APOE2 allele increased in tardive dyskinesia

Apolipoprotein E polymorphism is associated with susceptibility to schizophrenia among Saudis

INTRODUCTION

Apolipoprotein E (APOE) genotypes influence the phenotype of several neurodegenerative disorders including Alzheimer's and Parkinson disease and may affect schizophrenia pathogenesis. This study was undertaken to determine the association between APOE gene polymorphisms and schizophrenia in the Saudi population.

MATERIAL AND METHODS

APOE allele and genotype frequencies were studied in 380 Saudi subjects including schizophrenia patients and matched controls using polymerase chain reaction (PCR) and reverse-hybridization techniques.

RESULTS

The frequencies of the APOE allele ε2 and genotypes ε2/ε3 and ε2/ε4 were significantly higher in the schizophrenia patients as compared to controls, suggesting that the ε2 allele and its heterozygous genotypes may increase the susceptibility to schizophrenia. In contrast, the frequencies of the ε3 allele and ε3/ε3 genotype were lower in patients as compared to controls, suggesting a protective effect of APOE ε3 for schizophrenia. This study indicated that APOE ε4 was differentially associated with schizophrenia depending on the symptoms as the frequency of the ε4 allele was significantly higher in schizophrenia patients with positive symptoms. By contrast, no significant association between APOE ε4 and schizophrenia patients with negative symptoms was observed. Genotypes ε2/ε2 and ε4/ε4 were absent in patients and controls. Moreover, the age of onset was significantly lower in patients with the APOE ε2/ε3 genotype. There was no significant difference in the frequencies of APOE alleles and genotypes between male and female schizophrenia patients.

CONCLUSIONS

The results of this study clearly show that APOE alleles and genotypes are associated with risk of developing schizophrenia and early age of onset in Saudis.

Genetic association of apolipoprotein E polymorphisms with inflammatory bowel disease

AIM: To study the association of apolipoprotein E (APOE) polymorphisms with the susceptibility of inflammatory bowel disease (IBD) in Saudi patients.

METHODS: APOE genotyping was performed to evaluate the allele and genotype frequencies in 378 Saudi subjects including IBD patients with ulcerative colitis (n = 84) or Crohn’s disease (n = 94) and matched controls (n = 200) using polymerase chain reaction and reverse-hybridization techniques.

RESULTS: The frequencies of the APOE ε2 allele and ε2/ε3 and ε2/ε4 genotypes were significantly higher in IBD patients than in controls (P < 0.05), suggesting that the ε2 allele and its heterozygous genotypes may increase the susceptibility to IBD. On the contrary, the frequencies of the ε3 allele and ε3/ε3 genotype were lower in IBD patients as compared to controls, suggesting a protective effect of APOE ε3 for IBD. The prevalence of the ε4 allele was also higher in the patient group compared to controls, suggesting that the ε4 allele may also increase the risk of IBD. Our results also indicated that the APOE ε4 allele was associated with an early age of IBD onset. No effect of gender or type of IBD (familial or sporadic) on the frequency distribution of APOE alleles and genotypes was noticed in this study.

CONCLUSION: APOE polymorphism is associated with risk of developing IBD and early age of onset in Saudi patients, though further studies with a large-size population are warranted.

Vascular gene polymorphisms (EDNRA -231 G>A and APOE HhaI) and risk for migraine

Migraine is a neurovascular disorder, and hence, any alteration in vascular endothelial function by either the endothelin system or the apolipoproteins may contribute to its pathophysiology. Thus, we investigated the role of EDNRA -231 G>A and APOE HhaI polymorphism for a possible association with migraine. Genotyping of 613 subjects consisting of 217 migraine subjects, 217 healthy controls (HC), and 179 subjects with tension-type headache was performed using the standard PCR-RFLP method. Data were analyzed by taking the Bonferroni-corrected p-values into account. We found significant difference in the frequency of EDNRA AA genotype between migraine subjects when compared with HC (p-value = 0.005; OR = 2.542; confidence interval [CI] = 1.329-4.863). A similar trend was shown by female migraine subjects at genotype and allele levels. The association of EDNRA -231 G>A polymorphism with migraine fit a recessive model (migraine vs. HC, p-value = 0.002; OR = 1.917; CI = 2.268-2.898). Female migraineurs without aura (MO) followed a similar trend. In the case of APOE HhaI polymorphism, E3E4 and E2E3 genotypes conferred risk when taken together in case of migraine versus HC (p-value = 0.005; OR = 2.715; CI = 1.342-5.490) and migraine with aura (MA) versus HC (p-value = 0.004; OR = 3.422; CI = 7.992). The risk was also seen after stratification on the basis of gender in female migraineurs (total migraine and MA). The interaction of EDNRA and APOE genotypes did not show further significance. The AA genotype and A allele of EDNRA -231 G>A polymorphism conferred risk for total migraine and MO. In APOE HhaI polymorphism, E3E4 and E2E3 conferred risk when taken together in total migraine and MA.

The role of apolipoprotein E polymorphisms in levodopa-induced dyskinesia

OBJECTIVES

To determine the relationship between apolipoprotein E (APOE) polymorphisms to the time to appearance of levodopa-induced dyskinesia (LID) in patients with Parkinson's disease.

METHODS

The APOE genotype of 155 consecutive patients treated with levodopa was determined and its effect on the time of onset of LID was examined using Cox regression model, controlling for gender, age of disease onset, time to initiation of levodopa treatment and history of smoking.

RESULTS

Two patients were homozygous for the APOE ε2 allele, 7 had ε2/ε3, 1 had ε2/ε4, 130 had ε3/ε3, 12 had ε3/ε4 and 3 had ε4/ε4; LID appeared in 57.4% of the patients, appearing 4.1 ± 3.5 years after the initiation of levodopa treatment. The survival curve for LID was not affected by the APOE genotype (P = 0.34).

CONCLUSION

APOE polymorphisms were found not to be associated with either the occurrence or the time to development of LID.

Oxidative stress in tardive dyskinesia: genetic association study and meta-analysis of NADPH quinine oxidoreductase 1 (NQO1) and Superoxide dismutase 2 (SOD2, MnSOD) genes

INTRODUCTION

Tardive dyskinesia (TD) is a potentially irreversible side effect of antipsychotic medication treatment that occurs in approximately 25% of chronically treated schizophrenia patients. Oxidative stress has been one of the proposed mechanisms influencing TD risk. Pae et al. (2004) originally reported a significant association between TD and the NADPH quinine oxidoreductase 1 (NQO1) gene Pro187Ser (C609T, rs1800566) polymorphism in Korean schizophrenia patients; however, subsequent studies have not consistently replicated these findings. Similarly, Hori et al. (2000) reported an association between TD and the Manganese superoxide dismutase SOD2 (MnSOD) gene Ala9Val (rs4880) polymorphism in a Japanese sample, but most research groups failed to replicate their positive findings.

AIMS

We investigated the role of the NQO1 polymorphism Pro187Ser and SOD2 (Ala9Val) in a group of well-characterized schizophrenia patients (N=223) assessed for TD. We also performed a meta-analysis of all the previously published TD studies, including data from our sample, on these polymorphisms, Pro187Ser (N=5 studies) and Ala9Val (N=9 studies).

RESULTS

We did not observe a significant association of the Pro187Ser or Ala9Val polymorphism with TD occurrence or AIMS scores in our Caucasian and African American samples when analyzed independently. Meta-analysis did not reveal a significant association of the Pro187Ser/Ala9Val alleles or genotypes with TD occurrence.

CONCLUSIONS

Neither the NQO1 Pro187Ser nor the SOD2 Ala9Val appear to play a major role in TD risk, although additional polymorphisms should be tested before the role of NQO1 and SOD2 in TD can be completely excluded.

Apolipoprotein-E gene variants associated with cardiovascular risk factors in antipsychotic recipients

Interest exists in identifying the factors that specifically contribute to the increased prevalence of cardiovascular disease observed in psychiatric disease. The apolipoprotein-E (APOE) gene codes for a protein that has a key role in metabolism of cholesterol and triglycerides, with increased levels of apoE found in specific areas of post-mortem schizophrenic brains. This study investigated whether apoE variants influence the prevalence of cardiovascular risk factors (obesity, diabetes and dyslipidaemia), in patients receiving antipsychotic treatment, due to extension of the risk seen in the general population, but also due to the role of the APOE gene in mediating antipsychotic-induced side effects. Seven polymorphisms (rs741780, rs483082, rs429358, rs7412, rs10119, rs439401 and rs405509) were genotyped in 427 American Caucasian patients who were either receiving, or had been prescribed risperidone. Our results support the hypothesis that APOE gene variants influence the prevalence of diabetes and possibly overweight in psychiatric patients. Unfortunately, due to the cross sectional nature of this study, the contribution of antipsychotic treatment was not determined. These associations warrant prospective study to assess interaction between APOE gene variants and the propensity of antipsychotics to induce cardiovascular risk factors.