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Zuo B, Xu H, Pan Z, Mao L, Feng H, Zeng B, Tang W, Lu W. A likely pathogenic POLD1 variant associated with mandibular hypoplasia, deafness, progeroid features, and lipodystrophy syndrome in a Chinese patient. BMC Med Genomics 2022; 15:220. [PMID: 36280868 PMCID: PMC9590123 DOI: 10.1186/s12920-022-01374-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Mandibular hypoplasia, deafness, progeroid features, and lipodystrophy syndrome (MDPL; OMIM# 615381) is a rare autosomal dominant disorder, with only a few reported cases worldwide. Herein, we describe the clinical features and underlying molecular etiology of MDPL syndrome in an 8-year-old Chinese patient. Methods We performed otological, endocrine, ultrasound, and radiological examinations, as well as genetic testing. Additionally, the literature concerning MDPL was reviewed to do a retrospective analysis of the pathogenesis, genotype–phenotype correlation, and clinical management. Results The proband was diagnosed with MDPL, presenting with mandibular hypoplasia, a characteristic facial appearance, lipodystrophy, and sensorineural hearing loss (SNHL). Whole-exome sequencing and bioinformatics analysis revealed a de novo missense variant in the POLD1 gene, NM_002691.4:c.3185A>G (NP_002682.2:p.(Gln1062Arg)). The retrospective analysis showed wide variation in the MDPL phenotype, but the most frequent features included mandibular hypoplasia, characteristic facial appearance, lipodystrophy, and SNHL. Conclusions This study supplements the mutational spectrum of POLD1. The genetic analysis contributes to the diagnosis of syndromic deafness, and it has a vital role in clinical management and future genetic consultation.
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Affiliation(s)
- Bin Zuo
- grid.412633.10000 0004 1799 0733Department of Otorhinolaryngology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian-she Road, Zhengzhou, 450052 China
| | - Hongen Xu
- grid.207374.50000 0001 2189 3846Precision Medicine Center, Academy of Medical Science, Zhengzhou University, No. 40 Daxuebei Road, Zhengzhou, 450052 China ,grid.452842.d0000 0004 8512 7544The Research and Application Center of Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jing-ba Road, Zhengzhou, 450014 China
| | - Zhaoyu Pan
- grid.412633.10000 0004 1799 0733Department of Otorhinolaryngology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian-she Road, Zhengzhou, 450052 China
| | - Lu Mao
- grid.207374.50000 0001 2189 3846Precision Medicine Center, Academy of Medical Science, Zhengzhou University, No. 40 Daxuebei Road, Zhengzhou, 450052 China
| | - Haifeng Feng
- grid.412633.10000 0004 1799 0733Department of Otorhinolaryngology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian-she Road, Zhengzhou, 450052 China
| | - Beiping Zeng
- grid.207374.50000 0001 2189 3846Precision Medicine Center, Academy of Medical Science, Zhengzhou University, No. 40 Daxuebei Road, Zhengzhou, 450052 China
| | - Wenxue Tang
- grid.452842.d0000 0004 8512 7544The Research and Application Center of Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, No. 2 Jing-ba Road, Zhengzhou, 450014 China ,grid.207374.50000 0001 2189 3846Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, No. 40 Daxuebei Road, Zhengzhou, 450052 China
| | - Wei Lu
- grid.412633.10000 0004 1799 0733Department of Otorhinolaryngology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jian-she Road, Zhengzhou, 450052 China
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Chopra M, Caswell R, Barcia G, Rondeau S, Jonard L, Nitchké P, Amram D, Bellaiche ML, Abadie V, Parodi M, Denoyelle F, Hattersley A, Bole C, Lyonnet S, Marlin S. Mild MDPL in a patient with a novel de novo missense variant in the Cys-B region of POLD1. Eur J Hum Genet 2022; 30:960-966. [PMID: 35590056 PMCID: PMC9349287 DOI: 10.1038/s41431-022-01118-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/21/2021] [Accepted: 05/03/2022] [Indexed: 02/07/2023] Open
Abstract
DNA polymerase δ is one of the three main enzymes responsible for DNA replication. POLD1 heterozygous missense variants in the exonuclease domain result in a cancer predisposition phenotype. In contrast, heterozygous variants in POLD1 polymerase domain have more recently been shown to be the underlying basis of the distinct autosomal dominant multisystem lipodystrophy disorder, MDPL (mandibular hypoplasia, deafness, progeroid features, and lipodystrophy syndrome OMIM # 615381), most commonly a recurrent in-frame deletion of serine at position 604, accounting for 18 of the 21 reported cases of this condition. One patient with an unusually severe phenotype has been reported, caused by a de novo c. 3209 T > A, (p.(Ile1070Asn)) variant in the highly conserved CysB motif in the C-terminal of the POLD1 protein. This region has recently been shown to bind an iron-sulphur cluster of the 4Fe-4S type. This report concerns a novel de novo missense variant in the CysB region, c.3219 G > C, (p.(Ser1073Arg)) in a male child with a milder phenotype. Using in silico analysis in the context of the recently published structure of human Polymerase δ holoenzyme, we compared these and other variants which lie in close proximity but result in differing degrees of severity and varying features. We hypothesise that the c.3219 G > C, (p.(Ser1073Arg)) substitution likely causes reduced binding of the iron-sulphur cluster without significant disruption of protein structure, while the previously reported c.3209 T > A (p.(Ile1070Asn)) variant likely has a more profound impact on structure and folding in the region. Our analysis supports a central role for the CysB region in regulating POLD1 activity in health and disease.
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Affiliation(s)
- Maya Chopra
- Service de Génétique Clinique, Hôpital Necker, Assistance Publique Hôpitaux de Paris (AP-HP), and Imagine Institute, 75015, Paris, France.,Rosamund Stone Zander Translational Neuroscience Center, Boston Children's Hospital, Boston, USA
| | - Richard Caswell
- Institute of Biomedical and Clinical Science, University of Exeter School of Medicine, Exeter, UK
| | - Giulia Barcia
- Service de Génétique Moléculaire, Hôpital Necker, AP-HP, Paris, France
| | - Sophie Rondeau
- Service de Génétique Moléculaire, Hôpital Necker, AP-HP, Paris, France
| | - Laurence Jonard
- Service de Génétique Moléculaire, Hôpital Necker, AP-HP, Paris, France.,Centre de Référence des Surdités Génétiques, Institut Imagine, Hôpital Necker, AP-HP, Paris, France
| | - Patrick Nitchké
- Bioinformatics Platform, Institut Imagine, Université Paris Descartes, Paris, France
| | - Daniel Amram
- Service de Génétique Clinique, Centre Hopsitalier Intercommunal de Créteil, Créteil, France
| | - Marc-Lionel Bellaiche
- Service de Gastroentérologie pédiatrique, Hôpital Robert Debré, AP-HP, Paris, France
| | | | - Marine Parodi
- Service d'ORL pédiatrique, Hôpital Necker, AP-HP, Paris, France
| | | | - Andrew Hattersley
- Institute of Biomedical and Clinical Science, University of Exeter School of Medicine, Exeter, UK
| | - Christine Bole
- Paris Descartes-Sorbonne Paris Cité Université, Institut Imagine, Paris, France.,Genomics Platform, INSERM UMR 1163, Institut Imagine, Paris, France
| | - Stanislas Lyonnet
- Service de Génétique Clinique, Hôpital Necker, Assistance Publique Hôpitaux de Paris (AP-HP), and Imagine Institute, 75015, Paris, France.,Paris Descartes-Sorbonne Paris Cité Université, Institut Imagine, Paris, France.,INSERM-UMR1163, Institut Imagine, Paris, France
| | - Sandrine Marlin
- Service de Génétique Clinique, Hôpital Necker, Assistance Publique Hôpitaux de Paris (AP-HP), and Imagine Institute, 75015, Paris, France. .,Centre de Référence des Surdités Génétiques, Institut Imagine, Hôpital Necker, AP-HP, Paris, France. .,INSERM-UMR1163, Institut Imagine, Paris, France.
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Peng Y, Tang Q, Xiao F, Fu N. Regulation of Lipid Metabolism by Lamin in Mutation-Related Diseases. Front Pharmacol 2022; 13:820857. [PMID: 35281936 PMCID: PMC8914069 DOI: 10.3389/fphar.2022.820857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/24/2022] [Indexed: 12/12/2022] Open
Abstract
Nuclear lamins, known as type 5 intermediate fibers, are composed of lamin A, lamin C, lamin B1, and lamin B2, which are encoded by LMNA and LMNB genes, respectively. Importantly, mutations in nuclear lamins not only participate in lipid disorders but also in the human diseases, such as lipodystrophy, metabolic-associated fatty liver disease, and dilated cardiomyopathy. Among those diseases, the mechanism of lamin has been widely discussed. Thereby, this review mainly focuses on the regulatory mechanism of the mutations in the lamin gene in lipid alterations and the human diseases. Considering the protean actions, targeting nuclear lamins may be a potent therapeutic avenue for lipid metabolic disorders and human diseases in the future.
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Affiliation(s)
- Yue Peng
- The Affiliated Nanhua Hospital, Department of Gastroenterology, Hunan Provincial Clinical Research Center of Metabolic Associated Fatty Liver Disease, Hengyang, China
| | - Qianyu Tang
- The Affiliated Nanhua Hospital, Department of Gastroenterology, Hunan Provincial Clinical Research Center of Metabolic Associated Fatty Liver Disease, Hengyang, China
| | - Fan Xiao
- The Affiliated Nanhua Hospital, Clinical Research Institute, Hengyang Medical School, University of South China, Hengyang, China
- *Correspondence: Nian Fu, ; Fan Xiao,
| | - Nian Fu
- The Affiliated Nanhua Hospital, Department of Gastroenterology, Hunan Provincial Clinical Research Center of Metabolic Associated Fatty Liver Disease, Hengyang, China
- The Affiliated Nanhua Hospital, Clinical Research Institute, Hengyang Medical School, University of South China, Hengyang, China
- *Correspondence: Nian Fu, ; Fan Xiao,
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Gladys B, René W, Anabelle D, Ahmad M, Caroline F, Etienne S, Deniz K, Valerie B, Anick C, Jean-Paul M, Benoît M, Philippe K, Isabelle M. Child to adulthood clinical description of MDPL syndrome due to a novel variant in POLD1. Eur J Med Genet 2021; 64:104333. [PMID: 34517090 DOI: 10.1016/j.ejmg.2021.104333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/12/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022]
Abstract
Mandibular hypoplasia, Deafness, Progeroid features, and Lipodystrophy (MDPL) syndrome is a rare autosomal dominant disorder caused by mutations in POLD1 gene and characterized by mandibular hypoplasia, deafness, progeroid features and lipodystrophy. One recurrent mutation p.(Ser605del) was reported in almost all affected patients. We report a novel de novo c.3214A>C p.(Thr1072Pro) variant in POLD1 in a 28-year-old male with MDPL syndrome. We provide a clinical description, molecular/immunohistological results, and literature review.
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Affiliation(s)
- Battisti Gladys
- Centre for Human Genetics, Institut de Pathologie et de Génétique, Charleroi, Gosselies, Belgium
| | - Wintjens René
- Laboratory of Microbiology, Bioorganic and Macromolecular Chemistry, Université Libre de Bruxelles, Brussels, Belgium
| | - Decottignies Anabelle
- Telomeres Research Group, Genetic & Epigenetic Alterations of Genomes, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Merhi Ahmad
- IPG BioBank and Laboratory of Translational Oncology, Institut de Pathologie et de Génétique/Grand Hôpital de Charleroi, Gosselies, Belgium
| | - Fervaille Caroline
- Department of Anatomopathology, Cliniques de Mont-Godinne, CHU-UCL-Namur, Godinne, Belgium
| | - Sokal Etienne
- UCLouvain, Cliniques Universitaires St Luc, Service de Gastroentérologie et Hépatologie Pédiatrique, 10 Av Hippocrate, Bruxelles, Belgium
| | - Karadurmus Deniz
- Centre for Human Genetics, Institut de Pathologie et de Génétique, Charleroi, Gosselies, Belgium
| | - Benoit Valerie
- Centre for Human Genetics, Institut de Pathologie et de Génétique, Charleroi, Gosselies, Belgium
| | - Claessens Anick
- Department of Endocrinology, Vivalia, Cliniques Sud Luxembourg, Arlon, Belgium
| | - Martinet Jean-Paul
- Department of Hepato-Gastro-Enterology, Cliniques de Mont-Godinne, CHU-UCL-Namur, Godinne, Belgium
| | - Martiat Benoît
- Department of Oto-Rhino-Laryngology, Vivalia, Cliniques Sud Luxembourg, Arlon, Belgium
| | - Kinzinger Philippe
- Department of Orthopedic Surgery, Vivalia, Cliniques Sud Luxembourg, Arlon, Belgium
| | - Maystadt Isabelle
- Centre for Human Genetics, Institut de Pathologie et de Génétique, Charleroi, Gosselies, Belgium; Faculty of Medicine, Unamur, Namur, Belgium.
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Coppedè F. Mutations Involved in Premature-Ageing Syndromes. APPLICATION OF CLINICAL GENETICS 2021; 14:279-295. [PMID: 34103969 PMCID: PMC8180271 DOI: 10.2147/tacg.s273525] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/17/2021] [Indexed: 12/12/2022]
Abstract
Premature-ageing syndromes are a heterogeneous group of rare genetic disorders resembling features of accelerated ageing and resulting from mutations in genes coding for proteins required for nuclear lamina architecture, DNA repair and maintenance of genome stability, mitochondrial function and other cellular processes. Hutchinson–Gilford progeria syndrome (HGPS) and Werner syndrome (WS) are two of the best-characterized progeroid syndromes referred to as childhood- and adulthood-progeria, respectively. This article provides an updated overview of the mutations leading to HGPS, WS, and to the spectrum of premature-ageing laminopathies ranging in severity from congenital restrictive dermopathy (RD) to adult-onset atypical WS, including RD-like laminopathies, typical and atypical HGPS, more and less severe forms of mandibuloacral dysplasia (MAD), Néstor-Guillermo progeria syndrome (NGPS), atypical WS, and atypical progeroid syndromes resembling features of HGPS and/or MAD but resulting from impaired DNA repair or mitochondrial functions, including mandibular hypoplasia, deafness, progeroid features, and lipodystrophy (MDPL) syndrome and mandibuloacral dysplasia associated to MTX2 (MADaM). The overlapping signs and symptoms among different premature-ageing syndromes, resulting from both a large genetic heterogeneity and shared pathological pathways underlying these conditions, require an expert clinical evaluation in specialized centers paralleled by next-generation sequencing of panels of genes involved in these disorders in order to establish as early as possible an accurate clinical and molecular diagnosis for a proper patient management.
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Affiliation(s)
- Fabio Coppedè
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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Yu PT, Luk HM, Mok MT, Lo FI. Evolving clinical manifestations of mandibular hypoplasia, deafness, progeroid features, and lipodystrophy syndrome: From infancy to adulthood in a 31-year-old woman. Am J Med Genet A 2020; 185:995-998. [PMID: 33369179 DOI: 10.1002/ajmg.a.62035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/02/2020] [Accepted: 12/13/2020] [Indexed: 01/30/2023]
Abstract
Mandibular hypoplasia, deafness, progeroid feature, and lipodystrophy syndrome (MDPL, MIM# 615381) is an extremely rare and recently recognized early adult onset of progeroid syndrome, with features of generalized lipodystrophy, dysmorphic features, telangiectasia, early onset hearing loss, insulin resistance, and dyslipidemia. Here, we present a 31-year-old Chinese woman with MDPL, harboring the recurrent pathogenic variant p.(Ser605del) in POLD1, illustrating the evolving manifestations of this premature aging disorder from infancy to adulthood.
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Affiliation(s)
- Pui Tak Yu
- Department of Health, Clinical Genetic Service, Kowloon, Hong Kong
| | - Ho-Ming Luk
- Department of Health, Clinical Genetic Service, Kowloon, Hong Kong
| | - Myth T Mok
- Department of Health, Clinical Genetic Service, Kowloon, Hong Kong
| | - Fm Ivan Lo
- Department of Health, Clinical Genetic Service, Kowloon, Hong Kong
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Abstract
Dyslipidemias include both rare single gene disorders and common conditions that have a complex underlying basis. In London, ON, there is fortuitous close physical proximity between the Lipid Genetics Clinic and the London Regional Genomics Centre. For >30 years, we have applied DNA sequencing of clinical samples to help answer scientific questions. More than 2000 patients referred with dyslipidemias have participated in an ongoing translational research program. In 2013, we transitioned to next-generation sequencing; our targeted panel is designed to concurrently assess both monogenic and polygenic contributions to dyslipidemias. Patient DNA is screened for rare variants underlying 25 mendelian dyslipidemias, including familial hypercholesterolemia, hepatic lipase deficiency, abetalipoproteinemia, and familial chylomicronemia syndrome. Furthermore, polygenic scores for LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol, and triglycerides are calculated for each patient. We thus simultaneously document both rare and common genetic variants, allowing for a broad view of genetic predisposition for both individual patients and cohorts. For instance, among patients referred with severe hypertriglyceridemia, defined as ≥10 mmol/L (≥885 mg/dL), <1% have a mendelian disorder (ie, autosomal recessive familial chylomicronemia syndrome), ≈15% have heterozygous rare variants (a >3-fold increase over normolipidemic individuals), and ≈35% have an extreme polygenic score (a >3-fold increase over normolipidemic individuals). Other dyslipidemias show a different mix of genetic determinants. Genetic results are discussed with patients and can support clinical decision-making. Integrating DNA testing into clinical care allows for a bidirectional flow of information, which facilitates scientific discoveries and clinical translation.
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Affiliation(s)
- Robert A. Hegele
- From the Department of Medicine (R.A.H.), Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Biochemistry (R.A.H., J.S.D.), Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Robarts Research Institute (R.A.H., J.S.D.), Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Jacqueline S. Dron
- Department of Biochemistry (R.A.H., J.S.D.), Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Robarts Research Institute (R.A.H., J.S.D.), Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Dron JS, Wang J, McIntyre AD, Iacocca MA, Robinson JF, Ban MR, Cao H, Hegele RA. Six years' experience with LipidSeq: clinical and research learnings from a hybrid, targeted sequencing panel for dyslipidemias. BMC Med Genomics 2020; 13:23. [PMID: 32041611 PMCID: PMC7011550 DOI: 10.1186/s12920-020-0669-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 01/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In 2013, our laboratory designed a targeted sequencing panel, "LipidSeq", to study the genetic determinants of dyslipidemia and metabolic disorders. Over the last 6 years, we have analyzed 3262 patient samples obtained from our own Lipid Genetics Clinic and international colleagues. Here, we highlight our findings and discuss research benefits and clinical implications of our panel. METHODS LipidSeq targets 69 genes and 185 single-nucleotide polymorphisms (SNPs) either causally related or associated with dyslipidemia and metabolic disorders. This design allows us to simultaneously evaluate monogenic-caused by rare single-nucleotide variants (SNVs) or copy-number variants (CNVs)-and polygenic forms of dyslipidemia. Polygenic determinants were assessed using three polygenic scores, one each for low-density lipoprotein cholesterol, triglyceride, and high-density lipoprotein cholesterol. RESULTS Among 3262 patient samples evaluated, the majority had hypertriglyceridemia (40.1%) and familial hypercholesterolemia (28.3%). Across all samples, we identified 24,931 unique SNVs, including 2205 rare variants predicted disruptive to protein function, and 77 unique CNVs. Considering our own 1466 clinic patients, LipidSeq results have helped in diagnosis and improving treatment options. CONCLUSIONS Our LipidSeq design based on ontology of lipid disorders has enabled robust detection of variants underlying monogenic and polygenic dyslipidemias. In more than 50 publications related to LipidSeq, we have described novel variants, the polygenic nature of many dyslipidemias-some previously thought to be primarily monogenic-and have uncovered novel mechanisms of disease. We further demonstrate several tangible clinical benefits of its use.
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Affiliation(s)
- Jacqueline S. Dron
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
- Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5B7 Canada
| | - Jian Wang
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
| | - Adam D. McIntyre
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
| | - Michael A. Iacocca
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
- Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5B7 Canada
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford University, 450 Serra Mall, Stanford, CA 94305 USA
| | - John F. Robinson
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
| | - Matthew R. Ban
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
| | - Henian Cao
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
| | - Robert A. Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
- Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, ON N6A 5B7 Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5B7 Canada
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