@article {138, title = {Comprehensive cell type decomposition of circulating cell-free DNA with CelFiE.}, journal = {Nat Commun}, volume = {12}, year = {2021}, month = {2021 05 11}, pages = {2717}, abstract = {

Circulating cell-free DNA (cfDNA) in the bloodstream originates from dying cells and is a promising noninvasive biomarker for cell death. Here, we propose an algorithm, CelFiE, to accurately estimate the relative abundances of cell types and tissues contributing to cfDNA from epigenetic cfDNA sequencing. In contrast to previous work, CelFiE accommodates low coverage data, does not require CpG site curation, and estimates contributions from multiple unknown cell types that are not available in external reference data. In simulations, CelFiE accurately estimates known and unknown cell type proportions from low coverage and noisy cfDNA mixtures, including from cell types composing less than 1\% of the total mixture. When used in two clinically-relevant situations, CelFiE correctly estimates a large placenta component in pregnant women, and an elevated skeletal muscle component in amyotrophic lateral sclerosis (ALS) patients, consistent with the occurrence of muscle wasting typical in these patients. Together, these results show how CelFiE could be a useful tool for biomarker discovery and monitoring the progression of degenerative disease.

}, keywords = {Adult, Algorithms, Amyotrophic Lateral Sclerosis, B-Lymphocytes, Biomarkers, Case-Control Studies, Cell-Free Nucleic Acids, DNA Methylation, Epigenesis, Genetic, Female, Humans, Macrophages, Male, Monocytes, Muscle, Skeletal, Neutrophils, Organ Specificity, Pregnancy, Pregnancy Trimesters, T-Lymphocytes}, issn = {2041-1723}, doi = {10.1038/s41467-021-22901-x}, author = {Caggiano, Christa and Celona, Barbara and Garton, Fleur and Mefford, Joel and Black, Brian L and Henderson, Robert and Lomen-Hoerth, Catherine and Dahl, Andrew and Zaitlen, Noah} } @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 {116, title = {Epidemiology of Functional Seizures Among Adults Treated at a University Hospital.}, journal = {JAMA Netw Open}, volume = {3}, year = {2020}, month = {2020 12 01}, pages = {e2027920}, abstract = {

Importance: Functional seizures (formerly psychogenic nonepileptic seizures), paroxysmal episodes that are often similar to epileptic seizures in their clinical presentation and display no aberrant brain electrical patterns, are understudied. Patients experience a long diagnostic delay, few treatment modalities, a high rate of comorbidities, and significant stigma due to the lack of knowledge about functional seizures.

Objective: To characterize the clinical epidemiology of a population of patients with functional seizures observed at Vanderbilt University Medical Center (VUMC).

Design, Setting, and Participants: This case-control study included patients with functional seizures identified in the VUMC electronic health record (VUMC-EHR) system from October 1989 to October 2018. Patients with epilepsy were excluded from the study and all remaining patients in the VUMC medical center system were used as controls. In total, the study included 1431 patients diagnosed with functional seizures, 2251 with epilepsy and functional seizures, 4715 with epilepsy without functional seizures, and 502 200 control patients who received treatment at VUMC for a minimum of a 3 years. Data were analyzed from November 2018 to March 2020.

Exposure: Diagnosis of functional seizures, as identified from the VUMC-EHR system by an automated phenotyping algorithm that incorporated International Classification of Diseases, Ninth Revision (ICD-9) codes, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, Current Procedural Terminology codes, and natural language processing.

Main Outcomes and Measures: Associations of functional seizures with comorbidities and risk factors, measured in odds ratios (ORs).

Results: Of 2 346 808 total patients in the VUMC-EHR aged 18 years or older, 3341 patients with functional seizures were identified (period prevalence, 0.14\%), 1062 (74.2\%) of whom were women and for which the median (interquartile range) age was 49.3 (39.4-59.9) years. This assessment replicated previously reported associations with psychiatric disorders including posttraumatic stress disorder (PTSD) (OR, 1.22; 95\% CI, 1.21-1.24; P < 3.02 {\texttimes} 10-5), anxiety (OR, 1.14; 95\% CI, 1.13-1.15; P < 3.02 {\texttimes} 10-5), and depression (OR, 1.14; 95\% CI, 1.13-1.15; P < 3.02 {\texttimes} 10-5), and identified novel associations with cerebrovascular disease (OR, 1.08; 95\% CI, 1.06-1.09; P < 3.02 {\texttimes} 10-5). An association was found between functional seizures and the known risk factor sexual assault trauma (OR, 10.26; 95\% CI, 10.09-10.44; P < 3.02 {\texttimes} 10-5), and sexual assault trauma was found to mediate nearly a quarter of the association between female sex and functional seizures in the VUMC-EHR.

Conclusions and Relevance: This case-control study found evidence to support previously reported associations, discovered new associations between functional seizures and PTSD, anxiety, and depression. An association between cerebrovascular disease and functional seizures was also found. Results suggested that sexual trauma may be a mediating factor in the association between female sex and functional seizures.

}, keywords = {Adult, Anxiety, Case-Control Studies, Comorbidity, Delayed Diagnosis, Depression, Female, Hospitals, University, Humans, Male, Mental Disorders, Middle Aged, Odds Ratio, Risk Factors, Seizures, Stress Disorders, Post-Traumatic}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2020.27920}, author = {Goleva, Slavina B and Lake, Allison M and Torstenson, Eric S and Haas, Kevin F and Davis, Lea K} } @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 {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 {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} } @article {44, title = {Fine-mapping and functional studies highlight potential causal variants for rheumatoid arthritis and type 1 diabetes.}, journal = {Nat Genet}, volume = {50}, year = {2018}, month = {2018 10}, pages = {1366-1374}, abstract = {

To define potentially causal variants for autoimmune disease, we fine-mapped 76 rheumatoid arthritis (11,475 cases, 15,870 controls) and type 1 diabetes loci (9,334 cases, 11,111 controls). After sequencing 799 1-kilobase regulatory (H3K4me3) regions within these loci in 568 individuals, we observed accurate imputation for 89\% of common variants. We defined credible sets of <=5 causal variants at 5 rheumatoid arthritis and 10 type 1 diabetes loci. We identified potentially causal missense variants at DNASE1L3, PTPN22, SH2B3, and TYK2, and noncoding variants at MEG3, CD28-CTLA4, and IL2RA. We also identified potential candidate causal variants at SIRPG and TNFAIP3. Using functional assays, we confirmed allele-specific protein binding and differential enhancer activity for three variants: the CD28-CTLA4 rs117701653 SNP, MEG3 rs34552516 indel, and TNFAIP3 rs35926684 indel.

}, keywords = {Alleles, Arthritis, Rheumatoid, Case-Control Studies, CD28 Antigens, Chromosome Mapping, CTLA-4 Antigen, Diabetes Mellitus, Type 1, Gene Frequency, Genetic Loci, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Jurkat Cells, Mutation, Polymorphism, Single Nucleotide, Quantitative Trait Loci, RNA, Long Noncoding, Tumor Necrosis Factor alpha-Induced Protein 3}, issn = {1546-1718}, doi = {10.1038/s41588-018-0216-7}, author = {Westra, Harm-Jan and Mart{\'\i}nez-Bonet, Marta and Onengut-Gumuscu, Suna and Lee, Annette and Luo, Yang and Teslovich, Nikola and Worthington, Jane and Martin, Javier and Huizinga, Tom and Klareskog, Lars and Rantapaa-Dahlqvist, Solbritt and Chen, Wei-Min and Quinlan, Aaron and Todd, John A and Eyre, Steve and Nigrovic, Peter A and Gregersen, Peter K and Rich, Stephen S and Raychaudhuri, Soumya} } @article {47, title = {Weighted pseudolikelihood for SNP set analysis with multiple secondary outcomes in case-control genetic association studies.}, journal = {Biometrics}, volume = {73}, year = {2017}, month = {2017 12}, pages = {1210-1220}, abstract = {

We propose a weighted pseudolikelihood method for analyzing the association of a SNP set, example, SNPs in a gene or a genetic pathway or network, with multiple secondary phenotypes in case-control genetic association studies. To boost analysis power, we assume that the SNP-specific effects are shared across all secondary phenotypes using a scaled mean model. We estimate regression parameters using Inverse Probability Weighted (IPW) estimating equations obtained from the weighted pseudolikelihood, which accounts for case-control sampling to prevent potential ascertainment bias. To test the effect of a SNP set, we propose a weighted variance component pseudo-score test. We also propose a penalized IPW pseudolikelihood method for selecting a subset of SNPs that are associated with the multiple secondary phenotypes. We show that the proposed variable selection procedure has the oracle properties and is robust to misspecification of the correlation structure among secondary phenotypes. We select the tuning parameter using a weighted Bayesian Information-like Criterion (wBIC). We evaluate the finite sample performance of the proposed methods via simulations, and illustrate the methods by the analysis of the multiple secondary smoking behavior outcomes in a lung cancer case-control genetic association study.

}, keywords = {Case-Control Studies, Computer Simulation, Genetic Association Studies, Humans, Likelihood Functions, Lung Neoplasms, Phenotype, Polymorphism, Single Nucleotide, Smoking}, issn = {1541-0420}, doi = {10.1111/biom.12680}, author = {Sofer, Tamar and Schifano, Elizabeth D and Christiani, David C and Lin, Xihong} }