Resource

Widespread Macromolecular Interaction
Perturbations in Human Genetic Disorders
Graphical Abstract

Authors
Nidhi Sahni, Song Yi, ..., Susan Lindquist,
Marc Vidal

Correspondence
lindquist@wi.mit.edu (S.L.),
marc_vidal@dfci.harvard.edu (M.V.)

In Brief
A large-scale characterization of disease
mutations reveals surprisingly
widespread, yet specific perturbations inmacromolecular interactions. Different
mutations in the same gene lead todifferent interaction profiles, often
resulting in distinct disease phenotypes.

Highlightsd

Most missense disease mutations appear not to impair
protein folding or stabilitydInteraction profiling helps distinguish disease mutations
from non-disease variantsdDistinct interaction perturbations underlie distinct diseasephenotypesdIntegrative interaction networks enhance genotype-tophenotype understanding

Sahni et al., 2015, Cell 161, 647–660
April 23, 2015 ª2015 Elsevier Inc.
http://dx.doi.org/10.1016/j.cell.2015.04.013

Resource
Widespread Macromolecular Interaction
Perturbations in Human Genetic Disorders
Nidhi Sahni,1,2,3,21 Song Yi,1,2,3,21 Mikko Taipale,4,21 Juan I. Fuxman Bass,5,21 Jasmin Coulombe-Huntington,6,21
Fan Yang,1,2,7,8,9 Jian Peng,10 Jochen Weile,1,2,7,8,9 Georgios I. Karras,4 Yang Wang,1,2,3 István A. Kovács,1,2,11Atanas Kamburov,2,3 Irina Krykbaeva,4 Mandy H. Lam,8 George Tucker,10 Vikram Khurana,4 Amitabh Sharma,1,2,11
Yang-Yu Liu,2,11 Nozomu Yachie,1,2,7,8,9 Quan Zhong,2,3 Yun Shen,1,2,3 Alexandre Palagi,2,3 Adriana San-Miguel,2,3
Changyu Fan,1,2,3 Dawit Balcha,1,2,3 Amelie Dricot,1,2,3 Daniel M. Jordan,12,13 Jennifer M. Walsh,2,3 Akash A. Shah,2,3
Xinping Yang,2,3 Ani K. Stoyanova,2,3 Alex Leighton,10 Michael A. Calderwood,1,2,3 Yves Jacob,2,3,14 Michael E. Cusick,1,2,3
Kourosh Salehi-Ashtiani,2,3 Luke J. Whitesell,4,15 Shamil Sunyaev,12,16 Bonnie Berger,10,17 Albert-László Barabási,1,2,11,18
Benoit Charloteaux,1,2,3 David E. Hill,1,2,3 Tong Hao,1,2,3 Frederick P. Roth,1,2,7,8,9,19,22 Yu Xia,2,6,22
Albertha J.M. Walhout,2,5,22 Susan Lindquist,4,15,20,22,* and Marc Vidal1,2,3,22,*
1Genomic Analysis of Network Perturbations Center of Excellence in Genomic Science (CEGS), Dana-Farber Cancer Institute, Boston,
MA 02215, USA
2Center for Cancer Systems Biology (CCSB) and Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
3Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
4Whitehead Institute for Biomedical Research, Cambridge, MA 02142, USA
5Program in Systems Biology, Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA
6Department of Bioengineering, Faculty of Engineering, McGill University, Montreal, QC H3A 0C3, Canada
7Departments of Molecular Genetics and Computer Science, University of Toronto, Toronto, ON M5S 3E1, Canada
8Donnelly Centre, University of Toronto, Toronto, ON M5S 3E1, Canada
9Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, Toronto, ON M5G 1X5, Canada
10Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
11Center for Complex Network Research (CCNR) and Departments of Physics, Biology and Computer Science, Northeastern University,
Boston, MA 02115, USA
12Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
13Program in Biophysics, Harvard University, Cambridge, MA 02139, USA
14Département de Virologie, Unité de Génétique Moléculaire des Virus ARN (GMVR), Institut Pasteur, UMR3569, Centre National de laRecherche Scientifique, and Université Paris Diderot, Paris, France
15Department of Biology and Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
16The Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
17Department of Mathematics and Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge,
MA 02139, USA
18Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
19Canadian Institute for Advanced Research, Toronto, ON M5G 1Z8, Canada
20Howard Hughes Medical Institute, Cambridge, MA 02139, USA
21Co-first author
22Co-senior author*Correspondence: lindquist@wi.mit.edu (S.L.), marc_vidal@dfci.harvard.edu (M.V.)
http://dx.doi.org/10.1016/j.cell.2015.04.013

SUMMARY

How disease-associated mutations impair protein
activities in the context of biological networks remains
mostly undetermined. Although a few renowned alleles are well characterized, functional information is
missing for over 100,000 disease-associated variants.
Here we functionally profile several thousand missense mutations across a spectrum of Mendeliandisorders using various interaction assays. The majority of disease-associated alleles exhibit wild-type
chaperone binding profiles, suggesting they preserve
protein folding or stability. While common variantsfrom healthy individuals rarely affect interactions,
two-thirds of disease-associated alleles perturb protein-protein interactions, with half corresponding to‘‘edgetic’’ alleles affecting only a subset of interactions while leaving most other interactions unperturbed. With transcription factors, many alleles thatleave protein-protein interactions intact affect DNA
binding. Different mutations in the same gene leading
to different interaction profiles often result in distinct
disease phenotypes. Thus disease-associated alleles
that perturb distinct protein activities rather thangrossly affecting folding and stability are relatively
widespread.
INTRODUCTION
Over a hundred thousand genetic variants have been identified
across a large number of Mendelian disorders (Amberger et al.,2011), complex traits (Hindorff et al., 2009), and cancer types
Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc. 647

A

B
Gene

Genotype

Missense disease mutations
Edgotyping

Radically affect protein
folding/stability

Perturb molecularinteractions

PhenotypeC

Disease mutations

Figure 1. Systematic Characterization of
Human Disease Missense Mutations(A) Two possible effects of missense disease
mutations: protein folding/stability changes andmolecular interaction perturbations.
(B) Understanding mutational effects by edgotyping links genotype to phenotype. Solid anddashed lines represent retained and perturbed
interactions, respectively.
(C) Experimental pipeline for characterizing
alterations of molecular interactions, including
protein-chaperone (PCI), protein-protein (PPI) andprotein-DNA (PDI) interactions. WT: Wild-type,
Mut: mutation. TF: transcription factor. ‘‘1,’’ detected PPI; ‘‘0,’’ not detected PPI. Dashed oval:
variants in the same gene. See also Figure S1.

Gateway cloning

distinguishable diseases (Zhong et al.,2009). In addition, since genes and geneproducts do not function in isolation but
2,890 Mutinteract with each other in the context
1,140 WTof interactome networks (Vidal et al.,Protein-protein interaction (PPI)2011), it is likely that many diseases result
from perturbations of such complex netProtein-chaperone interaction 2,449 Mut
Protein-DNA interaction
(PCI)
(PDI)
works (Goh et al., 2007).
1,072 WT
Systematic
Missense mutations are among thescreenmost common sequence alterations in
2,332 Mut
70 Mut TFs
Mendelian disorders, accounting for
HI-II-14~7,200 genes
992 WT Pairwise
28 WT TFs Pairwise
more than half of all reported mutations
test (2x)test (12x)
Pairwise test (4x)460 Mut
in the Human Gene Mutation Database
220 WT WT 1 1 1 1
7 chaperones/(HGMD) (Stenson et al., 2014). In princi152 enhancers
Mut1 0 0 0 0quality control factors
ple, missense mutations may have no
Mut2 1 1 1 0
functional consequences, disrupt thethree-dimensional structure of the corresponding protein, or exert specific effects
on particular molecular or biochemicalinteractions (Figure 1A), such as proteinprotein interactions (PPIs), protein-DNA
interactions (PDIs), or enzyme-substrate
Integrated interaction profiles
interactions, while leaving all other funcProteins
Genes
Chaperones
Other macromolecules
tional properties unperturbed. We previMutations
DNA
Disease proteins
Molecular interactions
ously reported that a considerable portion of Mendelian disease mutations
could indeed be predicted computation(Chin et al., 2011). However, many fundamental questions re- ally to cause interaction-specific, or ‘‘edgetic,’’ perturbations
garding genotype-phenotype relationships remain unresolved (Zhong et al., 2009). However, only a small number of genes(Vidal et al., 2011). One critical challenge is to distinguish causal and associated mutations were experimentally tested in thatdisease mutations from non-pathogenic polymorphisms. Even study, and the extent to which disease mutations globally leadwhen causal mutations are identified, the functional conse- to interaction perturbations remains to be determined.
Here we describe a multi-pronged approach to systematicallyquence of such mutations is often elusive (Sahni et al., 2013).
Genotypic information alone rarely elucidates the mechanistic decipher molecular interaction perturbations associated withinsights pertaining to disease pathogenesis. Although genotype- missense mutations. Since chaperones and associated quality
phenotype relationships can be modeled under the assumption control factors (QCFs) can salvage unstable proteins by assistingthat most disease-associated mutations lead to complete loss of with folding, and an increase in protein-chaperone interactions
protein function, e.g., through radical changes such as protein (PCIs) has been observed for a number of disease mutants
misfolding and instability (Subramanian and Kumar, 2006) (Fig- (Whitesell and Lindquist, 2005), our systematic approach begins
ure 1A), the reality is often more complex, as in the case of with characterizing PCIs for large numbers of disease-associmutations affecting the same gene but giving rise to clinically ated alleles, followed by systematic measurements of PPI and
648 Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc.

PDI profile changes caused by mutations, a strategy referred toas ‘‘edgotyping’’ (Figure 1B).
We provide evidence for widespread interaction perturbations
across a broad spectrum of human Mendelian disorders. Our
results suggest that interaction profiling helps distinguish disease-causing mutations from common variants. Furthermore,
the integration of different types of molecular interactions expands our ability to understand complex genotype-phenotype
relationships.
RESULTS
Human Mutation ORFeome Version 1.1
To globally characterize disease-associated alleles, we selected
mutations associated with a wide range of disorders, including
cancer susceptibility and heart, respiratory, and neurologicaldiseases. We retrieved from HGMD (Stenson et al., 2014) a listof 16,400 mutations affecting over 1,200 genes for which wehave a wild-type (WT) open-reading frame (ORF) clone in our human ‘‘ORFeome’’ collection (Yang et al., 2011) and selected up
to four mutations per gene (Figure 1C; Tables S1A and S1B;
Extended Experimental Procedures). Using properties related to
RNA abundance, GO annotation, and protein domains (Extended
Experimental Procedures), we verified there is no significant bias
between our selected genes and the rest of the human genome
or all genes represented in HGMD (Figures S1B–S1G).
Altogether, we cloned and sequence-verified 2,890 humanmutant ORFs (hmORFs), each harboring a single nucleotidechange that results in an amino acid change relative to the corresponding WT ORF of 1,140 genes. To our knowledge, this human mutation ORFeome version 1.1 resource (hmORFeome1.1;
Figure S1A) is the most extensive human mutation collection reported to date.
Disease Mutations and Protein Folding and Stability
Using enhanced binding to a chaperone as an indicator of protein instability or misfolding, we examined how disease mutations impact protein folding and disposition. We determinedthe extent to which hmORF-encoded proteins and their WT
counterparts interact with QCFs using a quantitative highthroughput LUMIER assay (Taipale et al., 2012; Taipale et al.,2014) (Figure 1C and Table S2A). We selected the following
QCFs based on their broad specificity (Taipale et al., 2014):(1) the cytoplasmic chaperones HSP90 and HSC70, (2) theirco-chaperones BAG2 and CHIP/STUB1, (3) the proteasomal
regulatory subunit PSMD2 (formerly known as RPN1), and (4)the ER chaperones GRP78/BIP and GRP94 (Extended Experimental Procedures). We did not survey mitochondrial chaperones since only 7% of disease-associated gene products
are predicted to localize solely in mitochondria (Huntley et al.,2015).
Increased interaction between a QCF and mutant or WT
protein, as measured by the LUMIER assay, indicates a mutation-induced perturbation in conformational stability, often associated with compromised or complete loss of function (Taipale
et al., 2012). The interaction profiles of most mutant proteins
correlated with their WT counterparts. However, compared toa background control set, we observed a significant enrichmentof mutant alleles showing increased interaction with QCFs (Figures 2A–2H and S2A) but little or no enrichment for decreased
interaction (Figures 2A and S2B; Extended Experimental Procedures). The interaction profiles of mutant proteins with thedifferent cytoplasmic QCFs were highly correlated, distinct
from those with ER factors (Figure 2I). These results highlightthe coordination and specificity of cellular quality control pathways. Altogether 28% of the tested alleles exhibited increased
binding to at least one of the seven QCFs tested. Although thisfraction is likely a conservatively low estimate due to limited
assay sensitivity, the strong correlation between chaperone
interaction profiles (Figure 2I) suggests that the estimate would
not increase substantially by assaying more chaperones. We
validated several mutant-specific interactions with endogenous
chaperones by co-immunoprecipitation followed by western
blot, corroborating the results obtained with the LUMIER assay(Figure 2J).
We next estimated protein abundance using semiquantitative
ELISA, which provides a proxy for steady-state protein stability.
Although the expression levels of mutant alleles correlated with
their WT counterparts (Figure S2C), mutant proteins exhibiting
enhanced interactions with cytoplasmic, but not ER, chaperones
were detected at lower steady-state levels than their WT counterparts (p < 1.0 3 10 4; Figure 3A). This is possibly a result ofretention in the ER of mutant proteins that would normally besecreted and therefore not be detected by an assay that captures intracellular proteins. Interestingly, recessive alleles exhibited lower protein abundance levels and increased binding
with QCFs compared with proteins encoded by dominant alleles(Figures S2D and S2E). This is consistent with the hypothesisthat recessive mutations are more likely to result in loss-of-function phenotypes than dominant mutations (Lesage and Brice,2009).
To gain insight into the structural properties of mutant proteinsthat exhibit increased binding to QCFs, we assessed the impact
of different disease mutations on predicted protein structures.
The disease alleles associated with increased binding to QCFs
corresponded significantly more often to mutations of residues
buried in the core of the protein (Figure 3B and Table S1C),
and less often to mutations in intrinsically disordered regions(Figure 3C) when compared to mutant proteins with no change
in binding. Next, we estimated the relative ‘‘deleteriousness’’
associated with distinct genetic mutations using PolyPhen-2 algorithm (Adzhubei et al., 2010). Deleterious mutations predicted
by PolyPhen were significantly enriched in alleles that exhibited
increased binding to QCFs (Figure S2F).
Previous studies suggested that increased chaperone bindingreflects a change in protein stability (Falsone et al., 2004; Taipale
et al., 2012). To provide further evidence for this, we assessed
protein stability in cellular lysates by measuring solubility in acellular thermal shift assay (CeTSA). We found that the majority(5 of 6) of mutant proteins with increased chaperone binding
also exhibited decreased stability as measured by CeTSA (Figures S3A–S3D). In addition, computational predictions by the
FoldX program (Schymkowitz et al., 2005) suggest that mutant
proteins with increased binding to QCFs are likely to be significantly less stable than their WT counterpart (Figure 3D and Table
S2B). Taken together, experimental and computational analyses
Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc. 649

A

B

C

D

E

F

G

H

I

J

Figure 2. Most Disease Missense Mutations Do Not Impair Protein Folding or Stability(A) Differential Z score distributions in LUMIER assay. Normalized differential Z scores are calculated as the difference in chaperone binding between all mutant/
WT pairs expressed at detectable levels (n = 12,131). Non-expressed pairs serve as controls (n = 1,567).

(legend continued on next page)650 Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc.

Figure 3. Mutant Proteins with Enhanced
Binding to QCFs Are Likely to Be Unstable

2

***
1

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40
30
20

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n-

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12

20

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and in our human interactome map
HI-II-14 (Rolland et al., 2014) (Figure 1C).
Altogether, we obtained interaction profiles for 460 mutant proteins and their
220 WT counterparts and found 521 perturbed interactions out of 1,316 PPIs
(Table S3A).
To validate these results, we used theorthogonal in vivo Gaussia princeps luciferase protein complementation assay (GPCA) performed in human 293T cells (Cassonnet et al., 2011) (Table S3B). Unperturbed
interactions were recovered at a rate statistically indistinguishable
from that of a well-documented positive reference set (PRS),
similar to the interactions of the WT alleles (Braun et al., 2009; Venkatesan et al., 2009). Perturbed interactions were recovered at a
rate as low as a negative control ‘‘random reference set’’ (RRS)(Figures 4B and S4A), demonstrating the high quality of the identified perturbations induced by disease mutations.
To analyze global and topological characteristics of geneproducts with edgetic, quasi-null, or quasi-WT mutations, weused the human interactome map HI-II-14 (Rolland et al.,2014). According to the studied network properties (betweenness, k-core centrality, degree, closeness), the nodes (genes)
examined in our edgotyping study appear unbiased, in that their
topological properties are statistically indistinguishable fromother genes in the network (Figures S4B–S4F). Interestingly,
we found that the genes carrying edgetic mutations tend to be
more central than either non-edgetic genes or the rest of the
network (Table S4).
Out of a total of 197 mutations, corresponding to 89 WT proteins with two or more interaction partners, our interaction
profiling identified 26% as quasi-null alleles, 31% edgetic and
43% quasi-WT (Figure 4C and Table S3C). We also analyzed

Al
nd l
in
H g
SP
H 90
SC
70
BA
G
2
C
H
I
PS P
M
G D2
R
P
G 78
R
P9
4

-5

0

(A) Protein expression levels measured by ELISA.
x axis shows all tested mutants (All), mutants withno change (non-binding) or an increase in binding
to QCFs.
(B) Solvent accessibility of mutant proteins.
(C) Disorder analysis of mutant proteins.
(D) Stability predictions by FoldX. DDG, free energy change.
Dashed line (A and D) represents the median of all
mutants. p values (A) and (D) by one-sided Wilcoxon rank sum test; (B) and (C) by Chi-square
test. For n values, see Table S7B. *p < 0.05; **p <0.01; ***p < 0.001. See also Figures S2 and S3.

***
*

5

Al
nd l
in
H g
SP
H 90
SC
70
BA
G
2
C
H
PS IP
M
D
G 2
R
P7
G 8
R
P9
4

Percentage of mutations indisordered regionsC*** *** *** ***
**

***

10

Al
nd l
in
H g
SP
H 90
SC
70
BA
G
2
C
H
PS I P
M
D
G 2
R
P7
G 8
R
P9
4

-2

Percentage of mutations in
exposed residues

B
ELISA log2 ratio (Mut / WT)Asuggest that mutant proteins with enhanced binding to QCFs
have a destabilized protein structure.
Our quantitative survey of allele-specific interactions estimates that the majority of missense disease mutations do not
dramatically impact protein structure or folding (Tables S1D
and S2). Therefore, they may exert their deleterious effects
through other mechanisms such as perturbation of molecularinteractions.
Disease Mutations and PPI Perturbations
In principle, the effects of missense disease mutations on molecular interactions (Zhong et al., 2009), or ‘‘edgotype’’ (Sahni et al.,2013), could range from no apparent detectable change ininteractions (‘‘quasi-WT’’), to specific loss of some interaction(s)(‘‘edgetic’’), to an apparent complete loss of interactions (‘‘quasinull’’) (Figure 4A). To systematically characterize PPI perturbations associated with disease mutations and identify potential
gain of interactions, we used the yeast two-hybrid (Y2H) interaction assay followed by a stringent validation assay. After autoactivator removal, we screened 2,449 mutant proteins and their
1,072 corresponding WT proteins for interactions with proteinsencoded by the 7,200 ORFs in the human ORFeome v1.1
(Rual et al., 2004). Mutant and WT proteins were then tested
pair-wise against all partners found both in these Y2H screens(B–H) Interaction scatter plots for 2,332 disease alleles. Alleles were assayed for interaction with QCFs HSP90 (B), HSC70 (C), BAG2 (D), CHIP (E), PMSD2 (F),GRP78 (G), and GRP94 (H). EGFR L858R and v-Src can interact with HSP90 (Shimamura et al., 2005; Taipale et al., 2012), and TTR D18G and ELANE G181V caninteract with GRP78 (Köllner et al., 2006; Sörgjerd et al., 2006); hence used as controls. Filled circles with black border represent significantly increased
chaperone binding. Correlations by Pearson coefficient of determination, R2.
(I) Clustering analysis based on chaperone interaction profile similarity.
(J) Validation by co-immunoprecipitation (co-IP). LUMIER scores are shown below the blots.
See also Figure S2.

Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc. 651

BInteraction perturbed by mutation
Interaction unperturbed by mutation

Quasi-wild-type (QW) Quasi-null (QN)

Percentage of pairs recovered

A

60
50

Unperturbed interactions(n=466)

40

n = 8420

n = 62

10
0
1

2

E

3
4
5
Score threshold

6

P = 2.0x10-5

F

-5

10
5
0
-5

QN

Non-disease variants

n=2

n=2

n = 43

QW

E

E

E

QN

P = 1.0x10-5
4

P = 1.6x10-4

2
0
-2
-4

QN

QW

E

QN

H
*

30
*
20

10

0
D

QW

Differential expression (log2)0

P = 3.0x10

15Percentage with increased
chaperone binding

5

Differential Z scores (HSC70)

Differential Z scores (HSP90)

G

-2

10

E

QW

-2

P = 4.7x10

QW

n = 5130

P = 4.3x10-415Disease mutations

PRS(n=92)
RRS(n=92)
Perturbed interactions(n=208)

Edgetic (E)

D

C

1%RRS

QN

N

HSP90

D

N

HSC70

D

N

Union

Figure 4. Interaction Perturbation Profiles Distinguish Disease Mutations from Non-Disease Variants(A) Three classes of PPI profiles (edgotypes) for mutations.
(B) Percentage of protein pairs recovered in GPCA at increasing score thresholds. Shading indicates SE of the proportion.
(C) Distribution of different edgotype classes for disease mutations.
(D and E) Differential LUMIER interaction scores among different edgotype classes, for binding to HSP90 (D) and HSC70 (E). p values by one-sided unpaired t test.
(F) Differential expression among different edgotype classes (ELISA log2 ratio of mutant over WT). QW: n = 75, E: n = 49, QN: n = 42. p values by one-sided
Wilcoxon rank sum test.
(G) Distribution of different edgotype classes for non-disease variants.
(H) Increased binding to HSP90, HSC70, or either (Union) for non-disease (N) or disease (D) variant proteins. p values by one-sided Fisher’s exact test. Error bars
indicate SE of the proportion. *p < 0.05.
See also Figures S4 and S5.

disease mutations annotated by ClinVar (Landrum et al., 2014)
and found the distribution of quasi-null, edgetic, and quasi-WT
alleles was statistically indistinguishable from that of HGMD (Fig652 Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc.

ure S4G). We only identified two mutations that conferred PPI
gains, suggesting that gain of interactions may be a rare eventin human disease.

Protein Folding and Expression Levels of Edgetic
MutationsDifferences between edgotype classes could be due to protein
folding and/or relative expression levels. Quasi-null proteinsassociated significantly more with cytoplasmic, but not ER,
chaperones, whereas edgetic and quasi-WT proteins did not
significantly change their chaperone association (Figures 4D–
4E, and S5A–S5E). Quasi-null proteins appeared to be poorly
expressed, while edgetic and quasi-WT proteins were expressed at levels similar to those of their WT controls (Figure 4F).
We validated several mutant-chaperone interactions and expression profiles by co-immunoprecipitation with endogenous
chaperones, followed by western blot (Figure S5F). All tested
quasi-null proteins exhibited more binding to HSP90 and
HSC70, although they were expressed at lower levels than their
WT controls. However, the edgetic TAT-P220S protein and thequasi-WT NCF2-R395W protein did not show any detectablechaperone association. Among mutant proteins with no change
in chaperone binding, edgetic (28%) and quasi-WT (57%)
proteins comprised the majority, while quasi-null proteinscomprised a significantly lower percentage (15%) (Figure S5G).
Altogether, these results suggest that quasi-null proteins are
more often unstable/misfolded and diminished in their steadystate expression levels. In contrast, edgetic and quasi-WT proteins likely exhibit normal folding and expression levels, further
supporting the idea that they may cause disease through interaction perturbations or other mechanisms rather than simple
loss of protein function.
Disease-Causing Mutations Versus Common Variants
Genome-wide association studies have identified hundreds ofloci linked to particular disorders. However, these loci often
contain several genes and multiple variants, making it challenging to distinguish causal mutations from non-pathogenic
variants. We observed previously that among binary interactions
found by WT proteins, disease-causing alleles were more likely
to perturb interactions than non-disease variants (Rolland
et al., 2014). We further investigated both disease-causing alleles from HGMD and common variants identified in healthy individuals from diverse geographical sites (1000 Genomes Project
Consortium, 2012) (Table S1A) with respect to the edgetic character and chaperone binding of their protein products. Interaction profiling showed that only a small fraction of non-disease
alleles lost interactions (8%, Figure 4G), a 7-fold reduction relative to disease mutations (57%; p = 1.7 3 10 9; Figure 4C). In
addition, non-disease alleles on average did not alter chaperone
association (Table S2A), a characteristic distinct from disease
mutations annotated by HGMD (Figure 4H) or ClinVar (Figure S5H). Together, interaction perturbations can help distinguish disease-associated alleles from non-disease alleles.
To assess the predictive power of edgotyping to identify
disease-causing mutations, we determined its precision andsensitivity in classifying an allele as causal based on interaction
perturbation profiles. As a ‘‘gold standard’’ for causal alleles, weused a set of mutations annotated in HGMD as disease-causing(‘‘DM’’ in Table S1A). As a negative control, we used a set of alleles
most likely not associated with disease. We observed that 96%(105 of 109) of the alleles found to perturb interactions (E or QN)

were disease-causing (Figure S6A). Conversely, 61% (105 of
172) of disease-causing mutations annotated by HGMD wereinteraction-perturbing (Figure S6B). Together, our prediction
achieved a precision (96%) and sensitivity (61%) significantly
higher than random expectation. It is possible that current incompleteness of interaction network maps might limit the power ofedgotyping to properly classify disease-causing mutations. To
evaluate this possibility, we performed a down-sampling analysis
and found negligible effect on mutation classification over a broad
range of network sizes (Figure S6C).
Edgetic Mutations and Interaction Interfaces
To explore edgotypes from a structural point-of-view, we assessed the possible impact of distinct classes of mutations onprotein function using PolyPhen-2 analysis (Adzhubei et al.,2010). Interaction-perturbing mutations are significantly more
often predicted to be deleterious than non-interaction-perturbing mutations (Figure 5A). We next investigated whether mutations from the different classes might differ in evolutionary
conservation, based on the presumption that conservation ofamino acid residues is a property that generally reflects functionality (1000 Genomes Project Consortium, 2012; Subramanianand Kumar, 2006; Sunyaev, 2012). The residues affected byinteraction-perturbing mutations are significantly more conserved across species compared to non-interaction-perturbing
mutations (Figure S6D). However, PolyPhen and conservation
analysis could not distinguish between edgetic and quasi-nullmutations within the interaction-perturbing group.
Given that structural domains often mediate protein interactions, different classes of mutation might vary in their locations
relative to protein domains. Interaction-perturbing mutations
are indeed significantly enriched within structural domains
compared to non-interaction-perturbing alleles (Figure 5B and
Table S1C). In addition to structural domains, intrinsically disordered regions and linear motifs could also play a role in mediating PPIs. However, we found interaction-perturbing disease
alleles to be depleted in intrinsically disordered regions (Figure S6E), and occurring in linear motifs as frequently as non-perturbing alleles (Figure S6F). These results suggest that mutations
perturbing PPIs are preferentially located within structural domains. Nevertheless, none of the above properties could reliably
predict whether a mutation would give rise to an edgetic or
quasi-null PPI effect.
We next investigated whether edgetic and quasi-null mutations differ in their physical location within three-dimensional
protein structures (Zhong et al., 2009). Edgetic mutations are
significantly more enriched in structurally exposed residues
compared to quasi-null mutations (Figure 5C). Consistently,
edgetic mutations do not tend to cause a change in hydrophobicity, a destabilizing feature that generally disrupts protein function (Balasubramanian et al., 2005), while quasi-null mutations
often lead to a decrease in hydrophobicity (Figure S6G).
We also investigated whether or not edgetic mutations are
more frequently located at an interface that supports interaction
with a partner protein. Starting from all available structures of cocrystal complexes in the Protein Data Bank (PDB) involving a disease gene product, we determined the relative location of eachmutated residue within these structures (Extended Experimental
Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc. 653

P = 1.7x10-3

A

P = 0.01

B

P = 0.33
Percentage of mutations inP
Pfam domains

0.8
0.6
0.4
0.2
0
QW

E

P = 0.55

60
40
20
0
QW

E

QN

D
80
60

P = 2.3x10-5
P = 0.03

P = 0.018

40
20Percentage of mutationsat interface

Percentage of mutations in
exposed residues

P = 1.3x10-3

80

QN

C

0
QW

E

100

P = 8.9x10-5 P = 1.3x10-4

80
60
40

0
QW

E

QN

P = 2.3x10-2

P = 1.5x10-3

FP = 1.5x10-3 P = 1.6x10-5
100
80
60
40

(A) PolyPhen-2 scores for mutations in different
edgotype classes. p values by one-sided Wilcoxon
rank sum test.
(B) Percentage of mutations within Pfam domains.
p values by one-sided position-shuffling test.
(C) Percentage of mutations in exposed residues.
QW: n = 83; E: n = 61; QN: n = 50.
(D) Percentage of mutations at PPI interfaces. QW:
n = 59; E: n = 32; QN: n = 16.
(E) Percentage of interfacial mutations for perturbed (n = 14) and unperturbed (n = 18) interactions, compared to random mutations.
(F) Percentage of perturbed (n = 118) and unperturbed (n = 85) interactors expressed in disease
relevant tissues. Thirty random genes from RNASeq dataset are assessed for each disease gene.
p values from (C) to (F) by one-sided Fisher’s exact
test. Error bars (B) to (F), SE of the proportion. See
also Figure S5.

20

QN

E
Percentage of mutationsat specific interface

100

Percentage expressed indisease-relevant tissues

PolyPhen-2 score

1.0

Figure 5. Edgetic Mutations Perturb Interaction Interfaces with Protein Partners Expressed in Disease-Relevant Tissue

P = 2.9x10-3

50
40
30
20

ease-relevant tissues compared with unperturbed interactors or random genes(Figures 5F and S6H; Table S5B). These
results indicate that disease mutations
most often perturb interactions that arefunctionally relevant in the particular tissue(s) affected by a specific disease.

Distinct Interaction Perturbations
May Underlie Diverse Disease00
Phenotypes
Un
Pt
R
Un
Pt
R
Our edgotyping model suggests that
Unperturbed interaction interface (Un)Unperturbed partners (Un)different mutations in the same gene
Perturbed interaction interface (Pt)
Perturbed partners (Pt)may result in different, pleiotropic phenoRandom control (R)Random genes (R)typic outcomes through perturbation of
distinct interactions (Figure 6A). To test
this, we compared mutation edgotype
Procedures and Table S5A). In contrast to quasi-null mutations, classes and the resulting disease phenotypes. Among pleioedgetic mutations are significantly enriched at interaction inter- tropic genes associated with two or more diseases, mutant alfaces identified from the corresponding co-crystal structures leles associated with different disease manifestations were
(Figure 5D). Notably, edgetic mutations also exhibit a significant more likely to exhibit different edgotype classes of perturbed
tendency to reside at interaction interfaces with the perturbed PPI profiles (Table S5C).
This is exemplified by mutations in TPM3, which encodes
partners, as compared to unperturbed partners or random controls (Figure 5E). These results suggest that edgetic mutations slow muscle alpha-tropomyosin. Three TPM3 edgetic mutations
are preferentially located at PPI interfaces, perturbing the corre- L100M, R168G, and R245G are associated with fiber-type
disproportion myopathy through an unknown mechanism (Adzsponding interaction.
hubei et al., 2010; Clarke et al., 2008) (Figure 6B). These edgetic
Edgetic Mutations Perturb Interactions with Protein
mutations perturb five of the ten interaction partners of the WT
Partners Expressed in Disease-Relevant Tissues
gene product. The majority of perturbed partners are expressedWe hypothesized that protein interaction partners perturbed by in muscle, the tissue most relevant to this disease (Figure 6C).
edgetic mutations are likely to function together within the tissue One of the disrupted interactions is the interaction between
known to be affected by the relevant disease. To test this, we TPM3 and troponin, which was shown to be vital for the transduccompared gene expression patterns for perturbed and unper- tion of calcium-induced signals required for muscle contraction
turbed partners in disease-relevant tissues using RNA-seq (Gunning et al., 1990). Two other perturbed interactors, HSF2,
data from the Illumina Human Body Map 2.0 project. Perturbed involved in myotube regeneration (McArdle et al., 2006), andinteractors exhibit a striking tendency to be expressed in dis- CCHCR1, required for cytoskeleton organization (Tervaniemi
2010654 Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc.

et al., 2012), could also be of disease relevance. In contrast tothese edgetic mutations, the quasi-WT mutation M9R causes a
different disease, nemaline myopathy. M9R might affect actin
binding, thus leading to the formation of abnormal nemaline
rods (Laing et al., 1995).
The possible disease relevance of our approach was further
illustrated by edgetic mutations in the gene EFHC1, mutations
in which can cause epilepsy. One perturbed partner, ZBED1,
plays a role in a major cell proliferation pathway affected by
EFHC1 knockouts (Yamashita et al., 2007), while another perturbed interactor, TCF4, is required for neuronal differentiation(Flora et al., 2007) (Figure 6D).
We next reasoned that mutations perturbing a greater numberof interactions would be likely to have a larger impact on proteinfunction, and hence result in more severe phenotypic effects. We
used the age of disease onset as a proxy for severity and determined whether an increase in the fraction of interactions lost
correlated with an increase in severity for each pair of mutations
causing the same disease (as annotated by HGMD) (Figure 6E
and Table S5D). We found that mutations perturbing more PPIs
were associated with an earlier age of disease onset significantly
more often than random expectation (Figure 6E). Althoughcomputational predictions based on PolyPhen-2 were able todistinguish between interaction-perturbing versus non-perturbing alleles (Figure 5A), they did not perform as well as ourapproach in predicting disease severity (Figure S6I). This limitation is consistent with the inability of PolyPhen-2 to distinguishbetween edgetic and quasi-null mutations (Figure 5A).
Protein-DNA Interactions
We hypothesized that mutations for which no PPI perturbation
has yet been detected likely cause changes in other types ofmolecular interactions. As a proof-of-concept, we examinedthe effect of disease mutations on protein-DNA interactions(PDIs) between human transcription factors (TFs) (Reece-Hoyes
et al., 2011a) and developmental enhancers (Fuxman Bass et al.,2015). Our hmORFeome1.1 mutant library contains 70 TF ORFs
altogether harboring 173 mutations (Table S6A). A primary
screen using enhanced yeast-one hybrid (eY1H) assays (Reece-Hoyes et al., 2011b) identified PDIs between 152 enhancers(Visel et al., 2007) and 28 WT TFs (Figure 1C and Extended
Experimental Procedures). We then performed pairwise assays
to compare the PDIs of mutant TFs and their WT counterpartsin eY1H assays (Table S6B).
Using systematic PDI profiling, we determined edgotype classes for 58 mutations in 22 TFs that bound at least two enhancers.
We identified 38% of the mutations as quasi-null, 43% asedgetic (loss or gain of interaction), and 19% as quasi-WT (Figure 7A). More than 80% of TF missense disease mutations tested
either abrogated DNA binding or caused partial change of PDIs.
Interestingly, almost half of the mutations are edgetic, challenging the assumption that TF mutations that affect DNA binding do so in a similar fashion across their targets. Among these, asignificant fraction of mutations exhibit gain of PDIs, likely
because these mutations cause a reduction in DNA-binding
specificity and allow greater promiscuity in target recognition.
Given that TFs interact with their DNA targets through DNAbinding domains (DBDs), we assessed whether disease muta-

tions perturbing PDIs are enriched within DBDs. Mutations withinversus outside DBDs exhibited strikingly different PDI perturbation patterns (p = 1.1 3 10 3; Figure 7B and Table S6C). Among
quasi-null mutations, the proportion of mutations within DBDs
was 10-fold higher than outside DBD regions. These results
confirm that most PDI perturbing mutations reside within the
DBDs of proteins, further supporting the quality and validity of
our PDI perturbation data.
Mutations within the same TF that cause different PDI changes
would affect the expression of different targets, resulting indifferent diseases. We examined disease-causing TF mutations
in pleiotropic genes associated with two or more diseases.
Mutations with different PDI edgotype classes were likely to be
associated with different clinical manifestations (Figure 7C),
consistent with our results for PPI perturbations (Figure 6A).
Of the disease mutations for which both PPI and PDI data wereavailable, about half did not perturb any PPIs (Figure 7D). Interestingly, for 80% of these we did identify PDI perturbations.
For instance, mutations in the TGF-b-induced transcription factor TGIF1 cause holoprosencephaly (Gripp et al., 2000). While
the two mutant variants S28C and P63R are still able to bind theirprotein partners CTBP1 and CTBP2 (quasi-WT for PPI), both mutations completely abrogated the ability of TGIF1 to bind any of
the tested DNA targets (quasi-null for PDI) (Figure S7A). Clearly,
integrating different types of molecular interactions will enhance
our ability to understand specific mechanisms that underlie
many genetic disorders.
To gain further insights into alternative molecular interaction
perturbations, we computationally examined the effect of disease mutations on protein-chemical interactions (Reva et al.,2011). We found that the frequency with which disease mutations are at protein-chemical interfaces is significantly higher
than that of non-disease variants (Figure S7B). In addition,disease mutations that perturb PPIs have no discernable tendency to locate at protein-chemical interfaces (Figure S7C),
suggesting that protein-protein and protein-chemical interfaces
do not tend to overlap. Interestingly, 13% of PPI non-perturbing mutations are located at protein-chemical interfaces,
supporting the conclusion that these mutations could cause
disease through perturbation of alternative types of molecularinteractions.
We combined computational predictions and interaction
profiling to optimize our performance in disease mutation stratification. Although computational methods such as PolyPhen-2
could predict interaction-perturbing alleles as deleterious (Figure 5A), they fail to explain many disease-causing mutations,and misclassify them as ‘‘benign’’ (Figure S7D). Among thesemisclassified mutations, 50% could be explained by molecularinteraction perturbations (PCI, PPI, or PDI). For instance, theS140F mutation in PKP2 encoding the adhesion protein plakophilin leads to arrhythmogenic right ventricular dysplasia (Gerull
et al., 2004). While PolyPhen-2 predicts S140F as benign, theS140F mutant exhibited increased binding to the chaperones
HSC70 and BAG2, and lost all the PPIs of the WT protein (Table
S7A). All together, existing computational methods alone fail toprecisely predict disease causality. Examining different typesof molecular interaction perturbations is critical for a full comprehension of disease-causing mutations in human.
Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc. 655

A

E
0.16
Genotype 1

Genotype 2

Genotype 3
Observed
P = 6.0x10-3

0.12
Edgotype 2

Percentage of mutation pairscausing different diseases

Phenotype 1

Edgotype 3

Phenotype 2

80Frequency

Edgotype 1

0.08
Random expectation
0.04

Phenotype 3

P = 0.03

0
0

60

2

4

6

8

10

12

14

Number of concordant mutation pairs
40% PPI loss

20

Relative severity

0
Different
edgotype classes

Same
edgotype class

Concordant

Discordant

B
TPM3

L100M

R168G

R245G

M9R

Edgetic

Edgetic

Edgetic

Quasi-wild-type

MAD1L1TNNT1WASH3P
TFPT

OIP5

IFIT3

HSF2

SYCE1

CCHCR1KXD1Nemalinemyopathy

Myopathy withfiber-type disproportion

NormalC

D
TPM3 (Mut)

TPM3 (WT)EFHC1

MAD1L1TNNT1WASH3PTFPTOIP5RIMBP3
ZBED1
TEX11

P77T

T508R

Epilepsy

Epilepsy

CCDC36EFHC2GOLGA2
KRT15

TCF4

IFIT3

HSF2

SYCE1

CCHCR1
KXD1

REL
TRIP6
IKZF3
TRAF2
KCTD4
SH3GLB2
EIF4ENIF1HOMER3

Edgetic disease mutation
Specifically expressed in disease tissue
Not expressed in disease tissue
Constitutively expressed

NormalFigure 6. Heterogeneous Genetic Mutations Give Rise to Diverse Disease Outcomes through Distinct Interaction Perturbations(A) Schematic of pleiotropic disease outcomes resulting from distinct interaction patterns (edgotypes) caused by distinct mutations. Percentage of mutation pairscausing different diseases out of all pairs with different or the same edgotype classes is shown. n = 52. Error bars, SE of the proportion. p values by one-sided
Fisher’s exact test.
(B) Example of edgotyping four disease mutations in the pleiotropic gene TPM3.

(legend continued on next page)

656 Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc.

A

B

D

C

Figure 7. Integration of Protein-Protein and Protein-DNA Interaction Perturbations(A) PDI edgotype distribution for disease mutations in 22 TFs that bind to more than one enhancer.
(B) Histogram showing percentage of mutations within and outside DBDs as a function of the percentage of PDI loss. Numbers on x axis indicate bin range. pvalues by one-sided Wilcoxon rank sum test.
(C) Percentage of TF mutation pairs that cause different diseases out of all pairs with different or the same PDI edgotype classes (n = 17). Error bars, SE of the
proportion. p values by one-sided Fisher’s exact test.
(D) PPI-PDI integration enables mutation characterization at higher resolution. Percentage of mutations is shown for: PPI and PDI unperturbed; PPI unperturbed
and PDI perturbed; PPI perturbed and PDI unperturbed; and PPI and PDI perturbed in the integrated network.
See also Figure S7.

DISCUSSION
In this systematic characterization of mutations across various
human Mendelian disorders, we have found surprisingly wide-

spread disease-specific perturbations of macromolecular interactions. Approximately 60% of disease-associated missense
mutations perturb PPIs, among which half result in complete
loss of interactions, generally caused by protein misfolding and(C) Most perturbed partners of TPM3 are expressed in the disease-relevant tissue.
(D) Edgetic mutations in EFHC1 perturb epilepsy-related protein partners.
(E) Correlation between the fraction of PPI perturbation and age of onset for mutation pairs causing the same disease. p values by comparing the observed value
to 100,000 random controls (n = 13; Extended Experimental Procedures).
See also Figure S6.

Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc. 657

impaired expression, and the other half lead to edgetic perturbations. Importantly, different mutations in the same gene frequently result in different interaction perturbation profiles. Thisstrongly suggests that the ‘‘edgotype’’ of a mutation represents
a fundamental link between genotype and phenotype.
Our systematic edgotyping strategy provides a practical
approach to classifying candidate disease alleles emerging
from genome-wide association studies and from sporadic andsomatic mutation sequencing approaches. Edgotyping achieves
a high precision in identifying candidate disease-causing mutations based on the interaction perturbations relative to WT alleles(Figure S6A). However, the overall sensitivity of an edgotyping
approach is compromised due to the false negative rate inherent
to the assays used. We expect that a significant fraction of variants currently viewed as non-interaction-perturbing (quasi-WT)
will eventually be proven to be edgetic and possibly cause
disease. This circumstance likely arises from the incomplete
nature of current human interactome network maps (Rolland
et al., 2014). Nevertheless, because edgetic mutations cannot
become quasi-WT or quasi-null even as interactome maps
improve, our estimate of edgetic mutations already provides areliable minimum lower bound for their frequency.
An alternative possibility is that quasi-WT mutations affect disease phenotypes through perturbation of different types of molecular interactions. Biological signaling is regulated at multiple
levels, and various types of molecular interactions are involved(Sahni et al., 2013) as we have shown for PPI and PDI networks.
In addition, protein-RNA (Lee et al., 2006) and protein-metabolite(Carpten et al., 2007) interactions have also been shown to be
involved in disease. Perturbations of these alternative interaction
networks will undoubtedly result in distinct disease consequences. One can envision that integration of additional typesof interaction perturbation information with computational predictions will be necessary for a complete understanding of thecellular networks governing a particular disease state (Figure S7D). As a major benefit, perturbed interactions spotlightspecific targets and pathways that are altered in a patient-specific context. This type of information could provide a muchneeded guide in efforts to developing better diagnostic tools
and more personalized medical treatments.
EXPERIMENTAL PROCEDURES
Using ORFs in the human ORFeome v8.1 collection as template, we PCR
amplified the two DNA fragments flanking the mutations, followed by a fusion
PCR to stitch the fragments together. The resulting fusion ORFs harboring themutations were Gateway cloned into the Donor vector pDONR223 to derive
Entry clones (Rual et al., 2004), which were subsequently verified by next-generation sequencing (Yang et al., 2011).
Interaction with chaperones and other QCFs was performed using a quantitative LUMIER assay (Taipale et al., 2012; Taipale et al., 2014). All wild-type
and mutant allele clones were transferred via Gateway recombination into a
mammalian expression vector containing a C-terminal 3xFLAG-V5 tag. Stable
HEK293T cell lines expressing luciferase-QCF fusion proteins were generated
by lentiviral infection, and plasmids carrying wild-type and disease mutation
alleles were transfected into the stable HEK293T lines (Taipale et al., 2012).
Following capture of FLAG-tagged proteins, luminescence was measured todetermine QCF-target interaction. Following luminescence measurement,
FLAG-tagged mutant and wild-type proteins were detected as described(Taipale et al., 2012).

658 Cell 161, 647–660, April 23, 2015 ª2015 Elsevier Inc.

We performed a binary protein-protein interaction screen for all mutant andwild-type alleles as baits against 7,200 human prey proteins (Rual et al.,2004). The identified interactions were combined with the known pairs cataloged by the human binary interaction dataset HI-II-14 (Rolland et al., 2014).
All first-pass pairs from the primary Y2H screens were subjected to pairwise
testing in which all interactors of any allele of a gene were then tested against
all alleles of that gene. The resulting verified protein-protein interaction profilesof disease mutants were compared with their wild-type counterparts. We validated perturbed and unperturbed interactions from mutation-mediatedinteraction perturbation data (‘‘edgotyping’’ data) using an orthogonal in vivo
Gaussia princeps luciferase protein complementation assay (GPCA). Human
HEK293T cells were co-transfected with each construct expressing complementary fragments of the Gaussia luciferase fused in frame with the tested protein pairs and luciferase activity was measured as described (Cassonnet et al.,2011).
An enhanced yeast one-hybrid (eY1H) assay was used to detect binary protein-DNA interactions (PDIs) between a DNA bait and a protein prey (ReeceHoyes et al., 2011a; Reece-Hoyes et al., 2011b). DNA baits corresponding
to human enhancers were retrieved from the Vista Enhancer Browser (http://enhancer.lbl.gov) (Visel et al., 2007). Protein preys were a set of TFs for whichmutant clones are available in our human mutation ORFeome version 1.1. We
performed pairwise eY1H assays of an arrayed collection of TF preys
comprising all the wild-type TFs and their mutant clones against 152 available
enhancer baits.
Disease-causing mutations were annotated by HGMD, and the deleteriousness of amino acid substitutions was predicted by PolyPhen-2 program (Adzhubei et al., 2010). For structural features, distinct mutations were comparedwith respect to protein domains from the Pfam database, and interaction
interfaces on co-crystal structures from PDB. Tissue-specific gene expression
was analyzed with normalized RNA-seq data from Human Body Map 2.0(GSE30611). Network properties analyzed included betweenness centrality,
k-core centrality, degree, and closeness centrality (de Nooy et al., 2005).
Full details are provided in the Extended Experimental Procedures.
SUPPLEMENTAL INFORMATION
Supplemental Information includes Extended Experimental Procedures, seven
figures, and seven tables and can be found with this article online at http://dx.
doi.org/10.1016/j.cell.2015.04.013.
AUTHOR CONTRIBUTIONS
M.V., S.L., L.J.W., D.E.H., and K.S.-A. conceived the project. N.S., S.Y., M.T.,
and J.I.F.B. designed and performed experiments, with help from G.I.K., I.K.,
M.H.L., Q.Z., A.P., D.B., A.D., J.M.W., A.A.S., X.Y., A.K.S., and Y.J. J.C.-H.,
F.Y., J.P., J.W., Y.W., I.A.K., and T.H. performed computational analyses with
contributions from N.S., S.Y., M.T., J.I.F.B., A.K., G.T., V.K., A.S., Y.-Y.L., Y.S.,
A.S.-M., C.F., D.M.J., A.L., and B.C. V.K., Y.J., N.Y., M.E.C., M.A.C, S.S., B.B.,
L.J.W., B.C., and D.E.H. provided constructive feedback. M.A.C., S.S., B.B.,
D.E.H., A.-L.B., T.H., F.P.R., Y.X., A.J.M.W., S.L., and M.V. supervised researchand provided critical advice on the study. N.S., S.Y., M.T., J.I.F.B., J.C.-H.,
M.A.C., B.C., D.E.H., F.P.R., Y.X., A.J.M.W., S.L., and M.V. wrote the manuscript,
with contributions from other co-authors.
ACKNOWLEDGMENTS
We thank the members of the DFCI Center for Cancer Systems Biology(CCSB) for valuable discussions and acknowledge A.A. Chen, M. Koeva,
and E. Guney for helpful suggestions. This work was supported by NHGRI(P50HG004233 to M.V., F.P.R. and A.-L.B.; RC4HG006066 to M.V., T.H.,
D.E.H., K.S.-A., L.J.W., and S.L.; and R01HG001715 to M.V., D.E.H., and
F.P.R.), NIGMS (GM082971 to A.J.M.W.), NSF (CCF-1219007 to Y.X.), NSERC(RGPIN-2014-03892 to Y.X.), and the Krembil Foundation, a Canada Excellence Research Chair, an Ontario Research Fund–Research Excellence Award
awarded to F.P.R. J.I.F.B. is supported by a Pew Latin American Fellowship.
A.K. is supported by an EMBO Long-Term Fellowship. S.L. is an investigator

of the Howard Hughes Medical Institute. M.V. is a Chercheur Qualifié
Honoraire from the Fonds de la Recherche Scientifique (FRS-FNRS,
Wallonia-Brussels Federation).
Received: December 15, 2014
Revised: March 5, 2015
Accepted: April 6, 2015
Published: April 23, 2015
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