Nature and Nurture Interplay: Schizophrenia

Zusammenfassung

Es gibt mittlerweile stringente Belege aus Familien-, Zwillings- und Adoptionsstudien, die den wesentlichen genetischen Anteil der Erkrankung Schizophrenie beschreiben. Die Art der Übertragung ist allerdings sehr kompliziert und umfasst wenn überhaupt nur sehr selten ein einzelnes Gen. Vielmehr gründet sich die Schizophrenie auf zahlreiche Gene mit geringen Effekten und deren Zusammenspiel mit der Umwelt. Da aber die Gesamtgröße des genetischen Effektes für 80 % der Varianz verantwortlich ist, ist es schwierig, eindeutige Umweltfaktoren festzulegen. Lange Zeit herrschte sogar die Vorstellung vor, dass der Bereich der Umwelt vollständig aus epigenetischen bzw. stochastischen Phänomenen besteht, die mit den bekannten epidemiologischen Methoden nicht entdeckt werden könnten. Nichtsdestotrotz beeinflussen eine Vielzahl von sozialen Stressoren, z. B. „high-expressed emotion”-Verhalten bei Verwandten Schizophrener und wichtige Lebensereignisse den Verlauf der Erkrankung Schizophrenie und es ist bekannt, dass bestimmte körperliche Faktoren wie Geburtskomplikationen und Cannabismissbrauch auch zu einer Anfälligkeit für diese Erkrankung beitragen. Die jüngste Entdeckung verschiedener Kandidatengene der Schizophrenie lässt nicht nur auf ein besseres Verstehen der Neurobiologie dieser Erkrankung hoffen, sondern auch auf eine verbesserte Kenntnis hinsichtlich Risikoeinschätzung und Gen/Umwelt - Wechselwirkungen.

Abstract

There is compelling evidence from family, twin and adoption studies of a substantial genetic contribution to schizophrenia. The mode of transmission is complicated and very rarely if ever involves a single gene. Rather schizophrenia results from multiple genes of small effect and their interplay with the environment. Perhaps because the overall size of the genetic effect is large, accounting for about 80 % of variance, definite environmental factors have been difficult to pin down. It has even been suggested that „the environment” consists entirely of epigenetic or stochastic phenomena that can never be detected by a standard epidemiological methods. Nevertheless, a variety of social stressors, including high expressed emotion in relatives and life events affect the course of illness and certain physical factors such as obstetric complications and cannabis smoking have been implicated in contributing to liability to the disorder. The recent discovery of several positional candidate genes that have been replicated as being associated with liability to schizophrenia holds considerable promise not just for a better understanding of the neurobiology but also for improved knowledge about risk prediction and gene-environment interplay.

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