@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 {130, title = {Elevated Polygenic Burden for Autism Spectrum Disorder Is Associated With the Broad Autism Phenotype in Mothers of Individuals With Autism Spectrum Disorder.}, journal = {Biol Psychiatry}, volume = {89}, year = {2021}, month = {2021 03 01}, pages = {476-485}, abstract = {

BACKGROUND: Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental disorder that encompasses a complex and heterogeneous set of traits. Subclinical traits that mirror the core features of ASD, referred to as the broad autism phenotype (BAP), have been documented repeatedly in unaffected relatives and are believed to reflect underlying genetic liability to ASD. The BAP may help inform the etiology of ASD by allowing the stratification of families into more phenotypically and etiologically homogeneous subgroups. This study explores polygenic scores related to the BAP.

METHODS: Phenotypic and genotypic information were obtained from 2614 trios from the Simons Simplex Collection. Polygenic scores of ASD (ASD-PGSs) were generated across the sample to determine the shared genetic overlap between the BAP and ASD. Maternal and paternal ASD-PGSs were explored in relation to BAP traits and their child{\textquoteright}s ASD symptomatology.

RESULTS: Maternal pragmatic language was related to child{\textquoteright}s social communicative atypicalities. In fathers, rigid personality was related to increased repetitive behaviors in children. Maternal (but not paternal) ASD-PGSs were related to the pragmatic language and rigid BAP domains.

CONCLUSIONS: Associations emerged between parent and child phenotypes, with more associations emerging in mothers than in fathers. ASD-PGS associations emerged with BAP in mothers only, highlighting the potential for a female protective factor, and implicating the polygenic etiology of ASD-related phenotypes in the BAP.

}, keywords = {Autism Spectrum Disorder, Autistic Disorder, Child, Fathers, Female, Humans, Male, Mothers, Phenotype}, issn = {1873-2402}, doi = {10.1016/j.biopsych.2020.08.029}, author = {Nayar, Kritika and Sealock, Julia M and Maltman, Nell and Bush, Lauren and Cook, Edwin H and Davis, Lea K and Losh, Molly} } @article {134, title = {Regulatory genomic circuitry of human disease loci by integrative epigenomics.}, journal = {Nature}, volume = {590}, year = {2021}, month = {2021 02}, pages = {300-307}, abstract = {

Annotating the molecular basis of human disease remains an unsolved challenge, as 93\% of disease loci are non-coding and gene-regulatory annotations are highly incomplete. Here we present EpiMap, a compendium comprising 10,000~epigenomic maps across 800~samples, which we used to define chromatin states, high-resolution enhancers, enhancer modules, upstream regulators and downstream target genes. We used this resource to annotate 30,000~genetic loci that were associated with 540~traits, predicting trait-relevant tissues, putative causal nucleotide variants in enriched tissue enhancers and candidate tissue-specific target genes for each. We partitioned multifactorial traits into tissue-specific contributing factors with distinct functional enrichments and disease comorbidity patterns, and revealed both single-factor monotropic and multifactor pleiotropic loci. Top-scoring loci frequently had multiple predicted driver variants, converging through multiple enhancers with a common target gene, multiple genes in common tissues, or multiple genes and multiple tissues, indicating extensive pleiotropy. Our results demonstrate the importance of dense, rich, high-resolution epigenomic annotations for the investigation of complex traits.

}, keywords = {Chromatin, Disease, Enhancer Elements, Genetic, Epigenesis, Genetic, Epigenomics, Female, Gene Regulatory Networks, Genetic Loci, Genome-Wide Association Study, Humans, Male, Multifactorial Inheritance, Organ Specificity, Reproducibility of Results}, issn = {1476-4687}, doi = {10.1038/s41586-020-03145-z}, author = {Boix, Carles A and James, Benjamin T and Park, Yongjin P and Meuleman, Wouter and Kellis, Manolis} } @article {91, title = {Assessing Digital Phenotyping to Enhance Genetic Studies of Human Diseases.}, journal = {Am J Hum Genet}, volume = {106}, year = {2020}, month = {2020 05 07}, pages = {611-622}, abstract = {

Population-scale biobanks that combine genetic data and high-dimensional phenotyping for a large number of participants provide an exciting opportunity to perform genome-wide association studies (GWAS) to identify genetic variants associated with diverse quantitative traits and diseases. A major challenge for GWAS in population biobanks is ascertaining disease cases from heterogeneous data sources such as hospital records, digital questionnaire responses, or interviews. In this study, we use genetic parameters, including genetic correlation, to evaluate whether GWAS performed using cases in the UK Biobank ascertained from hospital records, questionnaire responses, and family history of disease implicate similar disease genetics across a range of effect sizes. We find that hospital record and questionnaire GWAS largely identify similar genetic effects for many complex phenotypes and that combining together both phenotyping methods improves power to detect genetic associations. We also show that family history GWAS using cases ascertained on family history of disease agrees with combined hospital record and questionnaire GWAS and that family history GWAS has better power to detect genetic associations for some phenotypes. Overall, this work demonstrates that digital phenotyping and unstructured phenotype data can be combined with structured data such as hospital records to identify cases for GWAS in biobanks and improve the ability of such studies to identify genetic associations.

}, keywords = {Asthma, Databases, Factual, Disease, Female, Genetics, Medical, Genome-Wide Association Study, Genotype, Humans, Male, Neoplasms, Phenotype, United Kingdom}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2020.03.007}, author = {DeBoever, Christopher and Tanigawa, Yosuke and Aguirre, Matthew and McInnes, Greg and Lavertu, Adam and Rivas, Manuel A} } @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 {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 {128, title = {A phenome-wide association study of 26 mendelian genes reveals phenotypic expressivity of common and rare variants within the general population.}, journal = {PLoS Genet}, volume = {16}, year = {2020}, month = {2020 11}, pages = {e1008802}, abstract = {

The clinical evaluation of a genetic syndrome relies upon recognition of a characteristic pattern of signs or symptoms to guide targeted genetic testing for confirmation of the diagnosis. However, individuals displaying a single phenotype of a complex syndrome may not meet criteria for clinical diagnosis or genetic testing. Here, we present a phenome-wide association study (PheWAS) approach to systematically explore the phenotypic expressivity of common and rare alleles in genes associated with four well-described syndromic diseases (Alagille (AS), Marfan (MS), DiGeorge (DS), and Noonan (NS) syndromes) in the general population. Using human phenotype ontology (HPO) terms, we systematically mapped 60 phenotypes related to AS, MS, DS and NS in 337,198 unrelated white British from the UK Biobank (UKBB) based on their hospital admission records, self-administrated questionnaires, and physiological measurements. We performed logistic regression adjusting for age, sex, and the first 5 genetic principal components, for each phenotype and each variant in the target genes (JAG1, NOTCH2 FBN1, PTPN1 and RAS-opathy genes, and genes in the 22q11.2 locus) and performed a gene burden test. Overall, we observed multiple phenotype-genotype correlations, such as the association between variation in JAG1, FBN1, PTPN11 and SOS2 with diastolic and systolic blood pressure; and pleiotropy among multiple variants in syndromic genes. For example, rs11066309 in PTPN11 was significantly associated with a lower body mass index, an increased risk of hypothyroidism and a smaller size for gestational age, all in concordance with NS-related phenotypes. Similarly, rs589668 in FBN1 was associated with an increase in body height and blood pressure, and a reduced body fat percentage as observed in Marfan syndrome. Our findings suggest that the spectrum of associations of common and rare variants in genes involved in syndromic diseases can be extended to individual phenotypes within the general population.

}, keywords = {Alagille Syndrome, Alleles, Biological Variation, Population, DiGeorge Syndrome, European Continental Ancestry Group, Female, Gene Frequency, Genetic Association Studies, Genetic Predisposition to Disease, Genetic Testing, Genetic Variation, Genome-Wide Association Study, Humans, Male, Marfan Syndrome, Noonan Syndrome, Phenotype, Polymorphism, Single Nucleotide, United Kingdom}, issn = {1553-7404}, doi = {10.1371/journal.pgen.1008802}, author = {Tcheandjieu, Catherine and Aguirre, Matthew and Gustafsson, Stefan and Saha, Priyanka and Potiny, Praneetha and Haendel, Melissa and Ingelsson, Erik and Rivas, Manuel A and Priest, James R} } @article {89, title = {A positively selected FBN1 missense variant reduces height in Peruvian individuals.}, journal = {Nature}, volume = {582}, year = {2020}, month = {2020 06}, pages = {234-239}, abstract = {

On average, Peruvian individuals are among the shortest in the world. Here we show that Native American ancestry is associated with reduced height in an ethnically diverse group of Peruvian individuals, and identify a population-specific, missense variant in the FBN1 gene (E1297G) that is significantly associated with lower height. Each copy of the minor allele (frequency of 4.7\%) reduces height by 2.2~cm (4.4~cm in homozygous individuals). To our knowledge, this is the largest effect size known for a common height-associated variant. FBN1 encodes the extracellular matrix protein fibrillin~1, which is a major structural component of microfibrils. We observed less densely packed fibrillin-1-rich microfibrils with irregular edges in the skin of individuals who were homozygous for G1297 compared with individuals who were homozygous for E1297. Moreover, we show that the E1297G locus is under positive selection in non-African populations, and that the E1297 variant shows subtle evidence of positive selection specifically within the Peruvian population. This variant is also significantly more frequent in coastal Peruvian populations than in populations from the Andes or the Amazon, which suggests that short stature might be the result of adaptation to factors that are associated with the coastal environment in Peru.

}, keywords = {Body Height, Female, Fibrillin-1, Gene Frequency, Genome-Wide Association Study, Heredity, Humans, Indians, South American, Male, Microfibrils, Mutation, Missense, Peru, Selection, Genetic}, issn = {1476-4687}, doi = {10.1038/s41586-020-2302-0}, author = {Asgari, Samira and Luo, Yang and Akbari, Ali and Belbin, Gillian M and Li, Xinyi and Harris, Daniel N and Selig, Martin and Bartell, Eric and Calderon, Roger and Slowikowski, Kamil and Contreras, Carmen and Yataco, Rosa and Galea, Jerome T and Jimenez, Judith and Coit, Julia M and Farro{\~n}ay, Chandel and Nazarian, Rosalynn M and O{\textquoteright}Connor, Timothy D and Dietz, Harry C and Hirschhorn, Joel N and Guio, Heinner and Lecca, Leonid and Kenny, Eimear E and Freeman, Esther E and Murray, Megan B and Raychaudhuri, Soumya} } @article {102, title = {Race, socioeconomic deprivation, and hospitalization for COVID-19 in English participants of a national biobank.}, journal = {Int J Equity Health}, volume = {19}, year = {2020}, month = {2020 07 06}, pages = {114}, abstract = {

Preliminary reports suggest that the Coronavirus Disease 2019 (COVID- 19) pandemic has led to disproportionate morbidity and mortality among historically disadvantaged populations. We investigate the racial and socioeconomic associations of COVID- 19 hospitalization among 418,794 participants of the UK Biobank, of whom 549 (0.13\%) had been hospitalized. Both Black participants (odds ratio 3.7; 95\%CI 2.5-5.3) and Asian participants (odds ratio 2.2; 95\%CI 1.5-3.2) were at substantially increased risk as compared to White participants. We further observed a striking gradient in COVID- 19 hospitalization rates according to the Townsend Deprivation Index - a composite measure of socioeconomic deprivation - and household income. Adjusting for socioeconomic factors and cardiorespiratory comorbidities led to only modest attenuation of the increased risk in Black participants, adjusted odds ratio 2.4 (95\%CI 1.5-3.7). These observations confirm and extend earlier preliminary and lay press reports of higher morbidity in non-White individuals in the context of a large population of participants in a national biobank. The extent to which this increased risk relates to variation in pre-existing comorbidities, differences in testing or hospitalization patterns, or additional disparities in social determinants of health warrants further study.

}, keywords = {Adult, Aged, Biological Specimen Banks, Continental Population Groups, Coronavirus Infections, COVID-19, Female, Health Status Disparities, Hospitalization, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral, Prospective Studies, Socioeconomic Factors, United Kingdom}, issn = {1475-9276}, doi = {10.1186/s12939-020-01227-y}, author = {Patel, Aniruddh P and Paranjpe, Manish D and Kathiresan, Nina P and Rivas, Manuel A and Khera, Amit V} } @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 {86, title = {A Robust Method Uncovers Significant Context-Specific Heritability in Diverse Complex Traits.}, journal = {Am J Hum Genet}, volume = {106}, year = {2020}, month = {2020 01 02}, pages = {71-91}, abstract = {

Gene-environment interactions (GxE) can be fundamental in applications ranging from functional genomics to precision medicine and is a conjectured source of substantial heritability. However, unbiased methods to profile GxE genome-wide are nascent and, as we show, cannot accommodate general environment variables, modest sample sizes, heterogeneous noise, and binary traits. To address this gap, we propose a simple, unifying mixed model for gene-environment interaction (GxEMM). In simulations and theory, we show that GxEMM can dramatically improve estimates and eliminate false positives when the assumptions of existing methods fail. We apply GxEMM to a range of human and model organism datasets and find broad evidence of context-specific genetic effects, including GxSex, GxAdversity, and GxDisease interactions across thousands of clinical and molecular phenotypes. Overall, GxEMM is broadly applicable for testing and quantifying polygenic interactions, which can be useful for explaining heritability and invaluable for determining biologically relevant environments.

}, keywords = {Adult, Animals, Computer Simulation, Female, Gene-Environment Interaction, Genetic Markers, Genome-Wide Association Study, Humans, Male, Mental Disorders, Middle Aged, Models, Genetic, Multifactorial Inheritance, Phenomics, Phenotype, Rats}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2019.11.015}, author = {Dahl, Andy and Nguyen, Khiem and Cai, Na and Gandal, Michael J and Flint, Jonathan and Zaitlen, Noah} } @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 {52, title = {Differential NOVA2-Mediated Splicing in Excitatory and Inhibitory Neurons Regulates Cortical Development and Cerebellar Function.}, journal = {Neuron}, volume = {101}, year = {2019}, month = {2019 02 20}, pages = {707-720.e5}, abstract = {

RNA-binding proteins (RBPs) regulate genetic diversity, but the degree to which they do so in individual cell types in~vivo is unknown. We developed NOVA2 cTag-crosslinking and immunoprecipitation (CLIP) to generate functional RBP-RNA maps from different neuronal populations in the mouse brain. Combining cell type datasets from Nova2-cTag and Nova2 conditional knockout mice revealed differential NOVA2 regulatory actions on alternative splicing (AS) on the same transcripts expressed in different neurons. This includes functional differences in transcripts expressed in cortical and cerebellar excitatory versus inhibitory neurons, where we find NOVA2 is required for, respectively, development of laminar structure, motor coordination, and synapse formation. We also find that NOVA2-regulated AS is coupled to NOVA2 regulation of intron retention in hundreds of transcripts, which can sequester the trans-acting splicing factor PTBP2. In summary, cTag-CLIP complements single-cell RNA sequencing (RNA-seq) studies by providing a means for understanding RNA regulation of functional cell diversity.

}, keywords = {Alternative Splicing, Animals, Antigens, Neoplasm, Cells, Cultured, Cerebellum, Cerebral Cortex, Excitatory Postsynaptic Potentials, Female, Inhibitory Postsynaptic Potentials, Male, Mice, Mice, Inbred C57BL, Nerve Tissue Proteins, Neurogenesis, Neurons, Polypyrimidine Tract-Binding Protein, RNA-Binding Proteins}, issn = {1097-4199}, doi = {10.1016/j.neuron.2018.12.019}, author = {Saito, Yuhki and Yuan, Yuan and Zucker-Scharff, Ilana and Fak, John J and Jereb, Sa{\v s}a and Tajima, Yoko and Licatalosi, Donny D and Darnell, Robert B} } @article {50, title = {Efficient Variant Set Mixed Model Association Tests for Continuous and Binary Traits in Large-Scale Whole-Genome Sequencing Studies.}, journal = {Am J Hum Genet}, volume = {104}, year = {2019}, month = {2019 02 07}, pages = {260-274}, abstract = {

With advances in whole-genome sequencing (WGS) technology, more advanced statistical methods for testing genetic association with rare variants are being developed. Methods in which variants are grouped for analysis are also known as variant-set, gene-based, and aggregate unit tests. The burden test and sequence kernel association test (SKAT) are two widely used variant-set tests, which were originally developed for samples of unrelated individuals and later have been extended to family data with known pedigree structures. However, computationally efficient and powerful variant-set tests are needed to make analyses tractable in large-scale WGS studies with complex study samples. In this paper, we propose the variant-set mixed model association tests (SMMAT) for continuous and binary traits using the generalized linear mixed model framework. These tests can be applied to large-scale WGS studies involving samples with population structure and relatedness, such as in the National Heart, Lung, and Blood Institute{\textquoteright}s Trans-Omics for Precision Medicine (TOPMed) program. SMMATs share the same null model for different variant sets, and a virtue of this null model, which includes covariates only, is that it needs to be fit only once for all tests in each genome-wide analysis. Simulation studies show that all the proposed SMMATs correctly control type I error rates for both continuous and binary traits in the presence of population structure and relatedness. We also illustrate our tests in a real data example of analysis of plasma fibrinogen levels in the TOPMed program (n = 23,763), using the Analysis Commons, a cloud-based computing platform.

}, keywords = {Chromosomes, Human, Pair 4, Cloud Computing, Female, Fibrinogen, Genetic Association Studies, Genetics, Population, Humans, Male, Models, Genetic, National Heart, Lung, and Blood Institute (U.S.), Precision Medicine, Research Design, Time Factors, United States, Whole Genome Sequencing}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2018.12.012}, author = {Chen, Han and Huffman, Jennifer E and Brody, Jennifer A and Wang, Chaolong and Lee, Seunggeun and Li, Zilin and Gogarten, Stephanie M and Sofer, Tamar and Bielak, Lawrence F and Bis, Joshua C and Blangero, John and Bowler, Russell P and Cade, Brian E and Cho, Michael H and Correa, Adolfo and Curran, Joanne E and de Vries, Paul S and Glahn, David C and Guo, Xiuqing and Johnson, Andrew D and Kardia, Sharon and Kooperberg, Charles and Lewis, Joshua P and Liu, Xiaoming and Mathias, Rasika A and Mitchell, Braxton D and O{\textquoteright}Connell, Jeffrey R and Peyser, Patricia A and Post, Wendy S and Reiner, Alex P and Rich, Stephen S and Rotter, Jerome I and Silverman, Edwin K and Smith, Jennifer A and Vasan, Ramachandran S and Wilson, James G and Yanek, Lisa R and Redline, Susan and Smith, Nicholas L and Boerwinkle, Eric and Borecki, Ingrid B and Cupples, L Adrienne and Laurie, Cathy C and Morrison, Alanna C and Rice, Kenneth M and Lin, Xihong} } @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 {35, title = {A common loss-of-function variant is associated with lower vitamin B concentration in African Americans.}, journal = {Blood}, volume = {131}, year = {2018}, month = {2018 06 21}, pages = {2859-2863}, keywords = {African Americans, Female, Genome-Wide Association Study, Humans, Loss of Function Mutation, Male, Polymorphism, Single Nucleotide, Transcobalamins, Vitamin B 12, Vitamin B Deficiency}, issn = {1528-0020}, doi = {10.1182/blood-2018-03-841023}, author = {Hu, Yao and Raffield, Laura M and Polfus, Linda M and Moscati, Arden and Nadkarni, Girish and Preuss, Michael H and Zhong, Xue and Wei, Qiang and Rich, Stephen S and Li, Yun and Wilson, James G and Correa, Adolfo and Loos, Ruth J F and Li, Bingshan and Auer, Paul L and Reiner, Alex P} } @article {45, title = {Quantifying the Polygenic Contribution to Cutaneous Squamous Cell Carcinoma Risk.}, journal = {J Invest Dermatol}, volume = {138}, year = {2018}, month = {2018 07}, pages = {1507-1510}, abstract = {

Genetic factors play an important role in cutaneous squamous cell carcinoma risk. Genome-wide association studies have identified 21 single nucleotide polymorphisms associated with cutaneous squamous cell carcinoma risk. Yet no studies have attempted to quantify the contribution of heritability to cutaneous squamous cell carcinoma risk by calculating the population attributable risk using a combination of all discovered genetic variants. Using an additive multi-locus linear logistic model, we determined the cumulative association of these 21 genetic regions to cutaneous squamous cell carcinoma population attributable risk. We computed a multi-locus population attributable risk of 62\%, suggesting that if the effects of all the risk alleles were removed from a population, the cutaneous squamous cell carcinoma risk would drop by 62\%. Using stratified analysis, we also examined the impact of sex on polygenic risk score, and found that men have an increased relative risk throughout the spectrum of the polygenic risk score. Quantifying the impact of genetic predisposition on the proportion of cancer cases can guide future research decisions and public health policy planning.

}, keywords = {Carcinoma, Squamous Cell, Female, Genetic Loci, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Linear Models, Logistic Models, Male, Models, Biological, Polymorphism, Single Nucleotide, Risk Assessment, Risk Factors, Sex Factors, Skin Neoplasms}, issn = {1523-1747}, doi = {10.1016/j.jid.2018.01.031}, author = {Sordillo, Joanne E and Kraft, Peter and Wu, Ann Chen and Asgari, Maryam M} } @article {15, title = {Cohort-specific imputation of gene expression improves prediction of warfarin dose for African Americans.}, journal = {Genome Med}, volume = {9}, year = {2017}, month = {2017 Nov 24}, pages = {98}, abstract = {

BACKGROUND: Genome-wide association studies are useful for discovering genotype-phenotype associations but are limited because they require large cohorts to identify a signal, which can be population-specific. Mapping genetic variation to genes improves power and allows the effects of both protein-coding variation as well as variation in expression to be combined into "gene level" effects.

METHODS: Previous work has shown that warfarin dose can be predicted using information from genetic variation that affects protein-coding regions. Here, we introduce a method that improves dose prediction by integrating tissue-specific gene expression. In particular, we use drug pathways and expression quantitative trait loci knowledge to impute gene expression-on the assumption that differential expression of key pathway genes may impact dose requirement. We focus on 116 genes from the pharmacokinetic and pharmacodynamic pathways of warfarin within training and validation sets comprising both European and African-descent individuals.

RESULTS: We build gene-tissue signatures associated with warfarin dose in a cohort-specific manner and identify a signature of 11 gene-tissue pairs that significantly augments the International Warfarin Pharmacogenetics Consortium dosage-prediction algorithm in both populations.

CONCLUSIONS: Our results demonstrate that imputed expression can improve dose prediction and bridge population-specific compositions. MATLAB code is available at https://github.com/assafgo/warfarin-cohort.

}, keywords = {Anticoagulants, Black or African American, Female, Gene Expression, Genome-Wide Association Study, Humans, Male, Tissue Distribution, Warfarin}, issn = {1756-994X}, doi = {10.1186/s13073-017-0495-0}, author = {Gottlieb, Assaf and Daneshjou, Roxana and DeGorter, Marianne and Bourgeois, Stephane and Svensson, Peter J and Wadelius, Mia and Deloukas, Panos and Montgomery, Stephen B and Altman, Russ B} } @article {18, title = {Genetic effects on gene expression across human tissues.}, journal = {Nature}, volume = {550}, year = {2017}, month = {2017 Oct 11}, pages = {204-213}, abstract = {

Characterization of the molecular function of the human genome and its variation across individuals is essential for identifying the cellular mechanisms that underlie human genetic traits and diseases. The Genotype-Tissue Expression (GTEx) project aims to characterize variation in gene expression levels across individuals and diverse tissues of the human body, many of which are not easily accessible. Here we describe genetic effects on gene expression levels across 44 human tissues. We find that local genetic variation affects gene expression levels for the majority of genes, and we further identify inter-chromosomal genetic effects for 93 genes and 112 loci. On the basis of the identified genetic effects, we characterize patterns of tissue specificity, compare local and distal effects, and evaluate the functional properties of the genetic effects. We also demonstrate that multi-tissue, multi-individual data can be used to identify genes and pathways affected by human disease-associated variation, enabling a mechanistic interpretation of gene regulation and the genetic basis of disease.

}, keywords = {Alleles, Chromosomes, Human, Disease, Female, Gene Expression Profiling, Gene Expression Regulation, Genetic Variation, Genome, Human, Genotype, Humans, Male, Organ Specificity, Quantitative Trait Loci}, issn = {1476-4687}, doi = {10.1038/nature24277}, author = {Battle, Alexis and Brown, Christopher D and Engelhardt, Barbara E and Montgomery, Stephen B} } @article {32, title = {Genetic identification of a common collagen disease in puerto ricans via identity-by-descent mapping in a health system.}, journal = {Elife}, volume = {6}, year = {2017}, month = {2017 09 12}, abstract = {

Achieving confidence in the causality of a disease locus is a complex task that often requires supporting data from both statistical genetics and clinical genomics. Here we describe a combined approach to identify and characterize a genetic disorder that leverages distantly related patients in a health system and population-scale mapping. We utilize genomic data to uncover components of distant pedigrees, in the absence of recorded pedigree information, in the multi-ethnic Bio biobank in New York City. By linking to medical records, we discover a locus associated with both elevated genetic relatedness and extreme short stature. We link the gene, , with a little-known genetic disease, previously thought to be rare and recessive. We demonstrate that disease manifests in both heterozygotes and homozygotes, indicating a common collagen disorder impacting up to 2\% of individuals of Puerto Rican ancestry, leading to a better understanding of the continuum of complex and Mendelian disease.

}, keywords = {Adolescent, Adult, Aged, Child, Collagen Diseases, Female, Fibrillar Collagens, Genotype, Heterozygote, Hispanic Americans, Homozygote, Humans, Male, Middle Aged, Molecular Epidemiology, Multigene Family, Musculoskeletal Diseases, New York City, Pedigree, Whole Genome Sequencing, Young Adult}, issn = {2050-084X}, doi = {10.7554/eLife.25060}, author = {Belbin, Gillian Morven and Odgis, Jacqueline and Sorokin, Elena P and Yee, Muh-Ching and Kohli, Sumita and Glicksberg, Benjamin S and Gignoux, Christopher R and Wojcik, Genevieve L and Van Vleck, Tielman and Jeff, Janina M and Linderman, Michael and Schurmann, Claudia and Ruderfer, Douglas and Cai, Xiaoqiang and Merkelson, Amanda and Justice, Anne E and Young, Kristin L and Graff, Misa and North, Kari E and Peters, Ulrike and James, Regina and Hindorff, Lucia and Kornreich, Ruth and Edelmann, Lisa and Gottesman, Omri and Stahl, Eli Ea and Cho, Judy H and Loos, Ruth Jf and Bottinger, Erwin P and Nadkarni, Girish N and Abul-Husn, Noura S and Kenny, Eimear E} } @article {19, title = {A genetic stochastic process model for genome-wide joint analysis of biomarker dynamics and disease susceptibility with longitudinal data.}, journal = {Genet Epidemiol}, volume = {41}, year = {2017}, month = {2017 Nov}, pages = {620-635}, abstract = {

Unraveling the underlying biological mechanisms or pathways behind the effects of genetic variations on complex diseases remains one of the major challenges in the post-GWAS (where GWAS is genome-wide association study) era. To further explore the relationship between genetic variations, biomarkers, and diseases for elucidating underlying pathological mechanism, a huge effort has been placed on examining pleiotropic and gene-environmental interaction effects. We propose a novel genetic stochastic process model (GSPM) that can be applied to GWAS and jointly investigate the genetic effects on longitudinally measured biomarkers and risks of diseases. This model is characterized by more profound biological interpretation and takes into account the dynamics of biomarkers during follow-up when investigating the hazards of a disease. We illustrate the rationale and evaluate the performance of the proposed model through two GWAS. One is to detect single nucleotide polymorphisms (SNPs) having interaction effects on type 2 diabetes (T2D) with body mass index (BMI) and the other is to detect SNPs affecting the optimal BMI level for protecting from T2D. We identified multiple SNPs that showed interaction effects with BMI on T2D, including a novel SNP rs11757677 in the CDKAL1 gene (P = 5.77 {\texttimes} 10 ). We also found a SNP rs1551133 located on 2q14.2 that reversed the effect of BMI on T2D (P = 6.70 {\texttimes} 10 ). In conclusion, the proposed GSPM provides a promising and useful tool in GWAS of longitudinal data for interrogating pleiotropic and interaction effects to gain more insights into the relationship between genes, quantitative biomarkers, and risks of complex diseases.

}, keywords = {Biomarkers, Body Mass Index, Computational Biology, Diabetes Mellitus, Type 2, Female, Gene-Environment Interaction, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Male, Models, Genetic, Models, Statistical, Polymorphism, Single Nucleotide, Risk, Stochastic Processes}, issn = {1098-2272}, doi = {10.1002/gepi.22058}, author = {He, Liang and Zhbannikov, Ilya and Arbeev, Konstantin G and Yashin, Anatoliy I and Kulminski, Alexander M} } @article {30, title = {The impact of rare variation on gene expression across tissues.}, journal = {Nature}, volume = {550}, year = {2017}, month = {2017 10 11}, pages = {239-243}, abstract = {

Rare genetic variants are abundant in humans and are expected to contribute to individual disease risk. While genetic association studies have successfully identified common genetic variants associated with susceptibility, these studies are not practical for identifying rare variants. Efforts to distinguish pathogenic variants from benign rare variants have leveraged the genetic code to identify deleterious protein-coding alleles, but no analogous code exists for non-coding variants. Therefore, ascertaining which rare variants have phenotypic effects remains a major challenge. Rare non-coding variants have been associated with extreme gene expression in studies using single tissues, but their effects across tissues are unknown. Here we identify gene expression outliers, or individuals showing extreme expression levels for a particular gene, across 44 human tissues by using combined analyses of whole genomes and multi-tissue RNA-sequencing data from the Genotype-Tissue Expression (GTEx) project v6p release. We find that 58\% of underexpression and 28\% of overexpression outliers have nearby conserved rare variants compared to 8\% of non-outliers. Additionally, we developed RIVER (RNA-informed variant effect on regulation), a Bayesian statistical model that incorporates expression data to predict a regulatory effect for rare variants with higher accuracy than models using genomic annotations alone. Overall, we demonstrate that rare variants contribute to large gene expression changes across tissues and provide an integrative method for interpretation of rare variants in individual genomes.

}, keywords = {Bayes Theorem, Female, Gene Expression Profiling, Genetic Variation, Genome, Human, Genomics, Genotype, Humans, Male, Models, Genetic, Organ Specificity, Sequence Analysis, RNA}, issn = {1476-4687}, doi = {10.1038/nature24267}, author = {Li, Xin and Kim, Yungil and Tsang, Emily K and Davis, Joe R and Damani, Farhan N and Chiang, Colby and Hess, Gaelen T and Zappala, Zachary and Strober, Benjamin J and Scott, Alexandra J and Li, Amy and Ganna, Andrea and Bassik, Michael C and Merker, Jason D and Hall, Ira M and Battle, Alexis and Montgomery, Stephen B} } @article {9, title = {Population- and individual-specific regulatory variation in Sardinia.}, journal = {Nat Genet}, volume = {49}, year = {2017}, month = {2017 May}, pages = {700-707}, abstract = {

Genetic studies of complex traits have mainly identified associations with noncoding variants. To further determine the contribution of regulatory variation, we combined whole-genome and transcriptome data for 624 individuals from Sardinia to identify common and rare variants that influence gene expression and splicing. We identified 21,183 expression quantitative trait loci (eQTLs) and 6,768 splicing quantitative trait loci (sQTLs), including 619 new QTLs. We identified high-frequency QTLs and found evidence of selection near genes involved in malarial resistance and increased multiple sclerosis risk, reflecting the epidemiological history of Sardinia. Using family relationships, we identified 809 segregating expression outliers (median z score of 2.97), averaging 13.3 genes per individual. Outlier genes were enriched for proximal rare variants, providing a new approach to study large-effect regulatory variants and their relevance to traits. Our results provide insight into the effects of regulatory variants and their relationship to population history and individual genetic risk.

}, keywords = {Alternative Splicing, Chromosome Mapping, Family Health, Female, Gene Expression Profiling, Genetic Predisposition to Disease, Genetic Variation, Genetics, Population, Genome-Wide Association Study, Genotype, Humans, Italy, Male, Polymorphism, Single Nucleotide, Quantitative Trait Loci, Transcription Initiation Site}, issn = {1546-1718}, doi = {10.1038/ng.3840}, author = {Pala, Mauro and Zappala, Zachary and Marongiu, Mara and Li, Xin and Davis, Joe R and Cusano, Roberto and Crobu, Francesca and Kukurba, Kimberly R and Gloudemans, Michael J and Reinier, Frederic and Berutti, Riccardo and Piras, Maria G and Mulas, Antonella and Zoledziewska, Magdalena and Marongiu, Michele and Sorokin, Elena P and Hess, Gaelen T and Smith, Kevin S and Busonero, Fabio and Maschio, Andrea and Steri, Maristella and Sidore, Carlo and Sanna, Serena and Fiorillo, Edoardo and Bassik, Michael C and Sawcer, Stephen J and Battle, Alexis and Novembre, John and Jones, Chris and Angius, Andrea and Abecasis, Gon{\c c}alo R and Schlessinger, David and Cucca, Francesco and Montgomery, Stephen B} } @article {33, title = {Whole-transcriptome sequencing in blood provides a diagnosis of spinal muscular atrophy with progressive myoclonic epilepsy.}, journal = {Hum Mutat}, volume = {38}, year = {2017}, month = {2017 06}, pages = {611-614}, abstract = {

At least 15\% of the disease-causing mutations affect mRNA splicing. Many splicing mutations are missed in a clinical setting due to limitations of in silico prediction algorithms or their location in noncoding regions. Whole-transcriptome sequencing is a promising new tool to identify these mutations; however, it will be a challenge to obtain disease-relevant tissue for RNA. Here, we describe an individual with a sporadic atypical spinal muscular atrophy, in whom clinical DNA sequencing reported one pathogenic ASAH1 mutation (c.458A>G;p.Tyr153Cys). Transcriptome sequencing on patient leukocytes identified a highly significant and atypical ASAH1 isoform not explained by c.458A>G(p<10 ). Subsequent Sanger-sequencing identified the splice mutation responsible for the isoform (c.504A>C;p.Lys168Asn) and provided a molecular diagnosis of autosomal-recessive spinal muscular atrophy with progressive myoclonic epilepsy. Our findings demonstrate the utility of RNA sequencing from blood to identify splice-impacting disease mutations for nonhematological conditions, providing a diagnosis for these otherwise unsolved patients.

}, keywords = {Acid Ceramidase, Child, Preschool, Humans, Male, Muscular Atrophy, Spinal, Mutation, Myoclonic Epilepsies, Progressive, Pathology, Molecular, RNA Splicing, Sequence Analysis, DNA, Transcriptome}, issn = {1098-1004}, doi = {10.1002/humu.23211}, author = {Kernohan, Kristin D and Fr{\'e}sard, Laure and Zappala, Zachary and Hartley, Taila and Smith, Kevin S and Wagner, Justin and Xu, Hongbin and McBride, Arran and Bourque, Pierre R and Consortium, Care Rare Canada and Bennett, Steffany A L and Dyment, David A and Boycott, Kym M and Montgomery, Stephen B and Warman Chardon, Jodi} }