儿童期起病的精神分裂症:从经典研究到基因组时代的遗传异质性系统综述。
Childhood-Onset Schizophrenia: A Systematic Overview of Its Genetic Heterogeneity From Classical Studies to the Genomic Era.
作者信息
Fernandez Arnaud, Drozd Malgorzata Marta, Thümmler Susanne, Dor Emmanuelle, Capovilla Maria, Askenazy Florence, Bardoni Barbara
机构信息
University Department of Child and Adolescent Psychiatry, Children's, Hospitals of NICE CHU-Lenval, Nice, France.
CoBTek, Université Côte d'Azur, Nice, France.
出版信息
Front Genet. 2019 Dec 18;10:1137. doi: 10.3389/fgene.2019.01137. eCollection 2019.
Childhood-onset schizophrenia (COS), a very rare and severe chronic psychiatric condition, is defined by an onset of positive symptoms (delusions, hallucinations and disorganized speech or behavior) before the age of 13. COS is associated with other neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder. Copy number variations (CNVs) represent well documented neurodevelopmental disorder risk factors and, recently, single nucleotide variations (SNVs) in genes involved in brain development have also been implicated in the complex genetic architecture of COS. Here, we aim to review the genetic changes (CNVs and SNVs) reported for COS, going from previous studies to the whole genome sequencing era. We carried out a systematic review search in PubMed using the keywords "childhood(early)-onset schizophrenia(psychosis)" and "genetic(s) or gene(s) or genomic(s)" without language and date limitations. The main inclusion criteria are COS (onset before 13 years old) and all changes/variations at the DNA level (CNVs or SNVs). Thirty-six studies out of 205 met the inclusion criteria. Cytogenetic abnormalities (n = 72, including 66 CNVs) were identified in 16 autosomes and 2 sex chromosomes (X, Y), some with a higher frequency and clinical significance than others (e.g., 2p16.3, 3q29, 15q13.3, 22q11.21 deletions; 2p25.3, 3p25.3 and 16p11.2 duplications). Thirty-one single nucleotide mutations in genes principally involved in brain development and/or function have been found in 12 autosomes and one sex chromosome (X). We also describe five SNVs in X-linked genes inherited from a healthy mother, arguing for the X-linked recessive inheritance hypothesis. Moreover, (19q13.2) is the only gene carrying more than one SNV in more than one patient, making it a strong candidate for COS. Mutations were distributed in various chromosomes illustrating the genetic heterogeneity of COS. More than 90% of CNVs involved in COS are also involved in ASD, supporting the idea that there may be genetic overlap between these disorders. Different mutations associated with COS are probably still unknown, and pathogenesis might also be explained by the association of different genetic variations (two or more CNVs or CNVs and SNVs) as well as association with early acquired brain lesions such as infection, hypoxia, or early childhood trauma.
儿童期起病的精神分裂症(COS)是一种非常罕见且严重的慢性精神疾病,其定义为在13岁之前出现阳性症状(妄想、幻觉以及言语或行为紊乱)。COS与其他神经发育障碍有关,如自闭症谱系障碍(ASD)和注意力缺陷多动障碍。拷贝数变异(CNV)是有充分文献记载的神经发育障碍风险因素,最近,参与大脑发育的基因中的单核苷酸变异(SNV)也被认为与COS复杂的遗传结构有关。在此,我们旨在回顾已报道的COS的基因变化(CNV和SNV),从先前的研究到全基因组测序时代。我们在PubMed上进行了系统检索,使用关键词“儿童期(早期)起病的精神分裂症(精神病)”和“遗传(学)或基因(s)或基因组(学)”,无语言和日期限制。主要纳入标准为COS(发病年龄在13岁之前)以及DNA水平的所有变化/变异(CNV或SNV)。205项研究中有36项符合纳入标准。在16条常染色体和2条性染色体(X、Y)中发现了细胞遗传学异常(n = 72,包括66个CNV),其中一些的频率和临床意义高于其他异常(例如,2p16.3、3q29、15q13.3、22q11.21缺失;2p25.3、3p25.3和16p11.2重复)。在12条常染色体和1条性染色体(X)中发现了31个主要参与大脑发育和/或功能的基因中的单核苷酸突变。我们还描述了从健康母亲遗传而来的X连锁基因中的5个SNV,支持X连锁隐性遗传假说。此外,(19q13.2)是唯一一个在不止一名患者中携带不止一个SNV的基因,使其成为COS的一个有力候选基因。突变分布在不同染色体上,说明了COS的遗传异质性。超过90%与COS相关的CNV也与ASD有关,支持了这些疾病之间可能存在遗传重叠的观点。与COS相关的不同突变可能仍然未知,发病机制也可能由不同遗传变异(两个或更多CNV或CNV和SNV)的关联以及与早期获得性脑损伤如感染、缺氧或儿童早期创伤的关联来解释。