Groups are labeled based on the leading term (the most significant). The most significant term is defined as the term with the highest number and percentage of initial genes. Kappa Score ≥0.5. Figure 3 showed that dopamine transport, learning, memory, and monoamine transport are the main BPs.
five times by selecting one hub-bottleneck gene and randomly selecting from other top genes (
Table 3,
Figure 2).
A backbone network was built from Mentha, Reactome, and Reactome-Fls sources for 7 hub-bottleneck elements. This network has 1609 nodes, and 2279 edges denote that 83% of the nodes relative to the main network are presented in the backbone network.
Different subtypes have been reported for OCD that may appear due to the interaction of different genes and environmental factors. Central genes in this study are reported with different subtypes (Table 4).
Application of ClueGO plugin for functional enrichment analysis of OCD seed genes based on BP terms is shown in Figure 3 and
Table 5.
Groups are labeled based on the leading term (the most significant). The most significant term is defined as the term with the highest number and percentage of initial genes. Kappa Score ≥0.5. Figure 3 showed that dopamine transport, learning, memory, and monoamine transport are the main BPs.
4. Discussion
Molecular studies of Obsessive-Compulsive Disorder (OCD) have just begun (
Zamanian-Azodi et al., 2015). Most of the recent investigations are focused on the genetic basis of OCD. Multiple genetic variants with small effect size are linked to OCD risk (
Gruenblatt, Hauser, & Walitza, 2014). While individual examining of genes is informative, interactome evaluation is essential as well. Genes are in a complex interaction structure that any genetic alterations may lead to functional phenotype changes of the whole system (
Chavez et al., 2013). PPI network analysis can identify specific interactome changes in a disease state. In this regard, examining the OCD interactome pattern can help gain further insight into the underlying mechanisms through topological analysis (
Mahboubi et al., 2018). In this study, a total number of 31 human candidate genes from genetic association studies are reviewed. Among them, 8 genes were previously reported significant for OCD by a meta-analysis (
Taylor, 2013).
On the other hand, none of the single candidate genes has been proved to be significantly associated with OCD by genome-wide association studies (
Gruenblatt et al., 2014). Moreover, mRNA expression profiling of postmortem brain of OCD patients showed no significant associations of these genes and mRNA expression profile (
Jaffe et al., 2014). Therefore, a network from reported genes may be inaccurate since they are incomplete and may show some bias towards neurotransmitter systems genes (
Gruenblatt et al., 2014). To somehow overcome this limitation, it is tried to select genes from genetic-based studies that were with at least one significant association report with OCD.
There are about 1.5 edges per node; however, this value’s variation is considerable for different nodes. For example, ESR1, the top node, is characterized by 899 links. This gene is discriminated by about 650 links from the second top score node. In a PPI network, central genes (hub-bottlenecks) are essential for network integrity and may be considered for more evaluations (
Mahboubi et al., 2018). Based on hub and bottleneck definition, when the function of one gene impairs, it may dramatically affect the function of other linked genes. Network analysis in Figure 1 (A & B) reveals that the location of the hub and bottleneck elements are well-defined in the right down region of degree and top region of BC distribution plots, respectively. Centrality analysis implies the significant contribution of ESR1, DRD2, HTR1B, DRD4, TNFA, HTR2A, and CDH2 in the OCD network. In the next step, a backbone network of central genes revealed 7 essential genes whose pivotal role in network integrity requires further analysis. About 83% of the nodes of the main network are presented in the backbone network. However, about 70% of the edges are constructed. As it is tabulated in Table 3, cross-validation confirms the robustness of the network since the frequency of hub-bottleneck genes was not affected by the changes in the initial genes. Therefore, the backbone network shows excellent accuracy for four deletions, and the pivotal role of hub-bottleneck genes is supported. According to Table 3 and
Figure 2, the accuracy values vary from 95% to 98%. Besides, detailed characteristic of each vital elements as collected in Table 4, indicates the importance of these genes in OCD subtypes. In this light, ESR1 as the top hub-bottleneck gene in the network may play a major role in OCD. On the other hand, studies showed that ESR1 is associated with other mental disorders as well. ESR1 is seen in the several regions of the brain that are connected to cognitive function and emotional behavior. Steroid hormones regulate compulsive behavior, mood, and cognition (
Sundermann, Maki, & Bishop, 2010). Estrogen hormone has a critical regulatory activity on serototonergic, glutamate, and dopaminergic pathways (
Alonso et al., 2011). Some kinds of variants in ESR1 can cause changes in estrogen responsivity in the brain (
Rettberg, Yao, & Brinton, 2014), resulting in the manifestation of many kinds of neuropsychiatric conditions (
Sundermann et al., 2010).
On the other hand, the critical associations of ESR1 polymorphisms in women’s neuropsychiatric disorders are suggested by many studies (
Sundermann et al., 2010;
Millet et al., 2003). Besides, gender plays a vital role in OCD phenotype (
Mathis et al., 2011). Women are more susceptible to certain types of OCD than men. For instance, cleaning obsessions and contamination compulsions are more evident in females that may be connected to ESR1 malfunction (
Nissen et al., 2016). It is also suggested by many clinical assessments that there is a vital connection between OCD onset and severity and reproductive cycle activity, in which the level of hormones varies greatly (
Vulink, Denys, Bus, & Westenberg, 2006;
Labad, Menchón, & Alonso, 2005;
Forray, Focseneanu, Pittman, McDougle, & Epperson, 2010;
Guglielmi et al., 2014). It seems that ESR1, as part of reproductive cycle events, may play a key role in the pathogenesis of OCD.
Moreover, its central role in the OCD network reflects the possible crucial role of female reproductive cycle activity in OCD onset and development. TNF-α, the second essential gene in the network, has a noticeable function in immunologic reactions that suggests the vital contribution of immunologic reactions in OCD risk. It is also reported in previous investigations that TNF-α has an essential role in some subtypes of OCD (
Hounie et al., 2008). DRD2 and DRD4 also implied key roles in the OCD network. It is also confirmed by previous studies that the dopamine system can be an appropriate target for OCD treatment. HTR1B and HTR2A are serotonin receptors, and their relation to OCD is gender-specific. HTR1B has a remarkable contribution in male patients (
Mas et al., 2014), while HTR2A is mostly involved in females (
Enoch et al., 2001). Another central gene, CDH2, has a primary role in early brain morphogenesis, long-term potentiation, synaptic plasticity, and synaptogenesis. This gene, as a producer of cell-cell adhesion protein, belongs to the cadherin gene superfamily. In OCD, dysregulation of the glutamate receptor availability may attribute to CDH2 polymorphisms (
McGregor et al., 2016).
According to the ClueGO findings (
Figure 3 and
Table 5), dopamine transport, learning, memory, and monoamine transport processes may play an essential role in OCD etiology. These BPs may be influenced by the different contributing polymorphisms. Most genes in these processes are among the ranked genes. The highest-ranked process in this analysis is dopamine transport. On the other hand, most of the prescribed medicines for OCD belong to the Selective Serotonin Reuptake Inhibitors (SSRIs) family. However, not all patients’ responses to this drug family and other treatment options are essential to be evaluated. One of the potential therapeutic targets is the dopamine system; dopaminergic antagonists are designed and showed promising treatment-resistant cases (
Koo et al., 2010). Here, the contribution of four central genes in the dopamine transport process suggests the important role of this process in OCD pathogenesis. Another nominated critical process in OCD pathogenesis is learning, suggesting that OCD patients may have impairments in learning. It has been reported that patients with OCD are slower in learning (
Gross-Isseroff et al., 1996). Memory is another involved process in OCD seed genes analysis. This fact can be justified by previous clinical findings of memory impairments in OCD (
Penadés, Catalán, Andrés, Salamero, & Gastó, 2005). In other words, our analysis provides more supports for memory process dysregulation in OCD. Overall, the investigation introduced some feasible candidates showing substantial participation in our network integrity and functions. Variation in OCD genes may lead to the formation of different combinations of genes’ functions. As a result, each of these combinations can correspond to a specific OCD subtype model. Activation of a particular combination is attributed to a specific internal or external stimulation. Hence, the onset of a specific subgroup for each individual depends on the origin of the trigger and the influenced pathway.
Our study results suggest topological information of interactome profile of OCD reported genes from genetic studies; however, it is in its initial phase. Our PPI network analysis can serve as a paradigm for later experiments such as genomic, proteomic, and metabolomic investigations. Thus, by enriching interaction sets, a more in-depth understanding of OCD etiology may be reachable. Finally, screening 31 genes associated with OCD leads to introducing a panel, including 7 crucial genes. This panel may potentially be used for diagnostic and therapeutic proposes of OCD after extensive validation tests.
Ethical Considerations
Compliance with ethical guidelines
All ethical principles are considered in this article.
Funding
This study was supported by the Proteomics Research center, Tehran.
Authors' contributions
All authors contributed equally to work.
Conflict of interest
The authors declared no conflict of interest.
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