Dose-dependent expression of claudin-5 is a modifying factor in schizophrenia

Mol Psychiatry. 2018 Nov;23(11):2156-2166. doi: 10.1038/mp.2017.156. Epub 2017 Oct 10.

Abstract

Schizophrenia is a neurodevelopmental disorder that affects up to 1% of the general population. Various genes show associations with schizophrenia and a very weak nominal association with the tight junction protein, claudin-5, has previously been identified. Claudin-5 is expressed in endothelial cells forming part of the blood-brain barrier (BBB). Furthermore, schizophrenia occurs in 30% of individuals with 22q11 deletion syndrome (22q11DS), a population who are haploinsufficient for the claudin-5 gene. Here, we show that a variant in the claudin-5 gene is weakly associated with schizophrenia in 22q11DS, leading to 75% less claudin-5 being expressed in endothelial cells. We also show that targeted adeno-associated virus-mediated suppression of claudin-5 in the mouse brain results in localized BBB disruption and behavioural changes. Using an inducible 'knockdown' mouse model, we further link claudin-5 suppression with psychosis through a distinct behavioural phenotype showing impairments in learning and memory, anxiety-like behaviour and sensorimotor gating. In addition, these animals develop seizures and die after 3-4 weeks of claudin-5 suppression, reinforcing the crucial role of claudin-5 in normal neurological function. Finally, we show that anti-psychotic medications dose-dependently increase claudin-5 expression in vitro and in vivo while aberrant, discontinuous expression of claudin-5 in the brains of schizophrenic patients post mortem was observed compared to age-matched controls. Together, these data suggest that BBB disruption may be a modifying factor in the development of schizophrenia and that drugs directly targeting the BBB may offer new therapeutic opportunities for treating this disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 22q11 Deletion Syndrome / genetics
  • 22q11 Deletion Syndrome / psychology
  • Animals
  • Blood-Brain Barrier / metabolism
  • Brain / metabolism
  • Claudin-5 / genetics*
  • Claudin-5 / physiology*
  • Disease Models, Animal
  • Endothelial Cells / metabolism
  • Female
  • Gene Expression Profiling / methods
  • HEK293 Cells
  • Humans
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Schizophrenia / metabolism*
  • Schizophrenia / physiopathology
  • Tight Junctions

Substances

  • CLDN5 protein, human
  • Claudin-5