Current challenges in GWAS integration and fine-mapping for variant interpretation

Over the past two decades, genome-wide association studies (GWAS) have identified thousands of trait- and disease-associated loci. However, the mechanistic understanding of these loci remains incomplete, which limits our ability to understand gene regulation and cellular programs underlying complex traits, predict disease risk, and develop therapeutics targeted to root causes. Here, we describe the current challenges for using GWAS to prioritize variants for functional follow-up experiments. These challenges span multiple domains, including limitations in data sharing and harmonization, limitations of statistical and functional fine-mapping, and the ambiguity in the added value of emerging deep learning frameworks for variant effect prediction as a complementary approach alongside traditional statistical genetics methods. We analyze these variant prioritization methods and suggest a multi-modal approach for resolving GWAS loci to a focused set of high-confidence variants for functional exploration. Fully realizing the potential of GWAS will require harmonized summary statistics and broader sharing of in-sample linkage disequilibrium (LD) data to enable robust and scalable causal variant prioritization.