A key challenge in the study of rare disease genetics is assembling large case cohorts for well- powered studies. We demonstrate the use of self-reported diagnosis data to study rare diseases at scale. We performed genome-wide association studies (GWAS) for 33 rare diseases using self-reported diagnosis phenotypes and re-discovered 29 known associations to validate our approach. In addition, we performed the first GWAS for Duane retraction syndrome, vestibular schwannoma and spontaneous pneumothorax, and report novel genome-wide significant associations for these diseases. We replicated these novel associations in non-European populations within the 23andMe, Inc. cohort as well as in the UK Biobank cohort. We also show that mixed model analyses including all ethnicities and related samples increase the power for finding associations in rare diseases. Our results, based on analysis of 19,084 rare disease cases for 33 diseases from 7 populations, show that large-scale online collection of self-reported data is a viable method for discovery and replication of genetic associations for rare diseases. This approach, which is complementary to sequencing-based approaches, will enable the discovery of more novel genetic associations for increasingly rare diseases across multiple ancestries and shed more light on the genetic architecture of rare diseases.
DNA methylation influences gene expression and is altered in many cancers, but the relationship between DNA methylation and cancer outcomes is not yet fully understood. If methylation of specific genes is associated with better or worse outcomes, it could implicate genes in driving cancer and suggest therapeutic strategies. To advance our understanding of DNA methylation in cancer biology, we conducted a pan-cancer analysis of the relationship between methylation and overall survival. Using data on 28 tumor types from The Cancer Genome Atlas (TCGA), we identified genes and genomic regions whose methylation was recurrently associated with survival across multiple cancer types. While global DNA methylation levels are associated with outcome in some cancers, we found that the gene-specific associations were largely independent of these global effects. Genes with recurrent associations across cancer types were enriched for certain biological functions, such as immunity and cell-cell adhesion. While these recurrently associated genes were found throughout the genome, they were enriched in certain genomic regions, which may further implicate certain gene families and gene clusters in affecting survival. By finding common features across cancer types, our results link DNA methylation to patient outcomes, identify biological mechanisms that could explain survival differences, and support the potential value of treatments that modulate the methylation of tumor DNA.
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