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van Zuydam NR, Ahlqvist E, Sandholm N, Deshmukh H, Rayner NW, Abdalla M, Ladenvall C, Ziemek D, Fauman E, Robertson NR, McKeigue PM, Valo E, Forsblom C, Harjutsalo V, Perna A, Rurali E, Marcovecchio ML, Igo RP, Salem RM, Perico N, Lajer M, Käräjämäki A, Imamura M, Kubo M, Takahashi A, Sim X, Liu J, van Dam RM, Jiang G, Tam CHT, Luk AOY, Lee HM, Lim CKP, Szeto CC, So WY, Chan JCN, Ang SF, Dorajoo R, Wang L, Clara TSH, McKnight AJ, Duffy S, Pezzolesi MG, Marre M, Gyorgy B, Hadjadj S, Hiraki LT, Ahluwalia TS, Almgren P, Schulz CA, Orho-Melander M, Linneberg A, Christensen C, Witte DR, Grarup N, Brandslund I, Melander O, Paterson AD, Tregouet D, Maxwell AP, Lim SC, Ma RCW, Tai ES, Maeda S, Lyssenko V, Tuomi T, Krolewski AS, Rich SS, Hirschhorn JN, Florez JC, Dunger D, Pedersen O, Hansen T, Rossing P, Remuzzi G, Brosnan MJ, Palmer CNA, Groop PH, Colhoun HM, Groop LC, McCarthy MI. A Genome-Wide Association Study of Diabetic Kidney Disease in Subjects With Type 2 Diabetes. Diabetes 2018; 67:1414-1427. [PMID: 29703844 PMCID: PMC6014557 DOI: 10.2337/db17-0914] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 03/30/2018] [Indexed: 01/10/2023]
Abstract
Identification of sequence variants robustly associated with predisposition to diabetic kidney disease (DKD) has the potential to provide insights into the pathophysiological mechanisms responsible. We conducted a genome-wide association study (GWAS) of DKD in type 2 diabetes (T2D) using eight complementary dichotomous and quantitative DKD phenotypes: the principal dichotomous analysis involved 5,717 T2D subjects, 3,345 with DKD. Promising association signals were evaluated in up to 26,827 subjects with T2D (12,710 with DKD). A combined T1D+T2D GWAS was performed using complementary data available for subjects with T1D, which, with replication samples, involved up to 40,340 subjects with diabetes (18,582 with DKD). Analysis of specific DKD phenotypes identified a novel signal near GABRR1 (rs9942471, P = 4.5 × 10-8) associated with microalbuminuria in European T2D case subjects. However, no replication of this signal was observed in Asian subjects with T2D or in the equivalent T1D analysis. There was only limited support, in this substantially enlarged analysis, for association at previously reported DKD signals, except for those at UMOD and PRKAG2, both associated with estimated glomerular filtration rate. We conclude that, despite challenges in addressing phenotypic heterogeneity, access to increased sample sizes will continue to provide more robust inference regarding risk variant discovery for DKD.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Case-Control Studies
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/genetics
- Diabetic Nephropathies/epidemiology
- Diabetic Nephropathies/genetics
- Female
- Genetic Predisposition to Disease
- Genome-Wide Association Study
- Humans
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/epidemiology
- Kidney Failure, Chronic/genetics
- Male
- Middle Aged
- Polymorphism, Single Nucleotide
- Renal Insufficiency, Chronic/complications
- Renal Insufficiency, Chronic/epidemiology
- Renal Insufficiency, Chronic/genetics
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Affiliation(s)
- Natalie R van Zuydam
- Wellcome Centre Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, U.K.
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, U.K
| | - Emma Ahlqvist
- Diabetes and Endocrinology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Diabetes and Obesity Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | | | - N William Rayner
- Wellcome Centre Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, U.K
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, U.K
- Human Genetics Programme, Wellcome Sanger Institute, University of Cambridge, Cambridge, U.K
| | - Moustafa Abdalla
- Wellcome Centre Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, U.K
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, U.K
- Department of Statistics, University of Oxford, Oxford, U.K
| | - Claes Ladenvall
- Diabetes and Endocrinology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Daniel Ziemek
- Inflammation and Immunology Research Unit, Pfizer, Berlin, Germany
| | - Eric Fauman
- Computational Target Validation, Pfizer, Cambridge, MA
| | - Neil R Robertson
- Wellcome Centre Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, U.K
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, U.K
| | - Paul M McKeigue
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, U.K
| | - Erkka Valo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Diabetes and Obesity Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Carol Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Diabetes and Obesity Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Diabetes and Obesity Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Annalisa Perna
- Clinical Research Center for Rare Diseases "Aldo e Cele Daccò," Istituto di Ricerche Farmacologiche "Mario Negri," Bergamo, Italy
| | - Erica Rurali
- Clinical Research Center for Rare Diseases "Aldo e Cele Daccò," Istituto di Ricerche Farmacologiche "Mario Negri," Bergamo, Italy
| | | | - Robert P Igo
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Rany M Salem
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA
| | - Norberto Perico
- Clinical Research Center for Rare Diseases "Aldo e Cele Daccò," Istituto di Ricerche Farmacologiche "Mario Negri," Bergamo, Italy
| | - Maria Lajer
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Annemari Käräjämäki
- Department of Primary Health Care, Vaasa Central Hospital, Vaasa, Finland
- Diabetes Center, Vaasa Health Care Center, Vaasa, Finland
| | - Minako Imamura
- Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
- Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Nishihara, Japan
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Atsushi Takahashi
- Department of Genomic Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jianjun Liu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Division of Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Guozhi Jiang
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Claudia H T Tam
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Andrea O Y Luk
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
| | - Heung Man Lee
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
- Integrated Bioinformatics Laboratory for Cancer and Metabolic Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Cadmon K P Lim
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Cheuk Chun Szeto
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing Yee So
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Juliana C N Chan
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Su Fen Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, National Healthcare Group, Singapore
| | - Rajkumar Dorajoo
- Division of Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ling Wang
- Division of Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Tan Si Hua Clara
- Clinical Research Unit, Khoo Teck Puat Hospital, National Healthcare Group, Singapore
| | | | - Seamus Duffy
- Centre for Public Health, Queen's University Belfast, Belfast, U.K
| | | | - Marcus G Pezzolesi
- Division of Nephrology and Hypertension and Diabetes & Metabolism Research Center, University of Utah Health, Salt Lake City, UT
| | | | - Michel Marre
- Sorbonnes Université, University Pierre and Marie Curie, INSERM UMRS 1166, Institute for Cardiometabolism and Nutrition, Department of Genomics and Pathophysiology of Cardiovascular Diseases, Paris, France
| | - Beata Gyorgy
- Sorbonnes Université, University Pierre and Marie Curie, INSERM UMRS 1166, Institute for Cardiometabolism and Nutrition, Department of Genomics and Pathophysiology of Cardiovascular Diseases, Paris, France
| | - Samy Hadjadj
- Endocrinology-Diabetology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Clinical Investigation Center 1402 and U1082, INSERM, University of Poitiers, Poitiers, France
- Faculté de Médecine et de Pharmacie, University of Poitiers, Poitiers, France
| | - Linda T Hiraki
- Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | | | - Tarunveer S Ahluwalia
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Almgren
- Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Christina-Alexandra Schulz
- Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Marju Orho-Melander
- Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Allan Linneberg
- Research Centre for Prevention and Health, Capital Region of Denmark, Glostrup, Denmark
- Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Cramer Christensen
- Department of Internal Medicine and Endocrinology, Vejle Hospital, Vejle, Denmark
| | - Daniel R Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ivan Brandslund
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry, Vejle Hospital, Vejle, Denmark
| | - Olle Melander
- Hypertension and Cardiovascular Disease, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Andrew D Paterson
- Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Canada
| | - David Tregouet
- Sorbonnes Université, University Pierre and Marie Curie, INSERM UMRS 1166, Institute for Cardiometabolism and Nutrition, Department of Genomics and Pathophysiology of Cardiovascular Diseases, Paris, France
| | | | - Su Chi Lim
- Diabetes Centre, Clinical Research Unit, Department of Medicine, Khoo Teck Puat Hospital, National Healthcare Group, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Ronald C W Ma
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
- Integrated Bioinformatics Laboratory for Cancer and Metabolic Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore
| | - Shiro Maeda
- Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
- Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Nishihara, Japan
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Valeriya Lyssenko
- Diabetes and Endocrinology, Department of Clinical Sciences, Lund University, Malmö, Sweden
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway
| | - Tiinamaija Tuomi
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Diabetes and Obesity Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
- Abdominal Center Endocrinology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | | | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA
| | - Joel N Hirschhorn
- Center for Basic and Translational Obesity Research and Division of Endocrinology, Boston Children's Hospital, Boston, MA
- Programs in Medical and Population Genetics and Metabolism, Broad Institute, Cambridge, MA
- Department of Genetics, Harvard Medical School, Boston, MA
| | - Jose C Florez
- Programs in Medical and Population Genetics and Metabolism, Broad Institute, Cambridge, MA
- Diabetes Clinical Research Center, Diabetes Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - David Dunger
- Department of Paediatrics, University of Cambridge, Cambridge, U.K
- Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, U.K
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Peter Rossing
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Giuseppe Remuzzi
- Clinical Research Center for Rare Diseases "Aldo e Cele Daccò," Istituto di Ricerche Farmacologiche "Mario Negri," Bergamo, Italy
- Unit of Nephrology and Dialysis, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | | | - Mary Julia Brosnan
- Cardiovascular, Metabolic and Endocrine Diseases Research Unit, Pfizer, Cambridge, MA
| | - Colin N A Palmer
- Pat Macpherson Centre for Pharmacogenetics and Pharmacogenomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, U.K
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Diabetes and Obesity Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Helen M Colhoun
- Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K
| | - Leif C Groop
- Diabetes and Endocrinology, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Mark I McCarthy
- Wellcome Centre Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, U.K
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, U.K
- National Institute for Health Research, Oxford Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, U.K
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Zuo J, Willcox CR, Mohammed F, Davey M, Hunter S, Khan K, Antoun A, Katakia P, Croudace J, Inman C, Parry H, Briggs D, Malladi R, Willcox BE, Moss P. A disease-linked ULBP6 polymorphism inhibits NKG2D-mediated target cell killing by enhancing the stability of NKG2D ligand binding. Sci Signal 2017; 10:10/481/eaai8904. [PMID: 28559451 DOI: 10.1126/scisignal.aai8904] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
NKG2D (natural killer group 2, member D) is an activating receptor found on the surface of immune cells, including natural killer (NK) cells, which regulates innate and adaptive immunity through recognition of the stress-induced ligands ULBP1 (UL16 binding protein 1) to ULBP6 and MICA/B. Similar to class I human leukocyte antigen (HLA), these NKG2D ligands have a major histocompatibility complex-like fold and exhibit pronounced polymorphism, which influences human disease susceptibility. However, whereas class I HLA polymorphisms occur predominantly in the α1α2 groove and affect antigen binding, the effects of most NKG2D ligand polymorphisms are unclear. We studied the molecular and functional consequences of the two major alleles of ULBP6, the most polymorphic ULBP gene, which are associated with autoimmunity and relapse after stem cell transplantation. Surface plasmon resonance and crystallography studies revealed that the arginine-to-leucine polymorphism within ULBP0602 affected the NKG2D-ULBP6 interaction by generating an energetic hotspot. This resulted in an NKG2D-ULBP0602 affinity of 15.5 nM, which is 10- to 1000-fold greater than the affinities of other ULBP-NKG2D interactions and limited NKG2D-mediated activation. In addition, soluble ULBP0602 exhibited high-affinity competitive binding for NKG2D and partially suppressed NKG2D-mediated activation of NK cells by other NKG2D ligands. These effects resulted in a decrease in a range of NKG2D-mediated effector functions. Our results reveal that ULBP polymorphisms affect the strength of human lymphocyte responses to cellular stress signals and may offer opportunities for therapeutic intervention.
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Affiliation(s)
- Jianmin Zuo
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Carrie R Willcox
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Fiyaz Mohammed
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Martin Davey
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Stuart Hunter
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Kabir Khan
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Ayman Antoun
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Poonam Katakia
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Joanne Croudace
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Charlotte Inman
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK
| | - Helen Parry
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK.,Department of Haematology, University Hospital Birmingham, Birmingham B15 2TH, UK
| | - David Briggs
- National Health Service Blood and Transplant, Birmingham B15 2SG, UK
| | - Ram Malladi
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK.,Department of Haematology, University Hospital Birmingham, Birmingham B15 2TH, UK
| | - Benjamin E Willcox
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK.
| | - Paul Moss
- Cancer Immunology and Immunotherapy Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK. .,Department of Haematology, University Hospital Birmingham, Birmingham B15 2TH, UK
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