Genetic variants associated with response to lithium treatment in bipolar disorder: A genome-wide association study
Journal
The Lancet
Journal Volume
387
Journal Issue
10023
Pages
1085-1093
Date Issued
2016
Author(s)
Heilbronner U.
Degenhardt F.
Adli M.
Akiyama K.
Akula N.
Ardau R.
Arias B.
Backlund L.
Banzato C.E.M.
Benabarre A.
Bengesser S.
Bhattacharjee A.K.
Biernacka J.M.
Birner A.
Brichant-Petitjean C.
Bui E.T.
Cervantes P.
Chen G.-B.
Chillotti C.
Cichon S.
Clark S.R.
Colom F.
Cousins D.A.
Cruceanu C.
Czerski P.M.
Dantas C.R.
Dayer A.
?tain B.
Falkai P.
Forstner A.J.
Fris?n L.
Fullerton J.M.
Gard S.
Garnham J.S.
Goes F.S.
Grof P.
Gruber O.
Hashimoto R.
Hauser J.
Herms S.
Hoffmann P.
Hofmann A.
Jamain S.
Jim?nez E.
Kahn J.-P.
Kassem L.
Kittel-Schneider S.
Kliwicki S.
K?nig B.
Kusumi I.
Lackner N.
Laje G.
Land?n M.
Lavebratt C.
Leboyer M.
Leckband S.G.
Jaramillo C.A.L.
Macqueen G.
Manchia M.
Martinsson L.
Mattheisen M.
McCarthy M.J.
McElroy S.L.
Mitjans M.
Mondimore F.M.
Monteleone P.
Nievergelt C.M.
N?then M.M.
?sby U.
Ozaki N.
Perlis R.H.
Pfennig A.
Reich-Erkelenz D.
Rouleau G.A.
Schofield P.R.
Schubert K.O.
Schweizer B.W.
Seem?ller F.
Severino G.
Shekhtman T.
Shilling P.D.
Shimoda K.
Simhandl C.
Slaney C.M.
Smoller J.W.
Squassina A.
Stamm T.
Stopkova P.
Tighe S.K.
Tortorella A.
Turecki G.
Volkert J.
Witt S.
Wright A.
Young L.T.
Zandi P.P.
Potash J.B.
Depaulo J.R.
Bauer M.
Reininghaus E.Z.
Nov?k T.
Aubry J.-M.
Maj M.
Baune B.T.
Mitchell P.B.
Vieta E.
Frye M.A.
Rybakowski J.K.
Kuo P.-H.
Kato T.
Grigoroiu-Serbanescu M.
Reif A.
Del Zompo M.
Bellivier F.
Schalling M.
Wray N.R.
Kelsoe J.R.
Alda M.
Rietschel M.
McMahon F.J.
Abstract
Background Lithium is a first-line treatment in bipolar disorder, but individual response is variable. Previous studies have suggested that lithium response is a heritable trait. However, no genetic markers of treatment response have been reproducibly identified. Methods Here, we report the results of a genome-wide association study of lithium response in 2563 patients collected by 22 participating sites from the International Consortium on Lithium Genetics (ConLiGen). Data from common single nucleotide polymorphisms (SNPs) were tested for association with categorical and continuous ratings of lithium response. Lithium response was measured using a well established scale (Alda scale). Genotyped SNPs were used to generate data at more than 6 million sites, using standard genomic imputation methods. Traits were regressed against genotype dosage. Results were combined across two batches by meta-analysis. Findings A single locus of four linked SNPs on chromosome 21 met genome-wide significance criteria for association with lithium response (rs79663003, p=1·37×10-8; rs78015114, p=1·31×10-8; rs74795342, p=3·31×10-9; and rs75222709, p=3·50×10-9). In an independent, prospective study of 73 patients treated with lithium monotherapy for a period of up to 2 years, carriers of the response-associated alleles had a significantly lower rate of relapse than carriers of the alternate alleles (p=0·03268, hazard ratio 3·8, 95% CI 1·1-13·0). Interpretation The response-associated region contains two genes for long, non-coding RNAs (lncRNAs), AL157359.3 and AL157359.4. LncRNAs are increasingly appreciated as important regulators of gene expression, particularly in the CNS. Confirmed biomarkers of lithium response would constitute an important step forward in the clinical management of bipolar disorder. Further studies are needed to establish the biological context and potential clinical utility of these findings. Funding Deutsche Forschungsgemeinschaft, National Institute of Mental Health Intramural Research Program. ? 2016 Elsevier Ltd.
SDGs
Other Subjects
glial cell line derived neurotrophic factor; lithium; long untranslated RNA; GFRA2 protein, human; glial cell line derived neurotrophic factor receptor; lithium derivative; adolescent; adult; aged; allele; Article; bipolar disorder; chromosome 21; female; gene linkage disequilibrium; gene locus; genetic association; genetic variability; genomics; genotype; human; major clinical study; male; monotherapy; phenotype; priority journal; relapse; single nucleotide polymorphism; treatment response; very elderly; bipolar disorder; clinical trial; genetic variation; genetics; genome-wide association study; middle aged; multicenter study; prospective study; treatment outcome; Bipolar Disorder; Female; Genetic Variation; Genome-Wide Association Study; Genotype; Glial Cell Line-Derived Neurotrophic Factor Receptors; Humans; Lithium Compounds; Male; Middle Aged; Phenotype; Polymorphism, Single Nucleotide; Prospective Studies; Treatment Outcome
Type
journal article