Glatt Charles E, Lee Francis S
Department of Psychiatry, Weill Cornell Medical College of Cornell University, New York, New York..
Department of Psychiatry, Weill Cornell Medical College of Cornell University, New York, New York.; Department of Pharmacology, Weill Cornell Medical College of Cornell University, New York, New York.; Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College of Cornell University, New York, New York.
Biol Psychiatry. 2016 Jan 1;79(1):25-31. doi: 10.1016/j.biopsych.2014.12.020. Epub 2015 Jan 8.
The value of common polymorphisms in guiding clinical psychiatry is limited by the complex polygenic architecture of psychiatric disorders. Common polymorphisms have too small an effect on risk for psychiatric disorders as defined by clinical phenomenology to guide clinical practice. To identify polymorphic effects that are large and reliable enough to serve as biomarkers requires detailed analysis of a polymorphism's biology across levels of complexity from molecule to cell to circuit and behavior. Emphasis on behavioral domains rather than clinical diagnosis, as proposed in the Research Domain Criteria framework, facilitates the use of mouse models that recapitulate human polymorphisms because effects on equivalent phenotypes can be translated across species and integrated across levels of analysis. A knockin mouse model of a common polymorphism in the brain-derived neurotrophic factor gene (BDNF) provides examples of how such a vertically integrated translational approach can identify robust genotype-phenotype relationships that have relevance to psychiatric practice.
常见多态性在指导临床精神病学方面的价值受到精神疾病复杂多基因结构的限制。按照临床现象学定义,常见多态性对精神疾病风险的影响过小,无法指导临床实践。要确定大到足以作为生物标志物的可靠多态性效应,需要从分子到细胞再到神经回路和行为等不同复杂层面详细分析多态性的生物学特性。正如“研究领域标准”框架所提议的,强调行为领域而非临床诊断,有助于使用能够重现人类多态性的小鼠模型,因为对等效表型的影响可以跨物种转化并整合到不同分析层面。脑源性神经营养因子基因(BDNF)常见多态性的基因敲入小鼠模型,为例证了这种垂直整合的转化方法如何能够识别与精神病学实践相关的强大基因型-表型关系。