Schizophrenia shows a unique metabolomics signature in plasma

Schizophrenia is a severe complex mental disorder affecting 0.5–1% of the world population. To date, diagnosis of the disease is mainly based on personal and thus subjective interviews. The underlying molecular mechanism of schizophrenia is poorly understood. Using targeted metabolomics we quantified and compared 103 metabolites in plasma samples from 216 healthy controls and 265 schizophrenic patients, including 52 cases that do not take antipsychotic medication. Compared with healthy controls, levels of five metabolites were found significantly altered in schizophrenic patients (P-values ranged from 2.9 × 10−8 to 2.5 × 10−4) and in neuroleptics-free probands (P-values ranging between 0.006 and 0.03), respectively. These metabolites include four amino acids (arginine, glutamine, histidine and ornithine) and one lipid (PC ae C38:6) and are suggested as candidate biomarkers for schizophrenia. To explore the genetic susceptibility on the associated metabolic pathways, we constructed a molecular network connecting these five aberrant metabolites with 13 schizophrenia risk genes. Our result implicated aberrations in biosynthetic pathways linked to glutamine and arginine metabolism and associated signaling pathways as genetic risk factors, which may contribute to patho-mechanisms and memory deficits associated with schizophrenia. This study illustrated that the metabolic deviations detected in plasma may serve as potential biomarkers to aid diagnosis of schizophrenia.

[1]  Anders D. Børglum,et al.  Genome-wide association study identifies five new schizophrenia loci , 2011, Nature Genetics.

[2]  P. Visscher,et al.  Rare chromosomal deletions and duplications increase risk of schizophrenia , 2008, Nature.

[3]  S. Hirsch,et al.  Elevated platelet calcium mobilization and nitric oxide synthase activity may reflect abnormalities in schizophrenic brain. , 1995, Biochemical and biophysical research communications.

[4]  H. Stefánsson,et al.  Common variants at VRK2 and TCF4 conferring risk of schizophrenia. , 2011, Human molecular genetics.

[5]  Damian Szklarczyk,et al.  The STRING database in 2011: functional interaction networks of proteins, globally integrated and scored , 2010, Nucleic Acids Res..

[6]  Jerzy Adamski,et al.  Procedure for tissue sample preparation and metabolite extraction for high-throughput targeted metabolomics , 2011, Metabolomics.

[7]  J. Rice,et al.  Comparison of direct interview and family history diagnoses of alcohol dependence. , 1995, Alcoholism, clinical and experimental research.

[8]  Jianxin Shi,et al.  Common variants on chromosome 6p22.1 are associated with schizophrenia , 2009, Nature.

[9]  David S. Wishart,et al.  HMDB: a knowledgebase for the human metabolome , 2008, Nucleic Acids Res..

[10]  Kenji Hashimoto,et al.  Elevated glutamine/glutamate ratio in cerebrospinal fluid of first episode and drug naive schizophrenic patients , 2005, BMC psychiatry.

[11]  A. Schmitt,et al.  Beschleunigter Abbau von Membranphospholipiden bei der Schizophrenie - Implikationen für die Hypofrontalitätshypothese , 1994 .

[12]  A. Singleton,et al.  Rare Structural Variants Disrupt Multiple Genes in Neurodevelopmental Pathways in Schizophrenia , 2008, Science.

[13]  W. Gattaz,et al.  [Accelerated breakdown of membrane phospholipids in schizophrenia--implications for the hypofrontality hypothesis]. , 1994, Fortschritte der Neurologie-Psychiatrie.

[14]  Ramón Cacabelos,et al.  Histamine function in brain disorders , 2001, Behavioural Brain Research.

[15]  L. Horrocks,et al.  Plasmalogens, phospholipase A2, and docosahexaenoic acid turnover in brain tissue , 2001, Journal of Molecular Neuroscience.

[16]  Edward T. Bullmore,et al.  Plasma Protein Biomarkers for Depression and Schizophrenia by Multi Analyte Profiling of Case-Control Collections , 2010, PloS one.

[17]  Elaine Holmes,et al.  Metabolic Profiling of CSF: Evidence That Early Intervention May Impact on Disease Progression and Outcome in Schizophrenia , 2006, PLoS medicine.

[18]  C. Spencer,et al.  Identification of loci associated with schizophrenia by genome-wide association and follow-up , 2008, Nature Genetics.

[19]  Peter Kampstra,et al.  Beanplot: A Boxplot Alternative for Visual Comparison of Distributions , 2008 .

[20]  M. Maj,et al.  Plasma concentrations of amino acids in chronic schizophrenics , 2002, European Psychiatry.

[21]  M. Egan,et al.  Schizophrenia, just the facts What do we know, how well do we know it? , 1988, Schizophrenia Research.

[22]  Peilin Jia,et al.  Common variants conferring risk of schizophrenia: A pathway analysis of GWAS data , 2010, Schizophrenia Research.

[23]  J. Suvisaari,et al.  Metabolome in schizophrenia and other psychotic disorders: a general population-based study , 2011, Genome Medicine.

[24]  Brad T. Sherman,et al.  Systematic and integrative analysis of large gene lists using DAVID bioinformatics resources , 2008, Nature Protocols.

[25]  Huseyin Vural,et al.  Is the Arginine-Nitric Oxide Pathway Involved in the Pathogenesis of Schizophrenia? , 2003, Neuropsychobiology.

[26]  G. F. Carl,et al.  Is plasma serine a marker for psychosis? , 1992, Biological Psychiatry.

[27]  G. Burbaeva,et al.  Glutamine synthetase and glutamate dehydrogenase in the prefrontal cortex of patients with schizophrenia , 2003, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[28]  M. Su,et al.  Potential metabolite markers of schizophrenia , 2011, Molecular Psychiatry.

[29]  Elvira Bramon,et al.  Gene variants associated with schizophrenia in a Norwegian genome-wide study are replicated in a large European cohort. , 2010, Journal of psychiatric research.

[30]  Susumu Goto,et al.  KEGG for representation and analysis of molecular networks involving diseases and drugs , 2009, Nucleic Acids Res..

[31]  D. Rujescu,et al.  Association of VSNL1 with schizophrenia, frontal cortical function, and biological significance for its gene product as a modulator of cAMP levels and neuronal morphology , 2011, Translational Psychiatry.

[32]  M. First,et al.  Structured clinical interview for DSM-IV axis II personality disorders : SCID-II , 1997 .

[33]  P. Kinnunen,et al.  Increased plasma phospholipase-A2 activity in schizophrenic patients: Reduction after neuroleptic therapy , 1987, Biological Psychiatry.

[34]  Giorgio Valle,et al.  The Gene Ontology in 2010: extensions and refinements , 2009, Nucleic Acids Res..

[35]  Q. Smith Transport of glutamate and other amino acids at the blood-brain barrier. , 2000, The Journal of nutrition.

[36]  J. McGrath,et al.  A Systematic Review of the Prevalence of Schizophrenia , 2005, PLoS medicine.

[37]  E. Smeraldi,et al.  Amino acid patterns in schizophrenia: Some new findings , 1990, Psychiatry Research.

[38]  J. Pierri,et al.  Gene Expression Profiling Reveals Alterations of Specific Metabolic Pathways in Schizophrenia , 2002, The Journal of Neuroscience.

[39]  Pall I. Olason,et al.  Common variants conferring risk of schizophrenia , 2009, Nature.

[40]  James M. Stone,et al.  Review: Glutamate and dopamine dysregulation in schizophrenia — a synthesis and selective review , 2007, Journal of psychopharmacology.

[41]  Gabi Kastenmüller,et al.  metaP-Server: A Web-Based Metabolomics Data Analysis Tool , 2010, Journal of biomedicine & biotechnology.

[42]  David B. Goldstein,et al.  A Genome-Wide Investigation of SNPs and CNVs in Schizophrenia , 2009, PLoS genetics.

[43]  Florian Kronenberg,et al.  Differences between Human Plasma and Serum Metabolite Profiles , 2011, PloS one.

[44]  Jeffrey K. Yao,et al.  Membrane phospholipid abnormalities in postmortem brains from schizophrenic patients , 2000, Schizophrenia Research.

[45]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[46]  Bernhard Bogerts,et al.  The many faces of nitric oxide in schizophrenia. A review , 2005, Schizophrenia Research.

[47]  Fabian J Theis,et al.  Discovery of Sexual Dimorphisms in Metabolic and Genetic Biomarkers , 2011, PLoS genetics.

[48]  M. Rietschel,et al.  New Genetic Findings in Schizophrenia: Is there Still Room for the Dopamine Hypothesis of Schizophrenia? , 2010, Front. Behav. Neurosci..

[49]  C. Kaufmann,et al.  Histamine metabolites in cerebrospinal fluid of patients with chronic schizophrenia: their relationships to levels of other aminergic transmitters and ratings of symptoms , 1995, Schizophrenia Research.

[50]  P. Kinnunen,et al.  Increased serum phospholipase A2 activity in schizophrenia: a replication study. , 1990, Biological psychiatry.

[51]  Craig Morgan,et al.  Environment and schizophrenia: environmental factors in schizophrenia: childhood trauma--a critical review. , 2006, Schizophrenia bulletin.

[52]  A. Serretti,et al.  Case–control association study for 10 genes in patients with schizophrenia: influence of 5HTR1A variation rs10042486 on schizophrenia and response to antipsychotics , 2012, European Archives of Psychiatry and Clinical Neuroscience.

[53]  Henry A. Nasrallah,et al.  Schizophrenia, “Just the Facts” What we know in 2008. 2. Epidemiology and etiology , 2008, Schizophrenia Research.

[54]  Anneclaire J. De Roos,et al.  Epidemiology and Etiology , 2013 .

[55]  P. Visscher,et al.  Common polygenic variation contributes to risk of schizophrenia and bipolar disorder , 2009, Nature.

[56]  David F. Horrobin,et al.  The membrane hypothesis of schizophrenia , 1994, Schizophrenia Research.

[57]  Christian Gieger,et al.  A genome-wide perspective of genetic variation in human metabolism , 2010, Nature Genetics.

[58]  R. Kirk Experimental Design: Procedures for the Behavioral Sciences , 1970 .

[59]  K. Krishnan,et al.  Metabolomic mapping of atypical antipsychotic effects in schizophrenia , 2007, Molecular Psychiatry.

[60]  H. Herken,et al.  Red blood cell nitric oxide levels in patients with schizophrenia , 2001, Schizophrenia Research.

[61]  David A Lewis,et al.  Catching Up on Schizophrenia Natural History and Neurobiology , 2000, Neuron.

[62]  M. Tsuang Schizophrenia: genes and environment , 2000, Biological Psychiatry.

[63]  Thomas W. Mühleisen,et al.  Association between genetic variation in a region on chromosome 11 and schizophrenia in large samples from Europe , 2012, Molecular Psychiatry.

[64]  Charles E. Vejnar,et al.  Human polymorphism at microRNAs and microRNA target sites. , 2013 .

[65]  W. Fenton,et al.  Essential fatty acids, lipid membrane abnormalities, and the diagnosis and treatment of schizophrenia , 2000, Biological Psychiatry.