June 29, 2026

MEDAISY

Small Steps Towards a Healthier Life

Quantifying the Genetics of Disease Inheritance in Primary Immunodeficiency

Quantifying the Genetics of Disease Inheritance in Primary Immunodeficiency

Abstract

We present a novel framework for quantifying the prior probability of observing disease-associated variants in any gene for a given phenotype. By integrating large-scale genomic annotations, including population allele frequencies and ClinVar variant classifications, with Hardy-Weinberg-based calculations, our method estimates per-variant observation probabilities under autosomal dominant (AD), autosomal recessive (AR), and X-linked modes of inheritance. Applied to 557 genes implicated in primary immunodeficiency and inflammatory disease, our approach generated 54,814 variant probabilities. First, these detailed, pre-calculated results provide robust priors for any gene-disease combination. Second, a score positive total metric summarises the aggregate pathogenic burden, serving as an indicator of the likelihood of observing a patient with the disease and reflecting genetic constraint. Validation in NFKB1 (AD) and CFTR (AR) disorders confirmed close concordance between predicted and observed case counts. The resulting datasets, available in both machine-readable and human-friendly formats, support Bayesian variant interpretation and clinical decision-making. 1

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Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study used only openly available statistic data from GnomAD, Clinvar, and PanelAppRex as cited in the manuscript.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Footnotes

  • The previous version reported the main methods and validation studies. This revision includes the zenodo data repository and a detailed study of the main results, including the genetic constraint in high-impact protein networks.

  • 1 Availability: This data is integrated in public panels at The source code and data are accessible as part of the variant risk estimation project at The variant-level data is available from the Zenodo repository: (VarRiskEst PanelAppRex ID 398 gene variants.tsv). VarRiskEst is available under the MIT licence.

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