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Chen F, Dong X, Yu Z, Zhang Y, Shi Y. The brain-heart axis: Integrative analysis of the shared genetic etiology between neuropsychiatric disorders and cardiovascular disease. J Affect Disord 2024; 355:147-156. [PMID: 38518856 DOI: 10.1016/j.jad.2024.03.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Multiple observational studies have reported substantial comorbidity between neuropsychiatric disorders and cardiovascular disease (CVD), but the underlying mechanisms remain largely unknown. METHODS Using GWAS summary datasets of 8 neuropsychiatric disorders and 6 cardiovascular diseases, an integrative analysis incorporating linkage-disequilibrium-score-regression (LDSC), Mendelian randomization (MR), functional mapping and annotation (FUMA), and functional enrichment analysis, was conducted to investigate shared genetic etiology of the brain-heart axis from the whole genome level, single-nucleotide polymorphism (SNP) level, gene level, and biological pathway level. RESULTS In LDSC analysis, 18 pairwise traits between neuropsychiatric disorders and CVD were identified with significant genetic overlaps, revealing extensive genome-wide genetic correlations. In bidirectional MR analysis, 19 pairwise traits were identified with significant causal relationships. Genetic liabilities to neuropsychiatric disorders, particularly attention-deficit hyperactivity disorder and major depressive disorder, conferred extensive significant causal effects on the risk of CVD, while hypertension seemed to be a risk factor for multiple neuropsychiatric disorders, with no significant heterogeneity or pleiotropy. In FUMA analysis, 13 shared independent significant SNPs and 887 overlapping protein-coding genes were detected between neuropsychiatric disorders and CVD. With GO and KEEG functional enrichment analysis, biological pathways of the brain-heart axis were highly concentrated in neurotransmitter synaptic transmission, lipid metabolism, aldosterone synthesis and secretion, glutathione metabolism, and MAPK signaling pathway. CONCLUSION Extensive genetic correlations and genetic overlaps between neuropsychiatric disorders and CVD were identified in this study, which might provide some new insights into the brain-heart axis and the therapeutic targets in clinical practice.
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Affiliation(s)
- Feifan Chen
- Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China.
| | - Xinyu Dong
- Department of Neurosurgery, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
| | - Zhiwei Yu
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China.
| | - Yihan Zhang
- Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China.
| | - Yuan Shi
- Department of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing 400014, China.
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Alver M, Kasela S, Haring L, Luitva LB, Fischer K, Möls M, Milani L. Genetic predisposition and antipsychotic treatment effect on metabolic syndrome in schizophrenia: a ten-year follow-up study using the Estonian Biobank. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100914. [PMID: 38707868 PMCID: PMC11066665 DOI: 10.1016/j.lanepe.2024.100914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/07/2024]
Abstract
Background Schizophrenia (SCZ) patients exhibit 30% higher prevalence of metabolic syndrome (MetS) compared to the general population with its suboptimal management contributing to increased mortality. Large-scale studies providing real-world evidence of the underlying causes remain limited. Methods To address this gap, we used real-world health data from the Estonian Biobank, spanning a median follow-up of ten years, to investigate the impact of genetic predisposition and antipsychotic treatment on the development of MetS in SCZ patients. Specifically, we set out to characterize antipsychotic treatment patterns, genetic predisposition of MetS traits, MetS prognosis, and body mass index (BMI) trajectories, comparing SCZ cases (n = 677) to age- and sex-matched controls (n = 2708). Findings SCZ cases exhibited higher genetic predisposition to SCZ (OR = 1.75, 95% CI 1.58-1.94), but lower polygenic burden for increased BMI (OR = 0.88, 95% CI 0.88-0.96) and C-reactive protein (OR = 0.88, 95% CI 0.81-0.97) compared to controls. While SCZ cases showed worse prognosis of MetS (HR 1.95, 95% CI 1.54-2.46), higher antipsychotic adherence within the first treatment year was associated with reduced long-term MetS incidence. Linear mixed modelling, incorporating multiple BMI timepoints, underscored the significant contribution of both, antipsychotic medication, and genetic predisposition to higher BMI, driving the substantially upward trajectory of BMI in SCZ cases. Interpretation These findings contribute to refining clinical risk prediction and prevention strategies for MetS among SCZ patients and emphasize the significance of incorporating genetic information, long-term patient tracking, and employing diverse perspectives when analyzing real-world health data. Funding EU Horizon 2020, Swedish Research Council, Estonian Research Council, Estonian Ministry of Education and Research, University of Tartu.
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Affiliation(s)
- Maris Alver
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Riia 23b, Tartu, 51010, Estonia
| | - Silva Kasela
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Riia 23b, Tartu, 51010, Estonia
| | - Liina Haring
- Department of Psychiatry, Institute of Clinical Medicine, University of Tartu, Raja 31, Tartu, 50417, Estonia
- Psychiatry Clinic of Tartu University Hospital, Raja 31, Tartu, 50417, Estonia
| | - Laura Birgit Luitva
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Riia 23b, Tartu, 51010, Estonia
| | | | | | - Krista Fischer
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Riia 23b, Tartu, 51010, Estonia
- Institute of Mathematics and Statistics, University of Tartu, Narva mnt 18, Tartu, 51009, Estonia
| | - Märt Möls
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Riia 23b, Tartu, 51010, Estonia
- Institute of Mathematics and Statistics, University of Tartu, Narva mnt 18, Tartu, 51009, Estonia
| | - Lili Milani
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Riia 23b, Tartu, 51010, Estonia
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Manchia M, Paribello P, Pisanu C, Congiu D, Antoniades A, Vogazianos P, Tozzi F, Pinna F, Aristodimou A, Caria P, Dettori T, Frau DV, Cocco C, Noli B, Panebianco C, Pazienza V, Carpiniello B, Squassina A. A Pilot Interaction Analysis of Gut Microbiota and Peripheral Markers of Aging in Severe Psychiatric Disorders: A Role for Lachnoclostridium? Int J Mol Sci 2023; 24:17618. [PMID: 38139446 PMCID: PMC10744008 DOI: 10.3390/ijms242417618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Excessive predominance of pathological species in the gut microbiota could increase the production of inflammatory mediators at the gut level and, via modification of the gut-blood barrier, at the systemic level. This pro-inflammatory state could, in turn, increase biological aging that is generally proxied by telomere shortening. In this study, we present findings from a secondary interaction analysis of gut microbiota, aging, and inflammatory marker data from a cohort of patients with different diagnoses of severe mental disorders. We analyzed 15 controls, 35 patients with schizophrenia (SCZ), and 31 patients with major depressive disorder (MDD) recruited among those attending a community mental health center (50 males and 31 females, mean and median age 46.8 and 46.3 years, respectively). We performed 16S rRNA sequencing as well as measurement of telomere length via quantitative fluorescence in situ hybridization and high-sensitivity C-reactive protein. We applied statistical modeling with logistic regression to test for interaction between gut microbiota and these markers. Our results showed statistically significant interactions between telomere length and gut microbiota pointing to the genus Lachnostridium, which remained significantly associated with a reduced likelihood of MDD even after adjustment for a series of covariates. Although exploratory, these findings show that specific gut microbiota signatures overexpressing Lachnoclostridium and interacting with biological aging could modulate the liability for MDD.
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Affiliation(s)
- Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
| | - Claudia Pisanu
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy; (C.P.); (D.C.); (A.S.)
| | - Donatella Congiu
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy; (C.P.); (D.C.); (A.S.)
| | - Athos Antoniades
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Paris Vogazianos
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Federica Tozzi
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Federica Pinna
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
| | - Aristos Aristodimou
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Paola Caria
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (P.C.); (T.D.); (D.V.F.)
| | - Tinuccia Dettori
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (P.C.); (T.D.); (D.V.F.)
| | - Daniela Virginia Frau
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (P.C.); (T.D.); (D.V.F.)
| | - Cristina Cocco
- NEF Laboratory, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (C.C.); (B.N.)
| | - Barbara Noli
- NEF Laboratory, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (C.C.); (B.N.)
| | - Concetta Panebianco
- Gastreonterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (C.P.); (V.P.)
| | - Valerio Pazienza
- Gastreonterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (C.P.); (V.P.)
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
| | - Alessio Squassina
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy; (C.P.); (D.C.); (A.S.)
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Strawbridge RJ, Graham N. Dissecting the Genetic Relationship Between Schizophrenia and Cardiovascular Disease. Am J Psychiatry 2023; 180:785-786. [PMID: 37908093 DOI: 10.1176/appi.ajp.20230714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Affiliation(s)
- Rona J Strawbridge
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK (Strawbridge, Graham); Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institute, Stockholm (Strawbridge)
| | - Nicholas Graham
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK (Strawbridge, Graham); Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institute, Stockholm (Strawbridge)
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Kalin NH. New Insights Into Psychotic Disorders. Am J Psychiatry 2023; 180:779-781. [PMID: 37908098 DOI: 10.1176/appi.ajp.20230755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Affiliation(s)
- Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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