Análise de expressão gênica e metilação de dna de pacientes em primeiro episódio psicótico virgens de tratamento

A esquizofrenia é o transtorno mental mais grave e incapacitante dentre os distúrbios psiquiátricos. A demora em instituir tratamento adequado e a duração do primeiro episódio psicótico estão entre os principais fatores de mau prognóstico da doença. O presente projeto propôs a investigação de marcadores genéticos e epigenéticos para o diagnóstico e tratamento da esquizofrenia por meio do estudo da expressão de genes alvos e do estudo do padrão de metilação de DNA (estudo de expressão gênica I). Paralelamente, em células progenitoras de neurônios, estudamos o efeito do silenciamento do gene MBD5 (Methyl-CpG Binding Domain Protein 5), importante para o neurodesenvolvimento e possivelmente relacionado à metilação de DNA (estudo funcional II). Para o estudo I, pacientes em primeiro episódio psicótico (PEP) virgens de tratamento e controles saudáveis foram submetidos à avaliação clínica e à coleta de sangue periférico. Os pacientes ressubmeteram-se às mesmas avaliações após oito semanas do início do tratamento com risperidona, sendo que parte deles também foram reavaliados após um ano de inclusão na pesquisa. Em todas as etapas de seguimento do estudo, o sangue dos pacientes foi recoletado, seguido pela extração de DNA e RNA das amostras. O estudo de expressão gênica I foi realizado por meio da técnica de PCR em tempo real quantitativo, e a análise metilação por meio de sequenciamento após conversão com bissulfito de sódio. Para o estudo funcional II, o silenciamento do gene MBD5 foi realizado em células progenitoras de neurônios. Elas foram submetidas ao sequenciamento de RNA, PCR em tempo real, Western blotting, e à citometria de fluxo. No estudo I os resultados indicaram uma redução na expressão do gene GCH1 (GTP cyclohydrolase 1) e um aumento na expressão dos genes NDEL1 (nudE neurodevelopment protein 1-like 1) e MBP (myelin basic protein) no sangue de pacientes em PEP quando comparados aos controles. Quando comparamos os pacientes antes e após o tratamento, o gene GABRR2 (gamma-aminobutyric acid (GABA) A receptor, rho 2) mostrou-se hipoexpresso após o tratamento com risperidona. Além disso, embora os dados sejam promissores, a expressão de GCH1 não parece ser regulada por metilação de DNA. Quanto ao estudo funcional II, foi observado que o silenciamento do gene MBD5 levava a um desbalanço entre proliferação e diferenciação das células progenitoras de neurônios. Os resultados desse estudo indicaram três genes possivelmente envolvidos na psicose propriamente dita, estando relacionados às vias dopaminérgicas e serotoninnérgicas (GCH1), ao neurodesenvolvimento (NDEL1) e à mielinização (MBP). Além disso, o gene GABRR2, embora não pareça ser alvo direto da risperidona, pode estar associado à resposta ao tratamento ou evolução da doença, indicando, assim, a importância da via GABAérgica. Estes dados poderão futuramente auxiliar a identificação de marcadores biológicos, tanto para a psicose quanto para o tratamento da esquizofrenia, possibilitando uma ação terapêutica precoce e acarretando na redução do tempo de psicose não tratada, o que pode resultar em diminuição da morbidade e melhor qualidade de vida para os pacientes. Também observamos que reduções na expressão de um gene envolvido em doenças do neurodesenvolvimento (MBD5) promovem um estado mais diferenciado que proliferativo de células progenitoras de neurônios, um fenômeno que parece estar presente nas alterações de outros genes envolvidos nessas doenças podendo, assim, ser um mecanismo convergente de doenças do neurodesenvolvimento, como o autismo, a deficiência intelectual e a esquizofrenia.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Gene expression changes associated with trajectories of psychopathology in a longitudinal cohort of children and adolescents

We aimed to identify blood gene expression patterns associated to psychopathological trajectories retrieved from a large community, focusing on the emergence and remission of general psychiatric symptoms. Hundred and three individuals from the Brazilian High-Risk Cohort Study (BHRCS) for mental disorders were classified in four groups according to Child Behavior Checklist (CBCL) total score at the baseline (w0) and after 3 years (w1): low–high (L–H) (N = 27), high–low (H–L) (N = 12), high–high (H–H) (N = 34) and low–low (L–L) groups (N = 30). Blood gene expression profile was measured using Illumina HT-12 Beadchips, and paired analyses comparing w0 and w1 were performed for each group. Results: 98 transcripts were differentially expressed comparing w0 and w1 in the L-H, 33 in the H–L, 177 in the H–H and 273 in the L–L. Of these, 66 transcripts were differentially expressed exclusively in the L–H; and 6 only in the H–L. Cross-Lagged Panel Models analyses revealed that RPRD2 gene expression at w1 might be influenced by the CBCL score at w0. Moreover, COX5B, SEC62, and NDUFA2 were validated with another technique and were also differentially regulated in postmortem brain of subjects with mental disorders, indicating that they might be important not only to specific disorders, but also to general psychopathology and symptoms trajectories. Whereas genes related to metabolic pathways seem to be associated with the emergence of psychiatric symptoms, mitochondrial inner membrane genes might be important over the course of normal development. These results suggest that changes in gene expression can be detected in blood in different psychopathological trajectories

The role of the CNR1 gene in schizophrenia: a systematic review including unpublished data

Objective: Schizophrenia is a multifactorial disorder. It is known that a combination of extensive multiple common alleles may be involved in its etiology, each contributing with a small to moderate effect, and, possibly, some rare alleles with a much larger effect size. We aimed to perform a systematic review of association studies between schizophrenia (and its subphenotypes) and polymorphisms in the CNR1 gene, which encodes cannabinoid receptors classically implicated in schizophrenia pathophysiology, as well as to present unpublished results of an association study in a Brazilian population. Methods: Two reviewers independently searched for eligible studies and extracted outcome data using a structured form. Papers were retrieved from PubMed and ISI Web of Knowledge using the search term schizophrenia in combination with CNR1 or CB1 or cannabinoid receptor. Twenty-four articles met our inclusion criteria. We additionally present data from a study of our own comparing 182 patients with schizophrenia and 244 healthy controls. Results: No consistent evidence is demonstrated. Conclusion: Some seemingly positive association studies stress the need for further investigations of the possible role of endocannabinoid genetics in schizophrenia.Fundacao de Amparo e Pesquisa do Estado de Sao Paulo (FAPESP) [2010/08968-6, 2011/50740-5, 2011/00030-1]Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)FAPESPCNPqCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Fundacao SafraFundacao ABADSUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Lab Interdisciplinar Neurociencias Clin LiNC, Sao Paulo, SP, BrazilIrmandade Santa Casa Misericordia Sao Paulo, Dept Psiquiatria, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Morfol & Genet, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Lab Interdisciplinar Neurociencias Clin LiNC, Sao Paulo, SP, BraziWeb of Scienc

Peripheral interleukin-2 level is associated with negative symptoms and cognitive performance in schizophrenia

Although several studies have pointed to a possible role of interleukin 2 (IL-2) in schizophrenia (SZ), association between IL-2 and the different groups of symptoms has not been explored. the objective of this study was to investigate a possible correlation of peripheral IL-2 levels with symptoms and cognitive performance in patients with SZ. in addition, we compared the plasma levels of IL-2 between patients with SZ and healthy controls. Twenty-nine chronically medicated outpatients with SZ according to DSM-IV were compared with twenty-six healthy controls. the patients were evaluated with the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Clinical Global Impression (CGI) and the Global Assessment of Functioning (GAF). All the participants had blood collected into EDTA tubes by venipuncture between 9:00 and 10:00 AM. Plasma concentrations of IL-2 were determined by cytometric bead array. A computerized neuropsychological battery assessed verbal learning, verbal fluency, working memory, set shifting, executive function, inhibition and intelligence. Patients with SZ had lower levels of IL-2 than healthy controls (p < 0.001). in the SZ group, IL-2 levels were positively correlated with scores in the digit span test (rho = 0.416, P = 0.025) and intelligence (rho = 0.464, P = 0.011). We also found a negative correlation between IL-2 and total score in the negative subscale of PANSS (rho = -0.447, p = 0.015). Our findings suggest that IL-2 may be involved in the mechanisms related to cognitive deterioration and negative symptomatology in schizophrenia. (C) 2014 Elsevier Inc. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Dept Psychiat, Schizophrenia Program PROESQ, BR-04044000 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LINC, BR-04039032 São Paulo, BrazilUniv Fed Minas Gerais, Translat Psychoneuroimmunol Grp, BR-31270901 Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Schizophrenia Program PROESQ, BR-04044000 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LINC, BR-04039032 São Paulo, BrazilWeb of Scienc

Effects of Risperidone on Cytokine Profile in Drug-Naive First-Episode Psychosis

Background: There is robust evidence that schizophrenia is characterized by immune-inflammatory abnormalities, including variations on cytokine levels. the results of previous studies, however, are heterogeneous due to several confounding factors, such as the effects of antipsychotic drugs. Therefore, research on drug-naive first-episode psychosis (FEP) patients is essential to elucidate the role of immune processes in that disorder.Methods: the aim of this study is to compare cytokine levels (IL-2, IL-10, IL-4, IL-6, IFN-gamma, TNF-alpha, and IL-17) in drug-naive FEP patients both before and after treatment with risperidone for 10 weeks, and to investigate possible associations between cytokine levels and clinical responses to treatment and presence of depressive symptoms. It this study, we included 55 drug-naive FEP patients who had repeated measurements of cytokine levels and 57 healthy controls.Results: We found that FEP patients had significantly higher IL-6, IL-10 and TNF-alpha levels than healthy controls. After risperidone treatment, these three cytokines and additionally IL-4 decreased significantly. No significant difference was found between the post-treatment cytokine levels in FEP patients and in healthy controls, suggesting that these alterations in cytokine profiles are a state marker of FEP. No significant association was found between risperidone-induced changes in cytokines and the clinical response to treatment or the presence of depression. There was a significant inverse association between the risperidone-induced changes in IL-10 and the negative symptoms.Conclusions: in conclusion, our results show a specific cytokine profile in FEP patients (monocytic and regulatory T-cell activation) and suggest immunoregulatory effects of risperidone treatment, characterized by suppressant effects on monocytic, Th2, and T-regulatory functions.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundacao SafraFundacao ABADSJanssenEli LillyLundbeckNovartisRocheUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilFac Ciencias Med Santa Casa São Paulo, Episode Psychosis Program 1, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morphol & Genet, Div Genet, São Paulo, BrazilDeakin Univ, Dept Psychiat, Geelong, Vic 3217, AustraliaChulalongkorn Univ, Dept Psychiat, Bangkok, ThailandUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morphol & Genet, Div Genet, São Paulo, BrazilWeb of Scienc

Catechol-O-methyltransferase (COMT) polymorphisms modulate working memory in individuals with schizophrenia and healthy controls

Objective: Cognitive impairment is a core feature of schizophrenia, related to dopaminergic dysfunction in the prefrontal cortex (PFC). It is hypothesized that functional single nucleotide polymorphism (SNP) rs4680 of the catechol-O-methyltransferase (COMT) gene could mediate the relationship between cognition and dopamine activity in the PFC. Other COMT SNPs could also play a role. Methods: We evaluated the role of three COMT SNPs (rs737865, rs165599, and rs4680) in schizophrenia and their impact on three working memory tasks. For genetic association analyses, 212 individuals with schizophrenia and 257 healthy controls (HCs) were selected. The Visual Working Memory (VWM) Task, Keep Track Task, and Letter Memory Task were administered to 133 schizophrenics and 93 HCs. Results: We found a significant association of rs737865, with the GG genotype exerting a protective effect and the GA haplotype (rs4680/rs165599) exerting a risk effect for schizophrenia. COMT rs4680 AA carriers and rs737865 AA carriers scored lowest on the Keep Track Task. When the genotype* group interaction effect was evaluated, rs165599 exerted opposite effects for VWM and Keep Track task performance in patients and controls, with AA carriers scoring lowest on both tests among controls, but highest among patients. Conclusion: These data support the hypothesis that COMT polymorphisms may be associated with schizophrenia and modulate cognition in patients and controls.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilFMABC, Dept Saude Colet, Santo Andre, SP, BrazilUniv Fed Sao Paulo, Lab Interdisciplinar Neurociencias Clin LiNC, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Morfol & Genet, Disciplina Genet, Sao Paulo, SP, BrazilCtr Univ Fundcao Inst Ensino Osasco UNIFIEO, Dept Psicol Educ, Osasco, SP, BrazilUniv Fed Sao Paulo, Dept Psicobiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Lab Interdisciplinar Neurociencias Clin LiNC, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Morfol & Genet, Disciplina Genet, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Psicobiol, Sao Paulo, SP, BrazilFAPESP: 2007/58736-1FAPESP: 2011/50740-5Web of Scienc

PRODH Polymorphisms, Cortical Volumes and Thickness in Schizophrenia

Schizophrenia is a neurodevelopmental disorder with high heritability. Several lines of evidence indicate that the PRODH gene may be related to the disorder. Therefore, our study investigates the effects of 12 polymorphisms of PRODH on schizophrenia and its phenotypes. To further evaluate the roles of the associated variants in the disorder, we have conducted magnetic resonance imaging (MRI) scans to assess cortical volumes and thicknesses. A total of 192 patients were evaluated using the Structured Clinical Interview for DSM-IV (SCID), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale, Global Assessment of Functioning (GAF) and Clinical Global Impression (CGI) instruments. the study included 179 controls paired by age and gender. the samples were genotyped using the real-time polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP)-PCR and Sanger sequencing methods. A sample of 138 patients and 34 healthy controls underwent MRI scans. One polymorphism was associated with schizophrenia (rs2904552), with the G-allele more frequent in patients than in controls. This polymorphism is likely functional, as predicted by PolyPhen and SIFT, but it was not associated with brain morphology in our study. in summary, we report a functional PRODH variant associated with schizophrenia that may have a neurochemical impact, altering brain function, but is not responsible for the cortical reductions found in the disorder.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo UNIFESP, Disciplina Genet, Dept Morfol & Genet, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, LiNC, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Psiquiatria, São Paulo, BrazilFac Med ABC FMABC, Dept Ginecol & Obstet, Disciplina Genet & Reprod Humana, São Paulo, BrazilFed Univ Para, Lab Genet Humana & Med, BR-66059 Belem, Para, BrazilUniv Fed ABC, Ctr Math Computat & Cognit, Santo Andre, BrazilUniversidade Federal de São Paulo UNIFESP, Disciplina Genet, Dept Morfol & Genet, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, LiNC, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Psiquiatria, São Paulo, BrazilFAPESP: 2011/50740-5FAPESP: 2007/58736-1Web of Scienc

Higher education in pandemic times: personalization, engagement, autonomy and new learning strategies

Uma modalidade massiva, distante, a distância massiva, transmissiva e não atrativa para os estudantes, ocasiona alguns fatores como falta de autonomia, desinteresse e como consequência, o não engajamento dos estudantes. A perspectiva inovadora deste estudo centra-se em examinar quais as recomendações para a personalização de estratégias didáticas através de recursos pedagógicos, visando promover uma educação on-line envolvente e engajadora para dinâmicas sustentáveis e frutíferas como formas de coaprender (IYENGAR, 2020). Diversificadas estratégias utilizando tecnologias digitais no ensino superior on-line, ampliam o desenvolvimento da autonomia para uma aprendizagem individual, coletiva e emancipadora (OKADA; SHEEHY, 2020). Literaturas mais recentes, algumas inclusive desenvolvidas durante a pandemia por COVID-19, indicam que novas abordagens de aprendizagem estão sendo fundamentadas em perspectivas diversificadas, de acordo com necessidades e preferências para o processo de adequação às condições e perfis dos estudantes (AGUADED; JARAMILLO-DENT; PONCE, 2021; FULLAN, 2020; OCDE, 2020). Quais tipos de recursos pedagógicos podem ser adotados para oportunizar uma aprendizagem divertida, destacada como “significativa - envolvente” no ensino superior on-line, considerando-se o cenário a partir do contexto da pandemia? Este estudo qualitativo exploratório analisou dados gerados de um questionário aberto on-line implementado pela rede UAb-PT voltado para estudantes durante o período de três meses no ensino superior dos países de língua portuguesa (Angola, Brasil e Portugal). Para a sistematização dos dados coletados, adotou-se a técnica do Discurso do Sujeito Coletivo (DSC) que propicia o agrupamento de depoimentos e sua respectiva síntese (LEFÈVRE; LEFÈVRE, 2005). Ao total, foram analisados dados de 570 estudantes respondentes do formulário on-line. A aprendizagem on-line divertida deve contemplar uso de tecnologias colaborativas, individuais, em rede para a coaprendizagem com atividades e exercícios diferenciados de acordo com as necessidades e preferências de uso da virtualidade. Esse tipo de abordagem personaliza a aprendizagem conforme o perfil do estudante, permite reflexões e abordagens pedagógicas mais envolventes e divertidas a partir do ponto de vista aliciante aos estudantes no ensino superior.A modality that is massive, distant, at massive distance, transmissive and not appealing to students, causes some issues such as lack of autonomy, lack of interest, and lack of engagement of the students. The innovative perspective of this study focuses on examining whether there are recommendations for personalizing teaching strategies using pedagogical resources, aiming to promote engaging and involving online learning for sustainable and productive dynamics as means of co-learning (IYENGAR, 2020). Diversified strategies using digital technologies in online higher education extends the development of autonomy for individual, collective, and emancipatory learning (OKADA; SHEEHY, 2020). Recent literature, some even produced during the COVID-19 pandemic, suggests that new learning approaches are based on diverse perspectives, according to needs and preferences tailored to the student’s profile (AGUADED; JARAMILLO-DENT; PONCE, 2021; FULLAN, 2020; OECD, 2020). Considering the Pandemic scenario, what types of pedagogical resources should be adopted to enable a fun learning, described as “meaningful / engaging” in online higher education? This exploratory qualitative study analyzed data generated from an online open questionnaire implemented by the UAb-PT network, aimed at higher education students from Portuguese speaking countries (Angola, Brazil and Portugal). The systematization of the data collected adopted the Discourse of the Collective Subject (DSC) technique, which facilitates grouping statements and its corresponding synthesis (LEFÈVRE; LEFÈVRE, 2005). In total, data from 570 students who answered the online questionnaire was analyzed. Fun online learning should include the use of technologies that are collaborative, individual, network-based for co-learning with differentiated activities and exercises, according to the needs and preferences of the use of virtuality. Such approach personalizes the learning based on the student’s profile, enables reflections and pedagogical approaches that are more engaging and fun for students in higher education.info:eu-repo/semantics/publishedVersio

Obsessive-compulsive symptoms, polygenic risk score, and thalamic development in children from the Brazilian High-Risk Cohort for Mental Conditions (BHRCS)

Background: Thalamic volume measures have been linked to obsessive-compulsive disorder (OCD) in children and adolescents. However, it is unclear if alterations in thalamic volumes occur before or after symptom onset and if there is a relation to the presence of sub-clinical obsessive-compulsive symptoms (OCS). Here, we explore the relationship between OCS and the rate of thalamic volume change in a cohort of children and youth at high risk to develop a mental disorder. A secondary aim was to determine if there is a relationship between OCS and the individual’s OCD polygenic risk score (OCD-PRS) and between the rate of thalamic volume change and the OCD-PRS. Methods: The sample included 378 children enrolled in the longitudinal Brazilian High-Risk Cohort for Mental Conditions. Participants were assessed for OCS and the symmetrized percent change (SPC) of thalamic volume across two time-points separated by 3 years, along with the OCD-PRS. Zero-altered negative binomial models were used to analyze the relationship between OCS and thalamic SPC. Multiple linear regressions were used to examine the relationship between thalamic SPC and OCD-PRS. Results: A significant relationship between OCS and the right thalamus SPC (p = 0.042) was found. There was no significant relationship between changes in thalamic volume SPC and OCD-PRS. Conclusions: The findings suggest that changes in the right thalamic volume over the course of 3 years in children may be associated to OCS. Future studies are needed to confirm these results and further characterize the specific nature of OCS symptoms associated with thalamic volumes