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O'Connell KS, Coombes BJ. Genetic contributions to bipolar disorder: current status and future directions. Psychol Med 2021; 51:2156-2167. [PMID: 33879273 PMCID: PMC8477227 DOI: 10.1017/s0033291721001252] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is a highly heritable mental disorder and is estimated to affect about 50 million people worldwide. Our understanding of the genetic etiology of BD has greatly increased in recent years with advances in technology and methodology as well as the adoption of international consortiums and large population-based biobanks. It is clear that BD is also highly heterogeneous and polygenic and shows substantial genetic overlap with other psychiatric disorders. Genetic studies of BD suggest that the number of associated loci is expected to substantially increase in larger future studies and with it, improved genetic prediction of the disorder. Still, a number of challenges remain to fully characterize the genetic architecture of BD. First among these is the need to incorporate ancestrally-diverse samples to move research away from a Eurocentric bias that has the potential to exacerbate health disparities already seen in BD. Furthermore, incorporation of population biobanks, registry data, and electronic health records will be required to increase the sample size necessary for continued genetic discovery, while increased deep phenotyping is necessary to elucidate subtypes within BD. Lastly, the role of rare variation in BD remains to be determined. Meeting these challenges will enable improved identification of causal variants for the disorder and also allow for equitable future clinical applications of both genetic risk prediction and therapeutic interventions.
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Affiliation(s)
- Kevin S. O'Connell
- Division of Mental Health and Addiction, NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, 0407Oslo, Norway
| | - Brandon J. Coombes
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
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Meek AR, Morzycki A, Carter MD, Barden C, Weaver DF. Serotonin as a drug receptor for Li +: a computational study. CAN J CHEM 2018. [DOI: 10.1139/cjc-2017-0665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Although Li+ is widely used to treat bipolar disorder, its antidepressant pharmacological mechanism of action remains unelucidated. Herein, based on molecular modelling studies, we present the novel hypothesis that one possible receptor for Li+ is serotonin (5-hydroxytryptamine, 5-HT), a small molecule neurotransmitter rather than a large macromolecular protein. The resulting Li+/5-HT drug–receptor complex subsequently interacts with “upstream” macromolecular receptors such as the 5-HT1A receptor differently than 5-HT alone, producing an enhanced antidepressant effect. The notion that a neurotransmitter could itself be a receptor for a therapeutic is an interesting receptor cascade concept. Using molecular mechanics and semi-empirical and ab initio levels of theory, the potential interactions between Li+ and 5-HT and between Li+ and 5-HIAA (5-hydroxyindoleacetic acid, a 5-HT metabolite) were examined. Molecular dynamics simulations were then used to examine how Li+ affects the binding of 5-HT to its target 5-HT1A antidepressant receptor. The results of these calculations suggest that Li+ can interact with 5-HT and in such a way that it modifies the ligand–protein interactions.
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Affiliation(s)
- Autumn R. Meek
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
| | - Alexander Morzycki
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
| | - Michael D. Carter
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
| | - Christopher Barden
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
| | - Donald F. Weaver
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
- Krembil Research Institute, University Health Network, University of Toronto, 60 Leonard Ave., Toronto, ON M5T 2S8, Canada
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Song J, Bergen SE, Kuja-Halkola R, Larsson H, Landén M, Lichtenstein P. Bipolar disorder and its relation to major psychiatric disorders: a family-based study in the Swedish population. Bipolar Disord 2015; 17:184-93. [PMID: 25118125 DOI: 10.1111/bdi.12242] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 04/15/2014] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Bipolar disorder (BPD) shares genetic components with other psychiatric disorders; however, uncertainty remains about where in the psychiatric spectra BPD falls. To understand the etiology of BPD, we studied the familial aggregation of BPD and co-aggregation between BPD and schizophrenia, depression, anxiety disorders, attention-deficit hyperactivity disorder, drug abuse, personality disorders, and autism spectrum disorders. METHODS A population-based cohort was created by linking several Swedish national registers. A total of 54,723 individuals with BPD were identified among 8,141,033 offspring from 4,149,748 nuclear families. The relative risk of BPD in relatives and the co-occurrence of other psychiatric disorders in patients with BPD and their relatives were compared to those of matched-population controls. Structural equation modeling was used to estimate the heritability and tetrachoric correlation. RESULTS The familial risks for relatives of BPD probands were 5.8-7.9 in first-degree relatives, and decreased with genetic distance. Co-occurrence risks for other psychiatric disorders were 9.7-22.9 in individuals with BPD and 1.7-2.8 in full siblings of BPD probands. Heritability for BPD was estimated at 58%. The correlations between BPD and other psychiatric disorders were considerable (0.37-0.62) and primarily due to genetic effects. The correlation with depression was the highest (0.62), and was 0.44 for schizophrenia. CONCLUSIONS The high familial risks provide evidence that genetic factors play an important role in the etiology of BPD, and the shared genetic determinants suggest pleiotropic effects across different psychiatric disorders. Results also indicate that BPD is in both the mood and psychotic spectra, but possibly more closely related to mood disorders.
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Affiliation(s)
- Jie Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm
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Ferentinos P, Rivera M, Ising M, Spain SL, Cohen-Woods S, Butler AW, Craddock N, Owen MJ, Korszun A, Jones L, Jones I, Gill M, Rice JP, Maier W, Mors O, Rietschel M, Lucae S, Binder EB, Preisig M, Tozzi F, Muglia P, Breen G, Craig IW, Farmer AE, Müller-Myhsok B, McGuffin P, Lewis CM. Investigating the genetic variation underlying episodicity in major depressive disorder: suggestive evidence for a bipolar contribution. J Affect Disord 2014; 155:81-9. [PMID: 24215895 DOI: 10.1016/j.jad.2013.10.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 10/14/2013] [Accepted: 10/16/2013] [Indexed: 01/30/2023]
Abstract
BACKGROUND Highly recurrent major depressive disorder (MDD) has reportedly increased risk of shifting to bipolar disorder; high recurrence frequency has, therefore, featured as evidence of 'soft bipolarity'. We aimed to investigate the genetic underpinnings of total depressive episode count in recurrent MDD. METHODS Our primary sample included 1966 MDD cases with negative family history of bipolar disorder from the RADIANT studies. Total episode count was adjusted for gender, age, MDD duration, study and center before being tested for association with genotype in two separate genome-wide analyses (GWAS), in the full set and in a subset of 1364 cases with positive family history of MDD (FH+). We also calculated polygenic scores from the Psychiatric Genomics Consortium MDD and bipolar disorder studies. RESULTS Episodicity (especially intermediate episode counts) was an independent index of MDD familial aggregation, replicating previous reports. The GWAS produced no genome-wide significant findings. The strongest signals were detected in the full set at MAGI1 (p=5.1×10(-7)), previously associated with bipolar disorder, and in the FH+ subset at STIM1 (p=3.9×10(-6) after imputation), a calcium channel signaling gene. However, these findings failed to replicate in an independent Munich cohort. In the full set polygenic profile analyses, MDD polygenes predicted episodicity better than bipolar polygenes; however, in the FH+ subset, both polygenic scores performed similarly. LIMITATIONS Episode count was self-reported and, therefore, subject to recall bias. CONCLUSIONS Our findings lend preliminary support to the hypothesis that highly recurrent MDD with FH+ is part of a 'soft bipolar spectrum' but await replication in larger cohorts.
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Affiliation(s)
- Panagiotis Ferentinos
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Margarita Rivera
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Granada, Spain
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Sarah L Spain
- Division of Genetics and Molecular Medicine, King's College London School of Medicine, Guy's Hospital, London, United Kingdom
| | - Sarah Cohen-Woods
- Department of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Amy W Butler
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom; Department of Psychiatry, University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Nicholas Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Ania Korszun
- Barts and The London Medical School, Queen Mary University of London, London, United Kingdom
| | - Lisa Jones
- Department of Psychiatry, Neuropharmacology & Neurobiology Section, University of Birmingham, Birmingham, United Kingdom
| | - Ian Jones
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Michael Gill
- Department of Psychiatry, Trinity Centre for Health Science, Dublin, Ireland
| | - John P Rice
- Department of Psychiatry, Washington University, St. Louis, Missouri, United States
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Ole Mors
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
| | - Marcella Rietschel
- Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | | | | | - Martin Preisig
- University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - Federica Tozzi
- Aptuit Center for Drug Discovery & Development, Verona, Italy
| | | | - Gerome Breen
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom
| | - Ian W Craig
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom
| | - Anne E Farmer
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom
| | | | - Peter McGuffin
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom
| | - Cathryn M Lewis
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom; Division of Genetics and Molecular Medicine, King's College London School of Medicine, Guy's Hospital, London, United Kingdom
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Barbosa IG, Huguet RB, Neves FS, Bauer ME, Teixeira AL. Imunologia do transtorno bipolar. JORNAL BRASILEIRO DE PSIQUIATRIA 2009. [DOI: 10.1590/s0047-20852009000100009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Pesquisas recentes têm implicado fatores imunes na patogênese de diversos transtornos neuropsiquiátricos. O objetivo do presente trabalho é revisar os trabalhos que investigaram a associação entre transtorno bipolar e alterações em parâmetros imunes. MÉTODOS: Artigos que incluíam as palavras-chave: "bipolar disorder", "mania", "immunology", "cytokines", "chemokines", "interleukins", "interferon" e "tumor necrosis factor" foram selecionados em uma revisão sistemática da literatura. As bases de dados avaliadas foram MedLine e Scopus, entre os anos de 1980 e 2008. RESULTADOS: Foram identificados 28 trabalhos que estudaram alterações imunes em pacientes com transtorno bipolar. Seis artigos investigaram genes relacionados à resposta imune; cinco, autoanticorpos; quatro, populações leucocitárias; 13, citocinas e/ou moléculas relacionadas à resposta imune e seis, leucócitos de pacientes in vitro. CONCLUSÕES: Embora haja evidências na literatura correlacionando o transtorno bipolar a alterações imunes, os dados não são conclusivos. O transtorno bipolar parece estar associado a níveis mais elevados de autoanticorpos circulantes, assim como à tendência à ativação imune com produção de citocinas pró-inflamatórias e redução de parâmetros anti-inflamatórios.
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Romero S, Delbello MP, Soutullo CA, Stanford K, Strakowski SM. Family environment in families with versus families without parental bipolar disorder: a preliminary comparison study. Bipolar Disord 2005; 7:617-22. [PMID: 16403187 DOI: 10.1111/j.1399-5618.2005.00270.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare family environmental characteristics of families with at least one bipolar parent and families with parents without any Axis I disorder. METHODS Family environment of 24 families with at least one parent with bipolar disorder (BPD) and 27 families with healthy parents (healthy families, HF) were assessed using the Family Environment Scale (FES). We compared FES subscale scores between BPD and HF. We also compared FES normative scores with scores of BPD families. RESULTS Seventeen (71%) of the 24 BPD families had at least one child with a mood disorder and one (3.7%) of the 27 HF had a child with a mood disorder. Families with BPD reported lower cohesion (p = 0.009) and expressiveness (p = 0.03) scores compared with HF, after controlling for group socioeconomic status differences. Bilineal BPD families had higher cohesion scores than unilineal BPD families (p = 0.05). We found no significant differences in any subscales between BPD families with (n = 9) versus without (n = 15) children with BPD. Compared with normative FES data BPD families reported lower cohesion (C) (p = 0.02) and independence (IND) (p = 0.004) scores and higher conflict (CON) (p = 0.02), intellectual-cultural orientation (ICO) (p = 0.05), moral-religious emphasis (MRE) (p < 0.001) and control (CTL) (p < 0.001) scores. CONCLUSION Our results suggest that members of BPD families may have difficulty communicating effectively with one another, suggesting that interventions aimed at improving this may be beneficial to patients with BPD. Results suggest that the impact of different lifestyles in different communities may influence FES scores, and thus it is important to use demographically matched comparison groups.
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Affiliation(s)
- Soledad Romero
- Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
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