作者
Duncan S. Palmer,Daniel P. Howrigan,Sinéad B. Chapman,Rolf Adolfsson,Nick Bass,Douglas Blackwood,Marco P. Boks,Chia-Yen Chen,Claire Churchhouse,Aiden P. Corvin,Nicholas Craddock,David Curtis,Arianna Di Florio,Faith Dickerson,Nelson B. Freimer,Fernando S. Goes,Xiaoming Jia,Ian Jones,Lisa Jones,Lina Jonsson,René S. Kahn,Mikael Landén,Adam E. Locke,Andrew M McIntosh,Andrew McQuillin,Derek W. Morris,Michael John Owen,Roel A. Ophoff,Michael J. Owen,Nancy L. Pedersen,Danielle Posthuma,Andreas Reif,Neil Risch,Catherine Schaefer,Laura Scott,Tarjinder Singh,Jordan W. Smoller,Matthew Solomonson,David St. Clair,Eli A. Stahl,Annabel Vreeker,James T.R. Walters,Weiqing Wang,Nicholas A. Watts,Robert Yolken,Peter P. Zandi,Benjamin M. Neale
摘要
We report results from the Bipolar Exome (BipEx) collaboration analysis of whole-exome sequencing of 13,933 patients with bipolar disorder (BD) matched with 14,422 controls. We find an excess of ultra-rare protein-truncating variants (PTVs) in patients with BD among genes under strong evolutionary constraint in both major BD subtypes. We find enrichment of ultra-rare PTVs within genes implicated from a recent schizophrenia exome meta-analysis (SCHEMA; 24,248 cases and 97,322 controls) and among binding targets of CHD8. Genes implicated from genome-wide association studies (GWASs) of BD, however, are not significantly enriched for ultra-rare PTVs. Combining gene-level results with SCHEMA, AKAP11 emerges as a definitive risk gene (odds ratio (OR) = 7.06, P = 2.83 × 10-9). At the protein level, AKAP-11 interacts with GSK3B, the hypothesized target of lithium, a primary treatment for BD. Our results lend support to BD's polygenicity, demonstrating a role for rare coding variation as a significant risk factor in BD etiology.