RT Journal Article SR Electronic T1 Evidence for secondary-variant genetic burden and non-random distribution across biological modules in a recessive ciliopathy JF bioRxiv FD Cold Spring Harbor Laboratory SP 362707 DO 10.1101/362707 A1 Maria Kousi A1 Onuralp Söylemez A1 Aysegül Ozanturk A1 Sebastian Akle A1 Irwin Jungreis A1 Jean Muller A1 Christopher A. Cassa A1 Harrison Brand A1 Jill Anne Mokry A1 Maxim Y. Wolf A1 Azita Sadeghpour A1 Kelsey McFadden A1 Richard A. Lewis A1 Michael E. Talkowski A1 Hélène Dollfus A1 Manolis Kellis A1 Erica E. Davis A1 Shamil R. Sunyaev A1 Nicholas Katsanis YR 2018 UL http://biorxiv.org/content/early/2018/07/05/362707.abstract AB The influence of genetic background on driver mutations is well established; however, the mechanisms by which the background interacts with Mendelian loci remains unclear. We performed a systematic secondary-variant burden analysis of two independent Bardet-Biedl syndrome (BBS) cohorts with known recessive biallelic pathogenic mutations in one of 17 BBS genes for each individual. We observed a significant enrichment of trans-acting rare nonsynonymous secondary variants compared to either population controls or to a cohort of individuals with a non-BBS diagnosis and recessive variants in the same gene set. Strikingly, we found a significant over-representation of secondary alleles in chaperonin-encoding genes, a finding corroborated by the observation of epistatic interactions involving this complex in vivo. These data indicate a complex genetic architecture for BBS that informs the biological properties of disease modules and presents a model paradigm for secondary-variant burden analysis in recessive disorders.