disease susceptibility Flashcards

1
Q

what type of genetic risk associated with schizophrenia

A

polygenic model

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2
Q

Disturbances in _ and _ systems points to role for polymorphisms in these systems in determining susceptibility to schizophrenia

A

dopaminergic
5HT (serotonin)

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3
Q

what studies are used to study schizophrenia susceptibility and what did it show

A

family and case control
- linage studies suggested the existence of susceptobility loci on up to 11 chromosomes

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4
Q

What genes are linked to schizophrenia susceptibility

A

□ ZNF804A-probable transcription factor (first gene identified in a GWAS)
□ Other transcription factors (eg. KLF6)
□ Various genes relevant to calcium signalling and glutamate signalling (eg. ATP2A2, which encodes a calcium pump). Variants in ATP2A2 also associate with bipolar disorder.
□ Genes involved in synaptic function

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5
Q

what was the result of a large GWAS of schizophrenia

A

74776 cases and 101023 controls (>7.5 million SNPs)
- 313 independent signals at 263 distinct loci
- ACE risk variant associates with low Angiotensin-converting enzyme (ACE) expression

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6
Q

how is ACE linked to the CNS

A
  • ACE is a dipeptidyl-carboxy oligopeptidase located on the cellular membrane of neurons
  • Involved in neurosignalling via its ability to catalyse the degradation of several neuro peptide substrates,
    such as bradykinin (BK), neurotensin (NT), substance P, enkephalins (EKs)
  • ACE has several functions in the CNS and is implicated in other phenotypes.
    Eg. levels associate with cognitive function and Alzheimers Disease
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7
Q

how is CYP2D6 and schizophrenia linked

A

-though the mechanism of linkage is unknown
-association signals localises to CYP2D6
-multiple functional variants = such as exon 3 skipping and numerous linked SNPs

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8
Q

how many anti-psychotic drugs does CYP2D6 metabolises

A

metabolises 40% of anti-psychotic

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9
Q

early onset alzheimers disease is often _ disorder

A

single gene/monogenic

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10
Q

late onset Alzheimer is more _ than early and shows only _ clustering within families

A

common, modest

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11
Q

which gene locus has been identified as a susceptibility locus from family studies of alzheimers

A

apolipoprotein E (APOE)

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12
Q

What was the result of the GWAS on Alzheimers disease

A

36 risk loci identified
HAVCR2 accumulates in aged microglia and binds precursor beta (amyloid protein)
BIN1 variant associates with endosome-size deregulation (an early biomarkers for AD)

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13
Q

what is apolipoprotein E

A

mediates transfer of cholesterol and phospholipids between cells and is important for injury repair in the brain

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14
Q

how are the variants of APOE different

A

E2 = protective
E2 -> E3 = Cys->Arg at 158
E3 -> E4 = Cys ->Arg at 112

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15
Q

what is the differece between APOE2 and APOE4

A

2 = lower chloesterol and higher APOE protein compared to 4

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16
Q

why is APOE4 a risk factor for alzheimers

A

due to the facilitating accumulation of b-amyloid protein in the brain

17
Q

people who are APOE4 homozygoous are almost certain to develop Alzheimers by what age

A

80

18
Q

the overall contribution of the APOIE locus to alzheimers susceptibility is approximately what ?

A

50%

19
Q

what was the result when APOE was genotyped to predict the clinical response to tacrine

A

acrine – an acetylcholinesterase inhibitor
APOE4 carriers are less responsive to therapeutic acetylcholine inhibition

20
Q

how to treat APOE4 driven Alzheimers

A
  • Rationale for gene therapy is to increase the expression of the protective APOE2 variant to overcome the effects of APOE4
  • issue with homozygous
21
Q

What was the results of the twin studies and smoking

A
  • indicates the importance of genetics in both the decisions to start smoking, continue and to quit
  • Some genetic linkage studies have been performed on smoking behaviour
22
Q

True or False - smoking is mongenic

A

False - it polygenic (as is addiction)
however there is also cultural factors that contribute

23
Q

which CYP has been linked to smoking

A
  • CYP2A6
  • it is responsible for 90% of nicotine metabolism to cotinine (active metabolite)
24
Q

what are the 3 types variation of CYP2A6

A

Wildtype, Mutation and deletion of whole genes

25
Q

How is nicotinic acetylcholine receptor linked to smoking behaviour

A

□ Nicotine binds to neuronal nicotinic acetylcholine receptors (NACHRs) (which are at 62% occupancy 6hs after smoking)
□ triggers the release of dopamine which gives an emotional reward
□ A smoker’s brain doesn’t release more dopamine than a non-smoker’s brain. They release dopamine at different times and become dependent on nicotine for dopamine release.

26
Q

What was results of the GWAS study on smoking behaviour

A

significant association between smoking/cigarettes smoked per day and
□ Chr 15 CHRNA3-nicotinic acetylcholine receptor alpha subunit 3
□ Chr 8 CHRNA6 and CHRNB3
□ Chr 19 CYP2A6 and CYP2B6
Genes that encode nicotinic acetylcholine receptors & CYP2A6

27
Q

what is the polymorphims is associated with nicotine dependence and lung cancer

A

D398N polymorphism in exon 5 of CHRA5(15q25)

28
Q

what is the link between schizophrenia and lung cancer

A

Reverse causation - smokers are more likely to take up smoking to relieve anxiety.

29
Q

what is licensed to assist with smoking cessation

A

Antidepressant bupropion - Genotype for CYP2B6 affects metabolism of this drug and overall response