
DURHAM, N.C. -- Duke University Medical Center researchers have
developed a new statistical genetic "fishing net" that they have cast
into a sea of complex genetic data on autistic children to harvest an
elusive autism gene.
Moreover, the researchers said that the success of the approach will
be broadly applicable to studying genetic risk factors for other complex
genetic diseases, such as hypertension, diabetes and multiple sclerosis.
In this case, the gene, which encodes part of a brain
neurotransmitter docking station called the gamma-Aminobutyric Acid
Receptor beta3-subunit (GABRB3), has been implicated in autism
previously, but never positively linked to the disease. Their findings
will be published in the March 2003 issue of the American Journal of
Human Genetics.
"Many research groups have been actively looking for genetic risk
factors that can lead to autism, but without much success," said
Margaret Pericak-Vance, Ph.D., director of the
Duke Center for Human
Genetics and lead investigator of the study.
Autism is the common term that encompasses an overlapping group of
complex developmental disorders that are diagnosed in about one in 1,000
children under the age of 3. Each autistic child has a unique set of
characteristics that affect his or her behavior, communication skills
and ability to interact with others. It is the very diverse, complex
nature of autism that has made it so difficult to locate distinct
genetic risk factors, said Pericak-Vance.
After several genetic studies turned up only a few vague genetic
clues, the research team decided a new approach was needed. Pericak-Vance
hypothesized that grouping patients with similar traits together
statistically might enhance the scientists' ability to distinguish
relevant genetic risk factors. To provide guidance, the scientists
turned to Michael Cuccaro, Ph.D., a clinical child psychologist at Duke
with extensive experience diagnosing and treating autism. Cuccaro
noticed that some but not all autistic children exhibit repetitive
compulsions and extreme difficulty with changes to their daily routine.
This character trait -- defined by Cuccaro as "insistence on sameness"
or "IS" -- helped the research team identify a subset of autism family
data to study in more detail.
Researchers, led by Yujun Shao, Ph.D., a genetic epidemiologist at
Duke, reorganized data collected from families in which more than one
child is affected by autism and grouped together all the families that
reported their autistic child had difficulty with change.
Cuccaro's theory that autistic children could be subdivided into at
least two groups gave the team of scientists from Duke and the
University of South Carolina an opportunity to test a new statistical
method, called "ordered subset analysis," developed by Elizabeth Hauser,
Ph.D., assistant research professor of medicine at Duke. This new
genetic fishing net allows scientists to sift through complex genetic
data and extract genetic risk factors that affect only some of the total
group.
In this case, when the researchers applied the new test only to those
families whose children scored high in the IS category, they discovered
a strong link to the GABRB3 gene on chromosome 15q, where no such link
had appeared before.
"This is the first successful application of ordered subset analysis
to help us pinpoint a genetic risk factor that would be missed by
looking at the larger group." said Pericak-Vance.
The researchers emphasize that this discovery is only the first step
in understanding how the GABRB3 gene, or others genes in the same region
of chromosome 15 might be involved in autism. Another clue may be gained
from previous research that has shown the same area on chromosome 15 is
just as responsible for Angelman Syndrome and Prader-Willi Syndrome --
two genetic disorders in which a subset of affected children also
exhibit repetitive behavior. Additional research will be necessary to
understand how defects in the GABRB3 gene might contribute to autistic
disorder, and how other genes or environmental factors also play a role.
"In the short term, however, I think what this will allow us to do is
encourage clinicians and researchers working with autistic children to
think about autism as consisting of different types or subgroups and not
a one-dimensional disorder," said Cuccaro. "I think that subgrouping,
over time, will allow us to develop a better understanding of how to
treat each individual with autism."
This is a case, said Cuccaro, where identifying subsets of patients
based on clinical observations has resulted in a significant
neurobiological finding, and it perhaps is pointing a way to bring
clinical observations to bear on complex genetic problems.
"The genomic revolution has given us a tremendous wealth of
information in terms of a road map and markers for finding disease
genes," said Pericak-Vance. "Now, we need to be able to look at complex
clinical information and come up with methods that can help us dissect
diseases that have multiple risk factors. This new statistical test will
allow us to find meaningful genetic risk factors that are diluted out
when tested as part of a larger heterogeneous group."
Members of the research team also included Marissa Menold, Chantelle
Wolpert, Leigh Elston, Karen Decena, Shannon Donnelly, Robert DeLong,
M.D., and John Gilbert, Ph.D., of Duke; and Sarah Ravan, Ruth Abramson
and Harry Wright, M.D., of the W.S. Hall Psychiatric Institute at the
University of South Carolina. The research was supported by grants from
the National Institutes of Health and the National Alliance of Autism
Research.
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