5
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Long HK, Osterwalder M, Welsh IC, Hansen K, Davies JOJ, Liu YE, Koska M, Adams AT, Aho R, Arora N, Ikeda K, Williams RM, Sauka-Spengler T, Porteus MH, Mohun T, Dickel DE, Swigut T, Hughes JR, Higgs DR, Visel A, Selleri L, Wysocka J. Loss of Extreme Long-Range Enhancers in Human Neural Crest Drives a Craniofacial Disorder. Cell Stem Cell 2020; 27:765-783.e14. [PMID: 32991838 PMCID: PMC7655526 DOI: 10.1016/j.stem.2020.09.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/09/2020] [Accepted: 09/02/2020] [Indexed: 01/09/2023]
Abstract
Non-coding mutations at the far end of a large gene desert surrounding the SOX9 gene result in a human craniofacial disorder called Pierre Robin sequence (PRS). Leveraging a human stem cell differentiation model, we identify two clusters of enhancers within the PRS-associated region that regulate SOX9 expression during a restricted window of facial progenitor development at distances up to 1.45 Mb. Enhancers within the 1.45 Mb cluster exhibit highly synergistic activity that is dependent on the Coordinator motif. Using mouse models, we demonstrate that PRS phenotypic specificity arises from the convergence of two mechanisms: confinement of Sox9 dosage perturbation to developing facial structures through context-specific enhancer activity and heightened sensitivity of the lower jaw to Sox9 expression reduction. Overall, we characterize the longest-range human enhancers involved in congenital malformations, directly demonstrate that PRS is an enhanceropathy, and illustrate how small changes in gene expression can lead to morphological variation.
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Affiliation(s)
- Hannah K Long
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Marco Osterwalder
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Ian C Welsh
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - Karissa Hansen
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - James O J Davies
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Yiran E Liu
- Cancer Biology Program, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mervenaz Koska
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alexander T Adams
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Biology, Stanford University, Stanford, CA 94305, USA
| | - Robert Aho
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - Neha Arora
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kazuya Ikeda
- Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
| | - Ruth M Williams
- MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Tatjana Sauka-Spengler
- MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Matthew H Porteus
- Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
| | - Tim Mohun
- The Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, Mill Hill, London NW7 1AA, UK
| | - Diane E Dickel
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Tomek Swigut
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jim R Hughes
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Douglas R Higgs
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK; Laboratory of Gene Regulation, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Axel Visel
- Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; US Department of Energy Joint Genome Institute, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; School of Natural Sciences, University of California, Merced, Merced, CA 95343, USA
| | - Licia Selleri
- Program in Craniofacial Biology, Department of Orofacial Sciences and Department of Anatomy, Institute of Human Genetics, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - Joanna Wysocka
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA; Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, CA 94305, USA.
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8
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Munroe PB, Addison S, Abrams DJ, Sebire NJ, Cartwright J, Donaldson I, Cohen MM, Mein C, Tinker A, Harmer SC, Aziz Q, Terry A, Struebig M, Warren HR, Vadgama B, Fowler DJ, Peebles D, Taylor AM, Lally PJ, Thayyil S. Postmortem Genetic Testing for Cardiac Ion Channelopathies in Stillbirths. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2018; 11:e001817. [PMID: 29874177 DOI: 10.1161/circgen.117.001817] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 11/07/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although stillbirth is a significant health problem worldwide, the definitive cause of death remains elusive in many cases, despite detailed autopsy. In this study of partly explained and unexplained stillbirths, we used next-generation sequencing to examine an extended panel of 35 candidate genes known to be associated with ion channel disorders and sudden cardiac death. METHODS AND RESULTS We examined tissue from 242 stillbirths (≥22 weeks), including those where no definite cause of death could be confirmed after a full autopsy. We obtained high-quality DNA from 70 cases, which were then sequenced for a custom panel of 35 genes, 12 for inherited long- and short-QT syndrome genes (LQT1-LQT12 and SQT1-3), and 23 additional candidate genes derived from genome-wide association studies. We examined the functional significance of a selected variant by patch-clamp electrophysiological recording. No predicted damaging variants were identified in KCNQ1 (LQT1) or KCNH2 (LQT2). A rare putative pathogenic variant was found in KCNJ2(LQT7) in 1 case, and several novel variants of uncertain significance were observed. The KCNJ2 variant (p. R40Q), when assessed by whole-cell patch clamp, affected the function of the channel. There was no significant evidence of enrichment of rare predicted damaging variants within any of the candidate genes. CONCLUSIONS Although a causative link is unclear, 1 putative pathogenic and variants of uncertain significance variant resulting in cardiac channelopathies was identified in some cases of otherwise unexplained stillbirth, and these variants may have a role in fetal demise. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01120886.
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Affiliation(s)
- Patricia B Munroe
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.).
| | - Shea Addison
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Dominic J Abrams
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Neil J Sebire
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - James Cartwright
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Ian Donaldson
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Marta M Cohen
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Charles Mein
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Andrew Tinker
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Stephen C Harmer
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Qadeer Aziz
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Anna Terry
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Monika Struebig
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Helen R Warren
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Bhumita Vadgama
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Darren J Fowler
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Donald Peebles
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Andrew M Taylor
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Peter J Lally
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.)
| | - Sudhin Thayyil
- From the Clinical Pharmacology (P.B.M., S.A., J.C., A.T., S.C.H., Q.A., H.R.W.) and National Institute for Health Research Barts Cardiovascular Biomedical Research Unit (P.B.M., A.T., H.R.W.), William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, United Kingdom; Genome Centre, Queen Mary University of London, United Kingdom (I.D., C.M., A.T., M.S., B.V.); Centre for Perinatal Neuroscience, Imperial College London, United Kingdom (S.A., P.J.L., S.T.); Paediatric Cardiology, Children's Hospital Boston, MA (D.J.A.); Histopathology, Great Ormond Street Hospital, London, United Kingdom (N.J.S.); Histopathology, Sheffield Children's Hospital, United Kingdom (M.M.C.); Histopathology, Southampton General Hospital, United Kingdom (D.J.F.); Institute for Women's Health, San Antonio, TX (D.P.); and Institute for Cardiovascular Science, University College London, United Kingdom (A.M.T.).
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