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1.
JCI Insight ; 9(8)2024 Apr 22.
Article in English | MEDLINE | ID: mdl-38646933

ABSTRACT

Inherited retinal dystrophies (IRDs) are progressive diseases leading to vision loss. Mutation in the eyes shut homolog (EYS) gene is one of the most frequent causes of IRD. However, the mechanism of photoreceptor cell degeneration by mutant EYS has not been fully elucidated. Here, we generated retinal organoids from induced pluripotent stem cells (iPSCs) derived from patients with EYS-associated retinal dystrophy (EYS-RD). In photoreceptor cells of RD organoids, both EYS and G protein-coupled receptor kinase 7 (GRK7), one of the proteins handling phototoxicity, were not in the outer segment, where they are physiologically present. Furthermore, photoreceptor cells in RD organoids were vulnerable to light stimuli, and especially to blue light. Mislocalization of GRK7, which was also observed in eys-knockout zebrafish, was reversed by delivering control EYS into photoreceptor cells of RD organoids. These findings suggest that avoiding phototoxicity would be a potential therapeutic approach for EYS-RD.


Subject(s)
Induced Pluripotent Stem Cells , Organoids , Retinal Dystrophies , Zebrafish , Animals , Humans , Eye Proteins/genetics , Eye Proteins/metabolism , Induced Pluripotent Stem Cells/metabolism , Light/adverse effects , Mutation , Organoids/metabolism , Retina/metabolism , Retina/pathology , Retinal Dystrophies/therapy , Retinal Dystrophies/genetics , Retinal Dystrophies/metabolism
2.
Mol Brain ; 17(1): 14, 2024 Mar 05.
Article in English | MEDLINE | ID: mdl-38444039

ABSTRACT

Synucleinopathies refer to a group of disorders characterized by SNCA/α-synuclein (α-Syn)-containing cytoplasmic inclusions and neuronal cell loss in the nervous system including the cortex, a common feature being cognitive impairment. Still, the molecular pathogenesis of cognitive decline remains poorly understood, hampering the development of effective treatments. Here, we generated induced pluripotent stem cells (iPSCs) derived from familial Parkinson's disease (PD) patients carrying SNCA A53T mutation, differentiating them into cortical neurons by a direct conversion method. Patient iPSCs-derived cortical neurons harboring mutant α-Syn exhibited increased α-Syn-positive aggregates, shorter neurites, and time-dependent vulnerability. Furthermore, RNA-sequencing analysis, followed by biochemical validation, identified the activation of the ERK1/2 and JNK cascades in cortical neurons with SNCA A53T mutation. This result was consistent with a reverted phenotype of neuronal death in cortical neurons when treated with ERK1/2 and JNK inhibitors, respectively. Our findings emphasize the role of ERK1/2 and JNK cascades in the vulnerability of cortical neurons in synucleinopathies, and they could pave the way toward therapeutic advancements for synucleinopathies.


Subject(s)
Synucleinopathies , alpha-Synuclein , Humans , MAP Kinase Signaling System , Neurons , Neurites
3.
J Cell Mol Med ; 28(7): e18214, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38509731

ABSTRACT

The majority of the population of glial cells in the central nervous system consists of astrocytes, and impairment of astrocytes causes various disorders. It is useful to assess the multiple astrocytic properties in order to understand their complex roles in the pathophysiology. Although we can differentiate human astrocytes from induced pluripotent stem cells (iPSCs), it remains unknown how we can analyse and reveal the multiple properties of astrocytes in complexed human disease conditions. For this purpose, we tested astrocytic differentiation protocols from feeder-free iPSCs based on the previous method with some modifications. Then, we set up extra- and intracellular assessments of iPSC-derived astrocytes by testing cytokine release, calcium influx, autophagy induction and migration. The results led us to analytic methods with conditions in which iPSC-derived astrocytes behave as in vivo. Finally, we applied these methods for modelling an astrocyte-related disease, Alexander disease. An analytic system using iPSC-derived astrocytes could be used to recapture complexities in human astrocyte diseases.


Subject(s)
Astrocytes , Induced Pluripotent Stem Cells , Humans , Cells, Cultured , Neurogenesis , Cytokines , Cell Differentiation
4.
Lab Invest ; 103(2): 100013, 2023 02.
Article in English | MEDLINE | ID: mdl-37039150

ABSTRACT

Amyotrophic lateral sclerosis (ALS) causes progressive degeneration of the motor neurons. In this study, we delivered the genetic construct including the whole locus of human mutant superoxide dismutase 1 (SOD1) with the promoter region of human SOD1 into porcine zygotes using intracytoplasmic sperm injection-mediated gene transfer, and we thereby generated a pig model of human mutant SOD1-mediated familial ALS. The established ALS pig model exhibited an initial abnormality of motor neurons with accumulated misfolded SOD1. The ALS pig model, with a body size similar to that of human beings, will provide opportunities for cell and gene therapy platforms in preclinical translational research.


Subject(s)
Amyotrophic Lateral Sclerosis , Superoxide Dismutase-1 , Animals , Humans , Male , Amyotrophic Lateral Sclerosis/genetics , Amyotrophic Lateral Sclerosis/pathology , Disease Models, Animal , Motor Neurons/pathology , Mutation , Semen , Superoxide Dismutase-1/genetics , Swine
5.
Sci Rep ; 12(1): 7988, 2022 05 14.
Article in English | MEDLINE | ID: mdl-35568729

ABSTRACT

Dyslipidemia is considered an essential component of the pathological process of amyotrophic lateral sclerosis (ALS), a fatal motor neuron disease. Although TAR DNA Binding Protein 43 kDa (TDP-43) links both familial and sporadic forms of ALS and cytoplasmic aggregates are a hallmark of most cases of ALS, the molecular mechanism and the in vivo relation of ALS dyslipidemia with TDP-43 have been unclear. To analyze the dyslipidemia-related gene expression by TDP-43, we performed expression microarray and RNA deep sequencing (RNA-Seq) using cell lines expressing high levels of TDP-43 and identified 434 significantly altered genes including sterol regulatory element-binding protein 2 (SREBP2), a master regulator of cholesterol homeostasis and its downstream genes. Elevated TDP-43 impaired SREBP2 transcriptional activity, leading to inhibition of cholesterol biosynthesis. The amount of cholesterol was significantly decreased in the spinal cords of TDP-43-overexpressed ALS model mice and in the cerebrospinal fluids of ALS patients. These results suggested that TDP-43 could play an essential role in cholesterol biosynthesis in relation to ALS dyslipidemia.


Subject(s)
Amyotrophic Lateral Sclerosis , DNA-Binding Proteins , Motor Neuron Disease , Sterol Regulatory Element Binding Protein 2 , Amyotrophic Lateral Sclerosis/metabolism , Animals , DNA-Binding Proteins/genetics , Humans , Mice , Sterol Regulatory Element Binding Protein 2/genetics , Sterols
6.
iScience ; 25(4): 103987, 2022 Apr 15.
Article in English | MEDLINE | ID: mdl-35330684

ABSTRACT

Retinal dystrophies (RDs) lead to irreversible vision impairment with no radical treatment. Although photoreceptor cells (PRCs) differentiated from human induced pluripotent stem cells (iPSCs) are essential for the study of RDs as a scalable source, current differentiation methods for PRCs require multiple steps. To address these issues, we developed a method to generate PRCs from human iPSCs by introducing the transcription factors, CRX and NEUROD1. This approach enabled us to generate induced photoreceptor-like cells (iPRCs) expressing PRC markers. Single-cell RNA sequencing revealed the transcriptome of iPRCs in which the genes associated with phototransduction were expressed. Generated iPRCs exhibited their functional properties in calcium imaging. Furthermore, light-induced damage on iPRCs was inhibited by an antioxidant compound. This simple approach would facilitate the availability of materials for PRC-related research and provide a useful application for disease modeling and drug discovery.

7.
Nat Aging ; 2(2): 125-139, 2022 02.
Article in English | MEDLINE | ID: mdl-37117761

ABSTRACT

Genome-wide association studies have demonstrated that polygenic risks shape Alzheimer's disease (AD). To elucidate the polygenic architecture of AD phenotypes at a cellular level, we established induced pluripotent stem cells from 102 patients with AD, differentiated them into cortical neurons and conducted a genome-wide analysis of the neuronal production of amyloid ß (Aß). Using such a cellular dissection of polygenicity (CDiP) approach, we identified 24 significant genome-wide loci associated with alterations in Aß production, including some loci not previously associated with AD, and confirmed the influence of some of the corresponding genes on Aß levels by the use of small interfering RNA. CDiP genotype sets improved the predictions of amyloid positivity in the brains and cerebrospinal fluid of patients in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. Secondary analyses of exome sequencing data from the Japanese ADNI and the ADNI cohorts focused on the 24 CDiP-derived loci associated with alterations in Aß led to the identification of rare AD variants in KCNMA1.


Subject(s)
Alzheimer Disease , Induced Pluripotent Stem Cells , Humans , Alzheimer Disease/genetics , Amyloid beta-Peptides/genetics , Genome-Wide Association Study , Neurons
8.
J Cell Mol Med ; 25(20): 9586-9596, 2021 10.
Article in English | MEDLINE | ID: mdl-34510713

ABSTRACT

Human pluripotent stem cells have the potential to differentiate into various cell types including skeletal muscles (SkM), and they are applied to regenerative medicine or in vitro modelling for intractable diseases. A simple differentiation method is required for SkM cells to accelerate neuromuscular disease studies. Here, we established a simple method to convert human pluripotent stem cells into SkM cells by using temperature-sensitive Sendai virus (SeV) vector encoding myoblast determination protein 1 (SeV-Myod1), a myogenic master transcription factor. SeV-Myod1 treatment converted human embryonic stem cells (ESCs) into SkM cells, which expressed SkM markers including myosin heavy chain (MHC). We then removed the SeV vector by temporal treatment at a high temperature of 38℃, which also accelerated mesodermal differentiation, and found that SkM cells exhibited fibre-like morphology. Finally, after removal of the residual human ESCs by pluripotent stem cell-targeting delivery of cytotoxic compound, we generated SkM cells with 80% MHC positivity and responsiveness to electrical stimulation. This simple method for myogenic differentiation was applicable to human-induced pluripotent stem cells and will be beneficial for investigations of disease mechanisms and drug discovery in the future.


Subject(s)
Cell Differentiation , Genetic Vectors , Muscle Development , Muscle Fibers, Skeletal/cytology , Muscle Fibers, Skeletal/metabolism , Pluripotent Stem Cells/cytology , Pluripotent Stem Cells/metabolism , Sendai virus , Calcium/metabolism , Calcium Signaling , Cell Differentiation/genetics , Cells, Cultured , Cellular Reprogramming/genetics , Embryonic Stem Cells/cytology , Embryonic Stem Cells/metabolism , Fluorescent Antibody Technique , Gene Expression , Genetic Vectors/genetics , Humans , Induced Pluripotent Stem Cells/cytology , Induced Pluripotent Stem Cells/metabolism , Muscle Development/genetics , Sendai virus/genetics , Temperature , Transgenes
9.
Stem Cell Res ; 55: 102504, 2021 08.
Article in English | MEDLINE | ID: mdl-34419750

ABSTRACT

Schizophrenia (SCZ) is one of the major psychiatric disorders. The genetic factor is certainly influential in the onset of the disease but is not decisive. There is no identified molecular/cellular marker of the disease, and the pathomechanism is still unknown. In this study, we generated human induced pluripotent stem cells (iPSCs) derived from SCZ-discordant fraternal twins, and they could contribute to elucidation of the pathomechanism of SCZ.


Subject(s)
Induced Pluripotent Stem Cells , Schizophrenia , Humans , Schizophrenia/genetics , Twins, Dizygotic
10.
Stem Cell Res ; 53: 102274, 2021 05.
Article in English | MEDLINE | ID: mdl-33714066

ABSTRACT

Idiopathic basal ganglia calcification (IBGC) is a rare neurodegenerative disease, characterized by abnormal calcium deposits in basal ganglia of the brain. The affected individuals exhibit movement disorders, and progressive deterioration of cognitive and psychiatric ability. The genetic cause of the disease is mutation in one of several different genes, SLC20A2, PDGFB, PDGFRB, XPR1 or MYORG, which inheritably or sporadically occurs. Here we generated an induced pluripotent stem cell (iPSC) line from an IBGC patient, which is likely be a powerful tool for revealing the pathomechanisms and exploring potential therapeutic candidates of IBGC.


Subject(s)
Basal Ganglia Diseases , Induced Pluripotent Stem Cells , Neurodegenerative Diseases , Basal Ganglia/metabolism , Basal Ganglia Diseases/genetics , Humans , Induced Pluripotent Stem Cells/metabolism , Mutation , Neurodegenerative Diseases/genetics , Sodium-Phosphate Cotransporter Proteins, Type III/genetics , Xenotropic and Polytropic Retrovirus Receptor
11.
Ann Neurol ; 89(6): 1226-1233, 2021 06.
Article in English | MEDLINE | ID: mdl-33565152

ABSTRACT

In amyotrophic lateral sclerosis (ALS), early diagnosis is essential for both current and potential treatments. To find a supportive approach for the diagnosis, we constructed an artificial intelligence-based prediction model of ALS using induced pluripotent stem cells (iPSCs). Images of spinal motor neurons derived from healthy control subject and ALS patient iPSCs were analyzed by a convolutional neural network, and the algorithm achieved an area under the curve of 0.97 for classifying healthy control and ALS. This prediction model by deep learning algorithm with iPSC technology could support the diagnosis and may provide proactive treatment of ALS through future prospective research. ANN NEUROL 2021;89:1226-1233.


Subject(s)
Amyotrophic Lateral Sclerosis/diagnosis , Deep Learning , Early Diagnosis , Induced Pluripotent Stem Cells , Motor Neurons , Aged , Female , Humans , Male , Middle Aged
12.
Stem Cell Res ; 49: 102095, 2020 12.
Article in English | MEDLINE | ID: mdl-33291009

ABSTRACT

Glycogen storage disease type 1a (GSD1a) is an autosomal recessive disorder caused by mutations of the glucose-6-phosphatase (G6PC) gene. Mutations of the G6PC gene lead to excessive accumulation of glycogen in the liver, kidney, and intestinal mucosa due to the deficiency of microsomal glucose-6-phosphatase. Human induced pluripotent stem cells (iPSCs) enable the production of patient-derived hepatocytes in culture and are therefore a promising tool for modeling GSD1a. Here, we report the establishment of human iPSCs from a GSD1a patient carrying a G6PC mutation (c.648G > T; p.Leu216 = ).


Subject(s)
Cell Line , Glycogen Storage Disease Type I , Induced Pluripotent Stem Cells , Glucose-6-Phosphatase/genetics , Glycogen Storage Disease Type I/genetics , Hepatocytes , Humans , Liver , Mutation
13.
Stem Cell Res ; 45: 101828, 2020 05.
Article in English | MEDLINE | ID: mdl-32413791

ABSTRACT

Parkinson's disease (PD) is a devastating movement disorder with an unknown etiology. Multiplications of the SNCA gene cause the autosomal dominant form of familial PD as well as missense mutations of the gene. We established and characterized a human induced pluripotent stem cell (iPSC) line from a PD patient carrying SNCA duplication. The iPSC line displayed a capacity to differentiate into midbrain dopaminergic neurons affected in PD. The iPSC line will be useful for disease modeling applications.


Subject(s)
Induced Pluripotent Stem Cells , Parkinson Disease , Dopaminergic Neurons , Humans , Mutation, Missense , Parkinson Disease/genetics , alpha-Synuclein/genetics
14.
NPJ Vaccines ; 5(1): 28, 2020.
Article in English | MEDLINE | ID: mdl-32219000

ABSTRACT

Pathological aggregates of tau proteins accumulate in the brains of neurodegenerative tauopathies including Alzheimer's disease and frontotemporal lobar degeneration (FTLD-tau). Although immunotherapies of these disorders against tau are emerging, it is unknown whether nasal delivery, which offers many benefits over traditional approaches to vaccine administration, is effective or not for tauopathy. Here, we developed vaccination against a secreted form of pathological tau linked to FTLD-tau using a Sendai virus (SeV) vector infectious to host nasal mucosa, a key part of the immune system. Tau vaccines given as nasal drops induced tissue tau-immunoreactive antibody production and ameliorated cognitive impairment in FTLD-tau model mice. In vivo imaging and postmortem neuropathological assays demonstrated the suppression of phosphorylated tau accumulation, neurotoxic gliosis, and neuronal loss in the hippocampus of immunized mice. These findings suggest that nasal vaccine delivery may provide a therapeutic opportunity for a broad range of populations with human tauopathy.

15.
Mol Brain ; 13(1): 38, 2020 03 19.
Article in English | MEDLINE | ID: mdl-32188464

ABSTRACT

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is one of the most common forms of hereditary cerebral small vessel diseases and is caused by mutations in NOTCH3. Our group has previously reported incorporation of NOTCH3 extracellular domain (N3ECD) in the CADASIL-specific granular osmiophilic materials and increase of PDGFRß immunoreactivity in CADASIL postmortem brains. Here, we aimed to establish an in vitro model of CADASIL, which can recapitulate those CADASIL phenotypes, using induced pluripotent stem cells (iPSCs). We have refined a differentiation protocol of endothelial cells to obtain mature mural cells (MCs) with their characteristic properties. iPSCs from three CADASIL patients with p.Arg182Cys, p.Arg141Cys and p.Cys106Arg mutations were differentiated into MCs and their functional and molecular profiles were compared. The differentiated CADASIL MCs recapitulated pathogenic changes reported previously: increased PDGFRß and abnormal structure/distribution of filamentous actin network, as well as N3ECD/LTBP-1/HtrA1-immunopositive deposits. Migration rate of CADASIL MCs was enhanced but suppressed by knockdown of NOTCH3 or PDGFRB. CADASIL MCs showed altered reactivity to PDGF-BB. Patient-derived MCs can recapitulate CADASIL pathology and are therefore useful in understanding the pathogenesis and developing potential treatment strategies.


Subject(s)
Cerebral Small Vessel Diseases/pathology , Induced Pluripotent Stem Cells/pathology , Models, Biological , Becaplermin/pharmacology , CADASIL/pathology , Cell Differentiation/drug effects , Cell Movement/drug effects , Cell Proliferation/drug effects , Humans , Induced Pluripotent Stem Cells/drug effects , Induced Pluripotent Stem Cells/metabolism , Phenotype , Receptor, Notch3/metabolism , Receptor, Platelet-Derived Growth Factor beta/metabolism
16.
Stem Cell Res ; 36: 101406, 2019 04.
Article in English | MEDLINE | ID: mdl-30849633

ABSTRACT

Mucopolysaccharidosis type I (MPS I) is a rare inherited metabolic disorder caused by defects in alpha-L-iduronidase (IDUA), a lysosomal protein encoded by IDUA gene. MPS I is a progressive multisystemic disorder with a wide range of symptoms, including skeletal abnormalities and cognitive impairment, and is characterized by a wide spectrum of severity levels caused by varied mutations in IDUA. A human iPSC line was established from an attenuated MPS I (Scheie syndrome) patient carrying an IDUA gene mutation (c.266G > A; p.R89Q). This disease-specific iPSC line will be useful for the research of MPS I.


Subject(s)
Cell Line , Iduronidase/genetics , Induced Pluripotent Stem Cells , Mucopolysaccharidosis I/genetics , Female , Humans , Middle Aged
17.
Clin Sci (Lond) ; 133(4): 583-595, 2019 02 28.
Article in English | MEDLINE | ID: mdl-30777884

ABSTRACT

Recent reports, including ours, have indicated that microRNA (miR)-33 located within the intron of sterol regulatory element binding protein (SREBP) 2 controls cholesterol homeostasis and can be a potential therapeutic target for the treatment of atherosclerosis. Here, we show that SPAST, which encodes a microtubule-severing protein called SPASTIN, was a novel target gene of miR-33 in human. Actually, the miR-33 binding site in the SPAST 3'-UTR is conserved not in mice but in mid to large mammals, and it is impossible to clarify the role of miR-33 on SPAST in mice. We demonstrated that inhibition of miR-33a, a major form of miR-33 in human neurons, via locked nucleic acid (LNA)-anti-miR ameliorated the pathological phenotype in hereditary spastic paraplegia (HSP)-SPG4 patient induced pluripotent stem cell (iPSC)-derived cortical neurons. Thus, miR-33a can be a potential therapeutic target for the treatment of HSP-SPG4.


Subject(s)
Genetic Therapy/methods , Induced Pluripotent Stem Cells/metabolism , MicroRNAs/genetics , Neural Stem Cells/metabolism , Neurites/metabolism , Oligonucleotides/genetics , Spastic Paraplegia, Hereditary/therapy , Spastin/genetics , 3' Untranslated Regions , Binding Sites , Cells, Cultured , Gene Expression Regulation , Humans , Induced Pluripotent Stem Cells/pathology , MicroRNAs/antagonists & inhibitors , MicroRNAs/metabolism , Neural Stem Cells/pathology , Neurites/pathology , Neurogenesis , Oligonucleotides/metabolism , Phenotype , Spastic Paraplegia, Hereditary/genetics , Spastic Paraplegia, Hereditary/metabolism , Spastic Paraplegia, Hereditary/pathology , Spastin/metabolism
18.
Cell Rep ; 21(8): 2304-2312, 2017 Nov 21.
Article in English | MEDLINE | ID: mdl-29166618

ABSTRACT

In the process of drug development, in vitro studies do not always adequately predict human-specific drug responsiveness in clinical trials. Here, we applied the advantage of human iPSC-derived neurons, which offer human-specific drug responsiveness, to screen and evaluate therapeutic candidates for Alzheimer's disease (AD). Using AD patient neurons with nearly 100% purity from iPSCs, we established a robust and reproducible assay for amyloid ß peptide (Aß), a pathogenic molecule in AD, and screened a pharmaceutical compound library. We acquired 27 Aß-lowering screen hits, prioritized hits by chemical structure-based clustering, and selected 6 leading compounds. Next, to maximize the anti-Aß effect, we selected a synergistic combination of bromocriptine, cromolyn, and topiramate as an anti-Aß cocktail. Finally, using neurons from familial and sporadic AD patients, we found that the cocktail showed a significant and potent anti-Aß effect on patient cells. This human iPSC-based platform promises to be useful for AD drug development.


Subject(s)
Alzheimer Disease/pathology , Amyloid beta-Peptides/immunology , Induced Pluripotent Stem Cells/cytology , Neurons/pathology , Alzheimer Disease/drug therapy , Alzheimer Disease/immunology , Amyloid beta-Protein Precursor/immunology , Drug Evaluation, Preclinical/methods , Humans
19.
Stem Cell Res ; 24: 12-15, 2017 10.
Article in English | MEDLINE | ID: mdl-29034879

ABSTRACT

Autosomal dominant lateral temporal epilepsy (ADLTE) is an inherited epileptic syndrome, and it is associated with mutations of leucine-rich glioma inactivated 1 (LGI1) gene. The underlying mechanisms of ADLTE are still unknown, as human neurons are difficult to obtain as a research tool. Human induced pluripotent stem cells (iPSCs) allow the generation of patient-derived neuronal cells in a dish, and can be a promising tool to model ADLTE. Here, we report the establishment of human iPSCs from an ADLTE patient carrying LGI1 mutation (c.1418C>T, p.Ser473Leu).


Subject(s)
Epilepsy, Temporal Lobe/genetics , Glioma/genetics , Induced Pluripotent Stem Cells/metabolism , Leucine/metabolism , Proteins/genetics , Epilepsy, Temporal Lobe/pathology , Genotype , Humans , Intracellular Signaling Peptides and Proteins , Mutation , Proteins/metabolism
20.
Stem Cell Res ; 24: 36-39, 2017 10.
Article in English | MEDLINE | ID: mdl-29034893

ABSTRACT

Peripheral blood mononuclear cells (PBMCs) were collected from a clinically diagnosed 20-year-old dystonia patient with a GCH1 mutation (DYT5). Episomal vectors were used to introduce reprogramming factors (OCT3/4, SOX2, KLF4, L-MYC, LIN28, and p53 carboxy-terminal dominant-negative fragment) to the PBMCs. The generated iPSCs expressed pluripotency markers, and were capable of differentiating into derivates of all three germ layers in vitro. The iPSC line also showed a normal karyotype and preserved the GCH1 mutation. This cellular model can provide opportunities to perform pathophysiological studies for aberrant dopamine metabolism-related disorders.


Subject(s)
Genetic Vectors/genetics , Induced Pluripotent Stem Cells/metabolism , Adult , Cell Differentiation , Humans , Kruppel-Like Factor 4 , Male , Mutation , Transcription Factors/genetics , Young Adult
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