Multi-cohort proteogenomic analyses reveal genetic effects across the proteome and diseasome

Cell. 2026 May 28;189(11):3339-3357.e11. doi: 10.1016/j.cell.2026.03.049. Epub 2026 May 6.

Abstract

Understanding the genetic regulation of circulating protein levels can provide new insights into disease mechanisms. Here, we present the largest proteogenomic study to date (n = 78,664 participants across 38 studies), identifying >24,000 protein quantitative trait loci (QTLs) associated with 1,116 proteins, acting near to (n = 5,040) or distant (n = 19,698) from the cognate gene. Using machine learning-guided effector gene assignment, we provide genetic evidence for pathways, cell types, and tissues that modulate circulating protein levels, highlighting N-linked glycosylation as an important regulatory pathway. We demonstrate that genetic instruments of protein production/function ("cis") versus modulation ("trans") reveal distinct phenotypic insights. We identify proteins as candidates for drug targets and engagement (e.g., plasma furin and cardiovascular diseases) by comparing cis-based genetic evidence with protein-disease associations. Systematic triangulation of trans-protein QTLs (pQTLs) with genetic and protein associations across many diseases highlights potential drug repurposing opportunities, e.g., tyrosine kinase 2 (TYK2) inhibitors for rheumatoid arthritis. Our multi-cohort meta-analyses generate proteogenomic insights into disease mechanisms and new treatment opportunities.

Keywords: N-linked glycosylation; causal inference; diseasome; drug repurposing; meta-analysis; pleiotropy; proteogenomics; proteomics; trans-pQTLs.

MeSH terms

  • Glycosylation
  • Humans
  • Proteogenomics* / methods
  • Proteome* / genetics
  • Proteome* / metabolism
  • Quantitative Trait Loci / genetics

Substances

  • Proteome