Morphological alterations in the brains of schizophrenia patients suggest that neurodevelopmental dysfunction is involved in the etiology of the disease. 1 Such dysfunction may be due to functional alterations of cell adhesion molecules, which play important roles in cell migration, axonal growth, fasciculation, synaptogenesis, and synaptic remodeling. We screened for mutations in the coding region of the close homologue to L1 gene (CHL1), which is located on human chromosome 3p26, in 24 Japanese patients with schizophrenia. A missense polymorphism (Leu17Phe) in the signal peptide region was identified. A case-control comparison revealed significantly higher frequencies of the Leu/Leu genotype (P = 0.004) and the Leu allele (P = 0.006) in 282 Japanese schizophrenic patients than in 229 Japanese control subjects. The estimated odds ratio for schizophrenia was 1.83 (95% CI, 1.28-2.26) for the Leu/Leu genotype compared with the other genotypes. An association between this CHL1 gene polymorphism and schizophrenia supports the notion that cell adhesion molecules are involved in the etiology of schizophrenia. Molecular Psychiatry (2002) 7, 412-415. DOI: 10.1038/ sj/mp/4000973Cell adhesion molecules (CAMs) play important roles in specifying cell-cell interactions during development, regeneration, and modification of synaptic activity. In humans, mutations in the L1 cell adhesion molecule (L1CAM) are associated with a neurological syndrome termed CRASH, which includes corpus callosum agenesis, mental retardation, adducted thumbs, spasticity, hydrocephalus, and a wide spectrum of other clinical features. A mouse model with null mutation in the L1CAM gene suggests roles for L1CAM in the mechanism of cortical dendrite differentiation as well as in guidance of callosal axons and regulation of hippocampal development. 2 An abnormality in expression of one of the CAMs could result in the histologic abnormalities observed in the brains of individuals with schizophrenia. 3 Increased neural CAM (NCAM) and decreased L1CAM immunoreactivities have been observed in the cerebrospinal fluid (CSF) of schizophrenic patients in comparison to immunoreactivities in normal control subjects. 4,5 A selective increase in levels of 105-to 115-kDa NCAM in the hippocampi and prefrontal cortices of patients with schizophrenia was found, though levels of other NCAMs and L1CAM were not altered. 6,7 Since NCAMs function can be impaired by viral neuroaminidase associated with maternal influenza infection during embryonic development, 8 and since increased CSF NCAM and decreased CSF L1CAM levels were found in affected but not non-affected twins in a study of monozygotic discordant twins, the changes in NCAMs observed in schizophrenia may not contribute to the genetic predisposition to schizophrenia. 4 However, schizophrenia is known to have a genetic component, and a cohort study suggested an interaction between genetic risk for schizophrenia and obstetric complications. 9,10 It is possible that mutations in the genes encoding CAMs are part of the gene...