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Genome-wide
                                                                                Association
                                                                                    Studies

                                                                                                   EPI 519
                                                                                           21 October 2010
                                                                                              Joshua C. Bis, PhD
                                                                        University of Washington, Cardiovascular
The Type 1 Diabetes Genetics Consortium. Nature Genetics, 2009 May 10
                                                                                            Health Research Unit
Complex phenotypes




             Manolio et al. J. Clin. Invest. 118:1590-1605 (2008).
rationale for association studies




                      Balding. Nature Reviews Genetics. 2006; 7:781-791
candidate genes




  Manolio, Boerwinkle, O’Donnell, Wilson. Arterioscler Thromb Vasc Biol. 2004;24:1567-1577.
highly consistent associations*
Trait                  Gene                   Polymorphism                  Frequency
Deep Vein              F5                     Arg506Gln                     0.015
Thrombosis
Graves’ disease        CTLA4                  Thr17Ala                      0.62
Type 1 diabetes        INS                    5’VNTR                        0.67
HIV infection          CCR5                   32 bp Ins/Del                 0.05-0.07
Alzheimer’s disease    APOE                   Epsilon 2/3/4                 0.16-0.24
Creutzfelt-Jakob       PRNP                   Met129Val                     0.37

 * Associations between polymorphisms and disease where at least 75% of identified studies
 achieved statistical significance. (out of 600 gene–disease studies reviewed)


                                                         Hirschhorn: Genet Med, Volume 4(2).March/April 2002.45-61
“genomics”
The field within genetics
concerned with the structure and
function of the entire DNA
sequence of an individual or
population.




                      -- Thomas Roderick
                     McDonald’s Raw Bar
                                   1986
genome-wide association study
               “… a study of common genetic
               variation across the entire
               human genome designed to
               identify genetic associations with
               observable traits.”


                              -- National Institutes of Health,
                           “Policy for sharing of data obtained in
                            NIH-sponsored or conducted GWAS”
“A major strength of the
genome-wide approach … has
been its freedom from reliance
on prior knowledge.”




-- “A HapMap harvest of insights into the genetics of
                                   common disease”
                          (Manolio, Brooks, Collins.)
genome-wide publication epidemic




                      genome.gov/GWAStudies :: 2 November 2009
Costs per Genotype
      $1.00
                       ABI
                     TaqMan

                                 ABI
                               SNPplex
                                           Illumina
      $0.10                               GoldenGate        Affymetrix
                                                            MegAllele
                                               Affymetrix
                                                  10K            Illumina
                                                             Infinium/Sentrix
                                                                                 Perlegen
      $0.01                                                             Affymetrix
                                                                        100k/500K        Illumina
                                                                                            2.5M
         # SNPs 1         10        100      103           104          105           106

                  2001                                                         2005
S. Chanock, NCI
Modified from http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=helpsnpfaq
haplotypes




     The International HapMap Consortium. Nature | Vol 437 | 27October2005
“… to create a public, genome-
wide database of common
human sequence variation,
providing information needed as
a guide to genetic studies of
clinical phenotypes.”


                      -- October 2002
Ben Fry, for Genome Research. November 2005
imputation



Use patterns of variation from HapMap to impute genotypes.
Increases power by allowing for association testing at
untyped markers and allows comparisons across studies and
platforms by using a common set of SNPs.
                           Li, Willer, Sanna, Abecasis. Annu Rev Genomics Hum Genet. 2009;10:387-406
(SOME PRACTICAL CONSIDERATIONS)
genotyping
genotyping
genotyping: raw data

                Ratio of intensities
                from two channels




                Calls = 2461
                No calls = 27
analysis × 2.5 million
association study
                                                  controls                                                                                                                                          cases
CC   CT   CT   TT   TT   CT   CC   TT   TT   CC   CC   CC   TT   TT   TT   CT   CC   TT   CT   TT   TT   CT   TT   CT   TT   TT   TT   CT   CT   CT   CT   TT   CT   CT   TT   CT   CT   CT   CC   CT   CT   CC   CC   CT   TT   CT   CT   TT   CC   CC   CT   CC   TT   CT
CT   CC   TT   TT   CC   CT   CT   CC   TT   CT   CT   TT   TT   CC   CT   CT   CC   CC   CC   CT   CT   CT   TT   CT   TT   CT   TT   TT   CC   CC   CT   CT   CC   CT   CT   TT   CC   CT   TT   CC   CC   CC   CT   CT   CT   CT   CT   CC   CT   CT   CC   CC   CT   CT
CT   TT   TT   CT   CT   CT   CT   TT   CT   CT   TT   TT   CC   CT   CC   CT   CT   CC   CT   CC   CT   CC   CT   CT   CC   CC   TT   TT   TT   TT   CC   CT   CC   CT   TT   CT   CC   CT   CC   CT   CT   TT   CT   CT   TT   CT   CT   TT   CT   CC   CC   CC   CC   CT
CT   CT   CT   TT   CT   CT   TT   CT   TT   CC   TT   CC   CC   TT   CC   CT   TT   CT   CC   CT   CT   CT   TT   CT   CT   CT   CT   CT   CT   CC   CT   CC   CT   CT   TT   CC   CC   TT   CT   CT   CT   TT   CT   CC   CT   CT   TT   CC   CT   TT   CC   CC   CC   CT
CT   CT   CT   CC   CC   CT   CC   CT   TT   CT   TT   CT   CT   CC   CT   CT   CT   CT   CT   TT   CC   CT   TT   TT   CC   TT   CC   CT   TT   CT
                                                                                                                                                      TT   CT   CT   CT   TT   CC   CT   CT   CC   CT   CT   CT   CT   CC   CT   CT   CC   CC   CC   CT   TT   CC   CC   CC
CT   CC   TT   CT   CT   TT   CT   TT   TT   CT   CT   CT   CT   TT   CT   CT   TT   CC   TT   CT   CT   CT   TT   TT   TT   CT   CT   CT   CT   CT
CT   CT   CC   CC   CC   TT   CC   CT   TT   CT   CC   CT   CT   TT   TT   TT   TT   CT   CC   TT   CT   CT   TT   CT   CT   CC   CC   CC   TT   CC   CC   TT   CT   CC   TT   TT   CC   CT   CT   CC   CC   CT   CC   CT   CT   CC   CT   TT   CC   CC   CC   CT   CT   CC
TT   CT   CT   CT   CT   CC   CT   TT   CC   CC   TT   TT   CC   TT   CT   CT   CT   CT   CC   CT   CT   CC   TT   CT   CT   CT   CT   CC   CT   CT   CT   CC   CT   CC   CC   CT   CT   CT   CT   TT   CC   CT   CC   CC   CT   CT   CT   CT   CT   CT   TT   CC   CT   CT
CT   TT   CC   TT   CT   CT   TT   CT   CC   CT   CT   CT   TT   CC   CC   CC   CT   CT   CC   CC   CC   CT   CT   CT   CT   CC   CT   CT   CT   CC   CT   CT   CC   CT   CC   CT   CT   CC   CC   CT   CT   CT   CC   CC   CC   TT   CT   TT   CT   CT   TT   CC   TT   TT
CT   CC   CT   TT   CC   TT   CT   TT   CT   CC   CT   CC   CT   CC   CT   TT   TT   CT   CT   CT   CT   CT   CC   TT   CC   CC   CT   CT   TT   CT   CT   CT   CC   TT   CT   CC   CT   CC   CT   CC   CC   CC   CC   CT   CT   CT   CC   CT   CC   CT   CT   CT   CC   CC
CT   CT   CT   CT   TT   CT   CT   TT   CT   CT   CT   CC   CC   CT   CT   CC   CC   CC   CT   CT   CT   CT   CT   CT   CC   CT   CT   CC   CT   TT   CT   CT   CT   CT   TT   CC   CT   CT   CT   CT   CT   CT   TT   CT   CT   CT   CC   TT   CT   CC   CC   TT   TT   TT
TT   TT   CT   CC   CT   CT   CT   CC   TT   CT   CC   CT   CC   TT   TT   CT   TT   TT   CT   CT   TT   CT   CT   TT   CT   TT   CC   CT   CT   CC   CT   TT   CC   TT   TT   CC   TT   CT   TT   TT   CT   TT   CT   CT   CC   TT   TT   CT   CT   CC   CC   CT   TT   CT
CT   CT   CC   CT   CT   CC   TT   TT   CC   CT   CC   CT   CT   CT   CT   CT   TT   CC   CC   CT   CC   TT   TT   TT   CC   CT   CC   CC   CC   CT   TT   CC   CC   CT   TT   CC   CT   CT   CT   CC   CT   CC   TT   TT   CT   CC   CT   CC   CT   CT   CT   CC   CT   CC
CC   CT   CT   TT   CT   CT   CT   CT   CT   CC   CT   TT   CC   CT   TT   CT   CC   CT   CT   CT   CC   CC   CT   CT   CT   TT   CT   CT   CT   CT
                                                                                                                                                      CC   CT   CT   CT   CC   CT   CC   TT   CT   CC   CT   CT   CT   CT   CC   CT   CC   TT   CT   TT   TT   TT   CT   CT
TT   CT   CT   TT   CT   CC   TT   CT   CC   TT   CT   CC   CC   CT   CT   CC   TT   CT   CC   CC   CT   CT   CT   CT   CC   CT   CT   CC   CT   CT
TT   CT   TT   CT   TT   TT   TT   CC   CT   CT   CC   CT   CT   CT   CT   CC   CT   CT   CT   CC   TT   CT   CC   TT   CT   CT   CT   CC   TT   TT   CT   CT   CT   CT   CC   CT   CT   CT   CC   CT   TT   TT   CT   CT   CC   TT   CT   CT   CC   TT   CC   TT   CT   CT
TT   TT   CT   CT   CT   CT   CT   CT   CT   CT   CT   CT   CT   CT   TT   CT   TT   CT   CT   CC   CT   CT   CT   CT   CC   CT   TT   TT   TT   CT   CT   CT   TT   CC   CC   CC   CC   CT   CT   TT   CT   CC   CT   CT   CC   CC   CC   CT   TT   TT   TT   CC   CT   CT
CC   CT   TT   CT   CT   CT   TT   TT   CC   CT   CC   CT   CC   CT   CT   TT   CC   TT   CC   CT   CT   TT   CC   CT   CC   CT   CT   CC   CT   CC   CC   CC   CC   TT   TT   CT   CT   TT   CT   CT   CT   CC   CT   CC   CC   CC   CC   CT   CC   CT   TT   CT   CT   CT
CT   TT   CT   TT   TT   CT   CC   CT   CT   TT   TT   CT   CC   CC   CC   CT   CT   CT   TT   CT   TT   CT   CT   CT   CT   TT   CT   TT   CC   TT   CT   CT   CC   CT   CT   CT   CT   CT   TT   TT   TT   TT   CC   CC   CC   CT   TT   CT   CC   CT   CT   CT   TT   CC
CT   CT   CC   CC   CC   CT   CC   CT   CC   TT   TT   TT   CC   CC   TT   CT   CT   CT   TT   CC   CT   CT   CC   CC   CT   TT   CT   CT   CT   TT   CT   CT   CC   CC   CC   CT   CC   TT   CC   CT   TT   TT   CC   CT   CC   TT   CT   CT   CT   CC   CC   CC   CT   CT
TT   CT   CT   CT   TT   CT   CT   CT   TT   CT   TT   CC   CT   CT   TT   CT   CT   TT   TT   CC   TT   TT   CC   CT   CT   CT   CC   CC   CT   TT   CT   TT   CT   TT   CT   CC   CC   CT   CC   CC   CT   TT   CT   CT   CT   CT   CC   CT   CC   TT   CT   CC   CC   CT
TT   CT   TT   CT   CT   CT   CT   TT   TT   CT   TT   CT   CT   CC   CT   CT   CT   TT   TT   CT   CC   CT   TT   CC   CT   TT   TT   CT   TT   CT   CC   CC   CT   CC   CT   TT   CT   CC   CT   CC   TT   CC   TT   CT   CC   CT   CC   CT   CT   CT   CC   CT   CT   TT
CT   CC   CT   TT   TT   CT   CT   TT   CT   CC   CT   TT   CT   CT   CT   CT   CT   CT   CC   CT   CT   CC   CT   CC   TT   CT   CC   TT   CT   TT   TT   CC   CT   TT   TT   CC   CT   CC   CT   CT   CT   TT   TT   CT   CC   TT   CT   CT   CC   CT   CC   TT   CT   CT
CT   TT   CC   CT   CT   CC   TT   CT   CC   TT   CC   CT   CT   TT   TT   CT   CT   TT   CT   CC   CC   CT   CT   TT   CT   CT   TT   CC   CC   CT
                                                                                                                                                      CC   CC   CT   CT   CC   CT   TT   CT   CT   CT   CT   CT   CT   TT   CC   CT   CT   TT   TT   CC   CT   TT   CC   TT
TT   CT   TT   TT   CT   CC   TT   CC   CT   CT   CC   TT   CT   CC   CT   CC   TT   CC   TT   CC   CT   TT   TT   TT   CT   CC   TT   CC   CC   CC
CT   CT   CC   TT   CC   TT   CT   CT   CC   TT   TT   CT   TT   CT   CC   CT   CC   CT   CT   CT   TT   TT   TT   CC   CT   CC   CC   CC   TT   TT   TT   TT   CC   CC   CC   TT   TT   CT   CC   CC   CT   CT   CC   CT   CT   TT   TT   CC   CT   CT   TT   TT   CT   TT
CT   CT   CT   CT   CT   TT   CT   CC   CT   TT   CT   TT   CC   CC   CT   TT   CT   CT   CC   CT   CT   CC   TT   TT   TT   CT   TT   CC   TT   TT   CC   CC   TT   TT   TT   TT   TT   CT   CT   CT   CT   CC   CC   CT   CC   CC   TT   CT   CC   CT   CT   CC   CT   CT
CC   CC   CC   CT   CT   TT   CT   CT   CC   TT   CT   CT   TT   CT   CT   CT   CC   TT   CT   CT   CC   CT   CC   CC   CT   CC   CT   CT   CT   TT   CC   CT   CC   CC   TT   CT   CT   CC   CT   CT   CC   CT   CT   CC   CT   CT   TT   CT   CT   CC   CC   TT   CC   CC
TT   CC   CC   TT   CT   CC   TT   TT   CT   TT   CT   CC   CT   CT   CT   TT   CC   CC   CC   CC   CT   CT   CT   CC   CT   CT   CT   TT   CT   CT   CT   CT   CC   CT   CT   CT   CT   TT   TT   CT   CC   CT   CT   CC   CT   CC   TT   CC   TT   CC   CC   TT   CT   CC
TT   TT   CT   CC   CT   CC   CC   CC   CT   CT   TT   CT   CT   CC   CC   TT   CC   CT   TT   CT   TT   CT   CC   CT   CT   TT   TT   TT   CT   TT   CC   CC   CC   TT   CT   CT   CT   CT   CC   CT   CT   CT   CT   CT   CC   TT   CT   CT   CT   TT   CT   CC   CC   TT
CC   CT   CT   CC   CT   CT   CC   CC   CT   CT   TT   CC   TT   TT   CT   CT   CT   TT   CT   CT   CT   CC   TT   TT   TT   CT   TT   TT   CT   CT   CC   TT   CT   CC   CC   CT   CT   CT   TT   CT   CT   CC   TT   CT   CT   CT   CT   CC   CT   CT   CC   CC   CC   CT
CC   CC   CC   CT   CT   CT   CT   CT   CC   CT   CC   CT   TT   CC   CT   TT   CT   CT   CT   CT   CT   TT   CT   TT   CT   CT   TT   TT   TT   CC   TT   CC   CT   CC   TT   CC   CT   CT   CT   CT   CC   CT   TT   CT   TT   CC   CT   CT   TT   CC   CC   CT   TT   TT
TT   CC   CC   CC   CT   CT   CC   CT   TT   TT   CT   CT   CC   TT   CT   TT   CT   TT   CT   CC   CC   CC   CT   TT   TT   TT   CT   CT   CC   CT
                                                                                                                                                      CT   TT   TT   CT   TT   CT   CC   CC   CT   CT   CT   CC   CC   CT   CT   CC   TT   CC   CT   CC   CT   CC   TT   CC
CT   CT   CC   CC   CT   CC   CC   TT   CT   CC   CT   CC   CT   CT   CC   CC   TT   CT   CC   TT   TT   CT   CT   TT   CT   CT   CC   TT   CC   CT
CT   CC   CT   CT   CC   CT   TT   CT   CT   CC   TT   TT   CT   CT   CT   CT   CC   TT   CT   CT   CC   CT   TT   TT   CC   CC   CT   TT   TT   CC   CT   CC   CT   CT   TT   CC   CT   TT   CT   CT   CT   CT   CT   CT   CT   CC   CC   CT   CC   CT   TT   CT   CC   CC
CT   CT   CC   CC   TT   CT   CT   TT   TT   CT   CT   CT   CT   CT   TT   CT   CT   CT   CC   CT   TT   CT   CT   CC   CT   CC   CT   TT   CT   CC   CT   CC   TT   CT   CT   CC   CT   CT   CT   CC   CC   CT   CC   CT   CC   CC   CC   TT   TT   CC   CT   CC   CC   TT
CC   TT   CC   TT   CT   CC   TT   CT   TT   CT   TT   TT   CT   CT   CT   TT   CC   CT   TT   CT   CC   TT   CT   TT   CC   TT   CT   TT   CT   CT   CT   CT   CT   CC   CT   CT   CT   CT   CT   CC   CC   TT   TT   CC   CC   CC   TT   TT   CT   CC   CC   TT   CT   TT
TT   TT   CC   CC   TT   CC   CC   CC   CC   CC   CT   CT   CT   CC   CT   CT   CC   CT   TT   CT   CT   CT   CT   CT   CT   TT   CT   CC   CT   CT   TT   CT   CC   CC   CC   CT   CT   TT   CC   TT   TT   CT   CT   CT   CT   CT   TT   CT   CC   CT   CT   CC   CT   CT
CC   CC   CT   CT   CT   CT   CT   TT   TT   CT   CT   TT   TT   CT   TT   CC   TT   TT   CT   CC   TT   TT   CT   TT   CC   TT   CC   CT   CT   TT   CT   CT   CT   CT   CC   CC   CT   TT   CC   TT   CT   CC   CT   CT   CT   CT   CC   CT   CT   TT   CT
CT   CC   TT   CT   CC   CT   CT   TT   CC   CT   CT   TT   TT   CT   CT   TT   CT   CC   CT   CT   CC   TT   CT   CC   CT   TT   TT   CC   CT   TT
CT   CC   CT   CT   TT   CC   CT   TT   TT   TT   TT   CT   TT   CT   TT   CT   CC   CT   CC   TT   CT   CT   CT   CT   TT   CT   CT   TT   CT   CT
TT   CT   TT   TT   CT   CT   CC   TT   CC   CT   CT   CC   CT   TT   CT   CT   CT   CT   TT   CT   CT   CT   TT   CC   CC   CC   CT   CC   TT   CC
TT   CT   CC   CT   CT   CC   CC   CC   CT   CT   CC   TT   CT   CT   CT   CT   CT   CT   CT   CT   TT   TT   CT   CC   CC   CT   CT   CT   CT   CC
CT   TT   TT   CT   CT   CT   CC   CT   CT   TT   CT   CT   CT   CT   CT   CC   CT   CT   CT   TT   CC   CC   TT   CT   CC   CT   CT   TT   CT   CC
CT   TT   CC   CT   CC   CT   CT   CT   TT   CC   CC   CT   CT   TT   CT   CT   CT   TT   CT   CC   CT   CT   CT   CT   TT   CT   CT   TT   CT   CC
CT   CT   CC   CT   CC   CT   CT   CT   CT   CT   CT   CT   CT   TT   TT   CC   CT   TT   CC   CT   TT   CC   CC   CT   CC   CC   CT   TT   CT   CC
CT   CT   CC   CC   CT   CT   CT   CT   CT   TT   TT   CT   CT   TT   CC   CC   CT   CT   CC   CT   CC   CT   TT   CC   CT   CT   CC   CC   TT   TT
TT   CT   TT   CT   TT   CT   TT   TT   CT   TT   CC   TT   CT   CT   CC   CC   CC   CC   CT   CT   TT   TT   TT   CC   CT   CC   CT   TT   CT   TT
CC   CT   TT   CT   CT   CC   CC   CT   CT   CT   TT   TT   TT   CT   CC   CT   TT   TT   CT   TT   CC   CT   TT   CC   CT   CC   CT   CT   CT   TT
CC   CC   CT   TT   TT   TT   CT   CT   CC   CT   TT   CT   CT   CT   TT   CT   TT   CC   CT   CC   CC   CT   CT   CC   CT   CC   TT   CT   CC   CT
CT   CC   CC   CT   CC   TT   CT   CT   CT   TT   CT   CT   CC   CT   CT   CC   TT   CC   CT   CT   TT   CT   CT   TT   TT   CT   CT   TT   TT   TT
CT   CT   CT   CC   CT   CT   CC   TT   CT   CT   CC   CC   CT   CC   CT   CT   CT   CT   CT   CC   CC   CC   CT   CT   TT   CT   TT   CT   CT   CT


                                                                                                                                                                          Odds ratio for C allele:
CT   CT   CT   CT   CT   TT   TT   TT   CT   CC   CT   CC   CT   TT   TT   TT   TT   TT   CT   CT   CT   TT   CT   CT   TT   CT   CC   CT   CT   CT
CT   CT   TT   TT   CT   CT   TT   TT   CC   CT   TT   TT   CC   CT   TT   CT   TT   TT   CT   TT   TT   CC   CC   CC   CC   CT   CT   CT   TT   CT
TT   CC   CC   CC   TT   CT   CT   TT   TT   CT   CT   CT   CT   CT   TT   CT   CT   CC   CT   CT   CT   CT   TT   CC   CC   CT   CT   CT   CC   TT
CT   TT   TT   CT   TT   TT   CC   CT   CC   TT   CT   CC   TT   CC   CC   CT   CC   CC   TT   TT   CT   CT   CC   CC   CT   TT   TT   CC   CT   TT
TT   TT   TT   CT   CT   CT   TT   CT   CT   CC   CC   CT   TT   CT   TT   CT   TT   CT   CC   CC   CT   CC   CT   CT   CT   TT   CC   CC   CT   CT
CT
CC
CT
TT
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                                                                                                                                                                          1.35, p = 6.3 x 10-7
CT   CC   CC   TT   CT   TT   CC   TT   CT   CT   CT   TT   CT   CT   CC   CC   CC   TT   CT   CT   CC   CT   CT   CT   CT   CC   CC   CT   CT   CC
CC   CC   CC   CC   CC   CT   CT   TT   CT   CT   CT   CT   CT   CT   TT   CT   CT   TT   TT   CT   CT   CT   TT   CT   CT   CT   CT   TT   TT   TT
CT   CC   CT   TT   TT   CT   TT   TT   TT   CT
Manhattan plot




            (McCarthy et al.,Nature Reviews Genetics, May 2008)
p-value
the probability of seeing your data or more extreme
   data if the null hypothesis is true.
By chance, with 1,000,000 statistical tests:
•  a threshold of p=0.05
   would show 50,000 “significant” associations
   360 cases : 360 controls
•  a threshold of p = 0.05/1,000,000 (5 x 10-8)
   would show 0.05 “significant” associations
   1590 cases: 1590 controls.
study design considerations
Case-control or cohort
Sample size
Phenotype definition

Comparability of cases and controls
  •  Genotyping quality
  •  Population substructure
  •  Laboratory procedures, genotyping, data cleaning
population stratification




     requires both allele frequency
   and disease prevalence differences
                              Balding. Nature Reviews Genetics. 2006; 7:781-791
Q-Q plots




      (modified from McCarthy et al.,Nature Reviews Genetics, May 2008)
Allele frequency & effect size
            Feasibility of identifying genetic variants by risk allele
            frequency and strength of genetic effect (odds ratio).




TA Manolio et al. Nature 461, 747-753 (2009) doi:10.1038/nature08494
reasons for larger sample size:
• More genotypes / tests    • Lower effect size

• More genotype error or    • Lower frequency of risk
  misclassification            allele

• Higher heterogeneity of   • Lower correlation
  association                 between marker allele
                              and risk allele.
power & sample size




                      (Rice, personal communication)
Multi-stage discovery
Carry-forward a large number of
potential associations through
multiple, narrowing stages.

Protect against false positives via
replication

Minimize false negative results
via permissive early thresholds
                                      From	
  Hoover,	
  R.	
  Epidemiology.	
  18(1):13-­‐17,	
  January	
  2007.	
  
Meta analysis
Combine results from several
studies to increase power using
traditional methods of meta-
analysis.

Allows for first stage discovery of
small effect sizes
(SELECTED EXAMPLES)
Wellcome Trust Case Control Consortium
Biggest projects undertaken to identify genetic variation that
   may be associated with disease
£ 9 million in funding from Wellcome Trust
GWAS of seven common diseases: 2,000 cases each and 3,000
   shared controls
All genotyping data available to scientific community


                             www.wtccc.org.uk; (Nature, vol 447, 7 June 2007)
Lon Cardon, SISG 2007
UK Control groups are NOT very
           different




                          Lon Cardon, SISG 2007
WTCCC Results
WTCCC results




                Samani, NEJM 2007
WTCCC results
Coronary Disease GWAS: 9p21
  author           McPherson            Helgadottir                 Samani                  Larson


  where              Science               Science                   NEJM                 BMC Med Gen
  when              May 2007              May 2007                August 2007              Sept 2007
  design             3-stage             case-control             case control               cohort
                   case control
 discovery            OHS 1           deCODE: Iceland A              WTCCC              Framingham Heart
                      OHS 2                                                                   Study
                      ARIC
replication           CCHS                 Iceland B         German Family Study
                       DHS            3 U.S. case-control
                      OHS-3
   case        severe premature CHD           MI            MI or revascularization +      incident MI
 definition                                                          fhx of CAD


age at onset          <60               <70 males                     <66
                                        <75 females
9p21 results
study         SNP           locus   hazard/odds ratio               PAR

ARIC          rs10757274    9p21    AB: 1.18 (1.02-1.37)            12-15%
                                    BB: 1.29 (1.09-1.52)
CCHS          rs10757274    9p21    AB: 1.26 (1.12-1.42)            10-13%
                                    BB: 1.38 (1.19-1.60)
deCODE        rs10757278    9p21    AB: 1.26 (1.16-1.36)            21%
                                    BB: 1.64 (1.47-1.82)
deCODE        rs10757278    9p21    AB: 1.49 (1.31-1.69)            31%
early onset                         BB: 2.02 (1.72 - 2.36)



                                                             Helgadottir, Science 2007
                                                             McPherson, Science 2007
9p21 Gene Region
9p21 locus
not located within a “gene”
region contains CDKN2A and CDKN2B genes
   •  role in cell proliferation, cell aging and apoptosis -
      important features of atherogenesis
   •  Sequencing did not reveal obvious candidates
may implicate a previously unrecognized gene or regulatory
  element
same region also associated with type 2 diabetes
MIGen: Population
Study                                    Cases (mean age)   Controls (mean age)
Italian ATVB (Italy)                           1,693               1,668
                                               (39 y)              (39 y)
Heart Attack Risk in Puget Sound (USA)          505                 559
                                               (46 y)              (45 y)
REGICOR (Spain)                                 312                 317
                                               (46 y)              (46 y)
MGH (USA)                                       204                 260
                                               (47 y)              (54 y)
FINRISK (Finland)                               167                 172
                                               (47 y)              (47 y)
Malmö Diet & Cancer (Sweden)                     86                  99
                                               (47 y)              (49 y)
MIGen: Design
MIGen: Early MI SNPs
      Locus          genes of interest
✔     1p13         CELSR2-PSRC1-SORT1
✔     1q41                MIA3
✘     2p36                  --
✪     2q33               WDR12
✪    3q22.3               MRAS
✪    6p24.1             PHACTR1
✘     6q25              MTHFD1L
✔     9p21           CDKN2A-CDKN2B
✔    10q11               CXCL12
✘    15q22               SMAD3
✪   19p13.2               LDLR
✪    21q22         MRPS6-SLC5A3-KCNE2
MIGen: Risk Score



4 replicated loci:
CDKN2A-B, CELSR2-PSRC1-SORT1, MIA3, CXCL12
5 new loci:
SLC5A3-MRPS6-KCNE2, PHACTR, WDR12, LDLR, PCSK9
(LESSONS, QUESTIONS, DIRECTIONS)
Published Genome-Wide Associations through 6/2010,
     904 published GWA at p<5x10-8 for 165 traits
                                           NHGRI GWA Catalog
                                           www.genome.gov/GWAStudies
new biology: genomic context




                          Manolio, NEJM 2010
new biology: mechanisms




                          Manolio, NEJM 2010
new biology: connections




                           Manolio, NEJM 2010
missing heritability (2009)
                                                    % of heritability
                                   number of loci      explained
Age-related macular degeneration         5                50%
Crohn’s disease                         32                20%
Type-2 diabetes                         18                6%
HDL cholesterol                          7                5%
Height                                  40                5%
Early-onset MI                           9                2.8%
Fasting glucose                          4                1.5%




                                                          Manolio, Nature 2009
missing heritability
many variants with small effects yet to be found
    •  larger sample sizes have revealed more loci
true positives below significance threshold
contribution of rare variants
failure to identify true causal variant
structural variants poorly captured by arrays
previous estimates of heritability flawed
GxG or GxE interactions
missing heritability (update)




Meta-analysis of > 100,000 discovers 59 new associations
SNPs explain ~12% of trait variability & ~ 25% heritability
Some predict MI risk; point to LDL/HDL differences
disease prediction




hope: highly predictive and affordable genetic tests
reality: low discriminatory and predictive ability    Manolio, NEJM 2010
next steps
Ever larger sample sizes
Studies of non-European ethnic populations
Sequencing implicated genetic regions
More complex genetic models
   •  Gene x Gene interactions
   •  pooling of rare variants
Functional biology: work in basic science and animal models
summary
GWAS have led to new        Don’t forget:
biology                       •  case definition
Small effect sizes             •  QC measures
Not useful in prediction      •  sample size and power
Much yet to be discovered     •  multiple testing
More complicated than we      •  independent replication
thought
“There have been few, if any,
similar bursts of discovery in the
history of medical research”




 -- “Drinking from the fire hose …” (Hunter & Knox)
Consumer Genotyping Toys
Consumer Genotyping Toys
Consumer Genotyping Toys
Consumer Genotyping Toys
Sources / References / Reading
1.     The International HapMap Consortium.* A haplotype map of the human genome. Nature, 2005. 437(7063): p. 1299-320.[16255080].
2.     The Type 1 Diabetes Genetics Consortium.* Genome-wide association study and meta-analysis find that over 40 loci affect risk of type 1 diabetes. Nature Genetics, 2009
       May 10 [19430480]
3.     Myocardial Infarction Genetics Consortium.* Genome-wide association of early-onset myocardial infarction with single nucleotide polymorphisms and copy number
       variants. Nat Genet. 2009 Mar;41(3):334-41 [19198609]
4.     The Wellcome Trust Case Control Constortium.* Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature, 2007. 447
       (7145): p. 661-78.[17554300].
5.     Balding, D.J., A tutorial on statistical methods for population association studies. Nat Rev Genet, 2006. 7(10): p. 781-91.[16983374].
6.     Christensen, K. and J.C. Murray, What genome-wide association studies can do for medicine. N Engl J Med, 2007. 356(11): p. 1094-7.[17360987].
7.     Frazer, K.A., et al., A second generation human haplotype map of over 3.1 million SNPs. Nature, 2007. 449(7164): p. 851-61.[17943122].
8.     Hirschhorn, J.N., et al., A comprehensive review of genetic association studies. Genet Med, 2002. 4(2): p. 45-61.[11882781]. 
9.     Hoover, R. The evolution of epidemiologic research: from cottage industry to "big" science. Epidemiology. 2007 Jan;18(1):13-7. [17179754]
10.    Hunter, D.J. and P. Kraft, Drinking from the fire hose--statistical issues in genomewide association studies. N Engl J Med, 2007. 357(5): p. 436-9.[17634446].
11.    Li Y, Willer C, Sanna S, Abecasis G., Genotype imputation. Annu Rev Genomics Hum Genet. 2009;10:387-406. [19715440]
12.    Johnson AD and O’Donnell CJ: Open access database of GWA results, BMC Medical Genetics 2009: 10:6
13.    Manolio, T.A., et al., Genetics of ultrasonographic carotid atherosclerosis. Arterioscler Thromb Vasc Biol, 2004. 24(9): p. 1567-77.[15256397].
14.    Manolio, T.A., L.D. Brooks, and F.S. Collins, A HapMap harvest of insights into the genetics of common disease. J Clin Invest, 2008. 118(5): p. 1590-605.[18451988].
15.    Manolio TA, Collins FS, Cox NJ, et al. Finding the missing heritability of complex diseases. Nature. 2009 Oct 8;461(7265):747-53. [19812666]
16.    Manolio, TA. Genomewide association studies and assessment of the risk of disease. N Engl J Med. 2010 Jul 8;363(2):166-76. [20647212]
17.    McCarthy, M.I., et al., Genome-wide association studies for complex traits: consensus, uncertainty and challenges. Nat Rev Genet, 2008. 9(5): p. 356-69.[18398418].
18.    Pearson, T.A. and T.A. Manolio, How to interpret a genome-wide association study. JAMA, 2008. 299(11): p. 1335-44.[18349094].
19.    Samani NJ, Erdmann J, Hall AS, et al. Genomewide association analysis of coronary artery disease. N Engl J Med. 2007 Aug 2;357(5):443-53. [17634449]
20.    Teslovich TM, Musunuru K, Smith AV, et al. Biological, clinical and population relevance of 95 loci for blood lipids. Nature. 2010 Aug 5;466(7307):707-13. [20686565]
21.    NHGRI catalog of published GWA studies (http://genome.gov/GWASstudies)
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Epi519 Gwas Talk

  • 1. Genome-wide Association Studies EPI 519 21 October 2010 Joshua C. Bis, PhD University of Washington, Cardiovascular The Type 1 Diabetes Genetics Consortium. Nature Genetics, 2009 May 10 Health Research Unit
  • 2.
  • 3. Complex phenotypes Manolio et al. J. Clin. Invest. 118:1590-1605 (2008).
  • 4. rationale for association studies Balding. Nature Reviews Genetics. 2006; 7:781-791
  • 5. candidate genes Manolio, Boerwinkle, O’Donnell, Wilson. Arterioscler Thromb Vasc Biol. 2004;24:1567-1577.
  • 6. highly consistent associations* Trait Gene Polymorphism Frequency Deep Vein F5 Arg506Gln 0.015 Thrombosis Graves’ disease CTLA4 Thr17Ala 0.62 Type 1 diabetes INS 5’VNTR 0.67 HIV infection CCR5 32 bp Ins/Del 0.05-0.07 Alzheimer’s disease APOE Epsilon 2/3/4 0.16-0.24 Creutzfelt-Jakob PRNP Met129Val 0.37 * Associations between polymorphisms and disease where at least 75% of identified studies achieved statistical significance. (out of 600 gene–disease studies reviewed) Hirschhorn: Genet Med, Volume 4(2).March/April 2002.45-61
  • 7. “genomics” The field within genetics concerned with the structure and function of the entire DNA sequence of an individual or population. -- Thomas Roderick McDonald’s Raw Bar 1986
  • 8. genome-wide association study “… a study of common genetic variation across the entire human genome designed to identify genetic associations with observable traits.” -- National Institutes of Health, “Policy for sharing of data obtained in NIH-sponsored or conducted GWAS”
  • 9. “A major strength of the genome-wide approach … has been its freedom from reliance on prior knowledge.” -- “A HapMap harvest of insights into the genetics of common disease” (Manolio, Brooks, Collins.)
  • 10. genome-wide publication epidemic genome.gov/GWAStudies :: 2 November 2009
  • 11. Costs per Genotype $1.00 ABI TaqMan ABI SNPplex Illumina $0.10 GoldenGate Affymetrix MegAllele Affymetrix 10K Illumina Infinium/Sentrix Perlegen $0.01 Affymetrix 100k/500K Illumina 2.5M # SNPs 1 10 100 103 104 105 106 2001 2005 S. Chanock, NCI
  • 13. haplotypes The International HapMap Consortium. Nature | Vol 437 | 27October2005
  • 14. “… to create a public, genome- wide database of common human sequence variation, providing information needed as a guide to genetic studies of clinical phenotypes.” -- October 2002
  • 15. Ben Fry, for Genome Research. November 2005
  • 16. imputation Use patterns of variation from HapMap to impute genotypes. Increases power by allowing for association testing at untyped markers and allows comparisons across studies and platforms by using a common set of SNPs. Li, Willer, Sanna, Abecasis. Annu Rev Genomics Hum Genet. 2009;10:387-406
  • 20. genotyping: raw data Ratio of intensities from two channels Calls = 2461 No calls = 27
  • 21. analysis × 2.5 million
  • 22. association study controls cases CC CT CT TT TT CT CC TT TT CC CC CC TT TT TT CT CC TT CT TT TT CT TT CT TT TT TT CT CT CT CT TT CT CT TT CT CT CT CC CT CT CC CC CT TT CT CT TT CC CC CT CC TT CT CT CC TT TT CC CT CT CC TT CT CT TT TT CC CT CT CC CC CC CT CT CT TT CT TT CT TT TT CC CC CT CT CC CT CT TT CC CT TT CC CC CC CT CT CT CT CT CC CT CT CC CC CT CT CT TT TT CT CT CT CT TT CT CT TT TT CC CT CC CT CT CC CT CC CT CC CT CT CC CC TT TT TT TT CC CT CC CT TT CT CC CT CC CT CT TT CT CT TT CT CT TT CT CC CC CC CC CT CT CT CT TT CT CT TT CT TT CC TT CC CC TT CC CT TT CT CC CT CT CT TT CT CT CT CT CT CT CC CT CC CT CT TT CC CC TT CT CT CT TT CT CC CT CT TT CC CT TT CC CC CC CT CT CT CT CC CC CT CC CT TT CT TT CT CT CC CT CT CT CT CT TT CC CT TT TT CC TT CC CT TT CT TT CT CT CT TT CC CT CT CC CT CT CT CT CC CT CT CC CC CC CT TT CC CC CC CT CC TT CT CT TT CT TT TT CT CT CT CT TT CT CT TT CC TT CT CT CT TT TT TT CT CT CT CT CT CT CT CC CC CC TT CC CT TT CT CC CT CT TT TT TT TT CT CC TT 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TT CT CT TT CT CT CT CC CT CT CT CC CT CT TT CT CT CT CC CT TT CT CT CT 1.35, p = 6.3 x 10-7 CT CC CC TT CT TT CC TT CT CT CT TT CT CT CC CC CC TT CT CT CC CT CT CT CT CC CC CT CT CC CC CC CC CC CC CT CT TT CT CT CT CT CT CT TT CT CT TT TT CT CT CT TT CT CT CT CT TT TT TT CT CC CT TT TT CT TT TT TT CT
  • 23. Manhattan plot (McCarthy et al.,Nature Reviews Genetics, May 2008)
  • 24. p-value the probability of seeing your data or more extreme data if the null hypothesis is true. By chance, with 1,000,000 statistical tests: •  a threshold of p=0.05 would show 50,000 “significant” associations 360 cases : 360 controls •  a threshold of p = 0.05/1,000,000 (5 x 10-8) would show 0.05 “significant” associations 1590 cases: 1590 controls.
  • 25. study design considerations Case-control or cohort Sample size Phenotype definition Comparability of cases and controls •  Genotyping quality •  Population substructure •  Laboratory procedures, genotyping, data cleaning
  • 26. population stratification requires both allele frequency and disease prevalence differences Balding. Nature Reviews Genetics. 2006; 7:781-791
  • 27. Q-Q plots (modified from McCarthy et al.,Nature Reviews Genetics, May 2008)
  • 28. Allele frequency & effect size Feasibility of identifying genetic variants by risk allele frequency and strength of genetic effect (odds ratio). TA Manolio et al. Nature 461, 747-753 (2009) doi:10.1038/nature08494
  • 29. reasons for larger sample size: • More genotypes / tests • Lower effect size • More genotype error or • Lower frequency of risk misclassification allele • Higher heterogeneity of • Lower correlation association between marker allele and risk allele.
  • 30. power & sample size (Rice, personal communication)
  • 31. Multi-stage discovery Carry-forward a large number of potential associations through multiple, narrowing stages. Protect against false positives via replication Minimize false negative results via permissive early thresholds From  Hoover,  R.  Epidemiology.  18(1):13-­‐17,  January  2007.  
  • 32. Meta analysis Combine results from several studies to increase power using traditional methods of meta- analysis. Allows for first stage discovery of small effect sizes
  • 34. Wellcome Trust Case Control Consortium Biggest projects undertaken to identify genetic variation that may be associated with disease £ 9 million in funding from Wellcome Trust GWAS of seven common diseases: 2,000 cases each and 3,000 shared controls All genotyping data available to scientific community www.wtccc.org.uk; (Nature, vol 447, 7 June 2007)
  • 36. UK Control groups are NOT very different Lon Cardon, SISG 2007
  • 38. WTCCC results Samani, NEJM 2007
  • 40. Coronary Disease GWAS: 9p21 author McPherson Helgadottir Samani Larson where Science Science NEJM BMC Med Gen when May 2007 May 2007 August 2007 Sept 2007 design 3-stage case-control case control cohort case control discovery OHS 1 deCODE: Iceland A WTCCC Framingham Heart OHS 2 Study ARIC replication CCHS Iceland B German Family Study DHS 3 U.S. case-control OHS-3 case severe premature CHD MI MI or revascularization + incident MI definition fhx of CAD age at onset <60 <70 males <66 <75 females
  • 41. 9p21 results study SNP locus hazard/odds ratio PAR ARIC rs10757274 9p21 AB: 1.18 (1.02-1.37) 12-15% BB: 1.29 (1.09-1.52) CCHS rs10757274 9p21 AB: 1.26 (1.12-1.42) 10-13% BB: 1.38 (1.19-1.60) deCODE rs10757278 9p21 AB: 1.26 (1.16-1.36) 21% BB: 1.64 (1.47-1.82) deCODE rs10757278 9p21 AB: 1.49 (1.31-1.69) 31% early onset BB: 2.02 (1.72 - 2.36) Helgadottir, Science 2007 McPherson, Science 2007
  • 43. 9p21 locus not located within a “gene” region contains CDKN2A and CDKN2B genes •  role in cell proliferation, cell aging and apoptosis - important features of atherogenesis •  Sequencing did not reveal obvious candidates may implicate a previously unrecognized gene or regulatory element same region also associated with type 2 diabetes
  • 44. MIGen: Population Study Cases (mean age) Controls (mean age) Italian ATVB (Italy) 1,693 1,668 (39 y) (39 y) Heart Attack Risk in Puget Sound (USA) 505 559 (46 y) (45 y) REGICOR (Spain) 312 317 (46 y) (46 y) MGH (USA) 204 260 (47 y) (54 y) FINRISK (Finland) 167 172 (47 y) (47 y) Malmö Diet & Cancer (Sweden) 86 99 (47 y) (49 y)
  • 46. MIGen: Early MI SNPs Locus genes of interest ✔ 1p13 CELSR2-PSRC1-SORT1 ✔ 1q41 MIA3 ✘ 2p36 -- ✪ 2q33 WDR12 ✪ 3q22.3 MRAS ✪ 6p24.1 PHACTR1 ✘ 6q25 MTHFD1L ✔ 9p21 CDKN2A-CDKN2B ✔ 10q11 CXCL12 ✘ 15q22 SMAD3 ✪ 19p13.2 LDLR ✪ 21q22 MRPS6-SLC5A3-KCNE2
  • 47. MIGen: Risk Score 4 replicated loci: CDKN2A-B, CELSR2-PSRC1-SORT1, MIA3, CXCL12 5 new loci: SLC5A3-MRPS6-KCNE2, PHACTR, WDR12, LDLR, PCSK9
  • 49. Published Genome-Wide Associations through 6/2010, 904 published GWA at p<5x10-8 for 165 traits NHGRI GWA Catalog www.genome.gov/GWAStudies
  • 50. new biology: genomic context Manolio, NEJM 2010
  • 51. new biology: mechanisms Manolio, NEJM 2010
  • 52. new biology: connections Manolio, NEJM 2010
  • 53. missing heritability (2009) % of heritability number of loci explained Age-related macular degeneration 5 50% Crohn’s disease 32 20% Type-2 diabetes 18 6% HDL cholesterol 7 5% Height 40 5% Early-onset MI 9 2.8% Fasting glucose 4 1.5% Manolio, Nature 2009
  • 54. missing heritability many variants with small effects yet to be found •  larger sample sizes have revealed more loci true positives below significance threshold contribution of rare variants failure to identify true causal variant structural variants poorly captured by arrays previous estimates of heritability flawed GxG or GxE interactions
  • 55. missing heritability (update) Meta-analysis of > 100,000 discovers 59 new associations SNPs explain ~12% of trait variability & ~ 25% heritability Some predict MI risk; point to LDL/HDL differences
  • 56. disease prediction hope: highly predictive and affordable genetic tests reality: low discriminatory and predictive ability Manolio, NEJM 2010
  • 57. next steps Ever larger sample sizes Studies of non-European ethnic populations Sequencing implicated genetic regions More complex genetic models •  Gene x Gene interactions •  pooling of rare variants Functional biology: work in basic science and animal models
  • 58. summary GWAS have led to new Don’t forget: biology •  case definition Small effect sizes •  QC measures Not useful in prediction •  sample size and power Much yet to be discovered •  multiple testing More complicated than we •  independent replication thought
  • 59. “There have been few, if any, similar bursts of discovery in the history of medical research” -- “Drinking from the fire hose …” (Hunter & Knox)
  • 64. Sources / References / Reading 1.  The International HapMap Consortium.* A haplotype map of the human genome. Nature, 2005. 437(7063): p. 1299-320.[16255080]. 2.  The Type 1 Diabetes Genetics Consortium.* Genome-wide association study and meta-analysis find that over 40 loci affect risk of type 1 diabetes. Nature Genetics, 2009 May 10 [19430480] 3.  Myocardial Infarction Genetics Consortium.* Genome-wide association of early-onset myocardial infarction with single nucleotide polymorphisms and copy number variants. Nat Genet. 2009 Mar;41(3):334-41 [19198609] 4.  The Wellcome Trust Case Control Constortium.* Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature, 2007. 447 (7145): p. 661-78.[17554300]. 5.  Balding, D.J., A tutorial on statistical methods for population association studies. Nat Rev Genet, 2006. 7(10): p. 781-91.[16983374]. 6.  Christensen, K. and J.C. Murray, What genome-wide association studies can do for medicine. N Engl J Med, 2007. 356(11): p. 1094-7.[17360987]. 7.  Frazer, K.A., et al., A second generation human haplotype map of over 3.1 million SNPs. Nature, 2007. 449(7164): p. 851-61.[17943122]. 8.  Hirschhorn, J.N., et al., A comprehensive review of genetic association studies. Genet Med, 2002. 4(2): p. 45-61.[11882781].  9.  Hoover, R. The evolution of epidemiologic research: from cottage industry to "big" science. Epidemiology. 2007 Jan;18(1):13-7. [17179754] 10.  Hunter, D.J. and P. Kraft, Drinking from the fire hose--statistical issues in genomewide association studies. N Engl J Med, 2007. 357(5): p. 436-9.[17634446]. 11.  Li Y, Willer C, Sanna S, Abecasis G., Genotype imputation. Annu Rev Genomics Hum Genet. 2009;10:387-406. [19715440] 12.  Johnson AD and O’Donnell CJ: Open access database of GWA results, BMC Medical Genetics 2009: 10:6 13.  Manolio, T.A., et al., Genetics of ultrasonographic carotid atherosclerosis. Arterioscler Thromb Vasc Biol, 2004. 24(9): p. 1567-77.[15256397]. 14.  Manolio, T.A., L.D. Brooks, and F.S. Collins, A HapMap harvest of insights into the genetics of common disease. J Clin Invest, 2008. 118(5): p. 1590-605.[18451988]. 15.  Manolio TA, Collins FS, Cox NJ, et al. Finding the missing heritability of complex diseases. Nature. 2009 Oct 8;461(7265):747-53. [19812666] 16.  Manolio, TA. Genomewide association studies and assessment of the risk of disease. N Engl J Med. 2010 Jul 8;363(2):166-76. [20647212] 17.  McCarthy, M.I., et al., Genome-wide association studies for complex traits: consensus, uncertainty and challenges. Nat Rev Genet, 2008. 9(5): p. 356-69.[18398418]. 18.  Pearson, T.A. and T.A. Manolio, How to interpret a genome-wide association study. JAMA, 2008. 299(11): p. 1335-44.[18349094]. 19.  Samani NJ, Erdmann J, Hall AS, et al. Genomewide association analysis of coronary artery disease. N Engl J Med. 2007 Aug 2;357(5):443-53. [17634449] 20.  Teslovich TM, Musunuru K, Smith AV, et al. Biological, clinical and population relevance of 95 loci for blood lipids. Nature. 2010 Aug 5;466(7307):707-13. [20686565] 21.  NHGRI catalog of published GWA studies (http://genome.gov/GWASstudies)