1. Introduction
Obsessive-Compulsive Disorder (OCD) is a complex neuropsychological condition with a lifetime prevalence of 1% to 2.5% in the general population (
Campos, Yoshimi, Simão, Torresan, & Torres, 2015). The World Health Organization (WHO) introduced OCD as a leading cause of non-fatal illness-related disability that primarily affects people with the age range of 15 to 44 years (
Zilhão et al., 2015). This anxiety disorder is characterized by intrusive thoughts and compulsive behaviors (
Carmi, Dar, Zohar, & Zangen, 2015). Dysfunction in corticostriatal circuits is the main known implicated part of brain in pathology of OCD and OC-spectrum disorders (
Burguiere, Monteiro, Mallet, Feng, & Graybiel, 2015).
The complex nature of this heterogeneous disorder is described by the influence of molecular and environmental interactions (
Jaffe et al., 2014). That is, the combination of many factors is responsible for manifestation of this disorder with different subtypes. The contribution of many genes with their polymorphisms expresses different subtypes with overlapped symptom dimensions. This complex clinical feature of OCD is accompanied by other related disorders (comorbidity), including Tourette syndrome, chronic hair pulling, trichotillomania, and anxiety (
Stewart, Jenike, & Keuthen, 2005). The complexity of OCD features made it challenging for treatment options. Most of the molecular studies in OCD are focused on genetic concept and genome-wide association studies of the disorder (
Lin, Cao, & Gao, 2015;
Zamanian-Azodi et al., 2015).
However, the pathophysiological origin of mental disorders, such as OCD, is still elusive despite these investigations. On the other hand, identification of the key relevant proteins in the disease condition is valuable for substantial insight of psychiatric disorders. By understanding etiological biomarkers of the disease, the underling mechanisms can be also explained (
Filiou, Turck, & Martins‐de‐Souza, 2010). Body fluids are very useful sources to detect the biomarker; 1 of the appropriate ones is serum. Serum contains the vast range of proteins originated from normal or abnormal function of cells and tissue processes (
Samavat et al., 2015;
Tang, Beer, & Speicher, 2011). Moreover, serum is a suitable source (easily sampling and preparation) for different kinds of investigations as well as proteomics. Proteomic studies are important to determine expression levels of the proteins (
Zali, Zamanian-Azodi, Tavirani, & Baghban, 2015). It is a powerful tool that provides useful information besides the other molecular studies
(Rezaei-Tavirani et al., 2016). As mentioned earlier, OCD has various subtype models. One of the common models for the females is the washing compulsion (
Noshirvani, Kasvikis, Marks, Tsakiris, & Monteiro, 1991). Proteins and mechanisms that correspond to the risk of this subtype are yet to be studied. To the authors` best knowledge, the current study was the 1st proteome analysis of obsessive-compulsive disorder. In the current pilot study, the proteome profile of patients with OCD washing phenotype was studied by 2D electrophoresis and bioinformatics.
2. Methods
2.1. Sample collection
2.1.1. Human subjects
The washing model cases (5 female patients) with moderate severity and control group (5 healthy volunteers) from Taleghani Hospital, Tehran, Iran, were diagnosed based on the diagnostic and statistical manual of mental disorders, 5th edition (DSM-5). The cases signed written informed consents, and the control and case groups were demographically matched. The proteome of these pooled medication-free patients was compared with that of the pooled controls.
2.1.2. Sample preparation
Blood collection was handled by venipuncture rout and 20-gauge needle. The samples were kept at room temperature for 30 minutes. After clotting, serum samples were separated by 2 times centrifugation at 2000g for 10 minutes at 4°C. Finally, the samples were maintained at −80°C for future processes (
Nejadi et al., 2015). The protein extraction was conducted by the acetone precipitation method, according to introduction of Sigma ProteoPrep Protein Precipitation Kit.
2.1.3. Proteomic experiment
All 2DE chemicals and Ready Strip™ IPG strips were provided by GE Health Life Science. Prior to 2DE, the total protein concentration of the samples was determined by Bradford assay. The 2DE procedure was handled with 3 replications of normal and OCD samples. The 1st dimension, isoelectric focusing (IEF) was carried out by the application of Bio-Rad Protein IEF Cell, 7cm nonlinear IPG with the pH range of 3 to 11. In this step, about 500µg protein was loaded for each gel. The IEF separates proteins based on their pI. In the 2nd dimension, proteins were separated based on Molecular Weight (MW) by 12% sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) gel and buffering systems in electrophoresis tank (Bio-Rad). After electrophoresis, the gels were dyed by Coomassie blue stating method and, then, scanned using Bio-Rad scanner (
Hasanzadeh, Rezaie-Tavirani, Seyyedi, & Emadi, 2015). Finally, Progenesis SameSpots software was employed to analyze protein expression changes. A value of 1.5-fold increase or decrease was used as a cut off. Statistically significant differences (P≤0.05) in spot intensities were identified using 1-way ANOVA analysis. The significantly altered proteins in the expression were identified by http://world-2dpage.expasy.org/swiss-2dpage/. The amounts of MW and pI were the indices to identify proteins from this database.
2.2. Network analysis
Further investigation, based on interaction analysis, was carried out by Cytoscape 3.4.0-Milestone 2 software (
Bader & Hogue, 2003). STRING database (DB) was the interaction source for PPI analysis by Cytoscape. STRING has the feature of providing comprehensive information from both experimental and predicted interactions of different databases with a probabilistic confidence score (
Szklarczyk et al., 2010). Proteins identified by 2DE experiment were searched through STRING DB integrated in Cytoscape. The protein names were the query inputs and the selected species for this query was Homo sapiens as available in the query box.
The confidence (score) cut off for interactions was set to 0.5. Furthermore, about 100 additional nodes were added to the current study investigated proteins to expand the network. Network Analyzer plug-in analyzed functional topological parameters (centrality) including node degree and betweenness centrality (BC). This application is a powerful software to examine biological networks for the centrality parameters calculation by resourceful graph algorithms (
Assenov, Ramírez, Schelhorn, Lengauer, & Albrecht, 2007).
Nodes that have high degree and betweenness values are the hub-bottleneck elements (
Rezaei-Tavirani et al., 2016). MCODE, a Cytoscape Plug-in, examines protein complexes (regions with high interconnections) in PPI network. This Cytoscape plug-in is a clustering algorithm that examines the modules in a PPI network. Highly connected parts are detected by identifying nodes (seed) that are locally dense, travel outward from it, find the local neighbors, and isolate them as a cluster. The clusters are ranked based on the interconnection scores. Another level of functional annotations can be introduced by identifying the protein clusters. That is, proteins in a specific cluster usually indicate similar annotations (
Bader & Hogue, 2003).
Finally, functional annotations of the current study investigated proteins and the detected modules were analyzed by the application of ClueGO plug-in (
Bindea et al., 2009). GlueGO2.1.7 and its extended tool CluePedia annoted genes for biological process (BP). ClueGO presents gene ontology ranging from general to very specific ones as groups of related terms with similar shared proteins. The linkage strength between the terms, calculated by kappa score, was 0 to 1 (
Bindea, Galon, & Mlecnik, 2013;
Bindea et al., 2009). The kappa score was set to 0.5 for BP analysis. Minimum and maximum levels of ontology were set to 3 and 8 as the default option, respectively. The P was also set to ≤0.05. The correction method for P≤0.05 was Bonferroni step down method. The enrichment/depletion test for the terms was set to 2-sided enrichment/depletion, based on hypergeometric.
3. Results
A total of 41 spots were differentially abundant in the OCD type that 18 showed upregulation and 23 downregulation. The abundant proteins, such as albumin and immunoglobulin, were not depleted in the current study. In Figure 1, positions of protein spots in this investigation are depicted. Progenesis SameSpots software revealed hierarchical clusters of proteins with similar expression correlations as dendrogram (Figure 2).
connected regions. Protein complexes of OCD PPI network were retrieved by MCODE (Table 4).
Eight clusters were detected in the network and 5 top-scored modules are presented. Cluster members are shown in red, and square nodes represent the seeds. Seed proteins are the important nodes with highest interaction score in the module. Seed proteins are PF4, CXCL10, HSPG2, and DERL1 for the clusters 1 to 4, respectively. SERPINE1, C3, APOA4, and HP are also present in the clusters 1 to 5, respectively. The statistical parameters of the analysis was based on the cutoff point of 2 and node score cutoff point of 0.2. Biological process analysis of four top clusters is presented in Figure 5.
Acknowledgements
Authors would like to thank Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, for the support. The current study was derived from the PhD thesis of Miss Mona Zamanian-Azodi.
Conflict of Interest
The authors declared no conflicts of interest.
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