Kennedy J L, Macciardi F M
Clarke Institute of Psychiatry, University of Toronto, Ontario, Canada.
Psychiatr Genet. 1998 Summer;8(2):67-71. doi: 10.1097/00041444-199800820-00008.
The largest cluster of positive results, considering both bipolar and schizophrenia, occurs in the 4p region that includes D4S394 and DRD5. Four groups report at least weakly positive linkage analyses this region for bipolar disorder, and two groups find weak positive allelic association with schizophrenia in the region, although at separate markers. On the other hand, at least five groups do not find evidence for linkage of bipolar disorder to this area of 4p. The pattern on 4q is less clear, with a mixture of negative and small positive results in either bipolar or schizophrenia families. Additional allelic association and TDT studies of 4p markers in bipolar disorder and in schizophrenia might be able to narrow the focus of the 4p investigations. The dopamine D5 receptor gene has seductive qualities as a candidate gene because of the pharmacology of psychotic disorders. It would be helpful to have additional markers developed close to or in the recoding region of DRD5 in order to have the extra information at the DNA level provided by haplotype analysis. Chromosome 4 susceptibility loci may figure prominently in alcoholism, although a great deal of work remains to be done. With just two groups reporting here, only a limited assessment of the overall effect of the ADH cluster and the GABA cluster is possible. However, these loci have merit as candidate genes, and thus further work on the current and additional families is clearly indicated.
综合双相情感障碍和精神分裂症来看,阳性结果最为集中的区域是4p,其中包括D4S394和多巴胺D5受体基因(DRD5)。四组研究报告称在该区域对双相情感障碍进行的连锁分析至少呈弱阳性,两组研究发现该区域与精神分裂症存在弱的阳性等位基因关联,不过涉及的是不同的标记。另一方面,至少有五组研究未发现双相情感障碍与4p这一区域存在连锁的证据。4q上的情况不太明确,在双相情感障碍或精神分裂症家族中既有阴性结果,也有少量阳性结果。对双相情感障碍和精神分裂症中4p标记进行更多的等位基因关联研究和传递不平衡检验(TDT)研究,可能有助于缩小4p区域的研究重点。由于精神障碍的药理学特性,多巴胺D5受体基因作为候选基因颇具吸引力。开发更多靠近DRD5编码区域或位于该区域内的标记将很有帮助,以便通过单倍型分析在DNA水平上获得更多信息。4号染色体的易感基因座在酒精中毒中可能起重要作用,尽管还有大量工作有待完成。此处仅有两组研究报告,因此只能对乙醇脱氢酶(ADH)基因簇和γ-氨基丁酸(GABA)基因簇的总体效应进行有限的评估。然而,这些基因座作为候选基因具有价值,因此显然需要对现有及更多家族展开进一步研究。