Reviewer #1 (Public review):
Summary:
Howard et al. performed deep mutational scanning on the MC4R gene, using a reporter assay to investigate two distinct downstream pathways across multiple experimental conditions. They validated their findings with ClinVar data and previous studies. Additionally, they provided insights into the application of DMS results for personalized drug therapy and differential ligand responses across variant types.
Strengths:
They captured over 99% of variants with robust signals and investigated subtle functionalities, such as pathway-specific activities and interactions with different ligands, by refining both the experimental design and analytical methods.
Weaknesses:
While the study generated informative results, it lacks a detailed explanation regarding the input library, replicate correlation, and sequencing depth for a given number of cells. Additionally, there are several questions that it would be helpful for authors to clarify.
(1) It would be helpful to clarify the information regarding the quality of the input library and experimental replicates. Are variants evenly represented in the library? Additionally, have the authors considered using long-read sequencing to confirm the presence of a single intended variant per construct? Finally, could the authors provide details on the correlation between experimental replicates under each condition?
(2) Since the functional readout of variants is conducted through RNA sequencing, it seems crucial to sequence a sufficient number of cells with adequate sequencing saturation. Could the authors clarify the coverage depth used for each RNA-seq experiment and how this depth was determined? Additionally, how many cells were sequenced in each experiment?
(3) It appears that the frequencies of individual RNA-seq barcode variants were used as a proxy for MR4C activity. Would it be important to also normalize for heterogeneity in RNA-seq coverage across different cells in the experiment? Variability in cell representation (i.e., the distribution of variants across cells) could lead to misinterpretation of variant effects. For example, suppose barcode_a1 represents variant A and barcode_b1 represents variant B. If the RNA-seq results show 6 reads for barcode_a1 and 7 reads for barcode_b1, it might initially appear that both variants have similar effect sizes. However, if these reads correspond to 6 separate cells each containing 1 copy of barcode_a1, and only 1 cell containing 7 copies of barcode_b1, the interpretation changes significantly. Additionally, if certain variants occupy a larger proportion of the cell population, they are more likely to be overrepresented in RNA sequencing.
(4) Although the assay system appears to effectively represent MC4R functionality at the molecular level, we are curious about the potential disparity between the DMS score system and physiological relevance. How do variants reported in gnomAD distribute within the DMS scoring system?
(5) To measure Gq signaling, the authors used the GAL4-VPR relay system. Is there additional experimental data to support that this relay system accurately represents Gq signaling?
(6) Identifying the variants responsive to the corrector was impressive. However, we are curious about how the authors confirmed that the restoration of MC4R activity was due to the correction of the MC4R protein itself. Is there a possibility that the observed effect could be influenced by other factors affected by the corrector? When the corrector was applied to the cells, were any expected or unexpected differential gene expression changes observed?
(7) As mentioned in the introduction, gain-of-function (GoF) variants are known to be protective against obesity. It would be interesting to see further studies on the observed GoF variants. Do the authors have any plans for additional research on these variants?