@article {146, title = {Sub-genic intolerance, ClinVar, and the epilepsies: A whole-exome sequencing study of 29,165 individuals.}, journal = {Am J Hum Genet}, volume = {108}, year = {2021}, month = {2021 06 03}, pages = {965-982}, abstract = {

Both mild and severe epilepsies are influenced by variants in the same genes, yet an explanation for the resulting phenotypic variation is unknown. As part of the ongoing Epi25 Collaboration, we performed a whole-exome sequencing analysis of 13,487 epilepsy-affected individuals and 15,678 control individuals. While prior Epi25 studies focused on gene-based collapsing analyses, we asked how the pattern of variation within genes differs by epilepsy type. Specifically, we compared the genetic architectures of severe developmental and epileptic encephalopathies (DEEs) and two generally less severe epilepsies, genetic generalized epilepsy and non-acquired focal epilepsy (NAFE). Our gene-based rare variant collapsing analysis used geographic ancestry-based clustering that included broader ancestries than previously possible and revealed novel associations. Using the missense intolerance ratio (MTR), we found that variants in DEE-affected individuals are in significantly more intolerant genic sub-regions than those in NAFE-affected individuals. Only previously reported pathogenic variants absent in available genomic datasets showed a significant burden in epilepsy-affected individuals compared with control individuals, and the ultra-rare pathogenic variants associated with DEE were located in more intolerant genic sub-regions than variants associated with non-DEE epilepsies. MTR filtering improved the yield of ultra-rare pathogenic variants in affected individuals compared with control individuals. Finally, analysis of variants in genes without a disease association revealed a significant burden of loss-of-function variants in the genes most intolerant to such variation, indicating additional epilepsy-risk genes yet to be discovered. Taken together, our study suggests that genic and sub-genic intolerance are critical characteristics for interpreting the effects of variation in genes that influence epilepsy.

}, keywords = {Case-Control Studies, Cohort Studies, Epilepsy, Exome, Genetic Markers, Genetic Predisposition to Disease, Genetic Testing, Genetic Variation, Humans, Phenotype, Whole Exome Sequencing}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2021.04.009} } @article {87, title = {Allelic Heterogeneity at the CRP Locus Identified by Whole-Genome Sequencing in Multi-ancestry Cohorts.}, journal = {Am J Hum Genet}, volume = {106}, year = {2020}, month = {2020 01 02}, pages = {112-120}, abstract = {

Whole-genome sequencing (WGS) can improve assessment of low-frequency and rare variants, particularly in non-European populations that have been underrepresented in existing genomic studies. The genetic determinants of C-reactive protein (CRP), a biomarker of chronic inflammation, have been extensively studied, with existing genome-wide association studies (GWASs) conducted in >200,000 individuals of European ancestry. In order to discover novel loci associated with CRP levels, we examined a multi-ancestry population (n = 23,279) with WGS (\~{}38{\texttimes} coverage) from the Trans-Omics for Precision Medicine (TOPMed) program. We found evidence for eight distinct associations at the CRP locus, including two variants that have not been identified previously (rs11265259 and rs181704186), both of which are non-coding and more common in individuals of African ancestry (\~{}10\% and \~{}1\% minor allele frequency, respectively, and rare or monomorphic in 1000 Genomes populations of East Asian, South Asian, and European ancestry). We show that the minor (G) allele of rs181704186 is associated with lower CRP levels and decreased transcriptional activity and protein binding in~vitro, providing a plausible molecular mechanism for this African ancestry-specific signal. The individuals homozygous for rs181704186-G have a mean CRP level of 0.23~mg/L, in contrast to individuals heterozygous for rs181704186 with mean CRP of 2.97~mg/L and major allele homozygotes with mean CRP of 4.11~mg/L. This study demonstrates the utility of WGS in multi-ethnic populations to drive discovery of complex trait associations of large effect and to identify functional alleles in noncoding regulatory regions.

}, keywords = {African Continental Ancestry Group, Asian Continental Ancestry Group, C-Reactive Protein, Cohort Studies, European Continental Ancestry Group, Gene Frequency, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Linkage Disequilibrium, Polymorphism, Single Nucleotide, Whole Genome Sequencing}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2019.12.002}, author = {Raffield, Laura M and Iyengar, Apoorva K and Wang, Biqi and Gaynor, Sheila M and Spracklen, Cassandra N and Zhong, Xue and Kowalski, Madeline H and Salimi, Shabnam and Polfus, Linda M and Benjamin, Emelia J and Bis, Joshua C and Bowler, Russell and Cade, Brian E and Choi, Won Jung and Comellas, Alejandro P and Correa, Adolfo and Cruz, Pedro and Doddapaneni, Harsha and Durda, Peter and Gogarten, Stephanie M and Jain, Deepti and Kim, Ryan W and Kral, Brian G and Lange, Leslie A and Larson, Martin G and Laurie, Cecelia and Lee, Jiwon and Lee, Seonwook and Lewis, Joshua P and Metcalf, Ginger A and Mitchell, Braxton D and Momin, Zeineen and Muzny, Donna M and Pankratz, Nathan and Park, Cheol Joo and Rich, Stephen S and Rotter, Jerome I and Ryan, Kathleen and Seo, Daekwan and Tracy, Russell P and Viaud-Martinez, Karine A and Yanek, Lisa R and Zhao, Lue Ping and Lin, Xihong and Li, Bingshan and Li, Yun and Dupuis, Jos{\'e}e and Reiner, Alexander P and Mohlke, Karen L and Auer, Paul L} } @article {120, title = {Evidence for secondary-variant genetic burden and non-random distribution across biological modules in a recessive ciliopathy.}, journal = {Nat Genet}, volume = {52}, year = {2020}, month = {2020 11}, pages = {1145-1150}, abstract = {

The influence of genetic background on driver mutations is well established; however, the mechanisms by which the background interacts with Mendelian loci remain unclear. We performed a systematic secondary-variant burden analysis of two independent cohorts of patients with Bardet-Biedl syndrome (BBS) with known recessive biallelic pathogenic mutations in one of 17 BBS genes for each individual. We observed a significant enrichment of trans-acting rare nonsynonymous secondary variants in patients with BBS compared with either population controls or a cohort of individuals with a non-BBS diagnosis and recessive variants in the same gene set. Strikingly, we found a significant over-representation of secondary alleles in chaperonin-encoding genes-a finding corroborated by the observation of epistatic interactions involving this complex in vivo. These data indicate a complex genetic architecture for BBS that informs the biological properties of disease modules and presents a model for secondary-variant burden analysis in recessive disorders.

}, keywords = {Alleles, Bardet-Biedl Syndrome, Cohort Studies, Exome, Genetic Variation, Humans}, issn = {1546-1718}, doi = {10.1038/s41588-020-0707-1}, author = {Kousi, Maria and S{\"o}ylemez, Onuralp and Ozanturk, Ayseg{\"u}l and Mourtzi, Niki and Akle, Sebastian and Jungreis, Irwin and Muller, Jean and Cassa, Christopher A and Brand, Harrison and Mokry, Jill Anne and Wolf, Maxim Y and Sadeghpour, Azita and McFadden, Kelsey and Lewis, Richard A and Talkowski, Michael E and Dollfus, H{\'e}l{\`e}ne and Kellis, Manolis and Davis, Erica E and Sunyaev, Shamil R and Katsanis, Nicholas} } @article {121, title = {A fast and scalable framework for large-scale and ultrahigh-dimensional sparse regression with application to the UK Biobank.}, journal = {PLoS Genet}, volume = {16}, year = {2020}, month = {2020 10}, pages = {e1009141}, abstract = {

The UK Biobank is a very large, prospective population-based cohort study across the United Kingdom. It provides unprecedented opportunities for researchers to investigate the relationship between genotypic information and phenotypes of interest. Multiple regression methods, compared with genome-wide association studies (GWAS), have already been showed to greatly improve the prediction performance for a variety of phenotypes. In the high-dimensional settings, the lasso, since its first proposal in statistics, has been proved to be an effective method for simultaneous variable selection and estimation. However, the large-scale and ultrahigh dimension seen in the UK Biobank pose new challenges for applying the lasso method, as many existing algorithms and their implementations are not scalable to large applications. In this paper, we propose a computational framework called batch screening iterative lasso (BASIL) that can take advantage of any existing lasso solver and easily build a scalable solution for very large data, including those that are larger than the memory size. We introduce snpnet, an R package that implements the proposed algorithm on top of glmnet and optimizes for single nucleotide polymorphism (SNP) datasets. It currently supports l1-penalized linear model, logistic regression, Cox model, and also extends to the elastic net with l1/l2 penalty. We demonstrate results on the UK Biobank dataset, where we achieve competitive predictive performance for all four phenotypes considered (height, body mass index, asthma, high cholesterol) using only a small fraction of the variants compared with other established polygenic risk score methods.

}, keywords = {Algorithms, Asthma, Biological Specimen Banks, Body Height, Body Mass Index, Cholesterol, Cohort Studies, Genetics, Population, Genome-Wide Association Study, Genotype, Humans, Logistic Models, Phenotype, Polymorphism, Single Nucleotide, Proportional Hazards Models, United Kingdom}, issn = {1553-7404}, doi = {10.1371/journal.pgen.1009141}, author = {Qian, Junyang and Tanigawa, Yosuke and Du, Wenfei and Aguirre, Matthew and Chang, Chris and Tibshirani, Robert and Rivas, Manuel A and Hastie, Trevor} } @article {75, title = {Genetic diagnoses in epilepsy: The impact of dynamic exome analysis in a pediatric cohort.}, journal = {Epilepsia}, volume = {61}, year = {2020}, month = {2020 02}, pages = {249-258}, abstract = {

OBJECTIVE: We evaluated the yield of systematic analysis and/or reanalysis of whole exome sequencing (WES) data from a cohort of well-phenotyped pediatric patients with epilepsy and suspected but previously undetermined genetic etiology.

METHODS: We identified and phenotyped 125 participants with pediatric epilepsy. Etiology was unexplained at the time of enrollment despite clinical testing, which included chromosomal microarray (57 patients), epilepsy gene panel (n = 48), both (n = 28), or WES (n = 8). Clinical epilepsy diagnoses included developmental and epileptic encephalopathy (DEE), febrile infection-related epilepsy syndrome, Rasmussen encephalitis, and other focal and generalized epilepsies. We analyzed WES data and compared the yield in participants with and without prior clinical genetic testing.

RESULTS: Overall, we identified pathogenic or likely pathogenic variants in 40\% (50/125) of our study participants. Nine patients with DEE had genetic variants in recently published genes that had not been recognized as epilepsy-related at the time of clinical testing (FGF12, GABBR1, GABBR2, ITPA, KAT6A, PTPN23, RHOBTB2, SATB2), and eight patients had genetic variants in candidate epilepsy genes (CAMTA1, FAT3, GABRA6, HUWE1, PTCHD1). Ninety participants had concomitant or subsequent clinical genetic testing, which was ultimately explanatory for 26\% (23/90). Of the 67 participants whose molecular diagnoses were "unsolved" through clinical genetic testing, we identified pathogenic or likely pathogenic variants in 17 (25\%).

SIGNIFICANCE: Our data argue for early consideration of WES with iterative reanalysis for patients with epilepsy, particularly those with DEE or epilepsy with intellectual disability. Rigorous analysis of WES data of well-phenotyped patients with epilepsy leads to a broader understanding of gene-specific phenotypic spectra as well as candidate disease gene identification. We illustrate the dynamic nature of genetic diagnosis over time, with analysis and in some cases reanalysis of exome data leading to the identification of disease-associated variants among participants with previously nondiagnostic results from a variety of clinical testing strategies.

}, keywords = {Adolescent, Adult, Age of Onset, Brain Diseases, Child, Child, Preschool, Chromosomes, Human, Cohort Studies, Epilepsy, Epilepsy, Generalized, Exome, Female, Genetic Testing, Genetic Variation, Humans, Infant, Male, Microarray Analysis, Phenotype, Whole Exome Sequencing, Young Adult}, issn = {1528-1167}, doi = {10.1111/epi.16427}, author = {Rochtus, Anne and Olson, Heather E and Smith, Lacey and Keith, Louisa G and El Achkar, Christelle and Taylor, Alan and Mahida, Sonal and Park, Meredith and Kelly, McKenna and Shain, Catherine and Rockowitz, Shira and Rosen Sheidley, Beth and Poduri, Annapurna} } @article {90, title = {Rare protein-altering variants in ANGPTL7 lower intraocular pressure and protect against glaucoma.}, journal = {PLoS Genet}, volume = {16}, year = {2020}, month = {2020 05}, pages = {e1008682}, abstract = {

Protein-altering variants that are protective against human disease provide in vivo validation of therapeutic targets. Here we use genotyping data from UK Biobank (n = 337,151 unrelated White British individuals) and FinnGen (n = 176,899) to conduct a search for protein-altering variants conferring lower intraocular pressure (IOP) and protection against glaucoma. Through rare protein-altering variant association analysis, we find a missense variant in ANGPTL7 in UK Biobank (rs28991009, p.Gln175His, MAF = 0.8\%, genotyped in 82,253 individuals with measured IOP and an independent set of 4,238 glaucoma patients and 250,660 controls) that significantly lowers IOP (β = -0.53 and -0.67 mmHg for heterozygotes, -3.40 and -2.37 mmHg for homozygotes, P = 5.96 x 10-9 and 1.07 x 10-13 for corneal compensated and Goldman-correlated IOP, respectively) and is associated with 34\% reduced risk of glaucoma (P = 0.0062). In FinnGen, we identify an ANGPTL7 missense variant at a greater than 50-fold increased frequency in Finland compared with other populations (rs147660927, p.Arg220Cys, MAF Finland = 4.3\%), which was genotyped in 6,537 glaucoma patients and 170,362 controls and is associated with a 29\% lower glaucoma risk (P = 1.9 x 10-12 for all glaucoma types and also protection against its subtypes including exfoliation, primary open-angle, and primary angle-closure). We further find three rarer variants in UK Biobank, including a protein-truncating variant, which confer a strong composite lowering of IOP (P = 0.0012 and 0.24 for Goldman-correlated and corneal compensated IOP, respectively), suggesting the protective mechanism likely resides in the loss of interaction or function. Our results support inhibition or down-regulation of ANGPTL7 as a therapeutic strategy for glaucoma.

}, keywords = {Adult, Aged, Aged, 80 and over, Angiopoietin-like Proteins, Biological Specimen Banks, Case-Control Studies, Cohort Studies, Female, Finland, Gene Frequency, Genetic Predisposition to Disease, Genetics, Population, Genome-Wide Association Study, Glaucoma, Humans, Intraocular Pressure, Loss of Function Mutation, Male, Middle Aged, Mutation, Missense, Polymorphism, Single Nucleotide, United Kingdom}, issn = {1553-7404}, doi = {10.1371/journal.pgen.1008682}, author = {Tanigawa, Yosuke and Wainberg, Michael and Karjalainen, Juha and Kiiskinen, Tuomo and Venkataraman, Guhan and Lemmel{\"a}, Susanna and Turunen, Joni A and Graham, Robert R and Havulinna, Aki S and Perola, Markus and Palotie, Aarno and Daly, Mark J and Rivas, Manuel A} } @article {63, title = {Identification of rare-disease genes using blood transcriptome sequencing and large control cohorts.}, journal = {Nat Med}, volume = {25}, year = {2019}, month = {2019 06}, pages = {911-919}, abstract = {

It is estimated that 350 million individuals worldwide suffer from rare diseases, which are predominantly caused by mutation in a single gene. The current molecular diagnostic rate is estimated at 50\%, with whole-exome sequencing (WES) among the most successful approaches. For patients in whom WES is uninformative, RNA sequencing (RNA-seq) has shown diagnostic utility in specific tissues and diseases. This includes muscle biopsies from patients with undiagnosed rare muscle disorders, and cultured fibroblasts from patients with mitochondrial disorders. However, for many individuals, biopsies are not performed for clinical care, and tissues are difficult to access. We sought to assess the utility of RNA-seq from blood as a diagnostic tool for rare diseases of different pathophysiologies. We generated whole-blood RNA-seq from 94 individuals with undiagnosed rare diseases spanning 16 diverse disease categories. We developed a robust approach to compare data from these individuals with large sets of RNA-seq data for controls (n = 1,594 unrelated controls and n = 49 family members) and demonstrated the impacts of expression, splicing, gene and variant filtering strategies on disease gene identification. Across our cohort, we observed that RNA-seq yields a 7.5\% diagnostic rate, and an additional 16.7\% with improved candidate gene resolution.

}, keywords = {Acid Ceramidase, Case-Control Studies, Child, Child, Preschool, Cohort Studies, Female, Genetic Variation, Humans, Male, Models, Genetic, Mutation, Oxidoreductases Acting on CH-CH Group Donors, Potassium Channels, Rare Diseases, RNA, RNA Splicing, Sequence Analysis, RNA, Whole Exome Sequencing}, issn = {1546-170X}, doi = {10.1038/s41591-019-0457-8}, author = {Fr{\'e}sard, Laure and Smail, Craig and Ferraro, Nicole M and Teran, Nicole A and Li, Xin and Smith, Kevin S and Bonner, Devon and Kernohan, Kristin D and Marwaha, Shruti and Zappala, Zachary and Balliu, Brunilda and Davis, Joe R and Liu, Boxiang and Prybol, Cameron J and Kohler, Jennefer N and Zastrow, Diane B and Reuter, Chloe M and Fisk, Dianna G and Grove, Megan E and Davidson, Jean M and Hartley, Taila and Joshi, Ruchi and Strober, Benjamin J and Utiramerur, Sowmithri and Lind, Lars and Ingelsson, Erik and Battle, Alexis and Bejerano, Gill and Bernstein, Jonathan A and Ashley, Euan A and Boycott, Kym M and Merker, Jason D and Wheeler, Matthew T and Montgomery, Stephen B} }