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Advancing human genetics research and drug discovery through exome sequencing of the UK Biobank

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Szustakowski, Joseph D., Balasubramanian, Suganthi, Kvikstad, Erika, Khalid, Shareef, Bronson, Paola G., Sasson, Ariella, Wong, Emily, Liu, Daren +104 more·2021·Nature Genetics

Published version of a preprint

Abstract

The UK Biobank Exome Sequencing Consortium (UKB-ESC) is a private–public partnership between the UK Biobank (UKB) and eight biopharmaceutical companies that will complete the sequencing of exomes for all ~500,000 UKB participants. Here, we describe the early results from ~200,000 UKB participants and the features of this project that enabled its success. The biopharmaceutical industry has increasingly used human genetics to improve success in drug discovery. Recognizing the need for large-scale human genetics data, as well as the unique value of the data access and contribution terms of the UKB, the UKB-ESC was formed. As a result, exome data from 200,643 UKB enrollees are now available. These data include ~10 million exonic variants—a rich resource of rare coding variation that is particularly valuable for drug discovery. The UKB-ESC precompetitive collaboration has further strengthened academic and industry ties and has provided teams with an opportunity to interact with and learn from the wider research community. The UK Biobank Exome Sequencing Consortium aims to sequence all the exomes of approximately 500,000 UK Biobank participants. This Perspective describes the results from approximately 200,000 exomes and discusses the lessons learned from this UK Biobank–biopharmaceutical company collaboration.

AI snapshot

Written from the paper’s full text.

TL;DR

The UK Biobank Exome Sequencing Consortium generated and released exome sequencing data for the first 200,643 UK Biobank participants, observing ~10M variants in targeted regions. The resource is intended to enable rare-variant human genetics studies and drug discovery, with coding variants and predicted loss-of-function variation characterized at scale.

Key findings

The first 200,643 UKB exomes covered a targeted region of 38,997,831 bases, with coverage exceeding 20X on 95.6% of sites on average; ~10M variants were observed, including 8,086,176 SNPs, 370,958 indels, and 1,596,984 multi-allelic variants.

  • Of the ~8M SNPs observed, 84.5% were coding: 2,139,318 (25.3%) synonymous, 4,549,694 (53.8%) missense, and 453,733 (5.4%) predicted loss-of-function (LOF) variants affecting at least one coding transcript.
  • Allele frequencies were skewed rare: 98% of synonymous, 99% of missense, and 99% of LOF variants had MAF <1%. Per individual, medians were 8,586 synonymous, 7,724 missense, and 202 LOF variants; restricting to canonical transcripts gave a median of 142 LOFs per individual.
  • Genes with heterozygous LOF variants increased modestly from 17,718 in UKB 50K to 18,045 in UKB 200K; genes with at least one homozygous LOF were 1,492 in UKB 200K, with a projection of 1,981 in 500K.

Methods

The OQFE protocol mapped raw FASTQ reads with BWA-MEM to GRCh38, retained supplementary alignments, added mate tags with samblaster, marked duplicates with Picard 2.21.2, and compressed final CRAMs with samtools.

  • The OQFE pipeline was applied to more than 200,000 UKB exome samples; variants were called per CRAM with DeepVariant 0.10.0 using a model retrained on exome data, restricted to the exome capture region plus 100 bp flanks, and gVCFs were merged with GLnexus 1.2.6 using default “DeepVariantWES” parameters.
  • QC included individual and variant missingness <10%, Hardy-Weinberg equilibrium p>10^-15, minimum depth of 7 for SNPs and 10 for indels, and allele balance >0.15 for SNPs and >0.20 for indels; annotation used SnpEff with Ensembl 85, canonical transcripts from MANE Select v0.9/APPRIS/Ensembl, and a strict LOF subset.

Limitations

The paper does not state a formal limitations section.

  • Evident from the text: exome sequencing is restricted to targeted coding regions plus 100 bp flanks, so noncoding and broader variation are not captured; the reported data are for the first 200,643 exomes, with 500K figures presented as projections rather than observed results.
  • Evident from the text: the sequenced cohort is predominantly European ancestry (93.7% in UKB 200K; 94.0% in UKB 500K), and phenotypes are defined using ICD10 codes plus self-reported questionnaire data, which may limit generalizability and phenotype precision; the paper also notes that identifying true LOF events is not straightforward and uses a strict LOF subset.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s41588-021-00885-0

Cites

121 of 121 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

No claims could be anchored to a verbatim quote in the text.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Almost all UK Biobank participants underwent genome-wide array genotyping and, more recently, proteome, whole-exome sequencing and whole-genome sequencing.

    “Further, almost all participants underwent genome-wide array genotyping and, more recently, proteome, whole-exome sequencing 83 and WGS 84 .”

    From Multimodal biomedical AI (2022) · cites this paper as [83]

    Citation 83 is attached to whole-exome sequencing. The Abstract reports exome data for the first roughly 200,000 of approximately 500,000 UK Biobank participants and says sequencing all participants was a future goal. It supports that exome sequencing had occurred, but not that almost all participants had undergone it; the separate citation 84 is attached to whole-genome sequencing. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Targeted-region variant total is overstated

    Minor

    The text reports approximately 10 million variants within the targeted regions, but the table gives 8,457,134. The table's SNP and indel counts sum exactly to 8,457,134, so the multi-allelic sites cannot be added as a separate category to reach 10 million.

  • Synonymous percentage does not match the stated SNP denominator

    Minor

    The sentence describes percentages of the approximately 8 million SNPs. On that denominator, 2,139,318 synonymous variants are 26.46%, not 25.3%; 25.3% instead uses the table's larger targeted-region variant total.

    Reported 25.3 · recomputed 26.456486

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Authors
Szustakowski, J. D., Balasubramanian, S., Kvikstad, E., Khalid, S., Bronson, P. G., Sasson, A., Wong, E., Liu, D., Wade Davis, J., Haefliger, C., Katrina Loomis, A., Mikkilineni, R., Noh, H. J., Wadhawan, S., Bai, X., Hawes, A., Krasheninina, O., Ulloa, R., Lopez, A. E., Smith, E. N., Waring, J. F., Whelan, C. D., Tsai, E. A., Overton, J. D., Salerno, W. J., Jacob, H., Szalma, S., Runz, H., Hinkle, G., Nioi, P., Petrovski, S., Miller, M. R., Baras, A., Mitnaul, L. J., Reid, J. G., UKB-ESC Research Team, Moiseyenko, O., Rios, C., Saha, S., Abecasis, G., Banerjee, N., Beechert, C., Boutkov, B., Cantor, M., Coppola, G., Economides, A., Eom, G., Forsythe, C., Fuller, E. D., Gu, Z., Habegger, L., Jones, M. B., Lanche, R., Lattari, M., LeBlanc, M., Li, D., Lotta, L. A., Manoochehri, K., Mansfield, A. J., Maxwell, E. K., Mighty, J., Nafde, M., O’Keeffe, S., Orelus, M., Padilla, M. S., Panea, R., Polanco, T., Pradhan, M., Rasool, A., Schleicher, T. D., Sharma, D., Shuldiner, A., Staples, J. C., Van Hout, C. V., Widom, L., Wolf, S. E., John, S., Chen, C.-Y., Sexton, D., Kupelian, V., Marshall, E., Swan, T., Eaton, S., Liu, J. Z., Loomis, S., Jensen, M., Duraisamy, S., Tetrault, J., Merberg, D., Badola, S., Reppell, M., Grundstad, J., Zheng, X., Deaton, A. M., Parker, M. M., Ward, L. D., Flynn-Carroll, A. O., Austin, C., March, R., Pangalos, M. N., Platt, A., Snowden, M., Matakidou, A., Wasilewski, S., Wang, Q., Deevi, S., Carss, K., Smith, K., Sogaard, M., Hu, X., Chen, X., & Ye, Z.
Affiliations
  • Bristol-Myers Squibb (United States) (US)
  • Regeneron (United States) (US)
  • Biogen (United States) (US)
  • AstraZeneca (United Kingdom) (GB)
  • AbbVie (United States) (US)
  • Alnylam Pharmaceuticals (United States) (US)
  • Pfizer (United States) (US)
Corresponding author
Reid, Jeffrey G.
Venue
Nature Genetics
Published
2021-06-28
Volume
53
Issue
7
Pages
942-948
ISSN
  • 1061-4036 (ISSN-L)
  • 1546-1718
OpenAlex
W3177160312
Cited by
401
References
121
Citations by year
2026: 32 · 2025: 66 · 2024: 64 · 2023: 83 · 2022: 107 · 2021: 46 · 2020: 3
FWCI
11.27
Type
journal article
Language
en
Open access
Locations
  • Nature Genetics (publishedVersion)
  • medRxiv (acceptedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
Keywords
exome sequencing, UK Biobank, rare coding variants, drug discovery, human genetics, pre-competitive collaboration, public-private partnerships, genetic data access
MeSH terms
Exome Sequencing, Human Genetics, United Kingdom, Humans, Research, Biological Specimen Banks, Genomics, Drug Discovery

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash (extract-v3) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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