Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
JAMA Psychiatry. 2022 Jul 1;79(7):667-676. doi: 10.1001/jamapsychiatry.2022.0914.
Certain psychiatric and immune-related disorders are reciprocal risk factors. However, the nature of these associations is unclear.
To characterize the pleiotropy between psychiatric and immune-related traits, as well as risk factors of hypothesized relevance.
DESIGN, SETTING, AND PARTICIPANTS: This genetic association study was conducted from July 10, 2020, to January 15, 2022. Analyses used genome-wide association (GWA) statistics related to 14 psychiatric traits; 13 immune-related phenotypes, ie, allergic, autoimmune, and inflammatory disorders; and 15 risk factors related to health-related behaviors, social determinants of health, and stress response. Genetically correlated psychiatric-immune pairs were assessed using 2-sample mendelian randomization (MR) with sensitivity analyses and multivariable adjustment for genetic associations of third variables. False discovery rate correction (Q value < .05) was applied for each analysis.
Genetic associations.
Genetic correlations and MR association estimates with SEs and P values. A data-driven approach was used that did not test a priori planned hypotheses.
A total of 44 genetically correlated psychiatric-immune pairs were identified, including 31 positive correlations (most consistently involving asthma, Crohn disease, hypothyroidism, and ulcerative colitis) and 13 negative correlations (most consistently involving allergic rhinitis and type 1 diabetes). Correlations with third variables were especially strong for psychiatric phenotypes. MR identified 7 associations of psychiatric phenotypes on immune-related phenotypes that were robust to multivariable adjustment, including the positive association of (1) the psychiatric cross-disorder phenotype with asthma (odds ratio [OR], 1.04; 95% CI, 1.02-1.06), Crohn disease (OR, 1.09; 95% CI, 1.05-1.14), and ulcerative colitis (OR, 1.09; 95% CI, 1.05-1.14); (2) major depression with asthma (OR, 1.25; 95% CI, 1.13-1.37); (3) schizophrenia with Crohn disease (OR, 1.12; 95% CI, 1.05-1.18) and ulcerative colitis (OR, 1.14; 95% CI, 1.07-1.21); and a negative association of risk tolerance with allergic rhinitis (OR, 0.77; 95% CI, 0.67-0.92).
Results of this genetic association study suggest that genetic liability for psychiatric disorders was associated with liability for several immune disorders, suggesting that vertical pleiotropy related to behavioral traits (or correlated third variables) contributes to clinical associations observed in population-scale data.
某些精神疾病和免疫相关疾病是相互的风险因素。然而,这些关联的性质尚不清楚。
描述精神疾病和免疫相关特征之间的多效性,以及假设相关的风险因素。
设计、设置和参与者:这是一项从 2020 年 7 月 10 日至 2022 年 1 月 15 日进行的遗传关联研究。分析使用与 14 种精神疾病特征;13 种免疫相关表型,即过敏、自身免疫和炎症性疾病;以及 15 种与健康相关行为、社会决定因素和应激反应相关的风险因素相关的全基因组关联(GWA)统计数据。使用双样本 Mendelian 随机化(MR)评估与遗传相关的精神-免疫对,并使用第三变量的遗传关联进行敏感性分析和多变量调整。对每个分析应用错误发现率校正(Q 值<.05)。
遗传关联。
遗传相关性和 MR 关联估计值及其 SE 和 P 值。使用了一种数据驱动的方法,没有预先测试计划好的假设。
共确定了 44 对具有遗传相关性的精神-免疫对,包括 31 个正相关(最一致的涉及哮喘、克罗恩病、甲状腺功能减退症和溃疡性结肠炎)和 13 个负相关(最一致的涉及过敏性鼻炎和 1 型糖尿病)。与第三变量的相关性对于精神疾病表型尤其强烈。MR 确定了 7 种精神疾病表型对免疫相关表型的关联,这些关联在多变量调整后仍然稳健,包括(1)精神障碍交叉表型与哮喘(优势比[OR],1.04;95%CI,1.02-1.06)、克罗恩病(OR,1.09;95%CI,1.05-1.14)和溃疡性结肠炎(OR,1.09;95%CI,1.05-1.14)之间的正相关;(2)重度抑郁症与哮喘(OR,1.25;95%CI,1.13-1.37);(3)精神分裂症与克罗恩病(OR,1.12;95%CI,1.05-1.18)和溃疡性结肠炎(OR,1.14;95%CI,1.07-1.21)之间的正相关;以及风险容忍度与过敏性鼻炎(OR,0.77;95%CI,0.67-0.92)之间的负相关。
这项遗传关联研究的结果表明,精神疾病的遗传易感性与多种免疫疾病的易感性有关,这表明与行为特征(或相关的第三变量)相关的垂直多效性有助于解释在人群规模数据中观察到的临床关联。