“…For example, a typical gain-of-function enhancer variant can result in ectopic gene expression and cause pathogenic effects in cells where the enhancer is normally inactive (Claussnitzer et al, 2015; Doan et al, 2016; Eufrásio et al, 2020; Kvon et al, 2020; Lewis et al, 2014; Putlyaeva et al, 2017; Turner et al, 2017; Yanchus et al, 2022). Likewise, loss-of-function enhancer variants often result in loss of enhancer activity in one cell type, while in other cell types, its activity is unaffected (Bengani et al, 2021; Bhatia et al, 2015, 2021; Shin et al, 2023; Spieler et al, 2014). These cell-type-specific effects of enhancer variants are difficult to capture with high-throughput methods such as massively-parallel reporter assays (MPRAs) and CRISPR inhibitor/activator screens, both of which are primarily performed in vitro (Findlay, 2021; Inoue & Ahituv, 2015; Maricque et al, 2018) or in one tissue (Brown et al, 2022; Capauto et al, 2023; Deng et al, 2023; Lagunas et al, 2023; Patwardhan et al, 2012; White et al, 2013).…”