From Population and Personalized to Personalized/Precision Medicine Manolis Dermitzakis

University of Geneva Dept Genetic Medicine and Development University of Geneva Medical School and Swiss Institute of Bioinformatics

[email protected]

http://funpopgen.unige.ch/ Our “engine” Revoluon in Medicine

• Advances in technology

• Deep learning of human Complex traits/disease

Space&

Time&

Popula'on)of)cells) Individual)cells)

)

GENE)A)

Modified from Dermitzakis Nat Genet 2008 HapMap: cataloguing “common” genec variaon

HapMap Consortium 2005 1000 genomes: cataloguing “all” genec variaon Genome-Wide association studies (GWAS) Gene expression as a key molecular phenotype – expression QTL (eQTL) analysis

1Mb$ TSS$ 1Mb$ 1Mb$window$

RNAseq$ gene$ SNPs$ cis$

trans$ eQTL$ Molecular"phenotype"

AA" AC" CC" Funconal variaon to organismal phenotype

GENETIC ASSOCIATION IS A CAUSAL LINK

1Mb$ TSS$ 1Mb$ 1Mb$window$

RNAseq$ gene$ SNPs$ Space& cis$ Interpretation of GWAS using molecular QTLs trans$ eQTL$ Time& eQTLs Molecular"phenotype" 1Mb TSS 1Mb AA" AC" CC" 1Mb window Mechanistic RNAseq insights to gene SNPs Genetic variation Methylation

Chromatin Background Rationale

Genome-wide association studies (GWAS) have identified hundreds of common DNA variants associated with multiple complex diseases and traits.

~90% of GWAS SNPs lie in noncoding regions (e.g. intergenic, introns). Associated (tag) SNP (*) Chr *

Genes * Causal mechanism? Causal gene/s? Many studies show trait-associated SNPs enriched for eQTLs

LCL eQTLs

LCL eQTLs

Peripheral blood monocyte, liver and adipose eQTLs Challenges in using eQTLs to interpret disease associations

- Measuring eQTLs in disease-relevant tissues or cell types

- Most human tissue types are hard to obtain

- Large sample sizes are required for statistical power Causal ssue inference

Associated"(tag)"SNP"(*)" Associated"(tag)"SNP"(*)" Chr" *" Chr" *"

Genes" *" Genes" *"

Genes" *" Genes" *" GTEx GOALS: • Atlas (database) of gene expression, regulaon, and eQTLs from a wide range of non-diseased human ssues • Biobank of ssues, DNA, RNA

ULTIMATE STUDY SIZE (by 1/2016): - 900 Postmortem Donors - Whole exome sequencing - Whole genome sequencing - RNA-Seq of ~30 ssues/donor (>20,000 ssues) PILOT PHASE (in 2010): - 175 Postmortem Donors - 1641 RNA-Seq of ~28 ssues/donor GTEx eQTL discovery Link eQTLs to GWAS Tissue acvity of GWAS in mulple ssues

40 33 20 31 24 47 22 28 24 27 26 29 30 20 22 27 37 22 43 26 30 29 45 40 28 34 25 41 41 48 24 29 29 23 36 44 15 28 31 37 41 23 16 42 body height 29 23 24 31 24 36 10 17 22 26 15 21 13 14 15 22 29 16 41 14 34 20 35 28 24 32 21 29 34 41 13 24 23 15 32 37 15 26 24 34 40 20 21 39 body mass index 27 21 20 32 25 40 10 20 26 25 15 26 19 11 16 33 32 15 41 13 32 22 37 28 25 31 21 30 37 42 12 23 25 17 34 37 7 30 27 36 38 22 21 36 body weight 27 19 20 29 21 40 11 18 24 24 14 25 15 12 15 32 31 15 42 12 31 21 35 27 24 30 20 28 35 39 10 22 24 16 33 38 5 27 26 35 38 12 17 31 lean body mass 62 35 38 49 16 56 20 29 28 42 27 31 30 17 16 19 35 30 49 28 35 28 46 42 36 47 28 43 59 55 39 46 20 38 43 49 13 33 41 51 57 13 16 42 schizophrenia 51 46 36 48 38 57 41 36 31 35 43 53 36 27 39 25 38 45 44 42 55 49 39 54 37 41 39 56 52 63 37 41 36 38 50 53 47 55 41 47 54 45 32 58 rheumatoid arthritis 49 26 21 33 31 48 33 38 27 37 15 33 15 26 23 20 31 27 27 33 33 20 48 41 48 27 25 48 42 45 21 23 31 19 39 50 26 25 17 42 45 50 20 41 crohn's disease 54 34 44 55 38 57 20 27 26 30 23 28 38 25 14 17 42 28 53 37 46 29 44 48 31 51 24 43 51 43 41 33 22 38 39 48 28 33 39 44 58 23 29 33 bipolar disorder 45 43 44 48 52 39 44 33 44 43 47 57 31 44 35 38 49 36 36 39 38 47 49 45 49 43 38 55 56 54 23 48 41 33 36 43 32 37 45 39 62 36 26 55 multiple sclerosis 53 44 24 31 21 54 18 32 39 36 29 38 27 21 35 38 36 41 45 36 40 38 45 44 32 30 24 48 35 56 23 38 25 29 43 57 28 21 36 36 51 30 33 55 anthropometry 46 41 27 40 31 45 13 12 21 28 24 12 27 33 13 25 41 31 45 13 24 23 38 32 29 23 24 39 35 47 28 28 19 33 34 33 8 26 15 43 43 25 43 54 coronary heart disease 43 32 20 22 7 42 22 21 10 15 21 6 0 0 7 9 24 24 31 43 24 17 21 25 50 36 43 30 32 40 8 35 14 0 22 28 40 21 29 37 39 0 0 41 type ii diabetes mellitus 49 34 38 51 35 55 29 38 32 30 33 45 38 40 35 47 39 33 52 32 50 48 31 35 45 30 15 56 46 40 50 39 36 31 40 48 30 35 32 41 40 38 38 53 inflammatory bowel disease 34 22 22 33 15 36 0 14 17 28 6 12 9 0 7 12 22 11 26 6 23 10 39 22 14 13 15 41 38 31 0 22 6 0 26 28 12 0 24 33 39 0 0 26 breast carcinoma 21 21 25 25 12 26 22 14 29 27 25 27 33 17 21 33 37 12 57 22 27 33 32 41 29 28 7 30 38 31 7 12 29 15 31 32 11 20 22 18 35 25 33 37 alzheimer's disease 55 67 48 45 37 63 29 48 41 47 41 31 27 33 54 38 54 38 64 37 48 35 49 63 56 55 22 56 60 57 35 50 44 32 46 65 28 48 51 51 50 67 54 67 ulcerative colitis 50 35 29 30 36 43 30 38 40 22 47 50 100 29 19 12 42 35 42 38 33 33 53 44 25 52 30 41 35 41 20 41 25 40 28 41 30 43 37 20 32 29 0 44 prostate carcinoma 47 44 57 42 43 55 42 38 23 39 30 26 50 43 26 60 47 48 51 38 50 42 54 44 39 43 53 57 66 61 14 39 32 53 59 62 33 41 48 38 43 43 57 46 systemic lupus erythematosus 36 28 35 49 14 42 15 41 30 36 27 25 33 29 20 12 26 29 45 25 36 30 46 54 36 44 29 34 44 63 44 41 7 45 46 50 23 13 46 55 59 14 33 36 attention deficit hyperactivity disorder 39 21 25 42 11 52 14 31 27 25 21 13 50 27 20 21 33 12 35 24 30 15 38 52 25 38 23 29 43 32 17 35 12 30 24 41 8 15 36 41 47 17 17 23 unipolar depression 47 55 25 31 35 52 30 19 12 32 11 17 33 9 17 20 44 50 55 31 42 25 39 50 35 46 10 34 46 51 40 29 23 27 34 32 25 57 41 31 57 14 33 43 asthma 65 61 48 60 33 63 33 56 20 42 38 20 22 22 46 36 52 43 57 59 44 74 35 76 59 56 33 81 42 61 55 46 29 54 44 66 27 53 39 61 58 40 20 63 type i diabetes mellitus 53 41 27 44 38 41 29 41 28 30 37 23 18 36 32 48 50 35 39 45 37 64 35 42 40 43 21 46 53 54 22 40 12 10 34 53 18 35 39 37 49 20 29 41 parkinson's disease 41 12 0 38 0 35 0 17 8 33 25 33 50 0 0 20 15 12 47 21 15 11 24 29 13 25 14 43 19 21 0 7 0 0 17 32 0 0 17 21 29 0 0 30 colorectal cancer 27 7 20 17 10 40 0 0 29 12 50 0 0 0 0 0 8 0 6 11 18 22 20 28 30 42 0 17 46 16 0 12 0 25 18 23 0 0 0 17 20 0 33 23 migraine disorder 26 17 33 26 21 43 0 33 20 25 20 12 0 17 10 0 25 25 33 21 28 7 26 26 29 22 0 20 25 11 20 25 8 25 24 35 25 18 25 25 42 25 0 17 coronary artery calcification 56 33 67 44 57 43 33 36 27 18 43 50 30 44 29 36 71 50 62 33 39 45 59 47 42 47 46 42 50 45 22 54 77 58 67 58 80 33 62 52 57 0 0 57 psoriasis 38 21 13 11 29 39 0 22 23 38 15 22 29 29 25 29 20 9 12 17 19 8 41 25 8 27 71 25 35 39 25 27 8 0 29 38 0 0 21 35 44 0 0 7 chronic kidney disease 18 46 33 25 0 33 25 14 33 11 25 17 33 33 14 17 33 12 38 22 31 40 33 12 21 29 0 39 11 21 27 13 0 17 23 18 25 17 18 37 50 0 11 31 venous thromboembolism 25 25 25 22 31 41 22 22 18 33 20 11 33 12 17 17 25 40 41 29 24 45 30 35 38 24 33 24 38 29 17 41 43 11 29 30 20 20 29 25 47 40 11 43 chronic obstructive pulmonary disease 25 11 29 29 40 64 33 50 20 25 0 20 40 50 33 33 20 0 33 29 30 33 18 27 20 22 40 31 18 42 0 0 0 33 22 25 0 10 20 17 13 0 0 38 celiac disease 25 36 50 33 17 27 0 67 33 30 0 67 0 33 0 20 25 60 46 12 31 15 58 27 15 18 11 50 23 25 0 18 20 67 14 31 0 0 27 42 50 0 0 18 metabolic syndrome 13 14 20 27 14 19 0 29 17 20 33 0 25 0 17 0 11 17 35 0 33 0 40 14 36 25 0 23 47 25 17 12 25 0 36 35 20 20 33 42 56 0 0 31 alcohol dependence 47 44 47 54 70 53 71 38 100 23 33 22 12 40 33 25 60 62 39 60 67 40 65 56 73 53 75 41 69 72 50 43 75 88 53 59 75 50 67 43 56 50 0 77 chronic lymphocytic leukemia 35 50 33 33 33 22 0 0 12 20 0 0 0 25 0 0 43 0 14 14 10 10 50 29 14 17 0 46 25 50 0 18 0 0 33 27 0 0 12 0 50 0 0 20 hypertension 33 8 0 15 11 33 0 0 0 0 0 0 0 0 0 0 9 22 36 0 7 11 14 21 0 31 29 31 20 57 14 8 0 0 25 14 0 0 0 27 27 0 0 18 stroke 47 55 40 46 58 33 80 29 29 25 33 60 0 60 17 50 45 64 24 38 58 40 47 44 30 58 38 64 36 32 17 33 33 14 45 57 22 50 54 31 57 60 25 59 biliary liver cirrhosis 17 9 20 50 0 44 0 25 43 22 0 0 0 0 0 0 12 20 20 0 17 0 11 33 43 38 0 50 43 36 0 33 17 0 29 44 0 12 0 67 18 0 100 60 obesity 38 23 33 31 22 33 25 27 30 18 18 30 29 22 22 29 20 43 50 29 38 25 53 31 42 33 40 43 42 42 75 38 40 50 27 46 50 40 50 33 38 67 67 45 lung carcinoma 44 33 0 57 25 43 0 25 20 20 20 20 25 33 20 50 33 0 50 25 29 33 67 38 17 25 0 30 50 25 0 40 25 67 17 50 25 0 29 20 50 0 0 33 mental or behavioural disorder 62 50 40 62 100 73 100 20 25 20 50 60 50 67 25 25 71 50 42 25 43 50 45 38 50 50 20 80 56 50 33 57 25 0 33 40 40 25 40 45 44 50 0 50 allergy 11 40 0 25 0 0 0 0 0 14 0 0 0 0 0 0 0 25 38 0 0 0 0 17 50 17 0 17 12 40 0 33 50 0 0 33 0 0 20 29 17 0 0 50 sporadic amyotrophic lateral sclerosis 36 50 50 44 50 56 20 29 25 43 38 60 67 50 33 67 43 40 88 67 38 71 62 62 57 50 60 56 50 67 40 57 0 50 57 55 50 60 50 45 40 40 50 55 longevity 62 75 67 70 50 56 50 44 50 62 43 43 80 43 50 50 50 44 62 57 67 67 58 45 86 86 43 58 50 73 57 33 40 60 60 50 75 71 60 38 64 60 83 64 graves disease 67 20 20 60 40 50 0 0 0 0 0 0 0 0 0 0 33 67 43 0 20 0 43 60 17 0 50 60 33 80 0 25 0 0 33 40 0 0 0 60 33 0 0 20 large artery stroke 90 86 67 89 60 89 80 33 60 75 83 83 80 67 83 60 78 75 40 80 86 88 83 75 83 56 60 80 67 91 60 75 100 88 40 67 50 50 71 50 90 40 33 64 narcolepsy 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 33 0 14 0 0 0 0 0 0 25 0 0 25 43 0 0 0 0 0 20 0 0 0 20 0 0 0 0 sudden cardiac arrest 75 0 14 29 0 71 0 0 43 50 0 17 0 100 0 0 25 50 30 0 50 0 22 14 14 0 0 57 12 22 0 67 40 100 22 33 0 0 50 11 11 0 0 43 intelligence 17 40 20 33 33 50 25 20 25 0 20 0 40 25 20 33 25 0 33 50 60 0 50 20 29 20 25 40 43 50 33 0 33 100 40 33 25 0 40 83 40 0 50 20 pancreatic carcinoma 33 0 0 0 100 0 0 0 0 0 0 0 0 0 20 0 33 20 25 0 33 25 60 14 0 25 0 33 14 38 20 17 33 0 33 43 0 0 50 25 50 0 0 14 bladder carcinoma 50 0 43 62 0 50 0 0 40 29 14 0 0 0 20 0 12 40 43 33 25 0 44 50 0 25 0 25 40 62 0 38 0 14 44 50 33 33 50 40 12 0 0 80 testicular carcinoma 44 17 17 38 0 20 0 25 33 33 67 0 0 0 0 0 20 33 56 50 50 0 38 25 33 33 0 33 29 62 100 0 0 33 33 44 0 33 29 38 30 0 100 44 mucocutaneous lymph node syndrome 80 60 75 100 0 100 50 75 25 20 67 20 50 100 100 67 100 50 60 75 75 100 60 100 33 67 0 67 100 80 100 50 100 100 33 80 0 33 100 50 50 100 100 67 eosinophilic esophagitis 40 20 67 83 40 25 0 33 33 33 0 0 0 0 33 67 25 33 17 25 20 50 43 50 0 0 0 33 25 17 50 33 100 0 40 50 0 25 20 20 33 20 0 62 Behcet's disease 75 67 0 50 0 75 0 50 0 33 0 33 50 50 0 0 25 50 50 0 0 0 33 75 0 50 33 33 33 60 0 50 50 0 0 17 0 0 0 20 40 0 0 20 hypospadias 38 0 50 14 0 25 0 0 0 20 0 0 0 0 0 50 20 0 17 0 0 50 0 0 14 22 0 0 38 33 0 0 0 0 50 50 0 0 0 33 22 0 0 20 conduct disorder 71 33 50 60 50 71 67 67 100 50 50 50 100 67 50 67 83 50 50 33 75 75 57 43 50 40 75 67 40 57 33 50 40 50 67 57 67 100 60 38 67 67 50 50 lupus nephritis 43 14 14 14 20 44 0 0 0 20 20 0 0 20 0 0 43 0 14 0 67 0 50 57 20 0 0 38 0 43 0 75 0 20 50 60 50 29 20 50 50 0 0 17 acute lymphoblastic leukemia 20 0 25 17 0 62 0 25 20 25 0 20 67 67 33 33 0 0 25 20 40 33 29 43 33 17 50 33 40 50 33 0 0 0 0 50 0 0 25 40 33 0 0 0 immune system disease 50 50 20 33 50 40 50 50 50 100 50 50 0 0 0 0 50 33 29 33 33 33 40 20 33 50 50 33 50 50 0 50 0 0 75 67 0 100 50 50 40 0 0 50 squamous cell carcinoma 57 17 14 17 50 29 50 25 25 20 25 40 50 25 25 25 60 0 12 25 33 50 29 33 50 17 0 25 29 38 0 43 25 0 60 62 0 33 50 50 14 0 0 33 ovarian carcinoma Liver Lung Testis Ovary Uterus Vagina Spleen Thyroid Pituitary Prostate Stomach Pancreas Nerve_Tibial Artery_Tibial Artery_Aorta Brain_Cortex Whole_Blood Adrenal_Gland Colon_Sigmoid Muscle_Skeletal Artery_Coronary Brain_Cerebellum Colon_Transverse Brain_Hippocampus Esophagus_Mucosa Heart_Left_Ventricle Brain_Hypothalamus Esophagus_Muscularis Adipose_Subcutaneous Heart_Atrial_Appendage Breast_Mammary_Tissue transformed_lymphocytes Brain_Frontal_Cortex_BA9 − Adipose_Visceral_Omentum Brain_Caudate_basal_ganglia Cells_Transformed_fibroblasts Brain_Cerebellar_Hemisphere Brain_Putamen_basal_ganglia Skin_Sun_Exposed_Lower_leg Small_Intestine_Terminal_Ileum Skin_Not_Sun_Exposed_Suprapubic Cells_EBV Brain_Anterior_cingulate_cortex_BA24 Esophagus_Gastroesophageal_Junction Brain_Nucleus_accumbens_basal_ganglia Type II Diabetes ssue acvity

0.25" Adipose_Subcutaneous"

Adipose_Visceral_Omentum"

0.2" Adrenal_Gland"

Artery_Aorta"

Artery_Coronary"

Adipose0.15" sub Artery_Tibial"

Brain_Anterior_cingulate_cortex_BA24"

Brain_Caudate_basal_ganglia" 0.1" Brain_Cerebellar_Hemisphere"

Brain_Cerebellum"

Brain_Cortex" 0.05" Brain_Frontal_Cortex_BA9"

Brain_Hippocampus"

Brain_Hypothalamus" 0" 1"

Tibial Artery Brain Use of GTEx as reference

Multiple tissues (>50) Clinical phenotypes

GTEx

Imputation of expression values

Cohort

Blood, skin etc So what’s next? - Learning human biology - Implementing in Medicine From Population and Personal Omics to Personal Biology

Key components missing: - Interpretation of the non-coding genome - Rare and private variants - Rare and private environments - Context dependence

Molecular phenotype context:

- Tissue - Time - Disease - Sex - Genotype - Environment Learning Human Biology – Implementing in Medicine Research

Pharmacological intervention Lifestyle (genotype/biomarker intervention informed) Disease manifestation New discoveries: Pharmacological intervention Lifestyle (genotype/biomarker intervention - New drugs informed) - New drug combs Intermediate phenotypes indicating increased risk - New biomarkers (trxone, proteome, metabolome, current/future biomarkers) - Knowledge of lifestyle effects

Genome Exposures Lifestyle (by choice)

Clinical Trials Each patient a research project

Patient 1 Research Patient 2 Patient 3 Research Research

Chemical intervention Lifestyle (genotype/ intervention Chemical Chemical biomarker driven) intervention Lifestyle intervention Lifestyle Disease manifestation (genotype/ intervention (genotype/ intervention biomarker driven) biomarker driven) Chemical New discoveries: Disease manifestation Disease manifestation intervention Lifestyle New discoveries: New discoveries: (genotype/ intervention Chemical Chemical biomarker driven) - New drugs intervention Lifestyle intervention Lifestyle Intermediate phenotypes indicating increased risk - New drug combs (genotype/ intervention (genotype/ intervention biomarker driven) - New drugs biomarker driven) - New drugs (trxone, proteome, metabolome, current/future biomarkers) - New biomarkers Intermediate phenotypes indicating increased risk - New drug combs Intermediate phenotypes indicating increased risk - New drug combs - Knowledge of (trxone, proteome, metabolome, current/future biomarkers) - New biomarkers (trxone, proteome, metabolome, current/future biomarkers) - New biomarkers lifestyle effects - Knowledge of - Knowledge of lifestyle effects lifestyle effects Genome Exposures Lifestyle (by choice)

Genome Exposures Lifestyle (by choice) Genome Exposures Lifestyle (by choice) Vast majority unknown Largely unknown Largely known

Vast majority unknown Largely unknown Largely known Vast majority unknown Largely unknown Largely known

Clinical Trials Clinical Trials Clinical Trials

Patient 4 Research Patient 5 Research Patient i Research

Chemical Chemical Chemical intervention Lifestyle intervention Lifestyle intervention Lifestyle (genotype/ intervention (genotype/ intervention (genotype/ intervention biomarker driven) biomarker driven) biomarker driven) Disease manifestation Disease manifestation Disease manifestation Chemical New discoveries: Chemical New discoveries: Chemical New discoveries: intervention Lifestyle intervention Lifestyle intervention Lifestyle (genotype/ intervention (genotype/ intervention (genotype/ intervention biomarker driven) - New drugs biomarker driven) - New drugs biomarker driven) - New drugs Intermediate phenotypes indicating increased risk - New drug combs Intermediate phenotypes indicating increased risk - New drug combs Intermediate phenotypes indicating increased risk - New drug combs (trxone, proteome, metabolome, current/future biomarkers) - New biomarkers (trxone, proteome, metabolome, current/future biomarkers) - New biomarkers (trxone, proteome, metabolome, current/future biomarkers) - New biomarkers - Knowledge of - Knowledge of - Knowledge of lifestyle effects lifestyle effects lifestyle effects

Genome Exposures Lifestyle (by choice) Genome Exposures Lifestyle (by choice) Genome Exposures Lifestyle (by choice)

Vast majority unknown Largely unknown Largely known Vast majority unknown Largely unknown Largely known Vast majority unknown Largely unknown Largely known

Clinical Trials Clinical Trials Clinical Trials Relative investment of resources over time Revolution in medicine

Deep understanding of the variability of the human body GTEx Acknowledgments The$GTEx$Consortium$ ! Analysis$Working$Group:$$$ caHUB&Operations&Management:& LDACC:!Kristin!G.!Ardlie1,!Gad!Getz1,2,!David!S.!Deluca1,!Taylor!R.!Young1,! 45 45 Ellen!T.!Gelfand1,!Ayellet!V.!Segrè1,!Timothy!J.!Sullivan1,!Casandra!A.! Leidos&Biomedical&Research&Inc.!"!Anna!M.!Smith ,!Stephen!A.!Buia ,! Trowbridge1,!Daniel!G.!MacArthur1,3,!Julian!B.!Maller1,3,!Taru!Tukiainen1,3,! Anita!H.!Undale45,!Karna!L.!Robinson45,!Nancy!Roche45,!Kimberly!M.! Monkol!Lek1,3,!Manolis!Kellis1,4,!Lucas!D.!Ward1,4,!Pouya!Kheradpour1,4,! Valentino45,!Angela!Britton45,!Robin!Burges45,!Debra!Bradbury45,!Kenneth!W.! Joel!Hirschhorn1,5,!Yan!Meng1,!Cameron!D.!Palmer1,5.! Hambright45,!John!Seleski45,!Greg!E.!Korzeniewski45.! 6 9 8 6 UNC/NCSU!–!Andrew!B.!Nobel ,!Ivan!Rusyn ,!Fred!A.!Wright ,!Gen!Li ,!! ! Sapient&Government&Services&>!Kenyon!Erickson47.! Andrey!A.!Shablin7,!Yi[Hui!Zhou8.!! U$Geneva!–!Emmanouil!T.!Dermitzakis10,11,12,!Roderic!Guigo21,22,23,! Brain&Bank&Operations:& 48 48 Daphne!! ! University&of&Miami!–!Deborah!C.!Mash ,!Margaret!Basile ,!Yvonne!! Koller19,!Mark!I.!McCarthy16,17,18,!Tuuli!Lappalainen10,11,12,13,14,15,!Manuel!A.!! Marcus48,!Jorge!Tejada48,!Mehran!Taherian48,!Chunrong!Lu48,!Barnaby!E.! Rivas16,!Alexis!Battle19,20,!Sara!Mostafavi19,!Jean!Monlong21,22,24,!Pedro!G.!! Robles48.! Ferreira10,11,12,!Michael!Sammeth21,22,25,!Halit!Ongen10,11,12.!! & U$Chicago!–!Nancy!J.!Cox31,!Dan!L.!Nicolae31,!Eric!R.!Gamazon31,!Anuar!! Konkashbaev31.!! Program&Management:& 46,49 46,49 44,46 U$Chicago!–!Jonathan!K.!Pritchard26,27,28,!Matthew!Stephens26,35,!Timothée!! NCI!–!Latarsha!J.!Carithers ,!Helen!M.!Moore ,!Ping!Guan ,!Carolyn! Flutre26,!Xiaoquan!Wen30.! Compton46,49,!Sherilyn!J.!Sawyer44,46,!Joanne!Peter!Demchok44,46,!Jimmie!B.! Harvard!–!Jun!Liu32,!Jun!Zhu33,34,!Zhidong!Tu33,34,!Bin!Zhang33,34,!Tao!! Vaught44,46,!Chana!A.!Rabiner44,46,!Nicole!C.!Lockhart44,46.! Huang33,34,!Quan!Long33,34,!Luan!Lin33,34,!Jialiang!Yang33,34.!! NHGRI&–!Simona!Volpi46,50,!Jeff!Struewing46,50,!Gary!F.!Temple46,50,!Joy! ! Boyer46,51,!Deborah!Colantuoni46,50.! Biospecimen$and$data$collection,$processing,$quality$control,$storage,$and$ 46,52 46,53 pathological$review:$ NIMH&–!Roger!Little ,!Susan!Koester .! 46,54 caHUB$Biospecimen$Source$Sites:$$ NIH&OD!–!Leslie!K.!Derr .! NDRI![!Amanda!Brown36,!Bernadette!Mestichelli36,!Denee!Tidwell36,! ! Edmund!! Writing&Committee:!!Kristin!G.!Ardlie1,!Gad!Getz1,2,!Fred!A.!Wright8,!Manolis! Lo36,!John!T.!Lonsdale36,!Jeffrey!A.!Thomas36,!Mike!Salvatore36,!Saboor! Kellis1,4,!Simona!Volpi46,50,!Emmanouil!T.!Dermitzakis10,11,12.! Shad36.! Roswell$Park![!Christopher!Choi37,!Barbara!A.!Foster37,!Michael!T.! Moser37,!! Ellen!Karasik37,!Kimberly!Ramsey37,!Bryan!M.!Gillard37.! Albert$Einstein$Medical$Center!–!Nancy!Young38.! Gift$of$Life$Donor$Program![!Rick!Hasz39.! LifeNet$Health$–!Gary!D.!Walters40.! UNYTS!–!Jason!P.!Bridge41,!Mark!Miklos41,!Susan!Sullivan41.! caHUB$ELSI$Study:$ ! VCU![!Laura!A.!Siminoff42,!Laura!K.!Barker42,!Heather!Traino42,!Magboeba!! !!!!!!!!!!!!!Mosavel42.! caHUB$Comprehensive$Biospecimen$Resource:$ Van$Andel!–!Scott!Jewel43,!Daniel!C.!Rohrer43,!Dana!R.!Valley43.! caHUB$Pathology$Resource$Center:$ ! NCI![!Philip!Branton44,46.! ! Leidos$Biomedical$Research$Inc.$[!Leslie!H.!Sobin45.! caHUB$Comprehensive$Data$Resource:$ Leidos$Biomedical$Research$Inc.![!Charles!Shive45,!David!Tabor45,!Liqun! Qi45,!Pushpa!Hariharan45,!Shenpei!Wu45.! ! Acknowledgments

Vital-IT