Schizophrenia (SCZ) is a severe neuropsychiatric disorder with a genetic component. Most candidate gene association studies have given mixed results. We investigated the GABAA receptor gamma2 subunit gene GABRG2, the dopamine receptor gene DRD3, and the Brain-derived neurotrophic factor gene BDNF that is required for D3 expression by genotyping polymorphisms spanning and surrounding these genes for association with SCZ, as well as suicidal behaviour. We also examined the BDNF, DRD3, as well as the dopamine receptor gene DRD2 and Protein Kinase B gene AKT1 for association with Tardive Dyskinesia (TD), a potentially irreversible motor side effect of long-term antipsychotic medication. Our analysis included single-marker tests, haplotype tests, and gene-gene interactions. We found a haplotype in the 5’ region of GABRG2 to be associated with SCZ in both families and matched case-control samples. We also found two synonymous DRD2 polymorphisms, rs6275 (C939T) and rs6277 (C957T), and their haplotypes, as well as a polymorphism 5’ of DRD3, rs905568, to be associated with TD. Further, we reviewed two putative functional DRD2 polymorphisms, -141C Ins/Del and TaqIA, in TD and found TaqIA 3’ of the gene to be associated with TD in a meta-analysis. Lastly, we found a significant interaction between AKT1 rs3730358 and DRD2 C939T in TD. Though replication studies are required, these results contribute to the future development of genetic tests to assess for the risks of SCZ and TD, leading to better outcome for patients suffering from these debilitating conditions.

Schizophrenia (SCZ) is a severe neuropsychiatric disorder with a genetic component. Most candidate gene association studies have given mixed results. We investigated the GABAA receptor gamma2 subunit gene GABRG2, the dopamine receptor gene DRD3, and the Brain-derived neurotrophic factor gene BDNF that is required for D3 expression by genotyping polymorphisms spanning and surrounding these genes for association with SCZ, as well as suicidal behaviour. We also examined the BDNF, DRD3, as well as the dopamine receptor gene DRD2 and Protein Kinase B gene AKT1 for association with Tardive Dyskinesia (TD), a potentially irreversible motor side effect of long-term antipsychotic medication. Our analysis included single-marker tests, haplotype tests, and gene-gene interactions. We found a haplotype in the 5’ region of GABRG2 to be associated with SCZ in both families and matched case-control samples. We also found two synonymous DRD2 polymorphisms, rs6275 (C939T) and rs6277 (C957T), and their haplotypes, as well as a polymorphism 5’ of DRD3, rs905568, to be associated with TD. Further, we reviewed two putative functional DRD2 polymorphisms, -141C Ins/Del and TaqIA, in TD and found TaqIA 3’ of the gene to be associated with TD in a meta-analysis. Lastly, we found a significant interaction between AKT1 rs3730358 and DRD2 C939T in TD. Though replication studies are required, these results contribute to the future development of genetic tests to assess for the risks of SCZ and TD, leading to better outcome for patients suffering from these debilitating conditions.

Schizophrenia demonstrates high heritability in part accounted for by common simple nucleotide variants (SNV), rare copy number variants (CNV) and, most recently, rare SNVs Although heritability explained by rare SNVs and CNVs is small compared to that explained by common SNVs, rare SNVs in functional sequences may identify specific disease mechanisms. However, current exome methods do not capture a large proportion of potentially functional bases where rare variation may impact disease risk: as much as two-thirds of conserved sequences lie outside the exome in non-coding regions of cross-species evolutionary constraint. We reasoned that the candidate loci from the Psychiatric Genomics Consortium Phase 1 (PGC-1) schizophrenia study represent good target loci to test for the impact of rare SNVs in non-coding constrained regions. We developed custom reagents to capture mammalian constrained non-coding regions, exons, and 5’- and 3’-untranslated regions (UTRs) in the 12 PGC-1 loci for pooled sequencing in 912 cases and 936 controls. Compared to our coding targets, our noncoding targets contain substantially more highly conserved bases (46,412 vs. 31,609) and variants (390 vs. 193). Using C-alpha to detect excess variance due to aggregate risk increasing or decreasing rare SNV effects, we identified signals attributable to alleles with MAF < 0.1% in both coding sequences and in functional non-coding sequences, including variants within ENCODE transcription factor binding sites, DNase hypersensitive regions, and histone modification sites in neuronal cell lines. We also observed significant excess risk-altering variation in the CUB domain of CSMD1, a gene expressed in the developing central nervous system. These results support the hypothesis that common and rare variants in the same loci contribute to schizophrenia risk, but highlight the need to expand capture strategies in order to detect trait-relevant sequence variation in a broader set of functional sequences.

Environmental and genetic factors contribute to the development of schizophrenia. For example, epidemiological evidence has linked infections during pregnancy with increased incidence of schizophrenia in the adult offspring. At the same time mutation to DISC1, a protein involved in neurone migration and synaptic plasticity, is an important genetic risk for the disorder. Accordingly, the aim of this project was to determine if these environmental and genetic influences converge along a common pathogenic pathway leading to schizophrenia. Using a model of prenatal infection by bacterial endotoxin in rodents, we demonstrated a 50% reduction in DISC1 protein expression in the hippocampus and cortex of juvenile offspring. In addition, we found a significant induction of prostaglandins (final mediators of the inflammatory process) in the fetal brain while many cytokines remained unaltered. Taken together our results identify prostaglandins as potential mediators of the teratogenic effects of prenatal infection and show that prenatal infection itself can affect systems related to genetic risk factors for schizophrenia, in this case DISC1.

No description available.

Os estudos de alto risco com descendentes de indivíduos portadores de psicoses fornecem uma oportunidade para estudar possíveis características fenotípicas e genéticas que podem estar envolvidas no desenvolvimento destes transtornos. Até o momento as pesquisas sobre a influência da vulnerabilidade genética e o ambiente sobre o comportamento das crianças de risco são escassos e inconclusivos. Objetivo: Revisão dos principais estudos genético-epidemiolólogicos e dos principais achados dos estudos de alto risco para psicose funcional. Revisão dos estudos genético-moleculares dos polimorfismos Ser9Gly (rs6280), VNTRDAT1 (NM_001044.3), Val66Met (rs6265) e 5HTTLPR (- X76753) e estudo de associação destes polimorfismos em mães portadoras de psicose funcional e em seus respectivos filhos. A distribuição destes polimorfismos em quatro características clínicas nos filhos (Síndrome Ansiedade/depressão e Retraimento/depressão do CBCL, atraso escolar e déficit intelectual) foi o objetivo secundário. Métodos: Sujeitos-Mães com esquizofrenia e transtorno afetivo bipolar atendidas no Instituto Psiquiatria do IPq-HCFMUSP e atendidas na Clínica de Ginecologia da mesma Universidade foram convidadas a participar.Para cada mãe, 1 filho foi escolhido, estratificando-se para gênero e idade (6-18 anos). Os entrevistadores eram cegos e aplicaram nas mães SCID (Entrevista Clínica Estruturada para DSM-IV) e GAF (Avaliação Global de Funcionamento) e nas crianças CBCL (Child Behavior Checklist) (Achenbach, 1983) e WASI (Wechsler Abbreviated Scale of Intelligence). Foi avaliado nível socioeconômico baseado em um instrumento utilizado em estudos de populacionais brasileiros (ANEP). As freqüências de polimorfismos da mães foi feita comparando-as segundo o diagnóstico psiquiátrico (Esquizofrenia, Transtorno Afetivo Bipolar e Controles). A análise das características das crianças foi realizado inicialmente segundo o diagnóstico da materno e posteriormente de acordo com possíveis síndromes clínicas que estas crianças apresentaram. A análise de dados foi executada pelo Programa Estatístico SPSS 15.0. Os grupos foram comparados de acordo com características através de Chi-quadrado de Pearson ou do Teste Exato de Fisher, adotando-se valor de significância de 0.05. RESULTADOS: 167 mães (58 com esquizofrenia, 47 com transtorno afetivo bipolar e 62 controles) e seus filhos participaram. Não se observaram diferenças significantes nos alelos e genótipos dos polimorfismos do Ser9Gly, VNTR-DAT1, Val66Met e 5HTTLPR. Houve diferença na freqüência das Síndromes Retraimento/depressão e Ansiedade/depressão no grupo de filhos de mães portadoras de TAB, porém sem associação com os polimorfismos estudados. Uma tendência de associação foi detectada entre homozigose ser9gly e prejuízo mental (p = 0,09) e uma associação entre homozigose 9 e 10 do VNTR-DAT1- (p=0,03) e Síndrome Ansiedade/Depressão nas crianças independente da diagnóstico da materno. CONCLUSÃO: Apesar da limitação do tamanho da amostra, nossos resultados apóiam a viabilidade metodológica dos estudos de risco alto para analise em genética molecular. Futuramente pretende-se explorar os dados encontrados com o aumento da amostra e com a introdução de novas variáveis advindas do segmento desta população. / The high-risk studies involving offspring of parents who developed psychoses provide the opportunity to clarify quantitative trait loci that may underlie liability traits. Until now, the research about the influence of genetic vulnerability and environmental factors on child behavior is scarce and inconclusive. Objective: In this research a review of the findings of previous HR studies in functional psychoses, the analyze polymorphisms distribution of the genes DRD3 (Ser9Gly - rs6280), DAT1 (VNTR-Variable Number of Tandem Repeats - NM_001044.3), BDNF (Val66Metrs6265) and serotonin transporter (5HTTLPR - X76753.2) among functional psychoses women and their offspring and polymorphisms distribution in four clinical characteristics among the offspring (Anxious/Depressed and Withdrawn/Depressed syndromes from CBCL, school delay and low intelligence coefficient) was done. Methods: Outpatient mothers with schizophrenia and bipolar referred from the Psychiatric Institute in Sao Paulo and outpatient mothers referred from the Gynecologic Clinic of the same university. For each mother, one offspring was chosen and stratified by gender and age (6-18 y.o.). Blinded interviewers applied the SCID (Structured Clinical Interview for DSM-IV) and Global Assessment of Functioning Scale (GAF) to the mothers, the Child Behavior Checklist (CBCL) (Achenbach, 1983) and WASI (Wechsler Abbreviated Scale of Intelligence) to the children. Socioeconomic status was evaluated based on a Brazilian standardized instrument used in population studies (ANEP). The polymorphisms distribution among mothers was done comparing the diagnoses (Controls, Bipolar Disorder and Schizophrenia). The analysis of the offspring characteristics was initially done according to mother s diagnosis and later according to likely clinical syndromes these children showed. Data analysis was performed with the Statistical Program for Social Sciences (SPSS - 15.0). The groups were compared according to characteristics using Pearson s Chi-square or Fisher s Exact Test adopting significance value of 0.05. RESULTS: 167 mothers (58 with schizophrenia, 47 with bipolar disorder and 62 controls) participated. No significant difference was observed in the allelic and genotype frequencies in the polymorphisms of the Ser9Gly, VNTR- DAT1, Val66Met- and 5HTTLPR. There was some difference in Anxious/Depressed and Withdrawn/Depressed syndromes frequency in the children from bipolar group, but without association with the polymorphism studied. A tendency of association was detected between homozygosis ser9gly DRD3 and mental impairment (p= 0,09), and an association between homozygosis 9* and 10* of DAT1-VNTR (p=0,03) and Anxious/Depressed in children, regardless of mother s diagnosis. CONCLUSION: Despite of the sample size limitation, our results supported the methodological feasibility of a high-risk study. Hereafter it intends to explore the data found by increasing the sample and introducing new variables from the follow up.

Os estudos de alto risco com descendentes de indivíduos portadores de psicoses fornecem uma oportunidade para estudar possíveis características fenotípicas e genéticas que podem estar envolvidas no desenvolvimento destes transtornos. Até o momento as pesquisas sobre a influência da vulnerabilidade genética e o ambiente sobre o comportamento das crianças de risco são escassos e inconclusivos. Objetivo: Revisão dos principais estudos genético-epidemiolólogicos e dos principais achados dos estudos de alto risco para psicose funcional. Revisão dos estudos genético-moleculares dos polimorfismos Ser9Gly (rs6280), VNTRDAT1 (NM_001044.3), Val66Met (rs6265) e 5HTTLPR (- X76753) e estudo de associação destes polimorfismos em mães portadoras de psicose funcional e em seus respectivos filhos. A distribuição destes polimorfismos em quatro características clínicas nos filhos (Síndrome Ansiedade/depressão e Retraimento/depressão do CBCL, atraso escolar e déficit intelectual) foi o objetivo secundário. Métodos: Sujeitos-Mães com esquizofrenia e transtorno afetivo bipolar atendidas no Instituto Psiquiatria do IPq-HCFMUSP e atendidas na Clínica de Ginecologia da mesma Universidade foram convidadas a participar.Para cada mãe, 1 filho foi escolhido, estratificando-se para gênero e idade (6-18 anos). Os entrevistadores eram cegos e aplicaram nas mães SCID (Entrevista Clínica Estruturada para DSM-IV) e GAF (Avaliação Global de Funcionamento) e nas crianças CBCL (Child Behavior Checklist) (Achenbach, 1983) e WASI (Wechsler Abbreviated Scale of Intelligence). Foi avaliado nível socioeconômico baseado em um instrumento utilizado em estudos de populacionais brasileiros (ANEP). As freqüências de polimorfismos da mães foi feita comparando-as segundo o diagnóstico psiquiátrico (Esquizofrenia, Transtorno Afetivo Bipolar e Controles). A análise das características das crianças foi realizado inicialmente segundo o diagnóstico da materno e posteriormente de acordo com possíveis síndromes clínicas que estas crianças apresentaram. A análise de dados foi executada pelo Programa Estatístico SPSS 15.0. Os grupos foram comparados de acordo com características através de Chi-quadrado de Pearson ou do Teste Exato de Fisher, adotando-se valor de significância de 0.05. RESULTADOS: 167 mães (58 com esquizofrenia, 47 com transtorno afetivo bipolar e 62 controles) e seus filhos participaram. Não se observaram diferenças significantes nos alelos e genótipos dos polimorfismos do Ser9Gly, VNTR-DAT1, Val66Met e 5HTTLPR. Houve diferença na freqüência das Síndromes Retraimento/depressão e Ansiedade/depressão no grupo de filhos de mães portadoras de TAB, porém sem associação com os polimorfismos estudados. Uma tendência de associação foi detectada entre homozigose ser9gly e prejuízo mental (p = 0,09) e uma associação entre homozigose 9 e 10 do VNTR-DAT1- (p=0,03) e Síndrome Ansiedade/Depressão nas crianças independente da diagnóstico da materno. CONCLUSÃO: Apesar da limitação do tamanho da amostra, nossos resultados apóiam a viabilidade metodológica dos estudos de risco alto para analise em genética molecular. Futuramente pretende-se explorar os dados encontrados com o aumento da amostra e com a introdução de novas variáveis advindas do segmento desta população. / The high-risk studies involving offspring of parents who developed psychoses provide the opportunity to clarify quantitative trait loci that may underlie liability traits. Until now, the research about the influence of genetic vulnerability and environmental factors on child behavior is scarce and inconclusive. Objective: In this research a review of the findings of previous HR studies in functional psychoses, the analyze polymorphisms distribution of the genes DRD3 (Ser9Gly - rs6280), DAT1 (VNTR-Variable Number of Tandem Repeats - NM_001044.3), BDNF (Val66Metrs6265) and serotonin transporter (5HTTLPR - X76753.2) among functional psychoses women and their offspring and polymorphisms distribution in four clinical characteristics among the offspring (Anxious/Depressed and Withdrawn/Depressed syndromes from CBCL, school delay and low intelligence coefficient) was done. Methods: Outpatient mothers with schizophrenia and bipolar referred from the Psychiatric Institute in Sao Paulo and outpatient mothers referred from the Gynecologic Clinic of the same university. For each mother, one offspring was chosen and stratified by gender and age (6-18 y.o.). Blinded interviewers applied the SCID (Structured Clinical Interview for DSM-IV) and Global Assessment of Functioning Scale (GAF) to the mothers, the Child Behavior Checklist (CBCL) (Achenbach, 1983) and WASI (Wechsler Abbreviated Scale of Intelligence) to the children. Socioeconomic status was evaluated based on a Brazilian standardized instrument used in population studies (ANEP). The polymorphisms distribution among mothers was done comparing the diagnoses (Controls, Bipolar Disorder and Schizophrenia). The analysis of the offspring characteristics was initially done according to mother s diagnosis and later according to likely clinical syndromes these children showed. Data analysis was performed with the Statistical Program for Social Sciences (SPSS - 15.0). The groups were compared according to characteristics using Pearson s Chi-square or Fisher s Exact Test adopting significance value of 0.05. RESULTS: 167 mothers (58 with schizophrenia, 47 with bipolar disorder and 62 controls) participated. No significant difference was observed in the allelic and genotype frequencies in the polymorphisms of the Ser9Gly, VNTR- DAT1, Val66Met- and 5HTTLPR. There was some difference in Anxious/Depressed and Withdrawn/Depressed syndromes frequency in the children from bipolar group, but without association with the polymorphism studied. A tendency of association was detected between homozygosis ser9gly DRD3 and mental impairment (p= 0,09), and an association between homozygosis 9* and 10* of DAT1-VNTR (p=0,03) and Anxious/Depressed in children, regardless of mother s diagnosis. CONCLUSION: Despite of the sample size limitation, our results supported the methodological feasibility of a high-risk study. Hereafter it intends to explore the data found by increasing the sample and introducing new variables from the follow up.