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Further clarification of the contribution of the tryptophan hydroxylase (TPH) gene to suicidal behavior using systematic allelic and genotypic meta-analyses

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Abstract

Suicide is a major public health issue, especially in western countries, accounting for approximately 1 million deaths every year throughout the world. The tryptophan hydroxylase (TPH) gene has been extensively studied as a candidate for suicidal behavior due to its role in serotonergic neurotransmission. Since the first study associating the gene with schizophrenia, there have been many attempts to replicate it. However, a number of these studies have produced contrary results, possibly reflecting inadequate statistical power and the use of different populations. Association data relating European and, more particularly, Asian populations has become increasingly available in recent years. To examine whether the aggregate data provide evidence of statistical significance, the current meta-analysis has combined all the published studies up to July 2005, and examined the polymorphisms (A779C, A218C, A-6526G) in the context of varied suicidal behaviors by analyzing the studies in total and in subsets. Compared with the inconsistent results of previous studies, the current results (22 references) confirm a strong overall association between suicidal behavior and the A779C/A218C polymorphisms, supporting the involvement of TPH in the pathogenesis of suicidal behavior.

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References

  • Abbar M, Courtet P, Amadeo S, Caer Y, Mallet J, Baldy-Moulinier M, Castelnau D, Malafosse A (1995) Suicidal behaviors and the tryptophan hydroxylase gene. Arch Gen Psychiatry 52:846–849

    PubMed  CAS  Google Scholar 

  • Abbar M, Courtet P, Bellivier F, Leboyer M, Boulenger JP, Castelhau D, Ferreira M, Lambercy C, Mouthon D, Paoloni-Giacobino A, Vessaz M, Malafosse A, Buresi C (2001) Suicide attempts and the tryptophan hydroxylase gene. Mol Psychiatry 6:268–273

    Article  PubMed  CAS  Google Scholar 

  • Arango V, Huang YY, Underwood MD, Mann JJ (2003) Genetics of the serotonergic system in suicidal behavior. J Psychiatr Res 37:375–386

    Article  PubMed  Google Scholar 

  • Bellivier F, Chaste P, Malafosse A (2004) Association between the TPH gene A218C polymorphism and suicidal behavior: a meta-analysis. Am J Med Genet B Neuropsychiatr Genet 124:87–91

    Article  Google Scholar 

  • Bellivier F, Leboyer M, Courtet P, Buresi C, Beaufils B, Samolyk D, Allilaire JF, Feingold J, Mallet J, Malafosse A (1998) Association between the tryptophan hydroxylase gene and manic-depressive illness. Arch Gen Psychiatry 55:33–37

    Article  PubMed  CAS  Google Scholar 

  • Bennett PJ, McMahon WM, Watabe J, Achilles J, Bacon M, Coon H, Grey T, Keller T, Tate D, Tcaciuc I, Workman J, Gray D (2000) Tryptophan hydroxylase polymorphisms in suicide victims. Psychiatr Genet 10:13–17

    PubMed  CAS  Google Scholar 

  • Courtet P, Picot MC, Bellivier F, Torres S, Jollant F, Michelon C, Castelnau D, Astruc B, Buresi C, Malafosse A (2004) Serotonin transporter gene may be involved in short-term risk of subsequent suicide attempts. Biol Psychiatry 55:46–51

    Article  PubMed  CAS  Google Scholar 

  • Du L, Bakish D, Hrdina PD (2001) Tryptophan hydroxylase gene 218A/C polymorphism is associated with somatic anxiety in major depressive disorder. J Affect Disord 65:37–44

    Article  PubMed  CAS  Google Scholar 

  • Du L, Faludi G, Palkovits M, Bakish D, Hrdina PD (2000) Tryptophan hydroxylase gene 218A/C polymorphism is not associated with depressed suicide. Int J Neuropsychopharmacol 3:215–220

    Article  PubMed  CAS  Google Scholar 

  • Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634

    PubMed  CAS  Google Scholar 

  • Faludi G, Du L, Palkovits M, Antal B, Sotonyi P, Hrdina PD (2000) Serotonin transporter, serotonin-2A receptor and tryptophan hydroxilase gene polymorphisms in depressed suicide victims. Neurobiology (Bp) 8:269–271

    CAS  Google Scholar 

  • Furlong RA, Ho L, Rubinsztein JS, Walsh C, Paykel ES, Rubinsztein DC (1998) No association of the tryptophan hydroxylase gene with bipolar affective disorder, unipolar affective disorder, or suicidal behaviour in major affective disorder. Am J Med Genet 81:245–247

    Article  PubMed  CAS  Google Scholar 

  • Geijer T, Frisch A, Persson ML, Wasserman D, Rockah R, Michaelovsky E, Apter A, Jonsson EG, Nothen MM, Weizman A (2000) Search for association between suicide attempt and serotonergic polymorphisms. Psychiatr Genet 10:19–26

    Article  PubMed  CAS  Google Scholar 

  • Gelernter J, Kranzler H, Lacobelle J (1998) Population studies of polymorphisms at loci of neuropsychiatric interest (tryptophan hydroxylase (TPH), dopamine transporter protein (SLC6A3), D3 dopamine receptor (DRD3), apolipoprotein E (APOE), mu opioid receptor (OPRM1), and ciliary neurotrophic factor (CNTF)). Genomics 52:289–297

    Article  PubMed  CAS  Google Scholar 

  • Han L, Nielsen DA, Rosenthal NE, Jefferson K, Kaye W, Murphy D, Altemus M, Humphries J, Cassano G, Rotondo A, Virkkunen M, Linnoila M, Goldman D (1999) No coding variant of the tryptophan hydroxylase gene detected in seasonal affective disorder, obsessive-compulsive disorder, anorexia nervosa, and alcoholism. Biol Psychiatry 45:615–619

    Article  PubMed  CAS  Google Scholar 

  • Ho LW, Furlong RA, Rubinsztein JS, Walsh C, Paykel ES, Rubinsztein DC (2000) Genetic associations with clinical characteristics in bipolar affective disorder and recurrent unipolar depressive disorder. Am J Med Genet 96:36–42

    Article  PubMed  CAS  Google Scholar 

  • Hong CJ, Tsai SJ, Wang YC (2001) Association between tryptophan hydroxylase gene polymorphism (A218C) and schizophrenic disorders. Schizophr Res 49:59–63

    Article  PubMed  CAS  Google Scholar 

  • Jernej B, Stefulj J, Hranilovic D, Balija M, Skavic J, Kubat M (2004) Intronic polymorphism of tryptophan hydroxylase and serotonin transporter: indication for combined effect in predisposition to suicide. J Neural Transm 111:733–738

    Article  PubMed  CAS  Google Scholar 

  • Kirov G, Owen MJ, Jones I, McCandless F, Craddock N (1999) Tryptophan hydroxylase gene and manic-depressive illness. Arch Gen Psychiatry 56:98–99

    Article  PubMed  CAS  Google Scholar 

  • Kunugi H, Ishida S, Kato T, Sakai T, Tatsumi M, Hirose T, Nanko S (1999) No evidence for an association of polymorphisms of the tryptophan hydroxylase gene with affective disorders or attempted suicide among Japanese patients. Am J Psychiatry 156:774–776

    PubMed  CAS  Google Scholar 

  • Lalovic A, Turecki G (2002) Meta-analysis of the association between tryptophan hydroxylase and suicidal behavior. Am J Med Genet 114:533–540

    Article  PubMed  CAS  Google Scholar 

  • Mann JJ, Brent DA, Arango V (2001) The neurobiology and genetics of suicide and attempted suicide: a focus on the serotonergic system. Neuropsychopharmacology 24:467–477

    Article  PubMed  CAS  Google Scholar 

  • Mann JJ, Malone KM, Nielsen DA, Goldman D, Erdos J, Gelernter J (1997) Possible association of a polymorphism of the tryptophan hydroxylase gene with suicidal behavior in depressed patients. Am J Psychiatry 154:1451–1453

    PubMed  CAS  Google Scholar 

  • Marshall SE, Bird TG, Hart K, Welsh KI (1999) Unified approach to the analysis of genetic variation in serotonergic pathways. Am J Med Genet 88:621–627

    Article  PubMed  CAS  Google Scholar 

  • New AS, Gelernter J, Yovell Y, Trestman RL, Nielsen DA, Silverman J, Mitropoulou V, Siever LJ (1998) Tryptophan hydroxylase genotype is associated with impulsive-aggression measures: a preliminary study. Am J Med Genet 81:13–17

    Article  PubMed  CAS  Google Scholar 

  • Nielsen DA, Goldman D, Virkkunen M, Tokola R, Rawlings R, Linnoila M (1994) Suicidality and 5-hydroxyindoleacetic acid concentration associated with a tryptophan hydroxylase polymorphism. Arch Gen Psychiatry 51:34–38

    PubMed  CAS  Google Scholar 

  • Nielsen DA, Jenkins GL, Stefanisko KM, Jefferson KK, Goldman D (1997) Sequence, splice site and population frequency distribution analyses of the polymorphic human tryptophan hydroxylase intron 7. Brain Res Mol Brain Res 45:145–148

    Article  PubMed  CAS  Google Scholar 

  • Nielsen DA, Virkkunen M, Lappalainen J, Eggert M, Brown GL, Long JC, Goldman D, Linnoila M (1998) A tryptophan hydroxylase gene marker for suicidality and alcoholism. Arch Gen Psychiatry 55:593–602

    Article  PubMed  CAS  Google Scholar 

  • Ohtani M, Shindo S, Yoshioka N (2004) Polymorphisms of the tryptophan hydroxylase gene and serotonin 1A receptor gene in suicide victims among Japanese. Tohoku J Exp Med 202:123–133

    Article  PubMed  CAS  Google Scholar 

  • Ono H, Shirakawa O, Nishiguchi N, Nishimura A, Nushida H, Ueno Y, Maeda K (2000) Tryptophan hydroxylase gene polymorphisms are not associated with suicide. Am J Med Genet 96:861–863

    Article  PubMed  CAS  Google Scholar 

  • Paik I, Toh K, Kim J, Lee C (2000) TPH gene may be associated with suicidal behavior, but not with schizophrenia in the Korean population. Hum Hered 50:365–369

    Article  PubMed  CAS  Google Scholar 

  • Paoloni-Giacobino A, Mouthon D, Lambercy C, Vessaz M, Coutant-Zimmerli S, Rudolph W, Malafosse A, Buresi C (2000) Identification and analysis of new sequence variants in the human tryptophan hydroxylase (TpH) gene. Mol Psychiatry 5:49–55

    Article  PubMed  CAS  Google Scholar 

  • Pooley EC, Houston K, Hawton K, Harrison PJ (2003) Deliberate self-harm is associated with allelic variation in the tryptophan hydroxylase gene (TPH A779C), but not with polymorphisms in five other serotonergic genes. Psychol Med 33:775–783

    Article  PubMed  CAS  Google Scholar 

  • Rotondo A, Schuebel K, Bergen A, Aragon R, Virkkunen M, Linnoila M, Goldman D, Nielsen D (1999) Identification of four variants in the tryptophan hydroxylase promoter and association to behavior. Mol Psychiatry 4:360–368

    Article  PubMed  CAS  Google Scholar 

  • Roy A, Rylander G, Forslund K, Asberg M, Mazzanti CM, Goldman D, Nielsen DA (2001) Excess tryptophan hydroxylase 17 779C allele in surviving cotwins of monozygotic twin suicide victims. Neuropsychobiology 43:233–236

    Article  PubMed  CAS  Google Scholar 

  • Rujescu D, Giegling I, Bondy B, Gietl A, Zill P, Moller HJ (2002) Association of anger-related traits with SNPs in the TPH gene. Mol Psychiatry 7:1023–1029

    Article  PubMed  CAS  Google Scholar 

  • Rujescu D, Giegling I, Sato T, Hartmann AM, Moller HJ (2003) Genetic variations in tryptophan hydroxylase in suicidal behavior: analysis and meta-analysis. Biol Psychiatry 54:465–473

    Article  PubMed  CAS  Google Scholar 

  • Souery D, Oswald P, Linkowski P, Mendlewicz J (2003) Molecular genetics in the analysis of suicide. Ann Med 35:191–196

    Article  PubMed  CAS  Google Scholar 

  • Souery D, Van Gestel S, Massat I, Blairy S, Adolfsson R, Blackwood D, Del-Favero J, Dikeos D, Jakovljevic M, Kaneva R, Lattuada E, Lerer B, Lilli R, Milanova V, Muir W, Nothen M, Oruc L, Papadimitriou G, Propping P, Schulze T, Serretti A, Shapira B, Smeraldi E, Stefanis C, Thomson M, Van Broeckhoven C, Mendlewicz J (2001) Tryptophan hydroxylase polymorphism and suicidality in unipolar and bipolar affective disorders: a multicenter association study. Biol Psychiatry 49:405–409

    Article  PubMed  CAS  Google Scholar 

  • Staner L, Uyanik G, Correa H, Tremeau F, Monreal J, Crocq MA, Stefos G, Morris-Rosendahl DJ, Macher JP (2002) A dimensional impulsive-aggressive phenotype is associated with the A218C polymorphism of the tryptophan hydroxylase gene: a pilot study in well-characterized impulsive inpatients. Am J Med Genet 114:553–557

    Article  PubMed  Google Scholar 

  • Tsai SJ, Hong CJ, Wang YC (1999) Tryptophan hydroxylase gene polymorphism (A218C) and suicidal behaviors. Neuroreport 10:3773–3775

    Article  PubMed  CAS  Google Scholar 

  • Turecki G, Zhu Z, Tzenova J, Lesage A, Seguin M, Tousignant M, Chawky N, Vanier C, Lipp O, Alda M, Joober R, Benkelfat C, Rouleau GA (2001) TPH and suicidal behavior: a study in suicide completers. Mol Psychiatry 6:98–102

    Article  PubMed  CAS  Google Scholar 

  • Underwood MD, Mann JJ, Arango V (2004) Serotonergic and noradrenergic neurobiology of alcoholic suicide. Alcohol Clin Exp Res 28:57S–69S

    Article  PubMed  CAS  Google Scholar 

  • van Heeringen K (2003) The neurobiology of suicide and suicidality. Can J Psychiatry 48:292–300

    PubMed  Google Scholar 

  • Zalsman G, Frisch A, King RA, Pauls DL, Grice DE, Gelernter J, Alsobrook J, Michaelovsky E, Apter A, Tyano S, Weizman A, Leckman JF (2001) Case control and family-based studies of tryptophan hydroxylase gene A218C polymorphism and suicidality in adolescents. Am J Med Genet 105:451–457

    Article  PubMed  CAS  Google Scholar 

  • Zill P, Buttner A, Eisenmenger W, Moller HJ, Bondy B, Ackenheil M (2004) Single nucleotide polymorphism and haplotype analysis of a novel tryptophan hydroxylase isoform (TPH2) gene in suicide victims. Biol Psychiatry 56:581–586

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

This work was supported by grants from the Ministry of Education, PRC, the national 973 and 863 programs, the National Natural Science Foundation of China, and the Shanghai Municipal Commission for Science and Technology.

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Correspondence to Lin He.

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Li, D., He, L. Further clarification of the contribution of the tryptophan hydroxylase (TPH) gene to suicidal behavior using systematic allelic and genotypic meta-analyses. Hum Genet 119, 233–240 (2006). https://doi.org/10.1007/s00439-005-0113-x

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