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Hernández-Díaz Y, Genis-Mendoza AD, González-Castro TB, Tovilla-Zárate CA, Juárez-Rojop IE, López-Narváez ML, Nicolini H. Association and Genetic Expression between Genes Involved in HPA Axis and Suicide Behavior: A Systematic Review. Genes (Basel) 2021; 12:1608. [PMID: 34681002 PMCID: PMC8536196 DOI: 10.3390/genes12101608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/02/2021] [Accepted: 10/06/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Suicide behavior (SB) has been highly associated with the response to stress and the hypothalamic-pituitary-adrenal (HPA) axis. The aim of this study was to summarize the results obtained in genetic studies that analyzed the HPA axis-stress pathway and SB through a systematic review. METHODS We performed an online search in PubMed, EBSCO, Web of Science, Scopus, and PsycoInfo databases up to May 2021. We followed the PRISMA guidelines for systematic reviews. We included case-control and expression studies that provided data on mRNA expression and single-nucleotide polymorphisms of genes associated with SB. RESULTS A total of 21,926 individuals participated across 41 studies (not repeats); 34 studies provided data on single-nucleotide polymorphisms in 21,284 participants and 11 studies reported data on mRNA expression in 1034 participants. Ten genes were identified: FKBP5, CRH, CRHBP, CRHR1, CRHR2, NR3C1, NR3C2, SKA2, MC2R, and POMC. CONCLUSIONS Our findings suggest that key stress pathway genes are significantly associated with SB and show potential as biomarkers for SB.
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Affiliation(s)
- Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86205, Tabasco, Mexico; (Y.H.-D.); (T.B.G.-C.)
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico;
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86205, Tabasco, Mexico; (Y.H.-D.); (T.B.G.-C.)
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Tabasco, Mexico
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86150, Tabasco, Mexico;
| | | | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico;
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2
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Hernández-Díaz Y, González-Castro TB, Tovilla-Zárate CA, Juárez-Rojop IE, López-Narváez ML, Pérez-Hernández N, Rodríguez-Pérez JM, Genis-Mendoza AD. Association between polymorphisms of FKBP5 gene and suicide attempt in a Mexican population: A case-control study. Brain Res Bull 2020; 166:37-43. [PMID: 33161050 DOI: 10.1016/j.brainresbull.2020.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 01/07/2023]
Abstract
Five polymorphisms (rs4713916, rs4713902, rs1360780, rs9296158 and rs3800373) of FKBP5 gene were analyzed in a case-control study comprising 423 Mexican individuals (146 individuals with suicide attempt and 277 controls). The SNP's were genotyped using the TaqMan-allelic assay. Genotype and allele frequencies were compared between the two groups, then the association between FKBP5 gene polymorphisms and suicide attempt was analyzed. We found a significant association of rs1360780 T minor allele (All, OR = 1.80, 95 % CI = 1.35-2.41, P = 0.0005; Males, OR = 2.25, 95 % CI = 1.44-3.50, P = 0.0002) as a suicide behavior risk factor. Conversely, rs3800373 C minor allele (All, OR = 0.61, 95 % CI = 0.46-0.83; P = 0.0013; Females, OR = 0.33, 95 % CI = 0.22-0.50; P = 0.0001) and the A-C-T-A-C haplotype (OR = 0.06, 95 % CI = 0.01-0.36; P = 0.002) were significantly associated as protective factors. No association was observed with the other SNP's. Our study suggests that SNP's in FKBP5 gene contribute to suicide behavior pathogenesis.
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Affiliation(s)
- Yazmín Hernández-Díaz
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, Mexico; División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, Mexico.
| | | | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, Mexico.
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, Mexico.
| | | | - Nonanzit Pérez-Hernández
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
| | - José Manuel Rodríguez-Pérez
- Departamento de Biología Molecular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico.
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico.
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3
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Change in FK506 binding protein 5 (FKBP5) methylation over time among preschoolers with adversity. Dev Psychopathol 2018; 29:1627-1634. [PMID: 29162173 DOI: 10.1017/s0954579417001286] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
FK506 binding protein 5 (FKBP5) alters stress response system functioning, and childhood maltreatment is associated with methylation of the FKBP5 gene. Yet it is unknown if maltreatment contributes to change in FKBP5 methylation over time. The current study draws upon a sample of 231 preschoolers, including 123 with child welfare documentation of moderate to severe maltreatment in the past 6 months, to understand if maltreatment contributes to change in FKBP5 methylation over a 6-month period. Review of child protection records and semistructured interviews in the home were used to assess maltreatment and exposure to other contextual stressors, as well as service utilization. Methylation of FKBP5 at two CpG sites in intron 7 was measured from saliva DNA at the time of initial study enrollment, and 6 months following enrollment. Child maltreatment was associated with change in FKBP5 methylation over time, but only when children were exposed to high levels of other contextual stressors. Service utilization was associated with increases in methylation over time, but only among children with the FKPB5 rs1360780 protective CC genotype. Methylation of FKBP5 is sensitive to stress exposure and may be a mechanism linking early adversity to long-term health and developmental outcomes.
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4
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Malhi GS, Outhred T, Das P, Morris G, Hamilton A, Mannie Z. Modeling suicide in bipolar disorders. Bipolar Disord 2018; 20:334-348. [PMID: 29457330 DOI: 10.1111/bdi.12622] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/17/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Suicide is a multicausal human behavior, with devastating and immensely distressing consequences. Its prevalence is estimated to be 20-30 times greater in patients with bipolar disorders than in the general population. The burden of suicide and its high prevalence in bipolar disorders make it imperative that our current understanding be improved to facilitate prediction of suicide and its prevention. In this review, we provide a new perspective on the process of suicide in bipolar disorder, in the form of a novel integrated model that is derived from extant knowledge and recent evidence. METHODS A literature search of articles on suicide in bipolar disorder was conducted in recognized databases such as Scopus, PubMed, and PsycINFO using the keywords "suicide", "suicide in bipolar disorders", "suicide process", "suicide risk", "neurobiology of suicide" and "suicide models". Bibliographies of identified articles were further scrutinized for papers and book chapters of relevance. RESULTS Risk factors for suicide in bipolar disorders are well described, and provide a basis for a framework of epigenetic mechanisms, moderated by neurobiological substrates, neurocognitive functioning, and social inferences within the environment. Relevant models and theories include the diathesis-stress model, the bipolar model of suicide and the ideation-to-action models, the interpersonal theory of suicide, the integrated motivational-volitional model, and the three-step theory. Together, these models provide a basis for the generation of an integrated model that illuminates the suicidal process, from ideation to action. CONCLUSION Suicide is complex, and it is evident that a multidimensional and integrated approach is required to reduce its prevalence. The proposed model exposes and provides access to components of the suicide process that are potentially measurable and may serve as novel and specific therapeutic targets for interventions in the context of bipolar disorder. Thus, this model is useful not only for research purposes, but also for future real-world clinical practice.
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Affiliation(s)
- Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Tim Outhred
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Pritha Das
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Grace Morris
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Amber Hamilton
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Zola Mannie
- Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
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Lutz PE, Mechawar N, Turecki G. Neuropathology of suicide: recent findings and future directions. Mol Psychiatry 2017; 22:1395-1412. [PMID: 28696430 DOI: 10.1038/mp.2017.141] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/21/2017] [Accepted: 05/26/2017] [Indexed: 12/11/2022]
Abstract
Suicide is a major public health concern and a leading cause of death in most societies. Suicidal behaviour is complex and heterogeneous, likely resulting from several causes. It associates with multiple factors, including psychopathology, personality traits, early-life adversity and stressful life events, among others. Over the past decades, studies in fields ranging from neuroanatomy, genetics and molecular psychiatry have led to a model whereby behavioural dysregulation, including suicidal behaviour (SB), develops as a function of biological adaptations in key brain systems. More recently, the unravelling of the unique epigenetic processes that occur in the brain has opened promising avenues in suicide research. The present review explores the various facets of the current knowledge on suicidality and discusses how the rapidly evolving field of neurobehavioural epigenetics may fuel our ability to understand, and potentially prevent, SB.
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Affiliation(s)
- P-E Lutz
- McGill Group for Suicide Studies, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - N Mechawar
- McGill Group for Suicide Studies, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - G Turecki
- McGill Group for Suicide Studies, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada
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6
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Targeted Sequencing of FKBP5 in Suicide Attempters with Bipolar Disorder. PLoS One 2016; 11:e0169158. [PMID: 28030643 PMCID: PMC5193409 DOI: 10.1371/journal.pone.0169158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 12/13/2016] [Indexed: 12/02/2022] Open
Abstract
FKBP5 is a critical component of the Hypothalamic-Pituitary-Adrenal (HPA) axis, a system which regulates our response to stress. It forms part of a complex of chaperones, which inhibits binding of cortisol and glucocorticoid receptor translocation to the nucleus. Variations in both the HPA axis and FKBP5 have been associated with suicidal behavior. We developed a systematic, targeted sequencing approach to investigate coding and regulatory regions in or near FKBP5 in 476 bipolar disorder suicide attempters and 473 bipolar disorder non-attempters. Following stringent quality control checks, we performed single-variant, gene-level and haplotype tests on the resulting 481 variants. Secondary analyses investigated whether sex-specific variations in FKBP5 increased the risk of attempted suicide. One variant, rs141713011, showed an excess of minor alleles in suicide attempters that was statistically significant following correction for multiple testing (Odds Ratio = 6.65, P-value = 7.5 x 10−4, Permuted P-value = 0.038). However, this result could not be replicated in an independent cohort (Odds Ratio = 0.90, P-value = 0.78). Three female-specific and four male-specific variants of nominal significance were also identified (P-value < 0.05). The gene-level and haplotype association tests did not produce any significant results. This comprehensive study of common and rare variants in FKBP5 focused on both regulatory and coding regions in relation to attempted suicide. One rare variant remained significant following correction for multiple testing but could not be replicated. Further investigation is required in larger sample sets to fully elucidate the association of this variant with suicidal behavior.
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7
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Pawlak J, Dmitrzak-Weglarz M, Wilkosc M, Szczepankiewicz A, Leszczynska-Rodziewicz A, Zaremba D, Kapelski P, Rajewska-Rager A, Hauser J. Suicide behavior as a quantitative trait and its genetic background. J Affect Disord 2016; 206:241-250. [PMID: 27479537 DOI: 10.1016/j.jad.2016.07.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 07/06/2016] [Accepted: 07/16/2016] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Studies have not given yet a clear answer what is the genetic background of suicidal predisposition. The associations between polymorphisms of the TPH1 and 5-HTTLPR genes and violent suicidal behavior was revealed with the least inconsistencies. METHOD We selected 10 "strong candidate genes" and 35 SNPs, SLC6A4 and ACP1 for replication study. We searched associations between precisely described suicidal phenotype in 825 affective patients and polymorphisms of selected neurobiological pathways genes as well as their interactions that constitute suicidal risk. RESULTS The results confirm the role of TPH1, TPH2, 5HT2A, CRHR1 and ACP1 variants in the risk of suicidal behavior. LIMITATIONS In our study we analyzed limited number of candidate genes and only one of them is linked to lithium mechanism of action. We had no data on pharmacological treatment of investigated patients and its relation to the time of suicide attempt. CONCLUSION Our results indicate that polymorphisms of various signaling pathways are involved in the pathogenesis of suicidal behavior. Non-genetic factors are also involved in the risk of suicidal attempts.
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Affiliation(s)
- Joanna Pawlak
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland.
| | - Monika Dmitrzak-Weglarz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Monika Wilkosc
- Department of Individual Differences, Institute of Psychology, University of Bydgoszcz, Poland
| | - Aleksandra Szczepankiewicz
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland; Department of Pediatrics, Laboratory of Molecular and Cell Biology, Poznan University of Medical Sciences, Poland
| | | | - Dorota Zaremba
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | - Pawel Kapelski
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
| | | | - Joanna Hauser
- Psychiatric Genetics Unit, Department of Psychiatry, Poznan University of Medical Sciences, Poland
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8
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Childhood adversity and epigenetic regulation of glucocorticoid signaling genes: Associations in children and adults. Dev Psychopathol 2016; 28:1319-1331. [PMID: 27691985 DOI: 10.1017/s0954579416000870] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Early childhood experiences have lasting effects on development, including the risk for psychiatric disorders. Research examining the biologic underpinnings of these associations has revealed the impact of childhood maltreatment on the physiologic stress response and activity of the hypothalamus-pituitary-adrenal axis. A growing body of literature supports the hypothesis that environmental exposures mediate their biological effects via epigenetic mechanisms. Methylation, which is thought to be the most stable form of epigenetic change, is a likely mechanism by which early life exposures have lasting effects. We present recent evidence related to epigenetic regulation of genes involved in hypothalamus-pituitary-adrenal axis regulation, namely, the glucocorticoid receptor gene (nuclear receptor subfamily 3, group C, member 1 [NR3C1]) and FK506 binding protein 51 gene (FKBP5), after childhood adversity and associations with risk for psychiatric disorders. Implications for the development of interventions and future research are discussed.
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9
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De la Cruz-Cano E. Association between FKBP5 and CRHR1 genes with suicidal behavior: A systematic review. Behav Brain Res 2016; 317:46-61. [PMID: 27638035 DOI: 10.1016/j.bbr.2016.09.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/08/2016] [Accepted: 09/12/2016] [Indexed: 12/26/2022]
Abstract
Suicide is one of the leading causes of death around the world with approximately one million suicides per year. An increasing number of neurobiological studies implicate HPA system dysfunction in suicide behavior, stimulating genetic research to focus on genes related to this system. This systematic review was focused on searching a correlation between FKBP5 and CRHR1 genes with suicidal behavior. Therefore, an electronic search strategy, using PubMed, EBSCO and Cochrane Library databases, was conducted from the inception of the studies into the databases to July 2016. The inclusion criteria were: use of at least one analysis investigating the relation between either the genetic variants in FKBP5 and/or CRHR1 genes with suicidal behavior. 2) use of a case-control design; 3) investigation about suicidal behavior in the form of suicide completion or history of at least one suicide attempt, as defined by each individual study; 4) inclusion of samples comprising control subjects; and 6) inclusion of reports written only in English language. The PRISMA guidelines were followed and the search strategy ensured that all possible studies were identified to compile the review. Using the keyword combinations, the search strategy provided 3334 articles, of which only 15 case-control studies were included in this systematic review. The included studies comprised 2526 subjects with suicidal behavior. A quantitative synthesis of results from the included studies was not undertaken due to marked methodological heterogeneity. This review showed a significant genetic association in most studies in FKBP5 and CRHR1 genes with a high rate of attempted suicide, pointing out that the expression of these genes and its polymorphisms could be a key predictor of suicide risk. In conclusion, this systematic review supports an association between suicidal behavior and genetic variants in FKBP5 and CRHR1 genes.
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Affiliation(s)
- Eduardo De la Cruz-Cano
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, C.P. 86100, Mexico; Secretaría de Salud, Hospital General de Comalcalco, Departamento de Laboratorio de Análisis Clínicos, Comalcalco, Tabasco C.P. 86300, Mexico.
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10
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Fudalej S, Kopera M, Wołyńczyk-Gmaj D, Fudalej M, Krajewski P, Wasilewska K, Szymański K, Chojnicka I, Podgórska A, Wojnar M, Płoski R. Association between FKBP5 Functional Polymorphisms and Completed Suicide. Neuropsychobiology 2016; 72:126-31. [PMID: 26630184 DOI: 10.1159/000441659] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 10/11/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis leads to impaired stress response. FK506-binding protein 51 (FKBP5), which influences HPA axis activity via glucocorticoid receptors, is supposed to play an important role in the regulation of negative feedback and glucocorticoid resistance. Since ineffective stress response mechanisms are considered as a biological background of suicide behavior, we aimed to analyze a possible association between FKBP5 functional polymorphisms and completed suicide. METHODS The selected FKBP5 polymorphisms rs1360780 and rs3800373 were genotyped in a sample of 563 suicide victims and 475 controls. RESULTS A significant association between the high-induction rs3800373 C allele and completed suicide was detected (OR = 1.36, p = 0.007). In this polymorphism, genotype distribution supported a codominant model of inheritance. The analyzed SNPs were in strong linkage disequilibrium (D' = 0.916 and r2 = 0.826) with the rs1360780 (T)-rs3800373 (C) haplotype apparently responsible for the observed association (OR = 1.34, p = 0.010). CONCLUSION The results of the present study indicate that genetic alterations in FKBP5 may influence vulnerability to suicide.
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Affiliation(s)
- Sylwia Fudalej
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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11
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Abstract
A growing body of evidence suggests that alterations of the stress response system may be a mechanism by which childhood maltreatment alters risk for psychopathology. FK506 binding protein 51 (FKBP5) binds to the glucocorticoid receptor and alters its ability to respond to stress signaling. The aim of the present study was to examine methylation of the FKBP5 gene (FKBP5), and the role of an FKBP5 genetic variant, in relation to childhood maltreatment in a sample of impoverished preschool-aged children. One hundred seventy-four families participated in this study, including 69 with child welfare documentation of moderate to severe maltreatment in the past 6 months. The children, who ranged in age from 3 to 5 years, were racially and ethnically diverse. Structured record review and interviews in the home were used to assess a history of maltreatment, other traumas, and contextual life stressors; and a composite variable assessed the number exposures to these adversities. Methylation of two sites in intron 7 of FKBP5 was measured via sodium bisulfite pyrosequencing. Maltreated children had significantly lower levels of methylation at both CpG sites (p < .05). Lifetime contextual stress exposure showed a trend for lower levels of methylation at one of the sites, and a trend for an interaction with the FKBP5 polymorphism. A composite adversity variable was associated with lower levels of methylation at one of the sites as well (p < .05). FKBP5 alters glucocorticoid receptor responsiveness, and FKBP5 gene methylation may be a mechanism of the biobehavioral effects of adverse exposures in young children.
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12
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Buoli M, Caldiroli A, Cumerlato Melter C, Serati M, de Nijs J, Altamura AC. Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review. Psychiatry Clin Neurosci 2016; 70:227-44. [PMID: 26969211 DOI: 10.1111/pcn.12386] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/24/2016] [Accepted: 03/06/2016] [Indexed: 12/23/2022]
Abstract
AIM We carried out a systematic review of the available literature about potential biomarkers of psychotic bipolar disorder (BD-P), a specific subset presenting worse outcome and greater risk of relapse than non-psychotic bipolar disorder (BD-NP). METHODS We searched the main psychiatric databases (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles with the main topic of BD-P compared to schizophrenia/BD-NP/healthy controls (HC) written in English from 1994 to 2015 were included. RESULTS BD-P patients presented higher kynurenic acid levels in the cerebrospinal fluid, elevated anti- S accharomyces cerevisiae antibodies levels, and lower serum levels of dehydroepiandrosterone sulfate and progesterone than BD-NP/HC. Event-related potentials abnormalities have been identified in BD-P with respect to BD-NP. BD-P patients also presented bigger ventricles but similar hippocampal volumes compared to BD-NP/HC. Although the results are contrasting, some cognitive deficits seemed to be related to the psychotic dimension of bipolar affective disorder, such as impairment in verbal/logical memory, working memory, verbal and semantic fluency and executive functioning. Finally, polymorphisms of genes, such as NRG1, 5HTTLPR (s), COMT, DAOA and some chromosome regions (16p12 and 13q), were positively associated with BD-P. CONCLUSION Data about the identification of specific biomarkers for BD-P are promising, but most of them have not yet been replicated. They could lead the clinicians to an early diagnosis and proper treatment, thus ameliorating outcome of BD-P and reducing the biological changes associated with a long duration of illness. Further studies with bigger samples are needed to detect more specific biological markers of the psychotic dimension of bipolar affective disorder.
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Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Cumerlato Melter
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jessica de Nijs
- Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Dalvie S, Fabbri C, Ramesar R, Serretti A, Stein DJ. Glutamatergic and HPA-axis pathway genes in bipolar disorder comorbid with alcohol- and substance use disorders. Metab Brain Dis 2016; 31:183-9. [PMID: 26563126 DOI: 10.1007/s11011-015-9762-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 11/06/2015] [Indexed: 01/13/2023]
Abstract
Glutamatergic neurotransmission has been shown to be dysregulated in bipolar disorder (BD), alcohol use disorder (AUD) and substance use disorder (SUD). Similarly, disruption in the hypothalamic-pituitary-adrenal (HPA)-axis has also been observed in these conditions. BD is often comorbid with AUD and SUD. The effects of the glutamatergic and HPA systems have not been extensively examined in individuals with BD-AUD and BD-SUD comorbidity. The aim of this investigation was to determine whether variants in the glutamatergic pathway and HPA-axis are associated with BD-AUD and BD-SUD comorbidity. The research cohort consisted of 498 individuals with BD type I from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). A subset of the cohort had comorbid current AUD and current SUD. A total of 1935 SNPs from both the glutamatergic and HPA pathways were selected from the STEP-BD genome-wide dataset. To identify population stratification, IBS clustering was performed using the program Plink 1.07. Single SNP association and gene-based association testing were conducted using logistic regression. A pathway analysis of glutamatergic and HPA genes was performed, after imputation using IMPUTE2. No single SNP was associated with BD-AUD or BD-SUD comorbidity after correction for multiple testing. However, from the gene-based analysis, the gene PRKCI was significantly associated with BD-AUD. The pathway analysis provided overall negative findings, although several genes including GRIN2B showed high percentage of associated SNPs for BD-AUD. Even though the glutamatergic and HPA pathways may not be involved in BD-AUD and BD-SUD comorbidity, PRKCI deserves further investigation in BD-AUD.
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Affiliation(s)
- Shareefa Dalvie
- MRC/UCT Human Genetics Research Unit, Division of Human Genetics, University of Cape Town, Observatory, Cape Town, South Africa.
| | - Chiara Fabbri
- Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, Bologna, Italy
| | - Raj Ramesar
- MRC/UCT Human Genetics Research Unit, Division of Human Genetics, University of Cape Town, Observatory, Cape Town, South Africa
| | - Alessandro Serretti
- Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, Bologna, Italy
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Observatory, Cape Town, South Africa
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Investigating the role of early childhood abuse and HPA axis genes in suicide attempters with bipolar disorder. Psychiatr Genet 2015; 25:106-11. [PMID: 25714448 DOI: 10.1097/ypg.0000000000000082] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Genes and the environment both play a major role in the risk for attempted suicide, and environments harboring stressors, such as early childhood abuse, have been linked to suicidal behavior. Such environments also disrupt the hypothalamic-pituitary-adrenal (HPA) axis pathway, which has been hypothesized to play a role in suicidal behavior. We investigated whether the risk for attempted suicide was attributable in part to the interaction between childhood physical and/or sexual abuse and genetic variation in 19 genes (±5 kb) integral to the HPA axis pathway. MATERIALS AND METHODS Using the Genetic Association Information Network Bipolar Disorder and Translational Genomics Research Institute cohorts, we implemented PLINK's logistic regression-based 'interaction' approach to search for evidence of an interaction between 235 genotyped HPA axis single-nucleotide polymorphisms and early childhood abuse. Our study included 631 bipolar disorder suicide attempters and 657 bipolar disorder nonattempters with information on abuse. RESULTS After correction for multiple testing, no significant interaction between the 235 HPA axis single-nucleotide polymorphisms and early childhood abuse was found. In our study, the strongest interaction was found with rs2664008 in the corticotropin-releasing hormone receptor 1 (CRHR1) gene, with a nominal interaction P-value of 1.22×10 and an interaction odds ratio of 0.47. CONCLUSION Our findings suggest that further work and larger sample sizes are required to elucidate the link between early childhood abuse and the HPA axis in suicidal behavior.
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Schaffer A, Isometsä ET, Tondo L, Moreno DH, Sinyor M, Kessing LV, Turecki G, Weizman A, Azorin JM, Ha K, Reis C, Cassidy F, Goldstein T, Rihmer Z, Beautrais A, Chou YH, Diazgranados N, Levitt AJ, Zarate CA, Yatham L. Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder. Aust N Z J Psychiatry 2015; 49:785-802. [PMID: 26185269 PMCID: PMC5116383 DOI: 10.1177/0004867415594427] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Bipolar disorder is associated with elevated risk of suicide attempts and deaths. Key aims of the International Society for Bipolar Disorders Task Force on Suicide included examining the extant literature on epidemiology, neurobiology and pharmacotherapy related to suicide attempts and deaths in bipolar disorder. METHODS Systematic review of studies from 1 January 1980 to 30 May 2014 examining suicide attempts or deaths in bipolar disorder, with a specific focus on the incidence and characterization of suicide attempts and deaths, genetic and non-genetic biological studies and pharmacotherapy studies specific to bipolar disorder. We conducted pooled, weighted analyses of suicide rates. RESULTS The pooled suicide rate in bipolar disorder is 164 per 100,000 person-years (95% confidence interval = [5, 324]). Sex-specific data on suicide rates identified a 1.7:1 ratio in men compared to women. People with bipolar disorder account for 3.4-14% of all suicide deaths, with self-poisoning and hanging being the most common methods. Epidemiological studies report that 23-26% of people with bipolar disorder attempt suicide, with higher rates in clinical samples. There are numerous genetic associations with suicide attempts and deaths in bipolar disorder, but few replication studies. Data on treatment with lithium or anticonvulsants are strongly suggestive for prevention of suicide attempts and deaths, but additional data are required before relative anti-suicide effects can be confirmed. There were limited data on potential anti-suicide effects of treatment with antipsychotics or antidepressants. CONCLUSION This analysis identified a lower estimated suicide rate in bipolar disorder than what was previously published. Understanding the overall risk of suicide deaths and attempts, and the most common methods, are important building blocks to greater awareness and improved interventions for suicide prevention in bipolar disorder. Replication of genetic findings and stronger prospective data on treatment options are required before more decisive conclusions can be made regarding the neurobiology and specific treatment of suicide risk in bipolar disorder.
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Affiliation(s)
- Ayal Schaffer
- Task Force on Suicide, The International Society for Bipolar Disorders (ISBD), Pittsburgh, PA, USA; Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Erkki T Isometsä
- Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
| | - Leonardo Tondo
- Lucio Bini Center, Cagliari, Italy; Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Doris H Moreno
- Section of Psychiatric Epidemiology and Mood Disorders Unit, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Lars Vedel Kessing
- Psychiatric Center Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gustavo Turecki
- Research and Academic Affairs, Department of Psychiatry, McGill University, Montréal, QC, Canada; McGill Group for Suicide Studies, Montréal, QC, Canada; Depressive Disorders Program, Douglas Institute, Montréal, QC, Canada; Departments of Psychiatry, Human Genetics, and Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Abraham Weizman
- Laboratory of Biological Psychiatry, The Felsenstein Medical Research Center, Petah Tikva, Israel; Research Unit, Geha Mental Health Center, Petah Tikva, Israel; Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jean-Michel Azorin
- Department of Adult Psychiatry, Sainte Marguerite Hospital, Marseille, France; University of Aix-Marseille II, Marseille, France
| | - Kyooseob Ha
- Mood Disorders Clinic and Affective Neuroscience Laboratory, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Korea Association for Suicide Prevention, Seoul, Republic of Korea
| | - Catherine Reis
- Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Frederick Cassidy
- Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioural Sciences, Duke University, Durham, NC, USA
| | - Tina Goldstein
- Department of Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Zoltán Rihmer
- Department of Clinical and Theoretical Mental Health, and Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Budapest, Hungary
| | - Annette Beautrais
- Department of Emergency Medicine, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yuan-Hwa Chou
- Section of Psychosomatic Medicine, Department of Psychiatry, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Nancy Diazgranados
- Laboratory of Clinical and Translational Studies, National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Anthony J Levitt
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Carlos A Zarate
- Experimental Therapeutics & Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, Bethesda, MD, USA
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Daskalakis NP, Binder EB. Schizophrenia in the spectrum of gene-stress interactions: the FKBP5 example. Schizophr Bull 2015; 41:323-9. [PMID: 25592294 PMCID: PMC4332957 DOI: 10.1093/schbul/sbu189] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Many studies have demonstrated that genotype (G) interacts with adverse life experiences (E) to produce individual differences in vulnerability and resilience to mental disorders, including schizophrenia. Genetic susceptibility to stress and the timing of the environmental exposure(s) are relevant for these interactions and represent common risk factors. We take the example of the FKBP5 gene to illustrate G × E interactions that predict pleiotropic psychiatric outcomes, including schizophrenia.
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Affiliation(s)
- Nikolaos P. Daskalakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY;,Mental Health Care Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY;,*To whom correspondence should be addressed; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, US; tel: +1-212-241-0250, fax: +1-212-828-4221, e-mail:
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany;,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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17
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Abstract
Suicide ranks among the leading causes of death around the world and takes a heavy emotional and public health toll on most societies. Both distal and proximal factors contribute to suicidal behaviour. Distal factors - such as familial and genetic predisposition, as well as early-life adversity - increase the lifetime risk of suicide. They alter responses to stress and other processes through epigenetic modification of genes and associated changes in gene expression, and through the regulation of emotional and behavioural traits. Proximal factors are associated with the precipitation of a suicidal event and include alterations in key neurotransmitter systems, inflammatory changes and glial dysfunction in the brain. This Review explores the key molecular changes that are associated with suicidality and discusses some promising avenues for future research.
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