MicroRNAs as a target for novel antipsychotics: a systematic review of an emerging field

The psychotic disorders of schizophrenia and bipolar affective disorder are among the most disabling of all medical conditions. Current drugs used to treat psychosis largely target monoamine receptors. Here we explore the possibility of developing new antipsychotics by targeting specific microRNAs (miRNAs). These are single-stranded RNA molecules, 21-23 nt in length that are not translated into proteins and function as regulatory molecules. A keyword search was performed using Medline, the ISI Web of Knowledge and Scopus for papers published up to June 2009. The search shows that to date studies of miRNAs have been far more abundant in schizophrenia than in bipolar affective disorder and the view that non-protein-coding genes have an important regulatory role with implications for the genetic liability to psychosis is gaining greater acceptance. The most promising miRNAs so far identified include miR-181, miR-346 and miR-195 in schizophrenia and miR-34a and miR-144 in bipolar disorder. It has been argued that miR-219 may be involved in both disorders. miRNAs offer an exciting potential for developing new antipsychotics, although research in the field is at an early stage. It will require a considerable advance in smart technologies to deliver either mimics or antagomirs to the appropriate site of action, but the development of selective small conventional molecules may negate this requirement.

Epigenetics of schizophrenia

Epigenetic regulators of gene expression including DNA cytosine methylation and posttranslational histone modifications could play a role for some of the molecular alterations associated with schizophrenia. For example, in prefrontal cortex of subjects with schizophrenia, abnormal DNA or histone methylation at sites of specific genes and promoters is associated with changes in RNA expression. These findings are of interest from a neurodevelopmental perspective because there is increasing evidence that epigenetic markings for a substantial portion of genes and loci are highly regulated during the first years of life. Furthermore, there is circumstantial evidence that a subset of antipsychotic drugs, including the atypical, Clozapine, interfere with chromatin remodeling mechanisms. Challenges for the field include (1) no clear consensus yet regarding disease-associated changes, (2) the lack of cell-specific chromatin assays which makes it difficult to ascribe epigenetic alterations to specific cell populations, and (3) lack of knowledge about the stability or turnover of epigenetic markings at specific loci in (brain) chromatin. Despite these shortcomings, the study of DNA and histone modifications in chromatin extracted from diseased and control brain tissue is likely to provide valuable insight into the genomic risk architecture of schizophrenia, particularly in the large majority of cases for which a straightforward genetic cause still remains elusive,

The molecular pathology of schizophrenia--focus on histone and DNA modifications

Dysfunction of cerebral cortex and other brain regions in schizophrenia is often accompanied by dysregulated expression of numerous genes. However, the underlying genetic risk architecture remains unclear for a large majority of cases. Therefore, the study of epigenetic regulators of gene expression, including covalent modifications of DNA and nucleosome core histones, offers an attractive alternative to further explore the molecular pathology of schizophrenia beyond the level of RNA quantification. Several studies reported alterations in DNA cytosine methylation and histone methylation at specific genes and promoters in postmortem brain of subjects with schizophrenia, often in conjunction with changes in levels of the corresponding RNAs. While evidence for such "epigenetic dysregulation" is increasing, many of the reported alterations await independent replication. Interestingly, studies across the lifespan indicate that DNA and histone methylation markings are developmentally regulated in human cerebral cortex, suggesting that at least some of the epigenetic changes in the brain of adult subjects with schizophrenia reflect disordered neurodevelopment.