport; induction of toll-like receptors (TLRs) in HSV1-infected astrocyte cultures, which has been linked to the likely effects of reactivation of the virus in brain. Several epidemiological studies have shown, using serological data, an association between systemic infections and cognitive decline, with HSV1 particularly implicated. Genetic studies too have linked various pathways in AD with those occurring on HSV1 infection. In relation to the potential usage of antivirals to treat AD patients, acyclovir (ACV) is effective in reducing HSV1-induced AD-like changes in cell cultures, and valacyclovir, the bioactive form of ACV, might be most effective if combined with an antiviral that acts by a different mechanism, such as intravenous immunoglobulin (IVIG).
Collapse
Affiliation(s)
- Ruth F. Itzhaki
- Faculty of Life Sciences, University of ManchesterManchester, Lancs, UK
| |
Collapse
|
56
|
Jonker I, Klein HC, Duivis HE, Yolken RH, Rosmalen JGM, Schoevers RA. Association between exposure to HSV1 and cognitive functioning in a general population of adolescents. The TRAILS study. PLoS One 2014; 9:e101549. [PMID: 24983885 PMCID: PMC4077793 DOI: 10.1371/journal.pone.0101549] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 06/08/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Infections with different herpes viruses have been associated with cognitive functioning in psychiatric patients and healthy adults. The aim of this study was to find out whether antibodies to different herpes viruses are prospectively associated with cognitive functioning in a general adolescent population. METHODS This study was performed in TRAILS, a large prospective general population cohort (N = 1084, 54% female, mean age 16.2 years (SD 0.6)). At age 16, immunoglobulin G antibodies against HSV1, HSV2, CMV and EBV were measured next to high sensitive C-Reactive Protein (hsCRP). Two years later, immediate memory and executive functioning were assessed using the 15 words task and the self ordered pointing task. Multiple linear regression analysis with bootstrapping was performed to study the association between viral infections and cognitive function, adjusting for gender, socioeconomic status, ethnicity, and cannabis use. RESULTS Presence of HSV1 antibodies was associated with memory function ((B = -0.272, 95% CI = -0.556 to -0.016, p = 0.047)), while the association with executive functioning did not reach statistical significance (B = 0.560, 95% CI is -0.053 to 1.184, p = 0.075). The level of HSV1 antibodies was associated with both memory function (B = -0.160, 95% CI = -0.280 to -0.039, p = 0.014) and executive functioning (B = 0.296, 95% CI = 0.011 to 0.578, p = 0.046). Other herpes viruses and hsCRP were not associated with cognitive functioning. CONCLUSIONS Both presence and level of HSV1 antibodies are prospectively associated with reduced cognitive performance in a large cohort of adolescents.
Collapse
Affiliation(s)
- Iris Jonker
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
- * E-mail:
| | - Hans C. Klein
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Hester E. Duivis
- Center of Research on Psychology in Somatic Diseases, Department of Medical and Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Robert H. Yolken
- Johns Hopkins Medical School, Baltimore, Maryland, United States of America
| | - Judith G. M. Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands
| | - Robert A. Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| |
Collapse
|
57
|
High prevalence of Human Herpesvirus 8 in schizophrenic patients. Psychiatry Res 2014; 216:192-7. [PMID: 24560611 DOI: 10.1016/j.psychres.2013.12.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 12/19/2013] [Accepted: 12/21/2013] [Indexed: 11/21/2022]
Abstract
Many studies have reported an association between Herpes family viruses and an increased risk of schizophrenia, but the role of Human Herpesvirus 8 (HHV8) has never been investigated. This study aimed to assess HHV8 prevalence in schizophrenic patients as well as the possible association between HHV8 infection and schizophrenia clinical features. We consecutively enrolled 108 patients meeting fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria of schizophrenia and 108 age and sex matched controls. Data about a number of demographic characteristics and potential HHV8 risk factors of infection were collected. Standardized psychopathology measures, disease severity and functioning level were obtained using Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), Clinical Global Impressions (CGI) and Global Assessment of functioning (GAF). The presence of anti-HHV8 antibodies was analyzed using an indirect immunofluorescence assay. A higher prevalence of HHV8 infection in schizophrenic patients than in controls was found. Marital status, having children, sexual behavior and risk factors of blood transmission were not associated with HHV8 prevalence. However, among schizophrenic patients, HHV8 prevalence was statically associated with positive symptoms. To our knowledge, this would be the first report of a possible role of HHV8 in the pathogenesis of schizophrenia. To prove this hypothesis, further investigation of HHV8 in schizophrenia with larger samples is needed.
Collapse
|
58
|
|
59
|
Houenou J, d'Albis MA, Daban C, Hamdani N, Delavest M, Lepine JP, Vederine FE, Carde S, Lajnef M, Cabon C, Dickerson F, Yolken RH, Tamouza R, Poupon C, Leboyer M. Cytomegalovirus seropositivity and serointensity are associated with hippocampal volume and verbal memory in schizophrenia and bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2014; 48:142-8. [PMID: 24083998 DOI: 10.1016/j.pnpbp.2013.09.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 08/27/2013] [Accepted: 09/07/2013] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Cytomegalovirus (CMV) is a member of the herpesviridae family that has a limbic and temporal gray matter tropism. It is usually latent in humans but has been associated with schizophrenia, bipolar disorder and cognitive deficits in some populations. Hippocampal decreased volume and dysfunction play a critical role in these cognitive deficits. We hypothesized that CMV seropositivity and serointensity would be associated with hippocampal volume and cognitive functioning in patients with schizophrenia or bipolar disorder. METHODS 102 healthy controls, 118 patients with bipolar disorder and 69 patients with schizophrenia performed the California Verbal Learning Test (CVLT) and had blood samples drawn to assess CMV IgG levels. A subgroup of 52 healthy controls, 31 patients with bipolar disorder and 27 patients with schizophrenia underwent T1 MRI for hippocampal volumetry. We analyzed the association between CMV serointensity and seropositivity with hippocampal volume. We also explored the correlation between CMV serointensity and seropositivity and CVLT scores. RESULTS In both patient groups but not in controls, higher CMV serointensity was significantly associated with smaller right hippocampal volume. Further, in the group of patients with schizophrenia but not bipolar disorder, CMV serointensity was negatively correlated with CVLT scores. CONCLUSION CMV IgG titers are associated with decreased hippocampal volume and poorer episodic verbal memory in patients with schizophrenia or bipolar disorder. The mechanism of this association warrants further exploration.
Collapse
Affiliation(s)
- J Houenou
- INSERM, U955, Equipe 15 "Psychiatrie Génétique", Créteil F-94000, France; Fondation Fondamental, Créteil F-94010, France; AP-HP, Groupe Henri Mondor - Albert Chenevier, Pôle de Psychiatrie, Créteil, F-94000, France; Neurospin, CEA Saclay, Gif-Sur-Yvette, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
60
|
Kodavali CV, Watson AM, Prasad KM, Celik C, Mansour H, Yolken RH, Nimgaonkar VL. HLA associations in schizophrenia: are we re-discovering the wheel? Am J Med Genet B Neuropsychiatr Genet 2014; 165B:19-27. [PMID: 24142843 DOI: 10.1002/ajmg.b.32195] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 08/02/2013] [Indexed: 01/18/2023]
Abstract
Associations between human leukocyte antigen (HLA) polymorphisms on chromosome 6p and schizophrenia (SZ) risk have been evaluated for over five decades. Numerous case-control studies from the candidate gene era analyzed moderately sized samples and reported nominally significant associations with several loci in the HLA region (sample sizes, n = 100-400). The risk conferred by individual alleles was modest (odds ratios < 2.0). The basis for the associations could not be determined, though connections with known immune and auto-immune abnormalities in SZ were postulated. Interest in the HLA associations has re-emerged following several recent genome-wide association studies (GWAS); which utilized 10- to 100-fold larger samples and also identified associations on the short arm of chromosome 6. Unlike the earlier candidate gene studies, the associations are statistically significant following correction for multiple comparisons. Like the earlier studies; they have modest effect sizes, raising questions about their utility in risk prediction or pathogenesis research. In this review, we summarize the GWAS and reflect on possible bases for the associations. Suggestions for future research are discussed. We favor, in particular; efforts to evaluate local population sub-structure as well as further evaluation of immune-related variables in future studies.
Collapse
Affiliation(s)
- Chowdari V Kodavali
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
| | | | | | | | | | | | | |
Collapse
|
61
|
Thomas P, Bhatia T, Gauba D, Wood J, Long C, Prasad K, Dickerson FB, Gur RE, Gur RC, Yolken RH, Nimgaonkar VL, Deshpande SN. Exposure to herpes simplex virus, type 1 and reduced cognitive function. J Psychiatr Res 2013; 47:1680-5. [PMID: 23920011 PMCID: PMC3809147 DOI: 10.1016/j.jpsychires.2013.07.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 07/03/2013] [Accepted: 07/03/2013] [Indexed: 12/25/2022]
Abstract
Herpes simplex virus, type 1 (HSV-1) causes cold sores, keratitis and rarely, fatal encephalitis. The infection is lifelong, with sensory ganglia serving as reservoirs of latent infection. Recently, exposure to HSV-1 has also been repeatedly associated with reduced cognitive function among healthy individuals without prior encephalitis. Though HSV-1 does not elevate risk for schizophrenia (SZ) per se, exposure is likewise associated with impaired cognitive functions among SZ patients. The range of cognitive changes observed in HSV-1 exposed persons has not been investigated systematically, nor is it known whether interaction between HSV-1 exposure and SZ related factors contributes to the impairment among SZ patients. Persons with or without schizophrenia/schizophreniform disorder (N = 298 total, DSM IV criteria) were assessed for HSV-1 exposure using serum HSV-1 antibody titers. The Penn Computerized Neurocognitive battery was used to assess eight cognitive domains with respect to accuracy and speed. There were no significant case-control differences in HSV-1 exposure. The SZ/schizophreniform disorder cases were significantly impaired in all cognitive domains compared with the controls. HSV-1 exposure was also associated with reduced cognitive function in the entire sample, but the magnitude of the effects and their patterns differed from the SZ related changes. Further, statistically significant interactions between HSV-1 exposure and SZ case status were not detected. HSV-1 exposure does not elevate risk for SZ, but it is associated with reduced function in specific cognitive domains regardless of SZ diagnostic status. An 'epidiagnostic' model for the association is proposed to explain the results.
Collapse
Affiliation(s)
- Pramod Thomas
- Department of Bio-Statistics, Dr S.M.C.S.I. Medical College, Karakonam, Thiruvananthapuram, Kerala, India
| | - Triptish Bhatia
- GRIP-NIH Project USA, Department of Psychiatry, Dr. RML Hospital, New Delhi India
| | | | - Joel Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA
| | - Colleen Long
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA
| | - Konasale Prasad
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA
| | - Faith B Dickerson
- Stanley Research Center, Sheppard Pratt Health System, 6501 North Charles St., Baltimore, MD 21204, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104-4283, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104-4283, USA
| | - Robert H Yolken
- Stanley Laboratory of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Vishwajit L Nimgaonkar
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA,Department of Human Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Smita N Deshpande
- Department of Psychiatry, PGIMER-Dr. Ram Manohar Lohia Hospital, New Delhi, India
| |
Collapse
|
62
|
Bhattacharjee S, Lukiw WJ. Alzheimer's disease and the microbiome. Front Cell Neurosci 2013; 7:153. [PMID: 24062644 PMCID: PMC3775450 DOI: 10.3389/fncel.2013.00153] [Citation(s) in RCA: 179] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 08/26/2013] [Indexed: 12/21/2022] Open
Affiliation(s)
- Surjyadipta Bhattacharjee
- Departments of Neurology, Neuroscience and Ophthalmology, LSU Neuroscience Center, Louisiana State University Health Sciences Center New Orleans, LA, USA
| | | |
Collapse
|
63
|
Prasad KM, Eack SM, Keshavan MS, Yolken RH, Iyengar S, Nimgaonkar VL. Antiherpes virus-specific treatment and cognition in schizophrenia: a test-of-concept randomized double-blind placebo-controlled trial. Schizophr Bull 2013; 39:857-66. [PMID: 22446565 PMCID: PMC3686443 DOI: 10.1093/schbul/sbs040] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To test our hypothesis that valacyclovir, an antiherpes virus-specific medication, added to antipsychotics (APs) would improve cognitive performance and psychopathology among schizophrenia subjects exposed to neurotropic herpes simplex virus, type 1 (HSV1). METHODS Using a double-blind placebo-controlled design, we randomized 24 HSV1-seropositive schizophrenia subjects to receive either valacyclovir (n = 12) or placebo (n = 12) for 18 weeks in addition to stable doses of APs. Valacyclovir dose was stabilized at 1.5 g twice daily orally. At each visit, subjects were evaluated for severity of psychopathology and side effects using standardized scales and a study-specific semistructured checklist. A computerized neurocognitive battery validated on both schizophrenia and healthy subjects was administered at baseline and follow-up. Intent-to-treat analysis, using linear regression models that included all randomized subjects, were used to examine differential changes in cognition and psychopathology scores over 18 weeks between valacyclovir and placebo, accounting for placebo response. RESULTS Valacyclovir group improved in verbal memory, working memory, and visual object learning compared with placebo group. The effect sizes (Cohen's d) were 0.79 for working memory, 1.14 for immediate verbal memory, and 0.97 for the visual object learning. Psychotic symptom severity did not improve. CONCLUSIONS Supplemental valacyclovir may alleviate impairments in cognitive domains that are often observed in schizophrenia but not psychotic symptoms in those exposed to HSV1. If replicated, this approach could provide a novel strategy to treat cognitive impairments in a subgroup of schizophrenia subjects who can be reliably identified using a blood test.
Collapse
Affiliation(s)
- Konasale M. Prasad
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA,To whom correspondence should be addressed; Department of Psychiatry, School of Medicine, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213, US; tel: 412-586-9014, fax: 412-246-6350, e-mail:
| | - Shaun M. Eack
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA,School of Social Work, University of Pittsburgh, Pittsburgh, PA
| | - Matcheri S. Keshavan
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Robert H. Yolken
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA
| | | |
Collapse
|
64
|
Bellivier F, Geoffroy PA, Scott J, Schurhoff F, Leboyer M, Etain B. Biomarkers of bipolar disorder: specific or shared with schizophrenia? Front Biosci (Elite Ed) 2013; 5:845-63. [PMID: 23747901 PMCID: PMC5127822 DOI: 10.2741/e665] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Kraepelin's observations of the differences in the course and outcome of dementia praecox and manic depression fundamentally influenced thinking about bipolar disorder (BP) and schizophrenia (SZ) for over a century. In modern times, there is increasing awareness that a greater understanding of the similarities between these two highly prevalent and disabling conditions can teach us as many lessons about the pathophysiology of severe mental disorders as does the pursuit of differentiating factors. We review publications on developmental, genetic, epidemiological, and outcome research that challenges the Kraepelian dichotomy. We highlight the increasing evidence of the overlap in genetic susceptibility. Neuro-developmental studies provide evidence of shared early pathological processes, whilst neurophysiological investigations also suggest that different genes may have a role in the development of both phenotypes. There is also evidence of overlapping neurocognitive phenotypes. It has become increasingly clear that a simple binary classification of these disorders represents an oversimplification. It may be more apposite to think in terms of genetic influences on six continuous symptom dimensions: neurobiological, cognitive, positive, negative, depressive and manic symptoms.
Collapse
|
65
|
Watson AMM, Prasad KM, Klei L, Wood JA, Yolken RH, Gur RC, Bradford LD, Calkins ME, Richard J, Edwards N, Savage RM, Allen TB, Kwentus J, McEvoy JP, Santos AB, Wiener HW, Go RCP, Perry RT, Nasrallah HA, Gur RE, Devlin B, Nimgaonkar VL. Persistent infection with neurotropic herpes viruses and cognitive impairment. Psychol Med 2013; 43:1023-1031. [PMID: 22975221 DOI: 10.1017/s003329171200195x] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Herpes virus infections can cause cognitive impairment during and after acute encephalitis. Although chronic, latent/persistent infection is considered to be relatively benign, some studies have documented cognitive impairment in exposed persons that is untraceable to encephalitis. These studies were conducted among schizophrenia (SZ) patients or older community dwellers, among whom it is difficult to control for the effects of co-morbid illness and medications. To determine whether the associations can be generalized to other groups, we examined a large sample of younger control individuals, SZ patients and their non-psychotic relatives (n=1852). Method Using multivariate models, cognitive performance was evaluated in relation to exposures to herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2) and cytomegalovirus (CMV), controlling for familial and diagnostic status and sociodemographic variables, including occupation and educational status. Composite cognitive measures were derived from nine cognitive domains using principal components of heritability (PCH). Exposure was indexed by antibodies to viral antigens. RESULTS PCH1, the most heritable component of cognitive performance, declines with exposure to CMV or HSV-1 regardless of case/relative/control group status (p = 1.09 × 10-5 and 0.01 respectively), with stronger association with exposure to multiple herpes viruses (β = -0.25, p = 7.28 × 10-10). There were no significant interactions between exposure and group status. CONCLUSIONS Latent/persistent herpes virus infections can be associated with cognitive impairments regardless of other health status.
Collapse
Affiliation(s)
- A M M Watson
- Departments of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
66
|
Bamne M, Wood J, Chowdari K, Watson AM, Celik C, Mansour H, Klei L, Gur RC, Bradford LD, Calkins ME, Santos AB, Edwards N, Kwentus J, McEvoy JP, Allen TB, Savage RM, Nasrallah HA, Gur RE, Perry RT, Go RC, Devlin B, Yolken R, Nimgaonkar VL. Evaluation of HLA polymorphisms in relation to schizophrenia risk and infectious exposure. Schizophr Bull 2012; 38:1149-54. [PMID: 22966150 PMCID: PMC3494045 DOI: 10.1093/schbul/sbs087] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Genome-wide association studies (GWAS) implicate single nucleotide polymorphisms (SNPs) on chromosome 6p21.3-22.1, the human leukocyte antigen (HLA) region, as common risk factors for schizophrenia (SZ). Other studies implicate viral and protozoan exposure. Our study tests chromosome 6p SNPs for effects on SZ risk with and without exposure. METHOD GWAS-significant SNPs and ancestry-informative marker SNPs were analyzed among African American patients with SZ (n = 604) and controls (n = 404). Exposure to herpes simplex virus, type 1 (HSV-1), cytomegalovirus (CMV), and Toxoplasma gondii (TOX) was assayed using specific antibody assays. RESULTS Five SNPs were nominally associated with SZ, adjusted for population admixture (P < .05, uncorrected for multiple comparisons). These SNPs were next analyzed in relation to infectious exposure. Multivariate analysis indicated significant association between rs3130297 genotype and HSV-1 exposure; the associated allele was different from the SZ risk allele. CONCLUSIONS We propose a model for the genesis of SZ incorporating genomic variation in the HLA region and neurotropic viral exposure for testing in additional, independent African American samples.
Collapse
Affiliation(s)
- Mikhil Bamne
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic,Pittsburgh, PA
| | - Joel Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic,Pittsburgh, PA
| | - Kodavali Chowdari
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic,Pittsburgh, PA
| | - Annie M. Watson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic,Pittsburgh, PA
| | - Cemil Celik
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA and Department of Psychiatry, GATA School of Medicine, Etlik-Ankara, Turkey
| | - Hader Mansour
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic,Pittsburgh, PA
| | - Lambertus Klei
- Computational Genetics Program, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ruben C. Gur
- Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA and Philadelphia Veteran’s Affairs Medical Center, Philadelphia, PA
| | | | - Monica E. Calkins
- Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA
| | - Alberto B. Santos
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina,Charleston, SC
| | - Neil Edwards
- Department of Psychiatry, University of Tennessee, College of Medicine, Memphis, TN
| | - Joseph Kwentus
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Joseph P. McEvoy
- Duke University Medical Center-John Umstead Hospital, Butler, NC
| | - Trina B. Allen
- Duke University Medical Center-John Umstead Hospital, Butler, NC
| | - Robert M. Savage
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL
| | - Henry A. Nasrallah
- Department of Psychiatry and Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Raquel E. Gur
- Department of Psychiatry, Neuropsychiatry Section, University of Pennsylvania, Philadelphia, PA
| | - Rodney T. Perry
- University of Alabama at Birmingham, Epidemiology and International Health, Birmingham, AL
| | - Rodney C.P. Go
- Department of Epidemiology and International Health, University of Alabama at Birmingham, Birmingham, AL
| | - Bernie Devlin
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA and Department of Human Genetics, Graduate School of Public Health Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Robert Yolken
- Johns Hopkins University Medical Center, Stanley Division of Developmental Neurovirology, Baltimore, MD
| | - Vishwajit L. Nimgaonkar
- Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA and Department of Human Genetics, Graduate School of Public Health Pittsburgh, University of Pittsburgh, Pittsburgh, PA;,To whom correspondence should be addressed; tel: 1-412-246-6353, fax: 1-412-246-6350, e-mail:
| |
Collapse
|
67
|
Abstract
Schizophrenia (SZ) is a common disorder that runs in families. It has a relatively high heritability, i.e., inherited factors account for the major proportion of its etiology. The high heritability has motivated gene mapping studies that have improved in sophistication through the past two decades. Belying earlier expectations, it is now becoming increasingly clear that the cause of SZ does not reside in a single mutation, or even in a single gene. Rather, there are multiple DNA variants, not all of which have been identified. Additional risk may be conferred by interactions between individual DNA variants, as well as 'gene-environment' interactions. We review studies that have accounted for a fraction of the heritability. Their relevance to the practising clinician is discussed. We propose that continuing research in DNA variation, in conjunction with rapid ongoing advances in allied fields, will yield dividends from the perspective of diagnosis, treatment prediction through pharmacogenetics, and rational treatment through discoveries in pathogenesis.
Collapse
Affiliation(s)
- Prachi Kukshal
- Department of Genetics, University of Delhi South Campus, New Delhi, India
| | - B. K. Thelma
- Department of Genetics, University of Delhi South Campus, New Delhi, India
| | - Vishwajit L. Nimgaonkar
- Departments of Psychiatry and Human Genetics, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Smita N. Deshpande
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital, New Delhi, India
| |
Collapse
|