@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 {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 {81, title = {Identification of cancer driver genes based on nucleotide context.}, journal = {Nat Genet}, volume = {52}, year = {2020}, month = {2020 02}, pages = {208-218}, abstract = {

Cancer genomes contain large numbers of somatic mutations but few of these mutations drive tumor development. Current approaches either identify driver genes on the basis of mutational recurrence or approximate the functional consequences of nonsynonymous mutations by using bioinformatic scores. Passenger mutations are enriched in characteristic nucleotide contexts, whereas driver mutations occur in functional positions, which are not necessarily surrounded by a particular nucleotide context. We observed that mutations in contexts that deviate from the characteristic contexts around passenger mutations provide a signal in favor of driver genes. We therefore developed a method that combines this feature with the signals traditionally used for driver-gene identification. We applied our method to whole-exome sequencing data from 11,873 tumor-normal pairs and identified 460 driver genes that clustered into 21 cancer-related pathways. Our study provides a resource of driver genes across 28 tumor types with additional driver genes identified according to mutations in unusual nucleotide contexts.

}, keywords = {Cluster Analysis, Computational Biology, Humans, Mutation, Neoplasms, Nucleotides, Proteins, Whole Exome Sequencing}, issn = {1546-1718}, doi = {10.1038/s41588-019-0572-y}, author = {Dietlein, Felix and Weghorn, Donate and Taylor-Weiner, Amaro and Richters, Andr{\'e} and Reardon, Brendan and Liu, David and Lander, Eric S and Van Allen, Eliezer M and Sunyaev, Shamil R} } @article {88, title = {Whole-Genome and RNA Sequencing Reveal Variation and Transcriptomic Coordination in the Developing Human Prefrontal Cortex.}, journal = {Cell Rep}, volume = {31}, year = {2020}, month = {2020 04 07}, pages = {107489}, abstract = {

Gene expression levels vary across developmental stage, cell type, and region in the brain. Genomic variants also contribute to the variation in expression, and some neuropsychiatric disorder loci may exert their effects through this mechanism. To investigate these relationships, we present BrainVar, a unique resource of paired whole-genome and bulk tissue RNA sequencing from the dorsolateral prefrontal cortex of 176 individuals across prenatal and postnatal development. Here we identify common variants that alter gene expression (expression quantitative trait loci [eQTLs]) constantly across development or predominantly during prenatal or postnatal stages. Both "constant" and "temporal-predominant" eQTLs are enriched for loci associated with neuropsychiatric traits and disorders and colocalize with specific variants. Expression levels of more than 12,000 genes rise or fall in a concerted late-fetal transition, with the transitional genes enriched for cell-type-specific genes and neuropsychiatric risk loci, underscoring the importance of cataloging developmental trajectories in understanding cortical physiology and pathology.

}, keywords = {Base Sequence, Brain, Computational Biology, Databases, Genetic, Genetic Predisposition to Disease, Genetic Variation, Genome-Wide Association Study, Genomics, Humans, Phenotype, Polymorphism, Single Nucleotide, Prefrontal Cortex, Quantitative Trait Loci, Sequence Analysis, RNA, Transcriptome, Whole Exome Sequencing, Whole Genome Sequencing}, issn = {2211-1247}, doi = {10.1016/j.celrep.2020.03.053}, author = {Werling, Donna M and Pochareddy, Sirisha and Choi, Jinmyung and An, Joon-Yong and Sheppard, Brooke and Peng, Minshi and Li, Zhen and Dastmalchi, Claudia and Santpere, Gabriel and Sousa, Andr{\'e} M M and Tebbenkamp, Andrew T N and Kaur, Navjot and Gulden, Forrest O and Breen, Michael S and Liang, Lindsay and Gilson, Michael C and Zhao, Xuefang and Dong, Shan and Klei, Lambertus and Cicek, A Ercument and Buxbaum, Joseph D and Adle-Biassette, Homa and Thomas, Jean-Leon and Aldinger, Kimberly A and O{\textquoteright}Day, Diana R and Glass, Ian A and Zaitlen, Noah A and Talkowski, Michael E and Roeder, Kathryn and State, Matthew W and Devlin, Bernie and Sanders, Stephan J and Sestan, Nenad} } @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 {55, title = {Methods for the Analysis and Interpretation for Rare Variants Associated with Complex Traits.}, journal = {Curr Protoc Hum Genet}, volume = {101}, year = {2019}, month = {2019 04}, pages = {e83}, abstract = {

With the advent of Next Generation Sequencing (NGS) technologies, whole genome and whole exome DNA sequencing has become affordable for routine genetic studies. Coupled with improved genotyping arrays and genotype imputation methodologies, it is increasingly feasible to obtain rare genetic variant information in large datasets. Such datasets allow researchers to gain a more complete understanding of the genetic architecture of complex traits caused by rare variants. State-of-the-art statistical methods for the statistical genetics analysis of sequence-based association, including efficient algorithms for association analysis in biobank-scale datasets, gene-association tests, meta-analysis, fine mapping methods that integrate functional genomic dataset, and phenome-wide association studies (PheWAS), are reviewed here. These methods are expected to be highly useful for next generation statistical genetics analysis in the era of precision medicine. {\textcopyright} 2019 by John Wiley \& Sons, Inc.

}, keywords = {Algorithms, Genetic Predisposition to Disease, Genome, Human, Genome-Wide Association Study, Genotype, High-Throughput Nucleotide Sequencing, Humans, Multifactorial Inheritance, Phenotype, Polymorphism, Single Nucleotide, Whole Exome Sequencing, Whole Genome Sequencing}, issn = {1934-8258}, doi = {10.1002/cphg.83}, author = {Weissenkampen, J Dylan and Jiang, Yu and Eckert, Scott and Jiang, Bibo and Li, Bingshan and Liu, Dajiang J} }