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Jalaiei A, Asadi MR, Daneshmandpour Y, Rezazadeh M, Ghafouri-Fard S. Clinical, molecular, physiologic, and therapeutic feature of patients with CHRNA4 and CHRNB2 deficiency: A systematic review. J Neurochem 2024. [PMID: 39193833 DOI: 10.1111/jnc.16200] [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: 05/05/2024] [Revised: 07/03/2024] [Accepted: 07/26/2024] [Indexed: 08/29/2024]
Abstract
The α4β2 nAChRs are crucial ion channels that control neurotransmitter release and play a role in various physiologic and pathologic processes. CHRNA4 encodes the α4-nAChRs, while CHRNB2 encodes the β2-nAChRs. Recent studies have found different variants of α4β2-nAChRs in individuals with conditions such as AD, ADHD, ALS, PD, and brain abnormalities. We conducted a scoping review following a six-stage methodology structure and adhering to PRISMA guidelines. We systematically reviewed articles using relevant keywords up to October 2, 2023. In this summary, we cover the clinical symptoms reported, the genes and protein structure of CHRNA4 and CHRNB2, mutations in these genes, inheritance patterns, the functional impact of mutations and polymorphisms in CHRNA4 and CHRNB2, and the epidemiology of these diseases. Recent research indicates that nAChRs may play a significant role in neurodegenerative disorders, possibly impacting neuronal function through yet undiscovered regulatory pathways. Studying how nAChRs interact with disease-related aggregates in neurodegenerative conditions may lead to new treatment options for these disorders.
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Affiliation(s)
- Abbas Jalaiei
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Asadi
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Daneshmandpour
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rezazadeh
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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2
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Kent KR, Hopfer CJ, Corley RP, Stallings MC. Executive functions as a mediator of childhood maltreatment on adult psychopathology: A longitudinal mediation analysis comparing maltreatment factor models. CHILD ABUSE & NEGLECT 2022; 123:105369. [PMID: 34883422 PMCID: PMC8859768 DOI: 10.1016/j.chiabu.2021.105369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/16/2021] [Accepted: 10/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Childhood maltreatment (CM), executive functions (EFs), and psychiatric disorders all correlate highly. Changes in EFs during adolescence related to CM present a possible mediating mechanism for the development of psychiatric disorders, yet no study has analyzed this longitudinally while comparing predictive capacity of different CM factor structures. We hypothesized that changes in EFs from adolescence to adulthood would mediate, in part, associations between CM, internalizing disorders (INT), and anti-social personality disorder (ASPD) while different subtypes of CM would differentially predict INT and ASPD. OBJECTIVE This study longitudinally examined the mediating effects of EFs on associations between CM, INT, and ASPD while comparing prediction of two CM factor structures. PARTICIPANTS High-risk subjects selected for drug use in adolescence (N = 658) from mean ages 16 to 23. METHODS A Bayesian structural equation model was deployed to analyze change in EFs as a mediator of the relationship between CM and adult INT and ASPD. CM was measured using two factor structures: a single overall factor and four correlated factors representing CM subtypes. RESULTS CM significantly predicted INT and ASPD but there was no evidence that the relationship was substantially mediated through EFs. High correlations among subtypes of CM limited the unique predictions of each subtype on INT and ASPD. CONCLUSION In this high-risk sample, the collinearity of CM subtypes obscured their predictions of outcome measures supporting the use of one CM factor. EFs did not significantly mediate associations between CM and psychiatric disorders, but further research on these relationships is warranted.
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Affiliation(s)
- Kyle R Kent
- Department of Psychology and Neuroscience, University of Colorado, Boulder, United States of America.
| | - Christian J Hopfer
- Department of Psychiatry, University of Colorado, Denver, United States of America
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, United States of America
| | - Michael C Stallings
- Department of Psychology and Neuroscience, University of Colorado, Boulder, United States of America; Institute for Behavioral Genetics, University of Colorado, Boulder, United States of America
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3
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Mooney-Leber SM, Caruso MJ, Gould TJ, Cavigelli SA, Kamens HM. The impact of adolescent stress on nicotine use and affective disorders in rodent models. Eur J Neurosci 2021; 55:2196-2215. [PMID: 34402112 PMCID: PMC9730548 DOI: 10.1111/ejn.15421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 12/19/2022]
Abstract
Recent findings indicate that stress exposure during adolescence contributes to the development of both nicotine use and affective disorders, suggesting a potential shared biological pathway. One key system that may mediate the association between adolescent stress and nicotine or affective outcomes is the hypothalamic-pituitary-adrenal (HPA) axis. Here we reviewed evidence regarding the effects of adolescent stress on nicotine responses and affective phenotypes and the role of the HPA-axis in these relationships. Literature indicates that stress, possibly via HPA-axis dysfunction, is a risk factor for both nicotine use and affective disorders. In rodent models, adolescent stress modulates behavioural responses to nicotine and increases the likelihood of affective disorders. The exact role that the HPA-axis plays in altering nicotine sensitivity and affective disorder development after adolescent stress remains unclear. However, it appears likely that adolescent stress-induced nicotine use and affective disorders are precipitated by repetitive activation of a hyperactive HPA-axis. Together, these preclinical studies indicate that adolescent stress is a risk factor for nicotine use and anxiety/depression phenotypes. The findings summarized here suggest that the HPA-axis mediates this relationship. Future studies that pharmacologically manipulate the HPA-axis during and after adolescent stress are critical to elucidate the exact role that the HPA-axis plays in the development of nicotine use and affective disorders following adolescent stress.
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Affiliation(s)
- Sean M Mooney-Leber
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA.,Department of Psychology, University of Wisconsin - Stevens Point, Stevens Point, WI, USA
| | - Michael J Caruso
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Thomas J Gould
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Sonia A Cavigelli
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA.,Center for Brain, Behavior, and Cognition, The Pennsylvania State University, University Park, PA, USA
| | - Helen M Kamens
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA.,Center for Brain, Behavior, and Cognition, The Pennsylvania State University, University Park, PA, USA
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Partial and full deletion of nicotinic acetylcholine receptor α4 and β2 subunits reduces sensitivity to acute nicotine administration and development of tolerance following chronic nicotine administration. Behav Pharmacol 2021; 31:688-701. [PMID: 32568759 DOI: 10.1097/fbp.0000000000000575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The diversity of nicotinic cholinergic receptor (nAChR) subunits underlies the complex responses to nicotine. Mice differing in the expression of α4 and β2 subunits, which are most widely expressed in brain, were evaluated for the responses to acute nicotine administration on Y-maze crossings and rears, open-field locomotion and body temperature following chronic treatment with nicotine (0, 0.25, 1.0 and 4.0 mg/kg/h). Deletion or partial deletion of the α4, β2 or both nAChR subunits reduced the sensitivity of mice to acute nicotine administration. This reduced sensitivity was gene dose-dependent. Modification of α4 subunit expression elicited a greater reduction in sensitivity than the modification of β2 subunit expression. No measurable tolerance was observed for mice of any genotype following chronic treatment with 0.25 mg/kg/h nicotine. Modest tolerance was noted following treatment with 1.0 mg/kg/h. Greater tolerance was observed following treatment with 4.0 mg/kg/h. The extent of tolerance differed among the mice depending on genotype: wild-type (α4 and β2) developed measurable tolerance for all four tests. Heterozygotes (α4, β2 and α4/β2) developed tolerance for only Y-maze crossings and body temperature. Null mutants (α4 and β2) did not become tolerant. However, following chronic treatment with 4.0 mg/kg/h nicotine, wild type, α4 and α4 mice displayed increased Y-maze crossings following acute administration of 0.5 mg/kg nicotine that may reflect the activity of α6β2*-nAChR. These results confirm the importance of the α4 and β2 nAChR subunits in mediating acute and chronic effects of nicotine on locomotion and body temperature in the mouse.
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Garcia‐Rivas V, Deroche‐Gamonet V. Not all smokers appear to seek nicotine for the same reasons: implications for preclinical research in nicotine dependence. Addict Biol 2019; 24:317-334. [PMID: 29480575 DOI: 10.1111/adb.12607] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 12/11/2017] [Accepted: 01/15/2018] [Indexed: 01/08/2023]
Abstract
Tobacco use leads to 6 million deaths every year due to severe long-lasting diseases. The main component of tobacco, nicotine, is recognized as one of the most addictive drugs, making smoking cessation difficult, even when 70 percent of smokers wish to do so. Clinical and preclinical studies have demonstrated consistently that nicotine seeking is a complex behavior involving various psychopharmacological mechanisms. Evidence supports that the population of smokers is heterogeneous, particularly as regards the breadth of motives that determine the urge to smoke. Here, we review converging psychological, genetic and neurobiological data from clinical and preclinical studies supporting that the mechanisms controlling nicotine seeking may vary from individual to individual. It appears timely that basic neuroscience integrates this heterogeneity to refine our understanding of the neurobiology of nicotine seeking, as tremendous progress has been made in modeling the various psychopharmacological mechanisms driving nicotine seeking in rodents. For a better understanding of the mechanisms that drive nicotine seeking, we emphasize the need for individual-based research strategies in which nicotine seeking, and eventually treatment efficacy, are determined while taking into account individual variations in the mechanisms of nicotine seeking.
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Affiliation(s)
- Vernon Garcia‐Rivas
- Université de Bordeaux France
- INSERM U1215, Psychobiology of Drug AddictionNeuroCentre Magendie France
| | - Véronique Deroche‐Gamonet
- Université de Bordeaux France
- INSERM U1215, Psychobiology of Drug AddictionNeuroCentre Magendie France
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Moretti M, Fasoli F, Gotti C, Marks MJ. Reduced α4 subunit expression in α4 +- and α4 +- /β2 +- nicotinic acetylcholine receptors alters α4β2 subtype up-regulation following chronic nicotine treatment. Br J Pharmacol 2018; 175:1944-1956. [PMID: 28585241 PMCID: PMC5980142 DOI: 10.1111/bph.13896] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/22/2017] [Accepted: 05/23/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND PURPOSE Genomic analysis has shown many variants in both CHRNA4 and CHRNB2, genes which encode the α4 and β2 subunits of nicotinic ACh receptors (nAChR) respectively. Some variants influence receptor expression, raising the possibility that CHRNA4 variants may affect response to tobacco use in humans. Chronic exposure to nicotine increases expression of nAChRs, particularly α4β2-nAChRs, in humans and laboratory animals. Here, we have evaluated whether the initial level of receptor expression affects the increase in expression. EXPERIMENTAL APPROACH Mice differing in expression of α4 and/or β2 nAChR subunits were chronically treated with saline, 0.25, 1.0 or 4.0 mg·kg-1 ·h-1 nicotine. Brain preparations were analysed autoradiographically by [125 I]-epibatidine binding, immunoprecipitation and Western blotting. KEY RESULTS Immunochemical studies confirmed that most of the [3 H]-epibatidine binding corresponds to α4β2*-nAChR and that increases in binding correspond to increases in α4 and β2 proteins. Consistent with previous reports, the dose-dependent increase in nAChR in wild-type mice following chronic nicotine treatment, measured with any of the methods, reached a maximum. Although receptor expression was reduced by approximately 50% in β2+- mice, the pattern of response to chronic treatment resembled that of wild-type mice. In contrast, both α4+- and α4+- /β2+- exhibited relatively greater up-regulation. Consistent with previous reports, α4β2α5-nAChR did not increase in response to nicotine. CONCLUSIONS AND IMPLICATIONS These results indicate that mice with reduced expression of the α4 nAChR subunit have a more robust response to chronic nicotine than mice with normal expression of this subunit. LINKED ARTICLES This article is part of a themed section on Nicotinic Acetylcholine Receptors. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.11/issuetoc.
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Affiliation(s)
- Milena Moretti
- CNR, Institute of Neuroscience Milan, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | | | - Cecilia Gotti
- CNR, Institute of Neuroscience Milan, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Michael J Marks
- Instute for Behavioral Genetics and Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
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7
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Melroy-Greif WE, Simonson MA, Corley RP, Lutz SM, Hokanson JE, Ehringer MA. Examination of the Involvement of Cholinergic-Associated Genes in Nicotine Behaviors in European and African Americans. Nicotine Tob Res 2017; 19:417-425. [PMID: 27613895 DOI: 10.1093/ntr/ntw200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/20/2016] [Indexed: 12/18/2022]
Abstract
Introduction Cigarette smoking is a physiologically harmful habit. Nicotinic acetylcholine receptors (nAChRs) are bound by nicotine and upregulated in response to chronic exposure to nicotine. It is known that upregulation of these receptors is not due to a change in mRNA of these genes, however, more precise details on the process are still uncertain, with several plausible hypotheses describing how nAChRs are upregulated. We have manually curated a set of genes believed to play a role in nicotine-induced nAChR upregulation. Here, we test the hypothesis that these genes are associated with and contribute risk for nicotine dependence (ND) and the number of cigarettes smoked per day (CPD). Methods Studies with genotypic data on European and African Americans (EAs and AAs, respectively) were collected and a gene-based test was run to test for an association between each gene and ND and CPD. Results Although several novel genes were associated with CPD and ND at P < 0.05 in EAs and AAs, these associations did not survive correction for multiple testing. Previous associations between CHRNA3, CHRNA5, CHRNB4 and CPD in EAs were replicated. Conclusions Our hypothesis-driven approach avoided many of the limitations inherent in pathway analyses and provided nominal evidence for association between cholinergic-related genes and nicotine behaviors. Implications We evaluated the evidence for association between a manually curated set of genes and nicotine behaviors in European and African Americans. Although no genes were associated after multiple testing correction, this study has several strengths: by manually curating a set of genes we circumvented the limitations inherent in many pathway analyses and tested several genes that had not yet been examined in a human genetic study; gene-based tests are a useful way to test for association with a set of genes; and these genes were collected based on literature review and conversations with experts, highlighting the importance of scientific collaboration.
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Affiliation(s)
- Whitney E Melroy-Greif
- Department of Molecular and Cellular Neuroscience, The Scripps Research Institute, La Jolla, CA
| | | | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO
| | - Sharon M Lutz
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - John E Hokanson
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Marissa A Ehringer
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO.,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
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8
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Melroy-Greif WE, Vadasz C, Kamens HM, McQueen MB, Corley RP, Stallings MC, Hopfer CJ, Krauter KS, Brown SA, Hewitt JK, Ehringer MA. Test for association of common variants in GRM7 with alcohol consumption. Alcohol 2016; 55:43-50. [PMID: 27788777 DOI: 10.1016/j.alcohol.2015.10.005] [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: 05/05/2014] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 10/21/2022]
Abstract
Recent work using a mouse model has identified the glutamate metabotropic receptor 7 (Grm7) gene as a strong candidate gene for alcohol consumption. Although there has been some work examining the effect of human glutamate metabotropic receptor 7 (GRM7) polymorphisms on human substance use disorders, the majority of the work has focused on other psychiatric disorders such as ADHD, major depressive disorder, schizophrenia, bipolar disorder, panic disorder, and autism spectrum disorders. The current study aimed to evaluate evidence for association between GRM7 and alcohol behaviors in humans using a single nucleotide polymorphism (SNP) approach, as well as a gene-based approach. Using 1803 non-Hispanic European Americans (EAs) (source: the Colorado Center on Antisocial Drug Dependence [CADD]) and 1049 EA subjects from an independent replication sample (source: the Genetics of Antisocial Drug Dependence [GADD]), two SNPs in GRM7 were examined for possible association with alcohol consumption using two family-based association tests implemented in FBAT and QTDT. Rs3749380 was suggestively associated with alcohol consumption in the CADD sample (p = 0.010) with the minor T allele conferring risk. There was no evidence for association in the GADD sample. A gene-based test using four Genome-Wide Association Studies (GWAS) revealed no association between variation in GRM7 and alcohol consumption. This study had several limitations: the SNPs chosen likely do not tag expression quantitative trait loci; a human alcohol consumption phenotype was used, complicating the interpretation with respect to rodent studies that found evidence for a cis-regulatory link between alcohol preference and Grm7; and only common SNPs imputed in all four datasets were included in the gene-based test. These limitations highlight the fact that rare variants, some potentially important common signals in the gene, and regions farther upstream were not examined.
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9
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Converging findings from linkage and association analyses on susceptibility genes for smoking and other addictions. Mol Psychiatry 2016; 21:992-1008. [PMID: 27166759 PMCID: PMC4956568 DOI: 10.1038/mp.2016.67] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/05/2016] [Accepted: 03/09/2016] [Indexed: 12/18/2022]
Abstract
Experimental approaches to genetic studies of complex traits evolve with technological advances. How do discoveries using different approaches advance our knowledge of the genetic architecture underlying complex diseases/traits? Do most of the findings of newer techniques, such as genome-wide association study (GWAS), provide more information than older ones, for example, genome-wide linkage study? In this review, we address these issues by developing a nicotine dependence (ND) genetic susceptibility map based on the results obtained by the approaches commonly used in recent years, namely, genome-wide linkage, candidate gene association, GWAS and targeted sequencing. Converging and diverging results from these empirical approaches have elucidated a preliminary genetic architecture of this intractable psychiatric disorder and yielded new hypotheses on ND etiology. The insights we obtained by putting together results from diverse approaches can be applied to other complex diseases/traits. In sum, developing a genetic susceptibility map and keeping it updated are effective ways to keep track of what we know about a disease/trait and what the next steps may be with new approaches.
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10
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Kamens HM, Corley RP, Richmond PA, Darlington TM, Dowell R, Hopfer CJ, Stallings MC, Hewitt JK, Brown SA, Ehringer MA. Evidence for Association Between Low Frequency Variants in CHRNA6/CHRNB3 and Antisocial Drug Dependence. Behav Genet 2016; 46:693-704. [PMID: 27085880 DOI: 10.1007/s10519-016-9792-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 04/05/2016] [Indexed: 11/24/2022]
Abstract
Common SNPs in nicotinic acetylcholine receptor genes (CHRN genes) have been associated with drug behaviors and personality traits, but the influence of rare genetic variants is not well characterized. The goal of this project was to identify novel rare variants in CHRN genes in the Center for Antisocial Drug Dependence (CADD) and Genetics of Antisocial Drug Dependence (GADD) samples and to determine if low frequency variants are associated with antisocial drug dependence. Two samples of 114 and 200 individuals were selected using a case/control design including the tails of the phenotypic distribution of antisocial drug dependence. The capture, sequencing, and analysis of all variants in 16 CHRN genes (CHRNA1-7, 9, 10, CHRNB1-4, CHRND, CHRNG, CHRNE) were performed independently for each subject in each sample. Sequencing reads were aligned to the human reference sequence using BWA prior to variant calling with the Genome Analysis ToolKit (GATK). Low frequency variants (minor allele frequency < 0.05) were analyzed using SKAT-O and C-alpha to examine the distribution of rare variants among cases and controls. In our larger sample, the region containing the CHRNA6/CHRNB3 gene cluster was significantly associated with disease status using both SKAT-O and C-alpha (unadjusted p values <0.05). More low frequency variants in the CHRNA6/CHRNB3 gene region were observed in cases compared to controls. These data support a role for genetic variants in CHRN genes and antisocial drug behaviors.
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Affiliation(s)
- Helen M Kamens
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO, 80309, USA
| | | | - Todd M Darlington
- Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO, 80309, USA
| | - Robin Dowell
- BioFrontiers Institute, University of Colorado, Boulder, CO, USA.,Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, CO, USA
| | - Christian J Hopfer
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael C Stallings
- Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO, 80309, USA.,Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - John K Hewitt
- Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO, 80309, USA.,Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - Sandra A Brown
- Department of Psychology and Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Marissa A Ehringer
- Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO, 80309, USA. .,Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.
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11
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Schwantes-An TH, Zhang J, Chen LS, Hartz SM, Culverhouse RC, Chen X, Coon H, Frank J, Kamens HM, Konte B, Kovanen L, Latvala A, Legrand LN, Maher BS, Melroy WE, Nelson EC, Reid MW, Robinson JD, Shen PH, Yang BZ, Andrews JA, Aveyard P, Beltcheva O, Brown SA, Cannon DS, Cichon S, Corley RP, Dahmen N, Degenhardt L, Foroud T, Gaebel W, Giegling I, Glatt SJ, Grucza RA, Hardin J, Hartmann AM, Heath AC, Herms S, Hodgkinson CA, Hoffmann P, Hops H, Huizinga D, Ising M, Johnson EO, Johnstone E, Kaneva RP, Kendler KS, Kiefer F, Kranzler HR, Krauter KS, Levran O, Lucae S, Lynskey MT, Maier W, Mann K, Martin NG, Mattheisen M, Montgomery GW, Müller-Myhsok B, Murphy MF, Neale MC, Nikolov MA, Nishita D, Nöthen MM, Nurnberger J, Partonen T, Pergadia ML, Reynolds M, Ridinger M, Rose RJ, Rouvinen-Lagerström N, Scherbaum N, Schmäl C, Soyka M, Stallings MC, Steffens M, Treutlein J, Tsuang M, Wall TL, Wodarz N, Yuferov V, Zill P, Bergen AW, Chen J, Cinciripini PM, Edenberg HJ, Ehringer MA, Ferrell RE, Gelernter J, Goldman D, Hewitt JK, Hopfer CJ, Iacono WG, Kaprio J, Kreek MJ, Kremensky IM, Madden PAF, McGue M, Munafò MR, Philibert RA, Rietschel M, Roy A, Rujescu D, Saarikoski ST, Swan GE, Todorov AA, Vanyukov MM, Weiss RB, Bierut LJ, Saccone NL. Association of the OPRM1 Variant rs1799971 (A118G) with Non-Specific Liability to Substance Dependence in a Collaborative de novo Meta-Analysis of European-Ancestry Cohorts. Behav Genet 2016; 46:151-69. [PMID: 26392368 PMCID: PMC4752855 DOI: 10.1007/s10519-015-9737-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 08/17/2015] [Indexed: 12/20/2022]
Abstract
The mu1 opioid receptor gene, OPRM1, has long been a high-priority candidate for human genetic studies of addiction. Because of its potential functional significance, the non-synonymous variant rs1799971 (A118G, Asn40Asp) in OPRM1 has been extensively studied, yet its role in addiction has remained unclear, with conflicting association findings. To resolve the question of what effect, if any, rs1799971 has on substance dependence risk, we conducted collaborative meta-analyses of 25 datasets with over 28,000 European-ancestry subjects. We investigated non-specific risk for "general" substance dependence, comparing cases dependent on any substance to controls who were non-dependent on all assessed substances. We also examined five specific substance dependence diagnoses: DSM-IV alcohol, opioid, cannabis, and cocaine dependence, and nicotine dependence defined by the proxy of heavy/light smoking (cigarettes-per-day >20 vs. ≤ 10). The G allele showed a modest protective effect on general substance dependence (OR = 0.90, 95% C.I. [0.83-0.97], p value = 0.0095, N = 16,908). We observed similar effects for each individual substance, although these were not statistically significant, likely because of reduced sample sizes. We conclude that rs1799971 contributes to mechanisms of addiction liability that are shared across different addictive substances. This project highlights the benefits of examining addictive behaviors collectively and the power of collaborative data sharing and meta-analyses.
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Affiliation(s)
- Tae-Hwi Schwantes-An
- Department of Genetics, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8232, St. Louis, MO, 63110, USA
- Genometrics Section, Computational and Statistical Genomics Branch, Division of Intramural Research, National Human Genome Research Institute, US National Institutes of Health (NIH), Baltimore, MD, 21224, USA
| | - Juan Zhang
- Department of Genetics, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8232, St. Louis, MO, 63110, USA
- Key Laboratory of Brain Function and Disease, School of Life Sciences, Chinese Academy of Sciences, University of Science and Technology of China, Hefei, Anhui, 230026, China
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Sarah M Hartz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Robert C Culverhouse
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Xiangning Chen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Hilary Coon
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159, Mannheim, Germany
| | - Helen M Kamens
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, 80309, USA
- Department of Integrative Physiology, University of Colorado, Boulder, CO, 80309, USA
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Bettina Konte
- Department of Psychiatry, Universitätsklinikum Halle (Saale), 06112, Halle (Saale), Germany
| | - Leena Kovanen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Antti Latvala
- Department of Public Health, University of Helsinki, Helsinki, 00014, Finland
| | - Lisa N Legrand
- Department of Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Whitney E Melroy
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, 80309, USA
- Department of Integrative Physiology, University of Colorado, Boulder, CO, 80309, USA
| | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Mark W Reid
- Oregon Research Institute, Eugene, OR, 97403, USA
| | - Jason D Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Pei-Hong Shen
- Section of Human Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Bao-Zhu Yang
- Department of Psychiatry, Yale University, New Haven, CT, 06516, USA
| | | | - Paul Aveyard
- Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, United Kingdom
| | - Olga Beltcheva
- Department of Medical Chemistry and Biochemistry, Molecular Medicine Center, Medical University-Sofia, 1431, Sofia, Bulgaria
| | - Sandra A Brown
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Dale S Cannon
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Sven Cichon
- Department. of Genomics, Life and Brain Center, Institute of Human Genetics, University of Bonn, Bonn, 53127, Germany
- Division of Medical Genetics, Department of Biomedicine, University Hospital Basel, University of Basel, Basel, 4003, Switzerland
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, 80309, USA
| | - Norbert Dahmen
- Ökumenisches Hainich-Klinikum, Mühlhausen/Thüringen, Germany
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, 2031, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, 3010, Australia
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | | | - Ina Giegling
- Department of Psychiatry, Universitätsklinikum Halle (Saale), 06112, Halle (Saale), Germany
| | - Stephen J Glatt
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Jill Hardin
- Center for Health Sciences, Biosciences Division, SRI International, Menlo Park, CA, 94025, USA
| | - Annette M Hartmann
- Department of Psychiatry, Universitätsklinikum Halle (Saale), 06112, Halle (Saale), Germany
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Stefan Herms
- Department. of Genomics, Life and Brain Center, Institute of Human Genetics, University of Bonn, Bonn, 53127, Germany
- Division of Medical Genetics, Department of Biomedicine, University Hospital Basel, University of Basel, Basel, 4003, Switzerland
| | - Colin A Hodgkinson
- Section of Human Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Per Hoffmann
- Department. of Genomics, Life and Brain Center, Institute of Human Genetics, University of Bonn, Bonn, 53127, Germany
- Division of Medical Genetics, Department of Biomedicine, University Hospital Basel, University of Basel, Basel, 4003, Switzerland
| | - Hyman Hops
- Oregon Research Institute, Eugene, OR, 97403, USA
| | - David Huizinga
- Institute of Behavioral Science, University of Colorado, Boulder, CO, 80309, USA
| | - Marcus Ising
- Max-Planck-Institute of Psychiatry, 80804, Munich, Germany
| | - Eric O Johnson
- Behavioral Health Research Division, Research Triangle Institute International, Durham, NC, 27709, USA
| | - Elaine Johnstone
- Department of Oncology, University of Oxford, Oxford, OX3 7DQ, United Kingdom
| | - Radka P Kaneva
- Department of Medical Chemistry and Biochemistry, Molecular Medicine Center, Medical University-Sofia, 1431, Sofia, Bulgaria
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159, Mannheim, Germany
| | - Henry R Kranzler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ken S Krauter
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, 80309, USA
- Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, CO, 80309, USA
| | - Orna Levran
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, 10065, USA
| | - Susanne Lucae
- Max-Planck-Institute of Psychiatry, 80804, Munich, Germany
| | - Michael T Lynskey
- Addictions Department, Institute of Psychiatry, King's College London, London, SE5 8BB, UK
| | | | - Karl Mann
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159, Mannheim, Germany
| | - Nicholas G Martin
- Department of Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, QLD, 4029, Australia
| | - Manuel Mattheisen
- Department. of Genomics, Life and Brain Center, Institute of Human Genetics, University of Bonn, Bonn, 53127, Germany
- Harvard School of Public Health, Boston, MA, 02115, USA
- Aarhus University, Aarhus, 8000, Denmark
| | - Grant W Montgomery
- Department of Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, QLD, 4029, Australia
| | | | - Michael F Murphy
- Childhood Cancer Research Group, University of Oxford, Oxford, OX3 7LG, UK
| | - Michael C Neale
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Momchil A Nikolov
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
- Department of Medical Chemistry and Biochemistry, Molecular Medicine Center, Medical University-Sofia, 1431, Sofia, Bulgaria
| | - Denise Nishita
- Center for Health Sciences, Biosciences Division, SRI International, Menlo Park, CA, 94025, USA
| | - Markus M Nöthen
- Department. of Genomics, Life and Brain Center, Institute of Human Genetics, University of Bonn, Bonn, 53127, Germany
| | - John Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Timo Partonen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Michele L Pergadia
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Maureen Reynolds
- Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Monika Ridinger
- Department of Psychiatry, University Medical Center Regensburg, University of Regensburg, 8548, Regensburg, Germany
- Psychiatric Hospital, Konigsfelden, Windisch, Switzerland
| | - Richard J Rose
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, 47405, USA
| | - Noora Rouvinen-Lagerström
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Norbert Scherbaum
- Addiction Research Group at the Department of Psychiatry and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Christine Schmäl
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159, Mannheim, Germany
| | - Michael Soyka
- Department of Psychiatry, University of Munich, 3860, Munich, Germany
- Private Hospital Meiringen, Meiringen, Switzerland
| | - Michael C Stallings
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, 80309, USA
- Department of Psychology & Neuroscience, University of Colorado, Boulder, CO, 80309, USA
| | - Michael Steffens
- Research Department, Federal Institute for Drugs and Medical Devices (BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Germany
| | - Jens Treutlein
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159, Mannheim, Germany
| | - Ming Tsuang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Tamara L Wall
- Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA
| | - Norbert Wodarz
- Department of Psychiatry, University Medical Center Regensburg, University of Regensburg, 8548, Regensburg, Germany
| | - Vadim Yuferov
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, 10065, USA
| | | | - Andrew W Bergen
- Center for Health Sciences, Biosciences Division, SRI International, Menlo Park, CA, 94025, USA
| | - Jingchun Chen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Paul M Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Marissa A Ehringer
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, 80309, USA
- Department of Integrative Physiology, University of Colorado, Boulder, CO, 80309, USA
| | - Robert E Ferrell
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale University, New Haven, CT, 06516, USA
- Department of Genetics, Yale University, New Haven, CT, 06516, USA
- Department of Neurobiology, Yale University, New Haven, CT, 06516, USA
| | - David Goldman
- Section of Human Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - John K Hewitt
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, 80309, USA
- Department of Psychology & Neuroscience, University of Colorado, Boulder, CO, 80309, USA
| | - Christian J Hopfer
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - William G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Jaakko Kaprio
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, 00271, Finland
- Department of Public Health, University of Helsinki, Helsinki, 00014, Finland
- Institute for Molecular Medicine FIMM, University of Helsinki, 00014, Helsinki, Finland
| | - Mary Jeanne Kreek
- Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, 10065, USA
| | - Ivo M Kremensky
- Department of Medical Chemistry and Biochemistry, Molecular Medicine Center, Medical University-Sofia, 1431, Sofia, Bulgaria
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit, UK Centre for Tobacco and Alcohol Studies, and School of Experimental Psychology, University of Bristol, Bristol, BS8 1TU, UK
| | | | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159, Mannheim, Germany
| | - Alec Roy
- Psychiatry Service, Department of Veteran Affairs, New Jersey VA Health Care System, East Orange, NJ, 07018, USA
| | - Dan Rujescu
- Department of Psychiatry, Universitätsklinikum Halle (Saale), 06112, Halle (Saale), Germany
| | - Sirkku T Saarikoski
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Gary E Swan
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - Alexandre A Todorov
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Michael M Vanyukov
- Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Robert B Weiss
- Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8232, St. Louis, MO, 63110, USA.
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12
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Melroy-Greif WE, Stitzel JA, Ehringer MA. Nicotinic acetylcholine receptors: upregulation, age-related effects and associations with drug use. GENES, BRAIN, AND BEHAVIOR 2016; 15:89-107. [PMID: 26351737 PMCID: PMC4780670 DOI: 10.1111/gbb.12251] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 12/16/2022]
Abstract
Nicotinic acetylcholine receptors are ligand-gated ion channels that exogenously bind nicotine. Nicotine produces rewarding effects by interacting with these receptors in the brain's reward system. Unlike other receptors, chronic stimulation by an agonist induces an upregulation of receptor number that is not due to increased gene expression in adults; while upregulation also occurs during development and adolescence there have been some opposing findings regarding a change in corresponding gene expression. These receptors have also been well studied with regard to human genetic associations and, based on evidence suggesting shared genetic liabilities between substance use disorders, numerous studies have pointed to a role for this system in comorbid drug use. This review will focus on upregulation of these receptors in adulthood, adolescence and development, as well as the findings from human genetic association studies which point to different roles for these receptors in risk for initiation and continuation of drug use.
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Affiliation(s)
- Whitney E. Melroy-Greif
- Department of Molecular and Cellular Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Jerry A. Stitzel
- Institute for Behavioral Genetics, University of Colorado Boulder, CO, USA
- Department of Integrative Physiology, University of Colorado Boulder, CO, USA
| | - Marissa A. Ehringer
- Institute for Behavioral Genetics, University of Colorado Boulder, CO, USA
- Department of Integrative Physiology, University of Colorado Boulder, CO, USA
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13
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Hancock DB, Reginsson GW, Gaddis NC, Chen X, Saccone NL, Lutz SM, Qaiser B, Sherva R, Steinberg S, Zink F, Stacey SN, Glasheen C, Chen J, Gu F, Frederiksen BN, Loukola A, Gudbjartsson DF, Brüske I, Landi MT, Bickeböller H, Madden P, Farrer L, Kaprio J, Kranzler HR, Gelernter J, Baker TB, Kraft P, Amos CI, Caporaso NE, Hokanson JE, Bierut LJ, Thorgeirsson TE, Johnson EO, Stefansson K. Genome-wide meta-analysis reveals common splice site acceptor variant in CHRNA4 associated with nicotine dependence. Transl Psychiatry 2015; 5:e651. [PMID: 26440539 PMCID: PMC4930126 DOI: 10.1038/tp.2015.149] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 08/19/2015] [Indexed: 01/04/2023] Open
Abstract
We conducted a 1000 Genomes-imputed genome-wide association study (GWAS) meta-analysis for nicotine dependence, defined by the Fagerström Test for Nicotine Dependence in 17 074 ever smokers from five European-ancestry samples. We followed up novel variants in 7469 ever smokers from five independent European-ancestry samples. We identified genome-wide significant association in the alpha-4 nicotinic receptor subunit (CHRNA4) gene on chromosome 20q13: lowest P=8.0 × 10(-9) across all the samples for rs2273500-C (frequency=0.15; odds ratio=1.12 and 95% confidence interval=1.08-1.17 for severe vs mild dependence). rs2273500-C, a splice site acceptor variant resulting in an alternate CHRNA4 transcript predicted to be targeted for nonsense-mediated decay, was associated with decreased CHRNA4 expression in physiologically normal human brains (lowest P=7.3 × 10(-4)). Importantly, rs2273500-C was associated with increased lung cancer risk (N=28 998, odds ratio=1.06 and 95% confidence interval=1.00-1.12), likely through its effect on smoking, as rs2273500-C was no longer associated with lung cancer after adjustment for smoking. Using criteria for smoking behavior that encompass more than the single 'cigarettes per day' item, we identified a common CHRNA4 variant with important regulatory properties that contributes to nicotine dependence and smoking-related consequences.
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Affiliation(s)
- D B Hancock
- Behavioral and Urban Health Program, Behavioral Health and Criminal Justice Research Division, Research Triangle Institute International, Research Triangle Park, NC, USA,Behavioral and Urban Health Program, Behavioral Health and Criminal Justice Research Division, Research Triangle Institute International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA. E-mail:
| | | | - N C Gaddis
- Research Computing Division, Research Triangle Institute International, Research Triangle Park, NC, USA
| | - X Chen
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA,Nevada Institute of Personalized Medicine and Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - N L Saccone
- Department of Genetics, Washington University in St. Louis, St. Louis, MO, USA
| | - S M Lutz
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - B Qaiser
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - R Sherva
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | | | - F Zink
- deCODE Genetics/Amgen, Reykjavik, Iceland
| | - S N Stacey
- deCODE Genetics/Amgen, Reykjavik, Iceland
| | - C Glasheen
- Behavioral and Urban Health Program, Behavioral Health and Criminal Justice Research Division, Research Triangle Institute International, Research Triangle Park, NC, USA
| | - J Chen
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - F Gu
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, USA
| | | | - A Loukola
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - I Brüske
- Institute of Epidemiology I, German Research Center for Environmental Health, Neuherberg, Germany
| | - M T Landi
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, USA
| | - H Bickeböller
- Department of Genetic Epidemiology, University of Göttingen—Georg-August University Göttingen, Göttingen, Germany
| | - P Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - L Farrer
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA,Department of Neurology, Boston University School of Medicine, Boston, MA, USA,Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA,Department of Genetics and Genomics, Boston University School of Medicine, Boston, MA, USA,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - J Kaprio
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland,National Institute for Health and Welfare, Helsinki, Finland,Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - H R Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA,VISN 4 Mental Illness Research, Education and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - J Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Genetics, Yale University School of Medicine, New Haven, CT, USA,Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA,VA CT Healthcare Center, Department of Psychiatry, West Haven, CT, USA
| | - T B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin, Madison, WI, USA
| | - P Kraft
- Department of Epidemiology, Harvard University School of Public Health, Boston, MA, USA,Department of Biostatistics, Harvard University School of Public Health, Boston, MA, USA
| | - C I Amos
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA,Department of Genetics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA,Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanoven, NH, USA
| | - N E Caporaso
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, USA
| | - J E Hokanson
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - L J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - E O Johnson
- Fellow Program and Behavioral Health and Criminal Justice Research Division, Research Triangle Institute International, Research Triangle Park, NC, USA
| | - K Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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14
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Eggert M, Winterer G, Wanischeck M, Hoda JC, Bertrand D, Steinlein O. The nicotinic acetylcholine receptor alpha 4 subunit contains a functionally relevant SNP Haplotype. BMC Genet 2015; 16:46. [PMID: 25934188 PMCID: PMC4417232 DOI: 10.1186/s12863-015-0204-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-coding single nucleotide polymorphisms within the nicotinic acetylcholine receptor alpha 4 subunit gene (CHRNA4) are robustly associated with various neurological and behavioral phenotypes including schizophrenia, cognition and smoking. The most commonly associated polymorphisms are located in exon 5 and segregate as part of a haplotype. So far it is unknown if this haplotype is indeed functional, or if the observed associations are an indirect effect caused by linkage disequilibrium with not yet identified adjacent functional variants. We therefore analyzed the functional relevance of the exon 5 haplotype alleles. RESULTS Using voltage clamp experiments we were able to show that the CHRNA4 haplotype alleles differ with respect to their functional effects on receptor sensitivity including reversal of receptor sensitivity between low and high acetylcholine concentrations. The results indicate that underlying mechanisms might include differences in codon usage bias and changes in mRNA stability. CONCLUSIONS Our data demonstrate that the complementary alleles of the CHRNA4 exon 5 haplotype are functionally relevant, and might therefore be causative for the above mentioned associations.
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Affiliation(s)
- Marlene Eggert
- Marlene Eggert, Institute of Human Genetics, Ludwig-Maximilians-University Hospital, 80336, Munich, Germany.
| | - Georg Winterer
- Georg Winterer, Experimental and Clinical Research Center (ECRC), Charité - University Medicine Berlin, Berlin, Germany.
| | - Mario Wanischeck
- Mario Wanischeck, Institute of Human Genetics, Ludwig-Maximilians-University Hospital, 80336, Munich, Germany.
| | - Jean-Charles Hoda
- Jean-Charles Hoda, SwissCheckUp SA, 1400, Yverdon-Les-Bains, Switzerland.
| | - Daniel Bertrand
- Daniel Bertrand, HiQScreen, 1222, Vésenaz, Geneva, Switzerland.
| | - Ortrud Steinlein
- Ortrud K Steinlein, Institute of Human Genetics, Ludwig-Maximilians-University Hospital, 80336, Munich, Germany.
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15
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Rocha Santos J, Tomaz PRX, Issa JS, Abe TO, Krieger JE, Pereira AC, Santos PCJL. CHRNA4 rs1044396 is associated with smoking cessation in varenicline therapy. Front Genet 2015; 6:46. [PMID: 25774163 PMCID: PMC4343187 DOI: 10.3389/fgene.2015.00046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 01/30/2015] [Indexed: 11/13/2022] Open
Abstract
Background: The large individual variability in response to drugs for smoking cessation suggests that specific treatments can be more effective in particular subgroups of smokers. In the context of personalized medicine, the main aim of the present study was to evaluate whether the CHRNA4 and CHRNB2 polymorphisms are associated with response to smoking cessation therapies in patients from a smoker assistance program. Methods: This cohort study enrolled 483 smoking patients who received behavioral counseling and drug treatment (varenicline, bupropion, and/or nicotine replacement therapy). Smoking cessation success was considered for patients who completed 6 months of continuous abstinence. Fagerström test for nicotine dependence (FTND) and Issa situational smoking scores were analyzed for nicotine dependence. The CHRNA4 (rs1044396 and rs2236196) and CHRNB2 (rs2072660 and rs2072661) polymorphisms were genotyped by high resolution melting analysis. Results: Patients with rs1044396 CC genotype had lower success rate in treatment with varenicline (29.5%) compared with carriers of CT or TT genotypes (50.9%; p = 0.007, n = 167). The CT or TT genotypes were associated with higher odds ratio for success (OR = 1.67, 95% CI = 1.10–2.53, p = 0.02), in a multivariate model. We did not observe significant differences in the FTND and Issa scores according to the studied polymorphisms. Conclusion: The CHRNA4 rs1044396 is associated with smoking cessation in individuals on varenicline therapy. We suggest that this polymorphism influences the varenicline response, but replications of this finding are needed.
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Affiliation(s)
- Juliana Rocha Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of Sao Paulo Medical School São Paulo, Brazil
| | - Paulo R X Tomaz
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of Sao Paulo Medical School São Paulo, Brazil
| | - Jaqueline S Issa
- Smoking Cessation Program Department, Heart Institute, University of Sao Paulo Medical School São Paulo, Brazil
| | - Tânia O Abe
- Smoking Cessation Program Department, Heart Institute, University of Sao Paulo Medical School São Paulo, Brazil
| | - José E Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of Sao Paulo Medical School São Paulo, Brazil
| | - Alexandre C Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of Sao Paulo Medical School São Paulo, Brazil
| | - Paulo C J L Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute, University of Sao Paulo Medical School São Paulo, Brazil
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16
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Brunzell DH, Stafford AM, Dixon CI. Nicotinic receptor contributions to smoking: insights from human studies and animal models. CURRENT ADDICTION REPORTS 2015; 2:33-46. [PMID: 26301171 DOI: 10.1007/s40429-015-0042-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
It is becoming increasingly evident that a variety of factors contribute to smoking behavior. Nicotine is a constituent of tobacco smoke that exerts its psychoactive effects via binding to nicotinic acetylcholine receptors (nAChRs) in brain. Human genetic studies have identified polymorphisms in nAChR genes, which predict vulnerability to risk for tobacco dependence. In vitro studies and animal models have identified the functional relevance of specific polymorphisms. Together with animal behavioral models, which parse behaviors believed to contribute to tobacco use in humans, these studies demonstrate that nicotine action at a diversity of nAChRs is important for expression of independent behavioral phenotypes, which support smoking behavior.
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Affiliation(s)
- Darlene H Brunzell
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA
| | - Alexandra M Stafford
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA
| | - Claire I Dixon
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA
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Rahman S, Engleman EA, Bell RL. Nicotinic receptor modulation to treat alcohol and drug dependence. Front Neurosci 2015; 8:426. [PMID: 25642160 PMCID: PMC4295535 DOI: 10.3389/fnins.2014.00426] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 12/04/2014] [Indexed: 01/10/2023] Open
Abstract
Alcohol and drug dependence are serious public health problems worldwide. The prevalence of alcohol and drug dependence in the United States and other parts of the world is significant. Given the limitations in the efficacy of current pharmacotherapies to treat these disorders, research in developing alternative pharmacotherapies continues. Preclinical and clinical evidence thus far has indicated that brain nicotinic acetylcholine receptors (nAChRs) are important pharmacological targets for the development of medications to treat alcohol and drug dependence. The nAChRs are a super family of ligand gated ion channels, and are expressed throughout the brain with twelve neuronal nAChR subunits (α2–α10 and β2–β4) identified. Here, we review preclinical and clinical evidence involving a number of nAChR ligands that target different nAChR subtypes in alcohol and nicotine addiction. The important ligands include cytisine, lobeline, mecamylamine, varenicline, sazetidine A and others that target α4β2* nAChR subtypes as small molecule modulators of the brain nicotinic cholinergic system are also discussed. Taken together, both preclinical and clinical data exist that support nAChR–based ligands as promising therapeutic agents for the treatment of alcohol and drug dependence.
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Affiliation(s)
- Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University Brookings, SD, USA
| | - Eric A Engleman
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine Indianapolis, IN, USA
| | - Richard L Bell
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine Indianapolis, IN, USA
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Rahman S, Engleman EA, Bell RL. Nicotinic receptor modulation to treat alcohol and drug dependence. Front Neurosci 2015. [DOI: https://doi.org/10.3389/fnins.2014.00426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Vandenbergh DJ, Schlomer GL. Finding genomic function for genetic associations in nicotine addiction research: the ENCODE project's role in future pharmacogenomic analysis. Pharmacol Biochem Behav 2014; 123:34-44. [PMID: 24486638 PMCID: PMC4117825 DOI: 10.1016/j.pbb.2014.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 01/17/2014] [Accepted: 01/22/2014] [Indexed: 11/16/2022]
Abstract
Tobacco-related behaviors and the underlying addiction to nicotine are complex tangles of genetic and environmental factors. Efforts to understand the genetic component of these traits have identified sites in the genome (single nucleotide polymorphisms, or SNPs) that might account for some part of the role of genetics in nicotine addiction. Encouragingly, some of these candidate SNPs remain significant in meta-analyses. However, genetic associations cannot be fully assessed, regardless of statistical significance, without an understanding of the functional consequences of the alleles present at these SNPs. The proper experimental test for allelic function can be very difficult to define, representing a roadblock in translating genetic results into treatment to prevent smoking and other nicotine-related behaviors. This roadblock can be navigated in part with a new web-based tool, the Encyclopedia of DNA Elements (ENCODE). ENCODE is a compilation of searchable data on several types of biochemical functions or "marks" across the genome. These data can be queried for the co-localization of a candidate SNP and a biochemical mark. The presence of a SNP within a marked region of DNA enables the generation of better-informed hypotheses to test possible functional roles of alleles at a candidate SNP. Two examples of such co-localizations are presented. One example reveals ENCODE's ability to relate a candidate SNP's function with a gene very far from the physical location of the SNP. The second example reveals a new potential function of the SNP, rs4105144, that has been genetically associated with the number of cigarettes smoked per day. Details for accessing the ENCODE data for this SNP are provided to serve as a tutorial. By serving as a bridge between genetic associations and biochemical function, ENCODE has the power to propel progress in untangling the genetic aspects of nicotine addiction - a major public health concern.
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Affiliation(s)
- David J Vandenbergh
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, USA; Penn State Institute of the Neurosciences, 101 Life Sciences Building, University Park, PA 16802, USA.
| | - Gabriel L Schlomer
- Department of Human Development and Family Studies, The Pennsylvania State University, 315 Health and Human Development, East, University Park, PA 16802, USA.
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Melroy WE, Stephens SH, Sakai JT, Kamens HM, McQueen MB, Corley RP, Stallings MC, Hopfer CJ, Krauter KS, Brown SA, Hewitt JK, Ehringer MA. Examination of genetic variation in GABRA2 with conduct disorder and alcohol abuse and dependence in a longitudinal study. Behav Genet 2014; 44:356-67. [PMID: 24687270 DOI: 10.1007/s10519-014-9653-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 03/15/2014] [Indexed: 02/06/2023]
Abstract
Previous studies have shown associations between single nucleotide polymorphisms (SNPs) in gamma aminobutyric acid receptor alpha 2 (GABRA2) and adolescent conduct disorder (CD) and alcohol dependence in adulthood, but not adolescent alcohol dependence. The present study was intended as a replication and extension of this work, focusing on adolescent CD, adolescent alcohol abuse and dependence (AAD), and adult AAD. Family based association tests were run using Hispanics and non-Hispanic European American subjects from two independent longitudinal samples. Although the analysis provided nominal support for an association with rs9291283 and AAD in adulthood and CD in adolescence, the current study failed to replicate previous associations between two well replicated GABRA2 SNPs and CD and alcohol dependence. Overall, these results emphasize the utility of including an independent replication sample in the study design, so that the results from an individual sample can be weighted in the context of its reproducibility.
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Affiliation(s)
- Whitney E Melroy
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO, USA
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Coon H, Piasecki TM, Cook EH, Dunn D, Mermelstein RJ, Weiss RB, Cannon DS. Association of the CHRNA4 neuronal nicotinic receptor subunit gene with frequency of binge drinking in young adults. Alcohol Clin Exp Res 2014; 38:930-7. [PMID: 24428733 PMCID: PMC3984345 DOI: 10.1111/acer.12319] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/14/2013] [Indexed: 01/24/2023]
Abstract
Background Binge drinking is responsible for over half of all alcohol‐related deaths and results in significant health and economic costs to individuals and society. Knowledge of genetic aspects of this behavior, particularly as it emerges in young adulthood, could lead to improved treatment and prevention programs. Methods We have focused on the association of variation in neuronal nicotinic receptor subunit genes (CHRNs) in a cohort of 702 Hispanic and non‐Hispanic White young adults who are part of the Social and Emotional Contexts of Adolescent Smoking Patterns (SECASP) study. Fifty‐five single nucleotide polymorphisms (SNPs) covering the variation in 5 CHRNs (CHRNA4,CHRNB2,CHRNA2, CHRNB3A6, and CHRNA5A3B4) were studied. Results Frequency of binge drinking and other correlated alcohol consumption measures were significantly associated with SNPs in CHRNA4 (p‐values ranged from 0.0003 to 0.02), but not with SNPs in other CHRNs. This association was independent of smoking status in our cohort. Conclusions Variants in CHRNA4 may contribute to risk of binge drinking in young adults in this cohort. Results will need to be confirmed in independent samples.
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Affiliation(s)
- Hilary Coon
- Department of Psychiatry , University of Utah School of Medicine, Salt Lake City, Utah
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McClure-Begley TD, Papke RL, Stone KL, Stokes C, Levy AD, Gelernter J, Xie P, Lindstrom J, Picciotto MR. Rare human nicotinic acetylcholine receptor α4 subunit (CHRNA4) variants affect expression and function of high-affinity nicotinic acetylcholine receptors. J Pharmacol Exp Ther 2014; 348:410-20. [PMID: 24385388 DOI: 10.1124/jpet.113.209767] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Nicotine, the primary psychoactive component in tobacco smoke, produces its behavioral effects through interactions with neuronal nicotinic acetylcholine receptors (nAChRs). α4β2 nAChRs are the most abundant in mammalian brain, and converging evidence shows that this subtype mediates the rewarding and reinforcing effects of nicotine. A number of rare variants in the CHRNA4 gene that encode the α4 nAChR subunit have been identified in human subjects and appear to be underrepresented in a cohort of smokers. We compared three of these variants (α4R336C, α4P451L, and α4R487Q) to the common variant to determine their effects on α4β2 nAChR pharmacology. We examined [(3)H]epibatidine binding, interacting proteins, and phosphorylation of the α4 nAChR subunit with liquid chromatography and tandem mass spectrometry (LC-MS/MS) in HEK 293 cells and voltage-clamp electrophysiology in Xenopus laevis oocytes. We observed significant effects of the α4 variants on nAChR expression, subcellular distribution, and sensitivity to nicotine-induced receptor upregulation. Proteomic analysis of immunopurified α4β2 nAChRs incorporating the rare variants identified considerable differences in the intracellular interactomes due to these single amino acid substitutions. Electrophysiological characterization in X. laevis oocytes revealed alterations in the functional parameters of activation by nAChR agonists conferred by these α4 rare variants, as well as shifts in receptor function after incubation with nicotine. Taken together, these experiments suggest that genetic variation at CHRNA4 alters the assembly and expression of human α4β2 nAChRs, resulting in receptors that are more sensitive to nicotine exposure than those assembled with the common α4 variant. The changes in nAChR pharmacology could contribute to differences in responses to smoked nicotine in individuals harboring these rare variants.
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Affiliation(s)
- T D McClure-Begley
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (T.D.M.-B., A.D.L., J.G., M.R.P.); Institute for Behavioral Genetics, University of Colorado, Boulder, Boulder, Colorado (T.D.M.-B.); Department of Pharmacology and Therapeutics, University of Florida, Gainesville, Florida (R.L.P., C.S.); W.M. Keck Biotechnology Research Laboratory (K.S.), Interdepartmental Neuroscience Program (A.D.L., M.R.P.), Department of Genetics (J.G., P.X.), and Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut (M.R.P.); Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut (J.G.); Center for Human Genome Variation, Duke University, Durham, North Carolina (P.X.); and Department of Neuroscience, Medical School of the University of Pennsylvania, Philadelphia, Pennsylvania (J.L.)
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