ASSIGNING PATIENTS TO GROUPS – BIOLOGY, DISEASE PROGRESSION, TREATMENT RESPONSE • PERSONALIZED, BUT NOT EVERYONE HAS A DIFFERENT DISEASE NATURE MEDICINE 19, 249 (2013) DOI:10.1038/NM0313-249
GENETIC CODE AND SYSTEM STATE • LOTS OF VARIABLES – WHOLE GENOME, TRANSCRIPT AND PROTEIN EXPRESSION, SPLICING, CHROMATIN STRUCTURE, MOLECULAR INTERACTION, TRANSCRIPTION FACTOR, METHYLATION, METABOLITE, PATIENT PHENOTYPE
X MILLIONS • >30X COVERAGE • ALIGNMENT TO REFERENCE GENOME • COMPUTE VARIANTS (MUTATIONS) • ANNOTATE VARIANTS • COMPUTE TIME: UP TO 2 DAYS/GENOME – OPTIMIZED 4 HOURS: 128G/2CPU/SSD, 3.1GHZ • MEDICALLY IMPORTANT TO BE FAST
DISEASES – 50% HAVE A KNOWN GENE RESPONSIBLE – QUADRUPLED RATE OF IDENTIFICATION SINCE 2012 • BRAIN DOPAMINE-SEROTONIN VESICULAR TRANSPORT DISEASE AND ITS TREATMENT – TWO YEARS FROM DISEASE DEFINITION TO GENE IDENTIFICATION TO TREATMENT NAT REV GENET. 2013 OCT;14(10):681-91 N ENGL J MED. 2013 FEB 7;368(6):543-5
James Vlasblom, Ron Ammar, Orion Buske, Eric Smith, Andrew Brook, Misko Dzamba, Khushi Chachcha, Sergiu Dumitriu Scientific Advisors: Christian Marshall, Kym Boycott, Marta Girdea, Peter Ray, Gary Bader, Michael Brudno
METHOTREXATE RESPONSE B New A A B B B A Personal Medical Network Responder Non-Responder New New patient (Predicted Non-Responder) Weakly similar Highly similar Response to treatment A Similar e.g. SNP, smoking status SHIRLEY HUI, RUTH ISSERLIN, HUSSAM KACA, TABITHA KUNG, KATHY SIMINOVITC
CANCER VS. NORMAL • EXPLAIN WHY STATES DIFFER – E.G. REGULATOR PERTURBATION – CAUSAL MODELING – PRIOR KNOWLEDGE ABOUT MECHANISM: PATHWAYS WITT H ET AL. CANCER CELL. 2011 AUG 16;20(2):143-57
Adhesion Regulation of GTPase Kinase Activity/Regulation CNS Development Intellectual Disability Autism GTPase/Ras Signaling Regulation of cell proliferation Positive regulation of cell proliferation Tyrosin kinase Vasculature develepment Palate develepment Organ Morphogenesis Behavior Heart develepment RHO Ras Membrane Kinase regulation Cell Motility (stricter cluster) Centrosome Nucleolus Cell cycle Regulation of hormone levels Aminoacid derivative / amine metabolism Synaptic vescicle maturation Reelin pathway LIS1 in neuronal migration and development Negative regulation of cell cycle cKIT pathway mTor pathway Zn finger domain Carboxyl esterase domain Ras signaling GTPase regulator Neuron migration Cell Motility (stricter cluster) Cell morphogenesis Cell projection organization CNS development Brain development Neurite development CNS neuron differentiation Axonogenesis Projection neuron axonogenesis Cerebral cortex cell migration SMC flexible hinge domain Urea and amine group metabolism MHC-I Zoom of CNS-Development ID ID ASD ASD Both 0% 12.5% Enriched in deletions FDR Known disease genes Enriched only in disease genes Node type (gene-set) Edge type (gene-set overlap) From disease genes to enriched gene-sets Between gene-sets enriched in deletions Between sets enriched in deletions and in disease genes or between disease sets only Pinto et al. Functional impact of global rare copy number variation in autism spectrum disorders. Nature. 2010 Jun 9.
CNV-AFFECTED GENE COUNT = 1 COUNT = 1 COUNT = 1 COUNT = 0 • IF WE HAVE AT LEAST ONE CNV AFFECTING AT LEAST ONE GENE IN A CERTAIN PATHWAY G I , THEN WE HAVE A PERTURBATION POTENTIAL IN THAT PATHWAY • WE COUNT THE PRESENCE / ABSENCE OF SUCH PERTURBATION POTENTIAL IN PATIENTS Patient #1 Patient #2 Patient #3 … Patient #i … Patient #n GS1 1 1 1 … 0 … 0 GS2 0 0 1 … 1 … 0 GS3 0 0 0 … 0 … 0 DANIELE MERICO PATHWAY ASSOCIATION TEST
THE FISHER’S EXACT TEST FOR ASSOCIATION •A SIGNIFICANT GENE-SET IS AFFECTED BY A MUTATION POTENTIAL MORE FREQUENTLY IN CASES THAN CONTROLS •THE FDR IS ESTIMATED BY SHUFFLING THE COLUMNS IN THE ‘GENE-SET BY PATIENT’ COUNT TABLE Case Control GSi 13 1 Not in GSi 1146 - 13 889 - 1 Patient #1 Patient #2 Patient #3 … Patient #i … Patient #n GS1 1 1 1 … 0 … 0 GS2 0 0 1 … 1 … 0 GS3 0 0 0 … 0 … 0 PATHWAY ASSOCIATION TEST
TESTS • MORE REPRODUCIBLE – E.G. GENE EXPRESSION SIGNATURES • EASIER TO INTERPRET – FAMILIAR CONCEPTS E.G. CELL CYCLE • IDENTIFIES MECHANISM – CAN EXPLAIN CAUSE VS. PARTS THINKING
COMES, SYLVA DONALDSON, MAX FRANZ, CHRISTIAN LOPES, FARZANA KAZI, JASON MONTOJO, HAROLD RODRIGUEZ, KHALID ZUBERI • GUILT-BY-ASSOCIATION PRINCIPLE • BIOLOGICAL NETWORKS ARE COMBINED INTELLIGENTLY TO OPTIMIZE PREDICTION ACCURACY • ALGORITHM IS MORE FAST AND ACCURATE THAN ITS PEERS
– CROWDSOURCING: TCGA PAN CANCER, DREAM • ENCOURAGING RESEARCHERS TO EXPLORE UNCHARTED TERRITORY • NEED FOR QUANTITATIVE THINKING IN BIOLOGY – NEW PH.D. PROGRAM IN THE MOLECULAR GENETICS DEPARTMENT AT THE UNIVERSITY OF TORONTO NATURE. 2011 FEB 10;470(7333):163 WWW.NATURE.COM/TCGA/
INCURABLE IN UP TO 45% OF PATIENTS STEVE MACK, MICHAEL TAYLOR, RUTH ISSERLIN - CANCER CELL. 2011 AUG 16;20(2):143-57 GENE EXPRESSION PATIENT AGE OVERALL SURVIVAL
AND MORBID LOCATION FOR CHILDHOOD IS THE POSTERIOR FOSSA (PF = BRAINSTEM + CEREBELLUM) • TWO SUBTYPES BY GENE EXPRESSION: PFA - YOUNG, DISMAL PROGNOSIS, PFB - OLDER, EXCELLENT PROGNOSIS. • WHOLE GENOME SEQUENCING (47 SAMPLES) SHOWED ALMOST NO MUTATIONS, HOWEVER DNA METHYLATION ARRAYS SHOWED CLEAR CLUSTERING INTO PFA AND PFB (79 SAMPLES) • PFA MORE TRANSCRIPTIONALLY SILENCED BY CPG METHYLATION STEVE MACK, MICHAEL TAYLOR, SCOTT ZUYDERDUYN NATURE, FEB. 2014
JÜRI REIMAND MOHAMED HELMY ANDREA UETRECHT MARINA OLHOVSKY CANCER GENOMICS FLORENCE CAVALLI DAVID SHIH ASHA ROSTAMIANFAR PRECISION MEDICINE RON AMMAR SHIRLEY HUI FUNDING HTTP://BADERLAB.ORG PATHWAY AND NETWORK ANALYSIS RUTH ISSERLIN IGOR RODCHENKOV SCOTT ZUYDERDUYN RUTH WONG VERONIQUE VOISIN SHAHEENA BASHIR KHALID ZHUBERI CHRISTIAN LOPES JASON MONTOJO MAX FRANZ HAROLD RODRIGUEZ