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Zhang YX, Yang LP, Gai C, Cheng CC, Guo ZY, Sun HM, Hu D. Association between variants of MTHFR genes and psychiatric disorders: A meta-analysis. Front Psychiatry 2022; 13:976428. [PMID: 36061291 PMCID: PMC9433753 DOI: 10.3389/fpsyt.2022.976428] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
Background Psychiatric disorders have seriously affected human life, one of the risk genes related to psychosis is the methylenetetrahydrofolatereductase (MTHFR) gene. This gene has a potential role in psychiatric disorders. Therefore, a meta-analysis is conducted to investigate the correlations between two prevalent MTHFR single nucleotide polymorphisms (SNPs), MTHFR C677T, A1298C, severe psychological disorders (schizophrenia, major depression, bipolar disorder). Methods A total of 81 published studies were screened and selected by a search of electronic databases up to April 2022. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association between MTHFR polymorphism and psychiatric disorders susceptibility by using random effect models. Results We found that MTHFR C677T polymorphism is significantly related to schizophrenia and major depression in the overall population. MTHFR C677T has been linked to an increased risk of bipolar disorder in the recessive model (TT vs. CT + CC). Ethnic subgroup analysis shows that schizophrenia and major depression significantly correlate with MTHFR C677T and A1298C in Asian populations but not Caucasians. Besides, schizophrenia is correlated substantially with MTHFR C677T in the African population. However, the MTHFR A1298C polymorphism is only marginally linked to major depression. Conclusion Findings of the current study revealed that MTHFR may contribute to the common pathogenesis of psychiatric diseases and that its variants may be essential in controlling the expression of psychosis-related genes. This study could help the researchers and health specialists in the early diagnosis and treatment of psychiatric disorders.
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Affiliation(s)
- Yu-Xin Zhang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lu-Ping Yang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Cong Gai
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Cui-Cui Cheng
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhen-yu Guo
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-Mei Sun
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Die Hu
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Meng X, Zheng JL, Sun ML, Lai HY, Wang BJ, Yao J, Wang H. Association between MTHFR (677C>T and 1298A>C) polymorphisms and psychiatric disorder: A meta-analysis. PLoS One 2022; 17:e0271170. [PMID: 35834596 PMCID: PMC9282595 DOI: 10.1371/journal.pone.0271170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/25/2022] [Indexed: 11/30/2022] Open
Abstract
Recent studies showed that genetic polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) is related to attention-deficit hyperactivity disorder (ADHD), bipolar disorder (BD) and schizophrenia (SCZ). However, no consistent conclusion has been determined. This meta-analysis aims to interrogate the relationship between MTHFR gene polymorphisms (677C>T and 1298A>C) and the occurrence of ADHD, BD and SCZ. We retrieved case-control studies that met the inclusion criteria from the PubMed database. Associations between MTHFR polymorphisms (677C>T and 1298A>C) and ADHD, BD and SCZ were measured by means of odds ratios (ORs) using a random effects model and 95% confidence intervals (CIs). Additionally, sensitivity analysis and publication bias were performed. After inclusion criteria were met, a total of five studies with ADHD including 434 cases and 670 controls, 18 studies with BD including 4167 cases and 5901 controls and 44 studies with SCZ including 16,098 cases and 19913 controls were finally included in our meta-analysis. Overall, our meta-analytical results provided evidence that the MTHFR 677C>T was associated with occurrence of BD and SCZ, while the 1298A>C polymorphism was related to ADHD and BD, and additionally the sensitivity analysis indicated these results were stable and reliable. This may provide useful information for relevant studies on the etiology of psychiatric disorders.
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Affiliation(s)
- Xinyao Meng
- School of Basic Medicine, Shenyang Medical College, Shenyang, P.R. China
| | - Ji-long Zheng
- Department of Forensic Medicine, China Criminal Police College, Shenyang, P.R. China
| | - Mao-ling Sun
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Hai-yun Lai
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Bao-jie Wang
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Jun Yao
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Hongbo Wang
- School of Basic Medicine, Shenyang Medical College, Shenyang, P.R. China
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The potential use of folate and its derivatives in treating psychiatric disorders: A systematic review. Biomed Pharmacother 2021; 146:112541. [PMID: 34953391 DOI: 10.1016/j.biopha.2021.112541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To examine the strengths and limitations of existing data to provide guidance for the use of folate supplements as treatment, with or without other psychotropic medications, in various psychiatric disorders. To identify area for further research in terms of the biosynthesis of mechanism of folate and genetic variants in metabolic pathway in human. METHODS A systematic review of published literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to assess whether folate supplements are beneficial in certain psychiatric disorders (depression, bipolar disorder, schizophrenia, autism spectrum disorder, and attention deficit hyperactivity disorder). Methodology of this review is registered with Prospero (Registration number CRD 42021266605). DATA SOURCES Eligible studies were identified using a systematic search of four electronic databases: Embase, Pubmed, PsycINFO, and Cochrane. The search strategy covered the time period from 1974 to August 16th, 2021. Therefore, this review examines randomized control trials or open-label trials completed during this period. RESULTS We identified 23 studies of folate supplements in various psychiatric disorders for critical review. Of these, 9 studies investigated the efficacy of folate supplements in major depressive disorders, 5 studies in schizophrenia, 6 studies in autism spectrum disorder, 2 studies in bipolar affective disorder and 1 study in attention deficit hyperactive disorder. The most consistent finding association of oral levomefolic acid or 5-methylfolate with improvement in clinical outcomes in mental health conditions as mentioned above, especially in major depressive disorder (including postpartum and post-menopausal depression), schizophrenia, autism spectrum disorder, attention deficit hyperactivity disorder and bipolar affective disorder. Folate supplements were well tolerated. LIMITATION Our results are not representative of all types of studies such as case reports or case series studies, nor are they representative of the studies conducted in languages that are not in English or not translated in English. CONCLUSION Increasing evidence from clinical trials consistently demonstrate folate supplements, especially levomefolic acid or 5-methylfolate, may improve clinical outcomes for certain psychiatric diseases, especially as an adjunct pharmacotherapy with minimal side effects.
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4
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The polygenic nature of telomere length and the anti-ageing properties of lithium. Neuropsychopharmacology 2019; 44:757-765. [PMID: 30559463 PMCID: PMC6372618 DOI: 10.1038/s41386-018-0289-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/29/2018] [Accepted: 11/27/2018] [Indexed: 12/27/2022]
Abstract
Telomere length is a promising biomarker for age-related disease and a potential anti-ageing drug target. Here, we study the genetic architecture of telomere length and the repositioning potential of lithium as an anti-ageing medication. LD score regression applied to the largest telomere length genome-wide association study to-date, revealed SNP-chip heritability estimates of 7.29%, with polygenic risk scoring capturing 4.4% of the variance in telomere length in an independent cohort (p = 6.17 × 10-5). Gene-enrichment analysis identified 13 genes associated with telomere length, with the most significant being the leucine rich repeat gene, LRRC34 (p = 3.69 × 10-18). In the context of lithium, we confirm that chronic use in a sample of 384 bipolar disorder patients is associated with longer telomeres (p = 0.03). As complementary evidence, we studied three orthologs of telomere length regulators in a Caenorhabditis elegans model of lithium-induced extended longevity and found all transcripts to be affected post-treatment (p < 0.05). Lithium may therefore confer its anti-ageing effects by moderating the expression of genes responsible for normal telomere length regulation. This is supported by our bipolar disorder sample, which shows that polygenic risk scores explain a higher proportion of the variance in telomere length amongst chronic lifetime lithium users (variance explained = 8.9%, p = 0.01), compared to non-users (p > 0.05). Consequently, this suggests that lithium may be catalysing the activity of endogenous mechanisms that promote telomere lengthening, whereby its efficacy eventually becomes limited by each individual's inherent telomere maintenance capabilities. Our work indicates a potential use of polygenic risk scoring for the prediction of adult telomere length and consequently lithium's anti-ageing efficacy.
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5
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Wan L, Li Y, Zhang Z, Sun Z, He Y, Li R. Methylenetetrahydrofolate reductase and psychiatric diseases. Transl Psychiatry 2018; 8:242. [PMID: 30397195 PMCID: PMC6218441 DOI: 10.1038/s41398-018-0276-6] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 08/07/2018] [Accepted: 09/10/2018] [Indexed: 11/26/2022] Open
Abstract
Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme for the critical process of one-carbon metabolism involving folate and homocysteine metabolisms. It is known that some polymorphism of MTHFR would result in reduction of MTHFR enzyme activity as well as DNA methylation process, later shown to have significant impacts in various psychiatric diseases. However, it is unclear whether the polymorphism of MTHFR could be an independent or an add-on risk factor for specific psychiatric symptoms, such as anxiety, depression, positive, or negative symptoms of schizophrenia, or acts as risk factor for specific psychiatric disorders, such as schizophrenia, major depression, autisms, and bipolar disorders. It is also understudied on whether folate supplements could be an effective treatment for psychiatric patients with defect MTHFR activity. In this review, we not only gathered the most recent discoveries on MTHFR polymorphism and related DNA methylation in various psychiatric disorders, but also highlighted the potential relationships between MTHFR activity and implication of folate-related function in specific mental diseases.
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Affiliation(s)
- Lin Wan
- Center for Brain Disorders Research, Capital Medical University & Beijing Institute of Brain Disorders, Beijing, 100069, China
| | - Yuhong Li
- Center for Brain Disorders Research, Capital Medical University & Beijing Institute of Brain Disorders, Beijing, 100069, China
| | - Zhengrong Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Zuoli Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Yi He
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Rena Li
- Center for Brain Disorders Research, Capital Medical University & Beijing Institute of Brain Disorders, Beijing, 100069, China.
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
- Center for Hormone Advanced Science and Education, Roskamp Institute, Sarasota, FL, 34243, USA.
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Kałużna EM, Strauss E, Świątek-Kościelna B, Zając-Spychała O, Gowin E, Nowak JS, Rembowska J, Januszkiewicz-Lewandowska D. The methylenetetrahydrofolate reductase 677T-1298C haplotype is a risk factor for acute lymphoblastic leukemia in children. Medicine (Baltimore) 2017; 96:e9290. [PMID: 29390492 PMCID: PMC5758194 DOI: 10.1097/md.0000000000009290] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The etiology of acute lymphoblastic leukemia (ALL) is complex, linked with both environmental exposures and genetic factors. Functional variants of the methylenetetrahydrofolate reductase (MTHFR) gene result in disturbance in folate metabolism and may affect susceptibility to cancer. The study was performed to evaluate whether MTHFR C677T and A1298C polymorphisms, analyzed separately and together, are associated with the development of ALL in a population under 18 years of age of Caucasian ancestry.The study included 117 pediatric patients (59% males, mean age at diagnosis 7.4 ± 5.2 years) with ALL, confirmed by conventional immunophenotyping surface-marker analysis and 404 healthy control subjects (48.5% men, mean age 37.7 ± 11.3 years). The MTHFR C677T and A1298C genotypes were analyzed using allele discrimination tests with Taq-Man fluorescent probes.The MTHFR 677TT genotype was related to a 2-fold increase in risk of ALL (P = .014). The 677T-1298C haplotype was found in ALL patients but not in controls (frequency 0.598%; P <.0001). The observed frequency of carriers of this rare haplotype was 12%, including 677CT/1298CC (1.7%), 677TT/1298AC (6.0%), and 677CT/1298AC (4.3%) genotypes.The MTHFR 677T allele alone or in combination with the MTHFR 1298C allele significantly increases the risk of development of ALL in Polish population under 18 years of age. Further studies of haplotype composition in subjects with the 677CT/1298AC genotype are necessary to assess the risk of childhood ALL.
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Affiliation(s)
| | - Ewa Strauss
- Institute of Human Genetics, Polish Academy of Sciences
- Department of Internal and Vascular Surgery, Poznan University of Medical Sciences, Laboratory for Basic Research and Translational Medicine
| | | | - Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences
| | - Ewelina Gowin
- Department of Family Medicine, Poznan University of Medical Sciences
| | | | | | - Danuta Januszkiewicz-Lewandowska
- Department of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences
- Department of Medical Diagnostics, Poznan, Poland
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7
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da Silva VC, de Oliveira AC, D’Almeida V. Homocysteine and Psychiatric Disorders. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2017. [DOI: 10.1177/2326409817701471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | - Vânia D’Almeida
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
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8
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A Computational Approach to Identify the Biophysical and Structural Aspects of Methylenetetrahydrofolate Reductase (MTHFR) Mutations (A222V, E429A, and R594Q) Leading to Schizophrenia. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2017; 108:105-125. [PMID: 28427558 DOI: 10.1016/bs.apcsb.2017.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The association between depression and methylenetetrahydrofolate reductase (MTHFR) has been continually demonstrated in clinical studies, yet there are sparse resources available to build a relationship between the mutations associated with MTHFR and depression. The common mutations found to be associated with schizophrenia and MTHFR are A222V, E429A, and R594Q. Although abundant research on structural and functional effects caused by A222V mutation is available, very less amount of studies have been done on the other two mutants (E429A and R594Q). Hence in this study, a comparative analysis was carried out between the most common A222V mutation, a prevalent E429A mutation, and a less prevalent and less deleterious R594Q mutation. To predict structural rearrangements upon mutation, we proposed a computational pipeline using in silico prediction tools, molecular docking, and molecular dynamics simulation analysis. Since the association of flavin adenine dinucleotide (FAD) is important for the functioning of the protein, binding analysis between protein and the coenzyme was performed. This would enable us to understand the interference level of each mutation over FAD-binding activity. Consequently, we found that two mutations (A222V and E429A) showed lesser binding activity and structural deviations when compared to the native molecule and mutant R594Q. Comparatively, higher structural changes were observed with A222V mutant complex in comparison to other mutant complexes. Computational studies like this could render better insights into the structural changes in the protein and their relationship with the disease condition.
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9
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Reininghaus U, Böhnke JR, Hosang G, Farmer A, Burns T, McGuffin P, Bentall RP. Evaluation of the validity and utility of a transdiagnostic psychosis dimension encompassing schizophrenia and bipolar disorder. Br J Psychiatry 2016; 209:107-13. [PMID: 26989099 DOI: 10.1192/bjp.bp.115.167882] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/19/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND In recent years, the Kraepelinian dichotomy has been challenged in light of evidence on shared genetic and environmental factors for schizophrenia and bipolar disorder, but empirical efforts to identify a transdiagnostic phenotype of psychosis remain remarkably limited. AIMS To investigate whether schizophrenia spectrum and bipolar disorder lie on a transdiagnostic spectrum with overlapping non-affective and affective psychotic symptoms. METHOD Multidimensional item-response modelling was conducted on symptom ratings of the OPerational CRITeria (OPCRIT) system in 1168 patients with schizophrenia spectrum and bipolar disorder. RESULTS A bifactor model with one general, transdiagnostic psychosis dimension underlying affective and non-affective psychotic symptoms and five specific dimensions of positive, negative, disorganised, manic and depressive symptoms provided the best model fit and diagnostic utility for categorical classification. CONCLUSIONS Our findings provide support for including dimensional approaches into classification systems and a directly measurable clinical phenotype for cross-disorder investigations into shared genetic and environmental factors of psychosis.
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Affiliation(s)
- Ulrich Reininghaus
- Ulrich Reininghaus, PhD, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands; Jan R. Böhnke, PhD, Hull York Medical School & Department of Health Sciences, University of York, UK; Georgina Hosang, PhD, Department of Psychology, Goldsmiths, University of London, London, UK; Anne Farmer, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Tom Burns, FRCPsych, Department of Psychiatry, University of Oxford, Oxford, UK; Peter McGuffin, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Richard P. Bentall, PhD, University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
| | - Jan R Böhnke
- Ulrich Reininghaus, PhD, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands; Jan R. Böhnke, PhD, Hull York Medical School & Department of Health Sciences, University of York, UK; Georgina Hosang, PhD, Department of Psychology, Goldsmiths, University of London, London, UK; Anne Farmer, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Tom Burns, FRCPsych, Department of Psychiatry, University of Oxford, Oxford, UK; Peter McGuffin, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Richard P. Bentall, PhD, University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
| | - Georgina Hosang
- Ulrich Reininghaus, PhD, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands; Jan R. Böhnke, PhD, Hull York Medical School & Department of Health Sciences, University of York, UK; Georgina Hosang, PhD, Department of Psychology, Goldsmiths, University of London, London, UK; Anne Farmer, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Tom Burns, FRCPsych, Department of Psychiatry, University of Oxford, Oxford, UK; Peter McGuffin, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Richard P. Bentall, PhD, University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
| | - Anne Farmer
- Ulrich Reininghaus, PhD, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands; Jan R. Böhnke, PhD, Hull York Medical School & Department of Health Sciences, University of York, UK; Georgina Hosang, PhD, Department of Psychology, Goldsmiths, University of London, London, UK; Anne Farmer, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Tom Burns, FRCPsych, Department of Psychiatry, University of Oxford, Oxford, UK; Peter McGuffin, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Richard P. Bentall, PhD, University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
| | - Tom Burns
- Ulrich Reininghaus, PhD, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands; Jan R. Böhnke, PhD, Hull York Medical School & Department of Health Sciences, University of York, UK; Georgina Hosang, PhD, Department of Psychology, Goldsmiths, University of London, London, UK; Anne Farmer, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Tom Burns, FRCPsych, Department of Psychiatry, University of Oxford, Oxford, UK; Peter McGuffin, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Richard P. Bentall, PhD, University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
| | - Peter McGuffin
- Ulrich Reininghaus, PhD, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands; Jan R. Böhnke, PhD, Hull York Medical School & Department of Health Sciences, University of York, UK; Georgina Hosang, PhD, Department of Psychology, Goldsmiths, University of London, London, UK; Anne Farmer, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Tom Burns, FRCPsych, Department of Psychiatry, University of Oxford, Oxford, UK; Peter McGuffin, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Richard P. Bentall, PhD, University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
| | - Richard P Bentall
- Ulrich Reininghaus, PhD, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK and Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands; Jan R. Böhnke, PhD, Hull York Medical School & Department of Health Sciences, University of York, UK; Georgina Hosang, PhD, Department of Psychology, Goldsmiths, University of London, London, UK; Anne Farmer, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Tom Burns, FRCPsych, Department of Psychiatry, University of Oxford, Oxford, UK; Peter McGuffin, FRCPsych, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Richard P. Bentall, PhD, University of Liverpool, Institute of Psychology, Health & Society, Liverpool, UK
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10
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Mullins N, Power RA, Fisher HL, Hanscombe KB, Euesden J, Iniesta R, Levinson DF, Weissman MM, Potash JB, Shi J, Uher R, Cohen-Woods S, Rivera M, Jones L, Jones I, Craddock N, Owen MJ, Korszun A, Craig IW, Farmer AE, McGuffin P, Breen G, Lewis CM. Polygenic interactions with environmental adversity in the aetiology of major depressive disorder. Psychol Med 2016; 46:759-770. [PMID: 26526099 PMCID: PMC4754832 DOI: 10.1017/s0033291715002172] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 09/22/2015] [Accepted: 09/22/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a common and disabling condition with well-established heritability and environmental risk factors. Gene-environment interaction studies in MDD have typically investigated candidate genes, though the disorder is known to be highly polygenic. This study aims to test for interaction between polygenic risk and stressful life events (SLEs) or childhood trauma (CT) in the aetiology of MDD. METHOD The RADIANT UK sample consists of 1605 MDD cases and 1064 controls with SLE data, and a subset of 240 cases and 272 controls with CT data. Polygenic risk scores (PRS) were constructed using results from a mega-analysis on MDD by the Psychiatric Genomics Consortium. PRS and environmental factors were tested for association with case/control status and for interaction between them. RESULTS PRS significantly predicted depression, explaining 1.1% of variance in phenotype (p = 1.9 × 10(-6)). SLEs and CT were also associated with MDD status (p = 2.19 × 10(-4) and p = 5.12 × 10(-20), respectively). No interactions were found between PRS and SLEs. Significant PRSxCT interactions were found (p = 0.002), but showed an inverse association with MDD status, as cases who experienced more severe CT tended to have a lower PRS than other cases or controls. This relationship between PRS and CT was not observed in independent replication samples. CONCLUSIONS CT is a strong risk factor for MDD but may have greater effect in individuals with lower genetic liability for the disorder. Including environmental risk along with genetics is important in studying the aetiology of MDD and PRS provide a useful approach to investigating gene-environment interactions in complex traits.
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Affiliation(s)
- N. Mullins
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - R. A. Power
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - H. L. Fisher
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - K. B. Hanscombe
- Division of Genetics and Molecular
Medicine, King's College London School of Medicine,
Guy's Hospital, London,
UK
| | - J. Euesden
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - R. Iniesta
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - D. F. Levinson
- Department of Psychiatry and Behavioral
Sciences, Stanford University, Stanford,
CA, USA
| | - M. M. Weissman
- Department of Psychiatry,
Columbia University and New York State Psychiatric Institute,
New York, NY, USA
| | - J. B. Potash
- Department of Psychiatry,
University of Iowa, Iowa City, IA,
USA
| | - J. Shi
- Division of Cancer Epidemiology and
Genetics, National Cancer Institute,
Bethesda, MD, USA
| | - R. Uher
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
- Department of Psychiatry,
Dalhousie University, Halifax,
Nova Scotia, Canada
| | - S. Cohen-Woods
- Discipline of Psychiatry,
School of Medicine, University of
Adelaide, Adelaide, South
Australia, Australia
| | - M. Rivera
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
- CIBERSAM-University of Granada and Instituto de
Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios
de Granada/Universidad de Granada, Granada,
Spain
| | - L. Jones
- Department of Psychiatry,
School of Clinical and Experimental Medicine,
University of Birmingham, Birmingham,
UK
| | - I. Jones
- MRC Centre for Neuropsychiatric Genetics and
Genomics, Neuroscience and Mental Health Research
Institute, Cardiff University,
Cardiff, UK
| | - N. Craddock
- MRC Centre for Neuropsychiatric Genetics and
Genomics, Neuroscience and Mental Health Research
Institute, Cardiff University,
Cardiff, UK
| | - M. J. Owen
- MRC Centre for Neuropsychiatric Genetics and
Genomics, Neuroscience and Mental Health Research
Institute, Cardiff University,
Cardiff, UK
| | - A. Korszun
- Barts and The London Medical School,
Queen Mary University of London, London,
UK
| | - I. W. Craig
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - A. E. Farmer
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - P. McGuffin
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
| | - G. Breen
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
- NIHR Biomedical Research Centre for Mental
Health, South London and Maudsley NHS Foundation Trust and Institute
of Psychiatry, Psychology & Neuroscience, King's College
London, London, UK
| | - C. M. Lewis
- MRC Social, Genetic and Developmental Psychiatry
Centre, Institute of Psychiatry, Psychology &
Neuroscience, King's College London,
London, UK
- Division of Genetics and Molecular
Medicine, King's College London School of Medicine,
Guy's Hospital, London,
UK
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11
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Ghanizadeh A, Singh AB, Berk M, Torabi-Nami M. Homocysteine as a potential biomarker in bipolar disorders: a critical review and suggestions for improved studies. Expert Opin Ther Targets 2015; 19:927-39. [PMID: 25882812 DOI: 10.1517/14728222.2015.1019866] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Homocysteine levels have been associated with major depression, but associations with bipolar disorder remain less clear. Some data suggest homocysteine levels have potential as a biomarker of treatment response; however the literature is mixed. AREAS COVERED Oxidized forms of homocysteine can be potentially neurotoxic leading to glutamate toxicity, apoptotic transformation and neurodegenerative processes. High homocysteine may be a risk biomarker for bipolar disorders, but the empirical base remains too weak for firm conclusions. This review discusses the current literature for homocysteine levels as a biomarker. EXPERT OPINION It is premature to foreclose the utility of homocysteine levels as a biomarker for bipolar disorder due the methodological inadequacies in the existing literature. These methodological design issues include lack of control for the confounding variables of concurrent medication, phase of bipolar disorder, gender, age, nutritional status, thyroid, liver and renal function, smoking or lean body mass. Well-powered association studies with confounder control could help shed more light on the important clinical question of homocysteine's utility as a biomarker in bipolar disorder. Future experiments are needed to examine the outcome of interventions modulating homocysteine for treating bipolar disorder. Only prospective randomized control trials will provide definitive evidence of the utility of homocysteine as a biomarker or therapeutic target.
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Affiliation(s)
- Ahmad Ghanizadeh
- Shiraz University of Medical Sciences, School of Medicine, Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry , Shiraz , Iran +00987116273070 ;
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12
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Wang LJ, Lee SY, Chen SL, Chang YH, Chen PS, Huang SY, Tzeng NS, Chen KC, Lee IH, Wang TY, Yang YK, Lu RB. A potential interaction between COMT and MTHFR genetic variants in Han Chinese patients with bipolar II disorder. Sci Rep 2015; 5:8813. [PMID: 25744938 PMCID: PMC4351536 DOI: 10.1038/srep08813] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/23/2014] [Indexed: 11/09/2022] Open
Abstract
Bipolar II disorder (BP-II), characterized by recurrent dysregulation of mood, is a serious and chronic psychiatric illness. However, BP-II is commonly under-recognized, even in psychiatric settings. Because dopaminergic disturbance is thought to be involved in the development of bipolar disorder (BPD), it seems essential to investigate dopamine-related genes like the catechol-O-methyltransferase (COMT) gene, which are involved in dopamine metabolism, and the methylenetetrahydrofolate reductase (MTHFR) gene, which may affect COMT methylation and COMT function. The current study examined the association and interaction of the COMT Val158Met and MTHFR C677T variants with BP-II. Nine hundred seventy-eight participants were recruited: 531 with BP-II and 447 healthy controls. The genotypes of the COMT and MTHFR polymorphisms were determined using a polymerase chain reaction-restriction fragment length polymorphism analysis. Logistic regression analysis showed a significant interaction effect of the COMT Val158Met Val/Val genotype and the MTHFR C677T C/T + T/T genotype (P = 0.039) for the protective effect on the odds of developing BP-II. Our findings support preliminary evidence that the COMT and MTHFR genes interact in BP-II, and they imply the connection of both dopaminergic pathways and methylation pathways in the pathogenesis of BP-II.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Shiou-Lan Chen
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yun-Hsuan Chang
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kao Chin Chen
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - I. Hui Lee
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-Yun Wang
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Ru-Band Lu
- Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
- Institute of Behavioral Medicine, college of medicine, National Cheng Kung University, Tainan, Taiwan
- Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
- Center for Neuropsychiatric Research, National Health Research Institute, Miaoli, Taiwan
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13
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Gatt JM, Burton KLO, Williams LM, Schofield PR. Specific and common genes implicated across major mental disorders: a review of meta-analysis studies. J Psychiatr Res 2015; 60:1-13. [PMID: 25287955 DOI: 10.1016/j.jpsychires.2014.09.014] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 09/15/2014] [Accepted: 09/15/2014] [Indexed: 02/07/2023]
Abstract
Major efforts have been directed at family-based association and case-control studies to identify the involvement of candidate genes in the major disorders of mental health. What remains unknown is whether candidate genes are associated with multiple disorders via pleiotropic mechanisms, and/or if other genes are specific to susceptibility for individual disorders. Here we undertook a review of genes that have been identified in prior meta-analyses examining specific genes and specific mental disorders that have core disruptions to emotional and cognitive function and contribute most to burden of illness- major depressive disorder (MDD), anxiety disorders (AD, including panic disorder and obsessive compulsive disorder), schizophrenia (SZ) and bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD). A literature review was conducted up to end-March 2013 which included a total of 1519 meta-analyses across 157 studies reporting multiple genes implicated in one or more of the five disorders studied. A total of 134 genes (206 variants) were identified as significantly associated risk variants for MDD, AD, ADHD, SZ or BD. Null genetic effects were also reported for 195 genes (426 variants). 13 genetic variants were shared in common between two or more disorders (APOE e4, ACE Ins/Del, BDNF Val66Met, COMT Val158Met, DAOA G72/G30 rs3918342, DAT1 40-bp, DRD4 48-bp, SLC6A4 5-HTTLPR, HTR1A C1019G, MTHR C677T, MTHR A1298C, SLC6A4 VNTR and TPH1 218A/C) demonstrating evidence for pleiotrophy. Another 12 meta-analyses of GWAS studies of the same disorders were identified, with no overlap in genetic variants reported. This review highlights the progress that is being made in identifying shared and unique genetic mechanisms that contribute to the risk of developing several major psychiatric disorders, and identifies further steps for progress.
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Affiliation(s)
- Justine M Gatt
- The Brain Dynamics Centre, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia; Westmead Millennium Institute, Westmead, NSW, 2145, Australia; Neuroscience Research Australia, Randwick, NSW, 2031, Australia; School of Psychology, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Karen L O Burton
- The Brain Dynamics Centre, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia; Westmead Millennium Institute, Westmead, NSW, 2145, Australia; Neuroscience Research Australia, Randwick, NSW, 2031, Australia; School of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Leanne M Williams
- The Brain Dynamics Centre, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia; Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford University, Stanford, CA, 94305-5717, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia; School of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
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14
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Permoda-Osip A, Dmitrzak-Weglarz M, Hauser J, Rybakowski JK. Are genes connected with homocysteine metabolism associated with bipolar disorder? Neuropsychobiology 2014; 69:107-11. [PMID: 24577139 DOI: 10.1159/000358091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/16/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Increased levels of homocysteine have been observed in various psychiatric disorders, among them in schizophrenia, depression and bipolar mood disorder. Of the genes connected with homocysteine metabolism, some studies have found an association between polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene and bipolar disorder. The aim of this study was to investigate a possible association between 5 polymorphisms of 4 genes coding enzymes of homocysteine metabolism and bipolar disorder. METHOD A total of 120 patients with bipolar disorder (24 male, 96 female) and 167 subjects from the general population (81 male, 86 female) were included in the study. Genotyping was performed for the C677T (rs1801133) and A1298C (rs1801131) polymorphisms of the MTHFR gene, for the T833C polymorphism (rs5742905) of the cystathionine-β-synthase (CBS) gene, for the A2756G polymorphism (rs1805087) of the homocysteine methyltransferase gene, and for the A66G polymorphism (rs1801394) of the methionine synthase reductase (MTRR) gene. RESULTS An association with bipolar disorder was found for the T833C polymorphism (rs5742905) of the CBS gene. However, in the patient sample, the genotypes of this polymorphism were not in Hardy-Weinberg equilibrium. No relationship to bipolar disorder was obtained for the remaining polymorphisms studied. CONCLUSIONS These results are the first suggesting a possible association between T833C polymorphism (rs5742905) of the CBS gene and bipolar disorder. We were unable to confirm an association between bipolar disorder and C677T polymorphism (rs1801133) of the MTHFR gene, as suggested in some previous studies.
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15
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Forty L, Ulanova A, Jones L, Jones I, Gordon-Smith K, Fraser C, Farmer A, McGuffin P, Lewis CM, Hosang GM, Rivera M, Craddock N. Comorbid medical illness in bipolar disorder. Br J Psychiatry 2014; 205:465-72. [PMID: 25359927 PMCID: PMC4248234 DOI: 10.1192/bjp.bp.114.152249] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Individuals with a mental health disorder appear to be at increased risk of medical illness. AIMS To examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden. METHOD Participants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria. RESULTS We found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset. CONCLUSIONS Bipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role.
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Greenberg S, Rosenblum KL, McInnis MG, Muzik M. The role of social relationships in bipolar disorder: a review. Psychiatry Res 2014; 219:248-54. [PMID: 24947918 DOI: 10.1016/j.psychres.2014.05.047] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 05/09/2014] [Accepted: 05/22/2014] [Indexed: 01/21/2023]
Abstract
Social relationships and attachment are core developmental elements of human existence and survival that evolve over the lifetime of an individual. The internal and external factors that influence them include the presence of illness in the individual or in their immediate environment. The developmental aspects of attachment and social relationships have become increasingly of interest and relevance in light of early developmental epigenetic modification of gene expression patterns that may influence subsequent behavioral patterns and outcomes. This review examines extant literature on attachment and social relationships in bipolar cohorts. Despite many methodological challenges, the findings indicate that social relationships and capacity for attachment are significantly compromised in individuals with bipolar disorder compared to other mood disorders and normal controls. Though extant research is limited, research clearly points toward the importance of social relationships on the etiology, course, and consequences of bipolar disorder. We highlight a number of key considerations for future research.
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Affiliation(s)
- Sarah Greenberg
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA.
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17
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MTHFR gene polymorphism and age of onset of schizophrenia and bipolar disorder. BIOMED RESEARCH INTERNATIONAL 2014; 2014:318483. [PMID: 25101272 PMCID: PMC4101969 DOI: 10.1155/2014/318483] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 05/20/2014] [Accepted: 06/15/2014] [Indexed: 11/28/2022]
Abstract
Objective. Several studies with contradictory results from different cultures about association of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism in schizophrenia and bipolar disorders. Little is known about this association in Arab culture and Egypt. So the present study aimed to assess the association of MTHFR C677T polymorphism in bipolar disorder (BD) and schizophrenia in comparison to control group. The association between MTHFR C677T polymorphism and the age at onset in schizophrenia or BD was also studied. Methods. Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) were used to examine the genotype and allele frequencies of MTHFR C677T polymorphism in 149 healthy subjects and 134 bipolar and 103 schizophrenia patients. Results. In BD and schizophrenia, there was a higher prevalence of MTHFR C677T polymorphism than healthy subjects. Earlier age at onset was found in patients with BD, carrying one copy of the T allele or CT genotypes but not in patients with schizophrenia. Conclusion. The present findings suggest that the MTHFR C677T polymorphisms are likely to be associated with the risk of developing BD and schizophrenia and influence the age at onset of BD but not the age at onset of schizophrenia.
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18
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Methylenetetrahydrofolate reductase (MTHFR) polymorphism susceptibility to schizophrenia and bipolar disorder: an updated meta-analysis. J Neural Transm (Vienna) 2014; 122:307-20. [PMID: 24938371 DOI: 10.1007/s00702-014-1261-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 06/10/2014] [Indexed: 01/30/2023]
Abstract
Previous studies examining the possible role of the methylenetetrahydrofolate reductase (MTHFR) polymorphisms in the development of schizophrenia (SZ) and bipolar disorder (BPD) have provided inconclusive findings, this meta-analysis was therefore designed to get a more reliable assessment. A total of 38 articles were identified through a search of electronic databases, up to 27 February 2014. Odds ratios (ORs) with 95% confidence interval (CIs) were calculated using random effects models. Meta-analysis showed that MTHFR C677T was significantly associated with SZ, the highest OR was found for the recessive model (for TT vs. CT + CC: OR = 1.34, 95% CI: 1.18-1.53); a marginal association of MTHFR C677T with increased risk of BPD has also been found for the recessive model (OR = 1.26, 95% CI: 1.00-1.59). Subgroup analysis by ethnicity indicated that the significant association with SZ and BPD existed among Asian and African populations, but not for the white. MTHFR A1298C was significant associated with SZ, the highest OR for the dominant model (OR = 1.13, 95% CI: 1.03-1.24). Subgroup analysis indicated a significant association with SZ existed in Asian populations, not among the white populations and no significant association was detected between the MTHFR A1298C and BPD in all groups. We conclude that MTHFR polymorphism is associated with SZ and BPD among Asian, African populations, but not the white.
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19
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Powell TR, McGuffin P, D'Souza UM, Cohen-Woods S, Hosang GM, Martin C, Matthews K, Day RK, Farmer AE, Tansey KE, Schalkwyk LC. Putative transcriptomic biomarkers in the inflammatory cytokine pathway differentiate major depressive disorder patients from control subjects and bipolar disorder patients. PLoS One 2014; 9:e91076. [PMID: 24618828 PMCID: PMC3949789 DOI: 10.1371/journal.pone.0091076] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 02/06/2014] [Indexed: 12/12/2022] Open
Abstract
Mood disorders consist of two etiologically related, but distinctly treated illnesses, major depressive disorder (MDD) and bipolar disorder (BPD). These disorders share similarities in their clinical presentation, and thus show high rates of misdiagnosis. Recent research has revealed significant transcriptional differences within the inflammatory cytokine pathway between MDD patients and controls, and between BPD patients and controls, suggesting this pathway may possess important biomarker properties. This exploratory study attempts to identify disorder-specific transcriptional biomarkers within the inflammatory cytokine pathway, which can distinguish between control subjects, MDD patients and BPD patients. This is achieved using RNA extracted from subject blood and applying synthesized complementary DNA to quantitative PCR arrays containing primers for 87 inflammation-related genes. Initially, we use ANOVA to test for transcriptional differences in a 'discovery cohort' (total n = 90) and then we use t-tests to assess the reliability of any identified transcriptional differences in a 'validation cohort' (total n = 35). The two most robust and reliable biomarkers identified across both the discovery and validation cohort were Chemokine (C-C motif) ligand 24 (CCL24) which was consistently transcribed higher amongst MDD patients relative to controls and BPD patients, and C-C chemokine receptor type 6 (CCR6) which was consistently more lowly transcribed amongst MDD patients relative to controls. Results detailed here provide preliminary evidence that transcriptional measures within inflammation-related genes might be useful in aiding clinical diagnostic decision-making processes. Future research should aim to replicate findings detailed in this exploratory study in a larger medication-free sample and examine whether identified biomarkers could be used prospectively to aid clinical diagnosis.
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Affiliation(s)
- Timothy R. Powell
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Peter McGuffin
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Ursula M. D'Souza
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Sarah Cohen-Woods
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Georgina M. Hosang
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Charlotte Martin
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Keith Matthews
- Division of Neuroscience, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Richard K. Day
- Division of Neuroscience, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Anne E. Farmer
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Katherine E. Tansey
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Leonard C. Schalkwyk
- King's College London, Institute of Psychiatry, MRC Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
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20
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Abstract
OBJECTIVE Folate is one of the most widely used nutraceuticals for the treatment of mood disorders. In this article, we review folate metabolism, its relationship with bipolar disorder, and its therapeutic potential. METHODS We searched PubMed and the Cochrane Library for relevant articles up to and including the year 2012. Background information, proposed mechanisms of action, and results from clinical trials were reviewed. RESULTS Folate is an essential cofactor involved in methylation reactions, which are critical for monoamine synthesis and homocysteine regulation. Folate level is thought to be associated with mood disorders and limited response to antidepressants. Functional deficiency, due to a common genetic variant of the methylenetetrahydrofolate reductase (NAD(P)H) (MTHFR) gene, could also affect the presentation of bipolar disorder. Sodium valproate and lamotrigine, commonly used mood stabilizers for the treatment of bipolar disorder, can potentially interfere with folate and homocysteine metabolism. Previous studies consistently support the efficacy of folate in the treatment of depression; one study showed efficacy in the treatment of mania. Biologically active forms of folate formulations, which do not require biochemical conversion, could be beneficial in the treatment of bipolar disorder. CONCLUSIONS Folate augmentation could be effective for the treatment of bipolar disorder. A common genetic variant of the MTHFR gene might impact the treatment effect of folate augmentation. The biologically active form of folate could potentially correct mood stabilizer-associated functional folate deficiency, help normalize monoamine synthesis, and improve outcomes.
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Affiliation(s)
- Ji Hyun Baek
- 1Bipolar Clinic and Research Program, Massachusetts General Hospital, Boston, USA
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21
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Chojnicka I, Sobczyk-Kopcioł A, Fudalej M, Fudalej S, Wojnar M, Waśkiewicz A, Broda G, Strawa K, Pawlak A, Krajewski P, Płoski R. No association between MTHFR C677T polymorphism and completed suicide. Gene 2012; 511:118-21. [DOI: 10.1016/j.gene.2012.09.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 04/21/2012] [Accepted: 09/05/2012] [Indexed: 10/27/2022]
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Abstract
As shown by clinical genetic studies, affective and anxiety disorders are complex genetic disorders with genetic and environmental factors interactively determining their respective pathomechanism. Advances in molecular genetic techniques including linkage studies, association studies, and genome-wide association studies allow for the detailed dissection of the genetic influence on the development of these disorders. Besides the molecular genetic investigation of categorical entities according to standardized diagnostic criteria, intermediate phenotypes comprising neurobiological or neuropsychological traits (e.g., neuronal correlates of emotional processing) that are linked to the disease of interest and that are heritable, have been proposed to be closer to the underlying genotype than the overall disease phenotype. These intermediate phenotypes are dimensional and more precisely defined than the categorical disease phenotype, and therefore have attracted much interest in the genetic investigation of affective and anxiety disorders. Given the complex genetic nature of affective and anxiety disorders with an interaction of multiple risk genes and environmental influences, the interplay of genetic factors with environmental factors is investigated by means of gene-environment interaction (GxE) studies. Pharmacogenetic studies aid in the dissection of the genetically influenced heterogeneity of psychotropic drug response and may contribute to the development of a more individualized treatment of affective and anxiety disorders. Finally, there is some evidence for genetic factors potentially shared between affective and anxiety disorders pointing to a possible overlapping phenotype between anxiety disorders and depression.
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Affiliation(s)
- Katharina Domschke
- Department of Psychiatry, University of Würzburg, Füchsleinstrasse 15, D-97080, Würzburg, Germany,
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23
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Ezzaher A, Mouhamed DH, Mechri A, Omezzine A, Neffati F, Douki W, Bouslama A, Gaha L, Najjar MF. Hyperhomocysteinemia in Tunisian bipolar I patients. Psychiatry Clin Neurosci 2011; 65:664-71. [PMID: 22176285 DOI: 10.1111/j.1440-1819.2011.02284.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS The aim of the present study was to investigate hyperhomocysteinemia in Tunisian bipolar I patients according to 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism. METHODS The subjects consisted of 92 patients with bipolar I disorder diagnosed according to DSM-IV, and 170 controls. Plasma total homocysteine, folate and vitamin B12 were measured. MTHFR C677T polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism. RESULTS Compared with controls, patients had a significantly higher homocysteine level (16.4 ± 9.8 vs 9.6 ± 4.5 µmol/L; P < 0.001) and a significantly lower folate level (3.2 ± 0.9 vs 6.5 ± 3.2 µg/L; P < 0.001). C677T MTHFR polymorphism genotype frequencies were in Hardy-Weinberg equilibrium. After adjustment for MTHFR C677T genotypes, hypofolatemia, hypovitamin B12 and for potential confounding factors, the odds ratio (OR) of hyperhomocysteinemia associated with bipolar disorder remained significant (OR, 5.53; 95% confidence interval: 1.92-15.86; P = 0.001). In patients, there was no significant change in hyperhomocysteinemia, hypofolatemia and hypovitamin B12 with regard to the clinical and therapeutic characteristics, whereas the highest prevalence of hyperhomocysteinemia was found in depressive patients and when illness duration was >12 years. Hypofolatemia was seen in all patients on lithium and in the majority of patients on carbamazepine, and the highest prevalence of hypovitamin B12 was noted in patients taking carbamazepine. CONCLUSION Hyperhomocysteinemia was more frequent in bipolar I patients independent of C677T polymorphism. Patients had reduced levels of folate, which modulates homocysteine metabolism. Indeed, this finding indicates that folate supplementation may be appropriate for bipolar patients with hyperhomocysteinemia.
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Affiliation(s)
- Asma Ezzaher
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, Monastir, Tunisia.
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Peerbooms OLJ, van Os J, Drukker M, Kenis G, Hoogveld L, de Hert M, Delespaul P, van Winkel R, Rutten BPF. Meta-analysis of MTHFR gene variants in schizophrenia, bipolar disorder and unipolar depressive disorder: evidence for a common genetic vulnerability? Brain Behav Immun 2011; 25:1530-43. [PMID: 21185933 DOI: 10.1016/j.bbi.2010.12.006] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 11/23/2010] [Accepted: 12/10/2010] [Indexed: 01/17/2023] Open
Abstract
Past analyses examining the relationship between genetic variation in the 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene and psychiatric disorders have provided mixed and largely inconclusive findings. MTHFR is involved in the one-carbon metabolic pathway which is essential for DNA biosynthesis and the epigenetic process of DNA methylation. We conducted a meta-analysis of all published case-control studies investigating associations between two common MTHFR single nucleotide polymorphisms (SNPs), MTHFR C677T (sample size 29,502) and A1298C (sample size 7934), and the major psychiatric disorders (i) schizophrenia (SZ), (ii) bipolar disorder (BPD), and (iii) unipolar depressive disorder (UDD). In order to examine possible shared genetic vulnerability, we also tested for associations between MTHFR and all of these major psychiatric disorders (SZ, BPD and UDD) combined. MTHFR C677T was significantly associated with all of the combined psychiatric disorders (SZ, BPD and UDD); random effects odds ratio (OR)=1.26 for TT versus CC genotype carriers; confidence interval (CI) 1.09-1.46); meta-regression did not suggest moderating effects of psychiatric diagnosis, sex, ethnic group or year of publication. Although MTHFR A1298C was not significantly associated with the combination of major psychiatric disorders, nor with SZ, there was evidence for diagnostic moderation indicating a significant association with BPD (random effects OR=2.03 for AA versus CC genotype carriers, CI: 1.07-3.86). Meta-analysis on UDD was not possible due to the small number of studies available. This study provides evidence for shared genetic vulnerability for SZ, BPD and UDD mediated by MTHFR 677TT genotype, which is in line with epigenetic involvement in the pathophysiology of these psychiatric disorders.
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Affiliation(s)
- Odette L J Peerbooms
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, European Graduate School of Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University, Maastricht, The Netherlands
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