Will family studies return to prominence in human genetics and genomics? Rare variants and linkage analysis of complex traits

A major focus of modern human genetics has been the search for genetic variations that contribute to human disease. These studies originated in families and used linkage methods as a primary analytical tool. With continued technical improvements, these family-based linkage studies have been very powerful in identifying genes contributing to monogenic disorders. When these methods were applied to disorders with complex, non-Mendelian patterns of inheritance they largely failed. The development of effective capabilities for Genome Wide Association Studies (GWAS) relegated family-based studies to a peripheral role in human genetics research. Despite the remarkable record of GWAS discoveries, common variations identified in GWAS account for a limited (frequently less than 10%) proportion of the heritable risk of qualitative traits or variance of quantitative traits. Next generation sequencing is facilitating a re-examination of family-based methods with surprising and intriguing results. We propose that rare variants of large effect underlie many linkage peaks, including complex quantitative phenotypes, and review the issues underlying this proposed basis for complex traits.