REELIN, GAD67, AND PSYCHOSIS
John M. Davis, Eminio Costa,
Alesandro Guidotti, M. Dneil Smalheiser, Dennis Grayson, Patricia Tuiting,
Cristeen Pesold and Yogesh Dwivedi
University of Illinois at Chicago
Costa and his coworkers studying
postmortem brains, principally of the Stanley Foundation collection, find that
schizophrenia and bipolar patients display a 50% decrease in Reelin protein, in
reelin mRNA, in the number of reelin stained neurons, in GAD67 protein and in
GAD67 mRNA in comparison to normal controls or non-psychotically depressed
patients. The number of neurons, the level of neuron specific enolase, a marker
for neurons, the levels of GAD67 protein and mRNA are normal. Furthermore
these changes are not related to lifetime neuroleptic dose, postmortem interval
etc. and if an artifact accounted for this finding, then it is an artifact
common to three brain banks and common to three radically different
assays. Costa’s laboratory has breed reelin mice (which have no reelin)
with normal mice to produce reelin heterozygous reeler mice. These mice
are grossly normal, but demonstrate a 50% decrease in reelin, in GAD67 and in
the number of dendritic spines plus an increase in neuro-packing density and a
decrease in cortical thickness due to a decrease in neuropil. The
heterozygous mice histology is remarkably similar to that of
schizophrenia. We hypothesize that a reelin defect, may produce a
reduction in synaptic spines which produces the decreased grey matter and
increased ventricular size observed in schizophrenia and bipolar disease.
We find that heterozygous GAD67 knockout mice have a 50% decrease in GAD67 mRNA
expression but normal reelin had no neuropil hypoplasia or decrease in dendritic
spine expression. Enlarged ventricles are associated with the following
cluster of measures: negative symptoms, cognitive impairment (e.g. working
memory, etc.), abnormal activation (blood flow, or glucose utilization) in the
prefrontal cortex (PFC) by cognitive stimulation and decreased NMR spectroscopic
markers (such as NAA signals) for neural tissues, the Enlarged Ventricles-PFC
Integrity cluster. It is possible that one could diagnose a Reelin
deficiency at birth (or before) and develop a drug that would alter the
regulation of reelin in such a manner that it would stimulate Reelin
function. Many workers have found GABAergic abnormalities in postmortem
brains from schizophrenics. We will review what is known of the effects of
GABAergic drugs (GABAa and GABAb) on schizophrenia. While benzodiazepines
have not long-term beneficial effects on schizophrenia, brief administration
(several days) does have a substantial beneficial effect in
schizophrenics. It is possible that schizophrenics rapidly develop
tolerance to this effect. The possibility that benzodiazepine partial
agonists, for which tolerance does not develop, might be effective
antipsychotics will be discussed.