Darbro Benjamin W, Singh Rohini, Zimmerman M Bridget, Mahajan Vinit B, Bassuk Alexander G
Department of Pediatrics, Division of Medical Genetics, University of Iowa, Iowa City, Iowa, United States of America.
Interdisciplinary Program in Genetics, University of Iowa, Iowa City, Iowa, United States of America.
PLoS One. 2016 Mar 2;11(3):e0149041. doi: 10.1371/journal.pone.0149041. eCollection 2016.
Autism spectrum disorder (ASD) is one phenotypic aspect of many monogenic, hereditary cancer syndromes. Pleiotropic effects of cancer genes on the autism phenotype could lead to repurposing of oncology medications to treat this increasingly prevalent neurodevelopmental condition for which there is currently no treatment. To explore this hypothesis we sought to discover whether autistic patients more often have rare coding, single-nucleotide variants within tumor suppressor and oncogenes and whether autistic patients are more often diagnosed with neoplasms. Exome-sequencing data from the ARRA Autism Sequencing Collaboration was compared to that of a control cohort from the Exome Variant Server database revealing that rare, coding variants within oncogenes were enriched for in the ARRA ASD cohort (p<1.0 x 10(-8)). In contrast, variants were not significantly enriched in tumor suppressor genes. Phenotypically, children and adults with ASD exhibited a protective effect against cancer, with a frequency of 1.3% vs. 3.9% (p<0.001), but the protective effect decreased with age. The odds ratio of neoplasm for those with ASD relative to controls was 0.06 (95% CI: 0.02, 0.19; p<0.0001) in the 0 to 14 age group; 0.35 (95% CI: 0.14, 0.87; p = 0.024) in the 15 to 29 age group; 0.41 (95% CI: 0.15, 1.17; p = 0.095) in the 30 to 54 age group; and 0.49 (95% CI: 0.14, 1.74; p = 0.267) in those 55 and older. Both males and females demonstrated the protective effect. These findings suggest that defects in cellular proliferation, and potentially senescence, might influence both autism and neoplasm, and already approved drugs targeting oncogenic pathways might also have therapeutic value for treating autism.
自闭症谱系障碍(ASD)是许多单基因遗传性癌症综合征的一个表型方面。癌症基因对自闭症表型的多效性作用可能导致肿瘤药物被重新用于治疗这种目前尚无治疗方法且日益普遍的神经发育疾病。为了探究这一假设,我们试图发现自闭症患者是否更常携带肿瘤抑制基因和癌基因中的罕见编码单核苷酸变异,以及自闭症患者是否更常被诊断患有肿瘤。将来自ARRA自闭症测序协作组的外显子测序数据与来自外显子变异服务器数据库的对照队列数据进行比较,结果显示癌基因中的罕见编码变异在ARRA自闭症谱系障碍队列中富集(p<1.0×10⁻⁸)。相比之下,肿瘤抑制基因中的变异没有显著富集。在表型上,患有自闭症谱系障碍的儿童和成人对癌症表现出保护作用,频率分别为1.3%和3.9%(p<0.001),但这种保护作用随年龄增长而降低。在0至14岁年龄组中,自闭症谱系障碍患者相对于对照组的肿瘤发生比值比为0.06(95%置信区间:0.02,0.19;p<0.0001);在15至29岁年龄组中为0.35(95%置信区间:0.14,0.87;p = 0.024);在30至54岁年龄组中为0.41(95%置信区间:0.15,1.17;p = 0.095);在55岁及以上年龄组中为0.49(95%置信区间:0.14,1.74;p = 0.267)。男性和女性均表现出这种保护作用。这些发现表明,细胞增殖缺陷以及潜在的细胞衰老可能会影响自闭症和肿瘤,并且已经获批的针对致癌途径的药物可能也具有治疗自闭症的价值。