@article {82, title = {Electronic health record phenotypes associated with genetically regulated expression of CFTR and application to cystic fibrosis.}, journal = {Genet Med}, volume = {22}, year = {2020}, month = {2020 07}, pages = {1191-1200}, abstract = {

PURPOSE: The increasing use of electronic health records (EHRs) and biobanks offers unique opportunities to study Mendelian diseases. We described a novel approach to summarize clinical manifestations from patient EHRs into phenotypic evidence for cystic fibrosis (CF) with potential to alert unrecognized patients of the disease.

METHODS: We estimated genetically predicted expression (GReX) of cystic fibrosis transmembrane conductance regulator (CFTR) and tested for association with clinical diagnoses in the Vanderbilt University biobank (N = 9142 persons of European descent with 71 cases of CF). The top associated EHR phenotypes were assessed in combination as a phenotype risk score (PheRS) for discriminating CF case status in an additional 2.8 million patients from Vanderbilt University Medical Center (VUMC) and 125,305 adult patients including 25,314 CF cases from MarketScan, an independent external cohort.

RESULTS: GReX of CFTR was associated with EHR phenotypes consistent with CF. PheRS constructed using the EHR phenotypes and weights discovered by the genetic associations improved discriminative power for CF over the initially proposed PheRS in both VUMC and MarketScan.

CONCLUSION: Our study demonstrates the power of EHRs for clinical description of CF and the benefits of using a genetics-informed weighing scheme in construction of a phenotype risk score. This research may find broad applications for phenomic studies of Mendelian disease genes.

}, keywords = {Adult, Cystic Fibrosis, Cystic Fibrosis Transmembrane Conductance Regulator, Electronic Health Records, Humans, Mutation, Phenotype}, issn = {1530-0366}, doi = {10.1038/s41436-020-0786-5}, author = {Zhong, Xue and Yin, Zhijun and Jia, Gengjie and Zhou, Dan and Wei, Qiang and Faucon, Annika and Evans, Patrick and Gamazon, Eric R and Li, Bingshan and Tao, Ran and Rzhetsky, Andrey and Bastarache, Lisa and Cox, Nancy J} } @article {110, title = {A Transcriptome-Wide Association Study Identifies Candidate Susceptibility Genes for Pancreatic Cancer Risk.}, journal = {Cancer Res}, volume = {80}, year = {2020}, month = {2020 10 15}, pages = {4346-4354}, abstract = {

Pancreatic cancer is among the most well-characterized cancer types, yet a large proportion of the heritability of pancreatic cancer risk remains unclear. Here, we performed a large transcriptome-wide association study to systematically investigate associations between genetically predicted gene expression in normal pancreas tissue and pancreatic cancer risk. Using data from 305 subjects of mostly European descent in the Genotype-Tissue Expression Project, we built comprehensive genetic models to predict normal pancreas tissue gene expression, modifying the UTMOST (unified test for molecular signatures). These prediction models were applied to the genetic data of 8,275 pancreatic cancer cases and 6,723 controls of European ancestry. Thirteen genes showed an association of genetically predicted expression with pancreatic cancer risk at an FDR <= 0.05, including seven previously reported genes (, and ) and six novel genes not yet reported for pancreatic cancer risk [6q27: OR (95\% confidence interval (CI), 1.54 (1.25-1.89); 13q12.13: OR (95\% CI), 0.78 (0.70-0.88); 14q24.3: OR (95\% CI), 1.35 (1.17-1.56); 17q12: OR (95\% CI), 6.49 (2.96-14.27); 17q21.1: OR (95\% CI), 1.94 (1.45-2.58); and 20p13: OR (95\% CI): 1.41 (1.20-1.66)]. The associations for 10 of these genes (, and ) remained statistically significant even after adjusting for risk SNPs identified in previous genome-wide association study. Collectively, this analysis identified novel candidate susceptibility genes for pancreatic cancer that warrant further investigation. SIGNIFICANCE: A transcriptome-wide association analysis identified seven previously reported and six novel candidate susceptibility genes for pancreatic cancer risk.

}, keywords = {Age Factors, Case-Control Studies, European Continental Ancestry Group, Female, Gene Expression Regulation, Neoplastic, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Male, Models, Genetic, Pancreatic Neoplasms, Polymorphism, Single Nucleotide}, issn = {1538-7445}, doi = {10.1158/0008-5472.CAN-20-1353}, author = {Liu, Duo and Zhou, Dan and Sun, Yanfa and Zhu, Jingjing and Ghoneim, Dalia and Wu, Chong and Yao, Qizhi and Gamazon, Eric R and Cox, Nancy J and Wu, Lang} } @article {111, title = {A unified framework for joint-tissue transcriptome-wide association and Mendelian randomization analysis.}, journal = {Nat Genet}, volume = {52}, year = {2020}, month = {2020 11}, pages = {1239-1246}, abstract = {

Here, we present a joint-tissue imputation (JTI) approach and a Mendelian randomization framework for causal inference, MR-JTI. JTI borrows information across transcriptomes of different tissues, leveraging shared genetic regulation, to improve prediction performance in a tissue-dependent manner. Notably, JTI includes the single-tissue imputation method PrediXcan as a special case and outperforms other single-tissue approaches (the Bayesian sparse linear mixed model and Dirichlet process regression). MR-JTI models variant-level heterogeneity (primarily due to horizontal pleiotropy, addressing a major challenge of transcriptome-wide association study interpretation) and performs causal inference with type I error control. We make explicit the connection between the genetic architecture of gene expression and of complex traits and the suitability of Mendelian randomization as a causal inference strategy for transcriptome-wide association studies. We provide a resource of imputation models generated from GTEx and PsychENCODE panels. Analysis of biobanks and meta-analysis data, and extensive simulations show substantially improved statistical power, replication and causal mapping rate for JTI relative to existing approaches.

}, keywords = {Animals, Gene Expression Profiling, Genetic Association Studies, Humans, Lipoproteins, LDL, Mendelian Randomization Analysis, Mice, Models, Genetic, Multifactorial Inheritance, Predictive Value of Tests}, issn = {1546-1718}, doi = {10.1038/s41588-020-0706-2}, author = {Zhou, Dan and Jiang, Yi and Zhong, Xue and Cox, Nancy J and Liu, Chunyu and Gamazon, Eric R} }