文献詳細
文献概要
特集 統合失調症の治療ゴールをめぐって
ゲノム医療の視点から
著者: 木村大樹1 尾崎紀夫1
所属機関: 1名古屋大学大学院医学系研究科精神医学分野
ページ範囲:P.447 - P.455
文献購入ページに移動抄録 近年のゲノム解析技術と情報解析技術の進歩,さらに国内外でコンソーシアム形成による研究の大規模化の結果,統合失調症の発症に関わるリスク変異が再現性を持って同定されている。しかし同時に,100%特定の精神障害発症につながるリスク変異はないこと,さらに特定のリスク変異と臨床表現型は1対1では対応せず,発達段階に応じて表現型が変化していくことも判明しており,今後,統合失調症を含む精神障害のゲノム情報を集約し,さらなる検証を重ねていく必要がある。一方,ゲノム変異から発症に至るメカニズムは不詳であり,同定されたリスク変異を出発点とした,統合失調症の病態解明や新規治療薬開発,向精神薬の副作用軽減を企図した研究が活発化しており,成果の臨床応用が期待されている。
今後,統合失調症臨床において,ゲノム医療に関連する知見の重要性は増すと考えられ,正しい知見を当事者・家族が医療者とともに共有する必要があるだろう。
今後,統合失調症臨床において,ゲノム医療に関連する知見の重要性は増すと考えられ,正しい知見を当事者・家族が医療者とともに共有する必要があるだろう。
参考文献
1)Sullivan PF, Daly MJ, O'Donovan M:Genetic architectures of psychiatric disorders:the emerging picture and its implications. Nat Rev Genet 13:537-551, 2012
2)尾崎紀夫:精神障害中の「未診断難病」について.精神経誌 120:83, 2018
3)Gratten J, Wray NR, Keller MC, et al:Large-scale genomics unveils the genetic architecture of psychiatric disorders. Nature Neurosci 17:782-790, 2014
4)Manolio TA, Collins FS, Cox NJ, et al:Finding the missing heritability of complex diseases. Nature 461:747-753, 2009
5)Schizophrenia Working Group of the Psychiatric Genomics Consortium:Biological insights from 108 schizophrenia-associated genetic loci. Nature 511:421-427, 2014
6)Network and Pathway Analysis Subgroup of Psychiatric Genomics Consortium:Psychiatric genome-wide association study analyses implicate neuronal, immune and histone pathways. Nat Neurosci 18:199-209, 2015
7)Khera AV, Chaffin M, Aragam KG, et al:Genome-wide polygenic scores for common diseases identify individuals with risk equivalent to monogenic mutations. Nat Genet 50:1219-1224, 2018
8)Kirov G:CNVs in neuropsychiatric disorders. Hum Mol Genet 24(R1):R45-R49, 2015
9)Kushima I, Aleksic B, Nakatochi M, et al:Comparative Analyses of Copy-Number Variation in Autism Spectrum Disorder and Schizophrenia Reveal Etiological Overlap and Biological Insights. Cell Rep 24:2838-2856, 2018
10)Kushima I, Aleksic B, Nakatochi M, et al:High-resolution copy number variation analysis of schizophrenia in Japan. Mol Psychiatry 22:430-440, 2017
11)Kawakubo H, Matsui Y, Kushima I, et al:A Network of Networks Approach for Modeling Interconnected Brain Tissue-Specific Networks. Bioinformatics. 2019 Jan 15. doi:10.1093/bionformatics/btz032[Epub ahead of print]
12)Bergen SE, Ploner A, Howrigan D, et al:Joint Contributions of Rare Copy Number Variants and Common SNPs to Risk for Schizophrenia. Am J Psychiatry. 2018 Nov 5, appiajp201817040467[Epub ahead of print]
13)Mullard A:Sting of Alzheimer's failures offset by upcoming prevention trials. Nat Rev Drug Discov 11:657-660, 2012
14)McDonald-McGinn DM, Sullivan KE, Marino B, et al:22q11.2 deletion syndrome. Nat Rev Dis Primers 1:15071, 2015
15)Fong PC, Boss DS, Yap TA, et al:Inhibition of poly(ADP-ribose)polymerase in tumors from BRCA mutation carriers. N Engl J Med 361:123-34, 2009
16)Sobue A, Kushima I, Nagai T, et al:Genetic and animal model analyses reveal the pathogenic role of a novel deletion of RELN in schizophrenia. Sci Rep 8:13046, 2018
17)Arioka Y, Shishido E, Kubo H, et al:Single-cell trajectory analysis of human homogenous neurons carrying a rare RELN variant. Transl Psychiatry 8:129, 2018
18)Estivill X, Govea N, Barcelo E, et al:Familial progressive sensorineural deafness is mainly due to the mtDNA A1555G mutation and is enhanced by treatment of aminoglycosides. Am J Hum Genet 62:27-35, 1998
19)Saito T, Ikeda M, Mushiroda T, et al:Pharmacogenomic Study of Clozapine-Induced Agranulocytosis/Granulocytopenia in a Japanese Population. Biol Psychiatry 80:636-642, 2016
20)RK CY, Merico D, Bookman M, et al:Whole genome sequencing resource identifies 18 new candidate genes for autism spectrum disorder. Nat Neurosci 20:602-611, 2017
21)Adachi T, Kawamura K, Furusawa Y, et al:Japan's initiative on rare and undiagnosed diseases(IRUD):towards an end to the diagnostic odyssey. Eur J Hum Genet 25:1025-1028, 2017
22)尾崎紀夫:精神科臨床における遺伝カウンセリング.精神経誌 109:786-796, 2007
23)Jonas RK, Montojo CA, Bearden CE:The 22q11.2 deletion syndrome as a window into complex neuropsychiatric disorders over the lifespan. Biol Psychiatry 75:351-360, 2014
24)Simons Vip Consortium:Simons Variation in Individuals Project(Simons VIP):a genetics-first approach to studying autism spectrum and related neurodevelopmental disorders. Neuron 73:1063-1067, 2012
25)Kaiser J:BIOMEDICINE. NIH opens precision medicine study to nation. Science 349:1433, 2015
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