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- Reisberg, Sulev, et al.
(författare)
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Translating genotype data of 44,000 biobank participants into clinical pharmacogenetic recommendations : challenges and solutions
- 2019
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Ingår i: Genetics in Medicine. - : NATURE PUBLISHING GROUP. - 1098-3600 .- 1530-0366. ; 21:6, s. 1345-1354
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Biomedical databases combining electronic medical records and phenotypic and genomic data constitute a powerful resource for the personalization of treatment. To leverage the wealth of information provided, algorithms are required that systematically translate the contained information into treatment recommendations based on existing genotype-phenotype associations. Methods: We developed and tested algorithms for translation of preexisting genotype data of over 44,000 participants of the Estonian biobank into pharmacogenetic recommendations. We compared the results obtained by genome sequencing, exome sequencing, and genotyping using microarrays, and evaluated the impact of pharmacogenetic reporting based on drug prescription statistics in the Nordic countries and Estonia. Results: Our most striking result was that the performance of genotyping arrays is similar to that of genome sequencing, whereas exome sequencing is not suitable for pharmacogenetic predictions. Interestingly, 99.8% of all assessed individuals had a genotype associated with increased risks to at least one medication, and thereby the implementation of pharmacogenetic recommendations based on genotyping affects at least 50 daily drug doses per 1000 inhabitants. Conclusion: We find that microarrays are a cost-effective solution for creating preemptive pharmacogenetic reports, and with slight modifications, existing databases can be applied for automated pharmacogenetic decision support for clinicians.
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| 2. |
- Tasa, Tonis, et al.
(författare)
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Genetic variation in the Estonian population : pharmacogenomics study of adverse drug effects using electronic health records
- 2019
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Ingår i: European Journal of Human Genetics. - : NATURE PUBLISHING GROUP. - 1018-4813 .- 1476-5438. ; 27:3, s. 442-454
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Tidskriftsartikel (refereegranskat)abstract
- Pharmacogenomics aims to tailor pharmacological treatment to each individual by considering associations between genetic polymorphisms and adverse drug effects (ADEs). With technological advances, pharmacogenomic research has evolved from candidate gene analyses to genome-wide association studies. Here, we integrate deep whole-genome sequencing (WGS) information with drug prescription and ADE data from Estonian electronic health record (EHR) databases to evaluate genome- and pharmacome-wide associations on an unprecedented scale. We leveraged WGS data of 2240 Estonian Biobank participants and imputed all single-nucleotide variants (SNVs) with allele counts over 2 for 13,986 genotyped participants. Overall, we identified 41 (10 novel) loss-of-function and 567 (134 novel) missense variants in 64 very important pharmacogenes. The majority of the detected variants were very rare with frequencies below 0.05%, and 6 of the novel lossof-function and 99 of the missense variants were only detected as single alleles (allele count = 1). We also validated documented pharmacogenetic associations and detected new independent variants in known gene-drug pairs. Specifically, we found that CTNNA3 was associated with myositis and myopathies among individuals taking nonsteroidal anti-inflammatory oxicams and replicated this finding in an extended cohort of 706 individuals. These findings illustrate that population-based WGS-coupled EHRs are a useful tool for biomarker discovery.
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| 3. |
- Torabi Moghadam, Behrooz
(författare)
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Computational discovery of DNA methylation patterns as biomarkers of ageing, cancer, and mental disorders : Algorithms and Tools
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Epigenetics refers to the mitotically heritable modifications in gene expression without a change in the genetic code. A combination of molecular, chemical and environmental factors constituting the epigenome is involved, together with the genome, in setting up the unique functionality of each cell type.DNA methylation is the most studied epigenetic mark in mammals, where a methyl group is added to the cytosine in a cytosine-phosphate-guanine dinucleotides or a CpG site. It has been shown to have a major role in various biological phenomena such as chromosome X inactivation, regulation of gene expression, cell differentiation, genomic imprinting. Furthermore, aberrant patterns of DNA methylation have been observed in various diseases including cancer.In this thesis, we have utilized machine learning methods and developed new methods and tools to analyze DNA methylation patterns as a biomarker of ageing, cancer subtyping and mental disorders.In Paper I, we introduced a pipeline of Monte Carlo Feature Selection and rule-base modeling using ROSETTA in order to identify combinations of CpG sites that classify samples in different age intervals based on the DNA methylation levels. The combination of genes that showed up to be acting together, motivated us to develop an interactive pathway browser, named PiiL, to check the methylation status of multiple genes in a pathway. The tool enhances detecting differential patterns of DNA methylation and/or gene expression by quickly assessing large data sets.In Paper III, we developed a novel unsupervised clustering method, methylSaguaro, for analyzing various types of cancers, to detect cancer subtypes based on their DNA methylation patterns. Using this method we confirmed the previously reported findings that challenge the histological grouping of the patients, and proposed new subtypes based on DNA methylation patterns. In Paper IV, we investigated the DNA methylation patterns in a cohort of schizophrenic and healthy samples, using all the methods that were introduced and developed in the first three papers.
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