RT Journal Article SR Electronic T1 Human knockouts in a cohort with a high rate of consanguinity JF bioRxiv FD Cold Spring Harbor Laboratory SP 031518 DO 10.1101/031518 A1 Danesh Saleheen A1 Pradeep Natarajan A1 Wei Zhao A1 Asif Rasheed A1 Sumeet Khetarpal A1 Hong-Hee Won A1 Konrad J. Karczewski A1 Anne H O’Donnell-Luria A1 Kaitlin E. Samocha A1 Namrata Gupta A1 Mozzam Zaidi A1 Maria Samuel A1 Atif Imran A1 Shahid Abbas A1 Faisal Majeed A1 Madiha Ishaq A1 Saba Akhtar A1 Kevin Trindade A1 Megan Mucksavage A1 Nadeem Qamar A1 Khan Shah Zaman A1 Zia Yaqoob A1 Tahir Saghir A1 Syed Nadeem Hasan Rizvi A1 Anis Memon A1 Nadeem Hayyat Mallick A1 Mohammad Ishaq A1 Syed Zahed Rasheed A1 Fazal-ur-Rehman Memon A1 Khalid Mahmood A1 Naveeduddin Ahmed A1 Ron Do A1 Daniel G. MacArthur A1 Stacey Gabriel A1 Eric S. Lander A1 Mark J. Daly A1 Philippe Frossard A1 John Danesh A1 Daniel J. Rader A1 Sekar Kathiresan YR 2015 UL http://biorxiv.org/content/early/2015/11/12/031518.abstract AB A major goal of biomedicine is to understand the function of every gene in the human genome.1 Null mutations can disrupt both copies of a given gene in humans and phenotypic analysis of such ‘human knockouts’ can provide insight into gene function. To date, comprehensive analysis of genes knocked out in humans has been limited by the fact that null mutations are infrequent in the general population and so, observing an individual homozygous null for a given gene is exceedingly rare.2,3 However, consanguineous unions are more likely to result in offspring who carry homozygous null mutations. In Pakistan, consanguinity rates are notably high.4 Here, we sequenced the protein-coding regions of 7,078 adult participants living in Pakistan and performed phenotypic analysis to identify homozygous null individuals and to understand consequences of complete gene disruption in humans. We enumerated 36,850 rare (<1 % minor allele frequency) null mutations. These homozygous null mutations led to complete inactivation of 961 genes in at least one participant. Homozygosity for null mutations at APOC3 was associated with absent plasma apolipoprotein C-III levels; at PLAG27, with absent enzymatic activity of soluble lipoprotein-associated phospholipase A2; at CYP2F1, with higher plasma interleukin-8 concentrations; and at either A3GALT2 or NRG4, with markedly reduced plasma insulin C-peptide concentrations. After physiologic challenge with oral fat, APOC3 knockouts displayed marked blunting of the usual post-prandial rise in plasma triglycerides compared to wild-type family members. These observations provide a roadmap to understand the consequences of complete disruption of a large fraction of genes in the human genome.