Major depressive disorder (MDD) is a common complex trait with enormous public health significance. As part of the Genetic Association Information Network (GAIN) initiative of the US Foundation for the National Institutes of Health, we conducted a genomewide association study of 435,291 SNPs genotyped in 1,738 MDD cases and 1,802 controls selected to be at low liability for MDD. Eleven of the top 200 signals localized to a 167 kb region overlapping the gene piccolo (PCLO, whose protein product localizes to the cytomatrix of the presynaptic active zone and plays an important role in monoaminergic neurotransmission in the brain) with p-values of 7.7×10−7 for rs2715148 and 1.2×10−6 for rs2522833. We undertook replication of SNPs in this region in 5 independent samples (6,079 MDD independent cases and 5,893 controls) but no SNP exceeded the replication significance threshold when all replication samples were analyzed together. However, there was heterogeneity in the replication samples, and secondary analysis of the original sample with the sample of greatest similarity yielded p=6.4×10−8 for the non-synonymous SNP rs2522833 that gives rise to a serine to alanine substitution near a C2 calcium-binding-domain of the PCLO protein. With the integrated replication effort, we present a specific hypothesis for further studies.

Introduction Cobalamin (vitamin B 12 ) is a coenzyme for the enzymes of intermediate metabolism, methionine synthase, and methylmalonyl-CoA mutase, and deficiency of the vitamin leads to potentially lethal manifestations such as megaloblastic anemia and severe combined degeneration of the central nervous system. Cobalamin deficiency, which is one of the most common vitamin-deficiency diseases, is most often due to failure at a step in the complicated and highly specific gastrointestinal uptake mechanisms for dietary cobalamin rather than an insufficient supply from food. 1 Intrinsic factor (IF) is a glycoprotein produced in the gastric epithelium. It tightly binds to cobalamin in the gastrointestestinal tract, and in the distal small intestine the IF-cobalamin complex is recognized by cubilin, a multiligand apical membrane protein that participates in endocytosis of the complex. 2,3 IF is subsequently degraded in enterocyte lysosomes, and cobalamin is secreted into plasma in complex with transcobalamin-II. 4 Cubilin is a large membrane protein (460 kDa) with a unique set of extracellular protein modules comprising 8 tandem epidermal growth factor domains followed by 27 tandem CUB domains (initially found in complement components C1r/C1s, Uegf, and bone morphogenic protein-1) harboring the IF-cobalamin binding site (CUB domains 5-8). 5,6 Although cubilin has no apparent transmembrane segment or cytoplasmic tail, several studies have shown that binding of IF-cobalamin to cubilin leads to endocytosis of the ligand and recycling of the receptor. 2,3 Besides expression and function in the intestine, cubilin has many-fold higher expression in the apical membrane of kidney proximal tubule and rodent yolk sac epithelial cells. 2,3,7,8 Consistent with this pattern of expression, cubilin is involved in reabsorption of several specific nutrient-carrying proteins from renal glomerular filtrate, including albumin, 9 transferrin, 10 vitamin D-binding protein, 11 and apolipoprotein AI, 12,13 and cubilin has a crucial but not-yet-defined role in early embryonic development of rodents. 14 Evidence to date indicates that the mechanism of cubilin-mediated endocytosis is the same in the various cubilin-expressing epithelia. 2 Accordingly, IF-cobalamin is effectively endocytosed in a cubilin-dependent manner in the proximal tubule 15 and yolk sac, 16 and because these tissues have higher density of cubilin in apical membranes and less luminal proteolytic activity than intestine, they have been the preferred tissues for studying cubilin function. 2,8,[14][15][16] However, it should be noted that ligands other than IF-cobalamin are likely to be physiologically more important in the kidney and yolk sac because little or no gastric IF circulates in plasma. An Inside Blood analysis of this article appears in the front of this issue.Reprints: Søren K. Moestrup, Institute of Medical Biochemistry, University of Aarhus, 8000 Aarhus C, Denmark; e-mail: skm@biobase.dk.The publication costs of this article were defrayed in part by page charge ...

BACKGROUNDPatients with metastatic sarcomas have poor outcomes and although the disease may be amenable to immunotherapies, information regarding the immunologic profiles of soft tissue sarcoma (STS) subtypes is limited.METHODSThe authors identified patients with the common STS subtypes: leiomyosarcoma, undifferentiated pleomorphic sarcoma (UPS), synovial sarcoma (SS), well‐differentiated/dedifferentiated liposarcoma, and myxoid/round cell liposarcoma. Gene expression, immunohistochemistry for programmed cell death protein (PD‐1) and programmed death‐ligand 1 (PD‐L1), and T‐cell receptor Vβ gene sequencing were performed on formalin‐fixed, paraffin‐embedded tumors from 81 patients. Differences in liposarcoma subsets also were evaluated.RESULTSUPS and leiomyosarcoma had high expression levels of genes related to antigen presentation and T‐cell infiltration. UPS were found to have higher levels of PD‐L1 (P≤.001) and PD‐1 (P≤.05) on immunohistochemistry and had the highest T‐cell infiltration based on T‐cell receptor sequencing, significantly more than SS, which had the lowest (P≤.05). T‐cell infiltrates in UPS also were more oligoclonal compared with SS and liposarcoma (P≤.05). A model adjusted for STS histologic subtype found that for all sarcomas, T‐cell infiltration and clonality were highly correlated with PD‐1 and PD‐L1 expression levels (P≤.01).CONCLUSIONSIn the current study, the authors provide the most detailed overview of the immune microenvironment in sarcoma subtypes to date. UPS, which is a more highly mutated STS subtype, provokes a substantial immune response, suggesting that it may be well suited to treatment with immune checkpoint inhibitors. The SS and liposarcoma subsets are less mutated but do express immunogenic self‐antigens, and therefore strategies to improve antigen presentation and T‐cell infiltration may allow for successful immunotherapy in patients with these diagnoses. Cancer 2017;123:3291‐304. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.