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Mutation in serotonin synthesis enzyme linked to increased risk of depression
Dysfunction of central serotonin (5-HT) neurotransmission is involved in the pathophysiology of depression. Many studies have suggested associations between depression and genes that control the central functions of monoamine oxidases, the 5-HT transporter, 5-HT receptors, and the rate-limiting enzyme of 5-HT synthesis, tryptophan hydroxylase, TPH2. Studies in mice revealed a link between a TPH2 gene mutation and a reduction in 5-HT levels. In addition mutant mice were reported to display different behaviors and responses to antidepressants. Similar mutations in human TPH2 which may affect brain 5-HT homeostasis in depression have been investigated.
TPH2 sequences from 300 subjects at risk of psychosocial and behavioral disorders were screened. A mutation, replacement of arginine with histidine, resulted in 80% loss of function in 5-HT production when expressed in cultured cells. The mutation was sought in a cohort of 87 patients with unipolar depression, 60 patients with bipolar depression, and 219 control subjects.
Nine patients with unipolar depression and three controls carried the mutant allele, whereas no carriers of the mutant allele were found among the bipolar disorder patients. Seven of the nine patients had family histories of mental illness or drug and alcohol abuse, and six had exhibited suicidal behavior or made a suicide attempt. One of the three controls had generalized anxiety symptoms, and the other two had mild depression and a family history of mental illness or drug and alcohol abuse.
These findings suggest that a mutation in human TPH2 resulting in a deficiency in brain 5-HT synthesis may contribute to vulnerability to unipolar major depression. These observations, however, merit to be confirmed in larger genetic studies.
Zhang X, Gainetdinov RR, Beaulieu JM, Sotnikova TD, Burch LH, Williams RB, Schwartz DA, Krishnan KR, Caron MG. Loss-of-Function Mutation in Tryptophan Hydroxylase-2 Identified in Unipolar Major Depression. Neuron 2005, 45: 11-16.

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