Computational and Experimental Protein Variant Interpretation in the Era of Precision Medicine

Collectively, rare genetic disorders affect a substantial portion of the world’s population. In most cases, those affected face difficulties in receiving a clinical diagnosis and genetic characterization. The understanding of the molecular mechanisms of these diseases and the development of therapeutic treatments for patients are also challenging. However, the application of recent advancements in genome sequencing/analysis technologies and computer-aided tools for predicting phenotype-genotype associations can bring significant benefits to this field. In this review, we highlight the most relevant online resources and computational tools for genome interpretation that can enhance the diagnosis, clinical management, and development of treatments for rare disorders. Our focus is on resources for interpreting single nucleotide variants. Additionally, we present use cases for interpreting genetic variants in clinical settings and review the limitations of these results and prediction tools. Finally, we have compiled a curated set of core resources and tools for analyzing rare disease genomes. Such resources and tools can be utilized to develop standardized protocols that will enhance the accuracy and effectiveness of rare disease diagnosis.

An open challenge of computational and experimental biology is understanding the impact of non-synonymous DNA variations on protein function and, subsequently, human health. The effects of these variants on protein stability can be measured as the difference in the free energy of unfolding (ΔΔG) between the mutated structure of the protein and its wild-type form. Throughout the years, bioinformaticians have developed a wide variety of tools and approaches to predict the ΔΔG. Although the performance of these tools is highly variable, overall they are less accurate in predicting ΔΔG stabilizing variations rather than the destabilizing ones. Here, we analyze the possible reasons for this difference by focusing on the relationship between experimentally-measured ΔΔG and seven protein properties on three widely-used datasets (S2648, VariBench, Ssym) and a recently introduced one (S669). These properties include protein structural information, different physical properties and statistical potentials. We found that two highly used input features, i.e., hydrophobicity and the Blosum62 substitution matrix, show a performance close to random choice when trying to separate stabilizing variants from either neutral or destabilizing ones. We then speculate that, since destabilizing variations are the most abundant class in the available datasets, the overall performance of the methods is higher when including features that improve the prediction for the destabilizing variants at the expense of the stabilizing ones. These findings highlight the need of designing predictive methods able to exploit also input features highly correlated with the stabilizing variants. New tools should also be tested on a not-artificially balanced dataset, reporting the performance on all the three classes (i.e., stabilizing, neutral and destabilizing variants) and not only the overall results.