The Role of Dopamine-Related Genes in Autism Spectrum Disorders: Evidence for Specific Genes and Risk for Asd in Families with Affected Males
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THE ROLE OF DOPAMINE-RELATED GENES IN AUTISM SPECTRUM DISORDERS: EVIDENCE FOR SPECIFIC GENES AND RISK FOR ASD IN FAMILIES WITH AFFECTED MALES by Joseph Alan Hettinger A thesis submitted to the Department of Physiology In conformity with the requirements for the degree of Doctor of Philosophy Queen’s University Kingston, Ontario, Canada (March, 2009) Copyright ©Joseph Alan Hettinger, 2009 Abstract Individuals with autism spectrum disorders (ASDs) are impaired in cognitive processes and emotional regulation, and exhibit stereotyped behaviours. Dopamine (DA) modulates executive functions, learning, memory, emotional processing and social cognition; all of which are impaired in individuals with ASDs. Because DA modulates a number of processes that are impaired in individuals with ASDs, genes in the dopaminergic pathway are good candidates for genes influencing autistic behaviours. As our previous findings suggested a role for a dopamine-related gene in families with only affected males, this thesis describes a comprehensive study of five genes affecting DA synthesis, levels and function in mothers and affected males with ASDs in an initial TEST cohort of 112 male-only affected sib-pair families as well as a replication study in three additional male-only family cohorts. I genotyped three to five polymorphisms in the TH, SLC6A3, DRD1, DRD2 and PPP1R1B genes and performed population-based single marker case-control comparisons, family-based association tests, quantitative transmission disequilibrium tests as well as haplotype- based analyses and tests for gene-gene interactions. I found evidence for association of the DRD1 (P=0.0027-0.040), DRD2 (P=0.0002-0.007) and PPP1R1B (P=0.00042- 0.001) genes with autism in affected males from the TEST cohort. Evidence for DA- related gene interactions were found between polymorphisms in DRD1, DRD2 and PPP1R1B (P=0.0094-0.012) in affected males relative to a comparison group. Furthermore, I found that polymorphisms in the TH and DRD1 genes were associated with the risk for mothers having sons with ASD in the TEST families (P=0.007-0.025) and putative risk alleles in DRD1 and DRD2 were preferentially transmitted from ii mothers (P=0.016) and fathers (P=0.023) respectively, to affected children. All findings remained significant following corrections for multiple testing. The TEST cohort findings were not replicated in other family cohorts. However, an examination of dysmorphology data for the different family sets revealed phenotypic differences and thus, genetic differences are to be expected. In summary, I found evidence for a contribution of DA-related genes in a specific family cohort with ASDs. Additional functional and phenotypic studies will enable a better understanding of the contributions and implications of these findings to our understanding of autism. iii Co-Authorship I am responsible for the majority of the experimental design, data collection, and analysis in this thesis. I produced the first draft of this thesis with subsequent drafts incorporating input from my supervisor, Dr. Jeanette J.A. Holden. As my supervisor, Dr. Holden had an essential and invaluable role during my studies. Cuiling Zhang aided in the data collection for one of the twenty-one polymorphisms examined in my study; she genotyped the HUMTH01 polymorphism in individuals from 74 families from the TEST cohort. iv In loving memory of my grandparents, Joseph and Mary Hettinger, Who shaped my past, And To my girlies, Dina, Stephany and Melanie, Who are my present and my future. v Acknowledgements Foremost, I thank Dr. Jeanette Holden for the opportunity to have been part of her research group and to have had her as a mentor, allowing me to learn and grow as a researcher. I warmly thank the members of my committee, Dr. Ward, Dr. Munoz and Dr. Bendena, for their input and assistance over the years and I thank Dr. Suzanne Lewis for her invaluable assistance in the dysmorphology comparisons. I also thank past and present members of the Holden lab. I extend considerable thanks to my parents for their support and encouragement over the years. vi Table of Contents Abstract ............................................................................................................................... ii Co-Authorship.................................................................................................................... iv Acknowledgements ............................................................................................................ vi Table of Contents .............................................................................................................. vii List of Figures .................................................................................................................. xiii List of Tables ................................................................................................................... xiv List of Abbreviations ....................................................................................................... xvi Chapter 1 Introduction .........................................................................................................1 1.1 Identification and Characterization of Autism Spectrum Disorders ........................1 1.1.1 Clinical Features .............................................................................................1 1.1.2 Diagnostic Tools .............................................................................................4 1.2 Epidemiology of ASDs ............................................................................................6 1.3 The Impact and Costs of ASDs ................................................................................8 1.4 Genetics of ASDs .....................................................................................................9 1.4.1 Family and Twin Studies ..............................................................................10 1.4.2 Mode of Inheritance ......................................................................................10 1.4.3 Threshold Model ...........................................................................................11 1.4.4 Identification of Susceptibility Genes in Autism ..........................................12 1.4.4.1 Cytogenetic Analyses and Chromosomal Abnormalities ....................12 1.4.4.2 Genome Scans ......................................................................................13 1.4.4.3 Candidate Gene Approach ...................................................................14 1.5 Genetic Studies of Neurotransmitter Systems and Autism ....................................16 1.5.1 Glutamate and GABA Pathways ..................................................................16 1.5.2 Serotonin Pathway ........................................................................................18 1.5.3 Other Neurochemical Pathways and Autism ................................................21 vii 1.6 The Dopamine Pathway .........................................................................................21 1.6.1 Dopamine as a Catecholamine ......................................................................21 1.6.2 Dopamine as a Neurotransmitter ..................................................................23 1.6.3 Dopamine and Movement .............................................................................24 1.6.4 Dopamine and Cognition ..............................................................................26 1.6.5 Dopamine, Emotional Processing and Social Interaction .............................33 1.6.6 Other Roles of Dopamine .............................................................................38 1.7 Purpose of Study ....................................................................................................41 1.7.1 Evidence for a Role of Dopamine in Autism ................................................42 1.7.2 A Model for Autism Susceptibility ...............................................................43 1.7.3 Rationale for Selection of Dopamine-related Candidate Genes ...................44 1.7.3.1 TH ........................................................................................................44 1.7.3.2 SLC6A3 ................................................................................................46 1.7.3.3 DRD1 ...................................................................................................48 1.7.3.4 DRD2 ...................................................................................................49 1.7.3.5 PPP1R1B .............................................................................................50 1.7.4 Plan of Study .................................................................................................51 Chapter 2 Materials and Methods ......................................................................................52 2.1 Subjects ..................................................................................................................52 2.2 Marker Selection, Amplification and Genotyping .................................................55 2.2.1 TH .................................................................................................................55 2.2.2 SLC6A3 .........................................................................................................58 2.2.3 DRD1 ............................................................................................................60