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      Exome sequencing and complex disease: practical aspects of rare variant association studies

      review-article
      1 , 2 , 3 , 1 , 2 , 3 , 4 , *
      Human Molecular Genetics
      Oxford University Press

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          Abstract

          Genetic association and linkage studies can provide insights into complex disease biology, guiding the development of new diagnostic and therapeutic strategies. Over the past decade, genetic association studies have largely focused on common, easy to measure genetic variants shared between many individuals. These common variants typically have subtle functional consequence and translating the resulting association signals into biological insights can be challenging. In the last few years, exome sequencing has emerged as a cost-effective strategy for extending these studies to include rare coding variants, which often have more marked functional consequences. Here, we provide practical guidance in the design and analysis of complex trait association studies focused on rare, coding variants.

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          Most cited references45

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          Genome-wide association studies for complex traits: consensus, uncertainty and challenges.

          The past year has witnessed substantial advances in understanding the genetic basis of many common phenotypes of biomedical importance. These advances have been the result of systematic, well-powered, genome-wide surveys exploring the relationships between common sequence variation and disease predisposition. This approach has revealed over 50 disease-susceptibility loci and has provided insights into the allelic architecture of multifactorial traits. At the same time, much has been learned about the successful prosecution of association studies on such a scale. This Review highlights the knowledge gained, defines areas of emerging consensus, and describes the challenges that remain as researchers seek to obtain more complete descriptions of the susceptibility architecture of biomedical traits of interest and to translate the information gathered into improvements in clinical management.
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            Sequence variants in the autophagy gene IRGM and multiple other replicating loci contribute to Crohn's disease susceptibility.

            A genome-wide association scan in individuals with Crohn's disease by the Wellcome Trust Case Control Consortium detected strong association at four novel loci. We tested 37 SNPs from these and other loci for association in an independent case-control sample. We obtained replication for the autophagy-inducing IRGM gene on chromosome 5q33.1 (replication P = 6.6 x 10(-4), combined P = 2.1 x 10(-10)) and for nine other loci, including NKX2-3, PTPN2 and gene deserts on chromosomes 1q and 5p13.
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              Deep resequencing of GWAS loci identifies independent rare variants associated with inflammatory bowel disease

              More than a thousand disease susceptibility loci have been identified via genome-wide association studies (GWAS) of common variants; however, the specific genes and full allelic spectrum of causal variants underlying these findings generally remain to be defined. We utilize pooled next-generation sequencing to study 56 genes in regions associated to Crohn’s Disease in 350 cases and 350 controls. Follow up genotyping of 70 rare and low-frequency protein-altering variants (MAF ~ .001-.05) in nine independent case-control series (16054 CD patients, 12153 UC patients, 17575 healthy controls) identifies four additional independent risk factors in NOD2, two additional protective variants in IL23R, a highly significant association to a novel, protective splice variant in CARD9 (p < 1e-16, OR ~ 0.29), as well as additional associations to coding variants in IL18RAP, CUL2, C1orf106, PTPN22 and MUC19. We extend the results of successful GWAS by providing novel, rare, and likely functional variants that will empower functional experiments and predictive models.
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                Author and article information

                Journal
                Hum Mol Genet
                Hum. Mol. Genet
                hmg
                hmg
                Human Molecular Genetics
                Oxford University Press
                0964-6906
                1460-2083
                15 October 2012
                13 September 2012
                13 September 2012
                : 21
                : R1 , Special Review Issue: Genomic Medicine
                : R1-R9
                Affiliations
                [1 ]Center for Human Genetic Research and Cardiovascular Research Center, simpleMassachusetts General Hospital , Boston, MA, USA,
                [2 ]simpleHarvard Medical School , Boston, MA, USA,
                [3 ]simpleBroad Institute of Harvard and MIT , Cambridge, simpleMA , USA and
                [4 ]Department of Biostatistics, simpleUniversity of Michigan School of Public Health , Ann Arbor, MI, USA
                Author notes
                [* ]To whom correspondence should be addressed at: M4614 SPH I Tower, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA. Tel: +1 7347634901; Fax: +1 7346158322; Email: goncalo@ 123456umich.edu
                Article
                dds387
                10.1093/hmg/dds387
                3459641
                22983955
                7d465e27-532f-4d97-b2fe-c1abf41bdb7b
                © The Author 2012. Published by Oxford University Press.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial reuse, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 21 August 2012
                : 7 September 2012
                Categories
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                Genetics
                Genetics

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