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Dysregulation of Peripheral Expression of the YWHA Genes Dysregulation of peripheral expression of the YWHA genes during conversion to psychosis Fanny Demars, Oussama Kebir, Aude Marzo, Anton Iftimovici, Catherine Schramm, Marie-Odile Krebs, Boris Chaumette To cite this version: Fanny Demars, Oussama Kebir, Aude Marzo, Anton Iftimovici, Catherine Schramm, et al.. Dysregu- lation of peripheral expression of the YWHA genes during conversion to psychosis. Scientific Reports, Nature Publishing Group, 2020, 10 (1), pp.9863. 10.1038/s41598-020-66901-1. inserm-02881451 HAL Id: inserm-02881451 https://www.hal.inserm.fr/inserm-02881451 Submitted on 25 Jun 2020 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. www.nature.com/scientificreports OPEN Dysregulation of peripheral expression of the YWHA genes during conversion to psychosis Fanny Demars1, Oussama Kebir1,2, Aude Marzo1, Anton Iftimovici1,3, Catherine Schramm4, ICAAR Study Group*, Marie-Odile Krebs1,2 ✉ & Boris Chaumette1,2,5 The seven human 14-3-3 proteins are encoded by the YWHA-gene family. They are expressed in the brain where they play multiple roles including the modulation of synaptic plasticity and neuronal development. Previous studies have provided arguments for their involvement in schizophrenia, but their role during disease onset is unknown. We explored the peripheral-blood expression level of the seven YWHA genes in 92 young individuals at ultra-high risk for psychosis (UHR). During the study, 36 participants converted to psychosis (converters) while 56 did not (non-converters). YWHA genes expression was evaluated at baseline and after a mean follow-up of 10.3 months using multiplex quantitative PCR. Compared with non-converters, the converters had a signifcantly higher baseline expression levels for 5 YWHA family genes, and signifcantly diferent longitudinal changes in the expression of YWHAE, YWHAG, YWHAH, YWHAS and YWAHZ. A principal-component analysis also indicated that the YWHA expression was signifcantly diferent between converters and non-converters suggesting a dysregulation of the YWHA co-expression network. Although these results were obtained from peripheral blood which indirectly refects brain chemistry, they indicate that this gene family may play a role in psychosis onset, opening the way to the identifcation of prognostic biomarkers or new drug targets. Schizophrenia is a frequent disabling psychotic disorder, resulting from complex interactions between genetic factors and pre/post-natal exposure to environmental insults. It is a progressive illness that typically emerges during late adolescence and is characterized by several stages: early vulnerability, at-risk mental state (also called ultra-high risk, UHR), frst episode of psychosis (FEP), and chronic disease1. It has been estimated that one third of UHR individuals convert to psychosis afer three years of follow-up (converters), while a large majority remain with subthreshold symptoms, exhibiting a decrease in intensity or remission (non-converters)2. Te biological mechanisms underlying this diferential prognosis are not yet understood. We have previously reported that some methylomic and transcriptomic changes accompany the emergence of psychosis during adolescence3,4. However, additional longitudinal biological studies on UHR patients are crucially needed to identify biomarkers and to improve the current understanding of the pathophysiological mechanisms that accompany conversion from prodromes to major psychosis. In recent decades, the importance of the YWHA gene family in neuropsychiatric disorders, including schizo- phrenia has been highlighted5,6. Te YWHA genes (YWHAB/G/E/Z/H/Q/S) encode the 14-3-3 proteins (β, γ, ε, ζ, η, θ and σ, respectively), a family of highly conserved, multifunctional isoforms highly expressed in the brain7,8. YWHAS is also known as SFN, the gene coding for Stratifn. Tese proteins form homo- and heterodimers which bind other proteins among several hundreds of possible targets9–11. Te YWHA gene family plays important roles in neuronal and synaptic development, function and plasticity5,12–15. In particular, they participate in the activation of the tyrosine and tryptophan hydroxylases, the rate limiting enzymes in the synthesis of some neuro- transmitters including serotonin and dopamine16. Consistent with this latter role, we recently reported a low level of dopaminergic metabolites in the cerebrospinal fuid of a 20-year-old woman sufering from schizophrenia and carrying a de novo copy number variant (CNV; dup17p13.3) encompassing the YWHAE gene17. Moreover, genetic 1Université de Paris, Institut of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, team Physiopathologie des Maladies Psychiatriques, GDR3557-Institut de Psychiatrie, Paris, France. 2GHU Paris Psychiatrie et Neurosciences, Paris, France. 3NeuroSpin, Commissariat à l’Energie Atomique, Gif-sur-Yvette, France. 4University of Montreal, Sainte Justine Hospital Research Center, Montreal, Canada. 5Department of Psychiatry, McGill University, Montreal, Canada. *A list of authors and their afliations appears at the end of the paper. ✉e-mail: [email protected] SCIENTIFIC REPORTS | (2020) 10:9863 | https://doi.org/10.1038/s41598-020-66901-1 1 www.nature.com/scientificreports/ www.nature.com/scientificreports Converters Non-converters P-value (Mann- Variable (N = 36) (N = 56) Whitney or Fisher test) Age 20.0 (2.53) 21.8 (3.65) 0.023 Sex ratio (male/female) 27/9 30/26 0.049 Tobacco (daily use) 50% 35.4% 0.25 Cannabis (use in the last 30 days) 37.5% 20.5% 0.12 Psychotropic medication at inclusion 62% 60% 1 Follow-up duration in months 9.8 (5.7) 13.7 (4.0) 0.002 BPRS at baseline 56.03 (13.88) 54.79 (12.11) 0.93 BPRS at the end of the follow-up 52.54 (14.00) 44.45 (11.36) 0.016 CGI at baseline 4.53 (0.84) 4.59 (0.82) 0.7 CGI at the end of the follow-up 4.78 (0.85) 3.74 (1.20) <10−3 Quality of RNA measured by RIN 8.51 (0.45) 8.38 (0.54) 0.11 Table 1. Demographic and clinical characteristics of the population. BPRS (Brief Psychiatric Rating Scale); CGI (Clinical Global Impressions Scale). P-values <0.05 are in bold. Values represent population mean (and standard deviation). studies have reported multiple single nucleotide polymorphisms (SNPs) in YWHAE, YWHAH and YWHAZ in diferent cohorts of patients with schizophrenia18–23. Several transcriptomic and proteomic analyses have iden- tifed alterations in 14-3-3 protein isoforms in postmortem brain tissue of people with schizophrenia6,24–26. All these studies support the implication of the YWHA genes in chronic stages of schizophrenia. To our knowledge, only one study focused on early stages of this disease by exploring the levels of mRNA of the YWHA gene family in FEP27. Tis study reported a signifcantly lower expression of YWHAB, YWHAE, YWHAG, YWHAQ and a signifcantly higher expression of YHWAS. Te authors proposed that the expression levels of the YWHA gene family could be used as indicators of schizophrenia severity. Tis promising fnding urged us to investigate whether the expression of the YWHA gene family is dysregu- lated in earlier stages of the disease, before the frst-episode of psychosis, and during the emergence of psychotic symptoms. Terefore, we have used the longitudinal clinical and biological data of the French ICAAR cohort of psychiatric help-seeking young adults to explore the expression levels of the seven YWHA genes in UHR partic- ipants using multiplex quantitative-PCR (Q-PCR). We compared the baseline as well as the longitudinal changes of the expression levels between converters and non-converters. Results Demographic and clinical data of the study population. In total, 92 UHR participants were evalu- ated. Among them, 36 participants developed psychotic disorders during the follow-up (converters) and 56 did not (non-converters). Te demographic and clinical characteristics (age, sex ratio, cannabis and tobacco use, psychotropic treatment intake, duration of the follow-up, severity of the symptoms, and RNA-sample quality) are reported in Table 1. At study start, there were no signifcant diferences between converter and non-converter groups for daily use of tobacco, cannabis use within the last month, and psychotropic medication. Tere were no signifcant diferences between groups in RNA quality from the samples obtained at the beginning and the end of the follow-up. Te follow-up was longer for non-converters (p = 0.002), because converters were reassessed rapidly afer conversion, whereas the follow-up was extended for non-converters to have greater confdence in concluding that outcome. As expected, the scores for clinical grading (BPRS, CGI) were not diferent at baseline but were higher in converters than non-convertors afer the follow-up. Converters were younger and more fre- quently male than non-converters; consequently, the statistical models were adjusted with respect to age and sex. Comparison of baseline expression of YWHA genes between converters and non-converters. In the logistic-regression analysis, the baseline expression levels for YHWAB, YWHAE, YWHAG, YWHAQ and YWHAZ were signifcantly higher in converters than in non-converters (Table 2, Fig. 1a–g, Supplementary Fig. 1). By contrast, the baseline expression levels of YWHAH and YWHAS were not signifcantly diferent between con- verters and non-converters. Te baseline expression levels of YWHAB, YWHAE, YWHAQ and YWHAS were signifcantly correlated with several clinical scores at the end of the follow-up, especially with the score of negative symptoms (Supplementary Table 1). Comparison of longitudinal changes in expression of YWHA genes between converters and non-converters. YWHA mRNA expression data at the end of the study were obtained for 67 patients (29 converters and 38 non-converters).
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