Summary Large-scale reference data sets of human genetic variation are critical for the medical and functional interpretation of DNA sequence changes. We describe the aggregation and analysis of high-quality exome (protein-coding region) sequence data for 60,706 individuals of diverse ethnicities generated as part of the Exome Aggregation Consortium (ExAC). This catalogue of human genetic diversity contains an average of one variant every eight bases of the exome, and provides direct evidence for the presence of widespread mutational recurrence. We have used this catalogue to calculate objective metrics of pathogenicity for sequence variants, and to identify genes subject to strong selection against various classes of mutation; identifying 3,230 genes with near-complete depletion of truncating variants with 72% having no currently established human disease phenotype. Finally, we demonstrate that these data can be used for the efficient filtering of candidate disease-causing variants, and for the discovery of human “knockout” variants in protein-coding genes.

As this was an opportunistic secondary use study, we did not recruit any participants.

As the sequencing of healthy and disease genomes becomes more commonplace, detailed annotation provides interpretation for individual variation responsible for normal and disease phenotypes. Current approaches focus on direct changes in protein coding genes, particularly nonsynonymous mutations that directly affect the gene product. However, most individual variation occurs outside of genes and, indeed, most markers generated from genome-wide association studies (GWAS) identify variants outside of coding segments. Identification of potential regulatory changes that perturb these sites will lead to a better localization of truly functional variants and interpretation of their effects. We have developed a novel approach and database, RegulomeDB, which guides interpretation of regulatory variants in the human genome. RegulomeDB includes high-throughput, experimental data sets from ENCODE and other sources, as well as computational predictions and manual annotations to identify putative regulatory potential and identify functional variants. These data sources are combined into a powerful tool that scores variants to help separate functional variants from a large pool and provides a small set of putative sites with testable hypotheses as to their function. We demonstrate the applicability of this tool to the annotation of noncoding variants from 69 full sequenced genomes as well as that of a personal genome, where thousands of functionally associated variants were identified. Moreover, we demonstrate a GWAS where the database is able to quickly identify the known associated functional variant and provide a hypothesis as to its function. Overall, we expect this approach and resource to be valuable for the annotation of human genome sequences. [Supplemental material is available for this article.]The increasing number of sequenced human genomes is providing a catalog of the large number of individual variations present in the human genome (The International HapMap Consortium 2005; The 1000 Genomes Project Consortium 2010). Many of these variants are expected to be responsible for normal and disease phenotypes. Similarly, large, genome-wide association studies (GWAS) continue to map diseases to associated genomic regions from large cohorts of individuals (Hindorff et al. 2012). Initial interpretation of results generated by both of these approaches has been limited to DNA regions that cause disruption of gene function through coding sequence changes typically identified using an application such as PolyPhen-2 (Adzhubei et al. 2010). However, ;95% of known variants within sequenced genomes and 88% of those variants from GWAS studies fall outside of coding regions and have been difficult to interpret ).Both large consortia and individual labs are generating a significant amount of regulatory information that is providing a better interpretation of the noncoding portions of the genome. The ENCODE Project, in particular, has mapped open chromatin and protein binding regions for large numbers of factors across many cell type...