Fanous Ayman H, van den Oord Edwin J, Riley Brien P, Aggen Steven H, Neale Michael C, O'Neill F Anthony, Walsh Dermot, Kendler Kenneth S
Washington VA Medical Center-Georgetown University Medical Center Schizophrenia Research Program, 50 Irving St. NW, Washington, DC 20422, USA.
Am J Psychiatry. 2005 Oct;162(10):1824-32. doi: 10.1176/appi.ajp.162.10.1824.
The purpose of this study was to determine whether a haplotype in the dystrobrevin binding protein 1 (DTNBP1) gene previously associated with schizophrenia not only increases the susceptibility to psychotic illness but also to a more or less clinically specific form of psychotic illness.
In the Irish Study of High-Density Schizophrenia Families, subjects with psychotic illness (N=755) were given lifetime ratings of clinical features according to the Operational Criteria Checklist for Psychotic Illness. Exploratory and confirmatory factor analyses were used to extract five factors-hallucinations, delusions, negative, manic, and depressive symptoms-and to create factor-derived scores. The family-based transmission disequilibrium test operationalized in the program TRANSMIT was used to determine whether a high-risk haplotype in the DTNBP1 gene was overtransmitted to subjects in the upper 20th and 40th percentiles for each factor score. These results were compared to baseline overtransmission by examining the empirical distribution of chi-square statistics in groups of 5,000 replicates in which 20% and 40% of ill subjects were randomly selected. This analysis was done for both narrow and broad definitions of psychotic illness.
Subjects in the upper 40th percentile for the negative symptom factor--in both the narrowly (p=0.004) and broadly (p=0.01) defined illness groups--were more likely to inherit the high-risk haplotype than would be expected by chance. No other significant relationships between clinical features and high-risk haplotype transmission were observed.
The etiologically relevant variation in DTNBP1, which is in presumptive linkage disequilibrium with the high-risk haplotype, may predispose individuals to a form of psychotic illness associated with high levels of negative symptoms. This finding supports previous evidence suggesting that genetic factors influence the clinical heterogeneity of schizophrenia.
本研究旨在确定肌萎缩蛋白结合蛋白1(DTNBP1)基因中一种先前与精神分裂症相关的单倍型,是否不仅会增加患精神病性疾病的易感性,还会增加患某种或多或少具有临床特异性的精神病性疾病的易感性。
在爱尔兰高密度精神分裂症家族研究中,根据精神病性疾病操作标准检查表,对患有精神病性疾病的受试者(N = 755)进行终生临床特征评分。采用探索性和验证性因素分析来提取五个因素——幻觉、妄想、阴性、躁狂和抑郁症状——并创建因素衍生分数。使用TRANSMIT程序中实施的基于家族的传递不平衡检验,来确定DTNBP1基因中的高危单倍型是否过度传递给每个因素得分处于第20和第40百分位数以上的受试者。通过检查5000次重复分组中卡方统计量的经验分布,将这些结果与基线过度传递进行比较,其中20%和40%的患病受试者是随机选择的。对精神病性疾病的狭义和广义定义均进行了此分析。
在狭义(p = 0.004)和广义(p = 0.01)定义的疾病组中,阴性症状因素处于第40百分位数以上的受试者比预期偶然情况更有可能遗传高危单倍型。未观察到临床特征与高危单倍型传递之间的其他显著关系。
与高危单倍型处于假定连锁不平衡状态的DTNBP1中的病因相关变异,可能使个体易患与高水平阴性症状相关的一种精神病性疾病。这一发现支持了先前的证据,表明遗传因素影响精神分裂症的临床异质性。