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• Cooperative activity of BRAF F595L and mutant HRAS in histiocytic sarcoma provides new insights into oncogenic BRAF signaling

  Mutations that activate the RAF-MEK-ERK signaling pathway, in particular BRAFV600E, occur in many cancers, and mutant BRAF-selective inhibitors have clinical activity in these diseases. Activating BRAF alleles are usually considered to be mutually exclusive with mutant RAS, whereas inactivating mutations in the D594F595G596 motif of the BRAF activation segment can coexist with oncogenic RAS and cooperate via paradoxical MEK/ERK activation. We determined the functional consequences of a largely uncharacterized BRAF mutation, F595L, which was detected along with an HRASQ61R allele by clinical exome sequencing in a patient with histiocytic sarcoma and also occurs in epithelial cancers, melanoma, and neuroblastoma, and investigated its interaction with mutant RAS. We demonstrate that, unlike previously described DFG motif mutants, BRAFF595L is a gain-of-function variant with intermediate activity towards MEK that does not act paradoxically, but nevertheless cooperates with mutant RAS to promote oncogenic signaling. Of immediate clinical relevance, BRAFF595L shows divergent responses to different mutant BRAF-selective inhibitors, whereas signaling driven by BRAFF595L with and without mutant RAS is efficiently blocked by pan-RAF and MEK inhibitors. Mutation data from primary patient samples and cell lines show that BRAFF595L, as well as other BRAF mutations with intermediate activity, frequently coincide with mutant RAS in a broad spectrum of cancers. These data define a novel class of activating BRAF mutations that cooperate with oncogenic RAS in a non-paradoxical fashion to achieve an optimal level of MEK-ERK signaling, extend the spectrum of patients with systemic histiocytic disorders and other malignancies who are candidates for therapeutic blockade of the RAF-MEK-ERK pathway, and underscore the value of comprehensive genetic profiling for understanding the signaling requirements of individual cancers.

  Dataset EGAD00001001384

• Mesothelioma Whole Genomes

  Genomic architecture of mesothelioma parent study is project 925. This project is set up in parallel to project 925 in order to Whole genome sequence ten of the 59 tumours in that project.

  Dataset EGAD00001001265

• Prader-Willi Syndrome and Early-onset Morbid Obesity Natural History Protocol

  This observational study will involve the comprehensive assessment of the medical, behavioral and nutritional history and the clinical features of individuals with Prader-Willi syndrome and individuals with features of PWS-like/EMO. A blood sample will be obtained from the participants in order to create a DNA and RNA repository. In those PWS participants with a known deletion a blood sample will be collected for DNA in order to perform array comparative genome hybridization (aCGH) microarray or Methylation-Specific Multiplex Ligation-dependent Probe Amplification (MS-MLPA) studies to characterize the extent of the deletion. DNA samples will be sent to the Consortium Center at Baylor College of Medicine for the performance of the aCGH studies and to either Dr. Driscoll or Dr. Butler lab for MS-MLPA analysis. No drugs or treatments will be administered through this protocol. Our goal is to enroll as many participants as possible over a 8 year period. Currently we have enrolled 297 total subjects of which 265 have PWS and 32 EMO. Our original goal was to have enrolled over the first 5 years a clinical database of 200 individuals with PWS and 100 with EMO. We have exceeded expectations in PWS enrollment, but have fallen short in the enrollment of individuals with EMO. Therefore, we would like to reset our goals. We now propose to have an enrollment goal of 400 total subjects of which 350 will have PWS and 50 will have EMO. Eligible participants will be initially enrolled in the natural history study from the 4 clinic sites currently involved with PWS (University of Florida, Kansas University Medical Center, Vanderbilt University and University of California at Irvine). Participants assessed will serve to provide a background of information and a willing cohort for future interventional studies. All participants will have had standard genetic testing at a commercial laboratory prior to entry into the study. The PWS participants will be classified into one of the 3 main molecular classes (deletion, UPD and ID). The EMO participants will have had laboratory testing ruling out PWS and chromosomal aneuploidy (e.g., trisomy 21, Klinefelter syndrome, etc.). Going forward we feel it is important that all newly recruited EMO subjects have an aCGH as part of their evaluation so we can identify those with discrete deletions, duplications or copy number variants (CNV) and compare them to those without aCGH abnormalities. The participants will be assessed annually (0-3 years of age) or biennially (> 3 years) in the Clinical Research Center (or equivalent facility) using standardized protocol including photographs for documentation purposes to compare the evolution of the clinical phenotype.

  Study phs000575

• Exploratory novel biomarker and resistance mechanism of milademetan, an MDM2 inhibitor, in MDM2 amplified intimal sarcoma from an open-label phase 1b/2 trial ���NCCH1806/MK004���

  Amplified Murine double minute 2 (MDM2) is found in > 70% of intimal sarcoma, known as one of the ultra-rare sarcomas. Milademetan (DS3032, RAIN-32) is a novel, specific, small-molecule MDM2 inhibitor that disrupts MDM2 and the tumor suppressor protein p53 interactions in tumor cells. We conducted a phase 1b/2 trial (Trial registration No: JMA-IIA00402) in patients with amplified MDM2 wild-type TP53 intimal sarcoma as a sub-study under the nationwide large registry for rare cancers in Japan (MASTERKEY Project). Eleven patients were enrolled, and ten were included in the efficacy analysis. Two (20%) patients had durable responses for > 15 months. Milademetan provided clinical benefits in patients with amplified MDM2 intimal sarcoma. Predictive biomarkers other than amplified MDM2 and acquired resistance mechanisms for milademetan are unknown. Whole-exome and RNA sequencing analyses of pre-treatment tissue samples were conducted to identify determinants of response. Genomic alterations were analyzed for 10 patients, and gene expression was analyzed for 9 patients using their pre-treatment tissue samples. Targeted sequencing of cell-free DNA (cfDNA) samples (liquid biopsy) was also conducted sequentially at three points [before treatment with milademetan (baseline), at Cycle 2 Day1, and at the time of disease progression] to identify determinants of response and resistance. From whole-exome and RNA sequencing analyses of pre-treatment tissue samples, we could not find any molecular pathways associated with the anti-tumor activity of milademetan. Focusing on 8 genes (CDK4, CDKN2A, CDKN2B, EGFR, ERBB3, MDM2, PDGFRA, TP53) known to be frequently affected in intimal sarcoma and 10 genes (AKT1, ATM, BBC3, CDKN1A, CDKN1C, CHEK2, MDM4, PMAIP1, PPM1D, TWIST1) reported to be associated with MDM2 inhibitor responses; we found that anti-tumor activity correlated with amplified TWIST1 (p-value = 0.028) and negatively with CDKN2A loss (p-value = 0.071). Eight of the 10 patients had their cfDNA collected sequentially at baseline, at Cycle 2 Day1 and disease progression; however, one did not consent to the exploratory analysis study using cfDNA, and one had cfDNA collected at baseline but not at disease progression due to ongoing treatment. Of the eight patients, TP53 mutations in cfDNA were detected in one and five patients at baseline and disease progression, respectively. The cfDNA allele frequency of TP53 mutations increased with disease progression. CDKN2A loss and amplified TWIST1 could be associated with the anti-tumor activity of milademetan in patients with MDM2 amplified intimal sarcoma. Acquired TP53 mutations were detected in sequential liquid biopsies as loss-of-function mutations, and these TP53 mutations might compromise the anti-tumor activity.

  Study JGAS000619

• The HLA-DQβ1 insertion is a strong achalasia risk factor and displays a geospatial north-south gradient among Europeans

  Idiopathic achalasia is a severe motility disorder of the esophagus and is characterized by a failure of the lower esophageal sphincter to relax due to a loss of neurons in the myenteric plexus. Most recently, we identified an 8 amino acid insertion in the cytoplasmic tail of HLA-DQβ1 as strong achalasia risk factor in a sample set from Central Europe, Italy, and Spain. Here, we tested whether the HLA-DQβ1 insertion also confers achalasia risk in the Polish and Swedish population. We could replicate the initial findings and the insertion shows strong achalasia association in both samples (Poland P = 1.84×10-04, Sweden P = 7.44×10-05). Combining all five European data sets – Central Europe, Italy, Spain, Poland, and Sweden – the insertion is achalasia associated with Pcombined = 1.67×10-35. In addition, we observe that the frequency of the insertion shows a geospatial north-south gradient. The insertion is less common in northern (around 6-7% in patients and 2% in controls from Sweden and Poland) compared to southern Europeans (around 16% in patients and 8% in controls from Italy) and shows a stronger attributable risk (AR) in the southern European population. Our study provides evidence that the prevalence of achalasia may differ between populations.

  Study EGAS00001001515

• Genome-Wide Association of Native and Post Aspirin Platelet Function Phenotypes

  The goal of this study was to identify genetic variants in a genome-wide association study (GWAS) that are associated with previously obtained platelet function phenotypes measured in each individual under baseline conditions and following 2 weeks of low dose aspirin (ASA). During this study we performed a high density 1 million-SNP genome scan on subjects from GeneSTAR (representing 800 2-generational families with a family history of premature coronary artery disease, 60% white and 40% African American, N=3232). We identified genomic loci associated with quantitative platelet phenotypes prioritized for their biological interest, determined associations between genomic loci and baseline platelet phenotypes (primary phenotypes are platelet aggregation in platelet rich plasma induced by collagen, adenosine diphosphate (ADP), arachidonic acid (AA), and epinephrine (Epi), determined associations between genomic loci and post-ASA platelet phenotypes, ie, measures of ASA "resistance" (primary phenotypes are as above, plus urinary levels of the prostaglandin metabolite, 11-dehydro-thromboxane B2 ), and compared peaks of association between genomic loci and three common baseline platelet phenotypes (collagen-, epinephrine-, and ADP-induced aggregation in platelet rich plasma) with associations found for these same phenotypes in the Framingham Heart Study. We also determined whether any significant genotype-phenotype associations in the 1 million SNP genome scan could be localized to any specific genes or potential genes of interest using publicly available databases and further examined whether candidate genes previously associated with a specific platelet phenotype are located in a genomic region of interest as determined from the SNP genome scan. We conducted replications of our findings, and are presently involved in larger scale meta-analysis of findings for pre-aspirin and post-aspirin associations. The study population is constituted of full siblings (SIBS) (ages 35-78 years) identified from The Johns Hopkins Sibling Study, now called GeneSTAR, the spouses of the SIBS, and their adult offspring (>21 years of age). They include 3200 individuals from approximately 300 African American and 500 white extended families. "Spouse" refers to the other parent of any SIB offspring, independent of marital status. Sibship sizes among families range from 1 to 16 (excluding index cases). On average, each SIB has 2 potentially eligible offspring. A family for this study is defined by all of the full sibships and the total numbers of offspring that come from all SIBS, rather than just the nuclear family.

  Study phs000375

• The patterns and dynamics of genomic instability in metastatic pancreatic cancer

  Pancreatic cancer is an aggressive malignancy with a five-year mortality of 97–98%, usually due to widespread metastatic disease. Previous studies indicate that this disease has a complex genomic landscape, with frequent copy number changes and point mutations, but genomic rearrangements have not been characterized in detail. Despite the clinical importance of metastasis, there remain fundamental questions about the clonal structures of metastatic tumours, including phylogenetic relationships among metastases, the scale of ongoing parallel evolution in metastatic and primary sites, and how the tumour disseminates. Here we harness advances in DNA sequencing to annotate genomic rearrangements in 13 patients with pancreatic cancer and explore clonal relationships among metastases. We find that pancreatic cancer acquires rearrangements indicative of telomere dysfunction and abnormal cell-cycle control, namely dysregulated G1-to-S-phase transition with intact G2–M checkpoint. These initiate amplification of cancer genes and occur predominantly in early cancer development rather than the later stages of the disease. Genomic instability frequently persists after cancer dissemination, resulting in ongoing, parallel and even convergent evolution among different metastases. We find evidence that there is genetic heterogeneity among metastasis-initiating cells, that seeding metastasis may require driver mutations beyond those required for primary tumours, and that phylogenetic trees across metastases show organ-specific branches. These data attest to the richness of genetic variation in cancer, brought about by the tandem forces of genomic instability and evolutionary selection.

  Study EGAS00000000064

• National Institute on Alcohol Abuse and Alcoholism (NIAAA) Postmortem Prefrontal Cortex eQTL and mQTL Study

  Mapping expression and methylation quantitative trait loci (eQTLs and mQTLs) using genome-wide genotype, transcriptome, and DNA methylome data can provide an unbiased approach to identify novel functional variants. One critical issue of the eQTL/mQTL analysis is that the role of genetic variants in regulating gene expression (or DNA methylation) can be tissue- or cell-specific. To unravel causal variants from disease-associated loci, it would be necessary to map eQTLs and mQTLs in both patients and controls. Those eQTLs and mQTLs in patients are more likely to be causal variants for the disease. Identification of disease- and tissue-specific eQTLs and mQTLs will help disentangle the role of the specific tissue in disease development as well. In the present study, we mapped eQTLs and mQTLs in postmortem prefrontal cortex of patients with alcoholism or alcohol use disorder (AUD) and matched control subjects by integrative analyses of genome-wide SNP genotype, mRNA transcriptome, and DNA methylome data. As AUD is comorbid with schizophrenia (SCZ), bipolar disorder (BIP), major depressive disorder (MDD), and attention deficit/hyperactivity disorder (ADHD), we further examined the co-localization of PFC eQTLs/mQTLs and GWAS-identified SNPs (mainly noncoding SNPs) that were associated with AUD as well as comorbid SCZ, BIP, MDD, and ADHD. Our study demonstrated the enrichment of PFC eQTLs/mQTLs in the above psychiatric disorder-associated genetic variants identified by genome-wide association studies (GWAS).

  Study phs001981

• Targeting the p53 pathway to treat Malignant Rhabdoid and High-Risk Atypical Teratoid Rhabdoid Tumors

  Rhabdoid tumors (RTs) predominantly affect young children and are among the deadliest pediatric solid tumors. Despite multimodal therapy consisting of surgery, radiation, and chemotherapy, children with these tumors have median survival of less than one year. RTs can arise throughout the body, including the central nervous system (CNS) where they are called atypical teratoid rhabdoid tumors (AT/RTs), and in extra-CNS locations such as the kidneys and other soft tissues where they are designated malignant RTs (MRTs). We previously identified MDM2 and MDM4 as therapeutic vulnerabilities in RTs and showed that treatment with the MDM2 inhibitor idasanutlin increased survival in mice bearing MRT xenografts. However, the therapeutic potential of idasanutlin in CNS RT tumors is unknown. Single agent therapies are prone to resistance and show limited clinical benefit on their own. Therefore, we sought to identify combination strategies incorporating idasanutlin that would be effective in both CNS and extra-CNS RTs. Here, we show that the XPO1 inhibitor selinexor increased nuclear retention of p53 and potentiated idasanutlin-induced p53 pathway activation and cytotoxicity in AT/RT and MRT cell lines in vitro. Importantly, combination therapy limited acquired resistance through TP53 mutation. In vivo, combination therapy was well-tolerated, reduced tumor burden, and increased survival in orthotopic models of both AT/RT and MRT. Our results demonstrate that combining idasanutlin with selinexor is a promising therapeutic strategy for children with rhabdoid tumors.

  Study EGAS00001007680

• Efficacy of JAK/STAT pathway inhibition in murine xenograft models of early T-cell precursor (ETP) acute lymphoblastic leukemia

  Early T-cell precursor (ETP) acute lymphoblastic leukemia (ALL) is a recently described subtype of T-ALL characterized by a unique immunophenotype and genomic profile as well as a high rate of induction failure. Frequent mutations in cytokine receptor and JAK/STAT signaling pathways led us to hypothesize that ETP-ALL is dependent on JAK/STAT signaling. Here we demonstrate aberrant activation of the JAK/STAT pathway in ETP-ALL blasts relative to non-ETP T-ALL. Moreover, ETP-ALL showed hyperactivation of STAT5 in response to IL7, an effect that was abrogated by the JAK1/2 inhibitor ruxolitinib. In vivo, ruxolitinib displayed activity in 6/6 patient-derived murine xenograft models of ETP-ALL, with profound single-agent efficacy in 5 models. Ruxolitinib treatment decreased peripheral blast counts relative to pre-treatment levels and compared to control (P<0.01) in 5/6 ETP-ALL xenografts, with marked reduction in mean splenic blast counts (P<0.01) in 6/6 samples. Surprisingly, both JAK/STAT pathway activation and ruxolitinib efficacy were independent of the presence of JAK/STAT pathway mutations, raising the possibility that the therapeutic potential of ruxolitinib in ETP-ALL extends beyond those cases with JAK mutations. These findings establish the preclinical in vivo efficacy of ruxolitinib in ETP-ALL, a biologically distinct subtype for which novel therapies are needed.

  Study EGAS00001001146

• RRBS sequencing of 7 tumour regions and a normal sample from a single TRACERx patient.

  Background: Epigenetic heterogeneity within a tumour can play an important role in tumour evolution and the emergence of resistance to treatment. It is increasingly recognised that the study of DNA methylation (DNAm) patterns along the genome - so-called `epialleles' - offers greater insight into epigenetic dynamics than conventional analyses which examine DNAm marks individually. Results: We have developed a Bayesian model to infer which epialleles are present in multiple regions of the same tumour. We apply our method to reduced representation bisulfite sequencing (RRBS) data from multiple regions of one lung cancer tumour and a matched normal sample. The model borrows information from all tumour regions to leverage greater statistical power. The total number of epialleles, the epiallele DNAm patterns, and a noise hyperparameter are all automatically inferred from the data. Uncertainty as to which epiallele an observed sequencing read originated from is explicitly incorporated by marginalising over the appropriate posterior densities. The degree to which tumour samples are contaminated with normal tissue can be estimated and corrected for. By tracing the distribution of epialleles throughout the tumour we can infer the phylogenetic history of the tumour, identify epialleles that differ between normal and cancer tissue, and define a measure of global epigenetic disorder. Conclusions: Detection and comparison of epialleles within multiple tumour regions enables phylogenetic analyses, identification of differentially expressed epialleles, and provides a measure of epigenetic heterogeneity.

  Study EGAS00001002484

• Epigenetic memory of SARS-CoV-2 mRNA vaccination in monocyte-derived macrophages

  Immune memory is key to effective antimicrobial responses, but the impact of mRNA vaccines on this process is not fully understood. Our research shows that SARS-CoV-2 mRNA vaccines alter the epigenetic profile of human macrophages, specifically enhancing histone acetylation, which is linked to immune training. Significant epigenetic changes, along with increased cytokine release, require two vaccine doses. However, these effects diminish over time but can be restored with a booster dose six months later, maintaining a strong pro-inflammatory response.

  Dataset EGAD50000000495

• 120 individuals from the TEENAGE study (Ntalla et al., 2013) have been genotyped on the Illumina HumanCoreExome-12v1-1_A array. This is a population-based study of adolescents from the Attica region in Greece

  120 individuals from the TEENAGE study (Ntalla et al., 2013) have been genotyped on the Illumina HumanCoreExome-12v1-1_A array. This is a population-based study of adolescents from the Attica region in Greece

  Study EGAS00001001733

• Spatially resolved antigen receptor and gene expression data from breast cancer patients

  The dataset includes spatially-resolved and single-cell antigen receptor, as well as gene expression, data from two different HER2+ breast cancer patients. The tumor piece obtained during surgery from each patient was divided into several regions and tissue sections were used for spatial transcriptomics (Visium, 10x genomics). As indicated, some tissue sections were analyzed by a new method (Spatial VDJ) to spatially resolve antigen receptor sequences (target capture), which was developed in our publication. In parallel, tissue pieces from the same tumor were dissociated for single-cell gene expression analysis (10x genomics GEX, VDJ, and feature barcoding/Hash Tag Oligonucleotide). The deposited data is in the form of fastq files. All processed data, metadata, micrographs of the tissue sections (of those used for spatial transcriptomics), and scripts used for the analysis are publicly available at Zenodo (DOI: 10.5281/zenodo.7961605). Final libraries were sequenced on NextSeq2000 (Illumina) or NovaSeq6000 (Illumina) and analyzed with Cell Ranger, Seurat, Space Ranger, and STutility pipelines.

  Dataset EGAD00001011061

• Spatially resolved antigen receptor and gene expression data from human tonsil tissue

  The dataset includes spatially-resolved gene expression and antigen receptor data from two Tonsil samples (1 and 2). Tissue sections from the tonsil samples were used for spatial transcriptomics (Visium, 10x genomics). Tonsil 2 tissue sections were analyzed by a new method (Spatial VDJ) to spatially resolve antigen receptor sequences (target capture), which was developed in our publication. Nearby or adjacent tissue sections (from Tonsil2) were also analyzed by a bulk antigen receptor sequencing approach (amplicon sequencing), by a method also newly developed by us in the same publication (Bulk SS3 VDJ). For Visium, the data were anonymized (all SNPs removed) using Bamboozle (Ziegenhain and Sandberg, Nature Communications 2021). The deposited data is in the form of fastq files. All remaining data, metadata, micrographs of the tissue sections (of those used for spatial transcriptomics), and scripts used for the analysis are available at Zenodo (DOI: 10.5281/zenodo.7961605). Final libraries were sequenced on NextSeq2000 (Illumina) or NovaSeq6000 (Illumina) and analyzed with Seurat, Space Ranger, and STutility pipelines.

  Dataset EGAD00001011062

• CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium Summary Results from Genomic Studies

  GWAS have successfully identified genetic loci associated with a variety of conditions such as type 2 diabetes and coronary disease. The large number of statistical tests required in GWAS has posed a special challenge because few studies that have DNA and high-quality phenotype data are sufficiently large to provide adequate statistical power for detecting small to modest effect sizes. Even before the era of GWAS, the requirement for large sample sizes and the importance of replication have served as powerful incentives for collaboration. Meta-analyses combining summary data from multiple sources have improved the ability to detect new loci. The Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium was formed to facilitate GWAS meta-analyses and replication among multiple large and well-phenotyped cohort studies. The design of the CHARGE Consortium was formed initially from 5 prospective cohort studies from the United States and Europe: the Age, Gene/Environment Susceptibility (AGES) - Reykjavik Study, the Atherosclerosis Risk in Communities (ARIC) Study, the Cardiovascular Health Study (CHS), the Framingham Heart Study (FHS), and the Rotterdam Study (RS). Additional studies have expanded the CHARGE consortium based upon the phenotypes and willingness to share information across the research community. In order to facilitate investigators across the world to examine relationships between phenotypes and genetic markers within CHARGE published reports, an open site is made available on dbGaP that provides the rsID and the p-value for inspection. Access to detailed summary statistics (including minor allele frequency, odds ratio/effect size) requires approval of a Data Access Request (DAR).

  Study phs000930

• Action to Control Cardiovascular Risk in Diabetes (ACCORD - Imaging)

  Available DataAction to Control Cardiovascular Risk in Diabetes (ACCORD-Imaging), provides access to ECG signals data from the ACCORD clinical trial. The clinical phenotyping and outcomes data from the trial are associated with ACCORD-BioLINCC, phs003551.ObjectivesThe purpose of this study was to determine if intensive glycemic control, multiple lipid management and intensive blood pressure control could prevent major cardiovascular events (myocardial infarction, stroke or cardiovascular death) in adults with type 2 diabetes mellitus. Secondary hypotheses included treatment differences in other cardiovascular outcomes, total mortality, microvascular outcomes, health-related quality of life and cost-effectiveness.BackgroundGlycemia Trial:Patients with type 2 diabetes mellitus die of cardiovascular disease (CVD) at rates two to four times higher than non-diabetic populations of similar demographic characteristics. They also experience increased rates of nonfatal myocardial infarction and stroke. With the growing prevalence of obesity in the United States, CVD associated with type 2 diabetes is expected to become an even greater public health challenge in the coming decades than it is now. Expected increases in event rates will be associated with a concomitant rise in suffering and resource utilization.The ACCORD study investigated whether intensive therapy to target normal glycated hemoglobin (HbA1c) levels would reduce cardiovascular events in patients with type 2 diabetes who had either established cardiovascular disease or additional cardiovascular risk factors when compared to standard therapy (HbA1c between 7.0% and 7.9%). A separate analysis investigated whether reduction of blood glucose concentration decreases the rate of microvascular complications in these patients.Lipid Therapy Trial:Patients with type 2 diabetes mellitus have an increased incidence of atherosclerotic cardiovascular disease attributable, in part, to associated risk factors such as dyslipidemia. This is characterized by elevated plasma triglyceride levels, low levels of high-density lipoprotein (HDL) cholesterol and small, dense low-density lipoprotein (LDL) particles. The ACCORD Lipid Therapy trial was designed to test the effect of a therapeutic strategy that uses a fibrate to raise HDL-C and lower triglyceride levels and uses a statin for treatment of LDL-C reduce the rate of CVD events compared to a strategy that only uses a statin for treatment of LDL-C on cardiovascular outcomes in patients with type 2 diabetes that were at high risk for cardiovascular disease.Blood Pressure Trial:Diabetes mellitus increases the risk of cardiovascular disease at every level of systolic blood pressure. Because cardiovascular risk in patients with diabetes is graded and continuous across the entire range of levels of systolic blood pressure, even at prehypertensive levels, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommended beginning drug treatment in patients with diabetes who have systolic blood pressures of 130 mm Hg or higher, with a treatment goal of reducing systolic blood pressure to below 130 mm Hg. There is, however, a paucity of evidence from randomized clinical trials to support these recommendations. The ACCORD Blood Pressure trial tested the effect of a target systolic blood pressure below 120 mm Hg on major cardiovascular events among high-risk persons with type 2 diabetes compared to a strategy that targeted a SBP of EYE Substudy:Diabetic retinopathy, an important microvascular complication of diabetes, is a leading cause of blindness in the United States. Randomized, controlled clinical trials in cohorts of patients with type 1 diabetes and those with type 2 diabetes have shown the beneficial effects of intensive glycemic control and intensive treatment of elevated blood pressure on the progression of diabetic retinopathy. Elevated serum cholesterol and triglyceride levels have been implicated, in observational studies and small trials, as additional risk factors for the development of diabetic retinopathy and visual loss. The ACCORD EYE Substudy evaluated the effects of the ACCORD medical strategies on the progression of diabetic retinopathy in a subgroup of trial patients.MIND Substudy:Studies suggest that older persons with type 2 diabetes have at least twice the likelihood of developing late-life cognitive impairment or dementia compared to those without. The mechanisms underlying these cognitive disorders are increasingly thought to reflect a mixed pathology pattern with contributions from vascular, neurodegenerative and neurovascular processes. Pathophysiological mechanisms that have been described include inflammation, oxidative stress, energy imbalance, protein misfolding, glucocorticoid-mediated effects and differences in genetic susceptibilities. The ACCORD MIND substudy took as a premise that early intervention with the ACCORD therapeutic strategies to improve glycemic control could mitigate the adverse effects of type 2 diabetes on the brain.Subjects10,251 patients with type 2 diabetes and HbA1c concentrations of 7.5% or more participated in the trial. Of these patients, 5518 were assigned to the lipid therapy arm and 4733 to the blood pressure arm. EYE Substudy:A subgroup of 2856 patients was evaluated for the effects of the ACCORD interventions at 4 years on the progression of diabetic retinopathy. Patients who, at baseline, had a history of proliferative diabetic retinopathy that had been treated with laser photocoagulation or vitrectomy were excluded.MIND Substudy:A subgroup of 2977 patients was evaluated for cognitive function and brain volume. The ACCORD MIND substudy excluded patients aged DesignPatients were randomly assigned to undergo either intensive glycemic control (targeting a glycated hemoglobin level EYE Substudy:EYE Substudy patients were evaluated at two standardized and comprehensive eye examinations for the effects of the ACCORD interventions at 4 years on the progression of diabetic retinopathy by 3 or more steps on the Early Treatment Diabetic Retinopathy Study Severity Scale (as assessed from seven-field stereoscopic fundus photographs, with 17 possible steps and a higher number of steps indicating greater severity) or the development of diabetic retinopathy necessitating laser photocoagulation or vitrectomy.MIND Substudy:The cognitive primary outcome, the Digit Symbol Substitution Test (DSST) score, was assessed at baseline, 20 and 40 months. Total brain volume (TBV), the primary brain structure outcome, was assessed with MRI at baseline and 40 months in a sub-set of 632 patients. All patients with follow-up data were included in the primary analyses.ConclusionsGlycemia Trial:As compared with standard therapy, the use of intensive therapy to target normal glycated hemoglobin levels for 3.5 years increased mortality and did not significantly reduce major cardiovascular events. (NEJM. 2008; 358(24): 2545-59).Microvascular Outcomes of the Glycemia Trial:Intensive therapy did not reduce the risk of advanced measures of microvascular outcomes, but delayed the onset of albuminuria and some measures of eye complications and neuropathy. Microvascular benefits of intensive therapy should be weighed against the risk of increased total and cardiovascular disease-related mortality, increased weight gain, and higher risk for severe hypoglycemia. (Lancet. 2010; 376(9739): 419-30)Lipid Therapy Trial:The combination of fenofibrate and simvastatin did not reduce the rate of fatal cardiovascular events, nonfatal myocardial infarction or nonfatal stroke, as compared with simvastatin alone. These results do not support the routine use of combination therapy with fenofibrate and simvastatin to reduce cardiovascular risk in the majority of high-risk patients with type 2 diabetes (NEJM. 2010; 362(17): 1563–1574).Blood Pressure Trial:In patients with type 2 diabetes at high risk for cardiovascular events, targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, did not reduce the rate of a composite outcome of fatal and nonfatal major cardiovascular events (NEJM. 2010; 362: 1575-1585).EYE Substudy:Intensive glycemic control and intensive combination treatment of dyslipidemia, but not intensive blood-pressure control, reduced the rate of progression of diabetic retinopathy (NEJM. 2010; 363: 233-244).MIND Substudy:Although significant differences in TBV favored the intensive therapy, cognitive outcomes were not different. Combined with the unfavorable effects on other ACCORD outcomes, MIND findings do not support using intensive therapy to reduce the adverse effects of diabetes on the brain in patients similar to MIND patients (Lancet Neurol. 2011; 10(11): 969–977).

  Study phs003562

• Genetic analysis of short stature using whole exome sequencing

  The aim of the study is to find the genetic aetiologies of short stature, using whole-exome sequencing technology.

  Study EGAS50000000578

• Somatic_mutations_in_twin_breast_cancers

  The aim of this study is to investigate the somatic mutations in twins with BRCA1/2 negative breast cancer with no strong family history.

  Study EGAS00001002379

• Whole genome sequencing (bam files) of 5 samples of myxofibrosarcoma and 5 matched pairs

  Myxofibrosarcoma (MFS) is a rare subtype of sarcomas in the elderly, whose genetic basis is poorly understood. To elucidate it, the whole genome sequence was performed.

  Dataset EGAD00001007825

• Identification of Host Genetic Factors That Are Determinant for the Development of Severe Forms of COVID-19

  We conducted whole exome sequencing (WXS) on 21 cases of Multisystem Inflammatory Syndrome in Children (MIS-C) related to COVID-19 from Brazil. All patients who were hospitalized underwent serum (ELISA) and molecular (RT-PCR) testing for SARS-CoV-2, and the main clinical symptoms associated with SARS-CoV-2 infection were collected. During hospitalization, data on complications, medical interventions, and laboratory findings were also collected. Our results revealed in an unprecedented way the occurrence of several rare loss-of-function variants in the NLRP12 gene among the affected children, and three other SNVs, predicted to be highly pathogenic, were identified in the IL17RC gene. An additional nonsense variant, in the IFNA10 gene, was identified in a single patient. Through in vitro functional analysis, we unequivocally demonstrated that these mutations impact NF-kB activation. These findings are similar to those observed in NLRP12-associated systemic autoinflammatory disorders, characterized by altered innate immune response, with increased NF-κB activation and excessive production of inflammatory cytokines. To our knowledge, our study is the first to provide a plausible molecular mechanism for MIS-C involving inborn errors in NLRP12. We suggest that some patients with MIS-C may benefit from Interleukin (IL)-1 pathway blockade treatments.

  Study phs003512

• A somatic reference standard for cancer genome sequencing with COLO829

  Identification of somatic alterations in cancer has become feasible with the massive adoption of next generation sequencing. However, due to variability in sequencing and informatics pipelines, a common somatic reference is needed. We thus performed paired whole genome sequencing of a metastatic melanoma cell line (COLO829) and a matched lymphoblastoid line (COLO829BL) across three institutions (TGen, Illumina, Genome Sciences Centre at the British Columbia Cancer Agency). We performed a meta-analysis of all data, in combination with the originally reported analysis of these cell lines by Pleasance et al (PMID: 20016485), and report a somatic reference standard based on consensus events. DNA extractions, library preparation, sequencing, and analysis were separately performed at each site. Results were compiled with sequence data previously generated for the cell lines to identify true positive variants, collectively representing a somatic reference standard. Overall, common somatic events include point mutations, small insertion/deletions, and genes affected by concurrent copy number changes. We additionally show divergence of somatic mutations in COLO829 associated with differences in cell line lineage. We present this reference to the community as a standard for enabling interpretation and identification of somatic mutations across institutions and analytical pipelines.

  Study EGAS00001001385

• Longitudinal Study of Fluoride and Other Factors Related to Dental Fluorosis, Dental Caries, and Bone Health

  This project is a combination of the Iowa Fluoride Study and the Iowa Bone Development Study from 1992 - 2019. The Iowa Fluoride Study (IFS) began in 1992 with recruitment of 1,882 mothers of newborns from eight Iowa hospital post-partum wards from March 1992 to February 1995. The focus of the IFS was to collect detailed fluoride, general dietary intake, and other data several times per year from age 6 weeks on and relate them to dental fluorosis and dental caries (cavities). Data collection occurred 3-5 times per year initially, and then twice per year after ~ age 4. Dental exams of the primary (baby) teeth were initiated at ~ age 5.The Iowa Bone Development Study (IBDS) grew out of the IFS in 1998 when we added a "normal bone development" focus, and soon after the age 5 dental exams, we began to collect genetic samples and accelerometry (motion sensor) data. All then-active parents of IFS-participating children were invited to have their child join the IBDS, and the majority agreed to do so. The majority of participating children received both ~ age 5 dental exams and bone densitometry assessments. The bone densitometry at age 5 was determined by dual-energy X-ray absorptiometry (DXA) of the hip, lumbar spine, and whole body.Dental exams for caries and fluorosis were performed again at age 8-9, along with DXA bone scans and accelerometry. DXA scans and accelerometry were performed again at ages 11 and 15 years, along with peripheral quantitative computed tomography (pQCT) scans of the distal tibia and radius, but no dental exams were performed.At ages 13 and 17, dental exams, DXA and pQCT scans, as well as accelerometry, were obtained.At age 19, no dental exams were conducted, but repeat DXA and pQCT scans and accelerometry were obtained, along with multi-slice detector CT (MDCT) of the distal tibia.At age 23, we conducted the final wave of exams, which included dental, DXA, pQCT, MDCT, and accelerometry assessments.In addition, parents were invited to participate once with DXA bone scans and to also provide limited questionnaire data about their own fluoride and dietary exposures and physical activity.Note: Please refer to the document Iowa Fluoride Study/Iowa Bone Development Study (IFS/IBDS) - dbGaP Data Tables: A User's Guide - Version 2.0 for a detailed reference manual on all of the clinical data submitted for this project.Note: No genetic data or specimens were submitted with this study. However, many of the child/parent participants in the study were genotyped. These genotyping data are linked to dbGaP Study Accession: phs000095 under Dr. Mary Marazita: "Dental Caries: Whole Genome Association and Gene X Environment Studies".<img style="width: 1155px;" 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

  Study phs002203

• Mechanisms of Therapy Driven Clonal Evolution in Oncogenic RAS Mutant Relapsed Acute Lymphoblastic Leukemia

  Although multi-agent combination chemotherapy is curative in a significant fraction of childhood acute lymphoblastic leukemia (ALL) patients, 20% of cases relapse and most die due to chemo-refractory disease. Here we used whole-exome and whole-genome sequencing to analyze the mutational landscape and pattern of clonal evolution at relapse in pediatric ALL cases. These analyses showed that ALL relapses originate from a common ancestral precursor clone of the diagnosis and relapsed populations and frequently harbor mutations implicated in chemotherapy resistance. RAS-MAPK pathway activating mutations in NRAS, KRAS and PTPN11 were present in 24/55 (44%) cases in our series. Notably, while some cases showed emergence of RAS mutant clones at relapse, in others, RAS mutant clones present at diagnosis were replaced by RAS wild type populations. Mechanistically, functional dissection of mouse and human wild type Kras and mutant Kras (Kras G12D) isogenic leukemia cells demonstrated induction of methotrexate resistance, but also improved response to vincristine, in mutant Kras- expressing lymphoblasts. These results identify chemotherapy driven selection as a central mechanism of leukemia clonal evolution and pave the road for the development of tailored personalized therapies for the treatment of relapsed ALL.

  Study phs001072

• Genetics of Congenital Anomalies of the Kidney and Urinary Tract

  The Genetics of Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) contributes data from unrelated individuals who were recruited at the Columbia University Medical Center (New York, USA), the Polish Registry of Congenital Malformations (Poland), the Universities of Parma, Bari, and Brescia, and the Gaslini Institute (Italy), the University of Skopje (Macedonia), and VUMC of Amsterdam (Netherlands). These individuals consented to share their data for scientific discovery. The purpose of the study is to investigate the genetic architecture of CAKUT.&nbsp; Additionally, part of the data in this study was generated from 418 DNA samples from the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) study, and supplied by the NIDDK Central Repository. The RIVUR study was conducted by the RIVUR study investigators, and supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The Genetics of CAKUT study was not conducted in collaboration with investigators of the RIVUR study and does not necessarily reflect the opinions or views of the RIVUR study, the NIDDK Central Repository, or the NIDDK.&nbsp;Genomic DNA samples were genotyped on Illumina Multi-Ethnic Global Arrays.

  Study phs001749

• HudsonAlpha Long Read Sequencing Data of Individuals with Rare Suspected Genetic Conditions

  The data included in this project were generated from several IRB projects focused on the identification of the underlying genetic cause of undiagnosed rare conditions in infants, children and adults enrolled across the southeastern United States. Long read genome sequencing was performed on DNA samples collected as part of an IRB-approved study and findings from this testing was returned to enrolled study participants and the clinical team providing care. Proband participants in these studies were enrolled in both inpatient (neonatal intensive care units) and outpatient settings. When possible, biological relatives (including both biological parents) were also enrolled to help clarify inheritance of variants identified. Sequencing and analysis for SouthSeq is conducted at the HudsonAlpha Institute for Biotechnology in Huntsville, Alabama (https://www.hudsonalpha.org/). Results of testing are disclosed to participants by genetic counselors or trained non-genetics providers who also facilitate sharing of results with the participants' medical care teams when appropriate. Further, participant families may choose to opt-into return of secondary findings identified in the proband, which focus on pathogenic and likely pathogenic variation identified within the current ACMG gene list.

  Study phs003537

• Novel immunodeficiency caused by homozygous mutations of SLC19A1

  The male proband suffered from infancy oral lesions, recurrent fever, diarrhea, vomiting, atopic dermatitis, dark discoloration patches on his skin and lip fissures; he suffered from anemia (megaloblastic), thrombocytopenia, hypogammaglobulinemia and lymphopenia; his growth and development are delayed. Whole exome sequencing identified only one variant predicted to have high impact and to potentially explain the patient’s phenotype, a homozygous missense chr21:46950793:C:T (hg19) SLC19A1 NM_194255:c.1042G>A (p.G348R). Sanger sequencing and segregation analysis confirmed the presence of the homozygous SLC19A1 c.1042G>A (G348R) missense variant in the proband, with a heterozygous state in his family. The same homozygous SLC19A1 variant was identified in a distantly-related male patient with a similar phenotype presentation, while his healthy family members were heterozygous. SLC19A1 is a folate transporter, and thus folic acid supplementation was performed for the proband: platelet counts normalized rapidly and anemia improved; hair and skin discoloration, mouth lesions and chronic diarrhea improved. In contrast, neurological and developmental issues remained unchanged and treatment had only a partial effect on the immune system. This further confirmed the causal role of SLC19A1 for the proband's condition.

  Study EGAS50000000356

• Jackson Heart Study - Images

  The Jackson Heart Study (JHS) is a large, community-based, observational study that recruited 5,306 African American adults from three counties (Hinds, Madison and Rankin) in the Jackson, MS area. Participants age 35-84 years at baseline were enrolled from each of 4 recruitment pools: (1) random, 17%, (2) volunteer, 30%, (3) currently enrolled in the Atherosclerosis Risk in Communities (ARIC) Study, 31%, and (4) secondary family members, 22% (family study participants were age&#8805;21 years). Data available include medical history, physical examination, blood/urine analytes, and interview questions on areas such as physical activity, stress, coping and spirituality, racism and discrimination, socioeconomic position, and access to health care. Extensive clinical phenotyping includes anthropometrics, electrocardiography, carotid ultrasound, ankle-brachial blood pressure index, echocardiography, CT chest and abdomen for coronary and aortic calcification, liver fat, subcutaneous and visceral fat measurements, and cardiac MRI. Participants have been contacted annually by telephone to update information, confirm vital status, document interim medical events, hospitalizations and functional status, and obtain sociocultural information. Ongoing cohort surveillance includes abstraction of medical records and death certificates for relevant International Classification of Diseases (ICD) codes and adjudication of nonfatal events and deaths.

  Study phs003747

• Biallelic loss of function PAX4 variants are a Novel Cause of Transient Neonatal Diabetes

  The identification of genes in which loss of function (LoF) variants cause neonatal diabetes mellitus (NDM) can provide unique insights into the development and function of human pancreatic beta cells. We describe the identification of biallelic PAX4 LoF variants in 2 unrelated individuals with transient NDM: one due to a homozygous p.(Arg126*) PAX4 stop gain variant and a second due to a homozygous c.-352_104del 2.65kb deletion affecting the first 4 exons and promoter of the PAX4 Matched Annotation from NCBI and EMBL-EBI select transcript. We confirmed reduced transcript expression due to nonsense mediated decay for the e p.(Arg126*) variant in CRISPR-edited iPSC-derived pancreatic endoderm cells. Analysis of PAX4 binding through integration of CUT&RUN and RNA-sequencing in PAX4 depleted endocrine cells identified genes directly regulated by PAX4 involved in both pancreatic islet development and glucose-sensitive insulin secretion. The remitting and relapsing diabetes in both probands demonstrates that in contrast to mice PAX4 is not essential for the development of pancreatic beta-cells and supports differences in the requirements of functional beta-cell mass across the life-course.

  Study EGAS50000000857

• NCI COVID-19 in Cancer Patients Study (NCCAPS): A Longitudinal Natural History Study

  NCCAPS is a longitudinal prospective cohort study designed to assess patient, disease and treatment factors associated with short- and long-term outcomes in patients with cancer who develop COVID-19. We also aimed to describe COVID-19 symptoms and treatments, and to describe disruptions in cancer treatment due to COVID-19. The study enrolled patients with cancer on active treatment or with a history of stem cell transplant or CAR-T cell therapy with new, active COVID-19, defined as being within 14 days of their first positive SARS-CoV-2 test. The study found that receipt of chemotherapy and baseline history of stroke, atrial fibrillation or pulmonary embolism were associated with a higher risk of hospitalization for COVID-19. Vaccination for SARS-CoV-2 was associated with a lower risk of hospitalization. Death due to COVID-19 was highest in patients with lymphoma, intermediate in those with acute leukemia and lung cancer, and lowest in those with other solid tumors and other hematologic cancers. Disruptions of cancer treatment were frequent in the first 30 days after SARS-CoV-2 infection.

  Study phs004178

• Proteomic predictors of individualized nutrient-specific insulin secretion in health and disease

  Population level variation and molecular mechanisms behind insulin secretion in response to carbohydrate, protein, and fat remain uncharacterized despite ramifications for personalized nutrition. We now define prototypical insulin secretion dynamics in response to the three macronutrients in islets from 140 cadaveric donors, including those diagnosed with type 2 diabetes. We leverage the insulin response heterogeneity and use transcriptomics and proteomics to identify molecular pathways of specific nutrient responsiveness. Surprisingly, we find robust insulin secretion to fatty acid stimulus in ~8% of donors, challenging the idea that fat has negligible effects on insulin release. Distinct islet proteomes with differences in metabolic signalling networks convey this hyper-responsiveness to fat relative to carbohydrate. By comparing human islets to human embryonic stem cell-derived islet clusters, we show that, unlike glucose-responsiveness, fat hyper-responsiveness is equivalent and may be a hallmark of functionally immature cells. Our study represents the first comparison of dynamic responses to nutrients and multi-omics analysis in human insulin secreting cells. Responses of different people’s islets to carbohydrate, protein, and fat lay the groundwork for personalized nutrition.

  Study EGAS00001007241

• Non-canonical NF-κB signaling skews B cells away from germinal center to low-affinity effector fate

  The non-canonical (NC) NF-κB pathway is a central regulator of B-cell development and survival, yet its role during B-cell mediated adaptive responses remains uncharted. Here, we uncover an unanticipated regulatory function for NC NF-κB in shaping humoral immunity. High-resolution mapping of NC NF-kB status in B cells from human lymphoid tissues revealed low activity in germinal center B-cells (GCB) than effector subsets, suggesting a selective attenuation. Consistently, mice model harboring B-cells with enforced NC NF-κB activation revealed near- complete loss of GCB and high-affinity antibodies, following vaccination. GCB loss was not driven by intrinsic defects in formation or expansion, but by an immune-niche dysregulation marked by regulatory T-cell expansion. Mechanistically, NC NF-κB activation promoted B-cell- derived IL-10, and blocking this axis normalize the niche and rescue GCB. Concurrently, NC NF- κB signaling boosted low-affinity antibody responses by transcriptionally priming follicular B- cells for plasmacytic differentiation. Together, these findings position NC NF-κB as a tunable rheostat linking B-cell signaling to immune-niche control and humoral immunity.

  Study EGAS50000001646

• Adaptive Therapy Exploits Fitness Deficits in Chemotherapy-Resistant Ovarian Cancer to Achieve Long-Term Tumor Control Open Access

  Drug resistance results in poor outcomes for cancer patients. Adaptive therapy is a potential strategy to address drug resistance that exploits competitive interactions between sensitive and resistant subclones. Here, we showed that adapting carboplatin dose according to tumor response (adaptive therapy) significantly prolonged survival of murine ovarian cancer models compared to standard carboplatin dosing, without increasing mean daily drug dose or toxicity. Platinum resistant ovarian cancer cells exhibited diminished fitness when drug was absent in vitro and in vivo, which caused selective decline of resistant populations due to reduced proliferation and increased apoptosis. Conversely fitter, sensitive cells re-grew when drug was withdrawn. Using a bioinformatics pipeline that exploits copy number changes to quantify the emergence of treatment resistance, analysis of cell‐free DNA obtained longitudinally from ovarian cancer patients during treatment showed subclonal selection through therapy, and measurements of resistant population growth correlated strongly with disease burden. These preclinical findings pave the way for future clinical testing of personalized adaptive therapy regimens tailored to the evolution of carboplatin resistance in individual ovarian cancer patients.

  Study EGAS50000001142

• Duplexseq_of_the_interstrand_crosslinks_WGS

  One of the most dangerous forms of DNA damage are interstrand crosslinks (ICLs), which covalently crosslink the two strands of the DNA double helix. The repair of these lesions is crucial for cellular survival due to their ability to block transcription and DNA replication. Initially, the major pathway that has been described in ICL repair involves a network of 22 genes that are mutated in a severe human genetic disease known as Fanconi Anemia (FA). Using synthetic lethality screens in the near-haploid human HAP1 cell line, we recently identified two potentially novel regulators of ICL repair, C1orf112 and THAP12. Loss of C1orf112 and THAP12 causes hypersensitivity to ICL-inducing DNA damaging agents, such as Mitomycin C (MMC). Additionally, C1orf112-depleted cells show elevated levels of micronuclei and accumulation of DNA damage in S-phase. To better understand how C1orf112 and THAP12 mediate the repair of ICLs, we want to perform mutational signature analysis, using the BotSeq method. Therefore, WT, C1orf112 and THAP12 knockout cells were cultured in vehicle or MMC treated conditions for 10 days and the genomic DNA was isolated. FANCA and FANCD2 knockout cells are taken along as controls in this experimental setting.

  Study EGAS00001006545

• Spatial multi-omic map of human myocardial infarction

  Myocardial infarction is a leading cause of mortality worldwide 1 . While advances have been made in acute treatment, an incomplete understanding of remodelling processes has limited the effectiveness of therapies to reduce late-stage mortality 2 . Here, we generate an integrative high- resolution map of human cardiac remodelling after myocardial infarction using single-cell gene expression, chromatin accessibility, and spatial transcriptomic profiling of multiple physiological zones at distinct time points in myocardium from myocardial infarction and control patients. Multimodal data integration allowed us to evaluate cardiac cell-type compositions at increased resolution, yielding insights into changes of the cardiac transcriptome and epigenome through the identification of distinct tissue structures of injury, repair and remodelling. We identified and validated disease-specific cardiac cell-states of major cell-types and analysed them in their spatial context, evaluating their dependency on other cell-types. Our data elucidates molecular principles of human myocardial tissue organisation, recapitulating a gradual cardiomyocyte and myeloid continuum following ischemic injury. In total, our study provides an integrative molecular map of human myocardial infarction and represents an essential reference for the field and paves the way for advanced mechanistic and therapeutic studies of cardiac disease.

  Study EGAS00001006330

• Risk and modifying factors in Frontotemporal Dementia

  Understanding the molecular mechanisms underlying frontotemporal dementia (FTD) is essential for the development of successful therapies. Here, we present Phase 1 of a multi-omics, multi-model data resource for FTD research which will allows in-depth molecular research into these mechanisms. We have integrated and analysed data from the frontal lobe of FTD patients with mutations in MAPT, GRN and C9orf72 and detected common and distinct dysregulated cellular pathways. Our results highlight that excitatory neurons are the most vulnerable neuronal cell type and that vascular aberrations are a common hallmark in FTD. Via integration of multi-omics data, we detected several transcription factors and pathways which regulate the strong neuroinflammation observed in FTD-GRN. Finally, using small RNA-seq data and verification experiments in cellular models, we identified several up-regulated miRNAs that inhibit cellular trafficking pathways in FTD and lead to microglial activation. In this work we shed light on novel mechanistic and pathophysiological hallmarks of FTD. In addition, we believe that this comprehensive, multi-omics data resource will further mechanistic FTD research by the community.

  Study EGAS00001004895

• Comparative transcriptome of CD34+ hematopoietic progenitors from myeloproliferative patients and control donors

  BCR-ABL-negative MPNs are related to mutations activating the JAK2/STAT pathway and occurring in hematopoietic stem cells (HSC). The most prevalent mutation is JAK2V617F. Calreticulin (CALR) and activating MPLW515 mutations are also observed in ET and PMF. Additional non-MPN mutations may be found, particularly in PMF, and can change disease phenotype or accelerate progression to myelofibrosis or leukemia. In this study, we wanted to compare the transcriptome of CD34+ progenitors from JAK2V617F postive MPN patients to the CD34+ progenitors from control donors. The patients were selected for their high JAK2V617F variant allele frequency (from 60 to 100% VAF). Peripheral blood from patients was collected in EDTA tubes. Hematopoietic progenitors (CD34+) were isolated from mononuclear cells (MNCs) by immunomagnetic enrichment (Miltenyi, Biotech) and were amplified for 5 days in serum-free medium in the presence of a cocktail of human recombinant cytokines containing EPO (1 U/mL) (Amgen Thousand Oaks, CA), TPO (20 ng/mL) (Kirin, Japan), SCF (25 ng/mL) (Biovitrum AB, Sweden), IL-3 (10 ng/mL), FLT3-L (10 ng/mL), G-CSF (20 ng/mL) and IL-6 (100 U/mL) (MiltenyiBiotec).

  Study EGAS00001005106

• Single cell RNA sequencing of synovial B cells in early Rheumatoid Arthritis

  Rheumatoid Arthritis (RA) is a prevalent autoimmune disease characterized by inflammation of the peripheral joints and occurence of autoantibodies, i.e. Rheumatoid Factor (RF) and anti-citrullinated protein antibodies (ACPA), in circulation. Previous studies have shown that there are memory B cells and autoantibody producing plasma cells present in the joint tissue of patients with long-standing RA. However, it has remained unclear, whether these B cell populations are already present in the joint tissue of patients at the disease onset and whether these are autoreactive. Here, we used a single cell RNA sequencing approach to dissect the B cell repertoire at this early timepoint. We found evidence for B and T cell interaction and presence of memory and plasma cell pools in ACPA- and ACPA+ RA. Our results demonstrated clonal relationships between the memory and plasma cell compartments and autoreactivity within the plasma cell pool. These findings challenge our understanding of the local adaptive immune response in the joints of ACPA- and ACPA+ RA patients with direct implications for B and T cell targeting therapy in both patient subgroups.

  Study EGAS00001005144

• Circulating tumor cells Exome sequencing from breast cancer

  Single cell technologies allow interrogating the extent of tumor heterogeneity, providing novel insights into tumor evolution and treatment resistance mechanisms. Here, we investigated the level of genetic heterogeneity among circulating tumor cells (CTCs) at the single nucleotide variation and copy number aberration (CNA) levels and compared it to synchronous matched primary tumor/metastatic lesion from 3 metastatic breast cancer patients with triple-negative (TNBC), HER2-positive (HER2+) and estrogen-receptor-positive (ER+) tumors. Whole exome sequencing was performed on 3 synchronous bulk tumor tissue and 21 single/pooled CTC samples. When comparing bulk tissue with CTCs from the same patient, we found similar CNA profiles and the same patient-specific driver mutations for the HER2+ and TNBC tumors. Different CNA profiles and driver mutations were found for the ER+ tumor, with two distinct clones being identified in the CTCs, one harboring an activating ESR1 mutation, the other one bearing a TP53 mutation. These data suggest that tumor tissue and CTCs provide in a subset of patients complementary clinically relevant information to map tumor heterogeneity and monitor tumor evolution. Further validation is needed.

  Study EGAS00001005228

• Genomic_Advances_in_Sepsis__GAinS__genotyping

  This cohort comprises a subset of pateints enrolled in the Genomic Advances in Sepsis (GAinS) study, an established biobank of adult sepsis patients. Patients with sepsis due to community acquired pneumonia or faecal peritonitis were recruited from 35 hospitals across the UK from 2005-2018, with samples for functional genomics and detailed clinical information collected over the first five days of ICU admission. DNA was extracted from buffy coat or whole blood samples using the Qiagen DNA extraction protocol, the automated Maxwell Blood purification kit (Promega), or the QIAamp Blood Midi kit protocol (Qiagen). Genotyping data were generated using the Illumina HumanOmniExpress BeadChip (295 patients), the Infinium CoreExome BeadChip (655 patients), and the Infinium Global Screening Array BeadChip (307 patients). Genotyping QC and imputation into the Haplotype Reference Consortium was perfomed within each batch. The datasets were combined and following post-imputation filtering data were available on 1168 samples. This data is part of a pre-publication release. For information on the proper use of pre-publication data shared by the Wellcome Trust Sanger Institute (including details of any publication moratoria), please see http://www.sanger.ac.uk/datasharing/

  Study EGAS00001007786

• FOXM1 is a biomarker of resistance to PI3Kα inhibition in ER+ breast cancer that is detectable using metabolic imaging (RNA-seq data)

  PIK3CA, encoding the PI3Kα isoform, is the most frequently mutated oncogene in estrogen receptor-positive breast cancer. Isoform-selective PI3K inhibitors are used clinically but intrinsic and acquired resistance limits their utility. Improved selection of patients that will benefit from these drugs requires novel predictive biomarkers. We show here that persistent FOXM1 expression following drug treatment is a biomarker of resistance to PI3Kα inhibition in ER+ breast cancer. Since the transcription factor drives expression of lactate dehydrogenase (LDH) but not hexokinase 2 (HK-II), changes in FOXM1 expression can be detected using magnetic resonance imaging of LDH-catalyzed hyperpolarized 13C label exchange between pyruvate and lactate but not by PET measurements of HK-II-mediated trapping of the glucose analog 2-deoxy-2-[18F]fluorodeoxyglucose.

  Study EGAS00001004452

• Collaborative Cohort of Cohorts for COVID-19 Research (C4R): Framingham Heart Study (FHS)

  Cohort DescriptionIn 1948, the researchers recruited 5,209 men and women between the ages of 30 and 62 from the town of Framingham, Massachusetts, and began the first round of extensive physical examinations and lifestyle interviews that they would later analyze for common patterns related to CVD development. Since 1948, the subjects have returned to the study every two years for an examination consisting of a detailed medical history, physical examination, and laboratory tests, and in 1971, the study enrolled a second-generation cohort -- 5,124 of the original participants&#39; adult children and their spouses -- to participate in similar examinations. The second examination of the Offspring cohort occurred eight years after the first examination, and subsequent examinations have occurred approximately every four years thereafter. In 1994, the need to establish a new study reflecting a more diverse community of Framingham was recognized, and the first Omni cohort of the Framingham Heart Study, consisting of 506 participants, was enrolled. In April 2002 4095 third generation of participants, the grandchildren of the original cohort, were added. In 2003, 103 spouses of the offspring Cohort (NOS), and a second group of 410 Omni participants were enrolled. Through 2019, the original cohort has completed a total of 32 exams, the Offspring cohort 9 exams, the OMNI1 cohort 4 exams, and GEN3, NOS and OMNI2 cohorts each have completed 3 exams. The FHS is a joint project of the National Heart, Lung and Blood Institute and Boston University.Data Being Submitted Wave 1 questionnaire data includes 3967 variables for up to 3112 FHS participants in C4R.Wave 2 questionnaire data includes 448 variables for up to 2337 FHS participants in C4R.Dried Blood Spot/Serosurvey data includes 7 variables for up to 2189 FHS participants in C4R.Derived data includes 43 variables for up to 3151 FHS participants in C4R.Phenotype data includes 113 variables for up to 3151 FHS participants in C4R.

  Study phs002911

• Sequencing to Guide Cancer Care (CanSeq)

  The overall goal of the CanSeq U01 project is to study the impact of whole-exome sequencing (WES) on the clinical care of cancer patients and oncology provider practices. The aims of Project 1 are to implement and establish the feasibility of germline and somatic WES in patients with advanced solid tumors (lung and colon); to develop a framework for interpreting and reporting for exome sequencing data; to determine the proportion of patients with &#34;actionable items&#34; compared to existing technologies; and to report on the percentage of patients in whom unique WES findings led to a clinical action. The aims of Project 2 are to implement a production-scale platform for WES from archival (FFPE) material; to identify biologically relevant somatic and germline alterations existing in tumor/normal DNA from individual patients; to produce an evidence-based list of clinically &#34;actionable&#34; genetic alterations; and to develop inferential models that predict the utility of tumor genomic data within the larger clinical context. The goals of Project 3 are to describe the impact of information derived through WES on cancer patients; to test the hypothesis that patients will want to receive information about all potentially informative somatic and germline variants; to study patients&#39; understanding of disclosed genomic information; and to describe the experiences of oncology providers as they implement WES into cancer care delivery.

  Study phs001075

• NHLBI TOPMed: Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE)

  ECLIPSE was a longitudinal observational study of 2164 COPD subjects and a smaller number of smoking controls (337) and nonsmoking controls (245) followed regularly for three years, with three chest CT scans (at baseline, one year, and three years) (Vestbo et al., 2008, PMID: 18216052). Subjects were enrolled at clinical centers in the US, Canada, Europe, and New Zealand. Inclusion criteria included subjects ages 40-75, at least 10 pack-years of smoking, and spirometry in GOLD grades 2-4 (COPD cases) or normal spirometry with post-bronchodilator FEV1 >85% (predicted) and FEV1/FVC>0.7 (controls). Study visits were performed at enrollment, three months, and every six months thereafter with spirometry, questionnaires, and other clinical evaluations. The ECLIPSE CT scans have been analyzed with the VIDA software for emphysema and airway phenotypes. ECLIPSE has provided key insights into the clinical epidemiology of COPD, including COPD exacerbations (Hurst, et. al., 2010, PMID: 20843247) and lung function decline in COPD (Vestbo, et. al., 2011, PMID: 21991892). ECLIPSE has been used in a number of genetic studies of COPD susceptibility and protein biomarkers (Faner, et. al., 2014, PMID: 24310110). Genome-wide gene expression microarray data are available in 147 induced sputum samples from COPD subjects and 248 peripheral blood samples from COPD and control subjects. Phenotype data for ECLIPSE subjects is available through dbGaP phs001252.

  Study phs001472

• Identification of RNA biomarkers in Parkinson's disease iPSC-derived neuronal cells

  Parkinson?s disease (PD) is an age-related, chronic and progressive neurodegenerative disorder characterized by a loss of multifocal neurons and subsequent motor symptoms. These overt motor symptoms are often preceded by prodromal non-motor symptoms. Though a number of genetic and environmental factors have been identified to play a role in PD, more exact methods for both diagnosing and assessing prognosis are yet to be discovered. Probing the transcriptomes of control and PD cells can give some interesting insight into changes caused by the disease (in both coding and non-coding gene expression), highlighting potential RNA biomarkers that may be used for PD diagnosis and as new drug targets. The study consists of two main sources of data: matched neural stem cell (NSC) and fully differentiated dopaminergic neurons derived from iPS cells. Both sets of data are made up of three samples from a control cell line, and five samples carrying a mutation in one of several genes known to be linked to heritable PD: PARK2, PARK22 or PARK9. All transcriptome libraries were synthesized and sequenced using no-amplification non-tagging cap analysis of gene expression (nAnT-iCAGE) on the Illumina HiSeq 2500 platform. Resulting data was mapped to the human genome annotation (hg38) and processed CAGE tags were clustered ready for differential expression analyses. The 16 samples here described were sequenced across two lanes.

  Study JGAS000142

• Identification of RNA biomarkers in Parkinson's disease iPSC-derived neuronal cells

  Parkinson���s disease (PD) is an age-related, chronic and progressive neurodegenerative disorder characterized by a loss of multifocal neurons and subsequent motor symptoms. These overt motor symptoms are often preceded by prodromal non-motor symptoms. Though a number of genetic and environmental factors have been identified to play a role in PD, more exact methods for both diagnosing and assessing prognosis are yet to be discovered. Probing the transcriptomes of control and PD cells can give some interesting insight into changes caused by the disease (in both coding and non-coding gene expression), highlighting potential RNA biomarkers that may be used for PD diagnosis and as new drug targets. The study consists of two main sources of data: matched neural stem cell (NSC) and fully differentiated dopaminergic neurons derived from iPS cells. Both sets of data are made up of three samples from a control cell line, and five samples carrying a mutation in one of several genes known to be linked to heritable PD: PARK2, PARK22 or PARK9. All transcriptome libraries were synthesized and sequenced using no-amplification non-tagging cap analysis of gene expression (nAnT-iCAGE) on the Illumina HiSeq 2500 platform. Resulting data was mapped to the human genome annotation (hg38) and processed CAGE tags were clustered ready for differential expression analyses. The 16 samples here described were sequenced across two lanes.

  Study JGAS000318

• Identification_of_cardiovascular_biomarkers_through_an_integrative_omics_approach

  Recent GWAS studies have made extensive use of large eQTL data sets to functionallyannotate index SNPs. With a large number of association signals located outside codingregions there has been an intense search among sequence variants affecting geneexpression at the transcriptional level. However, little progress has been made in mappingregulatory variants that affect protein levels at the translational or post-translational level. It isnow possible to undertake a protein QTL scan for focused sets of e.g. oxidized proteins bymass spectrometry. We have established a collaboration with a longitudinal, family-basedstudy in France, the Stanislas cohort, which comprises circa 1000 nuclear families (4,295individuals) and has follow up data for 10 years (three visits). We have undertaken a pilotstudy in a focus set of 257 subjects from 79 families with the aim to integrate GWAS,transcriptomic and DNA methylation data with proteomic data on a set of 100 proteinsmeasured in PBMCs. We have already generated GWAS data using Illumina's core-exomechip as well as DNA methylation profiles with the 450K array. We propose to use RNA seq togenerate transcriptomic data of the corresponding PBMCs.This data is part of a pre-publication release. For information on the proper use of pre-publication data shared by the Wellcome Trust Sanger Institute (including details of any publication moratoria), please see http://www.sanger.ac.uk/datasharing/

  Study EGAS00001000711

• mFAST-SeqS

  Recent progress in the analysis of cell-free DNA fragments (cell-free circulating tumor DNA, ctDNA) now allows monitoring of tumor genomes by non-invasive means. However, previous studies with plasma DNA from patients with cancer demonstrated highly variable allele frequencies of ctDNA. The comprehensive analysis of tumor genomes is greatly facilitated when plasma DNA has increased amounts of ctDNA. Therefore, a fast and cost-effective pre-screening method to identify such plasma samples without previous knowledge about alterations in the respective tumor genome could assist in the selection of samples suitable for further extensive qualitative analysis. To address this, we adapted the recently described FAST-SeqS method, which was originally established as a simple and effective, non-invasive screening method for fetal aneuploidy from maternal blood. We show that our modified FAST-SeqS method (mFAST-SeqS) can be used as a pre-screening tool for an estimation of the ctDNA percentage. Using a combined evaluation of genome-wide and chromosome-arm specific z-scores from dilution series with cell line DNA and by comparisons of plasma-Seq profiles with data from mFAST-SeqS, we established a detection limit of 10% or more of mutant alleles. Plasma samples with an mFAST-SeqS z-score above 5 showed highly concordant results compared to copy number profiles obtained from our previously described plasma-Seq approach.

  Study EGAS00001001133

• Targeted gene fusion sequencing (Fus-seq) in mesothelioma

  This is a small pilot data set to test the feasibility of cDNA exomes across 1200 cancer cell line panel. cDNA exomes or Fus-seq is further explained in this studies Abstract.

  Dataset EGAD00001000361

• Mucosal Melanoma transcriptomes

  This is an RNA sequencing dataset of 101 mucosal melanoma tumors. The original corresponding study is titled "Diversity of the immune microenvironment and response to checkpoint inhibitor immunotherapy in mucosal melanoma" by J.L. Vos et al., published in JCI Insight.

  Dataset EGAD50000000892

• Genetic architecture of disease in Greenland is shaped by demographic history, fine-structure, and selection - WGS data

  This file set has 448 Greenlandic individuals sequenced using Illumina 150 Paired end sequencing and has an average sequencing depth of 35X. The data is unfiltered, in VCF format, and covers 19.751.308 variants.

  Dataset EGAD50000000933

• Next-generation sequencing-based comprehensive genetic analysis of undiagnosed disease

  The purpose of this study is to perform comprehensive genetic analysis using next-generation sequencers to make genetic diagnosis of "undiagnosed diseases".

  Study JGAS000522

• Helleday_HRAS_Project

  This experiment is looking at the mutational signatures generated by engineered HRAS mutations by using whole genome sequence generated on massively parallel next generation sequencers.

  Study EGAS00001000332

• Orphan_Tumour_Study___familial_neuroblastoma

  The aim of this study is to study the genomes of ultra rare childhood tumours

  Study EGAS00001002171

• Landscape and significance of multiple mutations in oncogenes.

  This study is a comprehensive pan-cancer study of oncogenic multiple mutations (MMs) which includes long-read whole-genome sequencing data (n = 3).

  Study EGAS00001003763

• Linked Read Sequencing of Gastric Cancer Metastases for Complex SV Resolution

  In this study, linked read sequencing was performed on two ovarian metastases and matched normal tissue, from a patient with primary diffuse gastric cancer. Linked read sequencing is a DNA preparation technology whereby high molecular weight molecules of DNA are uniquely barcoded prior to fragmentation and sequencing, thus retaining information about genomic contiguity. This study performed an extended analysis of linked read sequencing data to resolve the complex structures of structural variants in the cancer genomes. Complex structural rearrangements were identified in the genomic region surrounding the known oncogene FGFR2, and the association between FGFR2 and gastric cancer metastasis was demonstrated in an organoid model.

  Study phs001362

• Development, maturation and maintenance of human prostate inferred from somatic mutations

  Stem cells within prostate epithelium frequently undergo malignant transformation, but there is limited information on their clonal dynamics and mutation burden in healthy human prostates. We sequenced whole genomes from 409 microdissections of prostate epithelium across 8 donors, using phylogenetic reconstruction with spatial mapping in a 59-year-old man’s prostate to provide high-resolution reconstruction of tissue dynamics across the lifespan. Somatic mutation burden increases linearly with age, at ~16 mutations/year/clone, and is higher in peripheral than peri-urethral regions. The 24-30 independent glandular subunits are established as rudimentary ductal structures during fetal development by 5-10 embryonic cells each. Puberty induces formation of further side branches and terminal acini by local stem cells disseminated through the rudimentary ducts during development. During adult tissue maintenance, clonal expansions are small, with limited geographic scope and minimal migration. Driver mutations are rare in normal ageing prostate epithelium, but the one canonical driver we did observe generated a sizable intraepithelial clonal expansion. By resolving unbiased, continuously occurring lineage-marking mutations, we define stem cell dynamics through embryogenesis, puberty and ageing, with relevance for prostate cancer.

  Dataset EGAD00001006591

• P647 Targeted resequencing project

  In collaboration with Dr Robert Semple we have identified a family harbouring an autosomal dominant variant, which leads to severe insulin resistance (SIR), short stature and facial dysmorphism. This family is unique within the SIR cohort in having normal lipid profiles, preserved adiponectin and normal INSR expression and phosphorylation. DNA is available for 7 affected and 7 unaffected family members across 3 generations. All 14 samples have been genotyped using microsatellites and the Affymetrix 6.0 SNP chip. Linkage analysis identified an 18.8Mb haplotype on chromosome 19 as a possible location of the causative variant. However, Exome sequencing of 3 affected and 1 unaffected family members has not identified the causative variant suggesting the possibility of an intronic or intergenic variant in this region or elsewhere in the genome. We propose to conduct whole genome sequencing of 5 members of the pedigree at a depth of 20X. The chosen samples are two sets of parents plus one member of an unaffected branch of the pedigree who shares the risk haplotype on chromosome 19. Sequencing of the two sets of parents will be used along with the genome-wide SNP data to impute 4 affected children giving an effect sample size of 6 affected individuals.

  Dataset EGAD00001000383

• Evolution and clinical impact of genetic epistasis within EGFR-mutant lung cancers: multi-timepoint exome sequencing of a single patient's disease

  This dataset is a time-series of EGFR-mutant NSCLC clinical specimens from an individual patient profiled using tumor-based whole exome sequencing and the data is in BAM format. DNA was extracted from FFPE for primary tumor and frozen tumor tissue samples and matched non-tumor tissue using the Qiagen Allprep DNA/RNA Mini Kit.  The library preparation protocol was based on the Agilent SureSelect Library Prep and Capture System. DNA was resuspended in a low TE buffer and sheared (Duty Cycle 5%; Intensity 175; Cycles/Burst: 200; Time: 300s, Corvaris S2 Utrasonicator).  Bar-coded exome libraries were prepared using the Agilent Sure Select V5 library kit per manfucaturer’s specifications. The libraries were run on the HiSeq2500. Raw paired end reads (100bp) in FastQ format generated by the Illumina pipeline were aligned to the full hg19 genomic assembly obtained from USCS, gencode 14, using bwa version 0.7.12. Picard tools version 1.117 was used to sort, remove duplicate reads and generate QC statistics. Tumor DNA was sequenced to median depth of 303X (range 114.39-383.41) and the matched germline DNA to average depth of 231.65.

  Dataset EGAD00001003769

• Timing the landmark events in the evolution of clear cell renal cell cancer

  Clear cell renal cancer is characterized by near-universal loss of the short arm of chromosome 3 (3p). This event arises through unknown mechanisms, but critically results in the loss of several tumor suppressor genes. We analyzed whole genomes from 95 biopsies across 33 patients with clear cell renal cancer (ccRCC) recruited into the Renal TRACERx study. We find novel hotspots of point mutations in the 5'-UTR of TERT, targeting a MYC-MAX repressor, that result in telomere lengthening. The most common structural abnormality generates simultaneous 3p loss and 5q gain (36% patients), typically through chromothripsis. Using molecular clocks, we estimate this occurs in childhood or adolescence, generally preceding emergence of the most recent common ancestor by years to decades. Similar genomic changes recent common ancestor by years to decades. Similar genomic changes are seen in inherited kidney cancers. Modeling differences in age-incidence between inherited and sporadic cancers suggests that the number of cells with 3p loss capable of initiating sporadic tumors is no more than a few hundred. Targeting essential genes in deleted regions of chromosome 3p could represent a potential preventative strategy for renal cancer.

  Dataset EGAD00001003445

• Somatic mutant selection is altered by prior NOTCH1 mutation in ageing esophageal epithelium

  Authors: Charlotte King1, Emilie Abbie1, Joanna C. Fowler1, Irina Abnizova1, Roshan K. Sood1, Swee Hoe Ong1, Michael W. J. Hall1,2, Faye Lynch-Williams3, Benjamin A. Hall4, Philip H. Jones1,2,5 Abstract: In cancer evolution, genome alterations often occur in a specific order, implying selection depends on the prior clonal genotype 1-3. It is unknown if similar constraints operate in normal epithelia. Here, we mapped mutations in normal mid-esophagus of aged UK subjects. Mutant NOTCH1 clones colonized most of the epithelium by age 60 and above 70 tissue was saturated with mutants under strong competitive selection. Mutant TP53 was more strongly selected in donors over 60 years of age. Samples predominantly mutant for NOTCH1 showed increased selection of NOTCH2 mutants and weaker selection of mutant TP53 compared with samples that were mostly NOTCH1 wild type. In mouse esophagus lacking Notch1 we observed strong selection of mutant Notch2 and other genes not selected in wild type esophagus. In normal ageing esophagus, the first driver mutation may change the trajectory of subsequent somatic evolution by altering mutant selection.

  Dataset EGAD00001015261

• San Francisco Bay Area Latina Breast Cancer Study

  The genome-wide association study (GWAS) includes participants enrolled into two different studies. The first study, the San Francisco Bay Area Cancer Study (SFBCS) is a population-based case-control study of breast cancer conducted in the San Francisco Bay Area and included women ages 35-79 years from three racial/ethnic groups: Non-Hispanic whites, African Americans, and Hispanics/Latinas. For the GWAS, only Hispanic/Latina women were included. Women diagnosed with invasive breast cancer between 1995 and 2002 were identified through the Greater Bay Area Cancer Registry. Controls were identified by random digit dialing and were frequency-matched to cases by age in 5 year increments and by race/ethnicity. Hispanic/Latina ethnicity was assessed by self-report. 175 Hispanic/Latina cases and 307 Hispanic/Latina controls from the SFBCS had given adequate consent and provided biospecimens that were used in the GWAS to be included in this data submission. The second study is the Northern California site of the Breast Cancer Family Registry (NC-BCFR). This population-based family study recruited breast cancer cases ages 18-64 years diagnosed from 1995-2009 that were identified through the Greater Bay Area Cancer Registry. Cases included all women at increased genetic susceptibility for breast cancer who met one or more of the following criteria: (a) being diagnosed with breast cancer at age &#60;35 years; b) having a personal history of ovarian cancer or childhood cancer; (c) being diagnosed with two different breast cancers (bilateral breast cancers), with the first one diagnosed at age &#60;50 years; and d) having one or more first-degree relatives with breast cancer, ovarian cancer or childhood cancer. Cases not meeting these criteria were randomly sampled and racial/ethnic minorities were oversampled. Controls were recruited by random digit dialing and were matched by 5-year age increments and by race/ethnicity. For the current GWAS only Latina/Hispanic cases and controls were included. Latina/Hispanic ethnicity was assessed by self-report. 631 Hispanic/Latina cases and 61 Hispanic/Latina controls from the NC-BCFR had given adequate consent and provided biospecimens that were used in the GWAS to be included in this data submission.

  Study phs000912

• Losartan Effects on Emphysema Progression (LEEP-BioLINCC)

  Data Access NOTE: Please refer to the &#8220;Authorized Access&#8221; section below for information about how access to the data from this accession differs from many other dbGaP accessions. Objectives To evaluate the efficacy of losartan, an angiotensin receptor blocker, to reduce emphysema progression in patients with COPD and mild to moderate emphysema. Background Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease comprising chronic bronchitis and emphysema. COPD is a major cause of morbidity and mortality. Smoking cessation slows the progression of the disease, and bronchodilators can provide sustained improvement in lung function, but there are no pharmacologic agents that clearly modify emphysema progression. Angiotensin receptor blockers (ARBs) have been suggested as potential drugs to slow the progression of COPD. A few trials have shown that patients treated with ARBs had slower progression of radiographic emphysema. The LEEP study was initiated to test the hypothesis that the ARB losartan would reduce the progression of emphysema in patients with COPD with mild to moderate emphysema.ParticipantsA total of 220 participants were enrolled. 108 participants were randomized to receive losartan, and 112 participants were randomized to receive the placebo.Design LEEP was a randomized, placebo-controlled multicenter trial. Participants were randomly assigned (1:1) to receive losartan or placebo. The dose was 50 mg losartan or placebo given as one capsule daily for 2 weeks, and, if well tolerated and the systolic blood pressure was >90 mm Hg, it was increased to two capsules. Participants and site investigators were masked to treatment assignment. Participant responses to the St George's Respiratory Questionnaire, the modified Medical Research Council dyspnea scale, the COPD Assessment Test, and the Physical Function&#8211;Short Form 20a were collected. The number and severity of COPD exacerbations were recorded. COPD exacerbations were defined as two or more new or worse symptoms for &#8805;3 days and classified by treatment as mild (neither antibiotics nor oral steroids), moderate (an antibiotic or oral steroid), or severe (hospitalization). The primary outcome measure was the change in quantitative whole-lung emphysema score after 48 weeks measured by the percentage of lung voxels less than -950 Hounsfield units (PCT950) on full inspiratory HRCT. Conclusions Losartan does not prevent progression of emphysema in patients with COPD who have mild to moderate pulmonary emphysema.

  Study phs004313

• UK10K_OBESITY_SCOOP

  In the UK10K project we propose a series of complementary genetic approaches to find new low frequency/rare variants contributing to disease phenotypes. These will be based on obtaining the genome wide sequence of 4000 samples from the TwinsUK and ALSPAC cohorts (at 6x sequence coverage), and the exome sequence (protein coding regions and related conserved sequence) of 6000 samples selected for extreme phenotypes. Our studies will focus primarily on cardiovascular-related quantitative traits, obesity and related metabolic traits, neurodevelopmental disorders and a limited number of extreme clinical phenotypes that will provide proof-of-concept for future familial trait sequencing. We will analyse directly quantitative traits in the cohorts and the selected traits in the extreme samples, and also use imputation down to 0.1% allele frequency to extend the analyses to further sample sets with genome wide genotype data. In each case we will investigate indels and larger structural variants as well as SNPs, and use statistical methods that combine rare variants in a locus or pathway as well as single-variant approaches.The SCOOP samples are part of the Obesity group and will undergo exome sequencing. Severe Childhood Onset Obesity Project (SCOOP) is a sub-cohort of the Genetics Of Obesity Study (GOOS) cohort established by Sadaf Farooqi and Steve O’Rahilly at the University of Cambridge over the last 12 years. The GOOS cohort contains &gt;4,000 patients of diverse geographic origin, many of whom have monogenic and syndromic forms of obesity, and includes patients that are offspring of consanguineous union. SCOOP is a subset of &gt;1500 UK Caucasian patients with severe, early onset obesity (all patients have a BMI Standard Deviation Score (SDS) &gt; 3 and obesity onset before the age of 10 years), in whom all known monogenic causes of obesity have been excluded. GWAS data on the SCOOP cohort will be available (WTCCC2 independent study) at the time of the start of this study. Data from this cohort has demonstrated that the prevalence of the common obesity risk alleles in FTO, MC4R and NEGR1 are amongst the highest within SCOOP, demonstrating its value also in the study of genetic variants with an impact on more common obesity. For further information with regard to this cohort please contact Sadaf Farooqi (isf20@medschl.cam.ac.uk).

  Study EGAS00001000124

• Transcriptome of Chronic Pain and Disease

  The Functional Genomics Section (FGS) is a part of the National Institute of Dental and Craniofacial Research (NIDCR) within the National Institutes of Health (NIH). Research at the FGS focuses on understanding the mechanics involved in nociception through both clinical samples from patients with chronic pain and mouse models of pain. Pain is relayed from the periphery to the central nervous system through specialized sensory neurons known as nociceptors. The cell body of nociceptors resides in neuronal structures that branch off of the spinal cord known as dorsal root ganglia (DRG). The DRG is a heterogenous tissue containing not only sensory neurons like nociceptors, but also glial cells, capillaries, fibroblasts, and resident macrophages. The interaction between the nociceptors and these DRG cell types can have a significant role in affecting neuronal hyperexcitability and downstream pain sensitivity. To better understand the cellular factors involved in producing conditions of chronic pain, DRGs from consenting organ donors were collected from individuals experiencing pain disorders such as painful diabetic neuropathy and rheumatoid arthritis. A multi-omics approach is being used to identify molecular mechanisms that lead to pain hypersensitivity in patients with chronic pain.&nbsp;&nbsp;

  Study phs002548

• Whole Exome Sequencing in Alopecia Areata Identifies Rare Mutations in KRT82

  Alopecia areata (AA) is an autoimmune disorder, in which the body's own immune cells attack hair follicels resulting in hair loss. It is a complex genetic disease with 14 associated loci previously identified in our genome-wide association study (GWAS). In the study, we performed the whole-exome sequencing (WES) on 849 AA patients with the aim to identify the novel rare variants in genes contributing to AA susceptibility. We performed gene-collapsing analyses and identified keratin 82 (KRT82 Gene ID: 3888) as the highest associated AA gene in the three rare damaging collapsing models with p&lt;6.7E-07 in one of the models. The KRT82 gene is a hair-specific type II keratin expressed in the hair shaft cuticle during the anagen phase of the hair cycle. We reported the lower expression of KRT82 in AA hair follicles, compared to controls, and the KRT82 expression is absent from the bulb region, the site of AA immune attack. This study emphasizes the significance of using WES and gene collapsing analyses to identify rare variation in a functionally relevant risk gene using a moderate sample size.&nbsp;&nbsp;

  Study phs002632

• The Environmental Determinants of Diabetes in the Young Study (TEDDY)

  Study Overview The Environmental Determinants of Diabetes in the Young (TEDDY) Study is a longitudinal study that investigates genetic and genetic-environmental interactions, including gestational events, childhood infections, dietary exposures, and other environmental factors after birth, in relation to the development of islet autoimmunity and type 1 diabetes (T1D). A consortium of six clinical centers assembled to participate in the development and implementation of the study to identify environmental triggers for the development of islet autoimmunity and T1D in genetically susceptible individuals. Beginning in 2004, the TEDDY study screened over 400,000 newborns for high-risk HLA-DR, DQ genotypes from both the general population and families already affected by T1D. The TEDDY study enrolled around 8,676 participants across six clinical centers worldwide (Finland, Germany, Sweden and three in the United States) in the 15-year prospective follow-up. Participants are followed every three months for islet autoantibody (IA) measurements with blood sampling until four years of age and then at least every six months until the age of 15. After the age of four, autoantibody positive participants continue to be followed at three month intervals and autoantibody negative participants are followed at six-month intervals. In addition to the analysis of autoantibodies, additional data and sample collection are performed at each visit. Parents collect monthly stool samples in early childhood. The parents also fill out questionnaires at regular intervals in connection with study visits and record information about diet and health status in the child's TEDDY Book between visits. Continued long-term follow-up of the currently active TEDDY participants will provide important scientific information on early childhood diet, reported and measured infections, vaccinations, and psychosocial stressors that may contribute to the development of type 1 diabetes and islet autoimmunity. Additional information on the TEDDY study is available in the following articles: Rewers et al., 2008, PMID: 19120261 and Hagopian et al., 2006, PMID: 17130573. Details of the TEDDY protocol can be found in Hagopian et al., 2011, PMID: 21564455. TEDDY data currently available in dbGaP include: gene expression, SNPs, exome, microbiome (gut, nasal, and plasma), RNA sequencing, and whole genome sequencing. For more information on TEDDY Study version history please refer to TEDDY Study dbGaP README File. ImmunoChip SNP DNA from whole blood samples on study participants and their family members (mothers, fathers, and siblings) was obtained and used for SNP genotyping. Genotyping was performed by the Center for Public Health Genomics at the University of Virginia using the Illumina ImmunoChip SNP array, which contains around 196,000 SNPs from 186 regions associated with 12 autoimmune diseases (Hadley et al., 2015, PMID: 26010309). Data cleaning and validation included the removal of subjects with a low call rate (&lt; 5% SNPs missing) and differences in reported sex and prior genotyping at the TEDDY HLA laboratory. Additionally, SNPs with a low call rate or Hardy-Weinberg equilibrium P value &lt; 10-6, except for chromosome 6 due to HLA eligibility requirements, were removed from the final dataset (T&#246;rn et al., 2015, PMID: 25422107).TEDDY-T1DExome ArrayDNA from whole blood samples on study participants and their family members (mothers, fathers, and siblings) was obtained and used for genotyping. Genotyping was performed by the University of Virginia using the Illumina TEDDY-T1DExome array. The TEDDY-T1DExome array is a custom chip that contains 550,601 markers from the Infinium CoreExome-24 v1.1 BeadChip and an additional 90,214 tagSNPs specifically selected by the TEDDY investigators based on their associations with nutrients, vitamins, type 2 diabetes, autoimmune diseases, body-mass index, or other exposures and phenotypes measured by TEDDY study.The Illumina GenTrain2 algorithm was used for genotype calling. Sample quality control metrics included sample call rate, heterozygosity rate and concordance of gender between the information reported and genotyped. Gene Expression The TEDDY study collected peripheral blood for the extraction of total RNA from enrolled children starting at 3 months of age, and then at 3 month intervals up to 48 months and then biannually. Total RNA was extracted using a high throughput (96-well format) extraction protocol using magnetic (MagMax) beads technology at the TEDDY RNA Laboratory, Jinfiniti Biosciences in Augusta, GA. Purified RNA (200 ng) was further used for cRNA amplification and labeling with biotin using Target Amp cDNA synthesis kit (Epicenter catalog no. TAB1R6924). Labeled cRNA was hybridized to the Illumina HumanHT-12 Expression BeadChips based on the manufacturer's instructions. The HumanHT-12 Expression BeadChip provides coverage for more than 47,000 transcripts and known splice variants across the human transcriptome. Microbiome The TEDDY microbiome study aimed to characterize the longitudinal development of the microbiome, including bacteria, viruses and other microorganisms in the gut, plasma, and nasal cavity of prediabetic and diabetic subjects compared to autoantibody negative non-diabetic subjects. Stool samples used were collected monthly from 3 to 48 months, after which stool samples were collected every 3 months. Nasal swab samples were collected every 3 months starting at 9 months of age until 48 months, after which nasal swabs were collected every 6 months. Plasma samples were collected every 3 months starting at 3 months of age until 48 months, after which plasma samples were collected every 6 months. If the subject was autoantibody positive at 48 months then they remained on the 3 month collection interval for nasal swab and plasma samples. Samples underwent 16s rRNA gene sequencing, DNA and viral RNA metagenomics shotgun sequencing, and sequencing of the internal transcribed spacer (ITS) regions. Additional information on the TEDDY microbiome data is available in the following articles: Vatanen et al., 2018, PMID: 30356183, Stewart et al., 2018, PMID: 30356187, and Vehik et al., 2020, PMID: 31792456. RNA Sequencing The TEDDY study aimed to characterize the transcriptome in subjects with islet autoimmunity and type 1 diabetes compared to matched control subjects. Peripheral blood was collected to extract total RNA from enrolled children starting at 3 months of age, and then at 3 month intervals up to 48 months and then biannually. Total RNA was extracted using a high throughput (96-well format) extraction protocol using magnetic (MagMax) beads technology at the TEDDY RNA Laboratory, Jinfiniti Biosciences in Augusta, GA. Purified RNA was then sent to the Broad Institute for the generation of the TEDDY RNA sequencing (RNA-Seq) data. The RNA samples were prepped using Superscript III reverse transcriptase and Illumina's TruSeq Stranded mRNA Sample Prep Kit. The TruSeq libraries were run on the Illumina HiSeq2500 platform. Whole Genome Sequencing The TEDDY study aimed to conduct deep whole genome sequencing and examine the genomic variations in subjects with islet autoimmunity and type 1 diabetes compared to matched autoantibody negative and non-diabetic children. DNA from whole blood was obtained from TEDDY children for whole genome sequencing. The WGS data were generated on the Illumina HiSeq X Ten system.

  Study phs001442

• LLDeep DAG2+ scRNA-seq in PBMCs

  Single cell transcriptomics of PBMCs of 47 donors from the Lifelines Deep cohort (general population, Northern part of the Netherlands). Cells of five or six different donors were pooled together in one sample pool, resulting in eight different sample pools. In total, 28.855 cells were captured and their transcriptomes were sequenced to an average depth of 74k. Genotype data was available for each donor, which allowed us to use the Demuxlet method that uses variable SNPs between the pooled individuals to determine which cell belongs to which individual. Since genotype information is lacking of 2 individuals, the transcriptome of only 45 individuals could be retrieved.

  Dataset EGAD00010001315

• SUM-seq data for spontaneous differentiation of iPSCs upon perturbation of GATA2, NR4A2 or SOX17

  We combined SUM-seq with arrayed CRISPR screening, modulating the expression of key lineage transcription factors (TFs) (GATA2 - mesoderm, SOX17 - endoderm, and NR4A2 - neuroectoderm) in hiPSCs via CRISPR interference (CRISPRi) or activation (CRISPRa) over a time course of spontaneous differentiation (days cultured in vitro: 0, 4, 12, and 18). This totalled to 54 samples (4 day/time points x 3 target TFs x 2-3 gRNAs per target x CRISPRi/a). Single-cell chromatin accessibility and gene expression data is provided as demultiplexed fastq files.

  Dataset EGAD50000001205

• The Emirati T2T-level Pangenome: A complete Diploid Graph of 58 Genomes

  This dataset is an Emirati telomere-to-telomere (T2T) pangenome graph in GBZ format built from 116 haplotype-resolved assemblies spanning 58 individuals (28 trio-based and 30 single-sample assemblies). Assemblies were generated with long-read sequencing (PacBio HiFi and ONT ultra-long) with standard polishing, then integrated into a graph representation. The genomes show high contiguity (median ≈150 Mb) and high consensus accuracy (median QV 59). The resulting GBZ graph captures globally shared and Emirati-enriched variation, including sequence in complex regions, and serves as a population-matched reference for downstream variant discovery and annotation.

  Dataset EGAD50000001756

• Single Cell RNASeq for ARMS tumors

  6 samples from 3 mice related to Alveolar Rhabdomysarcoma. In this study, we employ scRNA-seq to analyze ARMS tumors from a conditional mouse model of ARMS. The conditional knock-in mouse model of ARMS, in which the Pax3-Foxo1 allele is activated in the skeletal muscle cell lineage via Myf6Cre (Myf6CrePax3P3Fm/P3FmTrp53F2-10/F2-10; referred to hereafter as GEMM-ARMS) has been described previously23,24. These mice also carry Cre-activated reporters, eYFP to label Pax3::Foxo1-expressing cells and dsRED2 to labels Myh2-expressing cells. Some tumors are derived from GEMM-ARMS mice, and some are allografts of GEMM-ARMS tumors into immunodeficient mice

  Dataset EGAD50000002241

• An MTOR mutation hitchhikes through renal embryogenesis, driving multifocal, multiphenotypic tumours - WGS

  Embryogenesis is a vulnerable time. Mutations in developmental cells can result in the seeding of cells predisposed to disease within mature organs, creating a field effect. We characterise an embryonic cancer mutation that drives multifocal, multiphenotypic renal tumours in a 14-year-old girl. Their shared MTOR mutation, absent from normal tissues, increases protein flexibility which enables a FAT domain hinge to dramatically increase mTORC1 activity. Developmental mutations, not usually detected in traditional genetic screening, have vital clinical importance in guiding prognosis, targeted treatment, and family screening decisions for paediatric tumours.

  Dataset EGAD00001011645

• An MTOR mutation hitchhikes through renal embryogenesis, driving multifocal, multiphenotypic tumours - scRNA

  Embryogenesis is a vulnerable time. Mutations in developmental cells can result in the seeding of cells predisposed to disease within mature organs, creating a field effect. We characterise an embryonic cancer mutation that drives multifocal, multiphenotypic renal tumours in a 14-year-old girl. Their shared MTOR mutation, absent from normal tissues, increases protein flexibility which enables a FAT domain hinge to dramatically increase mTORC1 activity. Developmental mutations, not usually detected in traditional genetic screening, have vital clinical importance in guiding prognosis, targeted treatment, and family screening decisions for paediatric tumours.

  Dataset EGAD00001011647

• Renal habitat WXS

  This project is correlating the molecular profiling of renal tumours with multiparametric and 13C-MRI including by 13C-MRSI. . This dataset contains all the data available for this study on 2023-03-09.

  Dataset EGAD00001010125

• AVENIO Expanded ctDNA panel sequence alignments (BAMs) from plasma DNA of BC, CRC and NSCLC patients

  The AVENIO ctDNA Expanded Kit is a next-generation sequencing (NGS) liquid biopsy assay with a 77 gene panel (192 kb) containing genes in U.S. National Comprehensive Cancer Network (NCCN) Guidelines and emerging cancer biomarkers. This pan-cancer assay was applied to 48 plasma samples from patients with breast, colorectal and non-small cell lung cancer. After sequencing 150bp paired-end, reads were aligned to the hg38 genome with the AVENIO Oncology Analysis Software (version 2.0). These files are the deduplicated alignments generated by the analysis software used for subsequent variant, indel and CNV calling.

  Dataset EGAD00001006301

• Chracterising cellur pathways underlying CD3/CD28 activation of human CD4+ cells

  We devised an approach to disentangle the TCR and CD28 pathways upon stimulation in naive and memory primary human CD4+ T cells (Tcons) in response to defined stimulatory signals. Isolated memory and naïve T cells were activated using anti-CD3, anti-CD28 or both in combination. As a control we cultured cells in the same conditions but without the stimuli. We carried Chipmentation using the H3K27ac antibody on 200,000 cross-linked cells. 1) This data is part of a pre-publication release. For information on the proper use of pre-publication data shared by the Wellcome Trust Sanger Institute please see http://www.sanger.ac.uk/datasharing/ .

  Dataset EGAD00001006611

• An MTOR mutation hitchhikes through renal embryogenesis, driving multifocal, multiphenotypic tumours - RNA

  Embryogenesis is a vulnerable time. Mutations in developmental cells can result in the seeding of cells predisposed to disease within mature organs, creating a field effect. We characterise an embryonic cancer mutation that drives multifocal, multiphenotypic renal tumours in a 14-year-old girl. Their shared MTOR mutation, absent from normal tissues, increases protein flexibility which enables a FAT domain hinge to dramatically increase mTORC1 activity. Developmental mutations, not usually detected in traditional genetic screening, have vital clinical importance in guiding prognosis, targeted treatment, and family screening decisions for paediatric tumours.

  Dataset EGAD00001011646

• Development of a diagnostic gene panel for Gorlin syndrome and its application to liquid biopsy

  Gorlin syndrome is an autosomal dominant, rare disease caused by mutations in PTCH1, PTCH2, and SUFU with various symptoms in multiple organs making early diagnosis challenging. In this study, we generated a Gorlin syndrome gene panel that could help to overcome the difficulties in diagnosing Gorlin syndrome using a single test. This gene panel is time- and cost-efficient and highly reliable with a high-quality score of 30, on-target ratio, and coverage depth, and could detect more mutations than whole-exome sequencing of the same patient. Although the current in silico prediction tools have a limited genetic database of gene mutations in rare hereditary diseases, five prediction tools were used to identify pathological mutations. Pathogenic gene mutations were detected not only in PTCH1 but also in PTCH2 in five out of 12 patients with Gorlin syndrome diagnosed based on clinical symptoms. Using this gene panel, we showed the same gene mutation in the patients and their asymptomatic relatives; hence, it has enabled a highly reliable genetic diagnosis of Gorlin syndrome at a low cost requiring only blood sample.

  Study JGAS000308

• Sickle Cell Disease Implementation Consortium Registry (SCDIC Registry-BioLINCC)

  Data Access NOTE: Please refer to the "Authorized Access" section below for information about how access to the data from this accession differs from many other dbGaP accessions.Objectives: To understand the barriers to care and other factors related to reduced healthcare utilization after the transition from pediatric to adult SCD care which may contribute to increased morbidity and mortality.Background: Fifty years ago, it was rare for individuals with SCD to live beyond childhood. Advances in care delivery and treatment have more than doubled the life expectancy of individuals with sickle cell disease (SCD) since 1972. Beginning in the 1970s, measures such as newborn screening, prophylactic administration of penicillin, and immunization against bacterial infections decreased complications and morbidity, increasing the length and quality of life of children with SCD. Blood transfusions are currently the only proven way to prevent some of the major complications of SCD, especially recurrent stroke. They are also used frequently to help manage some of the acute complications of SCD. More recently, the use of hydroxyurea (HU) as a therapeutic agent to increase fetal hemoglobin has been shown to further reduce the debilitating symptoms of and improve survival in SCD. L-glutamine and crizanlizumab are additional treatments to reduce pain crises and voxelotor is approved to lower the risk of anemia and improve blood flow. In the absence of a widely accessible cure, treatment for SCD is usually aimed at avoiding crises, relieving symptoms, and preventing complications. Many of the advances in treatment have not translated into an increase in longevity or quality of life for adolescents and adults because of disparities in access to routine primary health care.Individuals with SCD experience a markedly increased mortality beginning in the second decade of life. The third and later decades of life are frequently associated with severe chronic pain progressive organ damage and frequent hospitalizations. The provision of evidence-based and expert opinion-based care in SCD is complicated by the difficulties that many patients experience in obtaining access to the health care system and in receiving long-term care from knowledgeable providers. A registry of 2,400 people with SCD was established to provide a rich resource to study the natural history of SCD and to understand barriers to care during the transition from pediatric to adult care. Participants: 2,438 participants with a confirmed diagnosis of SCD were enrolled into the registry over an 18-month period. At the time of enrollment, all participants were 15-45 years of age, English speaking, and without a bone marrow transplant.Design: The SCDIC Registry is a longitudinal observational cohort study. At enrollment, data collection included a medical record abstraction of clinical history, the most recent lab results, and a participant survey which included several patient reported outcomes from PROMIS, ASCQ-Me and NeuroQoL. Similar surveys were administered at annual follow-up. Four to five years after enrollment, a second record abstraction was completed with all clinical events that occurred since enrollment and another set of recent labs. There were many research questions proposed to be answered with the study data thus there was no primary outcome.Conclusions: As noted previously, there were no primary outcomes determined at the start of the study. Research questions included examination of co-morbidities, healthcare utilization, and patient reported outcomes. Key findings from the Registry include:Executive dysfunction, learning difficulties, and poor comprehension significantly associated with poor activities of daily living skills. Executive dysfunction also associated with HU non-adherence. Continuing HU after conception increased odds of miscarriage or stillbirth compared to women who were not using HU. Continuing HU after conception increased odds of low birth weight in infants. Compared to adolescents, young adults had significantly more severe pain, organ dysfunction, mental health disorders, sleep problems, and barriers to medical care. Young adults were significantly less likely to see a sickle cell specialist in the past 2 years. Females had higher pain frequency and severity, more pain episodes, anxiety, depression, hospitalizations, and higher fetal hemoglobin levels. Males had more respiratory, musculoskeletal, genitourinary, and cardiovascular complications, more skin ulcers, and more use of HU. Among 128 subjects that died during the study period, iron overload, pulmonary hypertension, and depression, were significant predictors of the risk of death in multivariate analyses.

  Study phs004203

• A common single nucleotide variant in T is strongly associated with chordoma

  Chordoma is a rare malignant bone tumor that expresses the transcription factor T. We conducted an association study of 40 patients with chordoma and 358 ancestry-matched, unaffected individuals with replication in an independent cohort. Whole-exome and Sanger sequencing of T exons reveals a strong risk association ( allelic odds ratio (OR) = 4.9, P = 3.3x10-11, CI= 2.9-8.1) with the common (minor allelic frequency &gt;5%) non-synonymous SNP rs2305089 in chordoma, which is exceptional in cancer genetics.

  Dataset EGAD00001000226

• Genomic characterization of co-existing biliary tract intraepithelial neoplasia and carcinoma lesions reveals distinct evolutionary paths of gallbladder cancer

  Gallbladder carcinoma is the most common cancer of the biliary tract with dismal survival largely due to delayed diagnosis. Biliary tract intraepithelial neoplasia (BilIN) is the common benign tumor that is suspected to be precancerous lesions. However, the genetic and evolutionary relationships between BilIN and carcinoma remain unclear. Here we performed whole-exome sequencing of coexisting low-grade BilIN (adenoma), high-grade BilIN, and carcinoma lesions, and normal tissues from the same patients.

  Dataset EGAD00001007792

• PROGRESS/ELEMENT DNA Methylation Study

  An extension to the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) birth cohort of Mexico City, the Programming Research in Obesity, GRowth, Environment and Social Stress (PROGRESS) Cohort is an ongoing longitudinal pre-birth cohort, established in 2006 in Mexico City, partnering Icahn School of Medicine at Mount Sinai with Harvard University and the National Institute of Public Health in Mexico, which was designed to study the effects of prenatal exposure to toxic metals, air pollution, phthalates, and stress on childhood development. Pregnant women of 18 years of age and older, pregnant for less than 20 weeks of gestation, had no documentation of heart or kidney disease, no use of steroids or anti-epilepsy drugs, no daily alcohol consumption, had telephone access, and planned to live in Mexico city for the following 3 years, and receiving care through the Mexican Social Security System were initially enrolled (n=1,054). In addition to clinical, demographic and exposure data collected, cord blood was collected to interrogate DNA methylation across the genome for over 300 mother-child dyads. Clinical assessments and exposures were captured during several life stages, including prenatal, infant (0-1 year), youth (1-18 years), and adulthood (mother). The PROGRESS cohort added well-documented phenotyping of children for obesity, metabolic dysfunction, respiratory outcomes, and cardiovascular outcomes, as well as measures of air pollutant, personal care/consumer product, non-chemical stress, and metal mixture exposures. No clinical trials were conducted in this cohort. The data collected in this study should provide a unique resource to investigate DNA methylation as it relates to several environmental exposures and adverse cardiometabolic and neurocognitive health in mothers and children from a prospective birthing cohort. For access to demographic, clinical, and exposure data please directly contact study principal investigators.

  Study phs002754

• Uncovering RNA Signatures of C9orf72-Linked ALS and Related Disorders

  Substantial clinical and pathological variability has been reported in patients carrying an expanded repeat in C9orf72, who are generally diagnosed with amyotrophic lateral sclerosis (ALS) and/or frontotemporal dementia (FTD). Emerging evidence suggests that C9orf72 expression, RNA foci, and dipeptide-repeat proteins contribute to C9orf72-related diseases; however, the majority of the clinicopathological variability remains unexplained. We hypothesize that RNA sequencing (RNA-Seq) might reveal individual genes or groups of highly correlated genes (modules) that could account for this variability, which may help to identify much-needed druggable targets and/or biomarkers. Our preliminary studies performed in the frontal cortex, where we compared C9orf72 expansion carriers to (disease) controls, demonstrated that the top differentially expressed gene was C9orf72 itself. We also noticed that differentially expressed genes were enriched for the endocytosis pathway, which is consistent with the reported function of the C9orf72 protein in vesicle trafficking. Furthermore, we detected a module enriched for vesicular pathways, and additionally, we discovered an association with survival after onset for several promising candidates involved in vesicular transport. To find new therapeutic targets and biomarkers, here we have completed RNA-Seq on an increased number of samples to examine another relevant region: the cerebellum. As such, we performed RNA-Seq on a well-characterized cohort of C9orf72 expansion carriers, patients without this expansion, and control subjects without neurological diseases. We used multivariable linear regression models for gene-level analysis, weighted correlation network analysis for module-level analysis, and leafcutter for splicing analysis. Using the cerebellar RNA-Seq data, we found a large number (&gt;6,000) of differentially expressed genes, with a notable increase in expression of homeobox genes in C9orf72 expansion carriers, as well as many gene modules that were associated with C9orf72 expansion status. Additionally, using leafcutter, we detected over 1,000 differential splicing events and an increase in the number of cryptic splicing events in C9orf72 expansion carriers.

  Study phs003065

• A Phase 2 Study of Tipifarnib in Large Granular Lymphocyte (LGL) Leukemia

  LGL leukemia can be divided into three subsets including the following: &#945;&#946; or &#947;&#948;T-LGL and NK-LGL leukemia. All three subtypes will be enrolled using a two-stage design. The primary endpoint of the study is assessment of overall clinical response. Correlative laboratory studies will be performed aimed at determining the mechanism of response to treatment. Thirteen participants will be accrued in the first stage at a dose of 300 mg BID administered intermittently every other week (i.e., 7 days on and 7 days off). If there are two or more responders, the protocol will be extended to a second stage of the study and accrual will be extended to 25 evaluable participants. Allowing for 10% rate of ineligibility due to unexpected events and dropout, we will accrue 14 patients in the first stage and 27 patients in total. Participants that withdraw from the study for reason unrelated to toxicity, will be replaced. There are two potential stopping rules for toxicity. If 3 or more participants out of the 13 enrolled in the first stage experiences grade IV neurotoxicity, the study will be stopped due to excessive toxicity. Dose reductions have been incorporated for hematologic toxicity. Treatment of T and NK LGL leukemia with immunosuppressive agents such as low-dose methotrexate generally require from four to six months for a clinical response and sometimes much longer. Therefore, in participants who show clinical improvement with less than grade three toxicity, tipifarnib treatment will be continued for as many as four additional months (12 months total). After the first 8 months, response will be assessed. The protocol treatment will be discontinued in participants with progression of disease. A long-term follow up will be performed for five years in patients that receive a complete clinical response. The long-term follow up will consist of vital signs, weight, CBCs, serum chemistries, and physical examination at six month intervals.

  Study phs000594

• Washington University PDX Development and Trial Center

  This data set is a collection of patient specimens from common and rare cancers that have been developed into patient-derived xenograft (PDX) models at the Washington University PDX Development and Trial Center (WU-PDTC). The goal of the PDTC is to develop and characterize PDX models, gaining insight into tumor biology, and validating biomarkers across all major tumor types. Pre-clinical experiments in these PDX models will be used to advance our ability to predict clinical responses to new molecularly targeted agents under development.

  Study phs002305

• Ballett

  TSO500 study: The project, called "BALLETT" (Belgian Approach of Local Laboratory Extensive Tumor Testing), has a double goal: (1) show the relevance of broad molecular profiling to improve oncological patients care, (2) demonstrate that broad molecular testing can be performed in a decentralized setting by local diagnostics laboratories in a fully standardized and uniform way while complying with the highest quality standards. NCT05058937 The publication number is: Your manuscript ID is bcr-2023-256124. Title: CUP and BRAF V600E meeting the BEACON combination.

  Study EGAS50000000478

• Transcriptome and epigenomic landscape of cytotrophoblasts from normal and HDP placentas

  Hypertensive isorders of pregnancy (HDP) is a severe pregnancy-related disorder that poses significant risks to both maternal and fetal health. Dysfunctional placental development is one of the major contributors to the onset of HDP. In this study, we investigated the gene expression and epigenomic modifications in cytotrophoblasts from normal and HDP placentas. The information obtained in this study contributes to the growing body of knowledge aimed at improving the diagnosis, management, and treatment of HDP.

  Study JGAS000667

• PEVOsq

  The PEVOData PEVOsq basket trial is an open-label, multi-center, phase II trial investigating the combination of pembrolizumab (an immune checkpoint inhibitor) with vorinostat (a histone deacetylase inhibitor). This trial focuses on treating patients with recurrent or metastatic squamous carcinomas, including cancers of the cervix, head and neck, anus, vulva/vagina, penis, and lung. The aim is to evaluate the efficacy and safety of this combination, with pembrolizumab administered every 3 weeks and vorinostat daily. Outcomes include overall response rate and progression-free survival.

  Study EGAS50000000731

• Metabolomic and transcriptomic analyses identify metabolic alterations and immune suppression in ovarian cancer

  The objective of this study is to identify metabolic alterations and related phenotypes specific to ovarian cancer by performing metabolomic analysis of plasma and tissue samples. In addition, transcriptomic analysis is conducted to investigate the relationship between metabolic status and immune-related gene expression. By integrating metabolomic and transcriptomic data, this study aims to clarify how metabolic reprogramming contributes to tumor progression and immune suppression, particularly the reduction of natural killer (NK) cell activity, in ovarian cancer.

  Study JGAS000831

• Regions of common inter-individual DNA methylation differences in human monocytes.

  Based on whole genome bisulfite sequencing of five human monocytes from unrelated individuals, we have identified regions of common inter-individual DNA methylation differences, where methylation is inversely correlated with active histone marks, but not with the expression of the associated genes. Genome-wide association studies in 1128 individuals show that allelic DNA methylation is caused by genetic variation in cis. At some loci, DNA methylation appears to be affected also by genetic variation in trans.

  Study EGAS00001002265

• Next generation sequencing of sporadic schwannomatosis samples

  Schwannomatosis (MIM #162091) is characterized by the development of multiple schwannomas without vestibular nerve involvement (which is a characteristic of neurofibromatosis type 2 - NF2). In an effort to detect novel genetic alterations predisposing to schwannomatosis, we sequenced eight tumor-blood DNA pairs from de novo schwannomatosis patients. The results of our study are present in the paper "Whole exome sequencing reveals that the majority of schwannomatosis cases remain unexplained after excluding SMARCB1 and LZTR1 germline variants" published in Acta Neuropathologica (PMID:25008767)

  Study EGAS00001000767

• Genetic landscape of relapsed DLBCL

  Diffuse large B-cell lymphoma is a heterogenous malignancy that can arise de novo or can result from histologic transformation from indolent lymphomas. Considerable sequencing effort has been placed on determining the mutations that are common at the time of diagnosis in DLBCL but little is known about the nature of relapsed disease. We have sequenced tumour and matched normal exomes of 38 rrDLBCL patients including 25 de novo DLBCLs and 13 transformed lymphomas to identify somatic mutations and copy number alterations associated with relapse.

  Study EGAS00001001553

• Assessment_of_genetic_and_epigenetic_variation_in_human_IPS_cells

  In order to progress human induced pluripotent stem cells (hiPSCs) towards the clinic, several outstanding questions must be addressed. It is possible to reprogram different somatic cell types into hiPSCs but it is unclear whether some cell types carry through fewer mutations through reprogramming (either due to mutations present in the primary cells, or mutations accumulated during reprogramming). Through in depth analysis of hiPSCs generated from different somatic cells, it will be possible to assess the variation in genetic stability of different cell types.

  Study EGAS00001000231

• Celiac disease-specific intestinal T cells analyzed with HLA-class II tetramers, RNA-seq and mass cytometry have a narrow, autoimmune-associated phenotype

  Celiac disease (CD) is an HLA-DQ2/8-associated autoimmune enteropathy driven by activation of gluten-specific CD4+ T lymphocytes upon gluten consumption. Much less is known about the phenotype and function of these cells or their correlation, if any, to disease-relevant cells in other autoimmune disorders. Here we use mass cytometry and RNA seq to show that gluten-specific blood and gut T cells occupy a small and phenotypically distinct T-cell subset.

  Study EGAS00001003017

• Genomic profiling of paediatric glioma cell lines

  Although paediatric gliomas resemble their adult counterparts in many ways, there appear to be distinct clinical and biological differences. One important factor hampering the development of new targeted therapies is the relative lack of cell lines derived from childhood glioma patients, as it is unclear whether the well-established adult lines commonly used are representative of the underlying molecular genetics of childhood tumours. We have carried out a detailed molecular profiling of paediatric glioma cell lines KNS42, SF188, UW479, RES259 and RES186.

  Study EGAS00001003006

• Assessment_of_genetic_and_epigenetic_variation_in_human_IPS_cells

  In order to progress human induced pluripotent stem cells (hiPSCs) towards the clinic, several outstanding questions must be addressed. It is possible to reprogram different somatic cell types into hiPSCs but it is unlcear whether some cell types carry through fewer mutations through reprogramming (either due to mutations present in the primary cells, or mutations accumulated during reprogramming). Through in depth analysis of hiPSCs generated from different somatic cells, it will be possible to assess the variation in genetic stability of different cell types.

  Study EGAS00001000492

• Multiomic profiling of pleomorphic rhabdomyosarcoma

  Rhabdomyosarcoma (RMS) describes rare soft-tissue tumors that exhibit features of skeletal muscle differentiation. The most common subtypes in children are alveolar and embryonal rhabdomyosarcoma, with the alveolar subtype characterized by PAX3/7 fusions. A lesser known and rarer subtype, pleomorphic rhabdomyosarcoma (PRMS), occurs most frequently in adults vetween the ages of 40 and 50. This pleomorphic subtype is often misdiagnosed and little is known about its molecular characterization. Here, we conducted comprehensive genomic, transcriptomic, and methylation profiling of these tumors.

  Study EGAS00001007230

• Variant calling dataset from the whole-exome study of familial pulmonary fibrosis in the Canary Islands-VCF files

  Sequence reads were obtained from a set of 13 families with familial pulmonary fibrosis in the Canary Islands, Spain, using Illumina paired-end reads, respectively, at the Institute of Technology and Renewable Energy (ITER). Briefly, we used bcl2fastq v2.18 to perform sample demultiplexing and BWA-MEM v0.7.15 (https://github.com/lh3/bwa) to align reads to GRCh37/hg19 reference. Resulting BAM files were assessed with SAMtools v1.3 (http://www.htslib.org) and Picard v2.10.10 (https://broadinstitute.github.io/picard/) for quality control steps. Small insertions/deletions (< 50 bp) and single nucleotide variants (SNVs) were identified using an in-house bioinformatics pipeline based on GATK HaplotypeCaller v3.8 (https://gatk.broadinstitute.org/hc/en-us/articles/360037225632-HaplotypeCaller). This pipeline follows the Best Practices recommendations for germline variant calling and its description is publicly available (https://github.com/genomicsITER/benchmarking/tree/master/WES).

  Dataset EGAD50000001152

• Profiling molecular heterogeneity in human primary microglia

  In the brain the cells that control inflammation are called a type of white blood cell called microglia. Microglia are located throughout the brain and spinal cord and account for 10–15% of all cells found within the brain. As the resident white blood cells, they are the main active immune defence in the central nervous system (CNS). Microglia are part of an important class of cells known as macrophages that have two main states: M1 and M2. M1 cells are pro- inflammatory, leading to more inflammation, while M2 are anti-inflammatory, and drive wound healing. In this study, we will collect primary microglia from surgical biospies of 100 individuals. This data is part of a pre-publication release. For information on the proper use of pre-publication data shared by the Wellcome Trust Sanger Institute (including details of any publication moratoria), please see http://www.sanger.ac.uk/datasharing/

  Dataset EGAD00001005736

• WES data for Early evolutionary branching across spatial domains predisposes to clonal replacement under chemotherapy in neuroblastoma

  Neuroblastoma (NB) is one of the most lethal childhood cancers due its propensity to treatment resistance. By spatial mapping of subclone geographies before and after chemotherapy across 89 tumor regions from 12 NBs, we find that densely packed territories of closely related subclones present at diagnosis are replaced under effective treatment by islands of distantly related survivor subclones, originating from a different most recent ancestor compared to lineages dominating before treatment. Conversely, in tumors that progressed under treatment, ancestors of subclones dominating later in disease are present already at diagnosis. Chemotherapy treated xenografts and cell culture models replicates these two contrasting scenarios and shows branching evolution to be a constant feature of proliferating NB cells. Phylogenies based on whole genome sequencing of 505 individual NB cells indicate that a rich repertoire of parallel subclones, emerges already with the first oncogenic mutations and lays the foundation for clonal replacement under treatment.

  Dataset EGAD00001015413