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Sunyaev, S. R.

Publications and source records attributed to Sunyaev, S. R..

At least 19 recordsLinked to original sources

Inference of elevated mutation rates and variant effects using 700k exomes

Genomic sequencing is now widely accessible for genetic diagnostics and is emerging as a component of newborn screening. This technological development generates the need to characterize incoming mutations, create comprehensive datasets of genes causing rare Mendelian disorders, and identify pathogenic variants. Large-scale exome sequencing datasets such as Genome Aggregation Database (gnomAD) have been assembled to help address these challenges. The recent release of gnomAD (v4; n = 730,947) uncovers millions of rare coding variants, many of which have arisen more than once by independent recurrent mutations in the rapidly growing recent human population. Here, we use newly developed theoretical understanding of sampling properties of rare variants to estimate key population genetics parameters of practical importance to human genetics such as demography history, mutation rate, and selection. Solely relying on population data, our method Population Inferred Estimates of Selection (PIES) identifies novel genes with loss-of-function mutational hotspots likely due to selection in spermatogonia. PIES efficiently estimates selection coefficients for heterozygous loss-of-function variants. Combining population genetics inference with variant effect predictors, PIES predicts pathogenic missense mutations and improves variant prioritization for genetic diagnostics and newborn screening.

genetics↗

A single-cell genetic colocalization test improves power and resolves disease-mediating cell types

Statistical colocalization testing methods can determine if the same single-nucleotide polymorphism (SNP) underlies both a genome-wide association study (GWAS) locus as well as an expression quantitative trait (eQTL) locus. This can nominate potential mechanistic pathways from SNPs to genes to traits, while providing cell type or tissue context. Surprisingly, systematic colocalization testing with bulk-tissue eQTLs fails to link the majority of GWAS loci with gene expression changes. Mapping eQTLs with single-cell expression data has the potential to reveal the missing regulatory effects of GWAS variants. However, current pseudobulk cluster-based approaches may be underpowered when clustering accuracy is imperfect or with an incorrectly selected cluster resolution. To improve power of single-cell colocalization tests, we developed a cluster-free method, scJLIM. By modeling eQTL interactions with continuous cell states (e.g., principal components), scJLIM estimates eQTL significance and colocalization in individual cells. We benchmarked our method with simulated data, demonstrating improvements in power over pseudobulk methods. In our main applications, we used scJLIM to analyze blood and brain scRNA-seq datasets paired with autoimmune and neurological disease GWAS, respectively. We identified nearly twice as many total colocalizations compared with traditional pseudobulk analyses carried out within the major cell populations of these tissues. Aligning with a recent experimental study, we highlighted an example of the ETS2 gene colocalizing with an inflammatory bowel disease GWAS locus in a subset of myeloid cells. For Parkinsons disease (PD), our results pointed to TRPV2 as a potential gene of interest, corroborated by transcriptional changes in both post-mortem PD brains and iPSC-derived neuronal models of alpha-synucleinopathy.

genomics↗

Segregating DNA lesions point to high selective advantage of tumor initiating cells

The complications with identifying cells at the origin of cancer and tracking their early divisions impede studies of cancer initiation. Recently, it was shown that some DNA lesions generated by a pulse of damage-inducing mutagen persist over multiple rounds of replication. Segregation of DNA lesions in the early genealogy of an expanding clone leaves a statistically interpretable footprint of cancer initiating events. Specifically, it allows for estimating the number of cell divisions between the initiating DNA lesion and the most recent common ancestor of the tumor. Here, we analyze footprints of segregating lesions from a previously published experimental mouse system, as well as post-chemotherapy human metastatic tumors and the blood of chemotherapy treated patients. In all contexts, clones tend to start early, usually within the span of 4 cell generations from mutagen exposure. Using a branching process model, we show that fitness advantage of early cancer drivers exceeds 30%, with each early division leading to at least 1.3 self-renewing cells. We highlight an example of a blood-derived single cell phylogeny with major subclones separated by just two cell divisions. Broadly, our approach allows inference of tumor initiation and growth parameters based on events preceding the most recent common ancestor of the initiating clone as opposed to characteristics of fully grown tumors.

cancer biology↗

NERINE reveals rare variant associations in gene networks across multiple phenotypes and implicates an SNCA-PRL-LRRK2 subnetwork in Parkinson's disease

There are two primary approaches to study the genetic basis of human phenotypes. Experiments in model systems generate interpretable gene networks but, in isolation, do not establish relevance to the human condition. Statistical genetics identifies relevant association signals at the variant or gene level but lacks tools to test specific mechanistic models, as existing methods do not incorporate the topology of gene-gene interactions. We bridge these two strategies by introducing a method that competitively tests network hypotheses with rare variant associations. A hierarchical model-based association test NERINE for the first time incorporates gene network topology while remaining resilient to network inaccuracies. We demonstrate NERINEs ability to test network hypotheses derived from both canonical pathway databases and model system screens. Comprehensive database-wide search of pathway networks with NERINE uncovers compelling associations for breast cancer, cardiovascular diseases, and type II diabetes, which are undetected by single-gene tests. Testing bespoke networks from experimental screens targeting key PD pathologies: dopaminergic neuron survival and -synuclein pathobiology, NERINE highlights rare variant burden in gene modules related to autophagy, vesicle traiicking, and protein homeostasis. Genome-scale CRISPRi-screening of -synuclein toxicity modifiers in human neurons and NERINE converge on PRL, revealing an intraneuronal -synuclein/prolactin stress response that may impact resilience to PD pathologies.

genetics↗

Inherent instability of simple DNA repeats shapes an evolutionarily stable distribution of repeat lengths

Using the Telomere-to-Telomere reference, we assembled the distribution of simple repeat lengths present in the human genome. Analyzing over two hundred mammalian genomes, we found remarkable consistency in the shape of the distribution across evolutionary epochs. All observed genomes harbor an excess of long repeats, which are potentially prone to developing into repeat expansion disorders. We measured mutation rates for repeat length instability, quantitatively modeled the per-generation action of mutations, and observed the corresponding long-term behavior shaping the repeat length distribution. We found that short repetitive sequences appear to be a straightforward consequence of random substitution. Evolving largely independently, longer repeats (above roughly 10 nt) emerge and persist in a rapidly mutating dynamic balance between expansion, contraction and interruption. These mutational processes, collectively, are sufficient to explain the abundance of long repeats, without invoking natural selection. Our analysis constrains properties of molecular mechanisms responsible for maintaining genome fidelity that underlie repeat instability.

genetics↗

Genetic association data are broadly consistent with stabilizing selection shaping human common diseases and traits

Results from genome-wide association studies (GWAS) enable inferences about the balance of evolutionary forces maintaining genetic variation underlying common diseases and other genetically complex traits. Natural selection is a major force shaping variation, and understanding it is necessary to explain the genetic architecture and prevalence of heritable diseases. Here, we analyze data for 27 traits, including anthropometric traits, metabolic traits, and binary diseases--both early-onset and post-reproductive. We develop an inference framework to test existing population genetics models based on the joint distribution of allelic effect sizes and frequencies of trait-associated variants. A majority of traits have GWAS results that are inconsistent with neutral evolution or long-term directional selection (selection against a trait or against disease risk). Instead, we find that most traits show consistency with stabilizing selection, which acts to preserve an intermediate trait value or disease risk. Our observations also suggest that selection may reflect pleiotropy, with each variant influenced by associations with multiple selected traits.

genomics↗

Deep sequencing of proteotoxicity modifier genes uncovers a Presenilin-2/beta-amyloid-actin genetic risk module shared among alpha-synucleinopathies

Whether neurodegenerative diseases linked to misfolding of the same protein share genetic risk drivers or whether different protein-aggregation pathologies in neurodegeneration are mechanistically related remains uncertain. Conventional genetic analyses are underpowered to address these questions. Through careful selection of patients based on protein aggregation phenotype (rather than clinical diagnosis) we can increase statistical power to detect associated variants in a targeted set of genes that modify proteotoxicities. Genetic modifiers of alpha-synuclein ([a]S) and beta-amyloid (A{beta}) cytotoxicity in yeast are enriched in risk factors for Parkinsons disease (PD) and Alzheimers disease (AD), respectively. Here, along with known AD/PD risk genes, we deeply sequenced exomes of 430 [a]S/A{beta} modifier genes in patients across alpha-synucleinopathies (PD, Lewy body dementia and multiple system atrophy). Beyond known PD genes GBA1 and LRRK2, rare variants AD genes (CD33, CR1 and PSEN2) and A{beta} toxicity modifiers involved in RhoA/actin cytoskeleton regulation (ARGHEF1, ARHGEF28, MICAL3, PASK, PKN2, PSEN2) were shared risk factors across synucleinopathies. Actin pathology occurred in iPSC synucleinopathy models and RhoA downregulation exacerbated [a]S pathology. Even in sporadic PD, the expression of these genes was altered across CNS cell types. Genome-wide CRISPR screens revealed the essentiality of PSEN2 in both human cortical and dopaminergic neurons, and PSEN2 mutation carriers exhibited diffuse brainstem and cortical synucleinopathy independent of AD pathology. PSEN2 contributes to a common-risk signal in PD GWAS and regulates [a]S expression in neurons. Our results identify convergent mechanisms across synucleinopathies, some shared with AD.

genomics↗

Joint, multifaceted genomic analysis enables diagnosis of diverse, ultra-rare monogenic presentations

Genomics for rare disease diagnosis has advanced at a rapid pace due to our ability to perform "N-of-1" analyses on individual patients with ultra-rare diseases. The increasing sizes of ultra-rare disease cohorts internationally newly enables cohort-wide analyses for new discoveries, but well-calibrated statistical genetics approaches for jointly analyzing these patients are still under development.1,2 The Undiagnosed Diseases Network (UDN) brings multiple clinical, research and experimental centers under the same umbrella across the United States to facilitate and scale N-of-1 analyses. Here, we present the first joint analysis of whole genome sequencing data of UDN patients across the network. We introduce new, well-calibrated statistical methods for prioritizing disease genes with de novo recurrence and compound heterozygosity. We also detect pathways enriched with candidate and known diagnostic genes. Our computational analysis, coupled with a systematic clinical review, recapitulated known diagnoses and revealed new disease associations. We further release a software package, RaMeDiES, enabling automated cross-analysis of deidentified sequenced cohorts for new diagnostic and research discoveries. Gene-level findings and variant-level information across the cohort are available in a public-facing browser (https://dbmi-bgm.github.io/udn-browser/). These results show that N-of-1 efforts should be supplemented by a joint genomic analysis across cohorts.

genetics↗

Quantifying constraint in human mitochondrial DNA

Mitochondrial DNA (mtDNA) has an important, yet often overlooked, role in health and disease. Constraint models quantify the removal of deleterious variation from the population by selection, representing a powerful tool for identifying genetic variation underlying human phenotypes1-4. However, a constraint model for the mtDNA has not been developed, due to its unique features. Here we describe the development of a mitochondrial constraint model and its application to the Genome Aggregation Database (gnomAD), a large-scale population dataset reporting mtDNA variation across 56,434 humans5. Our results demonstrate strong depletion of expected variation, suggesting most deleterious mtDNA variants remain undiscovered. To aid their identification, we compute constraint metrics for every mitochondrial protein, tRNA, and rRNA gene, revealing a spectrum of intolerance to variation. We characterize the most constrained regions within genes via regional constraint, and positions across the entire mtDNA via local constraint, showing their enrichment in pathogenic variation and functionally critical sites, including topological clustering in 3D protein and RNA structures. Notably, we identify constraint at often overlooked sites, such as rRNAs and non-coding regions. Lastly, we demonstrate how these metrics can improve the discovery of mtDNA variation underlying rare and common human phenotypes.

genetics↗

A mutation rate model at the basepair resolution identifies the mutagenic effect of Polymerase III transcription

De novo mutations occur with substantially different rates depending on genomic location, sequence context and DNA strand1-4. The success of many human genetics techniques, especially when applied to large population sequencing datasets with numerous recurrent mutations5-7, depends strongly on assumptions about the local mutation rate. Such techniques include estimation of selection intensity8, inference of demographic history9, and mapping of rare disease genes10. Here, we present Roulette, a genome-wide mutation rate model at the basepair resolution that incorporates known determinants of local mutation rate (http://genetics.bwh.harvard.edu/downloads/Vova/Roulette/). Roulette is shown to be more accurate than existing models1,6. Roulette has sufficient resolution at high mutation rate sites to model allele frequencies under recurrent mutation. We use Roulette to refine estimates of population growth within Europe by incorporating the full range of human mutation rates. The analysis of significant deviations from the model predictions revealed a 10-fold increase in mutation rate in nearly all genes transcribed by Polymerase III, suggesting a new mutagenic mechanism. We also detected an elevated mutation rate within transcription factor binding sites restricted to sites actively utilized in testis and residing in promoters.

genetics↗

Enrichment of somatic mutations in schizophrenia brain targets prenatally active transcription factor bindings sites

Schizophrenia (SCZ) is a complex neuropsychiatric disorder in which both germline genetic mutations and maternal factors, such as infection and immune activation, have been implicated, but how these two strikingly different mechanisms might converge on the same phenotype is unknown. During development, cells accumulate somatic, mosaic mutations in ways that can be shaped by the cellular environment or endogenous processes, but these early developmental mutational patterns have not been studied in SCZ. Here we analyzed deep (267x) whole-genome sequencing (WGS) of DNA from cerebral cortical neurons isolated from 61 SCZ and 25 control postmortem brains to capture mutations occurring before or during fetal neurogenesis. SCZ cases showed a >15% increase in genome-wide sSNV compared to controls (p < 2e-10). Remarkably, mosaic T>G mutations and CpG transversions (CpG>GpG or CpG>ApG) were 79- and 62-fold enriched, respectively, at transcription factor binding sites (TFBS) in SCZ, but not in controls. The pattern of T>G mutations resembles mutational processes in cancer attributed to oxidative damage that is sterically blocked from DNA repair by transcription factors (TFs) bound to damaged DNA. The CpG transversions similarly suggest unfinished DNA demethylation resulting in abasic sites that can also be blocked from repair by bound TFs. Allele frequency analysis suggests that both localized mutational spikes occur in the first trimester. We call this prenatal mutational process "skiagenesis" (from the Greek skia, meaning shadow), as these mutations occur in the shadow of bound TFs. Skiagenesis reflects as-yet unidentified prenatal factors and is associated with SCZ risk in a subset ([~]13%) of cases. In turn, mutational disruption of key TFBS active in fetal brain is well positioned to create SCZ-specific gene dysregulation in concert with germline risk genes. Skiagenesis provides a fingerprint for exploring how epigenomic regulation and prenatal factors such as maternal infection or immune activation may shape the developmental mutational landscape of human brain.

genomics↗

Mutagenesis at non-B DNA motifs in the human genome: a course correction

Non-B DNA structures formed by repetitive sequence motifs are known instigators of mutagenesis in experimental systems. Analyzing this phenomenon computationally in the human genome requires careful disentangling of intrinsic confounding factors, including overlapping and interrupted motifs, and recurrent sequencing errors. Accounting for these factors eliminates all signals of repeat-induced mutagenesis that extend beyond the motif boundary, and eliminates or dramatically shrinks the magnitude of mutagenesis within some motifs, contradicting previous reports. Mutagenesis not attributable to artifacts revealed several biological mechanisms. Polymerase slippage generates frequent indels within every variety of short tandem repeat motif, implicating slipped-strand structures. Interruption-correcting SNVs within STRs distinctly implicate error-prone Pol{kappa}. Secondary-structure formation promotes SNVs within palindromic repeats, as well as duplications within direct repeats. G-quadruplex motifs cause recurrent sequencing errors, while mutagenesis at Z-DNAs is conspicuously absent.

genomics↗

Purifying selection on noncoding deletions of human regulatory elements detected using their cellular pleiotropy

Genomic deletions provide a powerful loss-of-function model in non-coding regions to assess the role of purifying selection on human noncoding genetic variation. Regulatory element function is char-acterized by non-uniform tissue/cell-type activity, necessarily linking the study of fitness consequences from regulatory variants to their corresponding cellular activity. We used deletions from the 1000 Genomes Project (1000GP) and a callset we generated from genomes of participants in the Alzheimers Disease Neuroimaging Initiative (ADNI) in order to examine whether purifying selection preserves noncoding sites of chromatin accessibility (DHS), histone modification (enhancer, transcribed, polycomb-repressed, heterochromatin), and topologically associated domain loops (TAD-loops). To examine this in a cellular activity-aware manner, we developed a statistical method, Pleiotropy Ratio Score (PlyRS), which calculates a correlation-adjusted count of "cellular pleiotropy" for each noncoding base-pair by analyzing shared regulatory annotations across tissues/cell-types. Comparing real deletion PlyRS values to simulations in a length-matched framework and using genomic covariates in analyses, we found that purifying selection acts to preserve both DHS and enhancer sites, as evident by both depletion of deletions overlapping these annotations and a shift in the allele frequency spectrum of overlapping deletions towards rare alleles. However, we did not find evidence of purifying selection for transcribed, polycomb-repressed, or heterochromatin sites. Additionally, we found evidence that purifying selection is acting on TAD-loop boundary integrity by preserving co-localized CTCF binding sites. Notably, at regions of DHS, enhancer, and CTCF within TAD-loop boundaries we found evidence that both sites of tissue/cell-type-specific activity and sites of cellularly pleiotropic activity are preserved by selection. Significance StatementWe used natural genomic deletions as a loss-of-function model to assess the role of purifying selection in preserving human noncoding regulatory sites. We examined this in a cellular activity-aware manner through development of a statistical method, Pleiotropy Ratio Score (PlyRS), which calculates an adjusted count of "cellular pleiotropy" for each noncoding basepair by analyzing correlations from shared regulatory annotations across tissues/cell-types. By comparing real deletion PlyRS values to simulations, we found that purifying selection acts to preserve both DHS and enhancer sites and TAD-loop boundary integrity by preserving co-localized CTCF binding sites. Notably, we found evidence at these regulatory regions that both sites of tissue/cell-type-specific activity and sites of cellularly pleiotropic activity are preserved by selection.

evolutionary biology↗

Leveraging pleiotropy to discover and interpret GWAS results for sleep-associated traits

Genetic association studies of many heritable traits resulting from physiological testing often have modest sample sizes due to the cost and burden of the required phenotyping. This reduces statistical power and limits discovery of multiple genetic associations. We present a strategy to leverage pleiotropy between traits to both discover new loci and to provide mechanistic hypotheses of the underlying pathophysiology. Specifically, we combine a colocalization test with a locus-level test of pleiotropy. In simulations, we show that this approach is highly selective for identifying true pleiotropy driven by the same causative variant, thereby improves the chance to replicate the associations in underpowered validation cohorts and leads to higher interpretability. Here, as an exemplar, we use Obstructive Sleep Apnea (OSA), a common disorder diagnosed using overnight multi-channel physiological testing. We leverage pleiotropy with relevant cellular and cardio-metabolic phenotypes and gene expression traits to map new risk loci in an underpowered OSA GWAS. We identify several pleiotropic loci harboring suggestive associations to OSA and genome-wide significant associations to other traits, and show that their OSA association replicates in independent cohorts of diverse ancestries. By investigating pleiotropic loci, our strategy allows proposing new hypotheses about OSA pathobiology across many physiological layers. For example, we identify and replicate the pleiotropy across the plateletcrit, OSA and an eQTL of DNA primase subunit 1 (PRIM1) in immune cells. We find suggestive links between OSA, a measure of lung function (FEV1/FVC), and an eQTL of matrix metallopeptidase 15 (MMP15) in lung tissue. We also link a previously known genome-wide significant peak for OSA in the hexokinase 1 (HK1) locus to hematocrit and other red blood cell related traits. Thus, the analysis of pleiotropic associations has the potential to assemble diverse phenotypes into a chain of mechanistic hypotheses that provide insight into the pathogenesis of complex human diseases. Author SummaryLarge genetic studies with hundreds of thousands of patients have been successful at finding genetic variants that associate with disease traits in humans. However, smaller-scale studies can often have inadequate power to discover new genetic associations. Here, we use a small genetic study of Obstructive Sleep Apnea (OSA), to introduce a strategy that both helps find genetic associations and proposes biological hypotheses for the mechanisms behind those associations. To achieve this, we use large genetic studies carried out on traits that are related to OSA, and look for genetic variants that affect both OSA in our small study and the trait in question in the large study. By linking two or more traits at select loci, we were able to, among other results, find a locus that affects the expression of a gene in immune cells (DNA primase subunit 1), a marker of thrombotic and inflammatory processes (plateletcrit) and OSA. This results in a novel genetic association to OSA and a corresponding biological hypothesis behind its effect on OSA.

genetics↗

Population-specific causal disease effect sizes in functionally important regions impacted by selection

Many diseases and complex traits exhibit population-specific causal effect sizes with trans-ethnic genetic correlations significantly less than 1, limiting trans-ethnic polygenic risk prediction. We developed a new method, S-LDXR, for stratifying squared trans-ethnic genetic correlation across genomic annotations, and applied S-LDXR to genome-wide association summary statistics for 31 diseases and complex traits in East Asians (EAS) and Europeans (EUR) (average NEAS=90K, NEUR=267K) with an average trans-ethnic genetic correlation of 0.85 (s.e. 0.01). We determined that squared trans-ethnic genetic correlation was 0.82x (s.e. 0.01) smaller than the genome-wide average at SNPs in the top quintile of background selection statistic, implying more population-specific causal effect sizes. Accordingly, causal effect sizes were more population-specific in functionally important regions, including conserved and regulatory regions. In analyses of regions surrounding specifically expressed genes, causal effect sizes were most population-specific for skin and immune genes and least population-specific for brain genes. Our results could potentially be explained by stronger gene-environment interaction at loci impacted by selection, particularly positive selection.

genetics↗

Discovery of cancer driver genes based on nucleotide context

Many cancer genomes contain large numbers of somatic mutations, but few of these mutations drive tumor development. Current approaches to identify cancer driver genes are largely based on mutational recurrence, i.e. they search for genes with an increased number of nonsynonymous mutations relative to the local background mutation rate. Multiple studies have noted that the sensitivity of recurrence-based methods is limited in tumors with high background mutation rates, because passenger mutations dilute their statistical power. Here, we observe that passenger mutations tend to occur in characteristic nucleotide sequence contexts, while driver mutations follow a different distribution pattern determined by the location of functionally relevant genomic positions along the protein-coding sequence. To discover new cancer genes, we searched for genes with an excess of mutations in unusual nucleotide contexts that deviate from the characteristic context around passenger mutations. By applying this statistical framework to whole-exome sequencing data from 12,004 tumors, we discovered a long tail of novel candidate cancer genes with mutation frequencies as low as 1% and functional supporting evidence. Our results show that considering both the number and the nucleotide context around mutations helps identify novel cancer driver genes, particularly in tumors with high background mutation rates.

genetics↗

Applicability of the mutation-selection balance model to population genetics of heterozygous protein-truncating variants in humans

The fate of alleles in the human population is believed to be highly affected by the stochastic force of genetic drift. Estimation of the strength of natural selection in humans generally necessitates a careful modeling of drift including complex effects of the population history and structure. Protein truncating variants (PTVs) are expected to evolve under strong purifying selection and to have a relatively high per-gene mutation rate. Thus, it is appealing to model the population genetics of PTVs under a simple deterministic mutation-selection balance, as has been proposed earlier [1]. Here, we investigated the limits of this approximation using both computer simulations and data-driven approaches. Our simulations rely on a model of demographic history estimated from 33,370 individual exomes of the Non-Finnish European subset of the ExAC dataset [2]. Additionally, we compared the African and European subset of the ExAC study and analyzed de novo PTVs. We show that the mutation-selection balance model is applicable to the majority of human genes, but not to genes under the weakest selection.

genetics↗

Non-parametric polygenic risk prediction using partitioned GWAS summary statistics

In complex trait genetics, the ability to predict phenotype from genotype is the ultimate measure of our understanding of genetic architecture underlying the heritability of a trait. A complete understanding of the genetic basis of a trait should allow for predictive methods with accuracies approaching the traits heritability. The highly polygenic nature of quantitative traits and most common phenotypes has motivated the development of statistical strategies focused on combining myriad individually non-significant genetic effects. Now that predictive accuracies are improving, there is a growing interest in practical utility of such methods for predicting risk of common diseases responsive to early therapeutic intervention. However, existing methods require individual level genotypes or depend on accurately specifying the genetic architecture underlying each disease to be predicted. Here, we propose a polygenic risk prediction method that does not require explicitly modeling any underlying genetic architecture. We start with summary statistics in the form of SNP effect sizes from a large GWAS cohort. We then remove the correlation structure across summary statistics arising due to linkage disequilibrium and apply a piecewise linear interpolation on conditional mean effects. In both simulated and real datasets, this new non-parametric shrinkage (NPS) method can reliably allow for linkage disequilibrium in summary statistics of 5 million dense genome-wide markers and consistently improves prediction accuracy. We show that NPS improves the identification of groups at high risk for Breast Cancer, Type 2 Diabetes, Inflammatory Bowel Disease and Coronary Heart Disease, all of which have available early intervention or prevention treatments.

bioinformatics↗