22
|
Machado RD, Pauciulo MW, Thomson JR, Lane KB, Morgan NV, Wheeler L, Phillips III JA, Newman J, Williams D, Galiè N, Manes A, McNeil K, Yacoub M, Mikhail G, Rogers P, Corris P, Humbert M, Donnai D, Martensson G, Tranebjaerg L, Loyd JE, Trembath RC, Nichols WC. BMPR2 haploinsufficiency as the inherited molecular mechanism for primary pulmonary hypertension. Am J Hum Genet 2001; 68:92-102. [PMID: 11115378 PMCID: PMC1234937 DOI: 10.1086/316947] [Citation(s) in RCA: 416] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2000] [Accepted: 11/10/2000] [Indexed: 01/24/2023] Open
Abstract
Primary pulmonary hypertension (PPH) is a potentially lethal disorder, because the elevation of the pulmonary arterial pressure may result in right-heart failure. Histologically, the disorder is characterized by proliferation of pulmonary-artery smooth muscle and endothelial cells, by intimal hyperplasia, and by in situ thrombus formation. Heterozygous mutations within the bone morphogenetic protein type II receptor (BMPR-II) gene (BMPR2), of the transforming growth factor beta (TGF-beta) cell-signaling superfamily, have been identified in familial and sporadic cases of PPH. We report the molecular spectrum of BMPR2 mutations in 47 additional families with PPH and in three patients with sporadic PPH. Among the cohort of patients, we have identified 22 novel mutations, including 4 partial deletions, distributed throughout the BMPR2 gene. The majority (58%) of mutations are predicted to lead to a premature termination codon. We have also investigated the functional impact and genotype-phenotype relationships, to elucidate the mechanisms contributing to pathogenesis of this important vascular disease. In vitro expression analysis demonstrated loss of BMPR-II function for a number of the identified mutations. These data support the suggestion that haploinsufficiency represents the common molecular mechanism in PPH. Marked variability of the age at onset of disease was observed both within and between families. Taken together, these studies illustrate the considerable heterogeneity of BMPR2 mutations that cause PPH, and they strongly suggest that additional factors, genetic and/or environmental, may be required for the development of the clinical phenotype.
Collapse
MESH Headings
- Adolescent
- Adult
- Age of Onset
- Base Sequence
- Bone Morphogenetic Protein Receptors, Type II
- Cells, Cultured
- Child
- Child, Preschool
- Codon, Terminator/genetics
- DNA Mutational Analysis
- Exons/genetics
- Female
- Fluorescence
- Gene Dosage
- Genes, Dominant/genetics
- Haplotypes/genetics
- Humans
- Hypertension, Pulmonary/epidemiology
- Hypertension, Pulmonary/genetics
- Infant
- Introns/genetics
- Male
- Middle Aged
- Models, Genetic
- Mutation/genetics
- Pedigree
- Polymorphism, Genetic/genetics
- Protein Serine-Threonine Kinases/genetics
- RNA Splice Sites/genetics
- RNA, Messenger/analysis
- RNA, Messenger/genetics
- Sequence Deletion/genetics
Collapse
Affiliation(s)
- Rajiv D Machado
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Michael W. Pauciulo
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Jennifer R. Thomson
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Kirk B. Lane
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Neil V. Morgan
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Lisa Wheeler
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - John A. Phillips III
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - John Newman
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Denise Williams
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Nazzareno Galiè
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Alessandra Manes
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Keith McNeil
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Magdi Yacoub
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Ghada Mikhail
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Paula Rogers
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Paul Corris
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Marc Humbert
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Dian Donnai
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Gunnar Martensson
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Lisbeth Tranebjaerg
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - James E. Loyd
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - Richard C. Trembath
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| | - William C. Nichols
- Division of Medical Genetics, Departments of Medicine and Genetics, University of Leicester, Leicester, United Kingdom; Division of Human Genetics, Children’s Hospital Medical Center, Cincinnati; Vanderbilt University Medical Center, Nashville; Istituto di Cardiologia, Università di Bologna, Bologna; Pulmonary Vascular Diseases Unit, Papworth Hospital, Cambridge; National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Harefield, United Kingdom; William Leech Centre for Lung Research, Royal Freeman Hospital, Newcastle, United Kingdom; Service de Pneumologie et Reanimation Respiratoire, Hôpital Antoine Beclere, Clamart, France; Regional Genetic Service, St. Mary’s Hospital, Manchester, United Kingdom; Sahlgrenska University Hospital, Division of Heart and Lung Transplant, Göteborg, Sweden; and Department of Medical Genetics, University Hospital of Tromsö, Tromsö, Norway
| |
Collapse
|