Integrative methods, like colocalization and transcriptome-wide association studies (TWAS), identify transcriptomic mechanisms at only a small fraction of trait-associated genetic loci from genome-wide association studies (GWAS). Here, we show that a reliance on reference functional genomics panels of only total gene expression greatly contributes to this reduced discovery. This is particularly relevant for neuropsychiatric traits, as the brain expresses extensive, complex, and unique alternative splicing patterns giving rise to multiple genetically-regulated transcript-isoforms per gene.
We introduce isoTWAS, a scalable, multivariate framework to integrate genetics, isoform-level expression, and phenotypic associations in a step-wise testing framework. Multivariate predictive models were trained using isoform-level expression across tissues from the Genotype-Tissue Expression Project and in the developing and adult human brain from PsychENCODE. Across five neuropsychiatric traits, isoTWAS dramatically increased discovery of trait associations within GWAS loci, capturing 92 unique loci compared with 27 using gene-level TWAS. These power gains reflected a ~2-fold increase in the number of testable genes, an ~15-35% increase in total gene expression prediction accuracy, and the ability to jointly capture expression and splicing mechanisms. Results from extensive simulations showed no increase in false discovery rate and reinforce isoTWAS's advantages in prediction and trait mapping power over TWAS, especially when genetic effects on expression vary across isoforms of the same gene. We illustrate multiple biologically-relevant isoTWAS-identified trait associations undetectable by gene-level methods, including isoforms of AKT3, GIGFY2, and KMT5A with schizophrenia risk.
The isoTWAS framework addresses an unmet need to consider the transcriptome on the transcript-isoform level to maximize discovery of trait associations, especially for brain-relevant traits.