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Wright, C. F.

Publications and source records attributed to Wright, C. F..

7 recordsLinked to original sources

VEP-G2P: A Tool for Efficient, Flexible and Scalable Diagnostic Filtering of Genomic Variants

PurposeWe aimed to develop an efficient, flexible, scalable and evidence-based approach to sequence-based diagnostic analysis/re-analysis of conditions with very large numbers of different causative genes. We then wished to define the expected rate of plausibly causative variants coming through strict filtering in control in comparison to disease populations to quantify background diagnostic \"noise\".\n\nMethodsWe developed G2P (www.ebi.ac.uk/gene2phenotype) as an online system to facilitate the development, validation, curation and distribution of large-scale, evidence-based datasets for use in diagnostic variant filtering. Each locus-genotype-mechanism-disease-evidence thread (LGMDET) associates an allelic requirement and a mutational consequence at a defined locus with a disease entity and a confidence level and evidence links. We then developed an extension to Ensembl Variant Effect Predictor (VEP), VEP-G2P, which can filter based on G2P other widely used gene panel curation systems. We compared the output of disease-associated and control whole exome sequence (WES) using Developmental Disorders G2P (G2PDD; 2044 LGMDETs) and constitutional cancer predisposition G2P (G2PCancer; 128 LGMDETs).\n\nResultsWe have shown a sensitivity/precision of 97.3%/33% and 81.6%/22.7% for causative de novo and inherited variants respectively using VEP-G2PDD in DDD study probands WES. Many of the apparently diagnostic genotypes \"missed\" are likely false-positive reports with lower minor allele frequencies and more severe predicted consequences being diagnostically-discriminative features.\n\nConclusionCase:control comparisons using VEP-G2PDD established an observed:expected ratio of 1:30,000 plausibly causative variants in proband WES to ~1:40,000 reportable but presumed-benign variants in controls. At least half the filtered variants in probands represent background \"noise\". Supporting phenotypic evidence is, therefore, necessary in genetically-heterogeneous disorders. G2P and VEP-G2P provides a practical approach to optimize disease-specific filtering parameters in diagnostic genetic research.

genetics

Assessing the pathogenicity, penetrance and expressivity of putative disease-causing variants in a population setting

Over 100,000 genetic variants are classified as disease-causing in public databases. However, the true penetrance of many of these rare alleles is uncertain and may be over-estimated by clinical ascertainment. As more people undergo genome sequencing there is an increasing need to assess the true penetrance of alleles. Until recently, this was not possible in a population-based setting. Here, we use data from 388,714 UK Biobank (UKB) participants of European ancestry to assess the pathogenicity and penetrance of putatively clinically important rare variants.\n\nAlthough rare variants are harder to genotype accurately than common variants, we were able to classify 1,244 of 4,585 (27%) putatively clinically relevant rare variants genotyped on the UKB microarray as high-quality. We defined \"rare\" as variants with a minor allele frequency of <0.01, and \"clinically relevant\" as variants that were either classified as pathogenic/likely pathogenic in ClinVar or are in genes known to cause two specific monogenic diseases in which we have some expertise: Maturity-Onset Diabetes of the Young (MODY) and severe developmental disorders (DD). We assessed the penetrance and pathogenicity of these high-quality variants by testing their association with 401 clinically-relevant traits available in UKB.\n\nWe identified 27 putatively clinically relevant rare variants associated with a UKB trait but that exhibited reduced penetrance or variable expressivity compared with their associated disease. For example, the P415A PER3 variant that has been reported to cause familial advanced sleep phase syndrome is present at 0.5% frequency in the population and associated with an odds ratio of 1.38 for being a morning person (P=2x10-18). We also observed novel associations with relevant traits for heterozygous carriers of some rare recessive conditions, e.g. heterozygous carriers of the R799W ERCC4 variant that causes Xeroderma pigmentosum were more susceptible to sunburn (one extra sunburn episode reported, P=2x10-8). Within our two disease subsets, we were able to refine the penetrance estimate for the R114W HNF4A variant in diabetes (only ~10% by age 40yrs) and refute the previous disease-association of RNF135 in developmental disorders.\n\nIn conclusion, this study shows that very large population-based studies will help refine the penetrance estimates of rare variants. This information will be important for anyone receiving information about their health based on putatively pathogenic variants.

genetics

Common genetic variants contribute to risk of rare severe neurodevelopmental disorders

There are thousands of rare human disorders caused by a single deleterious, protein-coding genetic variant 1. However, patients with the same genetic defect can have different clinical presentation 2-4, and some individuals carrying known disease-causing variants can appear unaffected 5. What explains these differences? Here, we show in a cohort of 6,987 children with heterogeneous severe neurodevelopmental disorders expected to be almost entirely monogenic that 7.7% of variance in risk is attributable to inherited common genetic variation. We replicated this genome wide common variant burden by showing that it is over-transmitted from parents to children in an independent sample of 728 trios from the same cohort. Our common variant signal is significantly positively correlated with genetic predisposition to fewer years of schooling, decreased intelligence, and risk of schizophrenia. We found that common variant risk was not significantly different between individuals with and without a known protein-coding diagnostic variant, suggesting that common variant risk is not confined to patients without a monogenic diagnosis. In addition, previously published common variant scores for autism, height, birth weight, and intracranial volume were all correlated with those traits within our cohort, suggesting that phenotypic expression in individuals with monogenic disorders is affected by the same variants as the general population. Our results demonstrate that common genetic variation affects both overall risk and clinical presentation in disorders typically considered to be monogenic.

genetics

Mutational origins and pathogenic consequences of multinucleotide mutations in 6,688 trios with developmental disorders

De novo mutations (DNMs) in protein-coding genes are a well-established cause of developmental disorders (DD). However, known DD-associated genes only account for a minority of the observed excess of such DNMs. To identify novel DD-associated genes, we integrated healthcare and research exome sequences on 31,058 DD parent-offspring trios, and developed a simulation-based statistical test to identify gene-specific enrichments of DNMs. We identified 299 significantly DD-associated genes, including 49 not previously robustly associated with DDs. Despite detecting more DD-associated genes than in any previous study, much of the excess of DNMs of protein-coding genes remains unaccounted for. Modelling suggests that over 500 novel DD-associated genes await discovery, many of which are likely to be less penetrant than the currently known genes. Research access to clinical diagnostic datasets will be critical for completing the map of dominant DDs.

genomics

The contribution of non-canonical splicing mutations to severe dominant developmental disorders

Mutations which perturb normal pre-mRNA splicing are significant contributors to human disease. We used exome sequencing data from 7,833 probands with developmental disorders (DD) and their unaffected parents, as well as >60,000 aggregated exomes from the Exome Aggregation Consortium, to investigate selection around the splice site, and quantify the contribution of splicing mutations to DDs. Patterns of purifying selection, a deficit of variants in highly constrained genes in healthy subjects and excess de novo mutations in patients highlighted particular positions within and around the consensus splice site of greater functional relevance. Using mutational burden analyses in this large cohort of proband-parent trios, we could estimate in an unbiased manner the relative contributions of mutations at canonical dinucleotides (73%) and flanking non-canonical positions (27%), and calculated the positive predictive value of pathogenicity for different classes of mutations. We identified 18 patients with likely diagnostic de novo mutations in dominant DD-associated genes at non-canonical positions in splice sites. We estimate 35-40% of pathogenic variants in non-canonical splice site positions are missing from public databases.

genetics

Autosomal recessive coding variants explain only a small proportion of undiagnosed developmental disorders in the British Isles

Large exome-sequencing datasets offer an unprecedented opportunity to understand the genetic architecture of rare diseases, informing clinical genetics counseling and optimal study designs for disease gene identification. We analyzed 7,448 exome-sequenced families from the Deciphering Developmental Disorders study, and, for the first time, estimated the causal contribution of recessive coding variation exome-wide. We found that the proportion of cases attributable to recessive coding variants is surprisingly low in patients of European ancestry, at only 3.6%, versus 50% of cases explained by de novo coding mutations. Surprisingly, we found that, even in European probands with affected siblings, recessive coding variants are only likely to explain ~12% of cases. In contrast, they account for 31% of probands with Pakistani ancestry due to elevated autozygosity. We tested every gene for an excess of damaging homozygous or compound heterozygous genotypes and found three genes that passed stringent Bonferroni correction: EIF3F, KDM5B, and THOC6. EIF3F is a novel disease gene, and KDM5B has previously been reported as a dominant disease gene. KDM5B appears to follow a complex mode of inheritance, in which heterozygous loss-of-function variants (LoFs) show incomplete penetrance and biallelic LoFs are fully penetrant. Our results suggest that a large proportion of undiagnosed developmental disorders remain to be explained by other factors, such as noncoding variants and polygenic risk.

genetics

De novo mutations in regulatory elements cause neurodevelopmental disorders

SummaryDe novo mutations in hundreds of different genes collectively cause 25-42% of severe developmental disorders (DD). The cause in the remaining cases is largely unknown. The role of de novo mutations in regulatory elements affecting known DD associated genes or other genes is essentially unexplored. We identified de novo mutations in three classes of putative regulatory elements in almost 8,000 DD patients. Here we show that de novo mutations in highly conserved fetal-brain active elements are significantly and specifically enriched in neurodevelopmental disorders. We identified a significant two-fold enrichment of recurrently mutated elements. We estimate that, genome-wide, de novo mutations in fetaLbrain active elements are likely to be causal for 1-3% of patients without a diagnostic coding variant and that only a small fraction (<2%) of de novo mutations in these elements are pathogenic. Our findings represent a robust estimate of the contribution of de novo mutations in regulatory elements to this genetically heterogeneous set of disorders, and emphasise the importance of combining functional and evolutionary evidence to delineate regulatory causes of genetic disorders.

genetics