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       Same Genes Suspected in Both Depression and Bipolar Illness
   DIR By: Bipolar Girl
       Date: August 31, 2010, 4:19 pm
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       Same Genes Suspected in Both Depression and Bipolar Illness
       Increased Risk May Stem From Variation in Gene On/Off Switch
       Researchers, for the first time, have pinpointed a genetic
       hotspot that confers risk for both bipolar disorder and
       depression. People with either of these mood disorders were
       significantly more likely to have risk versions of genes at this
       site than healthy controls. One of the genes, which codes for
       part of a cell's machinery that tells genes when to turn on and
       off, was also found to be over-expressed in the executive hub of
       bipolar patients' brains, making it a prime suspect. The results
       add to mounting evidence that major mental disorders overlap at
       the molecular level.
       "People who carry the risk versions may differ in some dimension
       of brain development that may increase risk for mood disorders
       later in life," explained Francis McMahon, M.D., of the NIMH
       Mood and Anxiety Disorders Program, who led the study.
       McMahon and an international team of investigators, supported,
       in part by NIMH, report on the findings of their genome-wide
       meta-analysis online January 17, 2010 in the journal Nature
       Genetics.
       Background
       Major mood disorders affect 20 percent of the population and are
       among the leading causes of disability worldwide. It's long been
       known that bipolar disorder and unipolar depression often run
       together in the same families, hinting at some shared lineage.
       Yet, until now, no common genes or chromosomal locations had
       been identified.
       McMahon and colleagues analyzed data from five different
       genome-wide association studies (GWAS) totaling more than 13,600
       people, and confirmed their results in 3 additional independent
       samples totaling 4,677 people.
       Findings of This Study
       Genetic variations on Chromosome 3 were significantly associated
       with both mood disorders. The suspect gene, called PBRM1, codes
       for a protein critical for chromatin remodeling, a key process
       in regulating gene expression. A neighboring gene is involved in
       the proliferation of brain stem cells.
       The researchers pinpointed a "protective" version of the PBRM1
       gene that is carried by 41 percent of healthy controls, but only
       38 percent of people with bipolar and unipolar depression. The
       risk version was found in 62 percent of mood disorder cases and
       59 percent of controls. The researchers also showed that PBRM1
       is expressed more in the prefrontal cortex of people with
       bipolar disorder than in controls.
       Significance
       Since mood disorders likely involve altered gene expression
       during brain development and in response to stress, PBRM1's
       profile makes it a good potential candidate gene. This first
       genetic evidence of unipolar/bipolar overlap is also the first
       significant genome-wide association with any psychiatric illness
       in the Chromosome 3p region.
       However, the findings underscore limitations of the GWAS
       approach, which looks for connections to gene versions that are
       common in the population. Having one copy of this risk variant
       increases vulnerability for developing a mood disorder by a
       modest 15 percent. Why do some people with this variant — and
       presumably other, yet to be discovered, shared risk genes —
       develop bipolar disorder while others develop unipolar
       depression or remain healthy? Environmental influences and
       epigenetic factors may be involved, suggest the researchers, who
       note that "genetic association findings so far seem to account
       for little of the inherited risk for mood disorders."
       "Our results support the growing view that there aren't common
       genes with large effects that confer increased risk for mood
       disorders," said McMahon. "If there were, in this largest sample
       to date, we would have found them. The disorders likely involve
       many genes with small effects — and different genes in different
       families — complicating the search. Rarer genes with large
       effects may also exist."
       What's Next?
       Ultimately, findings such as these may lead to identification of
       common biological pathways that may play a role in both unipolar
       and bipolar illness and suggest strategies for better treatment,
       said McMahon. The results add to other evidence of overlap that
       is spurring a new NIMH initiative to make sense of research
       findings that don't fit neatly into current diagnostic
       categories. See: Genes and Circuitry, Not Just Clinical
       Observation, to Guide Classification for Research.
       depression and bipolar disorder in same family
       Bipolar disorder and unipolar depression often run in the same
       families, as this pedigree diagram illustrates. The new study is
       the first to trace both illnesses to a shared chromosomal
       hotspot.
       Source: NIMH Genetics Initiative Bipolar Disorder Consortium
       Reference
       Meta-analysis of genome-wide association data identifies a risk
       locus for major mood disorders on 3p21.1.the Bipolar Disorder
       Genome Study (BiGS) Consortium, McMahon FJ, Akula N, Schulze TG,
       Muglia P, Tozzi F, Detera-Wadleigh SD, Steele CJ, Breuer R,
       Strohmaier J, Wendland JR, Mattheisen M, Mühleisen TW, Maier W,
       Nöthen MM, Cichon S, Farmer A, Vincent JB, Holsboer F, Preisig
       M, Rietschel M. Nat Genet. 2010 Jan 17. [Epub ahead of
       print]PMID: 20081856
       Samples included in the meta-analysis:
       dbGaP National Institute of Mental Health bipolar disorder
       Genetic Association Information Network MDD
       Wellcome Trust Case Control Consortium
       German sample
       Systematic Treatment Enhancement Program for Bipolar Disorder
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