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Copy Number Variation, Genetic Interactions, and Disease
30 January 2009. Understanding how genetic variation contributes to human disease has become a major thrust of modern science. For example, considerable effort currently goes into genomewide association studies, which aim to identify markers that associate with a given disease, such as Alzheimer’s. But the effort is not paying off too well just yet. When it comes to teasing apart complex genetic traits driven by multiple genetic variations, many strategies fall woefully short. Likewise, the contribution to human disease of copy number variation, where duplication or deletions of whole sections of chromosomes can add or subtract complete genes, remains poorly understood. Two recent papers address these challenges—and reveal some surprises. In the January 21 American Journal of Human Genetics online, researchers led by Howard Hughes Investigator Evan Eichler at the University of Washington, Seattle, report that single copy number variants (CNV) may predispose individuals to a broad range of neurologic diseases, including schizophrenia, autism, and forms of mental retardation, suggesting that these variants may interact with other genetic and environmental factors to yield particular pathologies. And in the January 23 Science, researchers led by Barak Cohen at the Washington University School of Medicine, St. Louis, Missouri, describe how different genetic variations can interact to influence expression of specific phenotypes in the model organism brewer’s yeast. Such epistatic interactions are thought to play a major role in human diseases, such as Alzheimer’s and schizophrenia, but little headway has been made in deciphering those relationships.

Eichler and colleagues used array-based analysis of DNA samples from about 2,500 healthy people to estimate copy number variation in the human population as a whole. This study stands out for its large sample size, which enables it to give an overview of this type of genetic idiosyncrasy in the population at large. First author Andy Itsara and colleagues report that most individuals (extrapolated to 65 to 85 percent of the general population) harbor a CNV that is at least 100 kb of DNA long. Much larger (>500 kb) variants occur in 5 to 10 percent of individuals, while at least 1 percent of the population carries a CNV exceeding 1 Mb. CNVs longer than 100 kb are rare, while those topping 500 kb tend to be found in only one individual. These findings are in keeping with the idea that huge CNVs are bad for your health. Counted from the other side, any given CNV is present in the population at a frequency of 0.2 to 1.0 percent.

Previous analysis of a sample set designed to measure human genome diversity on a global scale (see Cann et al., 2002) suggested that certain world populations carry more than their fair share of CNVs—20 to 30 per person compared to the average of seven to nine (see Jakobsson et al., 2008). Itsara and colleagues examined the same sample set, and while they confirmed that two of those three populations, Melanesian and Papuan, did have a higher prevalence (11.9, and 10.3 CNV per individual) than other populations, the difference was marginal. The third group, the Kalash, had fewer CNVs than average. “Deeper population screens to assess the distribution of large and rare CNVs in the human population are clearly warranted, because although such variants may segregate within specific populations because of genetic drift, others may contribute disproportionately to disease susceptibility or alternatively be adaptive within those populations,” write the authors.

CNVs are clearly linked to disease. Triplication of the entire chromosome 21, for example, gives rise to Down syndrome, which is accompanied by a much greater risk for dementia. Duplication of the amyloid precursor protein gene on chromosome 21 leads to early-onset, familial AD (see ARF related news story), while duplication or triplication of the α-synuclein gene causes familial Parkinson disease (see ARF related news story and Ibanez et al., 2009). Abnormally high CNVs have also been linked to schizophrenia and autism (see related story on Schizophrenia Research Forum).

To assess the impact of CNVs on some neurologic diseases, Itsara and colleagues combined their data with those from nine genomewide association studies of schizophrenia, autism, and mental retardation, assembling CNV data on 6,860 affected individuals and 5,674 controls. Their analysis recovered known associations (e.g., deletions at chromosome 22q11 in some schizophrenia patients) and also revealed new, unexpected relationships.

The Seattle geneticists found that a chromosome 17p11.2 microdeletion normally associated with a disease called heredity neuropathy with liability to pressure palsies (HNPP) is also deleted in patients with schizophrenia and autism. At a locus on chromosome 16p12 that is predicted to be a risk candidate for schizophrenia (see Stone et al., 2008), Itsara and colleagues found a deletion in one autistic patient and no deletions in any controls, again suggesting some overlap between autism and schizophrenia risk factors. And their data suggest that at chromosome 3q29, where a microdeletion leads to a syndrome that includes mental retardation and other neurologic abnormalities (see Willatt et al., 2005), deletions again increase the risk for schizophrenia. The findings tie clinically separate disorders together through the same CNV, leading the authors to suggest that these loci render their carriers generally vulnerable to mental illness such that the specific manifestation in a particular person depends on genetic modifier or environmental effects.

Exactly such genetic modification is what Barak Cohen and colleagues tried to come to grips with in their yeast study, which focused on a widely variable trait—sporulation. In Saccharomyces cerevisiae sporulation is a complex, heritable trait. It is subject to environmental influence, and believed to fall under different selection pressure in different environments, such as the oak grove and the oak barrel. Yeast from the former sporulate at near 100 percent efficiency, but those from the latter, perhaps not surprisingly, are much less competent. Sporulation serves as a model for complex traits, including susceptibility to disease and resistance to pharmacological intervention, exhibited by humans. Many individual genetic risk factors for late-onset Alzheimer disease have been identified, for example (see AlzRisk database ), but it is not clear how any of them interact with each other to increase or even decrease susceptibility.

First author Justin Gerke and colleagues identified four nucleotide changes among three transcription factors that explain the natural variation in yeast sporulation efficiency. The researchers crossed two parent strains, one from the North American oak and one from a California wine barrel, and looked for quantitative trait loci in the offspring that match their sporulation efficiency.

The researchers identified five loci that accounted for most of the variation among the different offspring. Three of these loci, all of which turned out to harbor transcription factors, had large effects. By sequencing the different strains, the researchers found four nucleotide substitutions that account for almost 80 percent of the sporulation variation: a single nucleotide change in the regulatory region of RME1, a transcription factor that can suppress sporulation in certain cell types; two non-synonymous substitutions in the coding region of IME1, a master regulator that initiates sporulation; and a single coding change in RSF1, transcriptional activator of mitochondrial genes essential for respiration. By replacing nucleotides one, two, three, and four at a time, Gerke and colleagues found that all four alleles interact to alter the phenotype.

“Knowing how individual genetic polymorphisms combine to produce phenotypic change could strengthen evolutionary theory and advance applications such as personalized medicine,” write the authors. In general, epistatic interactions between genes are poorly understood and this study highlights the effect that even single nucleotides can have on a given trait. “This emphasizes the need to incorporate genetic interactions into models that seek to accurately predict phenotype from genotype,” write the authors, adding that “if prevalent, genetic interactions between nucleotides will be a major hurdle in the endeavor to connect genetic and phenotypic variation in humans.”—Tom Fagan.

References:
Itsara A, Cooper GM, Baker C, Girirajan S, Li J, Absher D, Krauss RM, Myers RM, Ridker PM, Chasman DI, Mefford H, Ying P, Nickerson DA, Eichler EE. Population analysis of large copy number variants. Am. J. Hum. Genet. 2009, Jan 21. Abstract

Gerke J, Lorenz K, Cohen B. Genetic interactions between transcription factors cause natural variation in yeast. Science. 2009, Jan. 23; 323:498-501. Abstract

 
Comments on Related News
  Related News: Synuclein and Parkinson's—It's All in the Dose

Comment by:  Michael Schlossmacher, ARF Advisor
Submitted 4 November 2003 Posted 4 November 2003

These two exciting articles provide significant momentum for the field of Parkinson's disease research. The Singleton/Farrer paper cements the role of α-synuclein as a central player in the pathogenesis of PD. Their discovery of an elevated gene dosage effect of the snca gene in the Iowa kindred bears obvious resemblance to the elevated gene dosage of the APP gene conferred by trisomy 21 and its role in the pathogenesis of Alzheimer's disease.

Omar el Agnaf's work raises many intriguing questions. One, whether α-synuclein levels in body fluids of humans may be used as a biomarker for the disease, and two, as to the precise source of α-synuclein in peripheral blood, which may be platelets. In that sense, el-Agnaf's work also shows intriguing parallels to Alzheimer's disease, as APP isoforms, including of amyloid β-protein, have been found in peripheral blood and CSF. These findings are also of possible relevance to multiple system atrophy, a PD-like illness in which α-synuclein deposits are predominantly found in oligodendroglia, a type of cell that...  Read more


  Related News: APP Double Dose Causes Early-Onset AD

Comment by:  Dennis Selkoe, ARF Advisor
Submitted 20 December 2005 Posted 20 December 2005

This is a very exciting development that strongly supports the amyloid hypothesis of AD causation. It appears to be symmetrical with the discovery of α-synuclein duplication (and triplication) in otherwise phenotypically normal individuals in the causation of PD. It suggests that increased expression of wild-type APP—whether from enhanced gene dosage, as in these families, or perhaps from alterations in regulatory elements of the APP gene in other families yet to be discovered—can directly cause AD.

View all comments by Dennis Selkoe

  Related News: APP Double Dose Causes Early-Onset AD

Comment by:  Elizabeth M. Fisher
Submitted 20 December 2005 Posted 20 December 2005

This is a very nice piece of work. First, it highlights the important issue of gene duplication in neurodegenerative disease. Second, the paper is very important for answering the question "Is duplication of APP alone (as in Down syndrome) sufficient to cause AD?" The authors have narrowed the AD region down to just four genes. This almost answers this question, but the genome may still have suprises up its sleeve, so it would be great for other labs to carry out similar analyses and see what the minimal duplicated region is to cause AD.

View all comments by Elizabeth M. Fisher

  Related News: APP Double Dose Causes Early-Onset AD

Comment by:  Alison Goate
Submitted 20 December 2005 Posted 20 December 2005

This is a very interesting paper that is totally consistent with the Aβ hypothesis. The observation that duplication of APP causes early-onset AD and CAA is consistent with the observations in Down syndrome (DS) and confirms that AD pathology in DS is due to APP overexpression. The presence of CAA is also interesting and supports data from the transgenic mice, DS, and other FAD mutations that overproduction of Aβ40 leads to CAA, while increased Aβ42 is associated with parenchymal plaques. This also fits with the observations in PD, where duplication and triplication of α-synuclein have been associated with early-onset PD.

I am surprised by the frequency of the duplications in their early-onset FAD samples (8 percent of FAD cases) and by the fact that each of the duplications is different but not associated with any other phenotype despite the presence of other genes in the duplicated region.

Lastly, these studies really beg the question: Does variation in APP expression contribute to risk for late-onset AD? We posed this possibility in the first...  Read more


  Related News: APP Double Dose Causes Early-Onset AD

Comment by:  Barbara Tate
Submitted 22 December 2005 Posted 22 December 2005

This brief paper describes a rare genetic abnormality in five different families with autosomal dominant, early-onset Alzheimer disease with cerebral amyloid angiopathy. Using three different techniques, this research group was able to establish that a very small portion of chromosome 21 is duplicated in these families. The chromosomal region includes the locus for APP, as well as other genes. Because the duplicated region is slightly different among the five families but in all families the APP locus is included, the conclusion that overproduction of APP is responsible for the disease is compelling. The disease phenotype is similar in all five families. It consists of progressive AD with abundant dense-core and diffuse amyloid deposits as well as neurofibrillary tangles, giving support to the hypothesis that overproduction of the amyloid protein initiates a cascade of events that leads to both plaques and tangles.

In addition, the patients studied by Rovelet-Lecrux et al. have severe cerebral amyloid angiopathy (CAA), and this vascular amyloid deposition is primarily...  Read more


  Related News: APP Double Dose Causes Early-Onset AD

Comment by:  Joy Snider
Submitted 22 December 2005 Posted 22 December 2005

This study by Rovelet-Lecrux et al. is interesting in several aspects: It points out that gene duplication may be a more common cause of early-onset familial Alzheimer disease than previously suspected, and it highlights the coexistence of two forms of amyloid pathology, parenchymal and vascular.

The authors did not comment on whether immunohistochemical stains for synuclein or ubiquitin were performed. It will be interesting to study the interactions between the pathological burden of amyloid (both parenchymal and vascular) and Lewy body pathology. Specifically, it will be interesting to determine whether the coexistence of Lewy body pathology with Alzheimer-type pathology in early-onset AD is limited to people harboring presenilin 1 mutations, or whether it is a more general feature seen in some patients independent of the gene mutation (or duplication).

View all comments by Joy Snider


  Related News: APP Double Dose Causes Early-Onset AD

Comment by:  Rachael Neve
Submitted 22 December 2005 Posted 22 December 2005

Obviously, the excitement of the paper derives from the fact that simple duplication of the APP gene can cause AD. Scientists had always assumed that it is the extra copy of APP that is responsible for the Alzheimer disease pathology that develops in virtually all individuals over the age of 40 with Down syndrome, but there was not definitive proof that this was the case. While this paper does not prove absolutely that it's the extra dose of APP in the duplicated segments that causes AD—the authors point out that the duplicated segments they studied in the families contained between five and 12 known genes—it certainly makes a good case for APP being the cause. If so, we can conclude that a simple overdose of the wild-type gene has the same clinical consequences as does one dose of the mutated FAD APP genes.

There are precedents for this; for example, either overexpression of the wild-type EGF receptor or else expression of mutant EGF receptors can cause oncogenesis, while either overexpression of wild type α-synuclein or expression of specific mutants of...  Read more


  Related News: APP Double Dose Causes Early-Onset AD

Comment by:  Deborah Uetz
Submitted 27 December 2005 Posted 30 December 2005

This is a very interesting paper. As the daughter of an Alzheimer's patient it is very important to know that progress is being made. Well done.

View all comments by Deborah Uetz
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