Method of diagnosing depression

Information

  • Patent Application
  • 20050239110
  • Publication Number
    20050239110
  • Date Filed
    March 29, 2005
    19 years ago
  • Date Published
    October 27, 2005
    19 years ago
Abstract
This invention provides a novel method of diagnosing the conditions of depression of a patient in a simple, objective, and accurate manner. In this method, gene expression is analyzed using mRNA of a subject's peripheral blood to evaluate whether or not the subject is afflicted with depression, the type of depression of a subject who had been evaluated as being afflicted with depression is identified, and the conditions of depression are then diagnosed in accordance with the type of depression.
Description

The present application claims priority from Japanese applications JP 2004-096068 filed on Mar. 29, 2004 and JP 2005-042534 filed on Feb. 18, 2005, the contents of which are hereby incorporated by reference into this application.


TECHNICAL FIELD

The present invention relates to a method of diagnosing depression. More particularly, the present invention relates to a method of diagnosing depression, wherein gene expression is analyzed using mRNA of patients' peripheral bloods to cluster patients afflicted with depression, and conditions thereof are then diagnosed.


BACKGROUND ART

Depression is a disease with high lifetime morbidity of approximately up to 10%, and this rate is predicted to further increase in the future due to stress in contemporary society. This disease seriously afflicts patients mentally and physically and imposes enormous damage upon their social lives. In addition, it is a serious disease that often leads to suicide. It is deduced that many of the people who commit suicide (as many as 30,000 or more per year in Japan) are afflicted with depression. This disease is also deeply associated with societal problems such as truancy, unemployment, and social withdrawal or medical problems such as alcohol-related disorders. Establishment of methods of precisely diagnosing and promptly treating this disease is indispensable for improving the quality of life, and thus is an urgent need of society as a whole.


Diagnosis of depression is, however, far from simple. Cardinal symptoms of depression are, for example, depressive mood, hypobulia, loss of interest and pleasure, disrupted concentration and attention, lowered self-esteem and self-confidence, feelings of guilt and worthlessness, pessimism about the future, thoughts of suicide, sleep disorders, and loss of appetite. These symptoms have features peculiar to depression, which differ from depressed feelings experienced by anyone, and also differ from the lowered mental activity and sense of exhaustion experienced by people afflicted with physical diseases. The symptoms of depression are mainly comprehended by taking a precise medical history, questioning when and how the symptoms in terms of mental activity were developed and what types of damages have been imposed upon their social and domestic lives, and confirming various symptoms based on a patient's attitude or the contents of conversations during consultation. For example, family medical history, anamnesis, physical conditions, early developmental history, life history, personality inclination, premorbid social adaptation, and the occurrence of any episode(s) that had triggered the disease can be important references. In order to accurately comprehend these factors, an interview needs to be conducted by a highly skilled specialist in psychiatric medicine for approximately 1 hour. Further, it should be confirmed that a patient does not have any major abnormalities in terms of general physical or neurological conditions. If necessary, the possibility of the existence of organic brain disorders is to be eliminated by electroencephalography or brain imaging tests. The patient is then subjected to diagnosis. The findings are compared with the diagnostic standards issued by the World Health Organization (WHO) or the American Psychiatric Association, and the diagnosis can be generally confirmed.


As a major drawback, conventional diagnostic methods require skilled techniques. Needless to say, thorough knowledge and practice concerning depression are required. However, there are numerous psychological, mental, and physical states that result in the exhibition of depressive conditions even though they are not forms of depression. Differential diagnosis also becomes essential. Accordingly, diagnosis must be conducted by a thoroughly trained specialist in psychiatric medicine. Depression, which is a common disease with lifetime morbidity of approximately 10%, however, is often the subject of consultation with primary care doctors. Diagnosis of depression without objective medical findings is not always easy for general doctors who may not be acquainted with psychiatric consultation. Depression is a medical disease that requires treatment of the body (brain), including medication. Accordingly, it is difficult for specialists in clinical psychology, such as clinical psychotherapists, or mental health workers, such as public health nurses, to independently diagnose depression.


Technical skill is required for diagnosis mainly because of a lack of simple and objective methods of diagnosis regarding symptoms. Although there is a screening method utilizing a self-administered questionnaire, people tend to fill in the questionnaire based on their subjective viewpoints. Thus, genuine depression cannot be distinguished from depressed feelings caused by personality-based factors, environmental factors, or poor physical conditions. Symptom rating scales employed by doctors are often used in determination of severity, although adequate questioning is required to evaluate each item. Thus, such methods cannot be alternatives to diagnosis.


Many testing methods have been heretofore attempted, with the aim of utilizing them as objective indicators. Depression causes functional alteration in brain monoamine systems. This alteration is known to have a considerable influence upon the neuroendocrine system, the neuroimmune system, and the autonomic nervous system via psychosomatic correlation. In particular, the application of the results of a dexamethasone suppression test that allows accurate comprehension of neuroendocrine abnormalities, i.e., a minor level of adrenal cortical hormone hypersecretion, to diagnosis of depression has been extensively examined from the 1980s onwards. Clinical application thereof was, however, not realized due to the necessity for complicated procedures such as the administration of test drugs and limitations in terms of sensitivity or specificity. At the study phase, other abnormalities in the neuroendocrine system, the neuroimmune system, the autonomic nervous system, circadian rhythms, sleep architecture, and the like had been reported. Recently, changes regarding conditions of brain blood flow or brain monoamine receptors are also pointed out as objective indicators, although they are still disadvantageous in terms of sensitivity and reproducibility. Given the aforementioned factors, diagnosis of a complicated psychiatric disease, i.e., depression, is difficult by a method of testing limited factors. Enormous amounts of time and labor are required to perform conventional testing methods and to diagnose the disease. From the viewpoint of simplicity, conventional techniques cannot be applied to routine medical care at present.


In the past, the catecholamine hypothesis, the indoleamine hypothesis, the GABA hypothesis, the glutamine hypothesis, the dopamine hypothesis, the neurogenesis hypothesis, and the like have been proposed as causes of depression. Many discrepancies of these hypotheses have been pointed out, and they have not yet resulted in conclusions. Linkage studies and association studies based on molecular genetic engineering and the search for sensitive domains of chromosomes by linkage analysis have been carried out. In the case of a disease such as depression, the diathesis (biological feature) of which is generated through interactions among multiple genes and environmental factors such as stress, therefore analysis of the pathogenic gene is extremely difficult. Based on past gene analysis, genes such as those related to serotonin transporter, serotonin 1A/2C receptor, dopamine D2/D3 receptor, dopamine transporter, tyrosine hydroxylase, tryptophan hydroxylase, monoamine oxidase, and ATPase have been reported as candidate functional genes associated with depression. For example, the correlation between Na/K-ATPase and psychiatric diseases, such as depression (Depress Anxiety 1997, 5, pp. 53-65) or dysthymia (J. Basic Clin. Physiol. Pharmacol. 2000, 11 (4), pp. 375-94), has been pointed out. Improvement of symptoms caused by an antidepressant, i.e., carbamazepine, is reported to be correlated with elevation of erythrocyte Na/K-ATPase activity (Neuropsychobiology 1999, 40 (3), pp. 134-9). Some researchers are, however, skeptical about the aforementioned reports, and additional tests have been conducted thereon.


SUMMARY OF THE INVENTION

An object of the present invention is to provide a novel method of diagnosing the conditions of depression of a subject in a simple, objective, and accurate manner.


The present inventors have focused on peripheral leukocytes that can be easily obtained as specimens and allow many receptors of factors associated with stress responses to be expressed therein in order to objectively diagnose the conditions of depression, in the development of which stress plays an important role. They have extensively analyzed the expression patterns of mRNAs of approximately 1,500 genes associated with stress responses and then developed certain patterns. Thus, they have found a method that is capable of classification patients afflicted with depression and diagnosing the conditions thereof. This has led to the completion of the present invention.


More specifically, the present invention relates to a method of diagnosing depression, wherein gene expression is analyzed using mRNA of a subject's peripheral blood to evaluate whether or not the subject is afflicted with depression, the type of depression of a subject who had been evaluated as being afflicted with depression is identified, and the conditions of depression are then diagnosed in accordance with the type of depression.


According to this method, the expression profiles of the marker gene for depression (an indicator for evaluating whether or not a subject has been afflicted with depression) selected from among the genes listed in Table 1 can be employed to evaluate whether or not a subject is afflicted with depression. When a subject was evaluated as being afflicted with depression, the expression profiles of the marker gene for classification (an indicator for classifying a patient afflicted with depression) selected from among the genes listed in Table 2 can be employed to identify the type of depression in the subject to be type PA or PB.


ATP2A2, SCYA5, STIP1, EEFIA1, GRB10, CASP6, TSSC1, RAB9, NFATC3, and TPR are particularly useful marker genes for depression. GNG10, CLK1, P2Y5, IFNGR1, TAF2F, PIM1, MAP2K3, HDGF, INSR, and COX6C are particularly useful marker genes for classification.


When a subject was evaluated to have type PA depression, the expression profile of the marker gene for diagnosing type PA depression (an indicator for the conditions or a course of treatment of a patient with type PA depression) selected from among the genes listed in Table 3 can be employed to more precisely diagnose the conditions thereof. When a subject was evaluated to have type PB depression, the expression profile of the marker gene for diagnosing type PB depression (an indicator for the conditions or a course of treatment of a patient with type PB depression) selected from among the genes listed in Table 4 can be employed to more precisely diagnose the conditions thereof


CDC10, GZMA, TNFRSF6, HSPCA, NR3C1, TOPBP1, ARNTL, RAP1A, POLR2B, and ITGB1 are particularly useful marker genes for depression. POU2F2, BCL2L1, DAXX, COX4, CD3G, FCER1G, NME2, CPT1B, HSPE1, and COX7A2 are particularly useful marker genes for classification.


According to another embodiment of the present invention, the expression profiles of the marker gene for depression selected from among the genes listed in Table 7 can be employed to evaluate whether or not a subject is afflicted with depression. When a subject was evaluated to be afflicted with depression, the expression profiles of the marker gene for classification selected from among the genes listed in Table 8 can be employed to identify the type of depression to be type PA or PB.


HLA-G, HRH4, PSMB9, ATP2A2, SCYA5, SLC6A4, CASP6, CSF2, HSD3B1, and RAB9 are particularly useful marker genes for depression. HSPE1, PSMA4, ADH5, PSMA6, COX17, HMGI, GPR24, COX6C, FGF2, and COX7C are particularly useful marker genes for classification.


When a subject was evaluated to have type PA depression, the expression profile of the marker gene for diagnosing type PA depression selected from among the genes listed in Table 9 can be employed to more precisely diagnose the conditions thereof. When a subject was evaluated to have type PB depression, the expression profile of the marker gene for diagnosing type PB depression selected from among the genes listed in Table 10 can be employed to more precisely diagnose the conditions thereof.


CLK1, PSMC6, TAF2F, P2Y5, CASP3, HSPCA, MSH2, SLC38A2, B2M, and AKAP11 are particularly useful marker genes for diagnosing type PA depression. CCNA2, HGF, GPR24, PTGER3, COX7A2, BDKRB2, UFD1L, HMG1, PSMA4, and ATP6J are particularly useful marker genes for diagnosing type PB depression.


According to the method of diagnosing depression of the present invention, the course of treating a single subject who had been diagnosed to be afflicted with depression can be accurately evaluated by comparing and analyzing the gene expression profiles before and after the treatment of the subject.


The methods of analyzing gene expression that are employed in the present invention are not particularly limited. DNA-immobilized solid substrates, such as chips, arrays, membrane filters, and capillaries, are preferable.


The present invention also provides a solid substrate for diagnosing depression having immobilized thereon probes that each independently specifically hybridize to any one of the genes listed in Tables 1 to 4 for detecting the target gene. Preferably, the target genes at least include ATP2A2, SCYA5, STIP1, EEF1A1, GRB10, CASP6, TSSC1, RAB9, NFATC3, and TPR listed in Table 1, GNG10, CLK1, P2Y5, IFNGR1, TAF2F, PIM1, MAP2K3, HDGF, INSR, and COX6C listed in Table 2, CDC10, GZMA, TNFRSF6, HSPCA, NR3C1, TOPBP1, ARNTL, RAP1A, POLR2B, and ITGB1 listed in Table 3, and POU2F2, BCL2L1, DAXX, COX4, CD3G, FCERIG, NME2, CPT1B, HSPE1, and COX7A2 listed in Table 4.


According to another embodiment of the present invention, the present invention provides a solid substrate for diagnosing depression having immobilized thereon probes that each independently specifically hybridize to any one of the genes listed in Tables 7 to 10 for detecting the target gene. Preferably, the target genes at least include HLA-G, HRH4, PSMB9, ATP2A2, SCYA5, SLC6A4, CASP6, CSF2, HSD3B1, and RAB9 listed in Table 7, HSPE1, PSMA4, ADH5, PSMA6, COX17, HMG1, GPR24, COX6C, FGF2, and COX7C listed in Table 8, CLK1, PSMC6, TAF2F, P2Y5, CASP3, HSPCA, MSH2, SLC38A2, B2M, and AKAP11 listed in Table 9, and CCNA2, HGF, GPR24, PTGER3, COX7A2, BDKRB2, UFD1L, HMG1, PSMA4, and ATP6J listed in Table 10.


The present invention further provides a system for diagnosing depression for performing the method of diagnosing depression of the present invention. This system comprises a means for comparing and analyzing the gene expression data of a subject with that of a healthy volunteer and of a patient afflicted with depression, which had been previously obtained, and can diagnose the conditions of depression of the subject in accordance with the type of depression.


Preferably, the aforementioned system further comprises a means of comparing and analyzing the gene expression data of a subject, of a healthy volunteer, and of a patient afflicted with depression in combination with the data concerning their age and sex.


In the present invention, gene expression is analyzed using patients' peripheral bloods to cluster patients afflicted with depression, and conditions thereof or the course of treatment are then diagnosed. Thus, depression can be diagnosed in a non-invasive, simple, and accurate manner.




BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 shows the groups of genes exhibiting significant differences between patients and healthy volunteers. Shading indicates the difference in expression levels of 10 or lower.



FIG. 2 shows the groups of genes exhibiting significant differences between the PA group and the PB group. Shading indicates the difference in expression levels of 10 or lower.



FIG. 3 shows the groups of genes exhibiting significant differences before/after treatment in the PA group. Shading indicates the difference in expression levels of 10 or lower.



FIG. 4 shows the groups of genes exhibiting significant differences before/after treatment in the PB group. Shading indicates the difference in expression levels of 10 or lower.



FIG. 5 schematically shows the method of diagnosing depression according to the present invention; wherein F1 indicates a DNA chip, F2 indicates probe DNA corresponding to the gene selected in the present invention, F3 indicates an excitation light source and a fluorescence detector, and F4 indicates a computer for regulating a fluorescence detector.



FIG. 6 schematically shows the system of diagnosing depression according to the present invention; wherein a database of personal information stores information such as sex and age.



FIG. 7 shows clustering of patient/healthy volunteer comparison.



FIG. 8 shows the gene expression data of subjects of the PA group. Shading indicates the difference in expression levels of 10 or lower.



FIG. 9 shows the gene expression data of subjects of the PB group. Shading indicates the difference in expression levels of 10 or lower.



FIG. 10 is a colored chart showing the results of cluster analysis for the group of genes with varying expression levels common in the patient group.



FIG. 11 is a colored chart showing the results of cluster analysis for the patients/healthy volunteers.



FIG. 12 is a colored chart showing the results of cluster analysis between a patient and a healthy volunteer and before/after treatment in the PA group.



FIG. 13 is a colored chart showing the results of cluster analysis between a patient and a healthy volunteer and before/after treatment in the PB group.



FIG. 14 is a colored chart showing the results of cluster analysis for the group of genes with varying expression levels common in the patient group.



FIG. 15 is a colored chart showing the results of cluster analysis for the patients/healthy volunteers.



FIG. 16 is a colored chart showing the results of cluster analysis between a patient and a healthy volunteer (P) and before/after treatment (N) in the PA group.



FIG. 17 is a colored chart showing the results of cluster analysis between a patient and a healthy volunteer (P) and before/after treatment (N) in the PB group.




DETAILED DESCRIPTION OF THE INVENTION

1. Marker Genes for Diagnosing Depression


The present inventors extracted RNA from the whole blood collected from patients and healthy volunteers as described below, and gene expression of patients was then analyzed using DNA chips, along with that of healthy volunteers. The marker genes were determined based on the results. A DNA chip comprises DNA fragments having nucleotide sequences corresponding to numerous genes immobilized on a substrate such as a glass substrate, and it is used for detecting RNA in a sample by hybridization. Instead of the aforementioned DNA chip, other DNA-immobilized solid substrates (such as DNA arrays, capillaries, or membrane filters) or quantitative assay techniques may be employed, as long as extensive analysis of gene expression is feasible.


Target patients were those who had agreed with the written description for participating in the research for developing the present diagnostic method selected from among untreated patients afflicted with depression. Patients with serious physical complications or those taking therapeutic agents for physical diseases were excluded. Diagnosis was made in accordance with a depressive episode specified in the International Classification of Diseases, 10th revision (ICD-10). Healthy volunteers with the same sex and age conditions were selected for each of the patients for comparison.


Differences in gene expression levels between samples obtained from patients and samples obtained from healthy volunteers or those between samples obtained from a single patient before and after treatment were determined. A group of genes having fluorescence intensities of 300 or higher in both of the data on patient/healthy volunteer comparison and the data on before/after treatment comparison was selected as the target genes.


Among the data on patient/healthy volunteer comparison, the gene with a significantly higher or lower expression level was selected via a significant difference test. The gene of the patient with significantly higher or lower expression level compared to that of the healthy volunteer was then selected as an indicator for evaluating whether or not the patient has been afflicted with depression, i.e., as the “marker gene for depression.”


Subsequently, the data on patient/healthy volunteer comparison was subjected to cluster analysis employing all the target genes (hierarchical clustering based on the cosine coefficient distance without a weight between clusters). As a result, the present inventors found that the patient/healthy volunteer comparison samples were roughly divided into two groups, i.e., the PA group and the PB group. The tests were carried out between groups, and the gene that was peculiar to each group was selected as an indicator for classifying a patient afflicted with depression, i.e., as the “marker gene for classification” of the patient afflicted with depression.


Based on the above results, the data on before/after treatment comparison was grouped. The data on patient/healthy volunteer comparison and the data on before/after treatment comparison were aligned for each patient in each group, and the data were compared and analyzed. The group of genes with reversed expression patterns between the data on patient/healthy volunteer comparison and the data on before/after treatment comparison was extracted. The reversed expression patterns between the data on patient/healthy volunteer comparison and the data on before/after treatment comparison indicate a change in gene expression that is observed characteristically when the patient afflicted with depression received treatment involving the use of an antidepressant. Specifically, the extracted group of genes is useful as an indicator for the conditions or the course of treatment of the patients afflicted with depression in each group. This group of genes was selected as the “marker genes for diagnosing each group (e.g., the marker genes for diagnosing type PA depression and the marker genes for diagnosing type PB depression).”


Expression levels of the marker gene was employed as an indicator to evaluate whether or not the subject had been afflicted with depression and the course of treatment by classification. This result was very consistent with the results of clinical finding. Thus, the marker genes according to the present invention were found to be effective.


2. Association Between Marker Gene and Depression


At present, mechanisms of depression are indefinite, although the following is known as a correlation between the group of genes selected as marker genes and depression or other psychiatric diseases.


The genes, the expression levels of which had been significantly varied in the patient/healthy volunteer comparison samples, contained a large number of cytokine-associated genes, such as SCYA5 encoding a T-cell-specific protein, TNFRSF9 or TNFSF10 belonging to the TNF superfamily, or IL1R2 or IL2RB (an interleukin receptor). The association between cytokine and depression has been pointed out. Inflammatory cytokines such as interleukins (IL)-1, 6, and 8 are associated with stress responses, and affect the central nervous system, thereby causing drowsiness, loss of appetite, and other symptoms. As a major side effect of interferon α used for treating hepatitis C, development of depression is well known. Based on the results attained via the present invention, significant changes in the expression level of cytokine-associated genes were observed in patients afflicted with depression, in the development of which stress may be involved, as anticipated. In particular, the expression level of interferon-associated genes was significantly changed. Thus, development of depression is considered to be associated with interferon therapy. Therefore, analysis of mRNA expression patterns of factors regulating functions of immune system cells was considered to be very useful for diagnosing depression.


It has been pointed out that ATRX is associated with X-chromosome-linked mental retardation (e.g., ATR-X syndrome, Carpenter syndrome, Juberg-Marsidi syndrome, or Smith-Fineman-Myers syndrome).


The expression level of the genes associated with the renin-angiotensin system, such as NR3C1 and SGK2, was found to vary in the case of patients afflicted with depression before and after treatment. Association of the renin-angiotensin system and sporadic Alzheimer's disease has been pointed out (Eur J Hum Genet. 2001: 9(6): 437-444). Also, association of the angiotensin-converting enzyme (ACE) gene polymorphism with schizophrenia has also been analyzed (Neuropsychobiology 2001; 44(1): 31-35).


Recently, the concept of perceiving clinical conditions involved with ion channel dysfunctions as “channel diseases” has been proposed. An ion channel serves as the most important function for neuron cell activity, and its association with epilepsy, ataxia, migraine, schizophrenia, Alzheimer's disease, and other neurodegenerative diseases has been pointed out (CNS Drug Rev 2001; 7(2): 214-240). Concerning Na/K-ATPase and psychiatric diseases, association of the ion channel with depression (Depress Anxiety 1997, 5, pp. 53-65) or dysthymia (J. Basic Clin. Physiol. Pharmacol. 2000, 11 (4), pp. 375-94) has been particularly noted. For example, the association between the Na/K-ATPase α subunit ATP1A3 (Biol Psychiatry 1998; 44: 47-51) or subunit ATP1B3 (Biol Psychiatry 1995; 37: 235-244) and bipolar disorders has been reported. Further, improvement of symptoms caused by an antidepressant, carbamazepine, is known to be correlated with elevation of erythrocyte Na/K-ATPase activity (Neuropsychobiology 1999, 40 (3), pp. 134-9). ATP1B3P1 is a pseudogene of ATP1B3 and is transcribed from the same genome. In the present invention, changes in the mRNA expression patterns of the gene encoding ATPase, such as ATP2A2, ATP2C1, ATP5JD, or ATP6H, reflect the state of depression. Accordingly, it was suggested that these genes were associated with depression in one way or another.


The expression level of the heat shock protein (HSP) family that is induced by a variety of forms of environmental stress and that contributes to the acquisition of stress responsiveness and stress resistance of cells also showed relatively major variation in leukocytes of patients afflicted with depression. mRNA expression levels were varied in HSPCB, HSPD1, HSPA10, or HSPA4. These HSP families are considered to be a group of genes important for the diagnosis of depression.


At present, mRNA expression levels of RNA polymerase II subunits or binding protein genes were both found to have been lowered, and their expression levels were found to have been restored as the disease state reached a state of remission, although association thereof with depression has not yet been clarified. Expression levels of a group of polymerase-associated genes, such as 140 kDa RNA polymerase II subunit protein gene (POLR2B), RNA polymerase II transcription elongation factor B (SIII) polypeptide 1 (TCEB1), RNA polymerase II transcription elongation factor B (SIII) polypeptide 1 homolog (TCEB1L), poly(A) polymerase, RNA polymerase β subunit, RNA polymerase III, and UDP-galactose transporter novel isozyme (SLC35A1), reflected conditions of depression.


Recently, research into the causes of depression in relation to receptor signalings and transcription factors mediating distinct gene expressions has drawn attention, in addition to the search for association of metabolism of neurotransmitters including monoamine or receptors themselves with depression. A monoamine receptor is a 7-transmembrane G-protein-coupled receptor that activates inositol phosphate cycles and protein kinase C (PKC). This receptor also activates the elevation of cyclic AMP and the protein kinase A (PKA) pathway. Further, transcription factors activated by these signal transducing molecules and their gene products are focused, and it is expected that associations of these pathways with functional disorders will be discovered. Lithium derivatives, the effects of which as mood stabilizers for patients afflicted with bipolar disorders have been verified, are actually reported to act on signal-transducing pathways such as G-proteins, inositol phosphate cycles, PKC, PKA, glycogen synthase kinase 3-β, or Akt cascade, thereby exhibiting pharmacological actions (Br J Psychiatry 2001; 41: suppl 128-133).


Evidence that would support such reports was found in a group of genes associated with conditions of depression. Lowered mRNA expression levels of signal-transducing factors, such as PKCη (PRKCH), PKCβ1 isozyme, and phosphoinosidite 3′-kinase α subunit (PIK3CA), were observed. Lithium inactivates glycogen synthase kinase 3 and intensifies Wnt signals. In the case of patients afflicted with depression, expression levels of connective tissue growth factor-associated protein WISP-3, β-catenin (CTNNB1), and transcription factor E2A (TCF3) were lowered, and their expression levels were restored as the symptoms reached a state of remission. Lowered mRNA expression levels of GTP-binding proteins, i.e., RAB4 and RAB7L1, were observed, and their restoration through treatment was observed.


Concerning growth factor-associated proteins, mRNA expression levels of TGF-β receptor, TGF-β-induced clone 22 homolog (TSC22), and the insulin signal transducing molecule IRS4, reflected the symptoms of depression. In addition, mRNA expression levels of anti-oncogenes, i.e., Rb-associated protein RBBP7 and growth inhibitory factors ING1 and PTEN, were all lowered in patients afflicted with depression, and these expression levels were restored as the disease condition reached a state of remission. In a reflection of the expression patterns of these growth-associated genes, mRNA expression levels of CDKN2C, CDK7, CCNB2, and CCNG1 associated with a cell cycle were all lowered, and lowered mRNA expression levels of topoisomerase IIβ and topoisomerase II-binding protein (TOPBP1) associated with DNA replication were observed. The evidence that suggests lowered general mitogen activity was observed in leukocytes of patients afflicted with depression. Expression levels of these genes were also restored as the symptoms reached a state of remission. Lowered mRNA expression levels of the DNA repair enzyme MSH6, an apoptosis signal molecule DAP3 or API1, and caspase 10 were associated with symptoms of patients afflicted with depression. When variations in growth-associated genes were examined altogether, a cell cycle was deduced to be generally lowered in leukocytes of patients afflicted with depression.


3. Method for Diagnosing Depression and System for Diagnosing Depression


The present invention has been completed based on the results of above experimentation. In the present invention, mRNA is extracted from a subject's peripheral blood, and its expression profile is examined, thereby resulting in diagnosis of depression in the subject in accordance with the type of depression. FIG. 5 schematically shows the method of diagnosing depression of the present invention, and FIG. 6 schematically shows the system of diagnosing depression of the present invention.


Techniques for examining the gene expression levels employed in the present invention are not limited to the DNA chips shown in FIG. 5. Any conventional techniques for analysis in the art can be employed. For example, nucleic acid hybridization utilizing other DNA-immobilized solid substrates such as DNA arrays or membrane filters, quantitative PCR such as RT-PCR or real-time PCR, Northern blotting, subtraction, differential display, differential hybridization, and cross-hybridization, can be employed. DNA-immobilized solid substrates, such as DNA chips, DNA arrays, membrane filters, and capillaries, are particularly preferable since a large number of genes can be extensively analyzed at a single operation.


The solid substrate that is employed in the present invention is prepared by immobilizing probes that each independently specifically hybridize to any one of the genes listed in Tables 1 to 4 to detect the target gene on a solid substrate, such as a glass or nylon membrane. Preferably, the target genes to be immobilized on the substrate at least include ATP2A2, SCYA5, STIP1, EEF1A1, GRB10, CASP6, TSSC1, RAB9, NFATC3, and TPR listed in Table 1, GNG10, CLK1, P2Y5, IFNGR1, TAF2F, PIM1, MAP2K3, HDGF, INSR, and COX6C listed in Table 2, CDC10, GZMA, TNFRSF6, HSPCA, NR3C1, TOPBP1, ARNTL, RAP1A, POLR2B, and ITGB1 listed in Table 3, and POU2F2, BCL2L1, DAXX, COX4, CD3G, FCER1Q NME2, CPT1B, HSPE1, and COX7A2 listed in Table 4. Alternatively, the solid substrate of the present invention is prepared by immobilizing probes that each independently specifically hybridize to any one of the genes listed in Tables 7 to 10 to detect the target gene on a solid substrate, such as a glasses or nylon membrane. Preferably, the target genes to be immobilized on the substrate at least include HLA-G, HRH4, PSMB9, ATP2A2, SCYA5, SLC6A4, CASP6, CSF2, HSD3B1, and RAB9 listed in Table 7, HSPE1, PSMA4, ADH5, PSMA6, COX17, HMG1, GPR24, COX6C, FGF2, and COX7C listed in Table 8, CLK1, PSMC6, TAF2F, P2Y5, CASP3, HSPCA, MSH2, SLC38A2, B2M, and AKAP11 listed in Table 9, and CCNA2, HGF, GPR24, PTGER3, COX7A2, BDKRB2, UFD1L, HMG1, PSMA4, and ATP6J listed in Table 10. A probe that is employed to detect genes can be designed as a sequence that is complementary to a region with high specificity of the marker gene (e.g., 3′ UTR) in accordance with a conventional technique. A synthetic oligo probe with a 25-100 base length or a PCR product with a 300-1,000 base length can be employed. A method of immobilizing a probe on a solid substrate is not particularly limited. In accordance with a conventional technique, a synthesized probe may be spotted on a solid substrate or a probe may be synthesized on a solid substrate.


For example, the RNA sample collected from a subject and the RNA sample collected from a healthy volunteer are respectively labeled with fluorescent dyes having different emission wavelengths, and they are applied to the same DNA chip for diagnosing depression to conduct competitive hybridization. The fluorescence intensity of each probe on the chip represents the differences in the gene expression intensities between the subject and the healthy volunteer. The expression profiles thereof can be then examined to diagnose the conditions of depression in the subject.


Alternatively, a certain RNA sample, for example, a commercialized universal RNA sample, is used as a standard sample, and comparison and analysis of expression levels of the subject's sample and the standard sample are conducted separately from those of the healthy volunteer's sample and the standard sample in the aforementioned manner to analyze expression data for both groups in comparison with each other. Thus, the conditions of depression in the subject can be diagnosed.


In any case, a subject and a healthy volunteer to be compared therewith preferably have the same age and sex conditions. For example, an acceptable age gap between them is up to 5 years.


If the expression data for healthy volunteers are classified in accordance with their age and sex and stored in a database, the subject and a healthy volunteer can be compared and analyzed by simply retrieving the data that match the conditions of the subject in terms of age and sex from the database. Also, the expression data for patients afflicted with depression and those for healthy volunteers are previously stored in the computer, and the computer is allowed to determine which of the expression patterns for patients or healthy volunteers are more similar to the subject's expression data, thereby diagnosing the conditions of depression in the subject (see FIG. 6).


Further, if the expression data for patients afflicted with depression is stored in the computer in accordance with the group (the PA group and the PB group), more accurate diagnosis in accordance with the type of depression in the subject can be realized. In accordance with the expression data of each group stored in the computer, for example, the computer is allowed to determine which of the expression patterns are more similar to those of the subject who had been diagnosed as afflicted with depression, and the evaluated data is then clustered. The clustered data of the subject is further evaluated by the computer in terms of the conditions or the course of treatment based on the expression profile of a diagnostic marker specific for each group.


A method for data analysis is not limited to clustering. Any conventional analytical techniques in the art, for example, a machine learning algorithm such as the one utilizing a support vector machine can be employed.


The method of the present invention can conduct the analysis with the use of 5 ml of blood obtained by conventional blood sampling without special cooperation provided by a patient. This diagnostic method can be carried out in a non-invasive, simple, and routine manner. This method of multidimensionally comprehending biological functions based on numerous mRNA expression levels is more adequate as a method of diagnosing complicated psychiatric diseases involving both mental and physical conditions such as depression in terms of its principle compared with the conventional method that assays only limited factors.


The results attained by the method of the present invention can be simply and clearly evaluated, they can be easily employed by primary care doctors as objective indicators for depression, and they are extremely useful for the establishment of diagnosis and introduction of therapy. A high-risk group can be accurately selected from among the groups of people through medical checkups or complete physical examinations provided by workplaces, schools, and communities. This enables early detection of depression in a simple and cost-effective manner. Accordingly, the method of the present invention significantly contributes to the improvement of peoples' mental health from the viewpoint of preventive care.


The usefulness of the method according to the present invention is not limited to primary care and medical checkups. Specialists in psychiatric medicine can apply this technique to the search for psychological, social, and environmental factors associated with the development of depression, evaluation of clinical conditions, diagnosis, evaluation of treatment, and determination of prognosis. Thus, this technique can be a revolutionary test technique in the field of psychiatric medicine, which dramatically improves a technique of diagnosing depression.


The present invention is hereafter described in greater detail with reference to the following examples, although it is not limited to these examples.


EXAMPLE 1
Selection of Marker Gene

1. Patients and Healthy Volunteers


Target patients were those who had agreed with the written description for participating in the research for developing the present diagnostic method selected from among untreated patients afflicted with depression who had visited the Department of Psychiatry and Neurology of the Tokushima University Hospital between November 2001 and June 2002. This research was approved by the ethics committee of Tokushima University Hospital. Diagnosis was made in accordance with a depressive episode specified in the International Classification of Diseases, 10th revision (ICD-10). Patients with serious physical complications or those taking therapeutic agents for physical diseases were excluded. Healthy volunteers with the same sex and age conditions were selected for each patient for comparison.


Thirty three patients whose samples before treatment had been obtained were 25 males and 8 females aged 23 to 74 (45.7 years old on average), and their Hamilton scores were between 10 and 38 points (23.2 points on average).


Samples were obtained from 15 patients after the treatment. They were 13 males and 2 females aged 27 to 68 (48.1 years old on average), and their Hamilton scores were between 2 and 25 (6.9 points on average). Treatment was mainly carried out by medication using antidepressants. The remission of symptoms was determined based on general clinical diagnosis. Samples satisfied the standard of having scores of 7 or less on the Hamilton Rating Scale, which are generally regarded as representing remission of symptoms, except for 5 samples. Samples after treatment were collected 68 to 211 days after the collection of samples before treatment (121 days on average). The mRNA expression level after treatment was compared with that of a sample taken from the same subject before treatment.


2. Analysis of Gene Expression


Blood (5 ml) was collected from the patients, and total RNA was extracted using a PAXgene Blood RNA System (Qiagen). Blood was collected by a doctor or nurse between 10:00 am and 1:00 pm from the patients under fasting conditions through cubitus veins under resting conditions. The yield of total RNA was 5 μg to 15 μg.


Subsequently, 5 μg of total RNA extracted from each patient was separated, annealed with an oligo (dT) 24 primer comprising a T7 promoter sequence added thereto, and first-strand DNA was synthesized. Thereafter, this first-strand DNA was used as a template to synthesize second-strand DNA having a T7 promoter sequence. Finally, the second-strand DNA was used as a template to synthesize RNA with the aid of T7 RNA polymerase. A random hexamer was annealed to 6 μg of the synthesized RNA to conduct a reverse transcriptase reaction, and Cy5-dCTP was incorporated into the strand. Thus, fluorescence-labeled cDNA was synthesized.


In a manner similar to the case of the patients, 5 ml of blood was collected from each of 33 healthy volunteers with the same sex and age conditions, and total RNA was then extracted. cDNA was similarly synthesized except for the use of Cy3 as a fluorescent label.


When comparing samples of a single subject before and after treatment, cDNA labeled with Cy3 and cDNA labeled with Cy5 were synthesized from the samples before and after treatment, respectively.


Equivalent amounts of two types of cDNAs for comparison and analysis were mixed, the resultant was applied to a DNA chip (a DNA chip for analyzing drug response, Hitachi Co., Ltd.), and hybridization was carried out at 62° C. for 12 hours. After washing, fluorescence intensity at each spot was assayed using a scanner (ScanArray 5000, GSI-Lumonics). Differences in gene expression levels between samples obtained from patients and samples obtained from healthy volunteers or those between samples obtained from a single patient before and after treatment were determined.


3. Data Analysis


(1) Selection of Marker Gene for Depression


A group of genes (489 genes) having fluorescence intensities of 300 or higher in all 48 groups of data was selected as the object of analysis. Among the data on patient/healthy volunteer comparison, the gene with a significantly higher or lower expression level was selected via a significant difference test. There were 30 genes of the patient with a significantly higher expression level compared to that of the healthy volunteer and 22 genes thereof with a significantly lower expression level (FIG. 1, FIG. 10, Table 1). These 52 genes are useful for evaluating whether or not the subject has been afflicted with depression, i.e., they are useful as marker genes for depression. Among them, the expression levels of ATP2A2, SCYA5, STIP1, EEF1A1, GRB10, CASP6, TSSC1, RAB9, NFATC3, and TPR were significantly varied, and thus, they were considered to be particularly useful marker genes for depression.

TABLE 1Group of genes exhibiting significant differences between patient/healthy volunteerSymbolNameCategoryGenBank IDAGTR1BH. sapiens mRNA for angiotensin II receptorangiotensinX65699AKAP6Homo sapiens A kinase (PRKA) anchor protein 6 (AKAP6)SignalNM_004274ALDH8Human aldehyde dehydrogenase (ALDH8) mRNAALDHU37519ATP2A2ATPase, Ca++ transporting, cardiac muscle, slow twitch 2ATPaseM23114ATP5J2ATP synthase, H+ transporting. mitochondrial F0 complex, subunit f, isoform 2ATPaseAF047436ATP6JATPase, H+ transporting, lysosomal (vacuolar proton pump), member JATPaseAF038954ATRXAlpha thalassemia/mental retardation syndrome X-linkedATPaseU72938CASP4Human cysteine protease (ICErel-II) mRNA, complete cdsAppoptosisU28014CASP6Human cysteine protease Mch2 isoform alpha (Mch2) mRNA, complete cdsAppoptosis, SignalU20536CCNA2Human mRNA for cyclin A; Cyclin A2CellCycleX51688CD3DHomo sapiens CD3D antigen, delta polypeptide (TiT3 complex) (CD3D), mRNASignalNM_000732CD3EHuman mRNA for T3 epsilon chain (20K) of T-cell receptor (from peripheralSignalX03884blood lymphocytes).CHST1Homo sapiens mRNA for keratan sulfate Gal-6-sulfotransferasesulfotransferaseAB003791CHST2Homo sapiens carbohydrate (N-acetylglucosamine-6-O) sulfotransferase 2sulfotransferaseNM_004267(CHST2)COX7A2Homo sapiens cytochrome c oxidase subunit VIIa polypeptide 2 (liver)mitochondria & stressNM_001865(COX7A2), nuclear gene encoding mitochondrial proteinCOX7CHomo sapiens cytochrome c oxidase subunit VIIcmitochondria & stressNM_001867CPT2Homo sapiens camitine palmitoyltransferase II (CPT2), nuclear gene encodingmitochondria & stressNM_000098mitochondrial proteinCYP8B1Homo sapiens sterol 12-alpha hydroxylase CYP8B1 (Cyp8b1) mRNA, partialP450AF090318cdsEEF1A1Homo sapiens eukaryotic translation elongation factor 1 alpha 1 (EEF1A1)glucocorticoidsNM_001402(Cortisol)GNB2L1Human MHC protein homologous to chicken B complex protein mRNA;SignalM24194Guanine nucleotide binding protein (G protein), beta polypeptide 2-like 1GNG5Homo sapiens G protein gamma 5 subunit mRNA; Guanine nucleotide bindingSignalAF038955protein (G protein), gamma 5GRB10Homo sapiens growth factor receptor-bound protein 10 (GRB10), mRNAInsulinNM_005311HLA-DRAHuman HLA-DR alpha-chain mRNA; Class II MHC alphaSignalK01171HSPCBHuman 90-kDa heat-shock protein gene, cDNA; Heat shock 90 kD protein 1,hspM16660betaIL1R2H. sapiens IL-1R2 mRNA for type II interleukin-1 receptor, (cell line CB23).CytokineX59770IL2RBHuman interleukin 2 receptor beta chain (p70-75) mRNA, complete cdsCytokine, SignalM26062IPF1Homo sapiens insulin promoter factor 1, homeodomain transcription factoInsulinNM_000209(IPF1)ISG20Human HEM45 mRNA, complete cdsCytokineU88964KARP1Ku86 autoantigen related protein 1SignalAF039597LBCHuman P47 LBC oncogene mRNA, complete cdsoncogeneU03634NFATC3Homo sapiens NF-AT4c mRNA, complete cdsSignal, TFL41067NFKBIAHomo sapiens MAD-3 mRNA encoding IkB-like activity, complete cds.SignalM69043IkBalphaNPR2LHomo sapiens candidate tumor suppressor gene 21 protein mRNA, completeSupressorAF040708cdsPGK1phosphoglycerate kinase 1polymeraseV00572PPARAHuman peroxisome proliferator activated receptor mRNA, complete cdsPPARL02932PRKCHHuman protein kinase C-L (PRKCL) mRNA: Protein kinase C, etaSignalM55284PSMC5Proteasome (prosome, macropain) 26S subunit. ATPase, 5ATPaseAF035309RAB9Human small GTP binding protein Rab9 mRNA, complete cds.oncogeneU44103RBBP5H. sapiens RBQ-3 mRNASignalX85134RPA1Replication protein A1 (70 kD)SignalM63488SCYA5Human T cell-specific protein (RANTES) mRNA. Small inducible cytokine A5CytokineM21121SP100Human nuclear autoantigen (SP-100) mRNASignalM60618STAT3Homo sapiens DNA-binding protein (APRF) mRNA, complete cdsSignal, TFL29277STIP1Homo sapiens stress-induced-phosphoprotein 1 (Hsp70/Hsp90-organizingstressNM_006819protein)SULT1C1Human sulfotransferase mRNA family 1C, member 1 (SULT1C1)sulfotransferaseU66036TNFRSF9Human activation dependent T cell mRNA, complete cdsCytokineL12964TNFSF10Human TNF-related apoptosis inducing ligand TRAIL mRNA, complete cdsCytokineU37518TPRH. sapiens tpr mRNA: Translocated promoter region (to activated METoncogeneX66397oncogene)TSC22Human putative regulatory protein TGF-beta-stimulated clone 22 homologGFU35048TSSC1Homo sapiens tumor suppressing STF cDNA 1 (TSSC1) mRNA, complete cdsSupressorAF019952UGT1A6Homo sapiens phenol UDP-glucuronosyltransferas (UDPGT) mRNAUGTJ04093WNT1Homo sapiens wingless-type MMTV integration site family, member 1 (WNT1),oncogene, SignalNM_005430mRNA


(2) Selection of Marker Gene for Classification


Thirty three pairs of subjects for patient/healthy volunteer comparison were subjected to cluster analysis utilizing all the genes (489 genes). Analysis was carried out by hierarchical clustering based on the cosine coefficient distance without a weight between clusters. This cluster analysis demonstrated that the patient/healthy volunteer comparison samples were roughly divided into 2 groups. Such 2 groups were designated as the PA group and the PB group. The 33 pairs of subjects for patient/healthy volunteer comparison were divided into the PA group (16 pairs), the PB group (16 pairs), and a pair that did not belong to either group. In order to extract the genes that were peculiar to the PA group and to the PB group, these groups were compared to each other. There were 56 genes that exhibited significant differences between the PA group and the PB group (FIG. 2, FIG. 11, Table 2). These 56 genes are useful for assigning patients afflicted with depression to the PA or PB group, i.e., they are useful as marker genes for classification the patients afflicted with depression. Among them, the expression levels of GNG10, CLK1, P2Y5, IFNGR1, TAF2F, PIM1, MAP2K3, HDGF, INSR, and COX6C were significantly varied, and thus, they were considered to be particularly useful marker genes for classification (Table 4).

TABLE 2Genes exhibiting significant differences between PA group and PB groupSymbolNameCategoryGenBank IDAFG3L2AFG3 (ATPase family gene 3, yeast)-like 2ATPaseNM_006796AP11Human inhibitor of apoptosis protein 2 mRNA; Apoptosis inhibitor 1Appoptosis, SignalU45879ARHGAP8Homo sapiens Rho GTPase activating protein 8 (ARHGAP8), mRNASignalNM_015366ARNTLHomo sapiens mRNA for BMAL1a: aryl hydrocarbon receptor nuclearAh receptorD89722translocator-likeATP2C1ATPase, Ca++−sequesteringATPaseAF225981CCNG1Human cyclin G1 mRNA, complete cdsCellCycleU47413CD163Homo sapiens CD163 antigen (CD163)expressed exclusivelyNM_004244on human monocyte;glucocorticoid-inducibleCDC10hCDC10 = CDC10 homolog [human, fetal lung, mRNA, 2314 nt].CellCycleS72008CDK8Homo sapiens mRNA for CDK8 protein kinase.CellCycleX85753CLK1Homo sapiens clk1 mRNA; CDC-like kinase 1CellCycleL29222COX6CHomo sapiens cytochrome c oxidase subunit VIc (COX6C), nuclear genemitochondria & stressNM_004374encoding mitochondrial proteinCOX7BHomo sapiens cytochrome c oxidase subunit VIIbmitochondria & stressNM_301866CRYBB1Human beta B1-crystallin mRNAsulfotransferaseU35340CTNNB1H. sapiens mRNA for beta-cateninSignalX87838DAXXHomo sapiens Fas-binding protein Daxx mRNA, complete cdsSignalAF015956E2F4Homo sapiens E2F transcription factor 4, p107/p130-binding (E2F4)TFNM_001950FCER1AHuman mRNA for high affinity IgE receptor alpha-subunit (FcERI); FcSignalX06948fragment of IgE, high affinity I, receptor for; alpha polypeptideGNG10Human G protein gamma-10 subunit mRNA; Guanine nucleotide bindingSignalU31383protein 10GSTM3Human glutathione transferase M3 (GSTM3) mRNAGSTMJ05459HDGFHuman mRNA for hepatoma-derived growth factor, complete cdsGFD16431HIF1AHomo sapiens hypoxia-inducible factor 1, alpha subunit (basichypoxia, TFNM_001530helix-loop-helix transcription factor)HSBP1Homo sapiens heat shock factor binding protein 1 HSBP1 mRNA; Heat shockhspAF068754factor binding protein 1HSPD1Heat shock 60 kD protein 1 (chaperonin)hspM34664IFNAR1Human interferon-alpha receptor (HuIFN-alpha-Rec) mRNA, complete cdsCytokine, SignalJ03171IFNGR1Human interferon-gamma receptor mRNA, complete cdsCytokine, SignalJ03143ING1Homo sapiens growth inhibitor p33ING1 (ING1) mRNA, complete cdsSignal, SupressorAF001954INSRHomo sapiens insulin receptor (INSR), mRNA,InsulinNM_000208IRS4Homo sapiens insulin receptor substrate 4 (IRS4)InsulinNM_003604ITGB1Integrin beta 1 (fibronectin receptor, beta polypeptide, antigen CD29SignalX07979includes MDF2, MSK12);KRAS2Human K-ras oncogene protein mRNA (KRAS2)oncogeneM54968MAP2K3Human mRNA for MAP kinase kinase 3b, complete cds, MEK3SignalD87116NCOR2Human silencing mediator of retinoid and thyroid hormone action (SMRT)NRU37146mRNA, Nuclear receptor co-repressor 2NR1H4Human famesol receptor HRR-1 (HRR-1) mRNA, complete cdsNR1(FXR)U68233NR3C1Human glucocorticoid receptor alpha mRNA, complete cdsglucocorticoidsM10901(Cortisol)NTEHomo sapiens mRNA for neuropathy target esteraseesteraseAJ004832P2Y5Homo sapiens purinergic receptor P2Y5 mRNASignalAF000546PAPpoly(A) polymerasepolymeraseX76770PIK3C3H. sapiens mRNA for phosphatidylinositol 3-kinase,SignalZ46973Phosphoinositide-3-kinase, class 3PIK3CAHuman phosphoinositide 3′-hydroxykinase p110-alpha subunit mRNA,SignalU79143Phosphoinositide-3-kinase, catalytic, alpha polypeptidePIM1Human h-pim-1 protein (h-pim-1) mRNA, complete cdsoncogeneM54915PLGHuman mRNA for plasminogenSignalX05199POLBpolymerase (DNA directed), betapolymeraseD29013POLQpolymerase (DNA-directed), thetapolymeraseAF043628POLR2Bpolymerase (RNA) II (DNA directed) polypeptide B (140 kD)polymeraseX63563PPARDHuman peroxisome proliferator activated receptor mRNA, complete cdsPPARL07592PRKCL2Human lipid-activated, protein kinase PRK2 mRNA; Protein kinase C-like 2SignalU33052PTENHuman mutated in multiple advanced cancers protein (MMAC1) mRNA;SupressorU92436putative protein-tyrosine phosphatase PTENPTPRCHuman mRNA for T200 leukocyte common antigen (CD45, LC-A).SignalY00062RAP1AHuman ras-related protein (Krev-1) mRNA, complete cdsSupressorM22995RBBP1Homo sapiens retinoblastoma-binding protein 1 (RBBP1) mRNASignalNM_002892TAF2FTATA box binding protein (TBP)-associated factor, RNA polymerase II, F,polymerase, TFU1806255 kDTANKHuman TRAF family member-associated NF-kB activator TANK mRNA,SignalU63830I-TRAFTCEB1transcription elongation factor B (SIII), polypeptide 1 (15 kD, elongin C)polymerase, TFL34587TCF4Homo sapiens transcription factor 4 (TCF4)Signal, TFNM_003199TLR1Homo sapiens Toll-like receptor 1 (TLR1) mRNA, complete cdsSignalU88540TNFRSF6H. sapiens mRNA for APO-1 cell surface antigen, FASAppoptosis, Cytokine,X63717Signal


(3) Selection of Diagnostic Marker Gene for Each Group


Based on the results attained above, 15 subjects for before/after treatment comparison were divided into the PA group (7 subjects) and the PB group (8 subjects). The data on patient/healthy volunteer comparison and the data on before/after treatment comparison were aligned for each patient in each group, and the data were compared and analyzed. The group of genes with reversed expression patterns between the patient/healthy volunteer comparison sample and the before/after treatment comparison sample was extracted (PA group: FIG. 3, FIG. 12, Table 3; PB group: FIG. 4FIG. 13, Table 4). Concerning the PA group, variations in expression levels of CDC10, GZMA, TNFRSF6, HSPCA, NR3C1, TOPBP1, ARNTL, RAP1A, POLR2B, and ITGB1 were particularly significant among the genes listed in Table 3. Concerning the PB group, variations in expression levels of POU2F2, BCL2L1, DAXX, COX4, CD3G, FCER1G, NME2, CPT1B, HSPE1, and COX7A2 were particularly significant among the genes listed in Table 4.


Changes in the Hamilton scores before and after the treatment are shown in Table 5. The reversed expression patterns between the data on patient/healthy volunteer comparison and the data on before/after treatment comparison indicate a change in gene expression that is observed characteristically when the patient afflicted with depression received treatment involving the use of an antidepressant. The group of genes is useful as an indicator for the conditions or the course of treatment of the patients afflicted with depression in each group. Specifically, they are useful diagnostic marker genes that are specific for each group.

TABLE 3Genes exhibiting significant differences before and after treatment in PA groupSymbolNameCategoryGenBank IDADAM17Homo sapiens snake venom-like protease (cSVP) mRNA. A disintegrin andCytokineU92649metalloproteinase domain 17 (tumor necrosis factor, alpha, convertingenzyme)ADH5Human alcohol dehydrogenase class III (ADH5) mRNAADHM29872ALDH10Human microsomal aldehyde dehydrogenase (ALD10) mRNAALDHU46689AP1S2Homo sapiens adaptor-related protein complex 1, sigma 2 subunit (AP1S2)AP-1NM_003916API1Human inhibitor of apoptosis protein 2 mRNA; Apoptosis inhibitor 1Appoptosis, SignalU45879ARNTLHomo sapiens mRNA for BMAL1a; aryl hydrocarbon receptor nuclearAh receptorD89722translocator-likeATP2C1ATPase, Ca++−sequesteringATPaseAF225981ATP6JATPase, H+ transporting, lysosomal (vacuolar proton pump), member JATPaseAF038954CASP1Human interleukin 1-beta converting enzyme isoform delta (IL1BCE) mRNA,Appoptosis, SignalU13699complete cdsCASP5Human cysteine protease (ICErel-III) mRNA, complete cdsAppoptosisU28015CD163Homo sapiens CD163 antigen (CD163)expressedNM_004244exclusively onhuman monocyte;glucocorticoid-inducibleCDC10hCDC10 = CDC10 homolog [human, fetal lung, mRNA, 2314 nt].CellCycleS72008CLK1Homo sapiens clk1 mRNA; CDC-like kinase 1CellCycleL29222COX6CHomo sapiens cytochrome c oxidase subunit VIc (COX6C), nuclear genemitochondria &NM_004374encoding mitochondrial proteinstressCOX7A2LHomo sapiens cytochrome c oxidase subunit VIIa polypeptide 2 likemitochondria &NM_004718stressCOX7BHomo sapiens cytochrome c oxidase subunit VIIbmitochondria &NM_001866stressCTNNB1H. sapiens mRNA for beta-cateninSignalX87838DAP3Human ionizing radiation resistance conferring protein mRNA; DeathAppoptosisU18321associated protein 3ESDHomo sapiens esterase D mRNAesteraseAF112219FCER1AHuman mRNA for high affinity IgE receptor alpha-subunit (FcERI); FcSignalX06948fragment of IgE, high affinity I, receptor for; alpha polypeptideFGF2Human basic fibroblast growth factor (FGF) mRNA (BFGP; FGFB; FGP2)GFM27968GNG10Human C protein gamma-10 subunit mRNA; Guanine nucleotide bindingSignalU31383protein 10GZMAHuman Hanukah factor serine protease (HuHF) mRNA (cytotoxicesteraseM18737T-lymphocyte-associated serine esterase 3)HDAC1Human mRNA for RPD3 protein, Histone deacetylase 1Signal, TFD50405HSBP1Homo sapiens heat shock factor binding protein 1 HSBP1 mRNA; Heat shockhspAF068754factor binding protein 1HSPA10Homo sapiens heat shock 70 kD protein 10 (HSC71) (HSPA10), mRNAhspNM_006597HSPA4Human heat shock protein 70 (hsp70) mRNA; Heat shock 70 kD protein 4hspL12723HSPCAHomo sapiens Hsp89-alpha-delta-N mRNA; Heat shock 90 kD protein 1, alphahspAF028832HSPD1Heat shock 60 kD protein 1 (chaperonin)hspM34664HSPE1Human chaperonin 10 mRNA; Heat shock 10 kD protein 1hspU07550IFNGR1Human interferon-gamma receptor mRNA, complete cdsCytokine, SignalJ03143IL10RAHuman interleukin-10 receptor mRNA, complete cdsCytokineU00672ING1Homo sapiens growth inhibitor p33ING1 (ING1) mRNA, complete cdsSignal, SupressorAF001954INSHomo sapiens insulin (INS), mRNATyrosineNM_000207Hydroxylase,insulinIRS4Homo sapiens insulin receptor substrate 4 (IRS4)InsulinNM_003604ITGB1Integrin, beta 1 (fibronectin receptor, beta polypeptide, antigen CD29 includesSignalX07979MDF2, MSK12);KARP1Ku86 autoantigen related protein 1SignalAF039597KRAS2Human K-ras oncogene protein mRNA (KRAS2)oncogeneM54968MAP3K7Homo sapiens mitogen-activated protein kinase kinase kinase 7 (MAP3K7),SignalNM_003188mRNA, TAK1MSH6Human DNA mismatch repair protein MSH6; mutS alpha 160-kDa subunit; G/TDNArepairU54777mismatch binding protein (GTMBP; GTBP)NR3C1Human glucocorticoid receptor alpha mRNA, complete cdsglucocorticoidsM10901(Cortisol)NRFHomo sapiens transcription factor NRFmitochondria &NM_017544stressNTEHomo sapiens mRNA for neuropathy target esteraseesteraseAJ004832P2Y5Homo sapiens purinergic receptor P2Y5 mRNASignalAF000546PAPpoly(A) polymerasepolymeraseX76770PGK1phosphoglycerate kinase 1polymeraseV00572PIK3C3H. sapiens mRNA for phosphatidylinositol 3-kinase,SignalZ46973Phosphoinositide-3-kinase, class 3PIK3CAHuman phosphoinositide 3′-hydroxykinase p110-alpha subunit mRNA,SignalU79143Phosphoinositide-3-kinase, catalytic, alpha polypeptidePOLBpolymerase (DNA directed), betapolymeraseD29013POLR2Bpolymerase (RNA) II (DNA directed) polypeptide B (140 kD)polymeraseX63563PPP3CCcalcineurin A catalytic subunit [human, testis, mRNA, 2134 nt]; ProteinSignalS46622phosphatase 3 (formerly 2B), catalytic subunit, gamma isoform (calcineurin Agamma)PRKCHHuman protein kinase C-L (PRKCL) mRNA; Protein kinase C, etaSignalM55284PTPN7Human mRNA for protein-tyrosine phosphatase; Protein tyrosineSignalD11327phosphatase, non-receptor type 7, HePTPRAB4Homo sapiens GTP-binding protein (RAB4) mRNA, complete cds.oncogeneM28211RAB7L1Homo sapiens mRNA for small GTP-binding protein, complete cdsoncogeneD84488RAP1AHuman ras-related protein (Krev-1) mRNA, complete cdsSupressorM22995RBBP1Homo sapiens retinoblastoma-binding protein 1 (RBBP1) mRNASignalNM_002892RBBP4Human chromatin assembly factor 1 p48 subunit (CAF1 p48 subunit);SignalX74262retinoblastoma-binding protein 4RBBP6H. sapiens RBQ-1 mRNASignalX85133RBBP7Human retinoblastoma-binding protein (RbAp46) mRNA, complete cdsSignalU35143RPC39polymerase (RNA) III (DNA directed) (39 kD)polymeraseU93869SGK2Homo sapiens serum/glucocorticoid regulated kinase 2hyperosmoticNM_016276stressSLC35A1solute carrier family 35 (CMP-sialic acid transporter), member 1polymeraseD87969TAF2FTATA box binding protein (TBP)-associated factor, RNA polymerase II, F,polymerase, TFU1806255 kDTAF2GTATA box binding protein (TBP)-associated factor, RNA polymerase II, G,polymerase, TFU2185832 kDTCEB1transcription elongation factor B (SIII), polypeptide 1 (15 kD, elongin C)polymerase, TFL34587TCEB1Ltranscription elongation factor B (SIII), polypeptide 1-likepolymerase, TFZ47087TNFRSF6H. sapiens mRNA for APO-1 cell surface antigen, FASAppoptosis,X63717Cytokine, SignalTNFSF10Human TNF-related apoptosis inducing ligand TRAIL mRNA, complete cdsCytokineU37518TOP2BH. sapiens TOP2 mRNA for DNA topoisomerase II (partial); TopoisomerasetopoiosomeraseZ15115(DNA) II beta (180 kD)TOPBP1Homo sapiens mRNA for DNA topoisomerase II binding protein, complete cdstopoiosomeraseAB019397









TABLE 4










Genes exhibiting significant differences before and after treatment in PB group










Symbol
Name
Category
GenBank ID





5T4

H. sapiens 5T4 gene for 5T4 Oncofetal antigen

oncogene
Z29083


AANAT
Human serotonin N-acetyltransferase mRNA, complete cds
NAT
U40347


ADCY9

Homo sapiens adenylate cyclase 9 (ADCY9)

Signal
NM_001116


ADH5
Human alcohol dehydrogenase class III (ADH5) mRNA
ADH
M29872


ADPRTL1
ADP-ribosyltransferase (NAD+; poly (ADP-ribose) polymerase)-like 1
polymerase
AF057160


AKAP6

Homo sapiens A kinase (PRKA) anchor protein 6 (AKAP6)

Signal
NM_004274


AKR1B1

Homo sapiens aldo-keto reductase family 1, member B1 (aldose reductase)

hyperosmotic stress
NM_001628


ALDH10
Human microsomal aldehyde dehydrogenase (ALD10) mRNA
ALDH
U46689


APG-1

Homo sapiens mRNA for heat shock protein apg-1; Heat shock protein

hsp
AB023421



(hsp110 family)


ARNTL

Homo sapiens mRNA for BMAL1a: aryl hydrocarbon receptor nuclear

Ah receptor
D89722



translocator-like


ATP2A2
ATPase, Ca++ transporting, cardiac muscle, slow twitch 2
ATPase
M23114


ATP5J2
ATP synthase, H+ transporting, mitochondrial F0 complex, subunit f, isoform
ATPase
AF047436



2


ATP5JD
ATP synthase, H+ transporting, mitochondnal F1F0, subunit d
ATPase
AF087135


ATP6DV
Vacuolar proton-ATPase, subunit D; V-ATPase, subunit D
ATPase
X71490


ATP6E
ATPase, H+ transporting, lysosomal (vacuolar proton pump) 31 kD; Vacuolar
ATPase
X76228



proton-ATPase, subunit E; V-ATPase, subunit E


ATP6H
ATPase, H+ transporting, lysosomal (vacuolar proton pump) 9 kD
ATPase
Y15286


ATP6S14
ATPase, vacuolar, 14 kD
ATPase
D49400


BAK1
Human bcl2 homologous antagonist/killer (BAK)
Appoptosis
U23765


BCL2L1

H. sapiens bcl-xL mRNA; BCL2-like 1

Signal
Z23115


CASP10
Human apoptotic cysteine protease Mch4 (Mch4) mRNA, complete cds
Appoptosis, Signal
U60519


CCNB2
Human cyclin B2 mRNA, complete cds
CellCycle
AF002822


CD3E
Human mRNA for T3 epsilon chain (20K) of T-cell receptor (from peripheral
Signal
X03884



blood lymphocytes),


CD3G
Human mRNA for T-cell receptor T3 gamma polypeptide, RON alpha
Signal
X04145


CD86
Human CD86 antigen mRNA, complete cds
Signal
U04343


CDC25C
Human cdc25Hs mRNA, complete cds
CellCycle
M34065


CDC2L5
Human cdc2-related protein kinase (CHED) mRNA; Cell division cycle 2-like
CellCycle
M80629



5 (cholinesterase-related cell division controller)


CDC37
Human CDC37 homolog mRNA, complete cds
CellCycle
U63131


CDK7

H. sapiens CDK activating kinase mRNA

CellCycle
X77743


CDKN2C

Homo sapiens cyclin-dependent kinase inhibitor (CDKN2C) mRNA, complete

CellCycle
AF041248



cds,; p18


CHST1

Homo sapiens mRNA for keratan sulfate Gal-6-sulfotransferase

sulfotransferase
AB003791


COX4

Homo sapiens cytochrome c oxidase subunit IV (COX4), nuclear gene

mitochondria &
NM_001861



encoding mitochondrial protein
stress


COX5A

Homo sapiens cytochrome c oxidase subunit Va

mitochondria &
NM_304255




stress


COX6C

Homo sapiens cytochrome c oxidase subunit VIc (COX6C), nuclear gene

mitochondria &
NM_004374



encoding mitochondrial protein
stress


COX7A2

Homo sapiens cytochrome c oxidase subunit VIIa polypeptide 2 (liver)

mitochondria &
NM_001865



(COX7A2), nuclear gene encoding mitochondrial protein
stress


COX7A2L

Homo sapiens cytochrome c oxidase subunit VIIa polypeptide 2 like

mitochondria &
NM_004718




stress


COX7B

Homo sapiens cytochrome c oxidase subunit VIIb

mitochondria &
NM_001866




stress


COX7C

Homo sapiens cytochrome c oxidase subunit VIIc

mitochondria &
NM_001867




stress


CPT1B

Homo sapiens camitine palmitoyltransferase I, muscle (CPT1B)

mitochondria &
NM_104377




stress


CSF1R
Human macrophage colony stimulating factor I receptor precursor (CSF1R);
oncogene
X03663



a proto-oncogene (c-fms)


CSF2RB
Human GM-CSF receptor beta chain mRNA; IL3R-beta
Cytokine, Signal
M59941


CSNK1A1

Homo sapiens casein kinase I alpha isoform (CSNK1A1) mRNA

Signal
L37042


CYP2A7
Human cytochrome P450 (CYP2A7) mRNA, complete cds
P450
U22029


CYP2C19
Human cytochrome P4502C19 (CYP2C19) mRNA, clone 11a
P450
M61854


CYP3A5P1
Human cytochrome P450 pseudogene mRNA
P450
L26985


DAXX

Homo sapiens Fas-binding protein Daxx mRNA, complete cds

Signal
AF015956


DCC
Human tumor suppressor protein DCC precursor; colorectal cancer
Supressor
X76132



suppressor


DDOST
Human mRNA for KIAA0115 gene;
UGT
D29643



Dolichyl-diphosphooligosaccharide-protein glycosyltransferase


DOK1
Docking protein 1, 62 kD (downstream of tyrosine kinase 1)
Gap-junciton
J70987


DUSP1

H. sapiens CL 100 mRNA for protein tyrosine phosphatase. Dual specificity

Signal
X68277



phosphatase 1, MKP1


E2F2

Homo sapiens transcription factor E2F-2 mRNA, complete cds (clone 9).

TF
L22846


E2F3

Homo sapiens E2F transcription factor 3(E2F3)

TF
Y10479


EEF1A1

Homo sapiens eukaryotic translation elongation factor 1 alpha 1 (EEF1A1)

glucocorticoids
NM_001402




(Cortisol)


ESD

Homo sapiens esterase D mRNA

esterase
AF112219


FCER1G
Human Fc-epsilon-receptor gamma-chain mRNA; Fc fragment of IgE, high
Signal
M33195



affinity I, receptor for; gamma polypeptide


FOS

Homo sapiens v-fos FBJ murine osteosarcoma viral oncogene homolog

oncogene, Signal, TF
NM_005252



(FOS), mRNA.


FRAT1

Homo sapiens frequently rearranged in advanced T-cell lymphomas (FRAT1)

Signal
NM_005479



mRNA


G22P1
Human Ku protein subunit mRNA; Thyroid autoantigen 70 kD (Ku antigen)
Signal
M32865


GJA5
gap junction protein, alpha 5, 40 kD (connexin 40)
Gap-junciton
L34954


GNA15
Human G-alpha 16 protein mRNA, complete cds; Guanine nucleotide binding
Signal
M63904



protein (G protein), alpha 15 (Gq class)


GNB3
Human guanine nucleotide-binding protein beta-3 subunit mRNA; Guanine
Signal
M31328



nucleotide binding protein (G protein), beta polypeptide 3


HLA-DRA
Human HLA-DR alpha-chain mRNA; Class II MHC alpha
Signal
K01171


HLA-DRB1
Human mRNA for HLA class II DR-beta 1 (Dw14); Class II MHC beta
Signal
X02902


HMG1
Human mRNA for high mobility group-1 protein (HMG-1).
sulfotransferase
X12597


HSBP1

Homo sapiens heat shock factor binding protein 1 HSBP1 mRNA; Heat

hsp
AF068754



shock factor binding protein 1


HSPA4
Human heat shock protein 70 (hsp70) mRNA; Heat shock 70 kD protein 4
hsp
L12723


HSPCB
Human 90-kDa heat-shock protein gene, cDNA; Heat shock 90 kD protein 1,
hsp
M16660



beta


HSPD1
Heat shock 60 kD protein 1 (chaperonin)
hsp
M34664


HSPE1
Human chaperonin 10 mRNA; Heat shock 10 kD protein 1
hsp
U07550


IGF1R
Human mRNA for insulin-like growth factor I receptor
GF, Signal
X04434


IGFBP7
prostacyclin-stimulating factor [human, cultured diploid flbroblastcells,
GF
S75725



mRNA, 1124 nt].


IL1R2

H. sapiens IL-1R2 mRNA for type II interleukin-1 receptor, (cell line CB23).

Cytokine
X59770


IL2RG
Human mRNA for interleukin 2 receptor gamma chain
Cytokine, Signal
D11086


ITGB2
Human leukocyte adhesion protein (LFA-1/Mac-1/p150.95 family) beta
Signal
M15395



subunit mRNA, CD18


LOC51189
ATPase inhibitor precursor
ATPase
AB029042


MADD

Homo sapiens MAP kinase-activating death domain protein (MADD) mRNA

Signal
U77352


MAFG

Homo sapiens basic-leucine zipper transcription factor MafG (MAFG),

oncogene, TF
AF059195



mRNA, complete cds


MAX

H. sapiens max mRNA

Signal
X60287


NFATC1
Human NF-ATc mRNA, complete cds
Signal, TF
U08015


NFATC3

Homo sapiens NF-AT4c mRNA, complete cds

Signal, TF
L41067


NME2
Human putative NDP kinase (nm23-H2S) mRNA, complete cds; c-myc
TF
M36981



purine-binding transcription factor puf


NR1H4
Human famesol receptor HRR-1 (HRR-1) mRNA, complete cds
NR1(FXR)
U68233


NRF

Homo sapiens transcription factor NRF

mitochondria &
NM_017544




stress


NTRK1
Human mRNA of transforming tyrosine kinase protein trk oncogene;
oncogene
X03541



high-affinity nerve growth factor receptor precursor;


PDAP1
Human PDGF associated protein mRNA (PAP)
GF
U41745


PDCD8

Homo sapiens apoptosis-inducing factor AIF mRNA, nuclear gene encoding

Signal
AF100928



mitochondrial protein; Programmed cell death 8


PGK1
phosphoglycerate kinase 1
polymerase
V00572


PIK3C3

H. sapiens mRNA for phosphatidylinositol 3-kinase,

Signal
Z46973



Phosphoinositide-3-kinase, class 3


PLCB4

Homo sapiens phospholipase C beta 4 (PLCB4) mRNA; Phospholipase C,

Signal
L41349



beta 4


POLR2B
polymerase (RNA) II (DNA directed) polypeptide B (140 kD)
polymerase
X63563


POLRMT
polymerase (RNA) mitochondrial (DNA directed)
polymerase
U75370


POU2F1
Human mRNA for octamer-binding protein Oct-1; POU domain, class 2,
TF
X13403



transcription factor 1


POU2F2
Human lymphoid-specific transcription factor mRNA; POU domain, class 2,
TF
M36542



transcription factor 2


PPARA
Human peroxisome proliferator activated receptor mRNA, complete cds
PPAR
L02932


PPARD
Human peroxisome proliferator activated receptor mRNA, complete cds
PPAR
L07592


PRKCBP1

Homo sapiens protein kinase C-binding protein RACK7 mRNA, partial cds;

Signal
U48251



Protein kinase C binding protein 1


PRKCH
Human protein kinase C-L (PRKCL) mRNA; Protein kinase C, eta
Signal
M55284


PRKCQ
Human protein kinase C theta (PKC) mRNA; Protein kinase C, theta
Signal
L07032


PSMC1
Proteasome (prosome, macropain) 26S subunit, ATPase, 1
ATPase
L02426


PTPN11

Homo sapiens SH-PTP3 mRNA for protein-tyrosine phosphatase: Protein

Signal
D13540



tyrosine phosphatase, non-receptor type 11; Shp2


PTPN6

H. sapiens PTP1C mRNA for protein-tyrosine phosphatase 1C.; Protein

Signal
X62055



tyrosine phosphatase, non-receptor type 6; SHP-1


PTPN7
Human mRNA for protein-tyrosine phosphatase; Protein tyrosine
Signal
D11327



phosphatase, non-receptor type 7, HePTP


RAB7L1

Homo sapiens mRNA for small GTP-binding protein, complete cds

oncogene
D84488


RASSF1

Homo sapiens putative tumor suppressor protein (RDA32) mRNA, complete

Supressor
AF061836



cds


RBBP2
RBP2 = retinoblastoma binding protein 2 [human, Nalm-6 pre-B cell leukemia,
Signal
S66431



mRNA, 6455 nt].


RDS
Retinal degeneration, slow (retinitis pigmentosa 7)
ATPase
M73531


RPA40
RNA polymerase I subunit
polymerase
AF008442


RXRG
Human retinoid X receptor-gamma mRNA, complete cds
RXR
U38480


SGK2

Homo sapiens serum/glucocorticoid regulated kinase 2

hyperosmotic stress
NM_016276


SLC35A1
solute carrier family 35 (CMP-sialic acid transporter), member 1
polymerase
D87969


SLC7A2

Homo sapiens solute carrier family 7 (cationic amino acid transporter, y+

hyperosmotic stress
NM_003046



system) member 2


ST14
Human SNC19 mRNA sequence Suppression of tumorigenicity 14 (colon
Supressor
U20428



carcinoma, matriptase, epithin)


STAT3

Homo sapiens DNA-binding protein (APRF) mRNA, complete cds

Signal, TF
L29277


STAT5

Homo sapiens signal transducer and activator of transcription (STAT5)

Signal, TF
L41142



mRNA


STAT5B
Human signal transducer and activator of transcription Stat5B mRNA,
TF
U47686



complete cds


STAT6
Human transcription factor IL-4 Stat mRNA, complete cds
Signal, TF
U16031


STIP1

Homo sapiens stress-induced-phosphoprotein 1 (Hsp70/Hsp90-organizing

stress
NM_006819



protein)


TAF2F
TATA box binding protein (TBP)-associated factor, RNA polymerase II, F,
polymerase, TF
U18062



55 kD


TCEB1
transcription elongation factor B (SIII), polypeptide 1 (15 kD, elongin C)
polymerase, TF
L34587


TCEB1L
transcription elongation factor B (SIII), polypeptide 1-like
polymerase, TF
Z47087


TCF15
Human basic helix-loop-helix transcription factor mRNA, complete cds
Signal, TF
U08336


TCF3
Human transcription factor (E2A) mRNA, complete cds
Signal, TF
M31523


TCF7L2

Homo sapiens mRNA for hTCF-4

Signal, TF
Y11306


TCFL1
Human YL-1 mRNA for YL-1 protein (nuclear protein with DNA-binding
Signal, TF
D43642



ability), complete cds


TFDP2
Human DP2 (Humdp2) mRNA; Transcription factor Dp-2 (E2F dimerization
TF
U18422



partner 2)


TGFB1
Human transforming growth factor-beta (TGF-beta; TGFB)
GF, Signal
X02812


TPST2

Homo sapiens tyrosylprotein sulfotransferase-2 mRNA

sulfotransferase
AF049891


TRA@
Human mRNA for T-cell receptor alpha chain (TCR-alpha),
Signal
X02592


TSSC1

Homo sapiens tumor suppressing STF cDNA 1 (TSSC1) mRNA, complete

Supressor
AF019952



cds


VAV1
Human mRNA for vav oncogene
oncogene, Signal
X16316


WISP2

Homo sapiens connective tissue growth factor related protein WISP-2

Signal
AF100780



(WISP2) mRNA, complete cds.
















TABLE 5










Changes in Hamilton scores before and after treatment










Before treatment
After treatment













#02
20
4


#04
26
25 


#05
25
9


#06
19
10 


#07
12
2


#10
16
3


#13
29
7


#14
19
5


#15
31
9


#16
27



#17
19
3


#29
28
8


#30
34
7


#31
15
3


#33
23
2







—: no data







EXAMPLE 2
Diagnosis of Depression Using Diagnostic Marker

The samples obtained from patients afflicted with depression and the samples obtained from healthy volunteers were employed to cluster the patients afflicted with depression and the healthy volunteers and to evaluate the course of treatment for the patients afflicted with depression.


1. Subjects


Three patients afflicted with depression and three healthy volunteers were employed as the subjects. Diagnosis was made in accordance with a depressive episode specified in the International Classification of Diseases, 10th revision (ICD-10). Patients with serious physical complications or those taking therapeutic agents for physical diseases were excluded. The samples obtained from 6 subjects were concealed whether they were patients afflicted with depression or healthy volunteers. Those samples were designated as Subjects A, B, C, D, E, and F.


2. Analysis of Gene Expression


Blood (5 ml) was collected from the subjects, and total RNA was extracted using a PAXgene Blood RNA System (Qiagen). The yield of total RNA was 5 μg to 15 μg. Subsequently, 5 μg of total RNA extracted from each subject was separated, annealed with an oligo (dT) 24 primer comprising a T7 promoter sequence added thereto, and first-strand DNA was synthesized. Thereafter, this first-strand DNA was used as a template to synthesize second-strand DNA having a T7 promoter sequence. Finally, the second-strand DNA was used as a template to synthesize RNA with the aid of T7 RNA polymerase. A random hexamer was annealed to 6 μg of RNA to conduct a reverse transcriptase reaction, and Cy5-dCTP was incorporated into the strand. Thus, fluorescence-labeled cDNA was synthesized.


For comparison, blood was collected from healthy volunteers having the same age and sex conditions with the subjects, and Cy3-cDNA was synthesized in the same manner as in the case of the patients' samples. Cy5-cDNA prepared from each subject's sample (6 μg) was mixed with the equivalent amount of Cy3-cDNA as a standard sample, the resultant was applied to a DNA chip (a DNA chip for analyzing drug response, Hitachi Co., Ltd.), and hybridization was carried out at 62° C. for 12 hours. After washing, fluorescence intensity at each spot was assayed using a scanner (ScanArray 5000, GSI-Lumonics), and the differences in the expression intensities of each gene between the standard sample and the sample obtained from the subject were determined using quantifying software (QuantArray, GSI-Lumonics).


3. Classification of Subjects


In accordance with the method described in Example 1, these 6 subjects were subjected to hierarchical clustering based on the cosine coefficient distance without a weight between clusters with the 33 subjects for patient/healthy volunteer comparison who had been already analyzed. This analysis demonstrated that Subjects D and E belonged to the PA group, Subject B belonged to the PB group, and Subjects A, C, and F did not belong to either group (FIG. 7). The concealed sample names were examined in relation to the results of clustering. This demonstrated that Subjects B, D, and E were patients afflicted with depression, and Subjects A, C, and F were healthy volunteers, which were completely consistent with the results of clustering.


4. Evaluation of Course of Treatment in Accordance with Type


Subsequently, the samples obtained from Subjects B, D, and E after treatment involving the use of antidepressants and the samples thereof before treatment were similarly subjected to analysis via DNA chips. The groups of genes listed in Table 3 were employed to observe changes in the gene expression patterns before and after treatment for Subjects D and E of the PA group. Similarly, the groups of genes listed in Table 4 were employed for Subject B of the PB group. After treatment, the gene expression patterns of all the patients were reversed from those before treatment. This indicates that the clinical conditions are in recovery trends (FIG. 8, FIG. 9).


5. Examination (Comparison with Hamilton Scaling)


The Hamilton scores of 3 patients afflicted with depression were as follows: Subject B: 22 points before treatment and 6 points after treatment; Subject D: 15 points before treatment and 1 point after treatment; and Subject E: 30 points before treatment and 2 points after treatment. Thus, the Hamilton scores were extremely consistent with the recovery trends of the clinical conditions indicated by the expression patterns of the groups of genes. Changes in the Hamilton scores before and after treatment are shown in Table 6.

TABLE 6Changes in Hamilton scores before and after treatmentBefore treatmentAfter treatmentSubject B302Subject D226Subject E151


6. Conclusion

As is apparent from the foregoing, diagnosis of depression via analysis of expression levels of a specific group of genes was extremely consistent with the results attained by clinical finding in terms of classification and evaluation of the course of treatment of patients afflicted with depression. This indicates that the present invention is very effective.


EXAMPLE 3
Selection of Diagnostic Marker

1. Patients and Healthy Volunteers


Target patients were those who had agreed with the written description for participating in the research for developing the present diagnostic method selected from among untreated patients afflicted with depression who had visited the Department of Psychiatry and Neurology of the Tokushima University Hospital between November 2001 and February 2004. This research was approved by the ethics committee of Tokushima University Hospital. Diagnosis was made in accordance with a depressive episode specified in the International Classification of Diseases, 10th revision (ICD-10). Patients with serious physical complications or those taking therapeutic agents for physical diseases were excluded. Healthy volunteers with the same sex and age conditions with each patient were selected for comparison.


Thirty two patients whose samples before treatment had been obtained were 20 males and 12 females aged 23 to 74 (45.1 years old on average), and their Hamilton scores were between 10 and 35 points (21.3 points on average).


Samples were obtained from 16 patients after the treatment. They were 9 males and 7 females aged 23 to 70 (47.5 years old on average), and their Hamilton scores were between I and 10 (4.3 points on average). Treatment was mainly carried out by medication using antidepressants. The remission of symptoms was determined based on general clinical diagnosis. After treatment, all the samples'satisfied the standard of having scores of 7 or less on the Hamilton Rating Scale, which are generally regarded as representing remission of symptoms, or the standard such that the Hamilton scores were reduced to half or less those before treatment. Thus, all the samples were determined to have reached the state of remission after treatment.


2. Analysis of Gene Expression


Blood (5 ml) was collected from the patients, and total RNA was extracted using a PAXgene Blood RNA System (Qiagen). Blood was collected by a doctor or nurse between 10:00 am and 1:00 pm from the patients under fasting conditions through cubitus veins under resting conditions. The yield of total RNA was 5 μg to 15 μg.


Subsequently, 5 μg of total RNA extracted from each patient was separated, annealed with an oligo (dT) 24 primer comprising a T7 promoter sequence added thereto, and first-strand DNA was synthesized. Thereafter, this first-strand DNA was used as a template to synthesize second-strand DNA having a T7 promoter sequence. Finally, the second-strand DNA was used as a template to synthesize RNA with the aid of T7 RNA polymerase. A random hexamer was annealed to 6 μg of the synthesized RNA to conduct a reverse transcriptase reaction, and Cy5-dCTP was incorporated into the strand. Thus, fluorescence-labeled cDNA was synthesized.


In a manner similar to the case of the patients, 5 ml of blood was collected from each of 32 healthy volunteers having the same sex and age conditions with the patients, and total RNA was then extracted. cDNA was similarly synthesized except for the use of Cy3 as a fluorescent label.


When comparing samples of a single subject before and after treatment, cDNA labeled with Cy3 and cDNA labeled with Cy5 were synthesized from the samples before and after treatment, respectively.


Equivalent amounts of two types of cDNAs for comparison and analysis were mixed, the resultant was applied to a DNA chip (Stress Chip, Hitachi Co., Ltd.), and hybridization was carried out at 62° C. for 12 hours. After washing, fluorescence intensity at each spot was assayed using a scanner (ScanArray 5000, GSI-Lumonics). Differences in gene expression levels between samples obtained from patients and samples obtained from healthy volunteers or those between samples obtained from a single patient before and after treatment were determined.


3. Data Analysis


(1) Selection of Marker Gene for Depression


A group of genes (801 genes) having fluorescence intensities of 300 or higher for Cy5 or Cy3 in all 48 groups of data was selected as the object of analysis. Among the data on patient/healthy volunteer comparison, the gene with a significantly higher or lower expression level was selected via a significant difference test. There were 14 genes of the patient with a significantly higher expression level compared to that of the healthy volunteer and 7 genes thereof with a significantly lower expression level (FIG. 14, Table 7). These 21 genes are useful for evaluating whether or not the subject has been afflicted with depression, i.e., they are useful as marker genes for depression. Among them, the expression levels of HLA-G, HRH4, PSMB9, ATP2A2, SCYA5, SLC6A4, CASP6, CSF2, HSD3B1, and RAB9 were significantly varied, and thus, they were considered to be particularly useful marker genes for depression.

TABLE 7Group of genes exhibiting significant differences between patient and healthyvolunteerSymbolNameCategoryGenBank IDHLA-GHLA-G histocompatibility antigen, class I, GM32800HRH4histamine H4 receptorNM_021624PSMB9proteasome (prosome, macropain) subunit, beta type, g (large multifunctionalBC008795protease 2)ATP2A2ATPase, Ca++ transporting, cardiac muscle, slow twitch 2ATPaseM23114SCYA5Human T cell-specific protein (RANTES) mRNA. Small inducible cytokine A5CytokineM21121SLC6A4solute carrier family 6 (neurotranamitter transporter, serotonin), member 4NM_001045CASP6Human cysteine protease Mch2 isoform alpha (Mch2) mRNA, complete cdsAppoptosis, SignalU20536CSF2Human T-cell granulocyte-macrophage colony stimulating factor (GM-CSF)Cytokine, SignalM10663mRNAHSD3B1Homo sapiens hydroxy-delta-5-steroid dehydrogenase, 3 beta- and steroidglucocorticoids (Cortisol)NM_000862delta-isomerase 1 (HSD3B1)RAB9Human small GTP binding protein Rab9 mRNA, complete cds,oncogeneU44103TPRH. sapiens tpr mRNA; Translocated promoter region (to activated METoncogeneX66397oncogene)ABCF1Homo sapiens TNF-alpha stimulated ABC protein (ABC50) mRNA, completeABC transporterAF027302cdsAKAP6Homo sapiens A kinase (PRKA) anchor protein 6 (AKAP6)SignalNM_004274PSMC5Proteasome (prosome, macropain) 26S subunit, ATPase, 5ATPaseAF035309Hs.14438Homo sapiens. Similar to histamine N-methyltransferase, clone MGC: 14500BC005907IMAGE: 4249496, mRNA, complete cdsKLK6kallikrein 6 (neurosin, zyme)AF013988STIP1Homo sapiens stress-induced-phosphoprotein 1 (Hsp70/Hsp90-organizingstressNM_006819protein)PGK1phosphoglycerate kinase 1polymeraseV00572PSMD5proteasome (prosome, macropain) 26S subunit, non-ATPase,5D31889TGFBR3Human transforming growth factor-beta type III receptor (TGF-beta) mRNA,GFL07594complete cdsTSSC1Homo sapiens tumor suppressing STF cDNA 1 (TSSC1) mRNA, complete cdsSupressorAF019952


(2) Selection of Marker Gene for Classification


Thirty two pairs of subjects for patient/healthy volunteer comparison were subjected to cluster analysis utilizing all the genes (801 genes). Analysis was carried out by hierarchical clustering based on the cosine coefficient distance without a weight between clusters. This cluster analysis demonstrated that the patient/healthy volunteer comparison samples were roughly divided into 2 groups. Such 2 groups were designated as the PA group and the PB group. The 32 pairs of subjects for patient/healthy volunteer comparison were divided into the PA group (16 pairs) and the PB group (16 pairs). In order to extract the genes that were peculiar to the PA group and to the PB group, these groups were compared to each other. There were 75 genes that exhibited significant differences between the PA group and the PB group (FIG. 15, Table 8). These 75 genes are useful for assigning patients afflicted with depression to the PA or PB group, i.e., they are useful as marker genes for classification the patients afflicted with depression. Among them, the expression levels of HSPE1, PSMA4, ADH5, PSMA6, COX17, HMG1, GPR24, COX6C, FGF2, and COX7C were significantly varied, and thus, they were considered to be particularly useful marker genes for classification.

TABLE 8Group of genes exhibiting significant differences between PA group and PBgroupSymbolNameCategoryGenBank IDHSPE1Human chaperonin 10 mRNA; Heat shock 10 kD protein 1hspU07550PSMA4proteasome (prosome, macropain) subunit, alpha type, 4BC005361ADH5Human alcohol dehydrogenase class III (ADH5) mRNAADHM29872PSMA6proteasome (prosome, macropain) subunit, alpha type 6X59417COX17Homo sapiens COX17 (yeast) homolog, cytochrome c oxidase assemblymitcondria & stressNM_005694proteinHMG1Human mRNA for high mobility group-1 protein (HMG-1).sulfotransferaseX12597GPR24G protein-coupled receptor 24BC001736COX6CHomo sapiens cytochrome c oxidase subunit VIc (COX6C), nuclear genemitcondria & stressNM_004374encoding mitochondrial proteinFGF2Human basic fibroblast growth factor (FGF) mRNA (BFGF; FGFB; FGF2)GFM27968COX7CHomo sapiens cytochrome c oxidase subunit VIIcmitcondria & stressNM_001867CCNA2Human mRNA for cyclin A; Cyclin A2CellCycleX51688PTGER3prostaglandin E receptor 3 (subtype EP3)X83860APG-1Homo sapiens mRNA for heat shock protein apg-1; Heat shock proteinhspAB023421(hsp110 family)HSPCAHomo sapiens Hsp89-alpha-delta-N mRNA; Heat shock 90 kD protein 1,hspAF028832alphaUBL1ubiquitin-like 1 (sentrin)Gap-juncitonU61397UCHL3Human ubiquitin carboxyl-terminal hydrolase (PGP 9.5, UCH-L3) isozymeesteraseM30496L3 mRNAHINTHomo sapiens protein kinase C inhibitor (PKCI-1) mRNA, Histidine triadSignalU51004nucleotide-binding proteinBDKRB2Homo sapiens bradykinin receptor B2heart stressNM_000623SOD1Homo sapiens superoxide dismutase 1, soluble (amyotrophic lateralSODNM_000454sclerosis 1 (adult)) (SOD1); Superoxide dismutase 1, soluble (amyotrophiclateral sclerosis 1 (adult))IL13RA2Human interleukin-13 receptor mRNA, complete cdsCytokineU70981HSBP1Homo sapiens heat shock factor binding protein 1 HSBP1 mRNA; HeathspAF068754shock factor binding protein 1EEF1A1Homo sapiens eukaryotic translation elongation factor 1 alpha 1 (EEF1A1)glucocorticoids (Cortisol)NM_001402PSMA7proteasome (prosome, macropain) subunit, alpha type, 7BC004427PSMA3proteasome (prosome, macropain) subunit, alpha type, 3BC005265UFD1LUbiquitin fusion degradation 1-likeBC005087CCNHHuman cyclin H mRNA, complete cdsCellCycleU11791ATP6JATPase, H+ transporting, lysosomal (vacuolar proton pump), member JATPaseAF038954HGFHuman hepatocyte growth factor mRNA (HGF); scatter factor (SF);GFM60718hepatopocitin APRDX4peroxiredoxin 4BC003609GZMAHuman Hanukah factor serine protease (HuHF) mRNA (cytotoxic/esteraseM18737T-lymphocyte-associated serine esterase 3)PSMD10proteasome (prosome, macropain) 265 subunit, non-ATPase, 10NM_002814COX7A2Homo sapiens cytochrome c oxidase subunit VIIa polypeptide 2 (liver)mitcondria & stressNM_001865(COX7A2), nuclear gene encoding mitochondrial proteinHSJ2Human heat shock protein, E. coli DnaJ homologue mRNA, complete cds;hspL08069Heat shock protein, DNAJ-like 2B2Mbeta-2-microglobulinAY007153TCEB1transcription elongation factor B (SIII), polypeptide 1 (15 kD, elongin C)polymerase, TFL34587HTR65-hydroxytryptamine (serotonin) receptor 6NM_000871TXNthioredoxinX77584HSPD1Heat shock 60 kD protein 1 (chaperonin)hspM34664PSMC6Proteasome (prosome, macropain) 26S subunit, ATPase, 6ATPaseAF006305POLR2Apolymerase (RNA) II (DNA directed) polypeptide A (220 kD); H. sapienspolymeraseX63564mRNA for RNA polymerase II largest subunitHSPA4Human heat shock protein 70 (hsp70) mRNA; Heat shock 70 kD protein 4hspL12723DAP3Human ionizing radiation resistance conferring protein mRNA; DeathAppoptosisU18321associated protein 3NME2Human putative NDP kinase (nm23-H2S) mRNA, complete cds; c-mycTFM36981purine-binding transcription factor pufCD86Human CD86 antigen mRNA, complete cdsSignalU04343IGBP1Immunoglobulin (CD79A) binding protein 1SignalY08915WISP3Homo sapiens connective tissue growth factor related protein WISP-3SignalAF100781(WISP3) mRNA, complete cds.COPS5Human Jun activation domain binding protein mRNA, complete cdsoncogeneU65928DBIdiazepam binding inhibitor (GABA receptor modulator, acyl-Coenzyme ABC006466binding protein)SCYA7Homo sapiens mRNA for monocyte chemotactic protein-3 (MCP-3). SmallCytokineX72308inducible cytokine A7 (monocyte chemotactic protein 3)NCOR2Human silencing mediator of retinoid and thyroid hormone action (SMRT)NRU37146mRNA. Nuclear receptor co-repressor 2PSMB1proteasome (prosome, macropain) subunit, beta type, 1BC000508DMBT1Homo sapiens mRNA for DMBT1 6 kb transcript variant 1 (DMBT1/6 kb.1).SupressorAJ000342POLR2HHuman RNA polymerase II subunit (hsRPB8) mRNA; polymerase (RNA) IIpolymeraseU37689(DNA directed) polypeptide HPSMA1proteasome (prosome, macropain) subunit, alpha type, 1BC002577PAPpoly(A) polymerasepolymeraseX76770HSPA10Homo sapiens heat shock 70 kD protein 10 (HSC71) (HSPA10), mRNAhspNM_006597PSMA5proteasome (prosome, macropain) subunit, alpha type, 5X61970P2Y5Homo sapiens purinergic receptor P2Y5 mRNASignalAF000546SLC35A1solute carrier family 35 (CMP-sialic acid transporter), member 1polymeraseD87969COX7BHomo sapiens cytochrome c oxidase subunit VIIbmitcondria & stressNM_001866HTR2A5-hydroxytryptamine (serotonin) receptor 2AX57830KLK12Homo sapiens kallikrein 12 (KLK12), mRNANM_019598Hs.351290Homo sapiens cDNA FLJ30648 fis, clone CTONG2006449, moderatelyAK055210similar to Drosophila melanogaster 26S proteasome regulatory complexsubunit p42A mRNAACEHomo sapiens dipeptidyl carboxypeptidase 1 (angiotensin I convertingangiotensinNM_000789enzyme) (ACE)NR1H4Human famesol receptor HRR-1 (HRR-1) mRNA, complete cdsNR1(FXR)U68233KIAA0107KIAA0107 gene productBC000904COX7A2LHomo sapiens cytochrome c oxidase subunit VIIa polypeptide 2 likemitcondria & stressNM_004718VCPvalosin-containing proteinBC007562RPA40RNA polymerase I subunitpolymeraseAF008442TXNLthioredoxin-like, 32 kDBC001156TAF2GTATA box binding protein (TBP)-associated factor, RNA polymerase II, G,polymerase, TFU2185832 kDTGFBR1Human activin receptor-like kinase (ALK-5) mRNA, complete cdsGF, SignalL11695DIA4Human, NAD(P)H: menadione oxidoreductase mRNANQOJ03934MAP2K3Human mRNA for MAP kinase kinase 3b complete cds, MEK3SignalD87116ATP5JDATP synthase, H+ transporting, mitochondrial F1F0, subunit dATPaseAF087135


(3) Selection of Diagnostic Marker Gene for Each Group


Based on the results attained above, 16 subjects for before/after treatment comparison were divided into the PA group (7 subjects) and the PB group (9 subjects). The data on patient/healthy volunteer comparison and the data on before/after treatment comparison were aligned for each patient in each group, and the data were compared and analyzed. The group of genes with reversed expression patterns between the data on patient/healthy volunteer comparison and the data on before/after treatment comparison was extracted (PA group: FIG. 16 (reversed patterns were clearly observed in 4 individuals), Table 9; PB group: FIG. 17, Table 10). Concerning the PA group, variation in expression levels of CLK1, PSMC6, TAF2F, P2Y5, CASP3, HSPCA, MSH2, SLC38A2, B2M, and AKAP11 were particularly significant among the genes listed in Table 9. Concerning the PB group, variation in expression levels of CCNA2, HGF, GPR24, PTGER3, COX7A2, BDKRB2, UFD1L, HMG1, PSMA4, and ATP6J were particularly significant among the genes listed in Table 10.

TABLE 9Group of genes exhibiting significant differences before and after treatment inPA groupSymbolNameCategoryGenBank IDCLK1Homo sapiens clk1 mRNA; CDC-like kinase 1CellCycleL29222PSMC6Proteasame (prosome, macropain) 26S subunit, ATPase, 6ATPaseAF006305TAF2FTATA box binding protein (TBP)-associated factor, RNA polymerase II, F, 55 kDpolymerase, TFU18062P2Y5Homo sapiens purinergic receptor P2Y5 mRNASignalAF000546CASP3Human cysteine protease CPP32 isoform alpha mRNA, complete cdsAppoptosis, SignalU13737HSPCAHomo sapiens Hsp89-alpha-delta-N mRNA; Heat shock 90 kD protein 1, alphahspAF028832MSH2Human DNA mismatch repair protein MSH2DNArepairU04045SLC38A2amino acid transporter 2AF259799B2Mbeta-2-microglobulinAY007153AKAP11A kinase (PRKA) anchor protein 11 (AKAP11); Homo sapiens mRNA forSignalAB014529KIAA0629 protein, partial cdsPSMA4proteasome (prosome, macropain) subunit, alpha type, 4BC005361EEFIA1Homo sapiens eukaryotic translation elongation factor 1 alpha 1 (EEF1A1)glucocorticoidsNM_001402(Cortisol)MAP2K6Human MAP kinase kinase 6 mRNA, complete cds; MEK6SignalU39064BMI1Human prot-oncogene (BMI-1) mRNA, complete cdsoncogeneL13689GABPB1Homo sapiens GA-binding protein transcription factor, beta subunit 1 (53 kD);mitcondria & stressNM_005254nuclear respiratory factor-2PTPRCHuman mRNA for T200 leukocyte common antigen (CD45, LC-A).SignalY00062TNFRSF6H. sapiens mRNA for APO-1 cell surface antigen, FASAppoptosis, Cytokine,X63717SignalFGF2Human basic fibroblast growth factor (FGF) mRNA (BFGF; FGFB; FGF2)GFM27968GJA4gap junction protein, alpha 4, 37 kD (connexin 37)Gap-juncitonM96789BCL2Human bcl-2 mRNA; apoptosis regulator bcl2oncogene, SignalM14745SMARCA3SWI/SNF related, matrix associated, actin dependent regulator of chromatin,ATPaseZ46606subfamily a, member 3IFIT1Human mRNA for 56-KDa protein induced by interferonCytokineX03557IFNGR1Human interferon-gamma receptor mRNA, complete cdsCytokine, SignalJ03143FCER1AHuman mRNA for high affinity IgE receptor alpha-subunit (FcERI); Pc fragmentSignalX06948of IgE, high affinity I, receptor for; alpha polypeptideGNG2Homo sapiens clone FLB4307 PRO1107 mRNASignalAF130106E2F3Homo sapiens E2F transcription factor 3(E2F3)TFY10479IL8Human beta-thromboglobulin-like protein mRNA, complete cdsCytokine, SignalM17017FRAT1Homo sapiens frequently rearranged in advanced T-cell lymphomas (FRAT1)SignalNM_005479mRNACOX17Homo sapiens COX17 (yeast) homolog, cytochrome c oxidase assembly proteinmitcondria & stressNM_005694GZMAHuman Hanukah factor serine protease (HuHF) mRNA (cytotoxicesteraseM18737T-lymphocyte-associated serine esterase 3)CDC10hCDC10 = CDC10 homolog [human, fetal lung, mRNA, 2314 nt].CellCycleS72008ADH5Human alcohol dehydrogenase class II (ADH5) mRNAADHM29872API1Human inhibitor of apoptosis protein 2 mRNA; Apoptosis inhibitor 1Appoptosis, SignalU45879PPP3CBHuman calcineurin A2 mRNA;SignalM29551GNG10Human G protein gamma-10 subunit mRNA; Guanine nucleotide binding proteinSignalU3138310MAP3K7Homo sapiens mitogen-activated protein kinase kinase kinase 7 (MAP3K7),SignalNM_003188mRNA, TAK1POLBpolymerase (DNA directed), betapolymeraseD29013NR3C1Human glucocorticoid receptor alpha mRNA, complete cdsglucocorticoidsM10901(Cortisol)ITGB1Integrin, beta 1 (fibronectin receptor, beta polypeptide, antigen CD29 includesSignalX07979MDF2, MSK12);COX6CHomo sapiens cytochrome c oxidase subunit VIc (COX6C), nuclear genemitcondria & stressNM_004374encoding mitochondrial proteinHSJ2Human heat shock protein, E. coli DnaJ homologue mRNA, complete cds; HeathspL08069shock protein, DNAJ-like 2AHRHuman AH-receptor mRNA, complete cdsAh receptorL19872TAF2GTATA box binding protein (TBP)-associated factor, RNA polymerase II, G, 32 kDpolymerase, TFU21858IL1R2H. sapiens IL-1R2 mRNA for type II interleukin-1 receptor, (cell line CB23).CytokineX59770









TABLE 10










Group of genes exhibiting significant differences before and after treatment in


PB group










Symbol
Name
Category
GenBank ID





CCNA2
Human mRNA for cyclin A; Cyclin A2
CellCycle
X51688


HGF
Human hepatocyte growth factor mRNA (HGF); scatter factor (SF);
GF
M60718



hepatopoeitin A


GPR24
G protein-coupled receptor 24

BC001736


PTGER3
prostaglandin E receptor 3 (subtype EP3)

X83860


COX7A2

Homo sapiens cytochrome c oxidase subunit VIIa polypeptide 2 (liver)

mitcondria & stress
NM_001865



COX7A2), nuclear gene encoding mitochondrial protein


BDKRB2

Homo sapiens bradykinin receptor B2

heart stress
NM_000623


UFD1L
Ubiquitin fusion degradation 1-like

BC005087


HMG1
Human mRNA for high mobility group-1 protein (HMG-1).
sulfotransferase
X12597


PSMA4
proteasome (prosome, macropain) subunit, alpha type, 4

BC005361


ATP6J
ATPase, H+ transporting, lysosomal (vacuolar proton pump), member J
ATPase
AF038954


HSPE1
Human chaperonin 10 mRNA; Heat shock 10 kD protein 1
hsp
U07550


IL13RA2
Human interleukin-13 receptor mRNA, complete cds
Cytokine
U70981


COX17

Homo sapiens COX17 (yeast) homolog, cytochrome c oxidase assembly

mitcondria & stress
NM_005694



protein


TSSC1

Homo sapiens tumor suppressing STF cDNA 1 (TSSC1) mRNA, complete

Supressor
AF019952



cds


PSMA7
proteasome (prosome, macropain) subunit, alpha type, 7

BC004427


ATP5J2
ATP synthase, H+ transporting, mitochondrial F0 complex, subunit f,
ATPase
AF047436



isoform 2


POLE
polymerase (DNA directed), epsilon
polymerase
L09561


HTR6
5-hydroxytryptamine (serotonin) receptor 6

NM_000871


APG-1

Homo sapiens mRNA for heat shock protein apg-1; Heat shock protein

hsp
AB023421



(hsp110 family)


CASP4
Human cysteine protease (ICErel-II) mRNA, complete cds
Appoptosis
U28014


HSPCA

Homo sapiens Hsp89-alpha-delta-N mRNA; Heat shock 90 kD protein 1,

hsp
AF028832



alpha


FGF2
Human basic fibroblast growth factor (FGF) mRNA (BFGF; FGFB; FGF2)
GF
M27968


ADH5
Human alcohol dehydrogenase class III (ADH5) mRNA
ADH
M29872


PSMA6
proteasome (prosome, macropain) subunit, alpha type 6

X59417


CCNH
Human cyclin H mRNA, complete cds
CellCycle
U11791


COX7C

Homo sapiens cytochrome c oxidase subunit VIIc

mitcondria & stress
NM_001867


SOD1

Homo sapiens superoxide dismutase 1, soluble (amyotrophic lateral

SOD
NM_000454



sclerosis 1 (adult)) (SOD1); Superoxide dismutase 1, soluble (amyotrophic



lateral sclerosis 1 (adult))


HTR2A
5-hydroxytryptamine (serotonin) receptor 2A

X57830


HSJ2
Human heat shock protein, E. coli DnaJ homologue mRNA, complete cds;
hsp
L08069



Heat shock protein, DNAJ-like 2


DAP3
Human ionizing radiation resistance conferring protein mRNA; Death
Appoptosis
U18321



associated protein 3


UCHL3
Human ubiquitin carboxyl-terminal hydrolase (PGP 9.5, UCH-L3) isozyme
esterase
M30496



L3 mRNA


CREBBP
Human CREB-binding protein (CBP) mRNA, complete cds
ATF/CREB
U47741


GSTTLp28
glutathione-S-transferase like; glutathione transferase omega

BC000127


PSMA3
proteasome (prosome, macropain) subunit, alpha type, 3

BC005265


UBL1
ubiquitin-like 1 (sentrin)
Gap-junciton
U61397


HSBP1

Homo sapiens heat shock factor binding protein 1 HSBP1 mRNA; Heat

hsp
AF068754



shock factor binding protein 1


NME2
Human putative NDP kinase (nm23-H2S) mRNA, complete cds; c-myc
TF
M36981



purine-binding transcription factor puf


PRDX4
peroxiredoxin 4

BC003609


COX4

Homo sapiens cytochrome c oxidase subunit IV (COX4), nuclear gene

mitcondria & stress
NM_001861



encoding mitochondrial protein


TGFBR1
Human activin receptor-like kinase (ALK-5) mRNA, complete cds
GF, Signal
L11695


PSMB7
proteasome (prosome, macropain) subunit, beta type, 7

BC000509


COX6C

Homo sapiens cytochrome c oxidase subunit VIc (COX6C), nuclear gene

mitcondria & stress
NM_004374



encoding mitochondrial protein


GABRR2
gamma-aminobutyric acid (GABA) receptor, rho 2

NM_002043


CASP5
Human cysteine protease (ICErel-III) mRNA, complete cds
Appoptosis
U28015


POLR2H
Human RNA polymerase II subunit (hsRPB8) mRNA; polymerase (RNA) II
polymerase
U37689



(DNA directed) polypeptide H


PSMB4
proteasome (prosome, macropain) subunit, beta type, 4

S71381


PSMB1
proteasome (prosome, macropain) subunit, beta type, 1

BC000508


HSPD1
Heat shock 60 kD protein 1 (chaperonin)
hsp
M34664


ESD

Homo sapiens esterase D mRNA

esterase
AF112219


WISP3

Homo sapiens connective tissue growth factor related protein WISP-3

Signal
AF100781



(WISP3) mRNA, complete cds,


ATP5JD
ATP synthase, H+ transporting, mitochondrial F1F0, subunit d
ATPase
AF087135









INDUSTRIAL APPLICABILITY

The method according to the present invention is a useful method for objectively diagnosing depression or evaluating the course of treatment for patients afflicted with depression in clinical settings.

Claims
  • 1. A method of diagnosing depression, wherein gene expression is analyzed using mRNA of a subject's peripheral blood to evaluate whether or not the subject is afflicted with depression, the type of depression of a subject who had been evaluated as being afflicted with depression is identified, and the conditions of depression are then diagnosed in accordance with the type of depression.
  • 2. The method of diagnosing depression according to claim 1, wherein the expression profiles of the marker gene for depression selected from among the genes listed in Table 1 are employed to evaluate whether or not a subject is afflicted with depression and the expression profiles of the marker gene for classification selected from among the genes listed in Table 2 are employed to identify the type of depression to be type PA or PB.
  • 3. The method of diagnosing depression according to claim 2, wherein the marker gene for depression includes at least ATP2A2, SCYA5, STIP1, EEF1A1, GRB10, CASP6, TSSC1, RAB9, NFATC3, and TPR listed in Table 1 and the marker gene for classification includes at least GNG10, CLK1, P2Y5, IFNGR1, TAF2F, PIM1, MAP2K3, HDGF, INSR, and COX6C listed in Table 2.
  • 4. The method of diagnosing depression according to claim 2, wherein the expression profiles of the marker gene for diagnosing type PA depression selected from among the genes listed in Table 3 are employed to diagnose the conditions of the type PA depression and the expression profiles of the marker gene for diagnosing type PB depression selected from among the genes listed in Table 4 are employed to diagnose the conditions of the type PB depression.
  • 5. The method of diagnosing depression according to claim 4, wherein the marker gene for diagnosing type PA depression includes at least CDC10, GZMA, TNFRSF6, HSPCA, NR3C1, TOPBP1, ARNTL, RAP1A, POLR2B, and ITGB1 listed in Table 3 and the marker gene for diagnosing type PB depression includes at least POU2F2, BCL2L1, DAXX, COX4, CD3GG, FCERIG, NME2, CPT1B, HSPE1, and COX7A2 listed in Table 4.
  • 6. The method of diagnosing depression according to claim 1, wherein the course of treating a single subject is evaluated by comparing and analyzing the gene expression profiles of the subject before and after the treatment.
  • 7. The method of diagnosing depression according to claim 1, wherein the gene expression analysis is carried out using DNA-immobilized solid substrates including chips, arrays, membrane filters, and capillaries.
  • 8. The method of diagnosing depression according to claim 1, wherein the expression profiles of the marker gene for depression selected from among the genes listed in Table 7 are employed to evaluate whether or not a subject is afflicted with depression and the expression profiles of the marker gene for classification selected from among the genes listed in Table 8 are employed to identify the type of depression to be type PA or PB.
  • 9. The method of diagnosing depression according to claim 8, wherein the marker gene for depression includes at least HLA-G, HRH4, PSMB9, ATP2A2, SCYA5, SLC6A4, CASP6, CSF2, HSD3B1, and RAB9 and the marker gene for classification includes at least HSPE1, PSMA4, ADH5, PSMA6, COX17, HMG1, GPR24, COX6C, FGF2, and COX7C.
  • 10. The method of diagnosing depression according to claim 9, wherein the expression profile of the marker gene for diagnosing type PA depression selected from among the genes listed in Table 9 are employed to diagnose the conditions of the type PA depression and the expression profile of the marker gene for diagnosing type PB depression selected from among the genes listed in Table 10 are employed to diagnose the conditions of the type PB depression.
  • 11. The method of diagnosing depression according to claim 10, wherein the marker gene for diagnosing type PA depression includes at least CLK1, PSMC6, TAF2F, P2Y5, CASP3, HSPCA, MSH2, SLC38A2, B2M, and AKAP11 and the marker gene for diagnosing type PB depression includes at least CCNA2, HGF, GPR24, PTGER3, COX7A2, BDKRB2, UFD1L, HMG1, PSMA4, and ATP6J.
  • 12. A solid substrate for diagnosing depression having immobilized thereon probes each independently specifically hybridize to any one of the genes listed in Tables 1 to 4 or the genes listed in Tables 7 to 10 for detecting the target gene.
  • 13. A solid substrate for diagnosing depression according to claim 12 having immobilized thereon probes each independently specifically hybridize to any one of the genes listed in Tables 1 to 4 for detecting the target gene, wherein the genes at least include ATP2A2, SCYA5, STIP1, EEF1A1, GRB10, CASP6, TSSC1, RAB9, NFATC3, and TPR listed in Table 1, GNG10, CLK1, P2Y5, IFNGR1, TAF2F, PIM1, MAP2K3, HDGF, INSR, and COX6C listed in Table 2, CDC10, GZMA, TNFRSF6, HSPCA, NR3C1, TOPBP1, ARNTL, RAP1A, POLR2B, and ITGB1 listed in Table 3, and POU2F2, BCL2L1, DAXX, COX4, CD3Q FCER1, NME2, CPT1B, HSPE1, and COX7A2 listed in Table 4.
  • 14. A solid substrate for diagnosing depression according to claim 12 having immobilized thereon probes each independently specifically hybridize to any one of the genes listed in Tables 7 to 10 for detecting the target gene, wherein the genes at least include HLA-G, HRH4, PSMB9, ATP2A2, SCYA5, SLC6A4, CASP6, CSF2, HSD3B1, and RAB9 listed in Table 7, HSPE1, PSMA4, ADH5, PSMA6, COX17, HMG1, GPR24, COX6C, FGF2, and COX7C listed in Table 8, CLK1, PSMC6, TAF2F, P2Y5, CASP3, HSPCA, MSH2, SLC38A2, B2M, and AKAP11 listed in Table 9, and CCNA2, HGF, GPR24, PTGER3, COX7A2, BDKRB2, UFD1L, HMG1, PSMA4, and ATP6J listed in Table 10.
  • 15. A system for diagnosing depression for performing the method of diagnosing depression according to claim 1, which comprises a means for comparing and analyzing the gene expression data of a subject with that of a healthy volunteer and of a patient afflicted with depression, which had been previously obtained, and diagnoses the conditions of depression of the subject in accordance with the type of depression.
  • 16. The system for diagnosing depression according to claim 15, which further comprises a means of comparing and analyzing the gene expression data of a subject, of a healthy volunteer, and of a patient afflicted with depression in combination with the data concerning their age and sex.
Priority Claims (2)
Number Date Country Kind
2004-96068 Mar 2004 JP national
2005-42534 Feb 2005 JP national