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Dogra S, Aguayo C, Xiang Z, Putnam J, Smith J, Johnston C, Foster DJ, Lindsley CW, Niswender CM, Conn PJ. Activation of Metabotropic Glutamate Receptor 3 Modulates Thalamo-accumbal Transmission and Rescues Schizophrenia-Like Physiological and Behavioral Deficits. Biol Psychiatry 2024; 96:230-242. [PMID: 38061467 PMCID: PMC11150332 DOI: 10.1016/j.biopsych.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND Polymorphisms in the gene encoding for metabotropic glutamate receptor 3 (mGlu3) are associated with an increased likelihood of schizophrenia diagnosis and can predict improvements in negative symptoms following treatment with antipsychotics. However, the mechanisms by which mGlu3 can regulate brain circuits involved in schizophrenia pathophysiology are not clear. METHODS We employed selective pharmacological tools and a variety of approaches including whole-cell patch-clamp electrophysiology, slice optogenetics, and fiber photometry to investigate the effects of mGlu3 activation on phencyclidine (PCP)-induced impairments in thalamo-accumbal transmission and sociability deficits. A chemogenetic approach was used to evaluate the role of thalamo-accumbal transmission in PCP-induced sociability deficits. RESULTS We first established that PCP treatment augmented excitatory transmission onto dopamine D1 receptor-expressing medium spiny neurons (D1-MSNs) in the nucleus accumbens (NAc) and induced sociability deficits. Our studies revealed a selective increase in glutamatergic synaptic transmission from thalamic afferents to D1-MSNs in the NAc shell. Chemogenetic silencing of thalamo-accumbal inputs rescued PCP-induced sociability deficits. Pharmacological activation of mGlu3 normalized PCP-induced impairments in thalamo-accumbal transmission and sociability deficits. Mechanistic studies revealed that mGlu3 activation induced robust long-term depression at synapses from the thalamic projections onto D1-MSNs in the NAc shell. CONCLUSIONS These data demonstrate that activation of mGlu3 decreases thalamo-accumbal transmission and thereby rescues sociability deficits in mouse modeling schizophrenia-like symptoms. These findings provide novel insights into the NAc-specific mechanisms and suggest that agents modulating glutamatergic signaling in the NAc may provide a promising approach for treating negative symptoms in schizophrenia.
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Affiliation(s)
- Shalini Dogra
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee.
| | - Caleb Aguayo
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee
| | - Zixiu Xiang
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee
| | - Jason Putnam
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee
| | - Joshua Smith
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee
| | - Curran Johnston
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina
| | - Daniel J Foster
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina
| | - Craig W Lindsley
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee; Department of Chemistry, Vanderbilt University, Nashville, Tennessee; Vanderbilt Institute for Chemical Biology, Vanderbilt University, Nashville, Tennessee
| | - Colleen M Niswender
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee; Vanderbilt Institute for Chemical Biology, Vanderbilt University, Nashville, Tennessee
| | - P Jeffrey Conn
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee; Vanderbilt Institute for Chemical Biology, Vanderbilt University, Nashville, Tennessee.
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Hernandez M, Cullell N, Cendros M, Serra-Llovich A, Arranz MJ. Clinical Utility and Implementation of Pharmacogenomics for the Personalisation of Antipsychotic Treatments. Pharmaceutics 2024; 16:244. [PMID: 38399298 PMCID: PMC10893329 DOI: 10.3390/pharmaceutics16020244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Decades of pharmacogenetic research have revealed genetic biomarkers of clinical response to antipsychotics. Genetic variants in antipsychotic targets, dopamine and serotonin receptors in particular, and in metabolic enzymes have been associated with the efficacy and toxicity of antipsychotic treatments. However, genetic prediction of antipsychotic response based on these biomarkers is far from accurate. Despite the clinical validity of these findings, the clinical utility remains unclear. Nevertheless, genetic information on CYP metabolic enzymes responsible for the biotransformation of most commercially available antipsychotics has proven to be effective for the personalisation of clinical dosing, resulting in a reduction of induced side effects and in an increase in efficacy. However, pharmacogenetic information is rarely used in psychiatric settings as a prescription aid. Lack of studies on cost-effectiveness, absence of clinical guidelines based on pharmacogenetic biomarkers for several commonly used antipsychotics, the cost of genetic testing and the delay in results delivery hamper the implementation of pharmacogenetic interventions in clinical settings. This narrative review will comment on the existing pharmacogenetic information, the clinical utility of pharmacogenetic findings, and their current and future implementations.
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Affiliation(s)
- Marta Hernandez
- PHAGEX Research Group, University Ramon Llull, 08022 Barcelona, Spain;
- School of Health Sciences Blanquerna, University Ramon Llull, 08022 Barcelona, Spain
| | - Natalia Cullell
- Fundació Docència i Recerca Mútua Terrassa, 08221 Terrassa, Spain; (N.C.); (A.S.-L.)
- Department of Neurology, Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain
| | - Marc Cendros
- EUGENOMIC Genómica y Farmacogenética, 08029 Barcelona, Spain;
| | | | - Maria J. Arranz
- PHAGEX Research Group, University Ramon Llull, 08022 Barcelona, Spain;
- Fundació Docència i Recerca Mútua Terrassa, 08221 Terrassa, Spain; (N.C.); (A.S.-L.)
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Mohamed Saini S, Bousman CA, Mancuso SG, Cropley V, Van Rheenen TE, Lenroot RK, Bruggemann J, Weickert CS, Weickert TW, Sundram S, Everall IP, Pantelis C. Genetic variation in glutamatergic genes moderates the effects of childhood adversity on brain volume and IQ in treatment-resistant schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:59. [PMID: 37709784 PMCID: PMC10502098 DOI: 10.1038/s41537-023-00381-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/20/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Suriati Mohamed Saini
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
- Department of Psychiatry, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
| | - Chad A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Medical Genetics, Psychiatry, and Physiology and Pharmacology, The University of Calgary, Calgary, AB, Canada
| | - Serafino G Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Psychiatry and Behavioural Science, University of New Mexico, Albuquerque, NM, USA
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Cynthia S Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, NY, USA
- Schizophrenia Research Laboratory, Neuroscience Research Australia, NSW, Australia
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, NY, USA
| | - Suresh Sundram
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Ian P Everall
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Western Centre for Health Research & Education, Sunshine Hospital, Western Health, St Albans, VIC, 3021, Australia
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McGuigan BN, Santini T, Keshavan MS, Prasad KM. Gene Expressions Preferentially Influence Cortical Thickness of Human Connectome Project Atlas Parcellated Regions in First-Episode Antipsychotic-Naïve Psychoses. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad019. [PMID: 37621304 PMCID: PMC10445951 DOI: 10.1093/schizbullopen/sgad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Altered gene expressions may mechanistically link genetic factors with brain morphometric alterations. Existing gene expression studies have examined selected morphometric features using low-resolution atlases in medicated schizophrenia. We examined the relationship of gene expression with cortical thickness (CT), surface area (SA), and gray matter volume (GMV) of first-episode antipsychotic-naïve psychosis patients (FEAP = 85) and 81 controls, hypothesizing that gene expressions often associated with psychosis will differentially associate with different morphometric features. We explored such associations among schizophrenia and non-schizophrenia subgroups within FEAP group compared to controls. We mapped 360 Human Connectome Project atlas-based parcellations on brain MRI on to the publicly available brain gene expression data from the Allen Brain Institute collection. Significantly correlated genes were investigated using ingenuity pathway analysis to elucidate molecular pathways. CT but not SA or GMV correlated with expression of 1137 out of 15 633 genes examined controlling for age, sex, and average CT. Among these ≈19%, ≈39%, and 8% of genes were unique to FEAP, schizophrenia, and non-schizophrenia, respectively. Variants of 10 among these 1137 correlated genes previously showed genome-wide-association with schizophrenia. Molecular pathways associated with CT were axonal guidance and sphingosine pathways (common to FEAP and controls), selected inflammation pathways (unique to FEAP), synaptic modulation (unique to schizophrenia), and telomere extension (common to NSZ and healthy controls). We demonstrate that different sets of genes and molecular pathways may preferentially influence CT in different diagnostic groups. Genes with altered expressions correlating with CT and associated pathways may be targets for pathophysiological investigations and novel treatment designs.
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Affiliation(s)
- Bridget N McGuigan
- University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tales Santini
- University of Pittsburgh Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Konasale M Prasad
- University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- University of Pittsburgh Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
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5
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Hu M, Xia Y, Zong X, Sweeney JA, Bishop JR, Liao Y, Giase G, Li B, Rubin LH, Wang Y, Li Z, He Y, Chen X, Liu C, Chen C, Tang J. Risperidone-induced changes in DNA methylation in peripheral blood from first-episode schizophrenia patients parallel changes in neuroimaging and cognitive phenotypes. Psychiatry Res 2022; 317:114789. [PMID: 36075150 DOI: 10.1016/j.psychres.2022.114789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Second generation antipsychotics such as risperidone are first-line pharmacotherapy treatment choices for schizophrenia. However, our ability to reliably predict and monitor treatment reaction is impeded by the lack of relevant biomarkers. As a biomarker for the susceptibility of schizophrenia and clozapine treatment response, DNA methylation (DNAm) has been studied, but the impact of antipsychotics on DNAm has not been explored in drug-naïve patients. OBJECTIVE The aim of the present study was to examine changes of DNAm after short-term antipsychotic therapy in first-episode drug-naïve schizophrenia (FES) to identify the beneficial and adverse effect of risperidone on DNAm and their relation to treatment outcome. METHODS Thirty-eight never treated schizophrenia patients and 38 demographically matched individuals (healthy controls) were assessed at baseline and at 8-week follow-up with symptom ratings, and cognitive and functional imaging procedures, at which time a blood draw for DNAm studies was performed. During the 8-week period, patients received treatment with risperidone monotherapy. An independent data set was used as replication. RESULTS We identified brain related pathways enriched in 4,888 FES-associated CpG sites relative to controls. Risperidone administration in patients altered DNAm in 5,979 CpG sites relative to baseline. Significant group differences in DNAm at follow-up were seen in FES patients at 6,760 CpG sites versus healthy controls. Through comparison of effect size, we found 87.54% out of the risperidone-associated changes in DNAm showed possible beneficial effect, while only 12.46% showed potential adverse effect. There were 580 DNAm sites in which changes shifted methylation levels to be indistinguishable from controls after risperidone treatment. The DNAm changes of some sites that normalized after treatment were correlated with treatment-related changes in symptom severity, spontaneous neurophysiological activity, and cognition. We replicated our results in an independent data set. CONCLUSION The normalizing effect of risperidone monotherapy on gene DNAm, and its correlation with clinically relevant phenotypes, indicates that risperidone therapy is associated with DNAm changes that are related to changes in brain physiology, cognition and symptom severity.
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Affiliation(s)
- Maolin Hu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yan Xia
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, United States; Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Xiaofen Zong
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, United States; Huaxi MR Research Center, Department of Radiology, Sichuan University, Chengdu, China
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology and Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Gina Giase
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Bingshan Li
- Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Leah H Rubin
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yunpeng Wang
- Center for Lifespan Changes in Brain and Cognition (LCBC), Department of Psychology, University of Oslo, 0317 Oslo, Norway
| | - Zongchang Li
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Ying He
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaogang Chen
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan, China; National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
| | - Chunyu Liu
- Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China; Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, United States.
| | - Chao Chen
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; Hunan Key Laboratory of Animal Models for Human Diseases, Central South University, Changsha, Hunan, China.
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China; Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China.
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Dogra S, Putnam J, Conn PJ. Metabotropic glutamate receptor 3 as a potential therapeutic target for psychiatric and neurological disorders. Pharmacol Biochem Behav 2022; 221:173493. [PMID: 36402243 PMCID: PMC9729465 DOI: 10.1016/j.pbb.2022.173493] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
Glutamate is a major excitatory neurotransmitter in the central nervous system (CNS) and abnormalities in the glutamatergic system underlie various CNS disorders. As metabotropic glutamate receptor 3 (mGlu3 receptor) regulates glutamatergic transmission in various brain areas, emerging literature suggests that targeting mGlu3 receptors can be a novel approach to the treatment of psychiatric and neurological disorders. For example, mGlu3 receptor negative allosteric modulators (NAMs) induce rapid antidepressant-like effects in both acute and chronic stress models. Activation of mGlu3 receptors can enhance cognition in the rodents modeling schizophrenia-like pathophysiology. The mGlu3 receptors expressed in the astrocytes induce neuroprotective effects. Although polymorphisms in GRM3 have been shown to be associated with addiction, there is not significant evidence about the efficacy of mGlu3 receptor ligands in rodent models of addiction. Collectively, drugs targeting mGlu3 receptors may provide an alternative approach to fill the unmet clinical need for safer and more efficacious therapeutics for CNS disorders.
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Affiliation(s)
- Shalini Dogra
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA
| | - Jason Putnam
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA
| | - P Jeffrey Conn
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA.
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Jiao S, Cao T, Cai H. Peripheral biomarkers of treatment-resistant schizophrenia: Genetic, inflammation and stress perspectives. Front Pharmacol 2022; 13:1005702. [PMID: 36313375 PMCID: PMC9597880 DOI: 10.3389/fphar.2022.1005702] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Treatment-resistant schizophrenia (TRS) often results in severe disability and functional impairment. Currently, the diagnosis of TRS is largely exclusionary and emphasizes the improvement of symptoms that may not be detected early and treated according to TRS guideline. As the gold standard, clozapine is the most prescribed selection for TRS. Therefore, how to predict TRS in advance is critical for forming subsequent treatment strategy especially clozapine is used during the early stage of TRS. Although mounting studies have identified certain clinical factors and neuroimaging characteristics associated with treatment response in schizophrenia, the predictors for TRS remain to be explored. Biomarkers, particularly for peripheral biomarkers, show great potential in predicting TRS in view of their predictive validity, noninvasiveness, ease of testing and low cost that would enable their widespread use. Recent evidence supports that the pathogenesis of TRS may be involved in abnormal neurotransmitter systems, inflammation and stress. Due to the heterogeneity of TRS and the lack of consensus in diagnostic criteria, it is difficult to compare extensive results among different studies. Based on the reported neurobiological mechanisms that may be associated with TRS, this paper narratively reviews the updates of peripheral biomarkers of TRS, from genetic and other related perspectives. Although current evidence regarding biomarkers in TRS remains fragmentary, when taken together, it can help to better understand the neurobiological interface of clinical phenotypes and psychiatric symptoms, which will enable individualized prediction and therapy for TRS in the long run.
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Affiliation(s)
- Shimeng Jiao
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Central South University, Changsha, China
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Changsha, Hunan, China
| | - Ting Cao
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Central South University, Changsha, China
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Changsha, Hunan, China
| | - Hualin Cai
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Central South University, Changsha, China
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Changsha, Hunan, China
- *Correspondence: Hualin Cai,
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Eum S, Hill SK, Bishop JR. Considering medication exposure in genomic association studies of cognition in psychotic disorders. Pharmacogenomics 2022; 23:791-806. [PMID: 36102182 DOI: 10.2217/pgs-2022-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cognitive dysfunction is a core feature of psychosis-spectrum illnesses, and the characterization of related genetic mechanisms may provide insights regarding the disease pathophysiology. Substantial efforts have been made to determine the genetic component of cognitive symptoms, without clear success. Illness-related moderators and environmental factors such as medications hinder the detection of genomic association with cognition. Polypharmacy is common in psychotic disorders, and the cumulative effects of medication regimens can confound gene-cognition associations. A review of the relative contributions of important pharmacological and genetic relationships identifies that the effects of medications on cognition in psychotic disorders may be at least, if not more, impactful than individual genes, thus underscoring the importance of accounting for medication exposure in gene-cognition association studies.
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Affiliation(s)
- Seenae Eum
- Department of Pharmacogenomics, School of Pharmacy, Shenandoah University, Fairfax, VA 22031, USA
| | - Scot Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA
| | - Jeffrey R Bishop
- Department of Experimental & Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA.,Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455, USA
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9
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Dogra S, Conn PJ. Metabotropic Glutamate Receptors As Emerging Targets for the Treatment of Schizophrenia. Mol Pharmacol 2022; 101:275-285. [PMID: 35246479 PMCID: PMC9092465 DOI: 10.1124/molpharm.121.000460] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Abstract
Accumulating evidence of glutamatergic abnormalities in the brains of schizophrenia patients has led to efforts to target various components of glutamatergic signaling as potential new approaches for schizophrenia. Exciting research suggests that metabotropic glutamate (mGlu) receptors could provide a fundamentally new approach for better symptomatic relief in patients with schizophrenia. In preclinical studies, the mGlu5 receptor positive allosteric modulators (PAMs) show efficacy in animal models relevant for all symptom domains in schizophrenia. Interestingly, biased pure mGlu5 receptor PAMs that do not potentiate coupling of mGlu5 receptors to N-methyl-D-aspartate (NMDA) receptors lack neurotoxic effects associated with mGlu5 PAMs that enhance coupling to NMDA receptors or have allosteric agonist activity. This provides a better therapeutic profile for treating schizophrenia-like symptoms. Additionally, the mGlu1 receptor PAMs modulate dopamine release in the striatum, which may contribute to their antipsychotic-like effects. Besides group I mGlu (mGlu1 and mGlu5) receptors, agonists of mGlu2/3 receptors also induce robust antipsychotic-like and procognitive effects in rodents and may be effective in treating symptoms of schizophrenia in a selective group of patients. Additionally, mGlu2/4 receptor heterodimers modulate glutamatergic neurotransmission in the prefrontal cortex at selective synapses activated in schizophrenia and therefore hold potential as novel antipsychotics. Excitingly, the mGlu3 receptor activation can enhance cognition in rodents, suggesting that mGlu3 receptor agonist/PAM could provide a novel approach for the treatment of cognitive deficits in schizophrenia. Collectively, the development of mGlu receptor-specific ligands may provide an alternative approach to meet the clinical need for safer and more efficacious therapeutics for schizophrenia. SIGNIFICANCE STATEMENT: The currently available antipsychotic medications do not show significant efficacy for treating negative symptoms and cognitive deficits in schizophrenia. Emerging preclinical and clinical literature suggests that pharmacological targeting of metabotropic glutamate receptors could potentially provide an alternative approach for designing safer and more efficacious therapeutics for treating schizophrenia.
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Affiliation(s)
- Shalini Dogra
- Department of Pharmacology and Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee
| | - P Jeffrey Conn
- Department of Pharmacology and Warren Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee
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10
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Turati J, Rudi J, Beauquis J, Carniglia L, López Couselo F, Saba J, Caruso C, Saravia F, Lasaga M, Durand D. A metabotropic glutamate receptor 3 (mGlu3R) isoform playing neurodegenerative roles in astrocytes is prematurely up-regulated in an Alzheimer's model. J Neurochem 2022; 161:366-382. [PMID: 35411603 DOI: 10.1111/jnc.15610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/14/2022] [Accepted: 03/23/2022] [Indexed: 12/26/2022]
Abstract
Subtype 3 metabotropic glutamate receptor (mGlu3R) displays a broad range of neuroprotective effects. We previously demonstrated that mGlu3R activation in astrocytes protects hippocampal neurons from Aβ neurotoxicity through stimulation of both neurotrophin release and Aβ uptake. Alternative-spliced variants of mGlu3R were found in human brains. The most prevalent variant, mGlu3Δ4, lacks exon 4 encoding the transmembrane domain and can inhibit ligand binding to mGlu3R. To date, neither its role in neurodegenerative disorders nor its endogenous expression in CNS cells has been addressed. The present paper describes for the first time an association between altered hippocampal expression of mGlu3Δ4 and Alzheimer's disease (AD) in the preclinical murine model PDAPP-J20, as well as a deleterious effect of mGlu3Δ4 in astrocytes. As assessed by western blot, hippocampal mGlu3R levels progressively decreased with age in PDAPP-J20 mice. On the contrary, mGlu3Δ4 levels were drastically increased with aging in nontransgenic mice, but prematurely over-expressed in 5-month-old PDAPP-J20-derived hippocampi, prior to massive senile plaque deposition. Also, we found that mGlu3Δ4 co-precipitated with mGlu3R mainly in 5-month-old PDAPP-J20 mice. We further showed by western blot that primary cultured astrocytes and neurons expressed mGlu3Δ4, whose levels were reduced by Aβ, thereby discouraging a causal effect of Aβ on mGlu3Δ4 induction. However, heterologous expression of mGlu3Δ4 in astrocytes induced cell death, inhibited mGlu3R expression, and prevented mGlu3R-dependent Aβ glial uptake. Indeed, mGlu3Δ4 promoted neurodegeneration in neuron-glia co-cultures. These results provide evidence of an inhibitory role of mGlu3Δ4 in mGlu3R-mediated glial neuroprotective pathways, which may lie behind AD onset.
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Affiliation(s)
- Juan Turati
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Julieta Rudi
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.,IATIMET Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Juan Beauquis
- Laboratorio de Neurobiología del Envejecimiento, Instituto de Biología y Medicina Experimental (IBYME), CONICET, Buenos Aires, Argentina.,Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Lila Carniglia
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Federico López Couselo
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Julieta Saba
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carla Caruso
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Flavia Saravia
- Laboratorio de Neurobiología del Envejecimiento, Instituto de Biología y Medicina Experimental (IBYME), CONICET, Buenos Aires, Argentina.,Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Mercedes Lasaga
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Daniela Durand
- INBIOMED Instituto de Investigaciones Biomédicas UBA-CONICET, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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11
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Elsheikh SSM, Müller DJ, Pouget JG. Pharmacogenetics of Antipsychotic Treatment in Schizophrenia. Methods Mol Biol 2022; 2547:389-425. [PMID: 36068471 DOI: 10.1007/978-1-0716-2573-6_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Antipsychotics are the mainstay treatment for schizophrenia. There is large variability between individuals in their response to antipsychotics, both in efficacy and adverse effects of treatment. While the source of interindividual variability in antipsychotic response is not completely understood, genetics is a major contributing factor. The identification of pharmacogenetic markers that predict antipsychotic efficacy and adverse reactions is a growing area of research and holds the potential to replace the current trial-and-error approach to treatment selection in schizophrenia with a personalized medicine approach.In this chapter, we provide an overview of the current state of pharmacogenetics in schizophrenia treatment. The most promising pharmacogenetic findings are presented for both antipsychotic response and commonly studied adverse reactions. The application of pharmacogenetics to schizophrenia treatment is discussed, with an emphasis on the clinical utility of pharmacogenetic testing and directions for future research.
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Affiliation(s)
| | - Daniel J Müller
- The Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Jennie G Pouget
- The Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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12
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Lisoway AJ, Chen CC, Zai CC, Tiwari AK, Kennedy JL. Toward personalized medicine in schizophrenia: Genetics and epigenetics of antipsychotic treatment. Schizophr Res 2021; 232:112-124. [PMID: 34049235 DOI: 10.1016/j.schres.2021.05.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 12/21/2022]
Abstract
Schizophrenia is a complex psychiatric disorder where genetic, epigenetic, and environmental factors play a role in disease onset, course of illness, and treatment outcome. Pharmaco(epi)genetic research presents an important opportunity to improve patient care through prediction of medication side effects and response. In this narrative review, we discuss the current state of research and important progress of both genetic and epigenetic factors involved in antipsychotic response, over the past five years. The review is largely focused on the following frequently prescribed antipsychotics: olanzapine, risperidone, aripiprazole, and clozapine. Several consistent pharmacogenetic findings have emerged, in particular pharmacokinetic genes (primarily cytochrome P450 enzymes) and pharmacodynamic genes involving dopamine, serotonin, and glutamate neurotransmission. In addition to studies analysing DNA sequence variants, there are also several pharmacoepigenetic studies of antipsychotic response that have focused on the measurement of DNA methylation. Although pharmacoepigenetics is still in its infancy, consideration of both genetic and epigenetic factors contributing to antipsychotic response and side effects no doubt will be increasingly important in personalized medicine. We provide recommendations for next steps in research and clinical evaluation.
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Affiliation(s)
- Amanda J Lisoway
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Canada
| | - Cheng C Chen
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Canada
| | - Clement C Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Arun K Tiwari
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Canada
| | - James L Kennedy
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Canada; Department of Psychiatry, University of Toronto, Canada.
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13
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Li J, Yu Y, Zhao J, Zhang J, Wang Y, Ding K, Gao X, Zhang K. Genetic variants of the type-3 metabotropic glutamate receptor gene associated with human spatial localization ability. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Arranz MJ, Salazar J, Hernández MH. Pharmacogenetics of antipsychotics: Clinical utility and implementation. Behav Brain Res 2020; 401:113058. [PMID: 33316324 DOI: 10.1016/j.bbr.2020.113058] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/23/2020] [Accepted: 12/04/2020] [Indexed: 02/06/2023]
Abstract
Decades of research have produced extensive evidence of the contribution of genetic factors to the efficacy and toxicity of antipsychotics. Numerous genetic variants in genes controlling drug availability or involved in antipsychotic processes have been linked to treatment variability. The complex mechanism of action and multitarget profile of most antipsychotic drugs hinder the identification of pharmacogenetic markers of clinical value. Nevertheless, the validity of associations between variants in CYP1A2, CYP2D6, CYP2C19, ABCB1, DRD2, DRD3, HTR2A, HTR2C, BDNF, COMT, MC4R genes and antipsychotic response has been confirmed in independent candidate gene studies. Genome wide pharmacogenomic studies have proven the role of the glutamatergic pathway in mediating antipsychotic activity and have reported novel associations with antipsychotic response. However, only a limited number of the findings, mainly functional variants of CYP metabolic enzymes, have been shown to be of clinical utility and translated into useful pharmacogenetic markers. Based on the currently available information, actionable pharmacogenetics should be reduced to antipsychotics' dose adjustment according to the genetically predicted metabolic status (CYPs' profile) of the patient. Growing evidence suggests that such interventions will reduce antipsychotics' side-effects and increase treatment safety. Despite this evidence, the use of pharmacogenetics in psychiatric wards is minimal. Hopefully, further evidence on the clinical and economic benefits, the development of clinical protocols based on pharmacogenetic information, and improved and cheaper genetic testing will increase the implementation of pharmacogenetic guided prescription in clinical settings.
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Affiliation(s)
- Maria J Arranz
- Fundació Docència i Recerca Mútua Terrassa, Spain; Centro de investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain; PHAGEX Research Group, Universitat Ramon LLull, Spain.
| | - Juliana Salazar
- Translational Medical Oncology Laboratory, Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain; U705, ISCIII Center for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain; PHAGEX Research Group, Universitat Ramon LLull, Spain
| | - Marta H Hernández
- PHAGEX Research Group, Universitat Ramon LLull, Spain; School of Health Sciences Blanquerna. University Ramon Llull, Barcelona, Spain
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15
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Zink CF, Barker PB, Sawa A, Weinberger DR, Wang M, Quillian H, Ulrich WS, Chen Q, Jaffe AE, Kleinman JE, Hyde TM, Prettyman GE, Giegerich M, Carta K, van Ginkel M, Bigos KL. Association of Missense Mutation in FOLH1 With Decreased NAAG Levels and Impaired Working Memory Circuitry and Cognition. Am J Psychiatry 2020; 177:1129-1139. [PMID: 33256444 DOI: 10.1176/appi.ajp.2020.19111152] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Altering the metabotropic glutamate receptor 3 (mGluR3) by pharmacology or genetics is associated with differences in learning and memory in animals and humans. GRM3 (the gene coding for mGluR3) is also genome-wide associated with risk for schizophrenia. The neurotransmitter N-acetyl-aspartyl-glutamate (NAAG) is the selective endogenous agonist of mGluR3, and increasing NAAG may improve cognition. Glutamate carboxypeptidase II (GCPII), coded by the gene folate hydrolase 1 (FOLH1), regulates the amount of NAAG in the synapse. The goal of this study was to determine the relationship between FOLH1, NAAG levels, measures of human cognition, and neural activity associated with cognition. METHODS The effects of genetic variation in FOLH1 on mRNA expression in human brain and NAAG levels using 7-T magnetic resonance spectroscopy (MRS) were measured. NAAG levels and FOLH1 genetic variation were correlated with measures of cognition in subjects with psychosis and unaffected subjects. Additionally, FOLH1 genetic variation was correlated with neural activity during working memory, as measured by functional MRI (fMRI). RESULTS A missense mutation in FOLH1 (rs202676 G allele) was associated with increased FOLH1 mRNA in the dorsolateral prefrontal cortex of brains from unaffected subjects and schizophrenia patients. This FOLH1 variant was associated with decreased NAAG levels in unaffected subjects and patients with psychosis. NAAG levels were positively correlated with visual memory performance. Carriers of the FOLH1 variant associated with lower NAAG levels had lower IQ scores. Carriers of this FOLH1 variant had less efficient cortical activity during working memory. CONCLUSIONS These data show that higher NAAG levels are associated with better cognition, suggesting that increasing NAAG levels through FOLH1/GCPII inhibition may improve cognition. Additionally, NAAG levels measured by MRS and cortical efficiency during working memory measured by fMRI have the potential to be neuroimaging biomarkers for future clinical trials.
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Affiliation(s)
- Caroline F Zink
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Peter B Barker
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Akira Sawa
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Daniel R Weinberger
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Min Wang
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Henry Quillian
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - William S Ulrich
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Qiang Chen
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Andrew E Jaffe
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Joel E Kleinman
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Thomas M Hyde
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Greer E Prettyman
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Mellissa Giegerich
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Kayla Carta
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Marcus van Ginkel
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
| | - Kristin L Bigos
- Baltimore Research and Education Foundation, Baltimore (Zink); Lieber Institute for Brain Development, Baltimore (Zink, Weinberger, Quillian, Ulrich, Chen, Jaffe, Kleinman, Hyde, Prettyman, Giegerich, Carta, van Ginkel, Bigos); Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zink, Sawa, Weinberger, Jaffe, Kleinman, Hyde, Bigos); Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore (Barker, Wang); Department of Oncology, Johns Hopkins School of Medicine, Baltimore (Barker); Kennedy Krieger Institute, Baltimore (Barker); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Sawa, Jaffe); Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger); McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Sawa, Weinberger, Jaffe); Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore (Sawa); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Weinberger, Hyde); Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Center for Computational Biology, Johns Hopkins University, Baltimore (Jaffe); Department of Neuroscience, University of Pennsylvania, Philadelphia (Prettyman); Eating Disorders Center for Treatment and Research, University of California San Diego (Giegerich); Department of Medicine, Division of Clinical Pharmacology, Johns Hopkins School of Medicine, Baltimore (Carta, van Ginkel, Bigos); and Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore (Bigos)
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16
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Yoshida K, Müller DJ. Pharmacogenetics of Antipsychotic Drug Treatment: Update and Clinical Implications. MOLECULAR NEUROPSYCHIATRY 2020; 5:1-26. [PMID: 32399466 PMCID: PMC7206586 DOI: 10.1159/000492332] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/20/2018] [Indexed: 12/24/2022]
Abstract
Numerous genetic variants have been shown to be associated with antipsychotic response and adverse effects of schizophrenia treatment. However, the clinical application of these findings is limited. The aim of this narrative review is to summarize the most recent publications and recommendations related to the genetics of antipsychotic treatment and shed light on the clinical utility of pharmacogenetics/pharmacogenomics (PGx). We reviewed the literature on PGx studies with antipsychotic drugs (i.e., antipsychotic response and adverse effects) and commonly used commercial PGx tools for clinical practice. Publications and reviews were included with emphasis on articles published between January 2015 and April 2018. We found 44 studies focusing on antipsychotic response and 45 studies on adverse effects (e.g., antipsychotic-induced weight gain, movement disorders, hormonal abnormality, and clozapine-induced agranulocytosis/granulocytopenia), albeit with mixed results. Overall, several gene variants related to antipsychotic response and adverse effects in the treatment of patients with schizophrenia have been reported, and several commercial pharmacogenomic tests have become available. However, further well-designed investigations and replication studies in large and well-characterized samples are needed to facilitate the application of PGx findings to clinical practice.
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Affiliation(s)
- Kazunari Yoshida
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Daniel J. Müller
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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17
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Karpouzian-Rogers T, Stocks J, Meltzer HY, Reilly JL. The effect of high vs. low dose lurasidone on eye movement biomarkers of prefrontal abilities in treatment-resistant schizophrenia. Schizophr Res 2020; 215:314-321. [PMID: 31706786 DOI: 10.1016/j.schres.2019.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/30/2019] [Accepted: 10/06/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Eye movement (EM) measures can serve as biomarkers to evaluate pharmacological effects on brain systems involved in cognition. In recent onset schizophrenia, antipsychotic treatment can improve attentional control on the antisaccade task and exacerbate working memory impairment on the memory guided saccade task; effects in treatment-resistant schizophrenia (TRS) are less clear. This study evaluated the effects of high versus low dose lurasidone on EM performance in TRS. METHODS TRS patients completed EM testing: 1) at baseline, on existing medication regimen (n = 42), 2) after 6 weeks of low dose (80 mg) lurasidone (n = 38), 3) after 12 weeks following randomization to low (80 mg) or high dose (240 mg) lurasidone (n = 27), and 4) after 24 weeks of treatment (n = 23). EM testing included prosaccade, antisaccade, and memory guided saccade tasks. RESULTS Six weeks of lurasidone resulted in increased prosaccade saccade latency and reduced antisaccade errors, with no change in memory guided saccade accuracy. After randomization, prosaccade and antisaccade latencies increased in only the high dose group, with no change in antisaccade errors in both groups. Memory guided saccade error increased in the high dose group and remained stable in the low dose group. CONCLUSION Among TRS, stabilization on low dose lurasidone was associated with improved executive control of attention reflected by reduced antisaccade errors. High dose lurasidone resulted in prolonged speed of reflexive and executive shifts of attention and reduced spatial working memory relative to low dose. These findings indicate that EM measures are helpful biomarkers of dose-dependent antipsychotic treatment effects on executive cognitive abilities in TRS.
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Affiliation(s)
- Tatiana Karpouzian-Rogers
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 710 N Lake Shore Drive, Chicago, IL, 60611, USA.
| | - Jane Stocks
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 710 N Lake Shore Drive, Chicago, IL, 60611, USA
| | - Herbert Y Meltzer
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 710 N Lake Shore Drive, Chicago, IL, 60611, USA
| | - James L Reilly
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 710 N Lake Shore Drive, Chicago, IL, 60611, USA
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18
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Kraguljac NV, Morgan CJ, Reid MA, White DM, Jindal RD, Sivaraman S, Martinak BK, Lahti AC. A longitudinal magnetic resonance spectroscopy study investigating effects of risperidone in the anterior cingulate cortex and hippocampus in schizophrenia. Schizophr Res 2019; 210:239-244. [PMID: 30630705 PMCID: PMC7881837 DOI: 10.1016/j.schres.2018.12.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 12/30/2022]
Abstract
Magnetic Resonance Spectroscopy is a popular approach to probe brain chemistry in schizophrenia (SZ), but no consensus exists as to the extent of alterations. This may be attributable to differential effects of populations studied, brain regions examined, or antipsychotic medication effects. Here, we measured neurometabolites in the anterior cingulate cortex (ACC) and hippocampus, two structurally dissimilar brain regions implicated in the SZ pathophysiology. We enrolled 61 SZ with the goal to scan them before and after six weeks of treatment with risperidone. We also scanned 31 matched healthy controls twice, six weeks apart. Using mixed effect repeated measures linear models to examine the effect of group and time on metabolite levels in each voxel, we report an increase in hippocampal glutamate + glutamine (Glx) in SZ compared to controls (p = 0.043), but no effect of antipsychotic medication (p = 0.330). In the ACC, we did not find metabolite alterations or antipsychotic medication related changes after six weeks of treatment with risperidone. The coefficients for the discriminant function (differentiating SZ from HC) in the ACC were greatest for NAA (-0.83), and in the hippocampus for Glx (0.76), the same metabolites were associated with greater treatment response in patients at trend level. Taken together, our data extends the existing literature by demonstrating regionally distinct metabolite alterations in the same patient group and suggests that antipsychotic medications may have limited effects on metabolite levels in these regions.
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Affiliation(s)
- Nina V. Kraguljac
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | | | - Meredith A. Reid
- MRI Research Center, Department of Electrical and Computer Engineering, Auburn University
| | - David M. White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Ripu D. Jindal
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham,Department of Neurology, Birmingham VA Medical Center
| | - Soumya Sivaraman
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Bridgette K. Martinak
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
| | - Adrienne C. Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
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19
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Jin LE, Wang M, Galvin VC, Lightbourne TC, Conn PJ, Arnsten AFT, Paspalas CD. mGluR2 versus mGluR3 Metabotropic Glutamate Receptors in Primate Dorsolateral Prefrontal Cortex: Postsynaptic mGluR3 Strengthen Working Memory Networks. Cereb Cortex 2019; 28:974-987. [PMID: 28108498 DOI: 10.1093/cercor/bhx005] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Indexed: 01/06/2023] Open
Abstract
The newly evolved circuits in layer III of primate dorsolateral prefrontal cortex (dlPFC) generate the neural representations that subserve working memory. These circuits are weakened by increased cAMP-K+ channel signaling, and are a focus of pathology in schizophrenia, aging, and Alzheimer's disease. Cognitive deficits in these disorders are increasingly associated with insults to mGluR3 metabotropic glutamate receptors, while reductions in mGluR2 appear protective. This has been perplexing, as mGluR3 has been considered glial receptors, and mGluR2 and mGluR3 have been thought to have similar functions, reducing glutamate transmission. We have discovered that, in addition to their astrocytic expression, mGluR3 is concentrated postsynaptically in spine synapses of layer III dlPFC, positioned to strengthen connectivity by inhibiting postsynaptic cAMP-K+ channel actions. In contrast, mGluR2 is principally presynaptic as expected, with only a minor postsynaptic component. Functionally, increase in the endogenous mGluR3 agonist, N-acetylaspartylglutamate, markedly enhanced dlPFC Delay cell firing during a working memory task via inhibition of cAMP signaling, while the mGluR2 positive allosteric modulator, BINA, produced an inverted-U dose-response on dlPFC Delay cell firing and working memory performance. These data illuminate why insults to mGluR3 would erode cognitive abilities, and support mGluR3 as a novel therapeutic target for higher cognitive disorders.
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Affiliation(s)
- Lu E Jin
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Min Wang
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Veronica C Galvin
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Taber C Lightbourne
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Peter Jeffrey Conn
- Department of Pharmacology and Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt UniversityMedical Center, Nashville, TN 37232-0697, USA
| | - Amy F T Arnsten
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
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20
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Vita A, Minelli A, Barlati S, Deste G, Giacopuzzi E, Valsecchi P, Turrina C, Gennarelli M. Treatment-Resistant Schizophrenia: Genetic and Neuroimaging Correlates. Front Pharmacol 2019; 10:402. [PMID: 31040787 PMCID: PMC6476957 DOI: 10.3389/fphar.2019.00402] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
Schizophrenia is a severe neuropsychiatric disorder that affects approximately 0.5–1% of the population. Response to antipsychotic therapy is highly variable, and it is not currently possible to predict those patients who will or will not respond to antipsychotic medication. Furthermore, a high percentage of patients, approximately 30%, are classified as treatment-resistant (treatment-resistant schizophrenia; TRS). TRS is defined as a non-response to at least two trials of antipsychotic medication of adequate dose and duration. These patients are usually treated with clozapine, the only evidence-based pharmacotherapy for TRS. However, clozapine is associated with severe adverse events. For these reasons, there is an increasing interest to identify better targets for drug development of new compounds and to establish better biomarkers for existing medications. The ability of antipsychotics to improve psychotic symptoms is dependent on their antagonist and reverse agonist activities at different neuroreceptors, and some genetic association studies of TRS have focused on different pharmacodynamic factors. Some genetic studies have shown an association between antipsychotic response or TRS and neurodevelopment candidate genes, antipsychotic mechanisms of action (such as dopaminergic, serotonergic, GABAergic, and glutamatergic) or pharmacokinetic factors (i.e., differences in the cytochrome families). Moreover, there is a growing body of literature on the structural and functional neuroimaging research into TRS. Neuroimaging studies can help to uncover the underlying neurobiological reasons for such resistance and identify resistant patients earlier. Studies examining the neuropharmacological mechanisms of antipsychotics, including clozapine, can help to improve our knowledge of their action on the central nervous system, with further implications for the discovery of biomarkers and the development of new treatments. The identification of the underlying mechanisms of TRS is a major challenge for developing personalized medicine in the psychiatric field for schizophrenia treatment. The main goal of precision medicine is to use genetic and brain-imaging information to improve the safety, effectiveness, and health outcomes of patients via more efficiently targeted risk stratification, prevention, and tailored medication and treatment management approaches. The aim of this review is to summarize the state of art of pharmacogenetic, pharmacogenomic and neuroimaging studies in TRS.
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Affiliation(s)
- Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giacomo Deste
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy
| | - Edoardo Giacopuzzi
- Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Paolo Valsecchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Cesare Turrina
- Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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21
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Widespread white-matter microstructure integrity reduction in first-episode schizophrenia patients after acute antipsychotic treatment. Schizophr Res 2019; 204:238-244. [PMID: 30177343 DOI: 10.1016/j.schres.2018.08.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/21/2018] [Accepted: 08/13/2018] [Indexed: 02/05/2023]
Abstract
Potential effects of initiating acute antipsychotic treatment on white matter (WM) microstructure in schizophrenia patients remain poorly characterized. Thirty-five drug-naïve first-episode schizophrenia patients were scanned before and after six weeks of treatment with second-generation antipsychotic medications. Nineteen demographically matched healthy subjects were scanned twice over the same time interval. Tract-based spatial statistics was used to test for changes in WM microstructural integrity after treatment. Widespread fractional anisotropy (FA) decrease was found in patients after antipsychotic treatment in bilateral posterior corona radiata, anterior corona radiata, superior corona radiata and posterior thalamic radiation, left posterior limb of the internal capsule, and mid-body of the corpus callosum. These effects appeared to result primarily from decreased axial diffusivity. These findings suggest an effect on brain white matter from acute antipsychotic therapy in schizophrenia.
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22
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Neale JH, Olszewski R. A role for N-acetylaspartylglutamate (NAAG) and mGluR3 in cognition. Neurobiol Learn Mem 2019; 158:9-13. [PMID: 30630041 DOI: 10.1016/j.nlm.2019.01.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/03/2018] [Accepted: 01/05/2019] [Indexed: 12/18/2022]
Abstract
The peptide transmitter N-acetylaspartylglutamate (NAAG) and its receptor, the type 3 metabotropic glutamate receptor (mGluR3, GRM3), are prevalent and widely distributed in the mammalian nervous system. Drugs that inhibit the inactivation of synaptically released NAAG have procognitive activity in object recognition and other behavioral models. These inhibitors also reverse cognitive deficits in animal models of clinical disorders. Antagonists of mGluR3 block these actions and mice that are null mutant for this receptor are insensitive to the actions of these procognitive drugs. A positive allosteric modulator of this receptor also has procognitive activity. While some data suggest that drugs acting on mGluR3 achieve their procognitive action by increasing arousal during acquisition training, exploration of the procognitive efficacy of NAAG is in its early stages and thus substantial opportunities exist to define the breadth and nature of this activity.
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Affiliation(s)
- Joseph H Neale
- Department of Biology, Georgetown University, Washington, DC, USA.
| | - Rafal Olszewski
- Department of Biology, Georgetown University, Washington, DC, USA.
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23
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Routhieaux M, Keels J, Tillery EE. The use of pharmacogenetic testing in patients with schizophrenia or bipolar disorder: A systematic review. Ment Health Clin 2018; 8:294-302. [PMID: 30397571 PMCID: PMC6213894 DOI: 10.9740/mhc.2018.11.294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction: Pharmacogenetic testing may assist in identifying an individual's risk of developing a mental illness as well as predict an individual's response to treatment. The objective of this study is to report published outcomes of pharmacogenetic testing in patients with schizophrenia or bipolar disorder. Methods: A systematic review using PubMed and EBSCOhost through April 2017 was performed to identify articles that reported pharmacogenetic testing in adult patients with either bipolar disorder or schizophrenia using the keywords pharmacy, pharmacogenomics, pharmacogenetics, psychiatry, bipolar disorder, schizophrenia, mood stabilizer, and antipsychotic. Results: A total of 18 articles were included in the final literature review. A wide variety of genes amongst adult patients with varying ethnicities were found to be correlated with the development of schizophrenia or bipolar disorder as well as response to antipsychotics and mood stabilizers. Discussion: While current studies show a correlation between genetic variations and medication response or disease predisposition for patients with schizophrenia and bipolar disorder, research is unclear on the type of therapeutic recommendations that should occur based on the results of the pharmacogenetic testing. Hopefully interpreting pharmacogenetic results will one day assist with optimizing medication recommendations for individuals with schizophrenia and bipolar disorder.
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Affiliation(s)
- Melanie Routhieaux
- PGY-1 Pharmacy Practice Resident, William Jennings Bryan Dorn VA Medical Center, Columbia, South Carolina
| | - Jessica Keels
- PGY-1 Pharmacy Practice Resident, William Jennings Bryan Dorn VA Medical Center, Columbia, South Carolina
| | - Erika E Tillery
- (Corresponding author) Associate Professor of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, South Carolina; Clinical Psychiatric Pharmacist, Division of Inpatient Services, G. Werber Bryan Psychiatric Hospital, Columbia, South Carolina,
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24
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Response to initial antipsychotic treatment in first episode psychosis is related to anterior cingulate glutamate levels: a multicentre 1H-MRS study (OPTiMiSE). Mol Psychiatry 2018; 23:2145-2155. [PMID: 29880882 DOI: 10.1038/s41380-018-0082-9] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 03/15/2018] [Accepted: 04/04/2018] [Indexed: 12/19/2022]
Abstract
Conventional antipsychotic medication is ineffective in around a third of patients with schizophrenia, and the nature of the therapeutic response is unpredictable. We investigated whether response to antipsychotics is related to brain glutamate levels prior to treatment. Proton magnetic resonance spectroscopy was used to measure glutamate levels (Glu/Cr) in the anterior cingulate cortex (ACC) and in the thalamus in antipsychotic-naive or minimally medicated patients with first episode psychosis (FEP, n = 71) and healthy volunteers (n = 60), at three sites. Following scanning, patients were treated with amisulpride for 4 weeks (n = 65), then 1H-MRS was repeated (n = 46). Remission status was defined in terms of Positive and Negative Syndrome Scale for Schizophrenia (PANSS) scores. Higher levels of Glu/Cr in the ACC were associated with more severe symptoms at presentation and a lower likelihood of being in remission at 4 weeks (P < 0.05). There were longitudinal reductions in Glu/Cr in both the ACC and thalamus over the treatment period (P < 0.05), but these changes were not associated with the therapeutic response. There were no differences in baseline Glu/Cr between patients and controls. These results extend previous evidence linking higher levels of ACC glutamate with a poor antipsychotic response by showing that the association is evident before the initiation of treatment.
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Abstract
PURPOSE OF REVIEW This review highlights recent advances in the investigation of genetic factors for antipsychotic response and side effects. RECENT FINDINGS Antipsychotics prescribed to treat psychotic symptoms are variable in efficacy and propensity for causing side effects. The major side effects include tardive dyskinesia, antipsychotic-induced weight gain (AIWG), and clozapine-induced agranulocytosis (CIA). Several promising associations of polymorphisms in genes including HSPG2, CNR1, and DPP6 with tardive dyskinesia have been reported. In particular, a functional genetic polymorphism in SLC18A2, which is a target of recently approved tardive dyskinesia medication valbenazine, was associated with tardive dyskinesia. Similarly, several consistent findings primarily from genes modulating energy homeostasis have also been reported (e.g. MC4R, HTR2C). CIA has been consistently associated with polymorphisms in the HLA genes (HLA-DQB1 and HLA-B). The association findings between glutamate system genes and antipsychotic response require additional replications. SUMMARY The findings to date are promising and provide us a better understanding of the development of side effects and response to antipsychotics. However, more comprehensive investigations in large, well characterized samples will bring us closer to clinically actionable findings.
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Hochberger W, Combs T, Reilly J, Bishop J, Keefe R, Clementz B, Keshavan M, Pearlson G, Tamminga C, Hill SK, Sweeney J. Deviation from expected cognitive ability across psychotic disorders. Schizophr Res 2018; 192:300-307. [PMID: 28545944 PMCID: PMC5699979 DOI: 10.1016/j.schres.2017.05.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/10/2017] [Accepted: 05/15/2017] [Indexed: 11/26/2022]
Abstract
Patients with schizophrenia show a deficit in cognitive ability compared to estimated premorbid and familial intellectual abilities. However, the degree to which this pattern holds across psychotic disorders and is familial is unclear. The present study examined deviation from expected cognitive level in schizophrenia, schizoaffective disorder, and psychotic bipolar disorder probands and their first-degree relatives. Using a norm-based regression approach, parental education and WRAT-IV Reading scores (both significant predictors of cognitive level in the healthy control group) were used to predict global neuropsychological function as measured by the composite score from the Brief Assessment of Cognition in Schizophrenia (BACS) test in probands and relatives. When compared to healthy control group, psychotic probands showed a significant gap between observed and predicted BACS composite scores and a greater likelihood of robust cognitive decline. This effect was not seen in unaffected relatives. While BACS and WRAT-IV Reading scores were themselves highly familial, the decline in cognitive function from expectation had lower estimates of familiality. Thus, illness-related factors such as epigenetic, treatment, or pathophysiological factors may be important causes of illness related decline in cognitive abilities across psychotic disorders. This is consistent with the markedly greater level of cognitive impairment seen in affected individuals compared to their unaffected family members.
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Affiliation(s)
- W.C. Hochberger
- Rosalind Franklin University of Medicine and Science, Department of Psychology
| | - T. Combs
- Rosalind Franklin University of Medicine and Science, Department of Psychology
| | - J.L. Reilly
- Northwestern University, Department of Psychiatry and Behavioral Sciences
| | - J.R. Bishop
- University of Minnesota, Department of Experimental and Clinical Pharmacology and Department of Psychiatry
| | - R.S.E. Keefe
- Duke University, Departments of Psychiatry, Neuroscience, and Psychology
| | | | | | - G.D. Pearlson
- Yale University School of Medicine, Department of Psychiatry
| | - C.A. Tamminga
- UT Southwestern Medical Center, Department of Psychiatry
| | - S. K. Hill
- Rosalind Franklin University of Medicine and Science, Department of Psychology,Corresponding author at: Rosalind Franklin University of Medicine and Science, Department of Psychology, 3333 Green Bay Rd., North Chicago, IL 60064, , Phone: (847) 578-8748
| | - J.A. Sweeney
- University of Cincinnati, Department of Psychiatry and Behavioral Neuroscience
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Kaneko H, Miura I, Kanno-Nozaki K, Horikoshi S, Hino M, Yabe H. COMT Val 108/158 Met polymorphism and treatment response to aripiprazole in patients with acute schizophrenia. Neuropsychiatr Dis Treat 2018; 14:1657-1663. [PMID: 29950847 PMCID: PMC6018926 DOI: 10.2147/ndt.s164647] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The COMT Val 108/158 Met polymorphism (rs4680) may affect treatment response to antipsychotics, as well as metabolism and dynamics of neurotransmitters during the treatment of schizophrenia. We investigated the effects of the COMT Val 108/158 Met polymorphism on treatment response to aripiprazole and plasma monoamine metabolite levels in patients with acute schizophrenia. MATERIALS AND METHODS Forty patients with schizophrenia were treated with aripiprazole for 6 weeks. We measured Positive and Negative Syndrome Scale (PANSS) and plasma levels of homovanillic acid (HVA) and plasma MHPG (3-methoxy-4-hydroxyphenethyleneglycol) at baseline and endpoint. The COMT Val 108/158 Met polymorphism was genotyped with the polymerase chain reaction and restriction fragment length polymorphism. RESULTS There were significant genotype-time interactions on PANSS total and general psychopathology scores, with Met/Met genotype showing greater improvement. The response rate to aripiprazole did not differ between COMT Val 108/158 Met genotype groups. We found a significant time effect on plasma MHPG levels, but no time effect on plasma HVA levels or time-genotype interactions in the plasma levels of HVA and MHPG. Although the responder rate did not differ among the 3 genotype groups. CONCLUSION Our results suggest that individuals with the Met/Met genotype had greater improvement in PANSS score after the treatment with aripiprazole. On the other hand, the Val 108/158 Met polymorphism may not induce changes in plasma levels of monoamine metabolites during aripiprazole treatment. Because of the small sample size, further studies are needed to confirm and to extend our results.
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Affiliation(s)
- Haruka Kaneko
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan.,Department of Neuropsychiatry, Hoshi General Hospital, Fukushima, Japan
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Keiko Kanno-Nozaki
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Sho Horikoshi
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mizuki Hino
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
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Genetics and Antipsychotic Response in Schizophrenia: an Update. Curr Behav Neurosci Rep 2017. [DOI: 10.1007/s40473-017-0119-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saini SM, Mancuso SG, Mostaid MS, Liu C, Pantelis C, Everall IP, Bousman CA. Meta-analysis supports GWAS-implicated link between GRM3 and schizophrenia risk. Transl Psychiatry 2017; 7:e1196. [PMID: 28786982 PMCID: PMC5611739 DOI: 10.1038/tp.2017.172] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 06/20/2017] [Indexed: 12/29/2022] Open
Abstract
Genome-wide association study (GWAS) evidence has identified the metabotropic glutamate receptor 3 (GRM3) gene as a potential harbor for schizophrenia risk variants. However, previous meta-analyses have refuted the association between GRM3 single-nucleotide polymorphisms (SNPs) and schizophrenia risk. To reconcile these conflicting findings, we conducted the largest and most comprehensive meta-analysis of 14 SNPs in GRM3 from a total of 11 318 schizophrenia cases, 13 820 controls and 486 parent-proband trios. We found significant associations for three SNPs (rs2237562: odds ratio (OR)=1.06, 95% confidence interval (CI)=1.02-1.11, P=0.017; rs13242038: OR=0.90, 95% CI=0.85-0.96, P=0.016 and rs917071: OR=0.94, 95% CI=0.91-0.97, P=0.003). Two of these SNPs (rs2237562, rs917071) were in strong-to-moderate linkage disequilibrium with the top GRM3 GWAS significant SNP (rs12704290) reported by the Schizophrenia Working Group of the Psychiatric Genomics Consortium. We also found evidence for population stratification related to rs2237562 in that the 'risk' allele was dependent on the population under study. Our findings support the GWAS-implicated link between GRM3 genetic variation and schizophrenia risk as well as the notion that alleles conferring this risk may be population specific.
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Affiliation(s)
- S M Saini
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Department of Psychiatry, UKM Medical Center, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia
| | - S G Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Md S Mostaid
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - C Liu
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Centre for Neural Engineering, The University of Melbourne, Carlton, VIC, Australia
- North Western Mental Health, Melbourne Health, Parkville, VIC, Australia
| | - I P Everall
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Centre for Neural Engineering, The University of Melbourne, Carlton, VIC, Australia
- North Western Mental Health, Melbourne Health, Parkville, VIC, Australia
| | - C A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of General Practice, The University of Melbourne, Parkville, VIC, Australia
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Xavier RM, Vorderstrasse A. Genetic Basis of Positive and Negative Symptom Domains in Schizophrenia. Biol Res Nurs 2017; 19:559-575. [PMID: 28691507 DOI: 10.1177/1099800417715907] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Schizophrenia is a highly heritable disorder, the genetic etiology of which has been well established. Yet despite significant advances in genetics research, the pathophysiological mechanisms of this disorder largely remain unknown. This gap has been attributed to the complexity of the polygenic disorder, which has a heterogeneous clinical profile. Examining the genetic basis of schizophrenia subphenotypes, such as those based on particular symptoms, is thus a useful strategy for decoding the underlying mechanisms. This review of literature examines the recent advances (from 2011) in genetic exploration of positive and negative symptoms in schizophrenia. We searched electronic databases PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature using key words schizophrenia, symptoms, positive symptoms, negative symptoms, cognition, genetics, genes, genetic predisposition, and genotype in various combinations. We identified 115 articles, which are included in the review. Evidence from these studies, most of which are genetic association studies, identifies shared and unique gene associations for the symptom domains. Genes associated with neurotransmitter systems and neuronal development/maintenance primarily constitute the shared associations. Needed are studies that examine the genetic basis of specific symptoms within the broader domains in addition to functional mechanisms. Such investigations are critical to developing precision treatment and care for individuals afflicted with schizophrenia.
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Affiliation(s)
| | - Allison Vorderstrasse
- 2 Duke Center for Applied Genomics and Precision Medicine, Duke University School of Nursing, Durham, NC, USA
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Panaccione I, Iacovelli L, di Nuzzo L, Nardecchia F, Mauro G, Janiri D, De Blasi A, Sani G, Nicoletti F, Orlando R. Paradoxical sleep deprivation in rats causes a selective reduction in the expression of type-2 metabotropic glutamate receptors in the hippocampus. Pharmacol Res 2017; 117:46-53. [DOI: 10.1016/j.phrs.2016.11.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/10/2016] [Accepted: 11/22/2016] [Indexed: 12/12/2022]
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Huang E, Zai CC, Lisoway A, Maciukiewicz M, Felsky D, Tiwari AK, Bishop JR, Ikeda M, Molero P, Ortuno F, Porcelli S, Samochowiec J, Mierzejewski P, Gao S, Crespo-Facorro B, Pelayo-Terán JM, Kaur H, Kukreti R, Meltzer HY, Lieberman JA, Potkin SG, Müller DJ, Kennedy JL. Catechol-O-Methyltransferase Val158Met Polymorphism and Clinical Response to Antipsychotic Treatment in Schizophrenia and Schizo-Affective Disorder Patients: a Meta-Analysis. Int J Neuropsychopharmacol 2016; 19:pyv132. [PMID: 26745992 PMCID: PMC4886669 DOI: 10.1093/ijnp/pyv132] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 11/19/2015] [Accepted: 12/02/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The catechol-O-methyltransferase (COMT) enzyme plays a crucial role in dopamine degradation, and the COMT Val158Met polymorphism (rs4680) is associated with significant differences in enzymatic activity and consequently dopamine concentrations in the prefrontal cortex. Multiple studies have analyzed the COMT Val158Met variant in relation to antipsychotic response. Here, we conducted a meta-analysis examining the relationship between COMT Val158Met and antipsychotic response. METHODS Searches using PubMed, Web of Science, and PsycInfo databases (03/01/2015) yielded 23 studies investigating COMT Val158Met variation and antipsychotic response in schizophrenia and schizo-affective disorder. Responders/nonresponders were defined using each study's original criteria. If no binary response definition was used, authors were asked to define response according to at least 30% Positive and Negative Syndrome Scale score reduction (or equivalent in other scales). Analysis was conducted under a fixed-effects model. RESULTS Ten studies met inclusion criteria for the meta-analysis. Five additional antipsychotic-treated samples were analyzed for Val158Met and response and included in the meta-analysis (ntotal=1416). Met/Met individuals were significantly more likely to respond than Val-carriers (P=.039, ORMet/Met=1.37, 95% CI: 1.02-1.85). Met/Met patients also experienced significantly greater improvement in positive symptoms relative to Val-carriers (P=.030, SMD=0.24, 95% CI: 0.024-0.46). Posthoc analyses on patients treated with atypical antipsychotics (n=1207) showed that Met/Met patients were significantly more likely to respond relative to Val-carriers (P=.0098, ORMet/Met=1.54, 95% CI: 1.11-2.14), while no difference was observed for typical-antipsychotic-treated patients (n=155) (P=.65). CONCLUSIONS Our findings suggest that the COMT Val158Met polymorphism is associated with response to antipsychotics in schizophrenia and schizo-affective disorder patients. This effect may be more pronounced for atypical antipsychotics.
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Affiliation(s)
- Eric Huang
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Clement C Zai
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Amanda Lisoway
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Malgorzata Maciukiewicz
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Daniel Felsky
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Arun K Tiwari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Jeffrey R Bishop
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Masashi Ikeda
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Patricio Molero
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Felipe Ortuno
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Stefano Porcelli
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Jerzy Samochowiec
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Pawel Mierzejewski
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Shugui Gao
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Benedicto Crespo-Facorro
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - José M Pelayo-Terán
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Harpreet Kaur
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Ritushree Kukreti
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Herbert Y Meltzer
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Jeffrey A Lieberman
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Steven G Potkin
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - Daniel J Müller
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin)
| | - James L Kennedy
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada (Mr Huang, Dr Zai, Ms Lisoway, Dr Maciukiewicz, Mr Felsky, Dr Tiwari, Dr Müller, and Dr Kennedy); Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN (Dr Bishop); Department of Psychiatry, Fujita Health University, Toyoake, Aichi, Japan (Dr Ikeda); Departamento de Psiquiatria, Clinica Universidad de Navarra, Pamplona, Spain (Drs Molero and Ortuno); Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy (Dr Porcelli); Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland (Dr Samochowiec); Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland (Dr Mierzejewski); Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China (Dr Gao); Department of Psychiatry, CIBERSAM, University Hospital Marqués de Valdecilla- IDIVAL, School of Medicine, University of Cantabria, Santander, Spain (Dr Pelayo-Terán); Institute of Genomics and Integrative Biology, Delhi, India (Drs Kaur and Kukreti); Feinberg School of Medicine, Northwestern University, Chicago, IL (Dr Meltzer); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr Lieberman); Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA (Dr Potkin).
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Stevenson JM, Reilly JL, Harris MSH, Patel SR, Weiden PJ, Prasad KM, Badner JA, Nimgaonkar VL, Keshavan MS, Sweeney JA, Bishop JR. Antipsychotic pharmacogenomics in first episode psychosis: a role for glutamate genes. Transl Psychiatry 2016; 6:e739. [PMID: 26905411 PMCID: PMC4872428 DOI: 10.1038/tp.2016.10] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 12/21/2015] [Indexed: 12/30/2022] Open
Abstract
Genetic factors may underlie beneficial and adverse responses to antipsychotic treatment. These relationships may be easier to identify among patients early in the course of disease who have limited exposure to antipsychotic drugs. We examined 86 first episode patients (schizophrenia, psychotic bipolar disorder and major depressive disorder with psychotic features) who had minimal to no prior antipsychotic exposure in a 6-week pharmacogenomic study of antipsychotic treatment response. Response was measured by change in Brief Psychiatric Rating Scale total score. Risperidone monotherapy was the primary antipsychotic treatment. Pharmacogenomic association studies were completed to (1) examine candidate single-nucleotide polymorphisms (SNPs) in genes known to be involved with glutamate signaling, and (2) conduct an exploratory genome-wide association study of symptom response to identify potential novel associations for future investigation. Two SNPs in GRM7 (rs2069062 and rs2014195) were significantly associated with antipsychotic response in candidate gene analysis, as were two SNPs in the human glutamate receptor delta 2 (GRID2) gene (rs9307122 and rs1875705) in genome-wide association analysis. Further examination of these findings with those from a separate risperidone-treated study sample demonstrated that top SNPs in both studies were overrepresented in glutamate genes and that there were similarities in neurodevelopmental gene categories associated with drug response from both study samples. These associations indicate a role for gene variants related to glutamate signaling and antipsychotic response with more broad association patterns indicating the potential importance of genes involved in neuronal development.
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Affiliation(s)
- J M Stevenson
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - J L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M S H Harris
- Jesse Brown Veterans Administration Medical Center, Chicago, IL, USA
| | - S R Patel
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - P J Weiden
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K M Prasad
- Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - J A Badner
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - V L Nimgaonkar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - M S Keshavan
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - J A Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - J R Bishop
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, USA
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Arranz MJ, Gallego C, Salazar J, Arias B. Pharmacogenetic studies of drug response in schizophrenia. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2016. [DOI: 10.1080/23808993.2016.1140554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Maj C, Minelli A, Giacopuzzi E, Sacchetti E, Gennarelli M. The Role of Metabotropic Glutamate Receptor Genes in Schizophrenia. Curr Neuropharmacol 2016; 14:540-50. [PMID: 27296644 PMCID: PMC4983747 DOI: 10.2174/1570159x13666150514232745] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/04/2015] [Accepted: 05/12/2015] [Indexed: 11/22/2022] Open
Abstract
Genomic studies revealed two main components in the genetic architecture of schizophrenia, one constituted by common variants determining a distributed polygenic effect and one represented by a large number of heterogeneous rare and highly disruptive mutations. These gene modifications often affect neural transmission and different studies proved an involvement of metabotropic glutamate receptors in schizophrenia phenotype. Through the combination of literature information with genomic data from public repositories, we analyzed the current knowledge on the involvement of genetic variations of the human metabotropic glutamate receptors in schizophrenia and related endophenotypes. Despite the analysis did not reveal a definitive connection, different suggestive associations have been identified and in particular a relevant role has emerged for GRM3 in affecting specific schizophrenia endophenotypes. This supports the hypothesis that these receptors are directly involved in schizophrenia disorder.
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Affiliation(s)
| | | | | | | | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, Biology and Genetic Division, University of Brescia, Viale Europa, 11 - 25123 Brescia, Italy.
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36
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Kinoshita A, Takizawa R, Koike S, Satomura Y, Kawasaki S, Kawakubo Y, Marumo K, Tochigi M, Sasaki T, Nishimura Y, Kasai K. Effect of metabotropic glutamate receptor-3 variants on prefrontal brain activity in schizophrenia: An imaging genetics study using multi-channel near-infrared spectroscopy. Prog Neuropsychopharmacol Biol Psychiatry 2015; 62:14-21. [PMID: 25914064 DOI: 10.1016/j.pnpbp.2015.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 04/16/2015] [Accepted: 04/16/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND The glutamatergic system is essential for learning and memory through its crucial role in neural development and synaptic plasticity. Genes associated with the glutamatergic system, including metabotropic glutamate receptor (mGluR or GRM) genes, have been implicated in the pathophysiology of schizophrenia. Few studies, however, have investigated a relationship between polymorphism of glutamate-related genes and cortical function in vivo in patients with schizophrenia. We thus explored an association between genetic variations in GRM3 and brain activation driven by a cognitive task in the prefrontal cortex in patients with schizophrenia. MATERIALS AND METHODS Thirty-one outpatients with schizophrenia and 48 healthy controls participated in this study. We measured four candidate single nucleotide polymorphisms (rs274622, rs2299225, rs1468412, and rs6465084) of GRM3, and activity in the prefrontal and temporal cortices during a category version of a verbal fluency task, using a 52-channel near-infrared spectroscopy instrument. RESULTS AND DISCUSSION The rs274622 C carriers with schizophrenia were associated with significantly smaller prefrontal activation than patients with TT genotype. This between-genotype difference tended to be confined to the patient group. GRM3 polymorphisms are associated with prefrontal activation during cognitive task in schizophrenia.
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Affiliation(s)
- Akihide Kinoshita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Ryu Takizawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London SE5 8AF, UK
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; Office for Mental Health Support, Division for Counseling and Support, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shingo Kawasaki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; Application Development Office, Hitachi Medical Corporation, Kashiwa City, Chiba 277-0804, Japan
| | - Yuki Kawakubo
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kohei Marumo
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Mamoru Tochigi
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Psychiatry, Teikyo University School of Medicine, Itabashi-ku, Tokyo 173-8605, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yukika Nishimura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan.
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Li ML, Hu XQ, Li F, Gao WJ. Perspectives on the mGluR2/3 agonists as a therapeutic target for schizophrenia: Still promising or a dead end? Prog Neuropsychopharmacol Biol Psychiatry 2015; 60:66-76. [PMID: 25724760 PMCID: PMC4426221 DOI: 10.1016/j.pnpbp.2015.02.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 02/16/2015] [Accepted: 02/17/2015] [Indexed: 01/08/2023]
Abstract
Group II metabotropic glutamate receptor (mGluR2/3) agonists once showed promise as non-dopaminergic antipsychotic drugs because of their efficacy in alleviating symptoms of schizophrenia (SZ) in both animal models and human patients. However, the recent failure of Phase III clinical trials dealt a huge blow to the scientific community and the aftershock of the setback in mGluR2/3 research can be felt everywhere from grant support and laboratory studies to paper publication. An immediate question raised is whether mGluR2/3 is still a promising therapeutic target for schizophrenia. Answering this question is not easy, but apparently a new strategy is needed. This article provides a focused review of literature on the study of mGluR2/3 agonists, especially on mGluR2/3 agonists' mechanism of action and efficacy in both normal conditions and animal models of SZ, as well as clinical studies in human patients with the disease. We argue that the cellular and molecular actions of mGluR2/3 agonists, the distinct roles between mGluR2 and mGluR3, as well as their effects on different stages of the disease and different subpopulations of patients, remain incompletely studied. Until the mechanisms associated with mGluR2/3 are clearly elucidated and all treatment options are tested, it would be a great mistake to terminate the study of mGluR2/3 as a therapeutic target for schizophrenia. This review will thus shed light on the comprehensive features of the translational potential mGluR2/3 agonists as well as the need for further research into the more selective activation of mGluR2.
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Affiliation(s)
- Meng-Lin Li
- Drexel University College of Medicine, Philadelphia, PA, USA,Department of Rehabilitation, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xi-Quan Hu
- Department of Rehabilitation, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Feng Li
- Department of Neurobiology and Anatomy, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Wen-Jun Gao
- Drexel University College of Medicine, Philadelphia, PA, USA.
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Yang X, Wang G, Wang Y, Yue X. Association of metabotropic glutamate receptor 3 gene polymorphisms with schizophrenia risk: evidence from a meta-analysis. Neuropsychiatr Dis Treat 2015; 11:823-33. [PMID: 25848280 PMCID: PMC4378872 DOI: 10.2147/ndt.s77966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
To date, the role of metabotropic glutamate receptor 3 (GRM3) rs274622, rs1468412, rs917071, rs6465084, and rs2299225 polymorphisms in schizophrenia remains controversial. To provide a clearer picture for the effect of the five most studied GRM3 polymorphisms on risk of schizophrenia, this meta-analysis with eligible data from published studies was performed. Relevant case-control studies were retrieved by literature search and selected according to established inclusion criteria. Odds ratios with 95% confidence intervals were used to assess the strength of association. A total of 33 individual studies were identified and included in our meta-analysis: nine for rs1468412, with 5,314 cases and 6,147 controls; six for rs917071, with 2,660 cases and 3,517 controls; seven for rs274622, with 3,820 cases and 4,015 controls; five for rs2299225, with 3,492 cases and 3,735 controls; and six for rs6465084, with 4,960 cases and 5,613 controls. However, no significant association was found between these GRM3 polymorphisms and schizophrenia in the overall population. With respect to rs1468412 polymorphism, a finding of very borderline statistical significance emerged in dominant comparison model for non-Asian populations, calling for large-scale verification to assess the marginally elevated risk of schizophrenia. In conclusion, these GRM3 polymorphisms have limited effect on the risks of schizophrenia. Further large and well-designed studies are needed to confirm this conclusion.
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Affiliation(s)
- Xiaoqin Yang
- Department of Bioinformatics, School of Life Science and Technology, Tongji University, Shanghai, People's Republic of China
| | - Guiping Wang
- Department of Pharmacy, College of Health Sciences, Guangzhou Medical University, People's Republic of China
| | - Yaodong Wang
- Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, People's Republic of China
| | - Xia Yue
- Department of Forensic Medicine, School of Basic Medical Sciences, Southern Medical University, Guangzhou, People's Republic of China
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