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Uncovering the genetic underpinnings for different psychiatric disorder combinations 揭示不同精神疾病组合的遗传基础
Pub Date : 2024-08-29 DOI: 10.1101/2024.08.29.24312761
Liangying Yin, Menghui Liu, Yujia Shi, Ruoyu Zhang, Simon Sai-Yu Lui, Hon-Cheong So
Psychiatric disorders are highly heterogeneous, and it is clinically meaningful to distinguish psychiatric disorders by the presence or absence of a specific comorbid condition. In this study, we employed a recently developed algorithm (CombGWAS) to decipher the genetic basis of psychiatric disorder combinations. The focus was on comorbidities and combinations of disorders, such as major depressive disorder(MDD) with and without schizophrenia(SCZ), which can be considered as two ‘subtypes’ of MDD. We also studied psychiatric disorders comorbid with obesity as disease subtypes.
精神疾病具有高度异质性,根据是否存在特定的合并症来区分精神疾病具有临床意义。在本研究中,我们采用了一种最新开发的算法(CombGWAS)来解读精神疾病组合的遗传基础。研究的重点是合并症和疾病组合,如重度抑郁障碍(MDD)合并精神分裂症(SCZ)和不合并精神分裂症(SCZ),这可被视为重度抑郁障碍的两种 "亚型"。我们还将肥胖症合并的精神障碍作为疾病亚型进行了研究。
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引用次数: 0
Substantial role of rare inherited variation in individuals with developmental disorders 罕见遗传变异在发育障碍患者中的重要作用
Pub Date : 2024-08-29 DOI: 10.1101/2024.08.28.24312746
Kaitlin E. Samocha, V. Kartik Chundru, Jack M. Fu, Eugene J. Gardner, Petr Danecek, Emilie M. Wigdor, Daniel S. Malawsky, Sarah J. Lindsay, Patrick Campbell, Tarjinder Singh, Ruth Y. Eberhardt, Giuseppe Gallone, Caroline F. Wright, Hilary C. Martin, Helen V. Firth, Matthew E. Hurles
While the role of de novo and recessively-inherited coding variation in risk for rare developmental disorders (DDs) has been well established, the contribution of damaging variation dominantly-inherited from parents is less explored. Here, we investigated the contribution of rare coding variants to DDs by analyzing 13,452 individuals with DDs, 18,613 of their family members, and 3,943 controls using a combination of family-based and case/control analyses. In line with previous studies of other neuropsychiatric traits, we found a significant burden of rare (allele frequency < 1×10-5) predicted loss-of-function (pLoF) and damaging missense variants, the vast majority of which are inherited from apparently unaffected parents. These predominantly inherited burdens are strongest in DD-associated genes or those intolerant of pLoF variation in the general population, however we estimate that ∼10% of the excess of these variants in DD cases is found within the DD-associated genes, implying many more risk loci are yet to be identified. We found similar, but attenuated, burdens when comparing the unaffected parents of individuals with DDs to controls, indicating that parents have elevated risk of DDs due to these rare variants, which are overtransmitted to their affected children. We estimate that 6-8.5% of the population attributable risk for DDs are due to rare pLoF variants in those genes intolerant of pLoF variation in the general population. Finally, we apply a Bayesian framework to combine evidence from these analyses of rare, mostly-inherited variants with prior de novo mutation burden analyses to highlight an additional 25 candidate DD- associated genes for further follow up.
虽然新发编码变异和隐性遗传编码变异在罕见发育障碍(DDs)风险中的作用已被充分证实,但对父母显性遗传的损伤性变异的贡献却探讨较少。在此,我们采用基于家族的分析和病例/对照分析相结合的方法,对 13,452 名发育障碍患者、18,613 名其家庭成员和 3,943 名对照者进行了分析,从而研究了罕见编码变异对发育障碍的影响。与之前对其他神经精神特质的研究结果一致,我们发现罕见(等位基因频率为1×10-5)的预测功能缺失(pLoF)和损伤性错义变异负担沉重,其中绝大多数变异是从明显未受影响的父母那里遗传而来。这些主要的遗传负担在 DD 相关基因或一般人群中不耐受 pLoF 变异的基因中最为严重,但我们估计,DD 病例中过量的这些变异中有 10% 是在 DD 相关基因中发现的,这意味着还有更多的风险位点有待确定。我们发现,与对照组相比,DD患者未受影响的父母也有类似的负担,但负担有所减轻,这表明父母患DD的风险因这些罕见变异而升高,而这些变异又过度传递给了他们的患儿。我们估计,6-8.5% 的 DDs 人口可归因风险是由于普通人群中不耐受 pLoF 变异的基因中的罕见 pLoF 变异造成的。最后,我们应用贝叶斯框架,将这些罕见、多为遗传变异的分析证据与先前的从头突变负荷分析结合起来,突出了另外 25 个与 DD 相关的候选基因,以便进行进一步的跟踪研究。
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引用次数: 0
Blood DNA methylation levels of the oxytocin promoter predict conversion from mild cognitive impairment to dementia in females within a clinical cohort of cognitive complaints 血液中催产素启动子 DNA 甲基化水平可预测认知障碍临床队列中女性从轻度认知障碍转变为痴呆症的情况
Pub Date : 2024-08-29 DOI: 10.1101/2024.08.28.24312742
Philippos Koulousakis, Rick Reijnders, Inez Ramakers, Frans Verhey, Tim Vanmierlo, Daniël L.A. van den Hove, Renzo J.M. Riemens
Recent studies have highlighted the role of oxytocin (OXT) in Alzheimer’s disease (AD) dementia and demonstrated its potential as a therapeutic target to reverse cognitive impairment and mitigate AD pathology. Epigenetic dysregulation of OXT has been identified in brain tissue from AD patients, and DNA methylation levels of the exact same locus in the blood of healthy aged individuals have shown predictive biomarker value for conversion to AD. Building on these insights, we investigated the DNA methylation status of the OXT promoter in blood in a prospective cohort of consecutive patients from the BioBank Alzheimer Center Limburg (BBACL). This cohort included males and females suffering from subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. Our findings revealed that DNA methylation levels of the OXT promoter at baseline predict the conversion from MCI to dementia in female participants. In addition to discovering differences in the OXT promoter related to sex, we also observed alterations associated with aging, alcohol consumption, and smoking. Overall, our findings underscore the implications of OXT and its DNA methylation changes in blood within the context of dementia.
最近的研究强调了催产素(OXT)在阿尔茨海默病(AD)痴呆症中的作用,并证明它有可能成为逆转认知障碍和减轻 AD 病理的治疗靶点。在阿尔茨海默病患者的脑组织中发现了 OXT 的表观遗传失调,而健康老年人血液中完全相同位点的 DNA 甲基化水平也显示了其对转化为阿尔茨海默病的预测性生物标志物价值。基于这些认识,我们在林堡生物银行阿尔茨海默病中心(BBACL)的前瞻性连续患者队列中调查了血液中 OXT 启动子的 DNA 甲基化状态。该队列包括患有主观认知能力下降(SCD)、轻度认知障碍(MCI)和痴呆症的男性和女性患者。我们的研究结果表明,基线 OXT 启动子的 DNA 甲基化水平可预测女性参与者从 MCI 向痴呆症的转化。除了发现 OXT 启动子与性别有关的差异外,我们还观察到与衰老、饮酒和吸烟有关的改变。总之,我们的研究结果强调了血液中的 OXT 及其 DNA 甲基化变化对痴呆症的影响。
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引用次数: 0
Genetic modifiers and ascertainment drive variable expressivity of complex disorders 遗传修饰因子和确定性驱动复杂疾病的可变表达性
Pub Date : 2024-08-28 DOI: 10.1101/2024.08.27.24312158
Matthew Jensen, Corrine Smolen, Anastasia Tyryshkina, Lucilla Pizzo, Deepro Banerjee, Matthew Oetjens, Hermela Shimelis, Cora Taylor, Vijay Kumar Pounraja, Hyebin Song, Laura Rohan, Emily Huber, Laila El Khattabi, Ingrid van de Laar, Rafik Tadros, Connie Bezzina, Marjon van Slegtenhorst, Janneke Kammeraad, Paolo Prontera, Jean-Hubert Caberg, Harry Fraser, Siddhartha Banka, Anke Van Dijck, Charles Schwartz, Els Voorhoeve, Patrick Callier, Anne-Laure Mosca-Boidron, Nathalie Marle, Mathilde Lefebvre, Kate Pope, Penny Snell, Amber Boys, Paul J. Lockhart, Myla Ashfaq, Elizabeth McCready, Margaret Nowacyzk, Lucia Castiglia, Ornella Galesi, Emanuela Avola, Teresa Mattina, Marco Fichera, Maria Grazia Bruccheri, Giuseppa Maria Luana Mandara, Francesca Mari, Flavia Privitera, Ilaria Longo, Aurora Curro, Alessandra Renieri, Boris Keren, Perrine Charles, Silvestre Cuinat, Mathilde Nizon, Olivier Pichon, Claire Beneteau, Radka Stoeva, Dominique Martin-Coignard, Sophia Blesson, Cedric Le Caignec, Sandra Mercier, Marie Vincent, Christa Martin, Katrin Mannik, Alexandre Reymond, Laurence Faivre, Erik Sistermans, R. Frank Kooy, David Amor, Corrado Romano, Joris Andreiux, Santhosh Girirajan
Variable expressivity of disease-associated variants implies a role for secondary variants that modify clinical features. We assessed the effects of modifier variants towards clinical outcomes of 2,252 individuals with primary variants. Among 132 families with the 16p12.1 deletion, distinct rare and common variant classes conferred risk for specific developmental features, including short tandem repeats for neurological defects and SNVs for microcephaly, while additional disease-associated variants conferred multiple genetic diagnoses. Within disease and population cohorts of 773 individuals with the 16p12.1 deletion, we found opposing effects of secondary variants towards clinical features across ascertainments. Additional analysis of 1,479 probands with other primary variants, such as 16p11.2 deletion and CHD8 variants, and 1,084 without primary variants, showed that phenotypic associations differed by primary variant context and were influenced by synergistic interactions between primary and secondary variants. Our study provides a paradigm to dissect the genomic architecture of complex disorders towards personalized treatment.
疾病相关变异的不同表达性意味着改变临床特征的次级变异的作用。我们评估了修饰变异对 2252 个原发性变异个体临床结果的影响。在132个16p12.1缺失的家庭中,不同的罕见和常见变异类别会导致特定发育特征的风险,包括导致神经系统缺陷的短串联重复序列和导致小头畸形的SNV,而其他疾病相关变异则会导致多种遗传诊断。在由 773 名 16p12.1 缺失个体组成的疾病和人群队列中,我们发现继发性变异对不同确定性的临床特征具有相反的影响。此外,我们还对 1,479 名有其他原发性变异(如 16p11.2 缺失和 CHD8 变异)的受试者和 1,084 名无原发性变异的受试者进行了分析,结果表明,表型关联因原发性变异背景而异,并受到原发性变异和继发性变异之间协同作用的影响。我们的研究为剖析复杂疾病的基因组结构以实现个性化治疗提供了一个范例。
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引用次数: 0
COA5 has an essential role in the early stage of mitochondrial complex IV assembly COA5 在线粒体复合体 IV 组装的早期阶段发挥着重要作用
Pub Date : 2024-08-28 DOI: 10.1101/2024.08.27.24312374
Jia Xin Tang, Alfredo Cabrera-Orefice, Jana Meisterknecht, Lucie Taylor, Geoffray Monteuuis, Maria Ekman Stensland, Adam Szczepanek, Karen L Stals, James Davison, Langping He, Sila Hopton, Tuula A Nyman, Christopher B Jackson, Angela Pyle, Monika Winter, Ilka Wittig, Robert W Taylor
Pathogenic variants in cytochrome c oxidase assembly factor 5 (COA5), a proposed complex IV (CIV) assembly factor, have been shown to cause clinical mitochondrial disease with two siblings affected by neonatal hypertrophic cardiomyopathy manifesting a rare, homozygous COA5 missense variant (NM_001008215.3: c.157G>C, p.Ala53Pro). The most striking observation in the affected individuals was an isolated impairment in the early stage of mitochondrial CIV assembly. In this study, we report an unrelated family in who we have identified the same COA5 variant with patient-derived fibroblasts and skeletal muscle biopsies replicating an isolated CIV deficiency. A CRISPR/Cas9-edited homozygous COA5 knockout U2OS cell line with similar biochemical profile was generated to interrogate the functional role of the human COA5 protein. Mitochondrial complexome profiling pinpointed a role for COA5 in early CIV assembly, more specifically, its involvement in the stage between MTCO1 maturation and the incorporation of MTCO2. We therefore propose that the COA5 protein plays an essential role for the biogenesis of MTCO2 and its integration into the early CIV assembly intermediate for downstream assembly of the functional holocomplex.
细胞色素 c 氧化酶组装因子 5(COA5)是一种拟议的复合体 IV(CIV)组装因子,其致病变异已被证明可导致临床线粒体疾病,两个患有新生儿肥厚型心肌病的兄弟姐妹表现出罕见的同基因 COA5 错义变异(NM_001008215.3:c.157G>C, p.Ala53Pro)。在受影响的个体中,最显著的观察结果是线粒体 CIV 组装的早期阶段出现了孤立的损伤。在本研究中,我们报告了一个非亲属关系的家族,我们在该家族中发现了相同的 COA5 变体,患者来源的成纤维细胞和骨骼肌活检复制了孤立的 CIV 缺乏症。通过 CRISPR/Cas9 编辑的同源 COA5 基因敲除 U2OS 细胞系具有相似的生化特征,以研究人类 COA5 蛋白的功能作用。线粒体复合体谱分析确定了 COA5 在早期 CIV 组装中的作用,更具体地说,它参与了 MTCO1 成熟和 MTCO2 结合之间的阶段。因此,我们认为 COA5 蛋白在 MTCO2 的生物生成以及将其整合到早期 CIV 组装中间体中,从而在下游组装功能性全复合体的过程中起着至关重要的作用。
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引用次数: 0
Immunological profiles in Lynch syndrome colorectal cancers are not specific to mismatch repair gene defects 林奇综合征结直肠癌的免疫特征与错配修复基因缺陷无关
Pub Date : 2024-08-28 DOI: 10.1101/2024.08.27.24311855
Noah C. Helderman, Marieke E. IJsselsteijn, Madalina Cabuta, Manon van der Ploeg, Tom van Wezel, Aysel Ahadova, Matthias Kloor, Hans Morreau, Maartje Nielsen, Noel F.C.C. de Miranda
Background and aims: Colorectal carcinomas (CRCs) in patients with Lynch syndrome (LS) exhibit heightened immunogenicity due to mismatch repair deficiency (MMR-d), often resulting in favorable responses to T cell immune checkpoint therapies. Recent studies indicate that the phenotype and genotype of LS-associated CRCs vary depending on the specific MMR gene mutated. Here, we investigated whether the immune profiles of LS-associated CRCs differ based on the MMR gene defects. Methods: Tissue material from 18 MLH1-, 16 MSH2-, 40 MSH6-, and 23 PMS2-mutated CRCs and 35 sporadic MMR-d CRCs were included in the study. Imaging mass cytometry (IMC) analysis, along with targeted multiplex immunofluorescence imaging (mIF) and immunohistochemistry, were applied to examine the tumor immune microenvironment, including Human Leukocyte Antigen (HLA) class I and programmed death-ligand 1 (PD-L1) expression. Results: Unsupervised hierarchical clustering of cell phenotypes identified by IMC, followed by mIF validation, revealed comparable lymphoid and myeloid cell infiltration levels across CRCs from all MMR groups. Infiltrating T cell levels negatively correlated with the number of mutations at coding microsatellite sequences, particularly in MLH1-mutated CRCs. HLA class I defects were observed in 76% of all CRCs. These defects were more frequently accompanied by β2M defects in hereditary MMR-d CRCs (67%) compared to sporadic MMR-d CRCs (37%), and did not associate with the number of γδ T cells, which were present in CRCs from all MMR groups. PD-L1 expression in tumor cells was only detected in 8% of all CRCs. Conclusion: Our findings illustrate that, from an immunological perspective, there is no evidence of differing immunogenic features across MMR defects. This is important to consider when developing preventive vaccine strategies and evaluating immunotherapy for LS patients and those with MMR-d CRCs.
背景和目的:林奇综合征(Lynch syndrome,LS)患者的结直肠癌(CRC)由于错配修复缺陷(MMR-d)而表现出更强的免疫原性,通常会对T细胞免疫检查点疗法产生有利的反应。最近的研究表明,LS 相关性 CRC 的表型和基因型因特定 MMR 基因突变而异。在此,我们研究了LS相关性CRC的免疫特征是否因MMR基因缺陷而有所不同。研究方法研究纳入了 18 例 MLH1、16 例 MSH2、40 例 MSH6 和 23 例 PMS2 突变的 CRC 以及 35 例散发性 MMR-d CRC 的组织材料。研究人员应用成像质控细胞仪(IMC)、靶向多重免疫荧光成像(mIF)和免疫组化技术检测肿瘤免疫微环境,包括人类白细胞抗原(HLA)I类和程序性死亡配体1(PD-L1)的表达。研究结果对 IMC 确定的细胞表型进行无监督分层聚类,然后进行 mIF 验证,结果显示所有 MMR 组的 CRC 中淋巴细胞和骨髓细胞浸润水平相当。浸润的T细胞水平与编码微卫星序列的突变数量呈负相关,尤其是在MLH1突变的CRC中。76%的 CRC 存在 HLA I 类缺陷。与散发性 MMR-d CRC(37%)相比,遗传性 MMR-d CRC(67%)中的这些缺陷更常伴有 β2M 缺陷,而且这些缺陷与 γδ T 细胞的数量无关,后者存在于所有 MMR 组的 CRC 中。只有 8% 的 CRC 检测到肿瘤细胞中有 PD-L1 表达。结论我们的研究结果表明,从免疫学的角度来看,没有证据表明不同的 MMR 缺陷具有不同的免疫原性特征。在为 LS 患者和 MMR-d CRC 患者制定预防性疫苗策略和评估免疫疗法时,这一点非常重要。
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引用次数: 0
The Genetic Relationships Between Post-Traumatic Stress Disorder and Its Corresponding Neural Circuit Structures 创伤后应激障碍与相应神经回路结构之间的遗传关系
Pub Date : 2024-08-26 DOI: 10.1101/2024.08.25.24312540
Qian Gong, Honggang Lyu, Lijun Kang, Simeng Ma, Nan Zhang, Xin-hui Xie, Enqi Zhou, Zipeng Deng, Jiewei Liu, Zhongchun Liu
Post-traumatic stress disorder (PTSD) may be linked to abnormalities in neural circuits that facilitate fear learning and memory processes. The precise degree to which this connection is influenced by genetic factors is still uncertain. This study aimed to investigate the genetic association between PTSD and its corresponding brain circuitry components. We conducted a meta-analysis using the summary of PTSD genome-wide association studies (GWAS) from multiple cohorts to enhance statistical power (sample size = 306,400). Based on the result, and utilizing the lifetime trauma events (LTE) trait as a control for PTSD, we investigated the genetic association of PTSD and LTE with 9 brain structure traits related to the brain circuitry (4 cortical, 2 subcortical, and 3 white matter) by various methodologies, including heritability tissue enrichment analysis, global and local genetic correlations, polygenic overlap analysis, and causal inference. As a result, we discovered the enrichment of heritability for PTSD within circuitry-relevant brain regions such as the cingulate cortex and frontal cortex, and we identified genetic correlations between PTSD and these brain regions. We have observed a polygenic overlap and a total of 31 novel jointly significant genetic loci (conjunction FDR < 0.05). These loci are involved in the process of DNA damage and repair as well as the pathway of neurodegenerative diseases. We also identified a potential causal relationship between PTSD and the surface area of the frontal pole. Our findings offer a valuable understanding of the genetic mechanisms underlying PTSD and its associated brain circuitry.
创伤后应激障碍(PTSD)可能与促进恐惧学习和记忆过程的神经回路异常有关。这种联系受遗传因素影响的确切程度仍不确定。本研究旨在调查创伤后应激障碍与相应脑回路成分之间的遗传关联。我们利用多个队列的创伤后应激障碍全基因组关联研究(GWAS)摘要进行了一项荟萃分析,以提高统计效力(样本量=306,400)。在此基础上,我们利用终生创伤事件(LTE)特质作为创伤后应激障碍的对照,通过遗传率组织富集分析、整体和局部遗传相关性、多基因重叠分析和因果推断等多种方法,研究了创伤后应激障碍和LTE与大脑回路相关的9个大脑结构特质(4个皮质、2个皮质下和3个白质)的遗传相关性。结果,我们发现创伤后应激障碍的遗传率在扣带回皮层和额叶皮层等与电路相关的脑区富集,并确定了创伤后应激障碍与这些脑区之间的遗传相关性。我们观察到了多基因重叠现象,共发现了 31 个新的联合显著遗传位点(联合 FDR < 0.05)。这些基因位点涉及 DNA 损伤和修复过程以及神经退行性疾病的发病途径。我们还发现了创伤后应激障碍与额极表面积之间的潜在因果关系。我们的研究结果为了解创伤后应激障碍及其相关脑回路的遗传机制提供了宝贵的信息。
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引用次数: 0
Differential Tractography: A Biomarker for Neuronal Function in Neurodegenerative Disease 差异牵张成像:神经退行性疾病中神经元功能的生物标志物
Pub Date : 2024-08-26 DOI: 10.1101/2024.08.25.24312255
Connor J Lewis, Zeynep Vardar, Anna Luisa Kühn, Jean M Johnston, Precilla D'Souza, William A Gahl, Mohammed Salman Shazeeb, Cynthia J Tifft, Maria T Acosta
GM1 gangliosidosis is an ultra-rare inherited neurodegenerative lysosomal storage disorder caused by biallelic mutations in the GLB1 gene. GM1 is uniformly fatal and has no approved therapies, although clinical trials investigating gene therapy as a potential treatment for this condition are underway. Novel outcome measures or biomarkers demonstrating the longitudinal effects of GM1 and potential recovery due to therapeutic intervention are urgently needed to establish efficacy of potential therapeutics. One promising tool is differential tractography, a novel imaging modality utilizing serial diffusion weighted imaging (DWI) to quantify longitudinal changes in white matter microstructure. In this study, we present the novel use of differential tractography in quantifying the progression of GM1 alongside age-matched neurotypical controls. We analyzed 113 DWI scans from 16 GM1 patients and 32 age-matched neurotypical controls to investigate longitudinal changes in white matter pathology. GM1 patients showed white matter degradation evident by both the number and size of fiber tract loss. In contrast, neurotypical controls showed longitudinal white matter improvements as evident by both the number and size of fiber tract growth. We also corroborated these findings by documenting significant correlations between cognitive global impression (CGI) scores of clinical presentations and our differential tractography derived metrics in our GM1 cohort. Specifically, GM1 patients who lost more neuronal fiber tracts also had a worse clinical presentation. This result demonstrates the importance of differential tractography as an important biomarker for disease progression in GM1 patients with potential extension to other neurodegenerative diseases and therapeutic intervention.
GM1 神经节苷脂病是一种超罕见的遗传性神经退行性溶酶体贮积症,由 GLB1 基因的双倍突变引起。GM1神经节苷脂病是一种致命性疾病,目前还没有获得批准的治疗方法,但研究基因疗法作为一种潜在治疗方法的临床试验正在进行中。为了确定潜在疗法的疗效,迫切需要新的结果测量或生物标志物来证明 GM1 的纵向影响以及治疗干预可能带来的恢复。其中一种很有前景的工具是差异束成像,这是一种新型成像模式,利用序列扩散加权成像(DWI)量化白质微观结构的纵向变化。在本研究中,我们展示了利用差异束成像量化 GM1 与年龄匹配的神经典型对照组的进展的新方法。我们分析了来自 16 名 GM1 患者和 32 名年龄匹配的神经典型对照者的 113 张 DWI 扫描图像,以研究白质病理学的纵向变化。GM1患者的白质退化表现在纤维束缺失的数量和大小上。与此相反,神经典型对照组的白质纵向变化则表现为纤维束数量和大小的增长。我们还通过记录临床表现的认知总体印象(CGI)评分与我们的GM1队列中不同纤维束成像得出的指标之间的显著相关性来证实这些发现。具体来说,神经元纤维束丢失较多的 GM1 患者的临床表现也较差。这一结果表明了差异束成像作为 GM1 患者疾病进展的重要生物标志物的重要性,并有可能推广到其他神经退行性疾病和治疗干预中。
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引用次数: 0
Exploring Youth-Perceived Barriers and Attitudes Towards the Clinical Use of Pharmacogenetic Testing to Optimise Antidepressant Pharmacotherapy 探索青少年对药物基因检测在临床上用于优化抗抑郁药物治疗的障碍和态度
Pub Date : 2024-08-26 DOI: 10.1101/2024.08.25.24312539
Bradley Roberts, Zahra Cooper, Georgia Landery, Susanne Stanley, Bernadette T Majda, Khan RL Collins, P Anthony Akkari, Sean D Hood, Jennifer Rodger
The field of pharmacogenetics (PGx) is experiencing significant growth, with increasing evidence to support its application in psychiatric care, suggesting its potential to personalise treatment plans, optimise medication efficacy, and reduce adverse drug reactions. However, the perceived utility and practicability of PGx for psychiatric treatment in youth remains underexplored. This study investigated youth-perceived barriers and attitudes towards the implementation of PGx testing to guide antidepressant treatment in primary care. Semi-structured focus groups and interviews were conducted with 17 participants aged between 18 to 24 years. These sessions were recorded and transcribed before thematic analysis was used to identify collective themes. Three key themes were identified, including attitudes towards the medication prescription process, concerns and attitudes towards PGx testing, and perceived barriers to its clinical implementation. Although PGx testing was positively perceived by most participants, all participants shared concerns about PGx testing. Participants voiced concerns about the financial impact of PGx testing, the potential for treatment delays, and the accuracy of PGx testing in guiding antidepressant treatment. Additionally, participants noted that the low awareness and willingness of general practitioners to incorporate PGx testing into routine practice could hinder successful clinical implementation. Prior to the implementation of PGx testing into Australian primary practices, it is essential to acknowledge patient perspectives and ensure that clinical practices remain patient-focused. This study highlights important considerations for integrating PGx testing into antidepressant pharmacotherapy and emphasizes the need for future research to address and mitigate youth-perceived barriers.
药物遗传学(PGx)领域正经历着巨大的发展,越来越多的证据支持其在精神科治疗中的应用,这表明它具有个性化治疗方案、优化药物疗效和减少药物不良反应的潜力。然而,PGx 在青少年精神病治疗中的实用性和可操作性仍未得到充分探索。本研究调查了青少年对实施 PGx 检测以指导初级保健中的抗抑郁治疗的障碍和态度。研究人员对 17 名年龄在 18-24 岁之间的参与者进行了半结构化焦点小组讨论和访谈。在进行主题分析以确定集体主题之前,对这些会议进行了记录和转录。确定了三个关键主题,包括对药物处方流程的态度、对 PGx 检验的关注和态度,以及对其临床实施障碍的看法。尽管大多数参与者对 PGx 检验持积极态度,但所有参与者都对 PGx 检验表示担忧。与会者对 PGx 检测的经济影响、治疗延误的可能性以及 PGx 检测在指导抗抑郁治疗方面的准确性表示担忧。此外,与会者还指出,全科医生对将 PGx 检测纳入常规实践的认识和意愿较低,这可能会阻碍临床实践的成功实施。在澳大利亚基层医疗机构实施 PGx 检测之前,必须承认患者的观点,并确保临床实践始终以患者为中心。本研究强调了将PGx检测纳入抗抑郁药物治疗的重要注意事项,并强调了未来研究解决和减轻青少年认知障碍的必要性。
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引用次数: 0
Large-scale genome-wide analyses with proteomics integration reveal novel loci and biological insights into frailty 大规模全基因组分析与蛋白质组学整合揭示了有关虚弱的新基因位点和生物学见解
Pub Date : 2024-08-26 DOI: 10.1101/2024.08.26.24312584
Jonathan Mak, Chenxi Qin, Anna Kuukka, FinnGen Consortium, Sara Hagg, Jake K. L. Lin, Juulia Jylhava
Frailty is a clinically relevant phenotype with significant gaps in our understanding of its etiology. We performed a genome-wide association study of frailty in FinnGen (N=500,737) and replicated the signals in the UK Biobank (N=429,463) using polygenic risk scores (PRSs). We prioritized genes through proteomics integration (N~45,000; UK Biobank) and colocalization of protein quantitative trait loci. Frailty was measured using the Hospital Frailty Risk Score (HFRS). We observed 1,588 variants associated with frailty (p<5x10-8) of which 1,242 were novel, i.e., previously unreported for any trait. The associations mapped to 106 genes of which 31 were novel. PRS replication validated the signals (β=0.074, p<2x10-16). Cell type enrichment analysis indicated expression in neuronal cells. Protein levels of KHK, CGREF1, MET, ATXN2, ALDH2, NECTIN2, APOC1, APOE and FOSB were associated with HFRS, whereas colocalized signals were observed within APOE and BRAP. Our results reveal novel genetic contributions and causal candidate genes for frailty.
虚弱是一种与临床相关的表型,但我们对其病因的了解还存在很大差距。我们在 FinnGen(N=500,737)中进行了一项关于虚弱的全基因组关联研究,并利用多基因风险评分(PRSs)在英国生物库(N=429,463)中复制了相关信号。我们通过蛋白质组学整合(N~45,000;英国生物库)和蛋白质定量性状位点的共定位来确定基因的优先顺序。虚弱程度采用医院虚弱风险评分(HFRS)进行测量。我们观察到 1,588 个与虚弱相关的变异(p<5x10-8),其中 1,242 个为新变异,即以前未报道过的任何性状。与虚弱相关的基因有 106 个,其中 31 个是新基因。PRS复制验证了这些信号(β=0.074,p<2x10-16)。细胞类型富集分析表明该基因在神经元细胞中表达。KHK、CGREF1、MET、ATXN2、ALDH2、NECTIN2、APOC1、APOE 和 FOSB 的蛋白水平与 HFRS 相关,而在 APOE 和 BRAP 中观察到了共定位信号。我们的研究结果揭示了造成虚弱的新的遗传贡献和因果候选基因。
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medRxiv - Genetic and Genomic Medicine
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