Bermudagrass (Cynodon spp.) breeding and cultivar development is hampered by limited information regarding its genetic and phenotypic diversity. A germplasm collection of 206 bermudagrass accessions from 29 countries was genotyped with high-throughput genotyping-by-sequencing technique. Genomic diversity in this diverse germplasm panel was assessed with multifaceted approaches including population structure, phylogenetic analysis, principal component analysis, and genetic diversity parameters. This study revealed substantial genetic variation in the Cynodon accessions, demonstrating the potential of this germplasm panel for further genetic studies and cultivar development in breeding programs. Another critical issue in turfgrass breeding is the lack of information regarding the genetic architecture of traits. Four agronomic traits leaf length, leaf width, internode distance and stem diameter were evaluated in a germplasm panel of common bermudagrass accessions. Then genome-wide association study was performed to dissect the genetic basis of the traits.

Flax (Linum usitatissimum L.) is a self-pollinated crop widely cultivated for fiber and oil production. Flaxseed is renowned for its health attributes but the presence of compounds, such as the heavy metal cadmium (Cd), is undesirable. Genomic studies in flax have produced large amounts of data in the last 15 years, providing useful resources to improve the genetic of this crop using genomics-based technologies and strategies. The goal of this thesis is therefore to capitalize on these advances to address the Cd problem and to propose solutions to improve breeding efficiencies. To find genomic-based solutions to Cd content, to the currently low breeding efficiency and to abiotic stress resistance in flax, this study utilized four major strategies: (1) genomic cross prediction, (2) gene family identification, (3) genome-wide association study (GWAS) and (4) genomic selection (GS). Characterization of the ATP-binding cassette (ABC) transporter and heavy metal associated (HMA) gene families was performed using the flax genome sequence. A total of 198 ABC transporter and 12 HMA genes were identified in the flax genome, of which nine were orthologous to Cd-associated genes in Arabidopsis, rice and maize. A transcriptomic analysis of eight tissues provided some support towards the functional annotation of these genes and confirmed the expression of these ABC transporter and HMA genes in flax seeds and other tissues. A diversity panel of 168 flax accessions was grown in the field at multiple locations and years and the seed content of 24 heavy metals (HMs) was measured. The panel was also sequenced and a single nucleotide polymorphism (SNP) dataset of nearly 43,000 SNPs was defined. A GWAS was conducted using these genotypic and phenotypic data and a total of 355 non-redundant quantitative trait nucleotides (QTNs) were identified for ten of the 24 metal contents. Overall, a total of 24 major and 331 minor effect QTNs were detected, including 11 that were pleiotropic. After allelic tests, 108 non-redundant QTNs were retained for eight of the ten metals and ranging from one for copper (Cu) to 70 for strontium (Sr). A total of 20 candidate genes for HM accumulation were identified at 12 of the 24 major QTN loci, of which five belonged to the ABC transporter family. Many of the metal contents, including Cd, appeared to be controlled by many genes of small effects; hence, GS is better suited than marker-assisted selection for application in breeding. To test this, predictive ability using ten GS statistical models was evaluated using trait-specific QTN and the random genome-wide 43K SNP datasets. Significantly higher predictive abilities were observed from the GS models built with the dataset made of QTNs associated with metal contents (70-80%) compared to that of the 43K dataset (10-25%). This study showed the feasibility of using GS to improve the predictive ability of polygenic traits such as metal content in seeds. GS can be applied in early generation selection to accelerate the improvement of abiotic stress resistance and either select low-Cd lines or discard high-Cd lines. These findings validate the use of a QTL-based strategy as a highly effective method for improving the efficiency of predictive ability of GS for highly complex traits such as resistance or tolerance to HM accumulation. Identification of both large and minor effect QTNs and/or pleiotropic effects hold potential for flax breeding improvement. Candidate gene functional validation can be performed using methods such as genome editing or targeting induced local lesions in genomes (TILLING).

Les facteurs régulant l’hématopoïèse en contexte de vieillissement s’avèrent incomplètement compris. Nous avons étudié les déterminants de la variabilité des traits de la formule sanguine complète dans une cohorte de 2996 femmes apparentées et non-apparentées d’ascendance française du Québec âgées de 55 à 101 ans. Les déterminants héréditaires ont été évalués par étude d’association pan-génomique. Des facteurs acquis, incluant comorbidités et hématopoïèse clonale, ont aussi été évalués. Des analyses multivariées ont été réalisées avec des modèles linéaires mixtes généralisés. Nous avons identifié des variants dans la région de GSDMA et PSMD3-CSF3 significativement associés au décompte de neutrophiles et un polymorphisme intronique à ARHGEF3 associé au décompte plaquettaire. L’effet de certains variants diminuait avec l’âge. Avec l’âge, les décomptes de neutrophiles et monocytes augmentaient tandis que le décompte des lymphocytes décroissait. Les valeurs de neutrophiles (4,1x109/L vs 3,83x109/L, valeur-p <0,001), monocytes (0,50x109/L vs 0,45x109/L, valeur-p <0,001) et plaquettes (259x109/L vs 243x109/L, valeur-p <0,001) étaient augmentées lors de comorbidités cardiométaboliques (maladie coronarienne, hypertension, diabète, dyslipidémie). L’hématopoïèse clonale ne modifiait pas les décomptes. En conclusion, nous identifions des déterminants génétiques héréditaires contribuant à la variabilité des décomptes cellulaires sanguins dans une cohorte vieillissante. De plus, le vieillissement est associé à des niveaux accrus de neutrophiles et monocytes et une diminution des lymphocytes indiquant un biais myéloïde, lequel est majoré lors de comorbidités métaboliques. L’hématopoïèse clonale ne contribue pas à ce biais myéloïde. Ces résultats supportent le fait que des facteurs extrinsèques, possiblement via un effet inflammatoire, promeuvent le biais myéloïde relié à l’âge. / Our understanding of the factors regulating peripheral blood cell traits in the setting of aging remains incomplete. We investigated the determinants underlying blood cell trait variability in a cohort of 2996 related and unrelated women of French ancestry from Québec aged 55 to 101 years. We performed a genome-wide association study to assess for genetic variants. We also assessed the impact of acquired factors such as chronic comorbidities and clonal hematopoiesis. Multivariate analyses were subsequently performed using generalized linear mixed models. We identify variants in the region of GSDMA and PSMD3-CSF3 that meet genome-wide requirements for neutrophil counts and a variant intronic to ARHGEF3 for platelet counts. With aging, the effect of certain variants decreased. Aging was associated with increasing neutrophil and monocyte counts and decreasing lymphocyte counts. We also document that individuals with cardiometabolic comorbidities (diabetes, coronary heart disease, hypertension and dyslipidemia) exhibit significantly higher neutrophil (4.1x109/L vs 3.83x109/L, p-value <0.001), monocyte (0.50x109/L vs 0.45x109/L p-value <0.001), and platelet (259x109/L vs 243x109/L, p-value <0.001) counts. Clonal hematopoiesis did not contribute significantly to these traits. In conclusion, germline variants related to GSDMA and PSMD3-CSF3 contribute to neutrophil counts and a SNP intronic to ARHGEF3 contributes to platelet counts. Aging is associated with a myeloid shift with increased levels of neutrophils and monocytes, and reduced lymphocyte counts. This myeloid-biased skewing is further increased with cardiometabolic comorbidities. Clonal hematopoiesis does not contribute to this phenomenon. These findings support that cellextrinsic factors may contribute to the myeloid shift possibly through low-grade inflammation.

Les cellules souches hématopoïétiques (CSH) assurent une production constante des cellules sanguines tout au long de la vie, mais sont vulnérables à l’acquisition de mutations pouvant mener à une transformation maligne. Les mutations qui confèrent un avantage de croissance entraîneront une prolifération clonale. L’étude de la clonalité est centrale à la compréhension de ces phénomènes. Historiquement, l’analyse de la clonalité a été possible grâce au principe de l’inactivation du chromosome X (ICX) chez les femmes qui entraîne la création de deux populations cellulaires, celle avec le X-paternel actif et celle avec le X-maternel actif. Une déviation (biais) de la proportion théorique de 1 :1 entre ces deux populations peut supposer une dominance clonale. Nous avons démontré un biais significatif de l’ICX chez les femmes avec l’âge. Ce phénomène peut être expliqué par plusieurs causes dont la sélection hémizygote (un des deux X possède des allèles plus forts que l’autre) et l’acquisition de mutations dans une CSH. Nous posons l’hypothèse que ces deux phénomènes coexistent et peuvent être distingués par une approche génomique. Nous avons recruté une cohorte de 2996 femmes canadiennes-françaises âgées entre 37 et 101 ans composée de 2172 individus issus de 321 familles et de 824 individus non apparentés. Deux tissus biologiques ont été recueillis : le sang périphérique (PMN, monocytes, lymphocytes T, lymphocytes B) et des cellules buccales. Le ratio de l’ICX a été déterminé par la méthode HUMARA, l’analyse de gènes associés à l’hématopoïèse clonale (19 gènes) a été faite par la méthode de séquençage NGS, et la cohorte a été génotypée à 700 625 loci polymorphiques de l’ADN (SNP). Des analyses bioinformatiques ont été - iv - appliquées pour étudier la contribution génétique au biais de l’ICX. Nous démontrons que : (i) le biais de l’ICX est plus prévalent dans les cellules sanguines par rapport aux cellules épithéliales et maximal dans les cellules myéloïdes; (ii) le biais augmente avec l’âge seulement dans les cellules sanguines et que cette influence est plus marquée pour les neutrophiles; (iii) la concordance du biais est très importante pour les différents types cellulaires sanguins, suggérant un mécanisme opérant au niveau de la CSH ; (iv) il y a une composante héréditaire liée au biais de l’ICX; (v) la présence de mutations acquises (TET2, DNMT3A, etc.) explique seulement une partie du biais ; (vi) à l’aide d’analyses par liaison génétique la présence d’une région sur le chromosome X à Xq21 (LOD score 4.9) qui est associée au biais des lymphocytes T et une autre sur le chromosome 1 à 1q21 (LOD score 6) qui est associée au biais des neutrophiles. Nous avons départagé la contribution liée à l’acquisition de mutations somatiques et identifié pour la première fois des régions liées à une prédisposition génétique. Nos travaux se poursuivront d’une part par l’analyse de gènes candidats dans les régions identifiées, et d’autre part nous tenterons d’identifier les cibles génétiques qui confèrent un potentiel de transformation maligne en utilisant une approche basée sur l’analyse du méthylome, de l’hydroxyméthylome et du transcriptome que nous venons de valider. Notre étude démontre la complexité de l’adaptation de l’hématopoïèse au vieillissement et ouvre des portes sur l’identification de facteurs prédisposant aux cancers hématologiques. / Hematopoietic stem cells (HSC) ensure a constant lifelong production of blood cells, but are vulnerable to acquisition of mutations, which may lead to malignant transformation. Mutations that confer a growth advantage will lead to clonal derivation of cells. The study of clonality is central to the understanding of hematopoiesis adaptation to aging. Historically, the first clonality assays were based on the principle of X-chromosome inactivation (XCI) in women. Women are mosaics with half the cells with the paternal X active and the other half with the maternal one. A skewing from the theoretical 1:1 ratio between these two populations of cells could infer clonal derivation of cells. More than 20 years ago, our team demonstrated, through analysis of (XCI) in women, that skewing increases with age. This intriguing phenomenon can be explained by several etiology including hemizygous selection (one of the 2 Xs has stronger alleles) or the acquisition of mutations giving a growth advantage. The first etiology is genetically predetermined and the second, acquired in somatic cells of bone marrow. We hypothesize that these two phenomena coexist and can be distinguished with a genomic approach. To test our hypothesis, we investigated skewing in a cohort of 2996 French-Canadian women aged 37 to 101 comprised of 2172 related individuals from 321 families and 824 unrelated individuals. We analyzed XCI ratios at the HUMARA locus in epithelial cells, neutrophils, T-cells, monocytes, B-lymphocytes. We genotyped the cohort for clonal hematopoiesis and looked for germline heritable components by genome wide association studies and linkage analyses. We document that skewing was more prevalent in blood cells than in epithelial cells, and maximal in myeloid cells. Skewing increases with age only in blood cells. Intra- vi - individual correlation of skewing blood cell types was strongly correlated, suggesting selection influences operating at the HSC. Sibship analyses demonstrated heritability which was strongest when parental origin of skewing was taken into account. Clonal hematopoiesis accounted only for a small proportion of the skewing trait but its importance increased in the very old. Linkage analysis identified a region at Xq21 for skewing occurring in T-cells (LOD score 4.9) suggesting a hemizygous cell selection influence. We also identified a region at 1q21 for skewing in neutrophils (LOD score 6) suggesting a gene-gene interaction with Xlinked genes. We have demonstrated that age-associated skewing is a complex trait caused in part by acquired mutations and genetic predisposition variants. We will pursue our investigation using a candidate gene approach in the two identified regions and will try to identify genetic targets of oncogenic potential by a method based on analysis of the methylome, hydroxymethylome and transcriptome that was have validated in this cohort. This thesis demonstrates the complexity of the adaptation mechanisms of hematopoiesis to aging and set the stage to identification of factors predisposing to hematological cancers.

No description available.

Der erste Teil dieser Arbeit beschreibt die Durchführung eines quantitativen Ansatzes zur Detektion von Protein-Protein-Interaktionen (PPI) mit einem Schwerpunkt für Proteine, die in vier häufigen neurodegenerativen Krankheiten eine Rolle spielen: die Alzheimer-, Parkinson- und Huntington-Krankheit, sowie die spinozerebelläre Ataxie Typ 1 (SCA1). Die Interaktionsstudie kombiniert die stabile Isotopen-Markierung von Aminosäuren in der Zellkultur mit der Affinitätsaufreinigung von Proteinen und hochauflösender Massenspektrometrie. Dieser Ansatz zielt darauf ab, systematisch die Interaktionspartner von gesunden und krankheitsassoziierten Proteinvarianten zu identifizieren und zu quantifizieren. Darüber hinaus wurde das quantitative Interaktionsverfahren genutzt, um zu prüfen ob PPI durch krankheitsassoziierte Mutationen beeinträchtigt werden. Neben der Validierung möglicher Nebeneffekte, sowie dem Vergleich mit Informationen über PPI aus der Literatur, wurde ein Teil der identifizierten Interaktoren durch zusätzliche Koimmunopräzipitations-Experimente in zwei verschiedenen Zelllinien bestätigt. Mit Hilfe von Drosophila SCA1-Krankheitsmodellen und in Kombination mit RNAi-basierter Stummschaltung identifizierter Interaktoren wurde festgestellt, dass ein großer Teil der Kandidaten Neurodegeneration in vivo beeinflusst. Zusätzlich wurden die Alzheimer-spezifischen PPI-Daten auf genomweite Assoziationsstudien übertragen. Bemerkenswerterweise waren Polymorphismen in einzelnen Nukleotiden in den Genen zugehöriger Interaktoren wahrscheinlicher mit solchen Genen assoziiert, die eine Prädisposition für die Alzheimer-Krankheit haben, als mit zufällig ausgewählten Genen. Schlussendlich konnten Folgeexperimente für zwei ausgewählte Interaktionspartner den Nachweis für eine bislang unbekannte Rolle der N-Glykosylierung und einen neuen Zusammenhang zwischen dem RNA-bindenden Protein LRPPRC und mitochondrialer Dysfunktion in der Alzheimer-Krankheit vorlegen. / The first part of the present thesis describes the establishment of a quantitative protein-protein interaction (PPI) screen with a focus on proteins involved in four common neurodegenerative diseases (NDDs): Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease (HD) and spinocerebellar ataxia type 1 (SCA1). The interaction screen combines stable-isotope labeling by amino acids in cell culture (SILAC) with protein affinity purification and high-resolution mass spectrometry. This approach aims to systematically identify and quantify interaction partners of normal and known disease-associated variants of proteins involved in NDDs. Moreover, the quantitative interaction screen was employed to study how PPIs are affected by disease-associated mutations. Along with validation of possible off-target effects and comparison of the data with literature-reported PPIs, a subset of identified interactors was validated by additional co-immunoprecipitation experiments in two different cell lines. Utilizing Drosophila models for SCA1 in combination with RNAi-mediated silencing of identified interactors, a large fraction of candidates was observed to also affect neurodegeneration in vivo. In addition, AD-specific PPI data was mapped to patient cohort data obtained from genome-wide associations studies. Notably, single-nucleotide polymorphisms in the genes of interactors of the disease-associated protein variants were more likely associated with susceptibility to AD than randomly selected genes. Finally, functional follow-ups for two selected interaction partners provided evidence for a yet unreported role of N-linked glycosylation in AD, and a novel link to mitochondrial dysfunction in AD by means of the RNA-binding protein LRPPRC.

Abstract Metabolic syndrome is a constellation of metabolic abnormalities predisposing to cardiovascular diseases (CVD), type 2 diabetes, and increased mortality. Due to the high prevalence and severe co-morbidities, metabolic syndrome constitutes a major burden for both public health and the global economy. Improved understanding of the detailed molecular mechanisms could provide novel strategies for the treatment and preferably prevention of the metabolic syndrome-related health issues. Recent advancements in ‘omics’ technologies have facilitated the development of novel tools to examine the links between genetic variation and human health. The new techniques allow determination of millions of genotypes or quantification of hundreds of metabolic measures from a single blood sample. In this thesis, genomics and metabolomics approaches are coupled to improve our understanding of the metabolic syndrome-related health issues. More precisely, my projects evaluate the metabolic effects of two lipid-lowering therapies and non-alcoholic fatty liver, as well as assess genetic determinants of chronic inflammation. The present results indicate generally consistent metabolic effects of statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) genetic inhibition. The subtle discrepancies observed could potentially contribute to differences in the efficacy to lower CVD risk between statins and PCSK9 inhibitors. The dissimilar metabolic effects of the four genetic variants that increase the risk of non-alcoholic fatty liver disease (NAFLD) highlight the heterogeneity of the molecular mechanisms involved in NAFLD pathogenesis. The results further suggest that fatty liver by itself might not promote unfavourable metabolic aberrations associated with fatty liver on a population level. The newly identified loci associating with inflammatory phenotypes elucidate the genetic mechanisms contributing to the inflammatory load. In particular, the present results suggest the important role of the locus determining the ABO blood types in the regulation of the soluble adhesion molecule levels. To conclude, this thesis successfully complements the knowledge of the molecular mechanisms involved in metabolic syndrome-related traits and provides examples of how to couple omics technologies in the study of complex traits or in the evaluation of drug effects. / Tiivistelmä Metabolinen oireyhtymä on tila, jossa useiden aineenvaihdunnallisten riskitekijöiden kasautuminen suurentaa riskiä sairastua tyypin 2 diabetekseen ja sydän- ja verisuonitauteihin sekä lisää kokonaiskuolleisuutta. Vakavista liitännäissairauksista ja suuresta esiintyvyydestä johtuen metabolinen oireyhtymä kuormittaa merkittävästi sekä terveydenhuoltoa että kansantaloutta. Jotta metabolisen oireyhtymän hoitoon ja ennaltaehkäisyyn voitaisiin kehittää uusia keinoja, on tärkeää ymmärtää paremmin oireyhtymän syntyyn vaikuttavat täsmälliset molekyylimekanismit. Niin sanottujen ’omiikka-tekniikoiden’ viimeaikainen kehitys tarjoaa uusia mahdollisuuksia tutkia geenimuutosten vaikutuksia terveyteen. Uusien tekniikoiden avulla voidaan määrittää miljoonia genotyyppejä tai satoja aineenvaihdunnan merkkiaineita yhdestä verinäytteestä. Tässä väitöskirjatyössä yhdistetään genomiikan ja metabolomiikan menetelmiä metaboliseen oireyhtymään liittyvien terveysongelmien tutkimiseksi. Väitöskirjani osatöissä arvioin kahden lipidilääkkeen sekä ei-alkoholiperäisen rasvamaksan aineenvaihdunnallisia vaikutuksia sekä pyrin tunnistamaan krooniseen tulehdukseen vaikuttavia geneettisiä tekijöitä. Tulosten mukaan statiinien ja PCSK9:n (engl. proprotein convertase subtilisin/kexin type 9) geneettisen eston aineenvaihduntavaikutukset ovat hyvin samankaltaiset. Kuitenkin havaitut pienet poikkeavuudet tietyissä merkkiaineissa voivat vaikuttaa eroavaisuuksiin siinä, kuinka tehokkaasti lääkeaineet alentavat sydäntautiriskiä. Suuret erot rasvamaksan riskiä lisäävien geenimuutosten vaikutuksissa aineenvaihduntaan korostavat rasvamaksaan liittyvien molekyylimekanismien monimuotoisuutta. Tulosten perusteella vaikuttaa siltä, että rasvan kertyminen maksaan ei luultavasti itsessään aiheuta suuria muutoksia verenkierron aineenvaihduntatuotteiden pitoisuuksiin. Tulehdusmerkkiaineisiin assosioituvat uudet geenialueet täydentävät tulehduksen molekyylimekanismeihin liittyvää tietoa. Tulokset korostavat ABO-veriryhmän määräävän geenin vaikutusta liukoisten adheesiomolekyylien pitoisuuksiin. Kaiken kaikkiaan väitöskirjan osatyöt tuovat uutta tietoa metaboliseen oireyhtymään liittyvien terveysongelmien molekyylimekanismeihin. Projektit havainnollistavat, miten omiikka-tekniikoita voidaan hyödyntää monitekijäisten fenotyyppien tutkimuksessa sekä lääkeaineiden aineenvaihduntavaikutusten arvioinnissa.

L'ulcère de Buruli (UB), infection à Mycobacterium ulcerans, troisième mycobactériose mondiale, connait une émergence rapide depuis 1980, essentiellement dans les pays d'Afrique subsaharienne. Jusqu’ici, les connaissances épidémiologiques sur l’UB étaient fondées sur des séries de cas cliniques non confirmés par laboratoire. Nous avons constitué la plus grande cohorte de cas confirmés à ce jour rassemblant plus de 1200 patients traités au CDTUB de Pobè au Bénin entre 2005 et 2011, afin de décrire l'épidémiologie clinique de la maladie et d'explorer l’architecture génétique de la susceptibilité à cette maladie. Les patients atteints d’UB sont des enfants (âge médian au diagnostic de 12 ans), présentant une lésion unique (96%), large (plus de 15 cm, 36%), ulcérative (66%) du membre inférieur (60%). Nous rapportons une présentation clinique atypique de l’UB, dans laquelle les patients présentent exclusivement une ostéomyélite à M. ulcerans. Le sex-ratio varie avec l’âge : les garçons sont majoritaires parmi les enfants (57% de patients masculins chez les moins de 15 ans), et les femmes parmi les adultes (33% de patients masculins). La présentation clinique dépend de l’âge et du sexe. 9% des patients masculins ont présenté une ostéomyélite contre 4% des patients féminins. Un an après la fin du traitement, 22% des patients présentent des séquelles fonctionnelles fixées. Une présentation clinique comportant une lésion oedémateuse, osseuse, de grande taille ou plusieurs lésions est significativement associée avec le développement de séquelles fonctionnelles (OR 7.64, IC95% [5.29-11.31]). Les patients coinfectés par le VIH ont un risque significativement plus élevé de développer un UB sévère (OR 2.77, IC95% [1.32-6.33]). Nous avons exploré l’architecture génétique de la susceptibilité à l’UB dans une perspective mendélienne et une perspective complexe. Le cas le plus sévère de la maladie observé dans ce centre appartient à une famille consanguine dans laquelle la ségrégation du phénotype suggère un défaut génétique mendélien récessif. Une analyse de liaison génétique par cartographie d'homozygotie suggère l’implication du locus des béta-défensines sur le chromosome 8 dans la pathogénèse de l'UB, et mène à l’identification d’une délétion homozygote ségrégeant parfaitement avec la maladie. Dans une perspective complexe, une étude d’association pangénomique a été réalisée après génotypage d’une cohorte de 400 cas et 400 témoins exposés sur plus de 2 millions de SNPs par la puce Illumina Omni2.5 et a permis l’identification de nombreux signaux d’intérêt. L’étude de réplication est en cours. La compréhension de la physiopathologie de l'infection à M. ulcerans est cruciale pour générer de nouvelles pistes thérapeutiques et vaccinales. La dissection du contrôle génétique de l'infection par l'hôte est en ce sens indispensable. / Buruli ulcer (BU), caused by Mycobacterium ulcerans, is the third most frequent mycobacteriosis worldwide. It has been rapidly emerging in sub-Saharan African countries since 1980. Until now, knowledge of BU epidemiology relied on series of non laboratory-confirmed clinical cases. From 2005-2011, we recruited the current largest cohort of laboratory-confirmed cases (more than 1,200 patients) at the Pobe CDTUB, Benin, to describe the clinical epidemiology of the disease and to explore the genetic architecture of human susceptibility to BU. Typically, patients with BU were children (median age at diagnosis 12 years) presenting with a unique (96%) large (≥15 cm, 36%) ulcerative (66%) lesion of the lower limb (60%). Atypical clinical presentation of BU included osteomyelitis with no identifiable present or past BU skin lesions. The sex ratio of BU widely varied with age, with male patients accounting for 57% of patients aged 15 years and younger, but only 33% of those older than 15 years. Clinical presentation of BU was significantly dependent on age and sex. 9% male patients had BU osteomyelitis, whereas only 4% of female patients did. 1 year after treatment, 22% of patients with follow-up information presented with permanent functional sequelae. Presentation with oedema, osteomyelitis, or large (≥15 cm in diameter), or multifocal lesions was significantly associated with occurrence of permanent functional sequelae (OR 7•64, 95% CI 5•29–11•31) and operationally defines severe BU. When coinfected with HIV, patients had a significantly higher risk to develop severe BU (OR 2.77, IC95% [1.32-6.33]). We explored the genetic architecture of susceptibility to BU in both mendelian and complex genetic frameworks. The most severe case of the disease to have been treated at the Pobe CDTUB belonged to a consanguineous family in which the segregation of the phenotype was indicative of a recessive mendelian genetic defect. Genetic linkage analysis by homozygosity mapping suggested the implication of the beta-defensin locus on chromosome 8 in BU pathogenesis and lead to the identification of a homozygous deletion, which co-segregated perfectly with the disease in the family. In a complex genetics approach, we undertook a genome-wide association study, which involved the genotyping of more than 2 million SNPs (Illumina Omni2.5) in a cohort of 400 cases and 400 exposed controls. We identified many signals of interest. The replication study is ongoing. Understanding BU physiopathology is crucial to the development of efficient vaccines and drugs. Dissection of the genetic control of the infection by M. ulcerans by its human host therefore constitutes an indispensable step.

Modern medical practice and science involve complex phenotypic definitions. Understanding patterns of association across this range of phenotypes requires co-analysis of high-dimensional association studies in order to characterise shared and distinct elements. In this thesis I address several problems in this area, with a general linking aim of making more efficient use of available data. The main application of these methods is in the analysis of genome-wide association studies (GWAS) and similar studies. Firstly, I developed methodology for a Bayesian conditional false discovery rate (cFDR) for levering GWAS results using summary statistics from a related disease. I extended an existing method to enable a shared control design, increasing power and applicability, and developed an approximate bound on false-discovery rate (FDR) for the procedure. Using the new method I identified several new variant-disease associations. I then developed a second application of shared control design in the context of study replication, enabling improvement in power at the cost of changing the spectrum of sensitivity to systematic errors in study cohorts. This has application in studies on rare diseases or in between-case analyses. I then developed a method for partially characterising heterogeneity within a disease by modelling the bivariate distribution of case-control and within-case effect sizes. Using an adaptation of a likelihood-ratio test, this allows an assessment to be made of whether disease heterogeneity corresponds to differences in disease pathology. I applied this method to a range of simulated and real datasets, enabling insight into the cause of heterogeneity in autoantibody positivity in type 1 diabetes (T1D). Finally, I investigated the relation of subtypes of juvenile idiopathic arthritis (JIA) to adult diseases, using modified genetic risk scores and linear discriminants in a penalised regression framework. The contribution of this thesis is in a range of methodological developments in the analysis of high-dimensional association study comparison. Methods such as these will have wide application in the analysis of GWAS and similar areas, particularly in the development of stratified medicine.

Indiana University-Purdue University Indianapolis (IUPUI) / Alzheimer's disease (AD) is a national priority, with nearly six million Americans affected at an annual cost of $200 billion and no available cure. A better understanding of the mechanisms underlying AD is crucial to combat its high and rising incidence and burdens. Most cases of AD are thought to have a complex etiology with numerous genetic and environmental factors influencing susceptibility. Recent genome-wide association studies (GWAS) have confirmed roles for several hypothesized genes and have discovered novel loci associated with disease risk. However, most GWAS-implicated genetic variants have displayed modest individual effects on disease risk and together leave substantial heritability and pathophysiology unexplained. As a result, new paradigms focusing on biological pathways have emerged, drawing on the hypothesis that complex diseases may be influenced by collective effects of multiple variants – of a variety of effect sizes, directions, and frequencies – within key biological pathways. A variety of tools have been developed for pathway-based statistical analysis of GWAS data, but consensus approaches have not been systematically determined. We critically review strategies for genetic pathway analysis, synthesizing extant concepts and methodologies to guide application and future development. We then apply pathway-based approaches to complement GWAS of key AD-related endophenotypes, focusing on two early, hallmark features of disease, episodic memory impairment and brain deposition of amyloid-β. Using GWAS and pathway analysis, we confirmed the association of APOE (apolipoprotein E) and discovered additional genetic modulators of memory functioning and amyloid-β deposition in AD, including pathways related to long-term potentiation, cell adhesion, inflammation, and NOTCH signaling. We also identified genetic associations to amyloid-β deposition that have classically been understood to mediate learning and memory, including the BCHE gene and signaling through the epidermal growth factor receptor. These findings validate the use of pathway analysis in complex diseases and illuminate novel genetic mechanisms of AD, including several pathways at the intersection of disease-related pathology and cognitive decline which represent targets for future studies. The complexity of the AD genetic architecture also suggests that biomarker and treatment strategies may require simultaneous targeting of multiple pathways to effectively combat disease onset and progression.