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Ramos-Mejía R, Heath KE, Modamio-Høybjør S, Huckstadt V, Calcagni J, Remondino R, Fano V. Unexpected findings in cervical spine in spondylometaphyseal dysplasia Sutcliff type FN1-related. Am J Med Genet A 2024; 194:e63469. [PMID: 37940834 DOI: 10.1002/ajmg.a.63469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
The autosomal dominant spondylometaphyseal dysplasia Sutcliff type or corner fracture type FN1-related is characterized by a combination of metaphyseal irregularities simulating fractures ("corner fractures"), developmental coxa vara, and vertebral changes. It is linked to heterozygous mutations in FN1 and COL2A1. Vertebral changes as delayed vertebral ossification, ovoid vertebral bodies, anterior vertebral wedging, and platyspondyly have been observed in this condition, while odontoid abnormalities have not been reported. We report an odontoid anomaly in a girl with SMD-CF FN1-related showing the heterozygous variant c.505T>A; p.(Cys169Ser), presenting at 11.9 years of age with acute quadriparesis. Images showed spinal cord compression and injury associated with os odontoideum and C1-C2 instability. She required decompression and instrumented occipitocervical stabilization, suffering from residual paraparesis. This paper describes the first case of SMD-CF FN1-related accompanied by odontoid anomalies.
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Affiliation(s)
- Rosario Ramos-Mejía
- Growth and Development Department, Hospital Garrahan, Buenos Aires, Argentina
| | - Karen E Heath
- Institute of Medical & Molecular Genetics (INGEMM), IdiPAZ, Hospital Universitario la Paz, UAM, Madrid, Spain
- Skeletal Dysplasia Multidisciplinary Unit (UMDE-ERN BOND), Hospital Universitario la Paz, Madrid, Spain
- European Research Network on Rare BONe Disorders (ERN-BOND), Madrid, Spain
- CIBERER, ISCIII, Madrid, Spain
| | - Silvia Modamio-Høybjør
- Institute of Medical & Molecular Genetics (INGEMM), IdiPAZ, Hospital Universitario la Paz, UAM, Madrid, Spain
- Skeletal Dysplasia Multidisciplinary Unit (UMDE-ERN BOND), Hospital Universitario la Paz, Madrid, Spain
- European Research Network on Rare BONe Disorders (ERN-BOND), Madrid, Spain
| | | | - Julián Calcagni
- Spinal Pathology Department, Hospital Garrahan, Buenos Aires, Argentina
| | - Rodrigo Remondino
- Spinal Pathology Department, Hospital Garrahan, Buenos Aires, Argentina
| | - Virginia Fano
- Growth and Development Department, Hospital Garrahan, Buenos Aires, Argentina
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2
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Ma J, Zhang Y, Ding X, Liang Z, Yang C, Deng Z, He H, Guan Z, Zeng C, Lin Y, Luo X. Co-occurrence of Spondyloepiphyseal Dysplasia and X-Linked Hypophosphatemia in a Three-Generation Chinese Family. Calcif Tissue Int 2023; 113:266-275. [PMID: 37278761 PMCID: PMC10449693 DOI: 10.1007/s00223-023-01104-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/25/2023] [Indexed: 06/07/2023]
Abstract
Rare genetic skeletal disorders (GSDs) remain the major problem in orthopedics and result in significant morbidity in patients, but the causes are highly diverse. Precise molecular diagnosis will benefit management and genetic counseling. This study aims to share the diagnostic experience on a three-generation Chinese family with co-occurrence of spondyloepiphyseal dysplasia (SED) and X-linked hypophosphatemia (XLH), and evaluate the therapeutic effects of two third-generation siblings. The proband, his younger brother, and mother presented with short stature, skeletal problems, and hypophosphatemia. His father, paternal grandfather, and aunt also manifested short stature and skeletal deformities. Whole exome sequencing (WES) of proband-brother-parents initially only found the proband and his younger brother had a pathogenic c.2833G > A(p.G945S) variant in the COL2A1 gene inherited from their father. Re-analysis of WES uncovered the proband and his younger brother also harbored a pathogenic ex.12 del variant in the PHEX gene transmitted from their mother. Sanger sequencing, agarose gel electrophoresis, and quantitative polymerase chain reaction proved these results. The proband and his younger brother were confirmed to have a paternally inherited SED and a maternally inherited XLH. During a 2.8-year follow-up, these two siblings remained short stature and hypophosphatemia, but their radiographic signs and serum bone alkaline phosphatase levels were improved with treatment of oral phosphate and calcitriol. Our study presents the first report of co-occurrence of SED and XLH, shows the possibility that two different rare GSDs co-exist in a single patient, and alerts clinicians and geneticists to be cautious about this condition. Our study also suggests that next-generation sequencing has limit in detecting exon-level large deletions.
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Affiliation(s)
- Jian Ma
- Translational Medicine Center, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Ye Zhang
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Xiaoxiao Ding
- Department of Child Health, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, 518028, China
| | - Zhijiang Liang
- Department of Public Health, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Chaoxiang Yang
- Department of Radiology, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Zhi Deng
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Hui He
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Zhihong Guan
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China
| | - Chunhua Zeng
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China.
| | - Yunting Lin
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, China.
| | - Xianqiong Luo
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Guangdong Women and Children Hospital, Guangzhou, 511442, China.
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Handa A, Grigelioniene G, Nishimura G. Radiologic Features of Type II and Type XI Collagenopathies. Radiographics 2020; 41:192-209. [PMID: 33186059 DOI: 10.1148/rg.2021200075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Type II collagen is a major component of the cartilage matrix. Pathogenic variants (ie, disease-causing aberrations) in the type II collagen gene (COL2A1) lead to an abnormal structure of type II collagen, causing a large group of skeletal dysplasias termed type II collagenopathies. Because type II collagen is also located in the vitreous body of the eyes and inner ears, type II collagenopathies are commonly associated with vitreoretinal degeneration and hearing impairment. Type II collagenopathies can be radiologically divided into two major groups: the spondyloepiphyseal dysplasia congenita (SEDC) group and the Kniest-Stickler group. The SEDC group is characterized by delayed ossification of the juxtatruncal bones, including pear-shaped vertebrae. These collagenopathies comprise achondrogenesis type 2, hypochondrogenesis, SEDC, and other uncommon subtypes. The Kniest-Stickler group is characterized by disordered tubular bone growth that leads to "dumbbell" deformities. It comprises Kniest dysplasia and Stickler dysplasia type 1, whose radiographic manifestations overlap with those of type XI collagenopathies (a group of disorders due to abnormal type XI collagen) such as Stickler dysplasia types 2 and 3. This phenotypic overlap is caused by type II and type XI collagen molecules sharing part of the same connective tissues. The authors describe the diagnostic pathways to type II and type XI collagenopathies and the associated differential diagnoses. In addition, they review the clinical features and genetic bases of these conditions, which radiologists should know to participate in multidisciplinary care and translational research. Online supplemental material is available for this article. ©RSNA, 2020.
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Affiliation(s)
- Atsuhiko Handa
- From the Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242 (A.H.); Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet and Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden (G.G.); and Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan (G.N.)
| | - Giedre Grigelioniene
- From the Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242 (A.H.); Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet and Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden (G.G.); and Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan (G.N.)
| | - Gen Nishimura
- From the Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242 (A.H.); Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet and Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden (G.G.); and Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan (G.N.)
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Zhang B, Zhang Y, Wu N, Li J, Liu H, Wang J. Integrated analysis of COL2A1 variant data and classification of type II collagenopathies. Clin Genet 2019; 97:383-395. [PMID: 31758797 DOI: 10.1111/cge.13680] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 11/29/2022]
Abstract
The COL2A1 gene encodes the alpha-1 chain of type II procollagen. Type II collagen, comprised of three identical alpha-1 chains, is the major component of cartilage. COL2A1 gene variants are the etiologies of genetic diseases, termed type II collagenopathies, with a wide spectrum of clinical presentations. To date, at least 460 distinct COL2A1 mutations, identified in 663 independent probands, and 21 definite disorders have been reported. Nevertheless, a well-defined genotype-phenotype correlation has not been established, and few hot spots of mutation have been reported. In this study, we analyzed data of COL2A1 variants and clinical information of patients obtained from the Leiden Open Variation Database 3.0, as well as the currently available relevant literature. We determined the characteristics of the COL2A1 variants and distributions of the clinical manifestations in patients, and identified four likely genotype-phenotype correlations. Moreover, we classified 21 COL2A1-related disorders into five categories, which may assist clinicians in understanding the essence of these complex phenotypes and prompt genetic screening in clinical practice.
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Affiliation(s)
- Boyan Zhang
- Orthopedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Yue Zhang
- Department of Radiation Oncology, First Bethune Hospital of Jilin University, Changchun, China
| | - Naichao Wu
- Orthopedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Jianing Li
- Jilin Provincial Key Laboratory of Animal Embryo Engineering, College of Animal Sciences, Jilin University, Changchun, China
| | - He Liu
- Orthopedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Jincheng Wang
- Orthopedic Medical Center, The Second Hospital of Jilin University, Changchun, China
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Costantini A, Valta H, Baratang NV, Yap P, Bertola DR, Yamamoto GL, Kim CA, Chen J, Wierenga KJ, Fanning EA, Escobar L, McWalter K, McLaughlin H, Willaert R, Begtrup A, Alm JJ, Reinhardt DP, Mäkitie O, Campeau PM. Novel fibronectin mutations and expansion of the phenotype in spondylometaphyseal dysplasia with "corner fractures". Bone 2019; 121:163-171. [PMID: 30599297 DOI: 10.1016/j.bone.2018.12.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/02/2018] [Accepted: 12/29/2018] [Indexed: 01/15/2023]
Abstract
Heterozygous pathogenic variants in the FN1 gene, encoding fibronectin (FN), have recently been shown to be associated with a skeletal disorder in some individuals affected by spondylometaphyseal dysplasia with "corner fractures" (SMD-CF). The most striking feature characterizing SMD-CF is irregularly shaped metaphyses giving the appearance of "corner fractures". An array of secondary features, including developmental coxa vara, ovoid vertebral bodies and severe scoliosis, may also be present. FN is an important extracellular matrix component for bone and cartilage development. Here we report five patients affected by this subtype of SMD-CF caused by five novel FN1 missense mutations: p.Cys123Tyr, p.Cys169Tyr, p.Cys213Tyr, p.Cys231Trp and p.Cys258Tyr. All individuals shared a substitution of a cysteine residue, disrupting disulfide bonds in the FN type-I assembly domains located in the N-terminal assembly region. The abnormal metaphyseal ossification and "corner fracture" appearances were the most remarkable clinical feature in these patients. In addition, generalized skeletal fragility with low-trauma bilateral femoral fractures was identified in one patient. Interestingly, the distal femoral changes in this patient healed with skeletal maturation. Our report expands the phenotypic and genetic spectrum of the FN1-related SMD-CF and emphasizes the importance of FN in bone formation and possibly also in the maintenance of bone strength.
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Affiliation(s)
- Alice Costantini
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm 171 76, Sweden
| | - Helena Valta
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki 00290, Finland
| | - Nissan Vida Baratang
- CHU Sainte Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada
| | - Patrick Yap
- Genetic Health Service New Zealand (Northern Hub), Auckland 1023, New Zealand
| | - Débora R Bertola
- Centro de Pesquisa sobre o Genoma Humano e Células-Tronco do Instituto de Biociências- Universidade de São Paulo, São Paulo, SP 05508-090, Brazil; Clinical Genetics Unit, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-000, Brazil
| | - Guilherme L Yamamoto
- Centro de Pesquisa sobre o Genoma Humano e Células-Tronco do Instituto de Biociências- Universidade de São Paulo, São Paulo, SP 05508-090, Brazil; Clinical Genetics Unit, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-000, Brazil
| | - Chong A Kim
- Clinical Genetics Unit, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP 05403-000, Brazil
| | - Jiani Chen
- University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | | | - Elizabeth A Fanning
- University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; Division of Genomic Diagnostics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Luis Escobar
- Payton Manning Children's Hospital at St. Vincent Health, Indianapolis, IN 46260, USA
| | | | | | | | - Amber Begtrup
- GeneDx, 207 Perry Parkway, Gaithersburg, MD 20877, USA
| | - Jessica J Alm
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm 171 76, Sweden
| | - Dieter P Reinhardt
- Department of Anatomy and Cell Biology, and Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada
| | - Outi Mäkitie
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm 171 76, Sweden; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki 00290, Finland; Department of Clinical Genetics, Karolinska University Hospital, Stockholm 171 76, Sweden; Folkhälsan Institute of Genetics, University of Helsinki, Helsinki 00290, Finland.
| | - Philippe M Campeau
- CHU Sainte Justine Research Centre and Department of Pediatrics, University of Montreal, Montreal, QC H3T 1C5, Canada.
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Cadoff EB, Sheffer R, Wientroub S, Ovadia D, Meiner V, Schwarzbauer JE. Mechanistic insights into the cellular effects of a novel FN1 variant associated with a spondylometaphyseal dysplasia. Clin Genet 2018; 94:429-437. [PMID: 30051459 DOI: 10.1111/cge.13424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/30/2018] [Accepted: 07/24/2018] [Indexed: 10/28/2022]
Abstract
Spondylometaphyseal dysplasia (SMD) is characterized by developmental changes in long bones and vertebrae. It has large phenotypic diversity and multiple genetic causes, including a recent link to novel variants in the extracellular matrix (ECM) protein fibronectin (FN), a regulator of ECM assembly and key link between the ECM and proper cell function. We identified a patient with a unique SMD, similar to SMD with corner fractures. The patient has been followed over 19 years and presents with short stature, genu varum, kyphoscoliosis, and pectus carinatum. Radiography shows metaphyseal changes that resolved over time, vertebral changes, and capitular avascular necrosis. Whole exome sequencing identified a novel heterozygous FN1 variant (p.Cys97Trp). Using mass spectroscopy, mutant FN was detected in plasma and in culture medium of primary dermal fibroblasts isolated from the patient, but mutant protein was much less abundant than wild-type FN. Immunofluorescence and immunoblotting analyses show that mutant fibroblasts assemble significantly lower amounts of FN matrix than wild-type cells, and mutant FN was preferentially retained within the endoplasmic reticulum. This work highlights the importance of FN in skeletal development, and its potential role in the pathogenesis of a subtype of SMD.
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Affiliation(s)
- E B Cadoff
- Department of Molecular Biology, Princeton University, Princeton, New Jersey
| | - R Sheffer
- Department of Genetics and Metabolic Disorders, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - S Wientroub
- Department of Pediatric Orthopedics, Dana-Dwek Children's Hospital, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Ovadia
- Department of Pediatric Orthopedics, Dana-Dwek Children's Hospital, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - V Meiner
- Department of Genetics and Metabolic Disorders, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - J E Schwarzbauer
- Department of Molecular Biology, Princeton University, Princeton, New Jersey
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Lee CS, Fu H, Baratang N, Rousseau J, Kumra H, Sutton VR, Niceta M, Ciolfi A, Yamamoto G, Bertola D, Marcelis CL, Lugtenberg D, Bartuli A, Kim C, Hoover-Fong J, Sobreira N, Pauli R, Bacino C, Krakow D, Parboosingh J, Yap P, Kariminejad A, McDonald MT, Aracena MI, Lausch E, Unger S, Superti-Furga A, Lu JT, Cohn DH, Tartaglia M, Lee BH, Reinhardt DP, Campeau PM, Campeau PM. Mutations in Fibronectin Cause a Subtype of Spondylometaphyseal Dysplasia with "Corner Fractures". Am J Hum Genet 2017; 101:815-823. [PMID: 29100092 DOI: 10.1016/j.ajhg.2017.09.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/12/2017] [Indexed: 01/15/2023] Open
Abstract
Fibronectin is a master organizer of extracellular matrices (ECMs) and promotes the assembly of collagens, fibrillin-1, and other proteins. It is also known to play roles in skeletal tissues through its secretion by osteoblasts, chondrocytes, and mesenchymal cells. Spondylometaphyseal dysplasias (SMDs) comprise a diverse group of skeletal dysplasias and often manifest as short stature, growth-plate irregularities, and vertebral anomalies, such as scoliosis. By comparing the exomes of individuals with SMD with the radiographic appearance of "corner fractures" at metaphyses, we identified three individuals with fibronectin (FN1) variants affecting highly conserved residues. Furthermore, using matching tools and the SkelDys emailing list, we identified other individuals with de novo FN1 variants and a similar phenotype. The severe scoliosis in most individuals and rare developmental coxa vara distinguish individuals with FN1 mutations from those with classical Sutcliffe-type SMD. To study functional consequences of these FN1 mutations on the protein level, we introduced three disease-associated missense variants (p.Cys87Phe [c.260G>T], p.Tyr240Asp [c.718T>G], and p.Cys260Gly [c.778T>G]) into a recombinant secreted N-terminal 70 kDa fragment (rF70K) and the full-length fibronectin (rFN). The wild-type rF70K and rFN were secreted into the culture medium, whereas all mutant proteins were either not secreted or secreted at significantly lower amounts. Immunofluorescence analysis demonstrated increased intracellular retention of the mutant proteins. In summary, FN1 mutations that cause defective fibronectin secretion are found in SMD, and we thus provide additional evidence for a critical function of fibronectin in cartilage and bone.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Philippe M Campeau
- Centre Hospitalier Universitaire Sainte Justine Research Centre, University of Montreal, Montreal, QC H3T 1C5, Canada.
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