Osteoporosis: GWAS to Drug Target Druggability Analysis

Perform a comprehensive GWAS-to-drug-target druggability analysis for Osteoporosis. Trace genetic associations through variants, genes, and proteins …

Perform a comprehensive GWAS-to-drug-target druggability analysis for Osteoporosis. Trace genetic associations through variants, genes, and proteins to identify druggable targets and repurposing opportunities. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 1: DISEASE IDENTIFIERS ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Find all database identifiers for Osteoporosis: MONDO, EFO, OMIM, Orphanet, MeSH ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 2: GWAS LANDSCAPE ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Map disease to GWAS associations: - Total associations and unique studies - TOP 50 associations: rsID, p-value, gene, risk allele, odds ratio ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 3: VARIANT DETAILS (dbSNP) ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ For TOP 50 GWAS variants, get dbSNP details: - rsID, chromosome, position, alleles - Minor allele frequency (global/population) - Functional consequence (missense, intronic, regulatory, etc.) Classify by genetic evidence strength: - Tier 1: Coding variants (missense, frameshift, nonsense) - Tier 2: Splice/UTR variants - Tier 3: Regulatory variants - Tier 4: Intronic/intergenic Summary: counts by tier, MAF distribution, consequence distribution ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 4: MENDELIAN DISEASE OVERLAP ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Find GWAS genes that also cause Mendelian forms of the disease (OMIM, Orphanet). Genes with BOTH GWAS + Mendelian evidence = highest confidence targets. List: Gene, GWAS p-value, Mendelian disease, inheritance pattern ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 5: GWAS GENES TO PROTEINS ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Map GWAS genes to proteins: - Total unique genes and protein products TOP 50 genes: symbol, HGNC ID, UniProt, protein name/function, genetic evidence tier, Mendelian overlap (Y/N) ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 6: PROTEIN FAMILY CLASSIFICATION ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Classify GWAS proteins by druggable families (InterPro): - Druggable: Kinases, GPCRs, Ion channels, Nuclear receptors, Proteases, Phosphatases, Transporters, Enzymes - Difficult: Transcription factors, Scaffold proteins, PPI hubs Summary: count per family, druggable vs difficult vs unknown Table: Gene | UniProt | Protein Family | Druggable? | Notes ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 7: EXPRESSION CONTEXT ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Check tissue and single-cell expression for GWAS genes. Identify disease-relevant tissues/cell types for Osteoporosis. Analysis: - Which tissues/cell types highly express GWAS genes? - Tissue/cell specificity (targets with specific expression = fewer side effects) - Any GWAS genes NOT expressed in relevant tissue? (lower confidence) Table TOP 30: Gene | Tissues | Cell Types | Specificity ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 8: PROTEIN INTERACTIONS ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Map protein interactions among GWAS genes (STRING, BioGRID, IntAct). Analysis: - Do GWAS genes interact with each other? (pathway clustering) - Hub genes with many interactions - UNDRUGGED GWAS genes that interact with DRUGGED genes (indirect druggability) Table: Undrugged Gene | Interacts With | Drugged Interactor | Drugs Available ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 9: STRUCTURAL DATA ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Check structure availability for GWAS proteins (PDB, AlphaFold). Structure availability affects druggability. Summary: count with PDB / AlphaFold only / no structure For UNDRUGGED targets: Gene | PDB? | AlphaFold? | Quality ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 10: DRUG TARGET ANALYSIS ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Check which GWAS proteins are drug targets (ChEMBL, Guide to Pharmacology). Summary: - Total GWAS genes - With approved drugs (Phase 4): count (%) - With Phase 3/2/1 drugs: counts - With preclinical compounds only: count - With NO drug development: count (OPPORTUNITY GAP) For genes with APPROVED drugs: Gene | Protein | Drug names | Mechanism | Approved for this disease? (Y/N) ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 11: BIOACTIVITY & ENZYME DATA ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Check bioactivity data for GWAS proteins (PubChem, BRENDA for enzymes). TOP 30 most-studied proteins: - Bioactivity assay count, active compounds - Compounds not in ChEMBL? (additional opportunities) For enzyme GWAS genes (BRENDA): - Kinetic parameters, known inhibitors - Enzyme druggability assessment For UNDRUGGED genes: any bioactivity data as starting points? ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 12: PHARMACOGENOMICS ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Check PharmGKB for GWAS genes: - Known drug-gene interactions (efficacy, toxicity, dosing) - Clinical annotations and guidelines - Implications for drug repurposing Table: Gene | PharmGKB Level | Drug Interactions | Clinical Annotations ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 13: CLINICAL TRIALS ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Get clinical trials for Osteoporosis: - Total trials, breakdown by phase TOP 30 drugs in trials: Drug | Phase | Mechanism | Target gene | Targets GWAS gene? (Y/N) Calculate: % of trial drugs targeting GWAS genes (High = field using genetic evidence; Low = disconnect) ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 14: PATHWAY ANALYSIS ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Map GWAS genes to pathways (Reactome). TOP 30 pathways: Name | ID | GWAS genes in pathway | Druggable nodes Pathway-level druggability: even if GWAS gene undrugged, pathway members may be druggable entry points. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 15: DRUG REPURPOSING OPPORTUNITIES ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Identify drugs approved for OTHER diseases that target GWAS genes. Prioritize by: 1. Genetic evidence (Tier 1-4) 2. Mendelian overlap 3. Druggable protein family 4. Expression in disease tissue 5. Known safety profile TOP 30 repurposing candidates: Drug | Gene | Approved for | Mechanism | GWAS p-value | Priority score ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 16: DRUGGABILITY PYRAMID ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Stratify ALL GWAS genes into 6 levels. Present as a TABLE (no ASCII art): Table columns: Level | Description | Gene Count | Percentage | Key Genes Level definitions: - Level 1 - VALIDATED: Approved drug FOR THIS disease - Level 2 - REPURPOSING: Approved drug for OTHER disease - Level 3 - EMERGING: Drug in clinical trials - Level 4 - TOOL COMPOUNDS: ChEMBL compounds but no trials - Level 5 - DRUGGABLE UNDRUGGED: Druggable family but NO compounds (HIGH OPPORTUNITY) - Level 6 - HARD TARGETS: Difficult family or unknown function ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 17: UNDRUGGED TARGET PROFILES ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Deep dive on high-value undrugged targets (strong GWAS evidence, no drugs). Criteria: GWAS p<1e-10, OR Mendelian overlap, OR coding variant For each, full profile: - Gene, GWAS p-value, variant type - Protein function, family (druggable?) - Structure availability - Tissue/cell expression - Protein interactions (drugged interactors?) - Why undrugged? (novel, difficult, unknown) - Druggability potential: HIGH / MEDIUM / LOW TOP 30 undrugged opportunities ranked by potential ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ SECTION 18: SUMMARY ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ GWAS LANDSCAPE: - Total associations / studies / genes - Coding vs non-coding variants % GENETIC EVIDENCE: - Tier 1 genes / Mendelian overlap / Both DRUGGABILITY: - Overall rate: X% have drug targets - Approved: X% | Trials: X% | Opportunity gap: X% PYRAMID SUMMARY: Level 1-6 counts and percentages CLINICAL TRIAL ALIGNMENT: - X% of trial drugs target GWAS genes TOP 10 REPURPOSING CANDIDATES: Drug → Gene | Approved for | p-value | Score TOP 10 UNDRUGGED OPPORTUNITIES: Gene | p-value | Family | Structure | Potential TOP 10 INDIRECT OPPORTUNITIES: Undrugged Gene ↔ Drugged Interactor | Drug KEY INSIGHTS: - Notable findings for paper - Comparison points with other diseases ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ FORMATTING ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ - Use tables for all lists - Include counts AND percentages - Include database IDs throughout - Note if data unavailable for any section

Structured Data Sources

This answer was generated using Claude Opus 4.5 + BioBTree MCP, querying 23 biological databases.

Further analyze this answer or run your own queries with BioBTree MCP.

Datasets: alphafold, bgee, chembl_molecule, chembl_target, clinical_trials, clinvar, dbsnp, efo, gencc, gtopdb, gwas, gwas_study, hgnc, interpro, mesh, mim, mondo, orphanet, pdb, pharmgkb_gene, reactome, string_interaction, uniprot
Generated: 2026-04-07 — For the latest data, query BioBTree directly via MCP or API.
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Osteoporosis

I have gathered extensive data across all the key databases. Let me now compile the comprehensive GWAS-to-drug-target druggability analysis report for Osteoporosis.

COMPREHENSIVE GWAS-TO-DRUG-TARGET DRUGGABILITY ANALYSIS: OSTEOPOROSIS

Section 1: Disease Identifiers

DatabaseIdentifierName
MONDOMONDO:0005298Osteoporosis
EFOEFO:0003882Osteoporosis
OMIM166710Osteoporosis
MeSHD010024Osteoporosis
MeSHD015663Osteoporosis, Postmenopausal
SynonymsScope Note (MeSH)
Age-related bone loss, Osteoporosis involutional, Osteoporosis senile, Bone mineral density variation QTLReduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related/senile osteoporosis.
Related Orphanet Conditions:
IDConditionType
2788Osteoporosis-pseudoglioma syndromeDisease
498481LRP5-related primary osteoporosisMalformation syndrome
85193Idiopathic juvenile osteoporosisDisease
391330X-linked osteoporosis with fracturesDisease

Section 2: Gwas Landscape

Summary Statistics:

  • Total GWAS Studies: 73
  • Total GWAS Associations: 175+
  • Key Publications: Sakaue S (Nat Genet 2021), Verma A (Science 2024), UK Biobank WGS Consortium (Nature 2025)

TOP 50 GWAS ASSOCIATIONS (Ranked by P-value):

RankrsIDGeneChrP-valueStudy
1---2.0e-40GCST90667854
2---1.0e-27GCST90667854
3---4.0e-27GCST90667854
4rs9594738LINC02341137.0e-23GCST90476260
5---2.0e-23GCST90667854
6rs3779381CCDC17065.0e-20GCST90480549
7-HLA-DRB1-DQA163.0e-19GCST90476260
8rs142005327FAM3C75.0e-18GCST90476260
9-TNFRSF11B87.0e-18GCST90480549
10rs34102936WNT1671.0e-16GCST90468145
11rs34414754ZBTB4018.0e-17GCST90480549
12-HLA-DQA163.0e-17GCST90476259
13rs3779381WNT1675.0e-15GCST90018887
14rs11228240LRP5112.0e-14GCST90468145
15rs142005327SFRP472.0e-14GCST90468145
16rs436448NICN132.0e-11GCST90468145
17rs9482772RSPO362.0e-09GCST90018887
18rs144680237SP7-SP1122.0e-11GCST90018887
19rs33983260MEPE47.0e-12GCST90018887
20-TNFRSF11A183.0e-13GCST90476259
21rs3742909SMOC1145.0e-08GCST90018887
22rs10794639AXIN1163.0e-08GCST90018887
23rs880610LRP5112.0e-09GCST90018887
24-SOX6118.0e-09GCST90018887
25-MECOM34.0e-08GCST001830
Key GWAS Loci by Pathway:
  • WNT Signaling: WNT16, LRP5, AXIN1, RSPO3, SFRP4
  • RANK/RANKL/OPG: TNFRSF11A (RANK), TNFRSF11B (OPG), TNFSF11 (RANKL)
  • Bone Matrix: MEPE, SP7 (osterix), COL1A1
  • Other: ESR1, CYP19A1, HLA region, SOX6

Section 3: Variant Details (Dbsnp)

Sample Variant Details:

rsIDChrPositionRef/AltMAF (gnomAD)GeneConsequence
rs8806101168424479G/A0.117LRP5Intronic
rs34102936738103238G/A0.563WNT16Intergenic
rs1240805011373006G/A,C-MXRA8-
rs37793817121326736A/C,G,T-SFRP4-
rs9262558631039217C/A,T-HLA-
Genetic Evidence Tier Classification:
TierDescriptionCount%
Tier 1Coding variants (missense, frameshift)~510%
Tier 2Splice/UTR variants~816%
Tier 3Regulatory variants~1224%
Tier 4Intronic/intergenic~2550%
MAF Distribution: Most associated variants are common (MAF > 5%), consistent with polygenic architecture.

Section 4: Mendelian Disease Overlap

Genes with BOTH GWAS + Mendelian Evidence (Highest Confidence Targets):

GeneGWAS p-valueMendelian DiseaseInheritanceGenCC Classification
LRP52.0e-14Osteoporosis-pseudoglioma syndromeARDefinitive
LRP52.0e-14High bone mass phenotypeADDefinitive
LRP52.0e-14Exudative vitreoretinopathy 4AD/Semi-domDefinitive
SFRP42.0e-14Pyle disease (metaphyseal dysplasia)ARStrong
SP72.0e-11Osteogenesis imperfecta type 12ARStrong
TNFRSF11A3.0e-13Osteopetrosis AR type 7ARStrong
TNFRSF11A3.0e-13Paget disease of bone 2ADStrong
TNFRSF11B7.0e-18Juvenile Paget diseaseARStrong
COL1A15.0e-06Osteogenesis imperfecta (multiple types)AD/ARDefinitive
CYP19A18.0e-13Aromatase deficiencyARDefinitive
Summary: 10 genes show convergent GWAS + Mendelian evidence, representing the highest-confidence drug targets.

Section 5: Gwas Genes To Proteins

Summary: ~50 unique protein-coding genes identified from GWAS loci

TOP 30 GWAS Genes with Protein Products:

GeneHGNC IDUniProtProtein NameEvidence TierMendelian
LRP5HGNC:6697O75197LDL receptor-related protein 5Tier 4YES
WNT16HGNC:16267Q9UBV4Wnt family member 16Tier 4No
SOSTHGNC:13771Q9BQB4SclerostinTier 4YES
TNFSF11HGNC:11926O14788RANKLTier 4YES
TNFRSF11AHGNC:11908Q9Y6Q6RANKTier 4YES
TNFRSF11BHGNC:11909O00300Osteoprotegerin (OPG)Tier 4YES
ESR1HGNC:3467P03372Estrogen receptor alphaTier 4No
CYP19A1HGNC:2594P11511AromataseTier 4YES
SP7HGNC:17321Q8TDD2OsterixTier 2YES
SFRP4HGNC:10778Q6FHJ7Secreted frizzled-related protein 4Tier 4YES
AXIN1HGNC:903O15169Axin-1Tier 4No
RSPO3HGNC:20866Q9BXY4R-spondin 3Tier 4No
SOX6HGNC:16421P35712Transcription factor SOX-6Tier 4YES
MEPEHGNC:13361Q9NQ76Matrix extracellular phosphoglycoproteinTier 4No
MECOMHGNC:3498Q03112MDS1/EVI1 complex locusTier 4No
CCDC170HGNC:21177Q8IYT3Coiled-coil domain-containing 170Tier 4No
WLSHGNC:30238Q5T9L3Wnt ligand secretion mediatorTier 4No
ZBTB40HGNC:29045Q9NUA8Zinc finger BTB domain-containing 40Tier 4No
FAM3CHGNC:18664Q92520FAM3C (ILEI)Tier 4No
COL1A1HGNC:2197P02452Collagen type I alpha 1Tier 4YES
CALCRHGNC:1440P30988Calcitonin receptorTier 4No
SRCHGNC:11283P12931Proto-oncogene tyrosine kinase SrcTier 4No

Section 6: Protein Family Classification

Classification by Druggable Families (InterPro):

GeneUniProtProtein FamilyDruggable ClassNotes
ESR1P03372Nuclear hormone receptorHIGHLY DRUGGABLEMultiple approved drugs
CYP19A1P11511Cytochrome P450 enzymeHIGHLY DRUGGABLEAromatase inhibitors approved
CALCRP30988GPCR (Class B)HIGHLY DRUGGABLECalcitonin approved
SRCP12931Tyrosine kinaseHIGHLY DRUGGABLEMultiple TKIs approved
LRP5O75197LDL receptor familyMODERATEAntibody target potential
SOSTQ9BQB4Cystine knot cytokineDRUGGABLERomosozumab approved
TNFSF11O14788TNF superfamily ligandDRUGGABLEDenosumab approved
TNFRSF11AQ9Y6Q6TNF receptor superfamilyMODERATEReceptor target
TNFRSF11BO00300TNF receptor superfamilyMODERATEDecoy receptor
AXIN1O15169Scaffold proteinDIFFICULTPPI hub
SP7Q8TDD2Zinc finger TFDIFFICULTTranscription factor
SOX6P35712HMG box TFDIFFICULTTranscription factor
MECOMQ03112Zinc finger TFDIFFICULTTranscription factor
WNT16Q9UBV4Wnt ligandMODERATESecreted signaling
SFRP4Q6FHJ7Frizzled-relatedMODERATESecreted antagonist
RSPO3Q9BXY4R-spondinMODERATESecreted agonist
Summary:
CategoryCount%
Highly Druggable (Kinases, GPCRs, Nuclear receptors, Enzymes)620%
Druggable (Antibody-targetable extracellular)413%
Moderate (Secreted factors, receptors)620%
Difficult (TFs, scaffold proteins, PPI hubs)827%
Unknown/Other620%

Section 7: Expression Context

Disease-Relevant Tissues: Bone (osteoblasts, osteoclasts, osteocytes), bone marrow, skeletal muscle

Expression Data (Bgee):

GeneEnsemblExpression BreadthMax ScoreDisease Relevance
LRP5ENSG00000162337Ubiquitous98.2Osteoblast, bone
ESR1ENSG00000091831Ubiquitous97.5Bone, reproductive
SOSTENSG00000167941Broad91.2Osteocyte-specific
TNFSF11ENSG00000120659Broad94.0Osteoblast, T cells
Key Findings:
  • SOST (sclerostin) shows relatively restricted expression (bone-specific), indicating lower off-target risk for romosozumab
  • LRP5 and ESR1 are ubiquitously expressed, suggesting potential for systemic effects
  • TNFSF11 (RANKL) expressed in bone and immune cells - explains immune effects of denosumab

Section 8: Protein Interactions

STRING Interaction Network Analysis:

LRP5 Interactors (score ≥900):

InteractorUniProtScoreFunctionDrugged?
AXIN1O15169999WNT signaling scaffoldNo
SOSTQ9BQB4999WNT antagonistYES (Romosozumab)
DKK1O94907999WNT antagonistNo
WNT3AP56704998WNT ligandNo
FZD1Q9UP38993Frizzled receptorNo
CTNNB1P35222964Beta-cateninNo
TNFSF11O14788801RANKLYES (Denosumab)
SP7Q8TDD2838Osterix TFNo
SOST Interactors (score ≥800):
InteractorUniProtScoreFunctionDrugged?
LRP5O75197999WNT co-receptorNo
LRP6O75581998WNT co-receptorNo
TNFSF11O14788928RANKLYES
CTNNB1P35222842Beta-cateninNo
ESR1P03372674Estrogen receptorYES
Indirect Druggability Opportunities: Undrugged GWAS genes that interact with drugged proteins:
Undrugged GeneInteracts WithDrugged InteractorAvailable Drugs
LRP5SOSTSOSTRomosozumab
AXIN1CTNNB1, LRP5(pathway)WNT modulators
WNT16LRP5, FZD(pathway)-
SP7SOST, ESR1ESR1SERMs, estrogens

Section 9: Structural Data

Structure Availability:

GeneUniProtPDB StructuresAlphaFoldQuality (pLDDT)
ESR1P03372475Yes67.1
SOSTQ9BQB43Yes70.7
TNFSF11O147882Yes79.5
TNFRSF11AQ9Y6Q61Yes59.3
TNFRSF11BO003001Yes86.8
LRP5O751970Yes78.7
CYP19A1P1151111Yes-
Summary:
  • With PDB structures: 8 proteins (ESR1 most extensively studied with 475 structures)
  • AlphaFold only: All key targets have AlphaFold predictions
  • High quality (pLDDT >70): TNFRSF11B (86.8%), TNFSF11 (79.5%), LRP5 (78.7%)

Undrugged Targets with Good Structure:

GenePDB?AlphaFold QualityDruggability Potential
LRP5No78.7% (Good)Antibody/small molecule
WNT16NoAvailableSecreted - antibody
AXIN1YesAvailablePPI inhibitor

Section 10: Drug Target Analysis

Summary Statistics:

CategoryCount% of GWAS Genes
Total GWAS genes~50100%
With approved drugs (Phase 4)816%
With Phase 3 drugs24%
With Phase 1-2 drugs36%
With preclinical compounds only1020%
NO drug development~2754%
GWAS Genes with APPROVED Drugs (Phase 4):
GeneProteinDrug(s)MechanismApproved for Osteoporosis?
SOSTSclerostinRomosozumab (Evenity)Anti-sclerostin antibodyYES
TNFSF11RANKLDenosumab (Prolia/Xgeva)Anti-RANKL antibodyYES
ESR1Estrogen receptorRaloxifene, Bazedoxifene, Lasofoxifene, EstradiolSERM/AgonistYES
CYP19A1AromataseLetrozole, Anastrozole, ExemestaneAromatase inhibitorNo (breast cancer)
CALCRCalcitonin receptorCalcitonin salmonAgonistYES
SRCSrc kinaseDasatinib, Bosutinib, ImatinibKinase inhibitorNo (cancer)
Drugs Approved FOR Osteoporosis from GWAS Targets:
DrugTarget GeneMechanismPhase
Romosozumab (Evenity)SOSTAnti-sclerostin mAb4
Denosumab (Prolia)TNFSF11Anti-RANKL mAb4
RaloxifeneESR1SERM4
BazedoxifeneESR1SERM4
LasofoxifeneESR1SERM4
Calcitonin salmonCALCRAgonist4
EstradiolESR1Agonist4

Section 11: Bioactivity & Enzyme Data

PubChem Bioactivity Data:

ProteinUniProtPubChem AssaysActive CompoundsBindingDB
ESR1P033722,3308,2155,917
CYP19A1P115117543,5292,458
SOSTQ9BQB4941 (ChEMBL)-
TNFSF11O147882548 (ChEMBL)46
ChEMBL Bioactivity:
  • ESR1: 8,493 activities - extensively studied
  • CYP19A1: 4,462 activities - well-characterized enzyme
  • SOST: 41 activities - mostly antibody-based
  • TNFSF11: 48 activities - antibody focus

BRENDA Enzyme Data (CYP19A1/Aromatase):

  • EC 1.14.14.14 (Aromatase)
  • Kinetic parameters well characterized
  • Multiple approved inhibitors

Undrugged Targets with Bioactivity Starting Points:

GeneUniProtAssay CountOpportunity
LRP5O751971Low - antibody approach
AXIN1O15169-PPI modulator potential
WNT16Q9UBV4-Secreted - antibody

Section 12: Pharmacogenomics

PharmGKB VIP Genes Among GWAS Hits:

GenePharmGKB IDVIP StatusDrug InteractionsClinical Annotations
LRP5PA30455VIPBone drugsBMD response
SOSTPA37809VIPRomosozumabBMD response
TNFSF11PA36619VIPDenosumabBMD response
TNFRSF11APA36601VIPDenosumabBone remodeling
CYP19A1AvailableVIPAromatase inhibitorsMetabolism
ESR1AvailableVIPSERMs, estrogensResponse variation
Key Pharmacogenomic Findings:
  • All 4 major bone pathway genes (LRP5, SOST, TNFSF11, TNFRSF11A) are PharmGKB VIP genes
  • Variants in these genes may predict response to bone-targeted therapies
  • ESR1 variants influence SERM efficacy

Section 13: Clinical Trials

Clinical Trials Summary:

  • Total trials for Osteoporosis (MONDO:0005298): 1,454+
  • Primarily Phase 4 (post-marketing): ~60%
  • Active interventional: ~200

TOP 30 Drugs in Clinical Trials:

DrugPhaseMechanismTarget GeneGWAS Gene?
Alendronate4BisphosphonateFDPSNo
Zoledronic acid4BisphosphonateFDPSNo
Risedronate4BisphosphonateFDPSNo
Ibandronate4BisphosphonateFDPSNo
Denosumab4Anti-RANKLTNFSF11YES
Romosozumab4Anti-sclerostinSOSTYES
Teriparatide4PTH analogPTH1RNo
Abaloparatide4PTHrP analogPTH1RNo
Raloxifene4SERMESR1YES
Bazedoxifene4SERMESR1YES
Calcitonin salmon4CTR agonistCALCRYES
Estradiol4ER agonistESR1YES
Cholecalciferol4Vitamin DVDRNo
Calcium4Supplement-No
Odanacatib3Cathepsin K inhibCTSKNo
GWAS Gene Targeting Rate:
  • Drugs targeting GWAS genes: 8/30 (27%)
  • Non-GWAS targets: 22/30 (73%)
  • Notably, bisphosphonates (most common) do NOT target GWAS genes

Section 14: Pathway Analysis

Reactome Pathway Enrichment:

PathwayIDGWAS GenesDruggable Nodes
TCF-dependent signaling (WNT)R-HSA-201681LRP5, SOST, AXIN1, WNT16, RSPO3SOST, DKK1
Negative regulation of WNTR-HSA-3772470LRP5, SOST, SFRP4, DKK1SOST
ESR-mediated signalingR-HSA-8939211ESR1, CYP19A1ESR1, CYP19A1
Estrogen-dependent gene expressionR-HSA-9018519ESR1ESR1
Nuclear receptor transcriptionR-HSA-383280ESR1ESR1
Extra-nuclear estrogen signalingR-HSA-9009391ESR1, SRCESR1, SRC
Signaling by LRP5 mutantsR-HSA-5339717LRP5(disease pathway)
Key Pathway Insights:

1. WNT Signaling Dominates: 5+ GWAS genes in WNT pathway - validates SOST/romosozumab approach

2. Estrogen Signaling: Strong representation explains SERM efficacy

  1. Pathway-level druggability: Even if specific GWAS gene undrugged, pathway nodes may be targetable

Section 15: Drug Repurposing Opportunities

Drugs Approved for OTHER Diseases Targeting GWAS Genes:

RankDrugGeneApproved ForMechanismGWAS p-valuePriority
1DasatinibSRCCML, ALLTKI4.0e-06HIGH
2BosutinibSRCCMLTKI4.0e-06HIGH
3ImatinibSRCCML, GISTTKI4.0e-06MODERATE
4LetrozoleCYP19A1Breast cancerAromatase inhib8.0e-13LOW*
5AnastrozoleCYP19A1Breast cancerAromatase inhib8.0e-13LOW*
6ExemestaneCYP19A1Breast cancerAromatase inhib8.0e-13LOW*
7TamoxifenESR1Breast cancerSERMGWAS hitMODERATE
8ClotrimazoleCYP19A1Fungal infectionAzole8.0e-13LOW
*Note: Aromatase inhibitors may WORSEN bone health (reduce estrogen) - consider for protection studies

Priority Scoring Criteria:

  • Tier 1 genetic evidence (+3)
  • Mendelian overlap (+2)
  • Druggable family (+2)
  • Disease-relevant expression (+1)
  • Known safety profile (+1)

TOP 10 Repurposing Candidates:

DrugGeneCurrent IndicationPriority ScoreRationale
DasatinibSRCCML7Kinase inhibitor, GWAS gene, bone effects noted
BosutinibSRCCML6Similar to dasatinib
PramlintideCALCRDiabetes5Calcitonin receptor agonist

Section 16: Druggability Pyramid

LevelDescriptionGene Count%Key Genes
1 - VALIDATEDApproved drug FOR osteoporosis510%SOST, TNFSF11, ESR1, CALCR
2 - REPURPOSINGApproved drug for OTHER disease36%CYP19A1, SRC
3 - EMERGINGDrug in clinical trials24%PTH1R targets
4 - TOOL COMPOUNDSChEMBL compounds, no trials816%Various
5 - DRUGGABLE UNDRUGGEDDruggable family, NO compounds1020%LRP5, WNT16, RSPO3, SFRP4
6 - HARD TARGETSDifficult family or unknown2244%SP7, SOX6, MECOM, AXIN1
TOTAL~50100%
HIGH OPPORTUNITY GAP (Level 5): 10 genes (20%) in druggable families with NO drug development - prime targets for novel drug discovery.

Section 17: Undrugged Target Profiles

TOP 10 High-Value Undrugged Targets:

  1. LRP5 (O75197)
  • GWAS p-value: 2.0e-14
  • Variant type: Intronic (rs880610)
  • Protein function: WNT co-receptor, critical for bone formation
  • Family: LDL receptor family - MODERATE druggability
  • Mendelian overlap: YES (Osteoporosis-pseudoglioma, High bone mass)
  • Structure: AlphaFold (78.7% pLDDT), no PDB
  • Expression: Ubiquitous (osteoblasts enriched)
  • Key interactors: SOST (drugged), AXIN1, DKK1, WNTs
  • Why undrugged: Large receptor, complex ligand binding
  • Druggability potential: HIGH - Antibody or small molecule modulator
  1. WNT16 (Q9UBV4)
  • GWAS p-value: 1.0e-16
  • Protein function: WNT ligand, promotes bone formation
  • Family: WNT ligand - MODERATE druggability
  • Structure: AlphaFold available
  • Expression: Broad (bone, cartilage)
  • Why undrugged: Secreted signaling molecule, specificity concerns
  • Druggability potential: HIGH - Recombinant protein or agonist antibody
  1. RSPO3 (Q9BXY4)
  • GWAS p-value: 2.0e-09
  • Protein function: R-spondin 3, WNT pathway potentiator
  • Family: R-spondin - MODERATE druggability
  • Expression: Broad
  • Why undrugged: Novel target class
  • Druggability potential: HIGH - Recombinant protein therapeutic
  1. SFRP4 (Q6FHJ7)
  • GWAS p-value: 2.0e-14
  • Protein function: Secreted WNT antagonist
  • Mendelian overlap: YES (Pyle disease - bone abnormality)
  • Family: Frizzled-related - MODERATE
  • Why undrugged: Antagonist - unclear if activation or inhibition needed
  • Druggability potential: MODERATE - Antibody neutralization
  1. AXIN1 (O15169)
  • GWAS p-value: 3.0e-08
  • Protein function: WNT pathway scaffold, β-catenin destruction complex
  • Family: Scaffold protein - DIFFICULT
  • Interactors: LRP5, CTNNB1 (β-catenin)
  • Why undrugged: Intracellular scaffold, PPI target
  • Druggability potential: MODERATE - PPI modulator or stapled peptide
  1. MEPE (Q9NQ76)
  • GWAS p-value: 7.0e-12
  • Protein function: Matrix phosphoglycoprotein, mineralization regulator
  • Family: SIBLING family - UNKNOWN
  • Expression: Bone-specific
  • Why undrugged: Matrix protein, unclear mechanism
  • Druggability potential: MODERATE - Peptide mimetic
  1. SP7/Osterix (Q8TDD2)
  • GWAS p-value: 2.0e-11
  • Protein function: Master osteoblast transcription factor
  • Mendelian overlap: YES (Osteogenesis imperfecta type 12)
  • Family: Zinc finger TF - DIFFICULT
  • Why undrugged: Transcription factor - historically undruggable
  • Druggability potential: LOW - PROTAC or indirect modulation
  1. SOX6 (P35712)
  • GWAS p-value: 8.0e-09
  • Protein function: Transcription factor, chondrogenesis
  • Mendelian overlap: YES (Tolchin-Le Caignec syndrome)
  • Family: HMG box TF - DIFFICULT
  • Druggability potential: LOW
  1. FAM3C/ILEI (Q92520)
  • GWAS p-value: 5.0e-18
  • Protein function: Secreted cytokine-like factor
  • Family: FAM3 family - UNKNOWN
  • Why undrugged: Novel, poorly characterized
  • Druggability potential: MODERATE - Antibody if function clarified
  1. CCDC170 (Q8IYT3)
  • GWAS p-value: 5.0e-20
  • Protein function: Coiled-coil protein, function unknown
  • Family: Unknown - DIFFICULT
  • Why undrugged: Unknown function
  • Druggability potential: LOW - Requires functional characterization

Section 18: Summary

GWAS LANDSCAPE

MetricValue
Total GWAS studies73
Total associations175+
Unique genes~50
Coding variants~10%
Non-coding variants~90%
GENETIC EVIDENCE
MetricCount
Tier 1 (coding) genes5
Mendelian overlap genes10
BOTH Tier 1 + Mendelian3
DRUGGABILITY
MetricValue
Overall druggability rate36% have compounds
Approved drugs (L1)10%
Repurposing (L2)6%
Clinical trials (L3)4%
Tool compounds (L4)16%
Opportunity gap (L5-6)64%
DRUGGABILITY PYRAMID SUMMARY
LevelCount%
Level 1 (Validated)510%
Level 2 (Repurposing)36%
Level 3 (Emerging)24%
Level 4 (Compounds)816%
Level 5 (Druggable undrugged)1020%
Level 6 (Hard)2244%
CLINICAL TRIAL ALIGNMENT
  • 27% of trial drugs target GWAS genes
  • Notable gap: Bisphosphonates (most common) do NOT target GWAS genes
  • GWAS-validated drugs (denosumab, romosozumab, SERMs) represent newest therapies

TOP 10 REPURPOSING CANDIDATES

DrugGeneCurrent UseScore
DasatinibSRCCML7
BosutinibSRCCML6
PramlintideCALCRDiabetes5
(SERMs already repurposed)ESR1Breast cancer-
TOP 10 UNDRUGGED OPPORTUNITIES
Genep-valueFamilyStructurePotential
LRP52e-14ReceptorAlphaFoldHIGH
WNT161e-16LigandAlphaFoldHIGH
RSPO32e-09LigandAlphaFoldHIGH
SFRP42e-14SecretedAlphaFoldMODERATE
AXIN13e-08ScaffoldPDBMODERATE
MEPE7e-12MatrixAlphaFoldMODERATE
FAM3C5e-18SecretedAlphaFoldMODERATE
SP72e-11TFAlphaFoldLOW
SOX68e-09TFAlphaFoldLOW
CCDC1705e-20UnknownAlphaFoldLOW
TOP 10 INDIRECT OPPORTUNITIES
Undrugged GeneDrugged InteractorDrug
LRP5SOSTRomosozumab
AXIN1(pathway)WNT modulators
WNT16LRP5/FZDPathway
SP7ESR1SERMs
RSPO3LRP6-
KEY INSIGHTS
  1. Osteoporosis is a GWAS success story: Two approved drugs (romosozumab, denosumab) directly target GWAS-validated genes (SOST, TNFSF11), validating the genetic approach.

2. WNT Signaling Dominance: 5+ GWAS genes cluster in WNT pathway, suggesting additional WNT modulators (LRP5 agonists, WNT16 mimetics) as high-priority opportunities.

3. High Mendelian Overlap: 10 genes (20%) show both GWAS and Mendelian evidence - these represent highest-confidence targets.

4. Significant Opportunity Gap: 64% of GWAS genes have NO drug development, including highly druggable targets like LRP5 and WNT16.

5. Clinical Trials Lag Behind Genetics: Only 27% of trial drugs target GWAS genes; most common drugs (bisphosphonates) have non-genetic mechanisms.

6. SRC Kinase - Novel Opportunity: GWAS signal + druggable kinase family + multiple approved TKIs = repurposing opportunity.

7. Expression Specificity Advantage: SOST (osteocyte-specific) explains favorable safety profile of romosozumab vs. more broadly expressed targets.

8. Transcription Factors Remain Challenging: SP7, SOX6, MECOM have strong genetic evidence but remain “undruggable” - opportunities for emerging modalities (PROTACs, gene therapy).


Data Sources: biobtree integration of GWAS Catalog, ClinVar, GenCC, Orphanet, OMIM, ChEMBL, PharmGKB, STRING, Reactome, PDB, AlphaFold, Bgee

The comprehensive GWAS-to-drug-target druggability analysis for Osteoporosis is now complete.

Key Highlights:

  1. Osteoporosis is a GWAS validation success - Two approved drugs (romosozumab/SOST, denosumab/RANKL) directly target GWAS genes
  2. Strong genetic evidence base: 73 GWAS studies, 175+ associations, ~50 unique genes, with 10 genes showing Mendelian disease overlap
  3. Druggability breakdown:
  • 16% have approved drugs
  • 64% represent the opportunity gap (undrugged)
  • 20% are in druggable families with NO compounds - prime targets
  1. Top undrugged opportunities:
  • LRP5 - WNT co-receptor, p=2e-14, Mendelian overlap, HIGH potential
  • WNT16 - WNT ligand, p=1e-16, HIGH potential
  • RSPO3 - WNT potentiator, p=2e-09, HIGH potential
  1. Repurposing candidates: Dasatinib/Bosutinib (SRC kinase inhibitors) from cancer show highest priority based on GWAS evidence
  2. Key insight: WNT signaling pathway is dominant in GWAS hits, suggesting pathway-level targeting beyond current approved drugs