Lisa E. Esterling

Serotonin transporter (5‐HTT) gene and bipolar affective disorder

Interactions with antidepressants, as well as other biochemical evidence, implicate the serotonin transporter 5-HTT in the etiology of affective disorders. However, genetic studies have produced conflicting results concerning an association of 5-HTT with bipolar disorder. We examined a variable number tandem repeat in the regulatory region of this gene to investigate the possible contribution of 5-HTT to bipolar disorder susceptibility in a 22-pedigree series. By affected-sib-pair analysis and the transmission/disequilibrium test, we found no significant linkage or association of 5-HTT to bipolar disorder. During the course of this study, we adapted a PCR technique designed to amplify long templates to replicating long GC stretches with complex structure. We also refined the location of 5-HTT by radiation hybrid mapping, placing the locus between D17S1294 and SHGC11022 on 17q11.2.

Genomic structure and novel variants of myo-inositol monophosphatase 2 (IMPA2)

Recently, we cloned the human myo-inositol monophosphatase 2 (IMPA2) cDNA and established its map location to chromosome 18p11.2, a region previously implicated in bipolar disorder. Because the myo-inositol monophosphatase enzyme has been shown to be inhibited by lithium, an effective therapeutic agent for bipolar disorder, IMPA2 is a plausible positional and functional candidate gene. To permit comprehensive screening for variants we characterized the genomic structure and isolated the potential promoter of IMPA2. The gene was found to encode eight exons spanning ˜27 kb. The proximal 1-kb 5′ flanking region did not contain an obvious TATA box but multiple potential binding sites for Sp1 and consensus motifs for AP2 and other transcription factors were evident. Sequencing of the coding region and splice junctions in unrelated bipolar disorder patients detected novel variants. A missense mutation in exon 2, His76Tyr, was found in one patient. His76 is evolutionarily conserved and replacement with Tyr introduces a potential site for phosphorylation. The other polymorphisms included an Rsai polymorphism, ivs1-15g>A, and a T → C silent mutation in the third nucleotide of codon 53 in exon 2. By Fishers exact test the silent mutation showed a trend for association (P = 0.051) with bipolar disorder suggesting that further scrutiny of this gene is warranted.

A NOVEL HUMAN MYO- INOSITOL MONOPHOSPHATASE GENE, IMP.18P, MAPS TO A SUSCEPTIBILITY REGION FOR BIPOLAR DISORDER

Within the broad susceptibility region for bipolar disorder on the pericentromeric portion of chromosome 18, the highest allele sharing in our 22-pedigree series has been found in markers mapping to 18p11.2. Studies by other investigators on independently ascertained pedigrees have also shown increased sharing in this region, making 18p11.2 a plausible site for a candidate gene search. We found expressed sequence tags (ESTs) mapping within this area that are homologous to the myo-inositol-1-phosphate phosphohydrolase (myo-inositol monophosphatase: IMP) gene of Xenopus laevis. Since IMP has been proposed to be the potential target of lithium, a drug commonly used for the treatment of bipolar disorder, we proceeded to characterize the cognate transcript. Northern blot analysis detected a major transcript of 1.5 kb with abundant expression in adult and fetal tissues, but minimal expression in whole brain. In subcortical brain regions, however, substantial levels of transcript were evident, most prominently in the caudate. We have isolated and sequenced the full-length cDNA. The deduced amino acid sequence revealed ~54% identity with an existing human IMP, which we found mapped to chromosome 8, and IMP of other species. The sequence also included motifs characteristic of the IMP gene family. To provide a more precise location of this gene, mapping with a panel of radiation hybrids (RH) was conducted. Multipoint RH analysis placed the gene between GNAL and D18S71 within the 18p11.2 region. We, therefore, designated this novel gene as IMP.18p. The physical position and possible function suggest that IMP.18p is an important candidate gene for bipolar disorder.

Childhood-onset schizophrenia/autistic disorder and t(1;7) reciprocal translocation: identification of a BAC contig spanning the translocation breakpoint at 7q21.

Childhood-onset schizophrenia (COS) is defined by the development of first psychotic symptoms by age 12. While recruiting patients with COS refractory to conventional treatments for a trial of atypical antipsychotic drugs, we discovered a unique case who has a familial t(1;7)(p22;q21) reciprocal translocation and onset of psychosis at age 9. The patient also has symptoms of autistic disorder, which are usually transient before the first psychotic episode among 40-50% of the childhood schizophrenics but has persisted in him even after the remission of psychosis. Cosegregating with the translocation, among the carriers in the family available for the study, are other significant psychopathologies, including alcohol/drug abuse, severe impulsivity, and paranoid personality and language delay. This case may provide a model for understanding the genetic basis of schizophrenia or autism. Here we report the progress toward characterization of genomic organization across the translocation breakpoint at 7q21. The polymorphic markers, D7S630/D7S492 and D7S2410/D7S646, immediately flanking the breakpoint, may be useful for further confirming the genetic linkage for schizophrenia or autism in this region. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:749-753, 2000. Published 2000 Wiley-Liss, Inc.

Map of candidate genes and STSs on 18p11.2, a bipolar disorder and schizophrenia susceptibility region.

Sir – Linkage and association studies suggest an overlap of bipolar disorder and schizophrenia susceptibility regions on chromosome 18p. Fine genetic mapping revealed the highest evidence of linkage at 18p11.2. Located in this region are GNAL and IMPA2, alleles of which have been associated with schizophrenia, raising the possibility of at least one predisposing gene for a major psychiatric disorder in the region. But, if neither GNAL nor IMPA2 is the susceptibility gene, then it is essential to identify and systematically scrutinize all candidate genes on 18p11.2 for risk-conferring mutations. To investigate this region further, we constructed an array of overlapping BAC and PAC clones spanning 8 cM region flanked by pter-D18S464 and D18S360E-pcen. Included in the contig were 16 BACs and four PACs upon which 47 sequence tag sites (STSs) were mapped through PCR. A total of 29 new STSs generated from BAC/PAC insert ends were used to facilitate chromosome walking and ordering of clones. The availability of the first draft of the human genome sequence permits determination of the position and order of candidate genes and new STSs. By using these sequences to conduct BLAST analysis on the National Center for Biotechnology Information (NCBI) database, we found that the D18S464 and D18S360E

An integrated physical map of 18p11.2: a susceptibility region for bipolar disorder

The reported linkage between bipolar disorder and a large pericentric portion of chromosome 18 has been replicated in an independent study. Further examination of this region showed that 18p11.2 had the greatest allele sharing in our pedigrees and increased sharing in other independently ascertained pedigree series permitting refinement of the region of significance. To facilitate positional cloning of a susceptibility gene, we used a combination of mapping reagents, including a subchromosomal somatic cell hybrid panel, a contig of clones in yeast artificial chromosomes (YAC), and a radiation hybrid (RH) panel, to construct a high resolution physical map of the region including sequence tag sites (STSs) and expressed sequence tags (ESTs). This approach generated the interlocus distance and order of 15 STSs and 16 ESTs including four novel transcripts, with an average of ~200 kb between loci, over a ~6-Mb region. This high resolution integrated map will be an important tool in providing loci for contig construction, and positional candidates for mutation screening.