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SIRS 2012—Schizophrenia Genetics: The Pile of Puzzle Pieces Grows

1 May 2012. More than 1,600 researchers and clinicians gathered in a rainy Florence from 14-18 April 2012 to discuss new schizophrenia research at the Third Schizophrenia International Research Society (SIRS) conference. Despite the clouds, the combination of espresso and data kept things animated in talks ranging from psychosocial treatment strategies and immune system interactions to the latest genetic puzzle pieces pouring from the sequencing machines.

Monday’s plenary speaker, Bill Byerly of the University of California, San Francisco, outlined the landscape of schizophrenia genetics, beginning with the linkage studies of yore, traversing the common variants detected by genomewide association studies (GWAS), moving on to the suspected copy number variations, and ending with sequencing, which he pointed out will rely on family data to help make sense of the rare variants turning up. He and other speakers emphasized that an assortment of variants—both rare and common—would contribute to schizophrenia risk.

Maria Karayiorgou of Columbia University in New York focused on the contributions made by rare “de-novo” events—spontaneously arising genetic glitches not inherited from parents. Though these may not explain schizophrenia’s high heritability, they could account for the stable prevalence of schizophrenia, despite the fact that individuals with the disorder tend not to have children. Karayiorgou reviewed her evidence for a higher burden of de-novo CNVs (see SRF related news story) in schizophrenia. In her view, these rare variants contribute to brain disease in combination with secondary factors, such as other rare mutations, common variants, environment, and chance—which would color the outcomes of these de-novo events.

Spotlight on sequencing
With the stage set, a genetics symposium the same afternoon featured several presentations of sequencing work in progress. Despite its ability to resolve rare, single nucleotide anomalies, sequencing seems to be complicating more than clarifying the picture of psychiatric genetics so far. That’s because sequencing finds variants galore in cases and controls alike—even rare, protein-altering ones—leaving researchers to figure out which of the many needles in the haystack contribute to risk for disease (see SRF related news story). It was clear at this symposium that many researchers are looking for direction from family studies to determine how to weigh the evidence.

David Porteous of the University of Edinburgh, Scotland, used a family approach to sort potentially causal variants from bystanders in a targeted resequencing study of disrupted in schizophrenia 1 (DISC1). With colleagues at Cold Spring Harbor Laboratory, Porteous and his team have been resequencing a 528 kb region of the DISC1 gene disrupted by a translocation found in a Scottish family beset not only by schizophrenia, but also by major depressive disorder (MDD) and bipolar disorder (BD). Sequencing this region in over 1,500 individuals (240 with schizophrenia, 221 with BD, 192 with MDD, and 889 healthy controls) turned up 2,010 rare variants, mostly located in the exome. One of these was R37W, a rare, protein-altering variant recently found to disrupt DISC1’s action in the nucleus (Malavasi et al., 2012). Porteous reported finding R37W in recurrent MDD, and it segregated with this illness in three families. The group is still sorting out whether any of these rare variants are specifically associated with schizophrenia.

How best to use sequencing depends on the genetic architecture of the disease, which researchers are still grappling with, said Richard McCombie of Cold Spring Harbor Laboratory, Long Island, New York. He stressed the difficulty presented by the overabundant variants when describing an ongoing case-control study of BD in his lab, saying, “This is a real signal-to-noise problem.” For example, sequencing all the synaptic genes of the genome (the “synaptome”) of 186 individuals revealed that 4,000 genes had a non-synonymous (amino-acid altering) variant in each person. While focusing on gene function might whittle these down, McCombie outlined another approach that first targets linkage regions for resequencing in families, finds the recurrent variants that crop up in other families, then follows those up in large case-control studies of about 20,000 samples total. He is pursuing this strategy for a region of chromosome 4 fingered by linkage in families with BD and MDD.

Shane McCarthy of Cold Spring Harbor Laboratory also presented the family approach in his account of exome sequencing trios consisting of an individual with schizophrenia and both parents. In 33 trios, he reported 138 de-novo variants, including 79 non-synonymous ones and 10 misplaced start or stop codons. Intriguing genes suggested by the predicted-to-be-damaging variants included TRAPPC9, a trafficking protein associated with mental retardation, and MECP2, the master transcription regulator known for its role in Rett syndrome. In collaboration with Byerly, McCarthy is also pursuing whole-genome sequencing in an extended family pedigree. To start to make sense of the three million variants found, he is focusing on those landing in linkage peaks. Five individuals had 126 non-synonymous variants in common, and one gene highlighted by these is DCDC2, already associated with neuronal migration and dyslexia.

Wanting to get at the rare variants not captured by genomewide association studies (GWAS), Shaun Purcell of Mount Sinai School of Medicine in New York described an exome-wide, gene-based association study of 1,500 Swedes, consisting of cases of schizophrenia and controls. This produced 290,000 single nucleotide variants, and one gene hit more than expected was NRG1, a favorite schizophrenia candidate in some quarters. Five different non-synonymous variants, both rare and common, were found in NRG1, and these were overrepresented in cases (n = 12) compared to controls (n = 1). Looking beyond this gene-based perspective, he also tried a functional pathway analysis to see if certain sets of genes carried more of these variants than expected. This showed that targets of miR-137, a transcriptional controller highlighted in the largest schizophrenia GWAS to date (see SRF related news story), are enriched for a burden of rare, non-synonymous coding variants in schizophrenia. Purcell also described ongoing exome sequencing of schizophrenia trios from a Bulgarian sample, reporting 309 de-novo variants enriched for synaptic proteins in 354 trios.

In an extreme version of the family approach, some are looking to the rare cases of monozygotic twins discordant for schizophrenia in the hopes that any differences would quickly divulge the genetic culprits. In a student-delivered symposium Tuesday afternoon, Christina Castellani of the University of Western Ontario in London, Canada, described preliminary findings of the whole-genome sequencing of two such pairs of twins, and one set of parents. She estimates these twins differ in 3 percent of their genome—more than expected, and representing thousands of variants to follow up—but still substantially less than the 75 percent difference obtained for two unrelated people.—Michele Solis.

 
Comments on Related News
Related News: GWAS Goes Bigger: Large Sample Sizes Uncover New Risk Loci, Additional Overlap in Schizophrenia and Bipolar Disorder

Comment by:  David J. Porteous, SRF Advisor
Submitted 21 September 2011 Posted 21 September 2011

Consorting with GWAS for schizophrenia and bipolar disorder: same message, (some) different genes
On 18 September 2011, Nature Genetics published the results from the Psychiatric Genetics Consortium of two separate, large-scale GWAS analyses, for schizophrenia (Ripke et al., 2011) and for bipolar disorder (Sklar et al., 2011), and a joint analysis of both. By combining forces across several consortia who have previously published separately, we should now have some clarity and definitive answers.

For schizophrenia, the Stage 1 GWAS discovery data came from 9,394 cases and 12,462 controls from 17 studies, imputing 1,252,901 SNPs. The Stage 2 replication sample comprised 8,442 cases and 21,397 controls. Of the 136 SNPs which reached genomewide significance in Stage 1, 129 (95 percent) mapped to the MHC locus, long known to be associated with risk of schizophrenia. Of the remaining seven SNPs, five mapped to previously identified loci. In total, just 10 loci met or...  Read more


View all comments by David J. Porteous

Related News: GWAS Goes Bigger: Large Sample Sizes Uncover New Risk Loci, Additional Overlap in Schizophrenia and Bipolar Disorder

Comment by:  Patrick Sullivan, SRF Advisor
Submitted 26 September 2011 Posted 26 September 2011
  I recommend the Primary Papers

The two papers appearing online in Nature Genetics last Sunday are truly important additions to our increasing knowledge base for these disorders. The core analyses have been presented multiple times at international meetings in the past two years.

Since then, the available sample sizes for both schizophrenia and bipolar disorder have grown considerably. If the recently published data are any guide, the next round of analyses should be particularly revealing.

The PGC results and almost all of the data that were used in these reports are available by application to the controlled-access repository.

Please see the references for views of this area that contrast with those of Professor Porteous.

References:

Sullivan P. Don't give up on GWAS. Molecular Psychiatry. 2011 Aug 9. Abstract

Kim Y, Zerwas S, Trace SE, Sullivan PF. Schizophrenia genetics: where next? Schizophr Bull. 2011;37:456-63. Abstract

View all comments by Patrick Sullivan


Related News: GWAS Goes Bigger: Large Sample Sizes Uncover New Risk Loci, Additional Overlap in Schizophrenia and Bipolar Disorder

Comment by:  Edward Scolnick
Submitted 28 September 2011 Posted 29 September 2011
  I recommend the Primary Papers

It is clear in human genetics that common variants and rare variants have frequently been detected in the same genes. Numerous examples exist in many diseases. The bashing of GWAS in schizophrenia and bipolar illness indicates, by those who make such comments, a lack of understanding of human genetics and where the field is. When these studies were initiated five years ago, next-generation sequencing was not available. Large samples of populations or trios or quartets did not exist. The international consortia have worked to collect such samples that are available for GWAS now, as well as for detailed sequencing studies. Before these studies began there was virtually nothing known about the etiology of schizophrenia and bipolar illness. The DISC1 gene translocation in the famous family was an important observation in that family. But almost a decade later there is still no convincing data that variants in Disc1 or many of its interacting proteins are involved in the pathogenesis of human schizophrenia or major mental illness.

Sequencing studies touted to be the Occam's...  Read more


View all comments by Edward Scolnick

Related News: GWAS Goes Bigger: Large Sample Sizes Uncover New Risk Loci, Additional Overlap in Schizophrenia and Bipolar Disorder

Comment by:  Nick CraddockMichael O'Donovan (SRF Advisor)
Submitted 11 October 2011 Posted 11 October 2011

At the start of the millennium, only two molecular genetic findings could be said with a fair amount of confidence to be etiologically relevant to schizophrenia and bipolar disorder. The first of these was that deletions of chromosome 22q11 that are known to cause velo-cardio-facial syndrome also confer a substantial increase in risk of psychosis. The second was the discovery by David St Clair, Douglas Blackwood, and colleagues (St Clair et al., 1990) of a balanced translocation involving chromosomes 1 and 11 that co-segregates with a range of psychiatric phenotypes in a single large family, was clearly relevant to the etiology of illness in that family (Blackwood et al., 2001). The latter finding has led to the conjecture, based upon a translocation breakpoint analysis reported by Kirsty Millar, David Porteous, and colleagues (Millar et al., 2000), that elevated risk in that family is conferred by altered function of a gene eponymously...  Read more


View all comments by Nick Craddock
View all comments by Michael O'Donovan

Related News: GWAS Goes Bigger: Large Sample Sizes Uncover New Risk Loci, Additional Overlap in Schizophrenia and Bipolar Disorder

Comment by:  Todd LenczAnil Malhotra (SRF Advisor)
Submitted 11 October 2011 Posted 11 October 2011

It is worth re-emphasizing that efforts such as the Psychiatric GWAS Consortium do not rule out potentially important discoveries from alternative strategies such as endophenotypic approaches or examination of rare variants. Indeed, such strategies will be necessary to understand the functional mechanisms implicated by GWAS hits.

Moreover, we note that the two recently published PGC papers were not designed to exclude a role for previously identified candidate loci such as DISC1 (Hodgkinson et al., 2004), or prior GWAS findings such as rs1344706 at ZNF804A (Williams et al., 2011). For both these loci, and many others that have been proposed, meta-analysis of available samples suggest very small effect sizes (OR ~1.1), as might be expected for common variants. As noted in Supplementary Table S12 of the schizophrenia PGC paper (Ripke et al., 2011), the currently available sample size (~9,000 cases/~12,000 controls) of the discovery cohort was still underpowered to detect variants...  Read more


View all comments by Todd Lencz
View all comments by Anil Malhotra

Related News: Autism Exome: Lessons for Schizophrenia?

Comment by:  Patrick Sullivan, SRF Advisor
Submitted 20 April 2012 Posted 23 April 2012
  I recommend the Primary Papers

Fascinating papers that likely presage work in the pipeline from multiple groups for schizophrenia. Truly groundbreaking work by some of the best groups in the business. Required reading for those interested in psychiatric genomics.

The identified loci provide important new windows into the neurobiology of ASD.

The results also pertain to the longstanding debate about the nature of ASD: does it result from many individually rare, Mendelian-like variants (potentially a different one in each person) and/or from the summation of the effects of many different common variants of subtle effects?

The multiple rare variant model now seems unlikely for ASD as, contrary to the expectations of some, ASD did not readily resolve into a handful of Mendelian-like diseases. (This comment is of course qualified by the limits of the technologies - which have, however, identified causal mutations for many monogenetic disorders.)

Readers might also want to read Ben Neale's   Read more


View all comments by Patrick Sullivan

Related News: SIRS 2012—Psychological and Social Treatment for Schizophrenia

Comment by:  Lewis Kirshner
Submitted 18 June 2012 Posted 20 June 2012

The field seems to be cautiously returning to look seriously at psychotherapeutic approaches. Paying attention to forms of cognition and affect has been a traditional form of therapy, and it seems foolish to ignore the clinical experiences of its many practitioners, despite conceptual problems of past work. We also have the benefits of studies indicating the effects of trauma on subsequent psychosis and developmental research on attachment and language that may mediate early neglect or trauma. Problems in development of TOM in insecure attachment may point to specific vulnerabilities.

References:

Berry K, Barrowclough C, Wearden A. Attachment theory: a framework for understanding symptoms and interpersonal relationships in psychosis. Behav Res Ther . 2008 Dec ; 46(12):1275-82. Abstract

Fonagy P, Target M. Playing with reality: I. Theory of mind and the normal development of psychic reality. Int J Psychoanal . 1996 Apr ; 77 ( Pt 2)():217-33. Abstract

Heins M, Simons C, Lataster T, Pfeifer S, Versmissen D, Lardinois M, Marcelis M, Delespaul P, Krabbendam L, van Os J, Myin-Germeys I. Childhood trauma and psychosis: a case-control and case-sibling comparison across different levels of genetic liability, psychopathology, and type of trauma. Am J Psychiatry . 2011 Dec ; 168(12):1286-94. Abstract

Lysaker PH, Outcalt SD, Ringer JM. Clinical and psychosocial significance of trauma history in schizophrenia spectrum disorders. Expert Rev Neurother . 2010 Jul ; 10(7):1143-51. Abstract

Read J, Gumley J. Can attachment theory help explain the relationship between childhood adversity and psychosis? Attachment New Directions in Psychotherapy. Relational Analysis. 2008;2:1-35.

View all comments by Lewis Kirshner

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