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WCPG 2012—Schizophrenia GWAS Make Waves

1 November 2012. The search for the common variants that contribute to psychiatric disorders using genomewide association studies (GWAS) continues (see SRF genetics review), with researchers also refining their hypotheses to ask whether variants found in one population apply to other ethnicities, or whether some variants might modify individual features of disease. Although the combined effects of validated common variants are small so far (the so-called “missing heritability” problem), researchers seemed optimistic that there were more variants to be found, and that an ensemble of variants—rare and common alike—would combine to influence risk for psychiatric disorders.

Wednesday’s plenary speakers at the 20th World Congress of Psychiatric Genetics held in Hamburg, Germany, 14-18 October, emphasized this polygenic nature, with Peter Visscher of the University of Queensland in Brisbane, Australia, by arguing that liability for a disorder like schizophrenia would stem from a combination of rare and common variants, de novo variants, and environment, and that different cases would carry different “portfolios” of risk factors. Although rare and common variants contribute to schizophrenia risk, Visscher remarked on a strange absence of the “low frequency” variants in between (with minor allele frequency between 0.5 and 5 percent) that may be revealed through larger sample sizes and/or sequencing efforts (see SRF related news story). By reviewing how heritability is estimated in the first place, he suggested that a recent estimate for schizophrenia heritability based on national registry data may be more representative of the samples used in GWAS (Wray et al., 2012); though lower than other estimates (e.g., 0.67 compared to 0.81 from Sullivan et al., 2003), this is still a substantial amount of heritability, which he argued could not be accounted for by de novo events, gene-gene interactions, or epigenetics.

To commemorate his receipt of the Snow and Ming Tsuang Lifetime Achievement Award, Raymond Crowe of the University of Iowa, Iowa City, recounted highlights from his career, which began at a time when American psychiatrists were not convinced of the heritability of mental illness. Describing his first forays into the genetic basis of panic disorder, he said that even these early family studies pointed to a polygenic, complex trait. As new findings confirm this with an unimaginable diversity of variants, he quipped, “This is not your mom and dad’s polygenic model.”

Polygenicity extreme
Supporters of GWAS insist that larger sample sizes are required to get common variants for psychiatric disorders up and over the very high bar set for genomewide significance (p <5 x 10-8), and this has been the case for other complex traits like diabetes or height. Now, schizophrenia fulfills this prediction, too, according to Stephan Ripke of the Broad Institute, Cambridge, Massachusetts, who presented results from the largest yet GWAS for schizophrenia organized by the Psychiatric Genomics Consortium (no longer called the "Psychiatric GWAS Consortium," but retaining the acronym "PGC"). Since their previous study, which found seven signals (see SRF related news story), the consortium has more than doubled the size of their discovery set, reaching over 50,000 samples. This “second wave” produced 62 genomewide significant hits, and 80 percent of these variants have the same effect in a replication dataset. Though the effect sizes of the 62 signals were small, together accounting for only 3 percent of risk for schizophrenia, Ripke said that the polygenic score used to estimate the collective contributions of all promising variants—even those not reaching genomewide significance—put their contribution even higher. He declined to mention specific genes, but instead emphasized the collaboration that made the detection of these signals possible, with some researchers even contributing data before publishing on it themselves. “The best parties are when everyone brings something to share,” he said.

Beyond Europe
A key question is whether these GWAS-detected signals, which are largely derived from samples of European descent, generalize to other ethnicities. Do disruptions to the same sets of genes increase risk for schizophrenia among diverse populations? Several posters at the Congress presented efforts to replicate GWAS and candidate gene results in far-flung, though small, samples, with mixed results in Indonesia, Japan, and Bosnia.

In a talk on Monday, Teresa de Candia of the University of Colorado, Boulder, advised some caution about generalizing GWAS results, based on her estimates of the genetic risk for schizophrenia shared between European-Americans and African-Americans. Using data from the Molecular Genetics of Schizophrenia (MGS) sample, she reasoned that if the same SNPs predict schizophrenia in both populations, the genetic similarity among those with schizophrenia would be greater than the genetic similarity between cases and controls, regardless of ethnicity. This comparison gave a middling answer, with evidence for both unique and shared risk factors, with the shared portion decreasing as African ancestry increased (the African-American genotypes indicate mixing with populations of European descent). The lack of shared variance may reflect unique causal variants in the two populations, or it may be due to the different genome structures of different ethnicities, which here means that an SNP marking a causal variant in European-Americans may not be associated with that causal variant (i.e., not be in linkage disequilibrium) in African-Americans.

Dimensions of disease
Despite their diagnostic categories, different mental illnesses resemble each other somewhat, and studies find that they run together in families (see SRF related news story; SRF news story). Noting phenotypic similarities between schizophrenia and bipolar disorder, and the emerging genetic overlaps between them, Ripke of the Broad Institute presented results in a talk on Tuesday from the PGC cross disorder group, which aims to identify shared genetic loci across distinct psychiatric disorders. A GWAS on combined schizophrenia and bipolar disorder samples (n = 19,800) compared to controls (n = 19,400) revealed several genomewide significant hits, flagging known genes (e.g., CACNA1C) and new ones (e.g., PIK3C2A, a kinase within an intracellular signaling pathway). To identify disease-specific signals, the researchers compared the two disorders directly, but no genomewide significant hits emerged, possibly because of the limited sample size. Ripke also explored whether the combined effects of variants fingered in bipolar disorder GWAS (quantified with a polygenic score) could explain symptoms in schizophrenia, like mania, depression, positive symptoms, and negative symptoms. Only one correlation emerged, with polygenic scores of bipolar-detected risk alleles measured in people with schizophrenia increasing with mania severity.

This suggests that common variants can describe more than just risk for a particular disorder—they might also modulate severity of symptoms, even across disease categories. In the poster aisles, interest for this dimensional picture of common variant action also seemed to be building. For example, a poster from Ayman Fanous of Georgetown University in Washington, DC, described a search for genetic markers in schizophrenia cases that varied with age at onset, positive symptoms, negative symptoms, mania, and depression. No genomewide significant hits came out of the subset of the PGC sample he used, but several promising ones (p <10-5) highlighted nervous system genes that have not turned up before in GWAS focused on risk alone. This suggests these genes may work independently from risk genes to modify aspects of the disorder.

GWAS meets cytomegalovirus
In a talk on Tuesday, Anders Børglum of Aarhus University in Denmark presented data on gene-environment interactions that may contribute to schizophrenia, based on a unique Danish resource that banks bloodspots of every person born in Denmark since 1981. From the blood, researchers not only gather SNP data about the people, but can also evaluate their mothers' infection status at the time of birth by measuring antibody titers to certain pathogens. This allowed researchers to directly test a hypothesis about maternal infection during pregnancy, specifically infection by cytomegalovirus, contributing to schizophrenia risk (see SRF related news story). Though no genomewide significant signals were found in a GWAS of 915 cases and 915 controls, Børglum did report a significant interaction between a SNP flagging CTNNA3, a gene involved in cell adhesion, and maternal cytomegalovirus infection, which increased risk fivefold. Børglum suggested that cytomegalovirus may disconnect complexes involved in cell adhesion, which could include alterations to synaptic function in schizophrenia.—Michele Solis.

 
Comments on Related News
Related News: Large Family Study Links Genetics of Schizophrenia, Bipolar Disorder

Comment by:  Alastair Cardno
Submitted 7 April 2009 Posted 7 April 2009
  I recommend the Primary Papers

The results of the family/adoption study by Lichtenstein et al. (2009) and our twin study (Cardno et al., 2002) are remarkably similar. Using a non-hierarchical diagnostic approach, the genetic correlation between schizophrenia and bipolar/mania was 0.60 in the family/twin study and 0.68 in the twin study. The heritability estimates were somewhat lower in the family/adoption (~60 percent) than twin study (~80 percent), but can still be said to be substantial and similar for both disorders.

When we adopted a hierarchical approach, with schizophrenia above mania, we found no monozygotic twin pairs where one twin had schizophrenia and the other had bipolar/mania, but with their considerably larger sample, Lichtenstein et al. (2009) were able to confirm a significantly elevated risk for bipolar disorder in siblings of probands with schizophrenia (RR = 2.7), even when individuals with co-occurrence of both disorders were excluded.

I think there is a potentially interesting link...  Read more


View all comments by Alastair Cardno

Related News: Schizophrenia Genetics 2: The Rise of GWAS

Comment by:  Chris Carter
Submitted 7 April 2010 Posted 8 April 2010

I wonder whether the relative lack of success in schizophrenia GWAS may be because the origin of schizophrenia may lie not so much in the genetic make-up of people with schizophrenia themselves, but in their prenatal experience, and possibly with the genes of the mother rather than with those of the offspring. Famine, rubella, influenza, herpes (HSV1 and HSV2), and poliovirus infection as well as high fever during pregnancy have all been listed as risk factors for the offspring developing schizophrenia in later life, as have maternal preeclampsia and obstetric complications. (See page at Polygenic Pathways for the many references.)

Maternal resistance to these effects is likely to be gene-dependent. Is it worth considering GWAS in the mothers rather than in the offspring?

View all comments by Chris Carter


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: Family Roots for Autism, Schizophrenia, Bipolar Disorder

Comment by:  Bernard Crespi
Submitted 30 July 2012 Posted 30 July 2012

In a new paper in Archives of General Psychiatry that has received considerable media attention, Sullivan et al. (Sullivan et al., 2012) use register data from Sweden and Israel to show higher rates of ASDs among individuals with family histories of schizophrenia and bipolar disorder. The authors interpret these results as indicating that ASD, schizophrenia, and bipolar disorder share etiology. This is a very interesting hypothesis that, if supported, would have important implications for our understanding of the genetic underpinnings of schizophrenia in relation to other conditions. However, two alternative hypotheses not involving shared causation may, at least in part, help to explain their results.

First, a recent set of studies demonstrates that drug treatments for schizophrenia and bipolar disorder increase the incidence of ASDs, or their biologically based phenotypic correlates, in offspring. Croen et al. (Croen et al., 2011) reported that prenatal exposure to...  Read more


View all comments by Bernard Crespi

Related News: Family Roots for Autism, Schizophrenia, Bipolar Disorder

Comment by:  William Carpenter, SRF Advisor (Disclosure)
Submitted 30 July 2012 Posted 30 July 2012

Shared risk for ASDs in bipolar and schizophrenia families is important, and the apparent gradient in risk with schizophrenia being greater than bipolar may be informative. From the view that schizophrenia and bipolar disorder are heterogeneous syndromes, the following is surmised:

  • The association with ASDs probably is related to specific aspects of shared features, perhaps impaired social affiliation or neurodevelopmental pathology.
  • These features are more common in schizophrenia than in bipolar disorder, so the gradient may be determined by the difference in proportion of relevant probands with the key features.
  • If the same data could be reduced to family definition based on probands who have impaired social affiliation and/or neurodevelopmental psychopathology, then the odds ratios might be substantially higher and the ORs for schizophrenia and bipolar disorder might be more similar.


View all comments by William Carpenter

Related News: Family Roots for Autism, Schizophrenia, Bipolar Disorder

Comment by:  John McGrath, SRF Advisor
Submitted 30 July 2012 Posted 30 July 2012
  I recommend the Primary Papers

This impressive study adds to the growing body of evidence demonstrating that heritable factors are shared among autism, schizophrenia, and bipolar disorder. The authors suggest that genetic factors could underlie the findings, but also remind the reader that environmental factors could play a role. They note that twin-based studies of heritability in schizophrenia and autism have demonstrated appreciable contributions for environmental factors that were shared between the affected individuals—usually referred to as common environmental effects. It should be noted that in this context, the word “common” does not equate with “prevalent.” With respect to shared genetic factors, the growing body of evidence regarding structural variation such as copy number variants is impressive. With respect to non-genetic factors, more work is needed—prenatal infection (which could trigger maternal immune activation) and nutrition (e.g., low vitamin D) might be candidate domains. If there are shared environmental risk factors contributing to schizophrenia, bipolar disorder, and...  Read more


View all comments by John McGrath

Related News: Deciphering Themes for Schizophrenia’s Genetic Variation

Comment by:  Patrick Sullivan, SRF AdvisorDanielle Posthuma
Submitted 16 November 2012 Posted 16 November 2012

Gilman et al. pose exceptionally important and salient questions: given that increasingly detailed genomic data have established that many genes are now strongly implicated in the etiology of schizophrenia, how do we understand this? How can these different components of the “parts list” for schizophrenia be pieced together to derive a cogent etiological hypothesis for further testing?

The authors use a new computational approach to address these questions, and derive lists related to axon guidance, neuronal cell mobility, synaptic function, and chromosomal remodeling. Additional analyses suggest the coherence of their lists. These are good clues that deserve further evaluation.

It was intriguing that the authors included multiple types of genetic variation—rare but potent copy number variants (e.g., Kirov et al., 2012), rare exonic mutations (Xu et al., 2012), and common variations from genomewide association studies (  Read more


View all comments by Patrick Sullivan
View all comments by Danielle Posthuma
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