@article {118, title = {Synaptic processes and immune-related pathways implicated in Tourette syndrome.}, journal = {Transl Psychiatry}, volume = {11}, year = {2021}, month = {2021 01 18}, pages = {56}, abstract = {

Tourette syndrome (TS) is a neuropsychiatric disorder of complex genetic architecture involving multiple interacting genes. Here, we sought to elucidate the pathways that underlie the neurobiology of the disorder through genome-wide analysis. We analyzed genome-wide genotypic data of 3581 individuals with TS and 7682 ancestry-matched controls and investigated associations of TS with sets of genes that are expressed in particular cell types and operate in specific neuronal and glial functions. We employed a self-contained, set-based association method (SBA) as well as a competitive gene set method (MAGMA) using individual-level genotype data to perform a comprehensive investigation of the biological background of TS. Our SBA analysis identified three significant gene sets after Bonferroni correction, implicating ligand-gated ion channel signaling, lymphocytic, and cell adhesion and transsynaptic signaling processes. MAGMA analysis further supported the involvement of the cell adhesion and trans-synaptic signaling gene set. The lymphocytic gene set was driven by variants in FLT3, raising an intriguing hypothesis for the involvement of a neuroinflammatory element in TS pathogenesis. The indications of involvement of ligand-gated ion channel signaling reinforce the role of GABA in TS, while the association of cell adhesion and trans-synaptic signaling gene set provides additional support for the role of adhesion molecules in neuropsychiatric disorders. This study reinforces previous findings but also provides new insights into the neurobiology of TS.

}, issn = {2158-3188}, doi = {10.1038/s41398-020-01082-z}, author = {Tsetsos, Fotis and Yu, Dongmei and Sul, Jae Hoon and Huang, Alden Y and Illmann, Cornelia and Osiecki, Lisa and Darrow, Sabrina M and Hirschtritt, Matthew E and Greenberg, Erica and Muller-Vahl, Kirsten R and Stuhrmann, Manfred and Dion, Yves and Rouleau, Guy A and Aschauer, Harald and Stamenkovic, Mara and Schl{\"o}gelhofer, Monika and Sandor, Paul and Barr, Cathy L and Grados, Marco A and Singer, Harvey S and N{\"o}then, Markus M and Hebebrand, Johannes and Hinney, Anke and King, Robert A and Fernandez, Thomas V and Barta, Csaba and Tarnok, Zsanett and Nagy, Peter and Depienne, Christel and Worbe, Yulia and Hartmann, Andreas and Budman, Cathy L and Rizzo, Renata and Lyon, Gholson J and McMahon, William M and Batterson, James R and Cath, Danielle C and Malaty, Irene A and Okun, Michael S and Berlin, Cheston and Woods, Douglas W and Lee, Paul C and Jankovic, Joseph and Robertson, Mary M and Gilbert, Donald L and Brown, Lawrence W and Coffey, Barbara J and Dietrich, Andrea and Hoekstra, Pieter J and Kuperman, Samuel and Zinner, Samuel H and Wagner, Michael and Knowles, James A and Jeremy Willsey, A and Tischfield, Jay A and Heiman, Gary A and Cox, Nancy J and Freimer, Nelson B and Neale, Benjamin M and Davis, Lea K and Coppola, Giovanni and Mathews, Carol A and Scharf, Jeremiah M and Paschou, Peristera and Barr, Cathy L and Batterson, James R and Berlin, Cheston and Budman, Cathy L and Cath, Danielle C and Coppola, Giovanni and Cox, Nancy J and Darrow, Sabrina and Davis, Lea K and Dion, Yves and Freimer, Nelson B and Grados, Marco A and Greenberg, Erica and Hirschtritt, Matthew E and Huang, Alden Y and Illmann, Cornelia and King, Robert A and Kurlan, Roger and Leckman, James F and Lyon, Gholson J and Malaty, Irene A and Mathews, Carol A and McMahon, William M and Neale, Benjamin M and Okun, Michael S and Osiecki, Lisa and Robertson, Mary M and Rouleau, Guy A and Sandor, Paul and Scharf, Jeremiah M and Singer, Harvey S and Smit, Jan H and Sul, Jae Hoon and Yu, Dongmei and Aschauer, Harald Aschauer Harald and Barta, Csaba and Budman, Cathy L and Cath, Danielle C and Depienne, Christel and Hartmann, Andreas and Hebebrand, Johannes and Konstantinidis, Anastasios and Mathews, Carol A and M{\"u}ller-Vahl, Kirsten and Nagy, Peter and N{\"o}then, Markus M and Paschou, Peristera and Rizzo, Renata and Rouleau, Guy A and Sandor, Paul and Scharf, Jeremiah M and Schl{\"o}gelhofer, Monika and Stamenkovic, Mara and Stuhrmann, Manfred and Tsetsos, Fotis and Tarnok, Zsanett and Wolanczyk, Tomasz and Worbe, Yulia and Brown, Lawrence and Cheon, Keun-Ah and Coffey, Barbara J and Dietrich, Andrea and Fernandez, Thomas V and Garcia-Delgar, Blanca and Gilbert, Donald and Grice, Dorothy E and Hagstr{\o}m, Julie and Hedderly, Tammy and Heiman, Gary A and Heyman, Isobel and Hoekstra, Pieter J and Huyser, Chaim and Kim, Young Key and Kim, Young-Shin and King, Robert A and Koh, Yun-Joo and Kook, Sodahm and Kuperman, Samuel and Leventhal, Bennett L and Madruga-Garrido, Marcos and Mir, Pablo and Morer, Astrid and M{\"u}nchau, Alexander and Plessen, Kerstin J and Roessner, Veit and Shin, Eun-Young and Song, Dong-Ho and Song, Jungeun and Tischfield, Jay A and Willsey, A Jeremy and Zinner, Samuel and Aschauer, Harald and Barr, Cathy L and Barta, Csaba and Batterson, James R and Berlin, Cheston and Brown, Lawrence and Budman, Cathy L and Cath, Danielle C and Coffey, Barbara J and Coppola, Giovanni and Cox, Nancy J and Darrow, Sabrina and Davis, Lea K and Depienne, Christel and Dietrich, Andrea and Dion, Yves and Fernandez, Thomas and Freimer, Nelson B and Gilbert, Donald and Grados, Marco A and Greenberg, Erica and Hartmann, Andreas and Hebebrand, Johannes and Heiman, Gary and Hirschtritt, Matthew E and Hoekstra, Pieter and Huang, Alden Y and Illmann, Cornelia and Jankovic, Joseph and King, Robert A and Kuperman, Samuel and Lee, Paul C and Lyon, Gholson J and Malaty, Irene A and Mathews, Carol A and McMahon, William M and M{\"u}ller-Vahl, Kirsten and Nagy, Peter and Neale, Benjamin M and N{\"o}then, Markus M and Okun, Michael S and Osiecki, Lisa and Paschou, Peristera and Rizzo, Renata and Robertson, Mary M and Rouleau, Guy A and Sandor, Paul and Scharf, Jeremiah M and Schl{\"o}gelhofer, Monika and Singer, Harvey S and Stamenkovic, Mara and Stuhrmann, Manfred and Sul, Jae Hoon and Tarnok, Zsanett and Tischfield, Jay and Tsetsos, Fotis and Willsey, A Jeremy and Woods, Douglas and Worbe, Yulia and Yu, Dongmei and Zinner, Samuel} } @article {85, title = {A brief history of human disease genetics.}, journal = {Nature}, volume = {577}, year = {2020}, month = {2020 01}, pages = {179-189}, abstract = {

A primary goal of human genetics is to identify DNA sequence variants that influence biomedical traits, particularly those related to the onset and progression of human disease. Over the past 25 years, progress in realizing this objective has been transformed by advances in technology, foundational genomic resources and analytical tools, and by access to vast amounts of genotype and phenotype data. Genetic discoveries have substantially improved~our understanding of the mechanisms responsible for many rare and common diseases and driven development of novel preventative and therapeutic strategies. Medical innovation will increasingly focus on delivering care tailored to individual patterns of genetic predisposition.

}, keywords = {Animals, Genetic Testing, Genetic Variation, Genomics, Genotype, Humans, Phenotype, Rare Diseases}, issn = {1476-4687}, doi = {10.1038/s41586-019-1879-7}, author = {Claussnitzer, Melina and Cho, Judy H and Collins, Rory and Cox, Nancy J and Dermitzakis, Emmanouil T and Hurles, Matthew E and Kathiresan, Sekar and Kenny, Eimear E and Lindgren, Cecilia M and MacArthur, Daniel G and North, Kathryn N and Plon, Sharon E and Rehm, Heidi L and Risch, Neil and Rotimi, Charles N and Shendure, Jay and Soranzo, Nicole and McCarthy, Mark I} } @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 {76, title = {Phenome-based approach identifies RIC1-linked Mendelian syndrome through zebrafish models, biobank associations and clinical studies.}, journal = {Nat Med}, volume = {26}, year = {2020}, month = {2020 01}, pages = {98-109}, abstract = {

Discovery of genotype-phenotype relationships remains a major challenge in clinical medicine. Here, we combined three sources of phenotypic data to uncover a new mechanism for rare and common diseases resulting from collagen secretion deficits. Using a zebrafish genetic screen, we identified the ric1 gene as being essential for skeletal biology. Using a gene-based phenome-wide association study (PheWAS) in the EHR-linked BioVU biobank, we show that reduced genetically determined expression of RIC1 is associated with musculoskeletal and dental conditions. Whole-exome sequencing identified individuals homozygous-by-descent for a rare variant in RIC1 and, through a guided clinical re-evaluation, it was discovered that they share signs with the BioVU-associated phenome. We named this new Mendelian syndrome CATIFA (cleft lip, cataract, tooth abnormality, intellectual disability, facial dysmorphism, attention-deficit hyperactivity disorder) and revealed further disease mechanisms. This gene-based, PheWAS-guided approach can accelerate the discovery of clinically relevant disease phenome and associated biological mechanisms.

}, keywords = {Abnormalities, Multiple, Animals, Behavior, Animal, Biological Specimen Banks, Chondrocytes, Disease Models, Animal, Extracellular Matrix, Fibroblasts, Guanine Nucleotide Exchange Factors, Humans, Models, Biological, Musculoskeletal System, Osteogenesis, Phenomics, Phenotype, Procollagen, Protein Transport, Secretory Pathway, Syndrome, Zebrafish, Zebrafish Proteins}, issn = {1546-170X}, doi = {10.1038/s41591-019-0705-y}, author = {Unlu, Gokhan and Qi, Xinzi and Gamazon, Eric R and Melville, David B and Patel, Nisha and Rushing, Amy R and Hashem, Mais and Al-Faifi, Abdullah and Chen, Rui and Li, Bingshan and Cox, Nancy J and Alkuraya, Fowzan S and Knapik, Ela W} } @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} } @article {64, title = {A Bayesian framework that integrates multi-omics data and gene networks predicts risk genes from schizophrenia GWAS data.}, journal = {Nat Neurosci}, volume = {22}, year = {2019}, month = {2019 05}, pages = {691-699}, abstract = {

Genome-wide association studies (GWAS) have identified more than 100 schizophrenia (SCZ)-associated loci, but using these findings to illuminate disease biology remains a challenge. Here we present integrative risk gene selector (iRIGS), a Bayesian framework that integrates multi-omics data and gene networks to infer risk genes in GWAS loci. By applying iRIGS to SCZ GWAS data, we predicted a set of high-confidence risk genes, most of which are not the nearest genes to the GWAS index variants. High-confidence risk genes account for a significantly enriched heritability, as estimated by stratified linkage disequilibrium score regression. Moreover, high-confidence risk genes are predominantly expressed in brain tissues, especially prenatally, and are enriched for targets of approved drugs, suggesting opportunities to reposition existing drugs for SCZ. Thus, iRIGS can leverage accumulating functional genomics and GWAS data to advance our understanding of SCZ etiology and potential therapeutics.

}, keywords = {Animals, Bayes Theorem, Disease Models, Animal, Gene Regulatory Networks, Genetic Predisposition to Disease, Genome-Wide Association Study, Genomics, Humans, Mice, Risk Factors, Schizophrenia}, issn = {1546-1726}, doi = {10.1038/s41593-019-0382-7}, author = {Wang, Quan and Chen, Rui and Cheng, Feixiong and Wei, Qiang and Ji, Ying and Yang, Hai and Zhong, Xue and Tao, Ran and Wen, Zhexing and Sutcliffe, James S and Liu, Chunyu and Cook, Edwin H and Cox, Nancy J and Li, Bingshan} } @article {60, title = {De novo pattern discovery enables robust assessment of functional consequences of non-coding variants.}, journal = {Bioinformatics}, volume = {35}, year = {2019}, month = {2019 May 01}, pages = {1453-1460}, abstract = {

MOTIVATION: Given the complexity of genome regions, prioritize the functional effects of non-coding variants remains a challenge. Although several frameworks have been proposed for the evaluation of the functionality of non-coding variants, most of them used {\textquoteright}black boxes{\textquoteright} methods that simplify the task as the pathogenicity/benign classification problem, which ignores the distinct regulatory mechanisms of variants and leads to less desirable performance. In this study, we developed DVAR, an unsupervised framework that leverage various biochemical and evolutionary evidence to distinguish the gene regulatory categories of variants and assess their comprehensive functional impact simultaneously.

RESULTS: DVAR performed de novo pattern discovery in high-dimensional data and identified five regulatory clusters of non-coding variants. Leveraging the new insights into the multiple functional patterns, it measures both the between-class and the within-class functional implication of the variants to achieve accurate prioritization. Compared to other two-class learning methods, it showed improved performance in identification of clinically significant variants, fine-mapped GWAS variants, eQTLs and expression-modulating variants. Moreover, it has superior performance on disease causal variants verified by genome-editing (like CRISPR-Cas9), which could provide a pre-selection strategy for genome-editing technologies across the whole genome. Finally, evaluated in BioVU and UK Biobank, two large-scale DNA biobanks linked to complete electronic health records, DVAR demonstrated its effectiveness in prioritizing non-coding variants associated with medical phenotypes.

AVAILABILITY AND IMPLEMENTATION: The C++ and Python source codes, the pre-computed DVAR-cluster labels and DVAR-scores across the whole genome are available at https://www.vumc.org/cgg/dvar.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

}, issn = {1367-4811}, doi = {10.1093/bioinformatics/bty826}, author = {Yang, Hai and Chen, Rui and Wang, Quan and Wei, Qiang and Ji, Ying and Zheng, Guangze and Zhong, Xue and Cox, Nancy J and Li, Bingshan} } @article {65, title = {Diagnostic Algorithms to Study Post-Concussion Syndrome Using Electronic Health Records: Validating a Method to Capture an Important Patient Population.}, journal = {J Neurotrauma}, volume = {36}, year = {2019}, month = {2019 Jul 15}, pages = {2167-2177}, abstract = {

Post-concussion syndrome (PCS) is characterized by persistent cognitive, somatic, and emotional symptoms after a mild traumatic brain injury (mTBI). Genetic and other biological variables may contribute to PCS etiology, and the emergence of biobanks linked to electronic health records (EHRs) offers new opportunities for research on PCS. We sought to validate the EHR data of PCS patients by comparing two diagnostic algorithms deployed in the Vanderbilt University Medical Center de-identified database of 2.8 million patient EHRs. The algorithms identified individuals with PCS by: 1) natural language processing (NLP) of narrative text in the EHR combined with structured demographic, diagnostic, and encounter data; or 2) coded billing and procedure data. The predictive value of each algorithm was assessed, and cases and controls identified by each approach were compared on demographic and medical characteristics. The NLP algorithm identified 507 cases and 10,857 controls. The negative predictive value in controls was 78\% and the positive predictive value (PPV) in cases was 82\%. Conversely, the coded algorithm identified 1142 patients with two or more PCS billing codes and had a PPV of 76\%. Comparisons of PCS controls to both case groups recovered known epidemiology of PCS: cases were more likely than controls to be female and to have pre-morbid diagnoses of anxiety, migraine, and post-traumatic stress disorder. In contrast, controls and cases were equally likely to have attention deficit hyperactive disorder and learning disabilities, in accordance with the findings of recent systematic reviews of PCS risk factors. We conclude that EHRs are a valuable research tool for PCS. Ascertainment based on coded data alone had a predictive value comparable to an NLP algorithm, recovered known PCS risk factors, and maximized the number of included patients.

}, issn = {1557-9042}, doi = {10.1089/neu.2018.5916}, author = {Dennis, Jessica and Yengo-Kahn, Aaron M and Kirby, Paul and Solomon, Gary S and Cox, Nancy J and Zuckerman, Scott L} } @article {56, title = {GRIK5 Genetically Regulated Expression Associated with Eye and Vascular Phenomes: Discovery through Iteration among Biobanks, Electronic Health Records, and Zebrafish.}, journal = {Am J Hum Genet}, volume = {104}, year = {2019}, month = {2019 Mar 07}, pages = {503-519}, abstract = {

Although the use of model systems for studying the mechanism of mutations that have a large effect is common, we highlight here the ways that zebrafish-model-system studies of a gene, GRIK5, that contributes to the polygenic liability to develop eye diseases have helped to illuminate a mechanism that implicates vascular biology in eye disease. A gene-expression prediction derived from a reference transcriptome panel applied to BioVU, a large electronic health record (EHR)-linked biobank at Vanderbilt University Medical Center, implicated reduced GRIK5 expression in diverse eye diseases. We tested the function of GRIK5 by depletion of its ortholog in zebrafish, and we observed reduced blood vessel numbers and integrity in the eye and increased vascular permeability. Analyses of EHRs in >2.6 million Vanderbilt subjects revealed significant comorbidity of eye and vascular diseases (relative risks 2-15); this comorbidity was confirmed in 150 million individuals from a large insurance claims dataset. Subsequent studies in >60,000 genotyped BioVU participants confirmed the association of reduced genetically predicted expression of GRIK5 with comorbid vascular and eye diseases. Our studies pioneer an approach that allows a rapid iteration of the discovery of gene-phenotype relationships to the primary genetic mechanism contributing to the pathophysiology of human disease. Our findings also add dimension to the understanding of the biology driven by glutamate receptors such as GRIK5 (also referred to as GLUK5 in protein form) and to mechanisms contributing to human eye diseases.

}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2019.01.017}, author = {Unlu, Gokhan and Gamazon, Eric R and Qi, Xinzi and Levic, Daniel S and Bastarache, Lisa and Denny, Joshua C and Roden, Dan M and Mayzus, Ilya and Breyer, Max and Zhong, Xue and Konkashbaev, Anuar I and Rzhetsky, Andrey and Knapik, Ela W and Cox, Nancy J} } @article {29, title = {Phenotype risk scores identify patients with unrecognized Mendelian disease patterns.}, journal = {Science}, volume = {359}, year = {2018}, month = {2018 03 16}, pages = {1233-1239}, abstract = {

Genetic association studies often examine features independently, potentially missing subpopulations with multiple phenotypes that share a single cause. We describe an approach that aggregates phenotypes on the basis of patterns described by Mendelian diseases. We mapped the clinical features of 1204 Mendelian diseases into phenotypes captured from the electronic health record (EHR) and summarized this evidence as phenotype risk scores (PheRSs). In an initial validation, PheRS distinguished cases and controls of five Mendelian diseases. Applying PheRS to 21,701 genotyped individuals uncovered 18 associations between rare variants and phenotypes consistent with Mendelian diseases. In 16 patients, the rare genetic variants were associated with severe outcomes such as organ transplants. PheRS can augment rare-variant interpretation and may identify subsets of patients with distinct genetic causes for common diseases.

}, keywords = {Databases, Genetic, DNA Mutational Analysis, Electronic Health Records, Exome, Genetic Association Studies, Genetic Diseases, Inborn, Genetic Predisposition to Disease, Genetic Variation, Humans, Phenotype, Risk Factors}, issn = {1095-9203}, doi = {10.1126/science.aal4043}, author = {Bastarache, Lisa and Hughey, Jacob J and Hebbring, Scott and Marlo, Joy and Zhao, Wanke and Ho, Wanting T and Van Driest, Sara L and McGregor, Tracy L and Mosley, Jonathan D and Wells, Quinn S and Temple, Michael and Ramirez, Andrea H and Carroll, Robert and Osterman, Travis and Edwards, Todd and Ruderfer, Douglas and Velez Edwards, Digna R and Hamid, Rizwan and Cogan, Joy and Glazer, Andrew and Wei, Wei-Qi and Feng, QiPing and Brilliant, Murray and Zhao, Zhizhuang J and Cox, Nancy J and Roden, Dan M and Denny, Joshua C} }