候选基因和有利位点:精神分裂症、躁狂抑郁症、自闭症、酗酒和阿尔茨海默病的分子遗传学研究策略。

Psychiatric developments Pub Date : 1986-01-01
H Gurling
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摘要

有人认为,如果不考虑遗传影响,对许多精神疾病进行更详细的诊断系统的进一步研究是不可能取得成果的。即使这样做了,例如,在进行分离分析以确定遗传传递模式时,精神疾病往往会带来一些特定的问题,妨碍准确的分析。由于分子生物学和遗传学技术已经使系统地研究人类疾病中的基因效应成为可能,现在应该有可能具体说明所涉及的基因。当这一目标实现后,基于遗传原因的诊断系统就可以发展起来。这将有助于更准确地查明环境因素。需要采取具体的策略来克服不确定的遗传模式、疾病等位基因不完整或不外显以及疾病异质性。对于21号染色体长臂部分的致病位点,可以提出高度推测性的假设。对于自闭症来说,在X染色体上脆弱的X位点或附近有一个疾病位点似乎是合理的。使用DNA标记将躁狂抑郁症的基因座初步定位到11号染色体,在一小部分家庭中,DNA标记也显示出X连锁的一些证据。精神分裂症似乎与任何有利的基因座无关。精神分裂症的候选基因包括编码多巴胺、其他神经递质受体或酶以及各种神经肽(如脑啡肽和内啡肽)的基因。
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Candidate genes and favoured loci: strategies for molecular genetic research into schizophrenia, manic depression, autism, alcoholism and Alzheimer's disease.

It is argued that further research to achieve more detailed diagnostic systems in many psychiatric disorders is unlikely to be productive without taking genetic effects into account. Even when this is done, for example when carrying out segregation analysis to determine a mode of genetic transmission, mental illnesses often pose specific problems that preclude accurate analysis. Because techniques in molecular biology and genetics have made it possible to study gene effects in human disease systematically it should now be possible to specify the genes that are involved. When this has been achieved then a diagnostic system based on genetic causation can develop. This will have the advantage of helping to pinpoint environmental factors more accurately. Specific strategies will need to be adopted to overcome uncertain modes of inheritance, incomplete or non-penetrance of disease alleles and disease heterogeneity. Highly speculative hypotheses can be put forward for a locus causing Alzheimer's disease on a portion of the long arm of chromosome 21. For autism it is plausible that there is a disease locus at or near the fragile X site on the X chromosome. A locus for manic depression has been very tentatively mapped using DNA markers to chromosome 11 and in a small proportion of families DNA markers have also shown some evidence for X linkage. Schizophrenia does not seem to be associated with any favoured loci. Candidate genes for schizophrenia include those encoding dopamine, other neurotransmitter receptors or enzymes and various neuropeptides such as enkephalin and beta endorphin.

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