More recently, exome sequencing studies have permitted the evaluation of de novo SNV mutations and indels in schizophrenia. In contrast to studies of de novo CNVs in schizophrenia, the exome-wide rate of de novo SNV/indel mutations is not increased in cases compared with the population expectation [ 11••]. Some smaller studies have reported slightly elevated rates of de novo SNV mutations, as well as a greater proportion of de novo mutations occurring as nonsynonymous, in schizophrenia compared with controls

[ 12, 13 and 14], but these findings were not observed in the largest study till date [ 11••]. However, loss-of-function de novo SNV/indel mutations are enriched among patients with poor educational attainment (these cases did

not have intellectual disability) [ 11••]. Multiple schizophrenia loss-of-function de novo SNV/indel NU7441 mutations have selleck compound been observed in two genes (TAF13, SETD1A) [ 11•• and 15], suggesting they are likely to be relevant to the disorder. The products of genes disrupted by damaging de novo mutations in schizophrenia show greater connectivity in protein–protein interaction (PPI) networks than expected by chance [ 13] or compared with controls [ 14]. Genes disrupted by nonsense de novo mutations in schizophrenia have also been shown to preferentially occur in genes subject to haploinsufficiency [ 12], suggesting many are likely to be pathogenic. Despite the lack of an increased exome-wide rate of de novo SNV/indel mutation in schizophrenia, these mutations are enriched among cases in previously associated sets of biologically related genes. Specifically, the ARC and NMDAR postsynaptic protein complexes, associated with schizophrenia in studies Progesterone of de novo CNVs, have been further implicated through significant enrichments in cases for nonsynonymous and loss-of-function de novo mutations

[ 11••]. Brain expressed genes targeted by fragile X mental retardation protein (FMRP) also show evidence for significant enrichments of de novo SNV/indel mutations in schizophrenia [ 11••] following an earlier observation for a similar enrichment for de novo mutations in ASD [ 16]. Other sets reported to be enriched for de novo mutations include those related to the assembly of actin filament bundles [ 11••], genes related to epigenetic regulation, specifically chromatin-remodelling [ 12, 13 and 15], and genes disrupted by de novo mutations in ASD and intellectual disability (ID) [ 11••]. Studies of rare (<1%) CNVs in schizophrenia have now reported several reproducible associations. It is established that patients with schizophrenia have a significantly increased genome-wide burden of rare CNVs compared with controls, with the strongest effect usually seen for large (>500 Kb) deletions [17, 18, 19 and 20].