Brennand Kristen J, Landek-Salgado Melissa A, Sawa Akira
Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Psychiatry, John Hopkins University School of Medicine, Baltimore, Maryland.
Biol Psychiatry. 2014 Jun 15;75(12):936-44. doi: 10.1016/j.biopsych.2013.10.025. Epub 2013 Nov 15.
Schizophrenia (SZ) is a devastating complex genetic mental condition that is heterogeneous in terms of clinical etiologies, symptoms, and outcomes. Despite decades of postmortem, neuroimaging, pharmacological, and genetic studies of patients, in addition to animal models, much of the biological mechanisms that underlie the pathology of SZ remain unknown. The ability to reprogram adult somatic cells into human induced pluripotent stem cells (hiPSCs) provides a new tool that supplies live human neurons for modeling complex genetic conditions such as SZ. The purpose of this review is to discuss the technical and clinical constraints currently limiting hiPSC-based studies. We posit that reducing the clinical heterogeneity of hiPSC-based studies, by selecting subjects with common clinical manifestations or rare genetic variants, will help our ability to draw meaningful insights from the necessarily small patient cohorts that can be studied at this time.
精神分裂症(SZ)是一种具有毁灭性的复杂遗传性精神疾病,在临床病因、症状和预后方面具有异质性。尽管对患者进行了数十年的尸检、神经影像学、药理学和遗传学研究,此外还有动物模型,但SZ病理学背后的许多生物学机制仍然未知。将成人体细胞重编程为人类诱导多能干细胞(hiPSC)的能力提供了一种新工具,可提供活的人类神经元来模拟诸如SZ等复杂遗传疾病。本综述的目的是讨论目前限制基于hiPSC研究的技术和临床限制。我们认为,通过选择具有共同临床表现或罕见遗传变异的受试者来减少基于hiPSC研究的临床异质性,将有助于我们从目前能够研究的必然规模较小的患者队列中得出有意义的见解。