Integrative multi-omic analysis identifies key transcription factors and target proteins in renal cell carcinoma and its subtypes.

To characterize key transcription factors (TFs) whose differential DNA binding can be altered by genetic variants associated with risk for renal cell carcinoma (RCC), we conducted a series of mixed model-based analyses integrating 449 TF ChIP-seq profiles across 9 kidney-related cell lines and summary statistics from a multi-ancestry genome-wide association study of RCC. We identified 96 unique TFs for which presence of SNPs in a neighborhood of TF ChIP-seq peaks are significantly associated (p-value <1×10-4) with their effect on RCC, including EPAS1, ARNT, PAX8 and PBRM1, previously implicated in RCC pathogenesis. Most TFs overlapped active promoters/enhancers in RCC tumors but remained significant after adjusting for tumor chromatin accessibility. Further, we found the co-occupancy of 220 pairs of RCC-related TFs to be associated with RCC risk (FDR<5%) beyond effects of individual TFs, highlighting synergistic regulation between pairs of TFs. To further investigate distal (trans) regulation of TF-binding disruption at RCC associated loci on the proteome, we used a set-based regression to aggregate the trans-effects of multiple loci overlapping with TF binding sites. Across 2,732 proteins profiled in UKB-PPP, identified 169 trans-associated (p-value<1.6×10-7) proteins, nominating specific targets for each TF. For example, we identified TLR3 and ZP3 to be associated with EPAS1, ARNT, and PBRM1, indicating these proteins are likely affected by RCC-related variants disrupting binding sites of the corresponding TFs. These results characterize the landscape of RCC-related TFs and implicate TF-mediated proteomic mechanisms in RCC pathogenesis, nominating testable targets for laboratory studies.