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Rosenstein RK, Rose JJ, Brooks SR, Tsai WL, Gadina M, Pavletic SZ, Nagao K, Cowen EW. Identification of Fibroinflammatory and Fibrotic Transcriptomic Subsets of Human Cutaneous Sclerotic Chronic Graft-Versus-Host Disease. JID Innov 2024; 4:100246. [PMID: 38357212 PMCID: PMC10864809 DOI: 10.1016/j.xjidi.2023.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 02/16/2024] Open
Abstract
Cutaneous sclerotic chronic graft-versus-host disease (cGVHD) is a common and highly morbid complication of allogeneic hematopoietic stem cell transplantation. Our goals were to identify signals active in the skin of patients with sclerotic cGVHD in an effort to better understand how to treat this manifestation and to explore the heterogeneity of the disease. We identified genes that are significantly upregulated in the skin of patients with sclerotic cGVHD (n = 17) compared with those in the skin of patients who underwent allogeneic hematopoietic stem cell transplantation without cutaneous cGVHD (n = 9) by bulk RNA sequencing. Sclerotic cGVHD was most associated with T helper 1, phagocytic, and fibrotic pathways. In addition, different transcriptomic groups of affected patients were discovered: those with fibrotic and inflammatory/T helper 1 gene expression (the fibroinflammatory group) and those with predominantly fibrotic/TGFβ-associated expression (the fibrotic group). Further study will help elucidate whether these gene expression findings can be used to tailor treatment decisions. Multiple proteins encoded by highly induced genes in the skin (SFRP4, SERPINE2, COMP) were also highly induced in the plasma of patients with sclerotic cGVHD (n = 16) compared with those in plasma of control patients who underwent allogeneic hematopoietic stem cell transplantation without sclerotic cGVHD (n = 17), suggesting these TGFβ and Wnt pathway mediators as candidate blood biomarkers of the disease.
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Affiliation(s)
- Rachel K. Rosenstein
- Center for Discovery and Innovation, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
- Department of Medicine, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | | | - Stephen R. Brooks
- Biodata Mining and Discovery Section, Office of Science and Technology, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Wanxia L. Tsai
- Translational Immunology Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Massimo Gadina
- Translational Immunology Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Steven Z. Pavletic
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Keisuke Nagao
- Cutaneous Leukocyte Biology Section, Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Edward W. Cowen
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Curiel RV, Nguyen W, Mamyrova G, Jones D, Ehrlich A, Brindle KA, Haji-Momenian S, Sheets R, Kim H, Jones OY, Rider LG, Chin AY, Dedeoglu F, DeMarco P, Gadina M, Hannan W, Jung L, Katz JD, Kim S, Lu S, Patel A, Ray L, Rouster‐Stevens K, Simon G, Son MB, Ting T, Tsai WL, Weiser P. Improvement in Disease Activity in Refractory Juvenile Dermatomyositis Following Abatacept Therapy. Arthritis Rheumatol 2023. [PMID: 36657109 DOI: 10.1002/art.42450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/29/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVE An open-label 24-week study was conducted to evaluate the safety and efficacy of abatacept in patients with refractory juvenile dermatomyositis (JDM). METHODS Ten patients >7 years of age with moderate disease activity were enrolled in a 24-week study to examine the safety and treatment response of subcutaneous abatacept. The primary endpoint was the International Myositis Assessment and Clinical Studies Group (IMACS) Definition of Improvement (DOI). Secondary endpoints included safety, change in core set activity measures (CSMs) of IMACS and Pediatric Rheumatology International Trials Organization (PRINTO), and the ACR-EULAR response criteria for JDM. Blinded radiologists assessed thigh magnetic resonance imaging (MRI). Interferon gene score (IFNGS) was performed on whole-blood RNA by NanoString and cytokines were assessed by Luminex. RESULTS Five patients achieved DOI at week 12, and nine achieved DOI at week 24, including two with minimal, four moderate, and three with major improvement by ACR-EULAR response criteria using IMACS CSMs. All CSMs improved from baseline at weeks 12 and 24, except muscle enzymes. Daily corticosteroid dose decreased from a mean of 16.7 mg at baseline to 10.2 mg at week 24 (p=0.002). Average MRI muscle edema score decreased from baseline 5.3 to 2.3 at week 24 (p=0.01). Six patients had down-trending IFNGS and galectin-9 at week 24. Decreases in IFNGS, IP-10, galectin-9 and IL-2 correlated with improvement in disease activity and in MRI muscle edema. Eleven Grade 2 or 3 treatment-emergent adverse events were observed. CONCLUSIONS This open-label study demonstrated abatacept may be beneficial for treatment-refractory JDM.
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Affiliation(s)
- Rodolfo V Curiel
- Division of Rheumatology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - William Nguyen
- Division of Rheumatology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Gulnara Mamyrova
- Division of Rheumatology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Derek Jones
- Division of Rheumatology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Alison Ehrlich
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Kathleen A Brindle
- Department of Radiology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Shahriar Haji-Momenian
- Department of Radiology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Robert Sheets
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of California San-Diego, Rady Children's Hospital, San Diego, CA
| | - Hanna Kim
- Division of Rheumatology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.,Juvenile Myositis Therapeutic and Translation Studies Unit (JMPTU), Pediatric Translation Research Branch (PTRB), National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) , National Institutes of Health (NIH), Bethesda, MD
| | - Olcay Y Jones
- Division of Rheumatology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.,Division of Pediatric Rheumatology, Walter Reed National Military Medical Center, Bethesda, MD
| | - Lisa G Rider
- Division of Rheumatology, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.,Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS) , NIH, Bethesda, MD
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Schnappauf O, Heale L, Dissanayake D, Tsai WL, Gadina M, Leto TL, Kastner DL, Malech HL, Kuhns DB, Aksentijevich I, Laxer RM. Homozygous variant p. Arg90His in NCF1 is associated with early-onset Interferonopathy: a case report. Pediatr Rheumatol Online J 2021; 19:54. [PMID: 33892719 PMCID: PMC8063424 DOI: 10.1186/s12969-021-00536-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/11/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Biallelic loss-of-function variants in NCF1 lead to reactive oxygen species deficiency and chronic granulomatous disease (CGD). Heterozygosity for the p.Arg90His variant in NCF1 has been associated with susceptibility to systemic lupus erythematosus, rheumatoid arthritis, and Sjögren's syndrome in adult patients. This study demonstrates the association of the homozygous p.Arg90His variant with interferonopathy with features of autoinflammation and autoimmunity in a pediatric patient. CASE PRESENTATION A 5-year old female of Indian ancestry with early-onset recurrent fever and headache, and persistently elevated antinuclear, anti-Ro, and anti-La antibodies was found to carry the homozygous p.Arg90His variant in NCF1 through exome sequencing. Her unaffected parents and three other siblings were carriers for the mutant allele. Because the presence of two NCF1 pseudogenes, this variant was confirmed by independent genotyping methods. Her intracellular neutrophil oxidative burst and NCF1 expression levels were normal, and no clinical features of CGD were apparent. Gene expression analysis in peripheral blood detected an interferon gene expression signature, which was further supported by cytokine analyses of supernatants of cultured patient's cells. These findings suggested that her inflammatory disease is at least in part mediated by type I interferons. While her fever episodes responded well to systemic steroids, treatment with the JAK inhibitor tofacitinib resulted in decreased serum ferritin levels and reduced frequency of fevers. CONCLUSION Homozygosity for p.Arg90His in NCF1 should be considered contributory in young patients with an atypical systemic inflammatory antecedent phenotype that may evolve into autoimmunity later in life. The complex genomic organization of NCF1 poses a difficulty for high-throughput genotyping techniques and variants in this gene should be carefully evaluated when using the next generation and Sanger sequencing technologies. The p.Arg90His variant is found at a variable allele frequency in different populations, and is higher in people of South East Asian ancestry. In complex genetic diseases such as SLE, other rare and common susceptibility alleles might be necessary for the full disease expressivity.
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Affiliation(s)
- Oskar Schnappauf
- National Human Genome Research Institute, National Institutes of Health, Bethesda, USA.
| | - Liane Heale
- grid.17063.330000 0001 2157 2938The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Dilan Dissanayake
- grid.17063.330000 0001 2157 2938The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Wanxia L. Tsai
- grid.94365.3d0000 0001 2297 5165National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, USA
| | - Massimo Gadina
- grid.94365.3d0000 0001 2297 5165National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, USA
| | - Thomas L. Leto
- grid.94365.3d0000 0001 2297 5165National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Daniel L. Kastner
- grid.94365.3d0000 0001 2297 5165National Human Genome Research Institute, National Institutes of Health, Bethesda, USA
| | - Harry L. Malech
- grid.94365.3d0000 0001 2297 5165National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Douglas B. Kuhns
- grid.418021.e0000 0004 0535 8394Frederick National Laboratory for Cancer Research, Frederick, USA
| | - Ivona Aksentijevich
- grid.94365.3d0000 0001 2297 5165National Human Genome Research Institute, National Institutes of Health, Bethesda, USA
| | - Ronald M. Laxer
- grid.17063.330000 0001 2157 2938The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Ferrada MA, Sikora KA, Luo Y, Wells KV, Patel B, Groarke EM, Ospina Cardona D, Rominger E, Hoffmann P, Le MT, Deng Z, Quinn KA, Rose E, Tsai WL, Wigerblad G, Goodspeed W, Jones A, Wilson L, Schnappauf O, Laird RS, Kim J, Allen C, Sirajuddin A, Chen M, Gadina M, Calvo KR, Kaplan MJ, Colbert RA, Aksentijevich I, Young NS, Savic S, Kastner DL, Ombrello AK, Beck DB, Grayson PC. Somatic Mutations in UBA1 Define a Distinct Subset of Relapsing Polychondritis Patients With VEXAS. Arthritis Rheumatol 2021; 73:1886-1895. [PMID: 33779074 DOI: 10.1002/art.41743] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/18/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Somatic mutations in UBA1 cause a newly defined syndrome known as VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome). More than 50% of patients currently identified as having VEXAS met diagnostic criteria for relapsing polychondritis (RP), but clinical features that characterize VEXAS within a cohort of patients with RP have not been defined. We undertook this study to define the prevalence of somatic mutations in UBA1 in patients with RP and to create an algorithm to identify patients with genetically confirmed VEXAS among those with RP. METHODS Exome and targeted sequencing of UBA1 was performed in a prospective observational cohort of patients with RP. Clinical and immunologic characteristics of patients with RP were compared based on the presence or absence of UBA1 mutations. The random forest method was used to derive a clinical algorithm to identify patients with UBA1 mutations. RESULTS Seven of 92 patients with RP (7.6%) had UBA1 mutations (referred to here as VEXAS-RP). Patients with VEXAS-RP were all male, were on average ≥45 years of age at disease onset, and commonly had fever, ear chondritis, skin involvement, deep vein thrombosis, and pulmonary infiltrates. No patient with VEXAS-RP had chondritis of the airways or costochondritis. Mortality was greater in VEXAS-RP than in RP (23% versus 4%; P = 0.029). Elevated acute-phase reactants and hematologic abnormalities (e.g., macrocytic anemia, thrombocytopenia, lymphopenia, multiple myeloma, myelodysplastic syndrome) were prevalent in VEXAS-RP. A decision tree algorithm based on male sex, a mean corpuscular volume >100 fl, and a platelet count <200 ×103 /μl differentiated VEXAS-RP from RP with 100% sensitivity and 96% specificity. CONCLUSION Mutations in UBA1 were causal for disease in a subset of patients with RP. This subset of patients was defined by disease onset in the fifth decade of life or later, male sex, ear/nose chondritis, and hematologic abnormalities. Early identification is important in VEXAS given the associated high mortality rate.
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Affiliation(s)
- Marcela A Ferrada
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Keith A Sikora
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Yiming Luo
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Kristina V Wells
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Bhavisha Patel
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Emma M Groarke
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | | | - Emily Rominger
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | | | - Mimi T Le
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Zuoming Deng
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Kaitlin A Quinn
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Emily Rose
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Wanxia L Tsai
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Gustaf Wigerblad
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Wendy Goodspeed
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Anne Jones
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Lorena Wilson
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Oskar Schnappauf
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Ryan S Laird
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Jeff Kim
- National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland
| | - Clint Allen
- National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland
| | | | - Marcus Chen
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Massimo Gadina
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | | | - Mariana J Kaplan
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Robert A Colbert
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | | | - Neal S Young
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Sinisa Savic
- NIHR Leeds Biomedical Research Centre of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Daniel L Kastner
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | | | - David B Beck
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Peter C Grayson
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
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5
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Beck DB, Ferrada MA, Sikora KA, Ombrello AK, Collins JC, Pei W, Balanda N, Ross DL, Ospina Cardona D, Wu Z, Patel B, Manthiram K, Groarke EM, Gutierrez-Rodrigues F, Hoffmann P, Rosenzweig S, Nakabo S, Dillon LW, Hourigan CS, Tsai WL, Gupta S, Carmona-Rivera C, Asmar AJ, Xu L, Oda H, Goodspeed W, Barron KS, Nehrebecky M, Jones A, Laird RS, Deuitch N, Rowczenio D, Rominger E, Wells KV, Lee CCR, Wang W, Trick M, Mullikin J, Wigerblad G, Brooks S, Dell'Orso S, Deng Z, Chae JJ, Dulau-Florea A, Malicdan MCV, Novacic D, Colbert RA, Kaplan MJ, Gadina M, Savic S, Lachmann HJ, Abu-Asab M, Solomon BD, Retterer K, Gahl WA, Burgess SM, Aksentijevich I, Young NS, Calvo KR, Werner A, Kastner DL, Grayson PC. Somatic Mutations in UBA1 and Severe Adult-Onset Autoinflammatory Disease. N Engl J Med 2020; 383:2628-2638. [PMID: 33108101 PMCID: PMC7847551 DOI: 10.1056/nejmoa2026834] [Citation(s) in RCA: 504] [Impact Index Per Article: 126.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adult-onset inflammatory syndromes often manifest with overlapping clinical features. Variants in ubiquitin-related genes, previously implicated in autoinflammatory disease, may define new disorders. METHODS We analyzed peripheral-blood exome sequence data independent of clinical phenotype and inheritance pattern to identify deleterious mutations in ubiquitin-related genes. Sanger sequencing, immunoblotting, immunohistochemical testing, flow cytometry, and transcriptome and cytokine profiling were performed. CRISPR-Cas9-edited zebrafish were used as an in vivo model to assess gene function. RESULTS We identified 25 men with somatic mutations affecting methionine-41 (p.Met41) in UBA1, the major E1 enzyme that initiates ubiquitylation. (The gene UBA1 lies on the X chromosome.) In such patients, an often fatal, treatment-refractory inflammatory syndrome develops in late adulthood, with fevers, cytopenias, characteristic vacuoles in myeloid and erythroid precursor cells, dysplastic bone marrow, neutrophilic cutaneous and pulmonary inflammation, chondritis, and vasculitis. Most of these 25 patients met clinical criteria for an inflammatory syndrome (relapsing polychondritis, Sweet's syndrome, polyarteritis nodosa, or giant-cell arteritis) or a hematologic condition (myelodysplastic syndrome or multiple myeloma) or both. Mutations were found in more than half the hematopoietic stem cells, including peripheral-blood myeloid cells but not lymphocytes or fibroblasts. Mutations affecting p.Met41 resulted in loss of the canonical cytoplasmic isoform of UBA1 and in expression of a novel, catalytically impaired isoform initiated at p.Met67. Mutant peripheral-blood cells showed decreased ubiquitylation and activated innate immune pathways. Knockout of the cytoplasmic UBA1 isoform homologue in zebrafish caused systemic inflammation. CONCLUSIONS Using a genotype-driven approach, we identified a disorder that connects seemingly unrelated adult-onset inflammatory syndromes. We named this disorder the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome. (Funded by the NIH Intramural Research Programs and the EU Horizon 2020 Research and Innovation Program.).
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Affiliation(s)
- David B Beck
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Marcela A Ferrada
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Keith A Sikora
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Amanda K Ombrello
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Jason C Collins
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Wuhong Pei
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Nicholas Balanda
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Daron L Ross
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Daniela Ospina Cardona
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Zhijie Wu
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Bhavisha Patel
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Kalpana Manthiram
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Emma M Groarke
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Fernanda Gutierrez-Rodrigues
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Patrycja Hoffmann
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Sofia Rosenzweig
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Shuichiro Nakabo
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Laura W Dillon
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Christopher S Hourigan
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Wanxia L Tsai
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Sarthak Gupta
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Carmelo Carmona-Rivera
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Anthony J Asmar
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Lisha Xu
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Hirotsugu Oda
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Wendy Goodspeed
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Karyl S Barron
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Michele Nehrebecky
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Anne Jones
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Ryan S Laird
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Natalie Deuitch
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Dorota Rowczenio
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Emily Rominger
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Kristina V Wells
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Chyi-Chia R Lee
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Weixin Wang
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Megan Trick
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - James Mullikin
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Gustaf Wigerblad
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Stephen Brooks
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Stefania Dell'Orso
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Zuoming Deng
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Jae J Chae
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Alina Dulau-Florea
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - May C V Malicdan
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Danica Novacic
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Robert A Colbert
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Mariana J Kaplan
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Massimo Gadina
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Sinisa Savic
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Helen J Lachmann
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Mones Abu-Asab
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Benjamin D Solomon
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Kyle Retterer
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - William A Gahl
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Shawn M Burgess
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Ivona Aksentijevich
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Neal S Young
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Katherine R Calvo
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Achim Werner
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Daniel L Kastner
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
| | - Peter C Grayson
- From the National Human Genome Research Institute (D.B.B., A.K.O., W.P., N.B., D.L.R., D.O.C., K.M., P.H., S.R., L.X., H.O., M.N., A.J., R.S.L., N.D., J.J.C., M.C.V.M., D.N., B.D.S., W.A.G., S.M.B., I.A., D.L.K.), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.A.F., K.A.S., S.N., W.L.T., S.G., C.C.-R., W.G., E.R., K.V.W., G.W., S.B., S.D., Z.D., R.A.C., M.J.K., M.G., P.C.G.), the National Institute of Dental and Craniofacial Research (J.C.C., A.J.A., A.W.), the Undiagnosed Diseases Program, Common Fund, Office of the Director (N.B., D.L.R., M.C.V.M., D.N., W.A.G.), the Hematology Branch, National Heart, Lung, and Blood Institute (Z.W., B.P., E.M.G., F.G.-R., L.W.D., C.S.H., N.S.Y.), the National Institute of Allergy and Infectious Diseases (K.S.B.), the Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (C.-C.R.L.), the National Institutes of Health (NIH) Intramural Sequencing Center, National Human Genome Research Institute (J.M.), the Department of Laboratory Medicine (W.W., M.T., A.D.-F., K.R.C.), and the National Eye Institute (M.A.-A.), NIH, Bethesda, and GeneDx, Gaithersburg (K.R.) - both in Maryland; and the National Amyloidosis Centre, Royal Free Hospital London NHS Foundation Trust and University College London, London (D.R., H.J.L.), and the National Institute for Health Research-Leeds Biomedical Research Centre and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds (S.S.) - both in the United Kingdom
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6
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Wu WC, Tsai WL, Lee MJ. Virtual and reality: risk and protective factors of cyber and offline relational victimization. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cyber victimization (CV) and offline relational victimization (ORV) both impede adolescent development and might pose self-harm or suicide. The aim of this work is to examine the risk and protective factors of the two experiences across gender.
Methods
A total of 1,712 junior and senior high school students who came from 34 schools randomly sampled from northern Taiwan. The study included multi-facet supports (i.e. maternal, paternal, grandparent, peer, and teacher supports), positive and negative peer connections, smartphone addiction and family characteristics (i.e. parental marital status and self-perceived financial status) as predictors.
Results
10.3% of the participants reported CV more than once (56.8% girls) and 35.2% of them reported ORV more than once (52.4% girls) in the last three months. Results of logistic regression models showed that smartphone addiction positively related to CV (boys: OR = 1.3, 95% CI = 1.1-1.6; girls: OR = 1.6, 95% CI = 1.3-2.0) and ORV (boys: OR = 1.2, 95% CI = 1.1-1.4; girls: OR = 1.2, 95% CI = 1.1-1.3) regardless gender. Negative peer connection related to ORV only among boys (OR = 1.4, 95% CI = 1.7-1.7). Low-level self-perceived financial status related to having CV (OR = 2.8, 95% CI = 1.4-5.5) and ORV (OR = 2.0, 95% CI = 1.2-3.4) only among girls. Interestingly, paternal support is the only significant protective factor among three family supports. Paternal support negatively associated with CV (OR = 0.8, 95% CI = 0.6-0.9) and ORV of boys (OR = 0.8, 95% CI = 0.7-0.9) as well as ORV of girls (OR = 0.8, 95% CI = 0.6-0.9). Furthermore, teacher support negatively associated with girls' CV (OR = 0.8, 95% CI = 0.6-0.9) and boys' ORV (OR = 0.8, 95% CI = 0.7-0.9).
Conclusions
The study identified a few gender-specific risk factors. For both gender, to prevent CV and ORV, supporting adolescents to avoid smartphone addiction is critical. Enhancing paternal support and teacher support can be effective in preventing adolescents' cyber and offline relational victimization.
Key messages
Paternal and teacher supports, rather than other sources of supports, are protective factors of cyber victimization and offline relational victimization among adolescents. Smartphone addiction, regardless of gender, not only positively associated with cyber victimization but also positively related to offline relational victimization.
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Affiliation(s)
- W C Wu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - W L Tsai
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - M J Lee
- Graduate Institute of Social Work, National Taiwan Normal University, Taipei, Taiwan
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7
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Kim H, Gunter-Rahman F, McGrath JA, Lee E, de Jesus AA, Targoff IN, Huang Y, O'Hanlon TP, Tsai WL, Gadina M, Miller FW, Goldbach-Mansky R, Rider LG. Expression of interferon-regulated genes in juvenile dermatomyositis versus Mendelian autoinflammatory interferonopathies. Arthritis Res Ther 2020; 22:69. [PMID: 32252809 PMCID: PMC7137415 DOI: 10.1186/s13075-020-02160-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background Juvenile dermatomyositis (JDM) is a systemic autoimmune disease with a prominent interferon (IFN) signature, but the pathogenesis of JDM and the etiology of its IFN signature remain unknown. The Mendelian autoinflammatory interferonopathies, Chronic Atypical Neutrophilic Dermatosis with Lipodystrophy and Elevated temperature (CANDLE) and STING-Associated Vasculopathy with onset in Infancy (SAVI), are caused by genetic mutations and have extremely elevated IFN signatures thought to drive pathology. The phenotypic overlap of some clinical features of CANDLE and SAVI with JDM led to the comparison of a standardized interferon-regulated gene score (IRG-S) in JDM and myositis-specific autoantibody (MSA) JDM subgroups, with CANDLE and SAVI. Methods A peripheral 28-component IRG-S assessed by NanoString™ in 57 JDM patients subtyped by MSA was compared with IRG-S in healthy controls (HC) and CANDLE/SAVI patients. Principal component analysis (PCA) was performed, and individual genes were evaluated for their contribution to the score. IRG-S were correlated with disease assessments and patient characteristics. Results IRG-S in JDM patients were significantly higher than in HC but lower than in CANDLE or SAVI. JDM IRG-S overlapped more with SAVI than CANDLE by PCA. Among MSA groups, anti-MDA5 autoantibody-positive patients’ IRG-S overlapped most with SAVI. The IFI27 proportion was significantly higher in SAVI and CANDLE than JDM, but IFIT1 contributed more to IRG-S in JDM. Overall, the contribution of individual interferon-regulated genes (IRG) in JDM was more similar to SAVI. IRG-S correlated moderately with JDM disease activity measures (rs = 0.33–0.47) and more strongly with skin activity (rs = 0.58–0.79) in anti-TIF1 autoantibody-positive patients. Weakness and joint disease activity (multinomial OR 0.91 and 3.3) were the best predictors of high IRG-S. Conclusions Our findings demonstrate peripheral IRG expression in JDM overlaps with monogenic interferonopathies, particularly SAVI, and correlates with disease activity. Anti-MDA5 autoantibody-positive JDM IRG-S were notably more similar to SAVI. This may reflect both a shared IFN signature, which is driven by IFN-β and STING pathways in SAVI, as well as the shared phenotype of vasculopathy in SAVI and JDM, particularly in anti-MDA5 autoantibody-positive JDM, and indicate potential therapeutic targets for JDM.
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Affiliation(s)
- Hanna Kim
- Pediatric Translational Research Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD, USA.
| | - Fatima Gunter-Rahman
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, NIH, Bethesda, MD, USA
| | | | - Esther Lee
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, NIH, Bethesda, MD, USA
| | - Adriana A de Jesus
- Translational Autoinflammatory Diseases Section, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Ira N Targoff
- VA Medical Center, University of Oklahoma Health Sciences Center, and Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Yan Huang
- Translational Autoinflammatory Diseases Section, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Terrance P O'Hanlon
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, NIH, Bethesda, MD, USA
| | - Wanxia L Tsai
- Translational Immunology Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD, USA
| | - Massimo Gadina
- Translational Immunology Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, MD, USA
| | - Frederick W Miller
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, NIH, Bethesda, MD, USA
| | - Raphaela Goldbach-Mansky
- Translational Autoinflammatory Diseases Section, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Lisa G Rider
- Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, NIH, Bethesda, MD, USA
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8
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Carmona-Rivera C, Khaznadar SS, Shwin KW, Irizarry-Caro JA, O'Neil LJ, Liu Y, Jacobson KA, Ombrello AK, Stone DL, Tsai WL, Kastner DL, Aksentijevich I, Kaplan MJ, Grayson PC. Deficiency of adenosine deaminase 2 triggers adenosine-mediated NETosis and TNF production in patients with DADA2. Blood 2019; 134:395-406. [PMID: 31015188 PMCID: PMC6659253 DOI: 10.1182/blood.2018892752] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/08/2019] [Indexed: 12/30/2022] Open
Abstract
Reduction of adenosine deaminase 2 (ADA2) activity due to autosomal-recessive loss-of-function mutations in the ADA2 gene (previously known as CECR1) results in a systemic vasculitis known as deficiency of ADA2 (DADA2). Neutrophils and a subset of neutrophils known as low-density granulocytes (LDGs) have been implicated in the pathogenesis of vasculitis, at least in part, through the formation of neutrophil extracellular traps (NETs). The study objective was to determine whether neutrophils and NETs play a pathogenic role in DADA2. In vivo evidence demonstrated NETs and macrophages in affected gastrointestinal tissue from patients with DADA2. An abundance of circulating LDGs prone to spontaneous NET formation was observed during active disease in DADA2 and were significantly reduced after remission induction by anti-tumor necrosis factor (TNF) therapy. Increased circulating LDGs were identified in unaffected family members with monoallelic ADA2 mutations. Adenosine triggered NET formation, particularly in neutrophils from female patients, by engaging A1 and A3 adenosine receptors (ARs) and through reactive oxygen species- and peptidylarginine deiminase-dependent pathways. Adenosine-induced NET formation was inhibited by recombinant ADA2, A1/A3 AR antagonists, or by an A2A agonist. M1 macrophages incubated with NETs derived from patients with DADA2 released significantly greater amounts of TNF-α. Treatment with an A2AAR agonist decreased nuclear translocation of NF-κB and subsequent production of inflammatory cytokines in DADA2 monocyte-derived macrophages. These results suggest that neutrophils may play a pathogenic role in DADA2. Modulation of adenosine-mediated NET formation may contribute a novel and directed therapeutic approach in the treatment of DADA2 and potentially other inflammatory diseases.
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Affiliation(s)
- Carmelo Carmona-Rivera
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD
| | - Sami S Khaznadar
- Molecular Recognition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Kyawt W Shwin
- Division of Rheumatic Diseases, Dallas VA Medical Center, UT Southwestern Medical Center, Dallas, TX
| | - Jorge A Irizarry-Caro
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD
| | - Liam J O'Neil
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD
| | - Yudong Liu
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD
| | - Kenneth A Jacobson
- Molecular Recognition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Amanda K Ombrello
- Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD; and
| | - Deborah L Stone
- Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD; and
| | - Wanxia L Tsai
- Translational Immunology Section, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD
| | - Daniel L Kastner
- Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD; and
| | - Ivona Aksentijevich
- Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD; and
| | - Mariana J Kaplan
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD
| | - Peter C Grayson
- Systemic Autoimmunity Branch, Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD
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9
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Carlucci PM, Purmalek MM, Dey AK, Temesgen-Oyelakin Y, Sakhardande S, Joshi AA, Lerman JB, Fike A, Davis M, Chung JH, Playford MP, Naqi M, Mistry P, Gutierrez-Cruz G, Dell'Orso S, Naz F, Salahuddin T, Natarajan B, Manna Z, Tsai WL, Gupta S, Grayson P, Teague H, Chen MY, Sun HW, Hasni S, Mehta NN, Kaplan MJ. Neutrophil subsets and their gene signature associate with vascular inflammation and coronary atherosclerosis in lupus. JCI Insight 2018; 3:99276. [PMID: 29669944 DOI: 10.1172/jci.insight.99276] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/09/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is associated with enhanced risk of atherosclerotic cardiovascular disease not explained by Framingham risk score (FRS). Immune dysregulation associated to a distinct subset of lupus proinflammatory neutrophils (low density granulocytes; LDGs) may play key roles in conferring enhanced CV risk. This study assessed if lupus LDGs are associated with in vivo vascular dysfunction and inflammation and coronary plaque. METHODS SLE subjects and healthy controls underwent multimodal phenotyping of vascular disease by quantifying vascular inflammation (18F-fluorodeoxyglucose-PET/CT [18F-FDG-PET/CT]), arterial dysfunction (EndoPAT and cardio-ankle vascular index), and coronary plaque burden (coronary CT angiography). LDGs were quantified by flow cytometry. Cholesterol efflux capacity was measured in high-density lipoprotein-exposed (HDL-exposed) radioactively labeled cell lines. Whole blood RNA sequencing was performed to assess associations between transcriptomic profiles and vascular phenotype. RESULTS Vascular inflammation, arterial stiffness, and noncalcified plaque burden (NCB) were increased in SLE compared with controls even after adjustment for traditional risk factors. In SLE, NCB directly associated with LDGs and associated negatively with cholesterol efflux capacity in fully adjusted models. A neutrophil gene signature reflective of the most upregulated genes in lupus LDGs associated with vascular inflammation and NCB. CONCLUSION Individuals with SLE demonstrate vascular inflammation, arterial dysfunction, and NCB, which may explain the higher reported risk for acute coronary syndromes. The association of LDGs and neutrophil genes with vascular disease supports the hypothesis that distinct neutrophil subsets contribute to vascular damage and unstable coronary plaque in SLE. Results also support previous observations that neutrophils may disrupt HDL function and thereby promote atherogenesis. TRIAL REGISTRATION Clinicaltrials.gov NCT00001372FUNDING. Intramural Research Program NIAMS/NIH (ZIA AR041199) and Lupus Research Institute.
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Affiliation(s)
- Philip M Carlucci
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Monica M Purmalek
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Amit K Dey
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | | | | | - Aditya A Joshi
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Joseph B Lerman
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Alice Fike
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Michael Davis
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Jonathan H Chung
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Martin P Playford
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Mohammad Naqi
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Pragnesh Mistry
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | | | - Stefania Dell'Orso
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Faiza Naz
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Taufiq Salahuddin
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Balaji Natarajan
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Zerai Manna
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Wanxia L Tsai
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Sarthak Gupta
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Peter Grayson
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Heather Teague
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Marcus Y Chen
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Hong-Wei Sun
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Sarfaraz Hasni
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
| | - Nehal N Mehta
- National Heart, Lung and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Mariana J Kaplan
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and
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10
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Demirkaya E, Zhou Q, Smith CK, Ombrello MJ, Deuitch N, Tsai WL, Hoffmann P, Remmers EF, Takeuchi M, Park YH, Chae J, Barut K, Simsek D, Adrovic A, Sahin S, Caliskan S, Chandrasekharappa SC, Hasni SA, Ombrello AK, Gadina M, Kastner DL, Kaplan MJ, Kasapcopur O, Aksentijevich I. Brief Report: Deficiency of Complement 1r Subcomponent in Early-Onset Systemic Lupus Erythematosus: The Role of Disease-Modifying Alleles in a Monogenic Disease. Arthritis Rheumatol 2017; 69:1832-1839. [PMID: 28544690 DOI: 10.1002/art.40158] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 05/18/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify a genetic cause of early-onset systemic lupus erythematosus (SLE) in a large consanguineous family from Turkey and to study the mechanisms of the disease. METHODS We performed whole-exome sequencing and single-nucleotide polymorphism array genotyping in family members with and without SLE. Protein and gene expression, cytokine profile, neutrophil extracellular trap (NET) formation, and presence of low-density granulocytes were evaluated in patient primary cells and serum samples. RESULTS We identified a novel, homozygous, loss-of-function mutation (p.Pro445Leufs*11) in the C1R gene. Using the Sanger method of DNA sequencing in 14 family members, we confirmed the presence of the mutation in 4 patients with SLE and in an asymptomatic 9-year-old girl. Complement levels were low in sera from patients with truncated C1r protein. Two siblings with SLE who were available for detailed evaluation exhibited strong type I interferon (IFN) inflammatory signatures despite their disease being clinically inactive at the time of sampling. The type I IFN transcriptional signature in the patients' blood correlated with disease expressivity, whereas the neutrophil signature in peripheral blood mononuclear cells was likely associated with disease severity. The female patient with SLE with the most severe phenotype presented with a stronger neutrophil signature, defined by enhanced NET formation and the presence of low-density granulocytes. Analysis of exome data for modifying alleles suggested enrichment of common SLE-associated variants in the more severely affected patients. Lupus-associated HLA alleles or HLA haplotypes were not shared among the 4 affected subjects. CONCLUSION Our findings revealed a novel high-penetrance mutation in C1R as the cause of monogenic SLE. Disease expressivity in this family appears to be influenced by additional common and rare genetic variants.
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Affiliation(s)
- Erkan Demirkaya
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Qing Zhou
- National Human Genome Research Institute, NIH, Bethesda, Maryland, and Zhejiang University, Hangzhou, China
| | - Carolyne K Smith
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Michael J Ombrello
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Natalie Deuitch
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Wanxia L Tsai
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | | | - Elaine F Remmers
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Masaki Takeuchi
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Yong Hwan Park
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - JaeJin Chae
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | | | - Dogan Simsek
- Gulhane Educational and Research Hospital, Ankara, Turkey
| | | | | | | | | | - Sarfaraz A Hasni
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | | | - Massimo Gadina
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
| | - Daniel L Kastner
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Mariana J Kaplan
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland
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11
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Furumoto Y, Smith CK, Blanco L, Zhao W, Brooks SR, Thacker SG, Abdalrahman Z, Sciumè G, Tsai WL, Trier AM, Nunez L, Mast L, Hoffmann V, Remaley AT, O'Shea JJ, Kaplan MJ, Gadina M. Tofacitinib Ameliorates Murine Lupus and Its Associated Vascular Dysfunction. Arthritis Rheumatol 2017; 69:148-160. [PMID: 27429362 DOI: 10.1002/art.39818] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 07/12/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Dysregulation of innate and adaptive immune responses contributes to the pathogenesis of systemic lupus erythematosus (SLE) and its associated premature vascular damage. No drug to date targets both systemic inflammatory disease and the cardiovascular complications of SLE. Tofacitinib is a JAK inhibitor that blocks signaling downstream of multiple cytokines implicated in lupus pathogenesis. While clinical trials have shown that tofacitinib exhibits significant clinical efficacy in various autoimmune diseases, its role in SLE and the associated vascular pathology remains to be characterized. METHODS MRL/lpr lupus-prone mice were administered tofacitinib or vehicle by gavage for 6 weeks (therapeutic arm) or 8 weeks (preventive arm). Nephritis, skin inflammation, serum levels of autoantibodies and cytokines, mononuclear cell phenotype and gene expression, neutrophil extracellular traps (NETs) release, endothelium-dependent vasorelaxation, and endothelial differentiation were compared in treated and untreated mice. RESULTS Treatment with tofacitinib led to significant improvement in measures of disease activity, including nephritis, skin inflammation, and autoantibody production. In addition, tofacitinib treatment reduced serum levels of proinflammatory cytokines and interferon responses in splenocytes and kidney tissue. Tofacitinib also modulated the formation of NETs and significantly increased endothelium-dependent vasorelaxation and endothelial differentiation. The drug was effective in both preventive and therapeutic strategies. CONCLUSION Tofacitinib modulates the innate and adaptive immune responses, ameliorates murine lupus, and improves vascular function. These results indicate that JAK inhibitors have the potential to be beneficial in SLE and its associated vascular damage.
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Affiliation(s)
- Yasuko Furumoto
- Translational Immunology Section, Office of Science Technology (OST), NIAMS, NIH
| | | | - Luz Blanco
- Systemic Autoimmunity Branch, NIAMS, NIH
| | - Wenpu Zhao
- Systemic Autoimmunity Branch, NIAMS, NIH
| | | | | | | | | | - Wanxia L Tsai
- Translational Immunology Section, Office of Science Technology (OST), NIAMS, NIH
| | - Anna M Trier
- Translational Immunology Section, Office of Science Technology (OST), NIAMS, NIH
| | - Leti Nunez
- Translational Immunology Section, Office of Science Technology (OST), NIAMS, NIH
| | - Laurel Mast
- Translational Immunology Section, Office of Science Technology (OST), NIAMS, NIH
| | - Victoria Hoffmann
- Diagnostic and Research Services Branch, Office of the Director, NIH
| | | | - John J O'Shea
- Molecular Immunology and Inflammation Branch, NIAMS, NIH
| | | | - Massimo Gadina
- Translational Immunology Section, Office of Science Technology (OST), NIAMS, NIH
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12
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Hsu HC, Lee SY, Lai CM, Tsai WL, Chiu HT. 0820 LINKING STRESS TO PARENTING COMPETENCE AMONG TAIWANESE MOTHERS OF PRETERM INFANTS: THE MEDIATING ROLE OF SLEEP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Brehm A, Liu Y, Sheikh A, Marrero B, Omoyinmi E, Zhou Q, Montealegre G, Biancotto A, Reinhardt A, de Jesus AA, Pelletier M, Tsai WL, Remmers EF, Kardava L, Hill S, Kim H, Lachmann HJ, Megarbane A, Chae JJ, Brady J, Castillo RD, Brown D, Casano AV, Gao L, Chapelle D, Huang Y, Stone D, Chen Y, Sotzny F, Lee CCR, Kastner DL, Torrelo A, Zlotogorski A, Moir S, Gadina M, McCoy P, Wesley R, Rother KI, Hildebrand PW, Brogan P, Krüger E, Aksentijevich I, Goldbach-Mansky R. Additive loss-of-function proteasome subunit mutations in CANDLE/PRAAS patients promote type I IFN production. J Clin Invest 2016; 126:795. [PMID: 26829627 DOI: 10.1172/jci86020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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14
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Brehm A, Liu Y, Sheikh A, Marrero B, Omoyinmi E, Zhou Q, Montealegre G, Biancotto A, Reinhardt A, Almeida de Jesus A, Pelletier M, Tsai WL, Remmers EF, Kardava L, Hill S, Kim H, Lachmann HJ, Megarbane A, Chae JJ, Brady J, Castillo RD, Brown D, Casano AV, Gao L, Chapelle D, Huang Y, Stone D, Chen Y, Sotzny F, Lee CCR, Kastner DL, Torrelo A, Zlotogorski A, Moir S, Gadina M, McCoy P, Wesley R, Rother KI, Hildebrand PW, Brogan P, Krüger E, Aksentijevich I, Goldbach-Mansky R. Additive loss-of-function proteasome subunit mutations in CANDLE/PRAAS patients promote type I IFN production. J Clin Invest 2015; 125:4196-211. [PMID: 26524591 DOI: 10.1172/jci81260] [Citation(s) in RCA: 199] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 09/10/2015] [Indexed: 01/03/2023] Open
Abstract
Autosomal recessive mutations in proteasome subunit β 8 (PSMB8), which encodes the inducible proteasome subunit β5i, cause the immune-dysregulatory disease chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE), which is classified as a proteasome-associated autoinflammatory syndrome (PRAAS). Here, we identified 8 mutations in 4 proteasome genes, PSMA3 (encodes α7), PSMB4 (encodes β7), PSMB9 (encodes β1i), and proteasome maturation protein (POMP), that have not been previously associated with disease and 1 mutation in PSMB8 that has not been previously reported. One patient was compound heterozygous for PSMB4 mutations, 6 patients from 4 families were heterozygous for a missense mutation in 1 inducible proteasome subunit and a mutation in a constitutive proteasome subunit, and 1 patient was heterozygous for a POMP mutation, thus establishing a digenic and autosomal dominant inheritance pattern of PRAAS. Function evaluation revealed that these mutations variably affect transcription, protein expression, protein folding, proteasome assembly, and, ultimately, proteasome activity. Moreover, defects in proteasome formation and function were recapitulated by siRNA-mediated knockdown of the respective subunits in primary fibroblasts from healthy individuals. Patient-isolated hematopoietic and nonhematopoietic cells exhibited a strong IFN gene-expression signature, irrespective of genotype. Additionally, chemical proteasome inhibition or progressive depletion of proteasome subunit gene transcription with siRNA induced transcription of type I IFN genes in healthy control cells. Our results provide further insight into CANDLE genetics and link global proteasome dysfunction to increased type I IFN production.
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15
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Liu Y, Jesus AA, Marrero B, Yang D, Ramsey SE, Sanchez GAM, Tenbrock K, Wittkowski H, Jones OY, Kuehn HS, Lee CCR, DiMattia MA, Cowen EW, Gonzalez B, Palmer I, DiGiovanna JJ, Biancotto A, Kim H, Tsai WL, Trier AM, Huang Y, Stone DL, Hill S, Kim HJ, St Hilaire C, Gurprasad S, Plass N, Chapelle D, Horkayne-Szakaly I, Foell D, Barysenka A, Candotti F, Holland SM, Hughes JD, Mehmet H, Issekutz AC, Raffeld M, McElwee J, Fontana JR, Minniti CP, Moir S, Kastner DL, Gadina M, Steven AC, Wingfield PT, Brooks SR, Rosenzweig SD, Fleisher TA, Deng Z, Boehm M, Paller AS, Goldbach-Mansky R. Activated STING in a vascular and pulmonary syndrome. N Engl J Med 2014; 371:507-518. [PMID: 25029335 PMCID: PMC4174543 DOI: 10.1056/nejmoa1312625] [Citation(s) in RCA: 910] [Impact Index Per Article: 91.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The study of autoinflammatory diseases has uncovered mechanisms underlying cytokine dysregulation and inflammation. METHODS We analyzed the DNA of an index patient with early-onset systemic inflammation, cutaneous vasculopathy, and pulmonary inflammation. We sequenced a candidate gene, TMEM173, encoding the stimulator of interferon genes (STING), in this patient and in five unrelated children with similar clinical phenotypes. Four children were evaluated clinically and immunologically. With the STING ligand cyclic guanosine monophosphate-adenosine monophosphate (cGAMP), we stimulated peripheral-blood mononuclear cells and fibroblasts from patients and controls, as well as commercially obtained endothelial cells, and then assayed transcription of IFNB1, the gene encoding interferon-β, in the stimulated cells. We analyzed IFNB1 reporter levels in HEK293T cells cotransfected with mutant or nonmutant STING constructs. Mutant STING leads to increased phosphorylation of signal transducer and activator of transcription 1 (STAT1), so we tested the effect of Janus kinase (JAK) inhibitors on STAT1 phosphorylation in lymphocytes from the affected children and controls. RESULTS We identified three mutations in exon 5 of TMEM173 in the six patients. Elevated transcription of IFNB1 and other gene targets of STING in peripheral-blood mononuclear cells from the patients indicated constitutive activation of the pathway that cannot be further up-regulated with stimulation. On stimulation with cGAMP, fibroblasts from the patients showed increased transcription of IFNB1 but not of the genes encoding interleukin-1 (IL1), interleukin-6 (IL6), or tumor necrosis factor (TNF). HEK293T cells transfected with mutant constructs show elevated IFNB1 reporter levels. STING is expressed in endothelial cells, and exposure of these cells to cGAMP resulted in endothelial activation and apoptosis. Constitutive up-regulation of phosphorylated STAT1 in patients' lymphocytes was reduced by JAK inhibitors. CONCLUSIONS STING-associated vasculopathy with onset in infancy (SAVI) is an autoinflammatory disease caused by gain-of-function mutations in TMEM173. (Funded by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases; ClinicalTrials.gov number, NCT00059748.).
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Affiliation(s)
- Y Liu
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A A Jesus
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - B Marrero
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D Yang
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S E Ramsey
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - G A Montealegre Sanchez
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - K Tenbrock
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H Wittkowski
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - O Y Jones
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H S Kuehn
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - C-C R Lee
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M A DiMattia
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - E W Cowen
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - B Gonzalez
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - I Palmer
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J J DiGiovanna
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A Biancotto
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H Kim
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - W L Tsai
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A M Trier
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - Y Huang
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D L Stone
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S Hill
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H J Kim
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - C St Hilaire
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S Gurprasad
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - N Plass
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D Chapelle
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - I Horkayne-Szakaly
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D Foell
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A Barysenka
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - F Candotti
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S M Holland
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J D Hughes
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H Mehmet
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A C Issekutz
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M Raffeld
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J McElwee
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J R Fontana
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - C P Minniti
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S Moir
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D L Kastner
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M Gadina
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A C Steven
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - P T Wingfield
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S R Brooks
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S D Rosenzweig
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - T A Fleisher
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - Z Deng
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M Boehm
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A S Paller
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - R Goldbach-Mansky
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
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Liu Y, Jesus AA, Marrero B, Yang D, Ramsey SE, Sanchez GAM, Tenbrock K, Wittkowski H, Jones OY, Kuehn HS, Lee CCR, DiMattia MA, Cowen EW, Gonzalez B, Palmer I, DiGiovanna JJ, Biancotto A, Kim H, Tsai WL, Trier AM, Huang Y, Stone DL, Hill S, Kim HJ, St Hilaire C, Gurprasad S, Plass N, Chapelle D, Horkayne-Szakaly I, Foell D, Barysenka A, Candotti F, Holland SM, Hughes JD, Mehmet H, Issekutz AC, Raffeld M, McElwee J, Fontana JR, Minniti CP, Moir S, Kastner DL, Gadina M, Steven AC, Wingfield PT, Brooks SR, Rosenzweig SD, Fleisher TA, Deng Z, Boehm M, Paller AS, Goldbach-Mansky R. Activated STING in a vascular and pulmonary syndrome. N Engl J Med 2014. [PMID: 25029335 DOI: 10.1056/nejmoa1312625)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND The study of autoinflammatory diseases has uncovered mechanisms underlying cytokine dysregulation and inflammation. METHODS We analyzed the DNA of an index patient with early-onset systemic inflammation, cutaneous vasculopathy, and pulmonary inflammation. We sequenced a candidate gene, TMEM173, encoding the stimulator of interferon genes (STING), in this patient and in five unrelated children with similar clinical phenotypes. Four children were evaluated clinically and immunologically. With the STING ligand cyclic guanosine monophosphate-adenosine monophosphate (cGAMP), we stimulated peripheral-blood mononuclear cells and fibroblasts from patients and controls, as well as commercially obtained endothelial cells, and then assayed transcription of IFNB1, the gene encoding interferon-β, in the stimulated cells. We analyzed IFNB1 reporter levels in HEK293T cells cotransfected with mutant or nonmutant STING constructs. Mutant STING leads to increased phosphorylation of signal transducer and activator of transcription 1 (STAT1), so we tested the effect of Janus kinase (JAK) inhibitors on STAT1 phosphorylation in lymphocytes from the affected children and controls. RESULTS We identified three mutations in exon 5 of TMEM173 in the six patients. Elevated transcription of IFNB1 and other gene targets of STING in peripheral-blood mononuclear cells from the patients indicated constitutive activation of the pathway that cannot be further up-regulated with stimulation. On stimulation with cGAMP, fibroblasts from the patients showed increased transcription of IFNB1 but not of the genes encoding interleukin-1 (IL1), interleukin-6 (IL6), or tumor necrosis factor (TNF). HEK293T cells transfected with mutant constructs show elevated IFNB1 reporter levels. STING is expressed in endothelial cells, and exposure of these cells to cGAMP resulted in endothelial activation and apoptosis. Constitutive up-regulation of phosphorylated STAT1 in patients' lymphocytes was reduced by JAK inhibitors. CONCLUSIONS STING-associated vasculopathy with onset in infancy (SAVI) is an autoinflammatory disease caused by gain-of-function mutations in TMEM173. (Funded by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases; ClinicalTrials.gov number, NCT00059748.).
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Affiliation(s)
- Y Liu
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A A Jesus
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - B Marrero
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D Yang
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S E Ramsey
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - G A Montealegre Sanchez
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - K Tenbrock
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H Wittkowski
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - O Y Jones
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H S Kuehn
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - C-C R Lee
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M A DiMattia
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - E W Cowen
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - B Gonzalez
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - I Palmer
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J J DiGiovanna
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A Biancotto
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H Kim
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - W L Tsai
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A M Trier
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - Y Huang
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D L Stone
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S Hill
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H J Kim
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - C St Hilaire
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S Gurprasad
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - N Plass
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D Chapelle
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - I Horkayne-Szakaly
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D Foell
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A Barysenka
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - F Candotti
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S M Holland
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J D Hughes
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - H Mehmet
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A C Issekutz
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M Raffeld
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J McElwee
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - J R Fontana
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - C P Minniti
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S Moir
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - D L Kastner
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M Gadina
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A C Steven
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - P T Wingfield
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S R Brooks
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - S D Rosenzweig
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - T A Fleisher
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - Z Deng
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - M Boehm
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - A S Paller
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
| | - R Goldbach-Mansky
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (Y.L., A.A.J., B.M., G.A.M.S., M.A.D., I.P., H.K., W.L.T., A.M.T., Y.H., N.P., D.C., M.G., A.C.S., P.T.W., S.R.B., Z.D., R.G-M.), National Cancer Institute (C.-C.R.L., E.W.C., J.J.D., M.R.), National Heart, Lung, and Blood Institute (D.Y., A. Biancotto, C.S.H., J.R.F., C.P.M., M.B.), Department of Laboratory Medicine (H.S.K., S.G., S.D.R., T.A.F.), National Human Genome Research Institute (D.L.S., F.C., D.L.K.), Department of Radiology and Imaging Services (S.H.), National Institute on Deafness and Other Communication Disorders (H.J.K.), and National Institute of Allergy and Infectious Diseases (S.M.H., S.M.) - all at the National Institutes of Health (NIH), and Walter Reed National Military Medical Center (O.Y.J., I.H.-S.) - both in Bethesda, MD; Dalhousie University, Halifax, NS, Canada (S.E.R., A.C.I.); Rheinisch-Westfaelische Technische Hochschule Aachen, Aachen (K.T.), and University Hospital of Muenster, Muenster (H.W., D.F., A. Barysenka) - both in Germany; Luis Calvo Mackenna Hospital, Santiago, Chile (B.G.); Merck Research Laboratories, Boston (J.D.H., H.M., J.M.); and Northwestern University Feinberg School of Medicine, Chicago (A.S.P.)
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Zhou Q, Yang D, Ombrello AK, Zavialov AV, Toro C, Zavialov AV, Stone DL, Chae JJ, Rosenzweig SD, Bishop K, Barron KS, Kuehn HS, Hoffmann P, Negro A, Tsai WL, Cowen EW, Pei W, Milner JD, Silvin C, Heller T, Chin DT, Patronas NJ, Barber JS, Lee CCR, Wood GM, Ling A, Kelly SJ, Kleiner DE, Mullikin JC, Ganson NJ, Kong HH, Hambleton S, Candotti F, Quezado MM, Calvo KR, Alao H, Barham BK, Jones A, Meschia JF, Worrall BB, Kasner SE, Rich SS, Goldbach-Mansky R, Abinun M, Chalom E, Gotte AC, Punaro M, Pascual V, Verbsky JW, Torgerson TR, Singer NG, Gershon TR, Ozen S, Karadag O, Fleisher TA, Remmers EF, Burgess SM, Moir SL, Gadina M, Sood R, Hershfield MS, Boehm M, Kastner DL, Aksentijevich I. Early-onset stroke and vasculopathy associated with mutations in ADA2. N Engl J Med 2014; 370:911-20. [PMID: 24552284 PMCID: PMC4193683 DOI: 10.1056/nejmoa1307361] [Citation(s) in RCA: 534] [Impact Index Per Article: 53.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND We observed a syndrome of intermittent fevers, early-onset lacunar strokes and other neurovascular manifestations, livedoid rash, hepatosplenomegaly, and systemic vasculopathy in three unrelated patients. We suspected a genetic cause because the disorder presented in early childhood. METHODS We performed whole-exome sequencing in the initial three patients and their unaffected parents and candidate-gene sequencing in three patients with a similar phenotype, as well as two young siblings with polyarteritis nodosa and one patient with small-vessel vasculitis. Enzyme assays, immunoblotting, immunohistochemical testing, flow cytometry, and cytokine profiling were performed on samples from the patients. To study protein function, we used morpholino-mediated knockdowns in zebrafish and short hairpin RNA knockdowns in U937 cells cultured with human dermal endothelial cells. RESULTS All nine patients carried recessively inherited mutations in CECR1 (cat eye syndrome chromosome region, candidate 1), encoding adenosine deaminase 2 (ADA2), that were predicted to be deleterious; these mutations were rare or absent in healthy controls. Six patients were compound heterozygous for eight CECR1 mutations, whereas the three patients with polyarteritis nodosa or small-vessel vasculitis were homozygous for the p.Gly47Arg mutation. Patients had a marked reduction in the levels of ADA2 and ADA2-specific enzyme activity in the blood. Skin, liver, and brain biopsies revealed vasculopathic changes characterized by compromised endothelial integrity, endothelial cellular activation, and inflammation. Knockdown of a zebrafish ADA2 homologue caused intracranial hemorrhages and neutropenia - phenotypes that were prevented by coinjection with nonmutated (but not with mutated) human CECR1. Monocytes from patients induced damage in cocultured endothelial-cell layers. CONCLUSIONS Loss-of-function mutations in CECR1 were associated with a spectrum of vascular and inflammatory phenotypes, ranging from early-onset recurrent stroke to systemic vasculopathy or vasculitis. (Funded by the National Institutes of Health Intramural Research Programs and others.).
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Affiliation(s)
- Qing Zhou
- The authors' affiliations are listed in the Appendix
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Wang K, Forbes JG, Wittebort RJ, Yadavalli VK, Tsai WL. Nanomechanics of intrinsically disordered proteins in signaling pathways. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.296.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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19
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Forbes JG, Tsai WL, Wittebort RJ, Wang K. Intrinsically Disordered Titin PEVK as a Molecular Velcro: Salt-Bridge Dynamics and Elasticity. Biophys J 2009. [DOI: 10.1016/j.bpj.2008.12.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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20
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Forbes JG, Yadavali VK, Tsai WL, Wang K. Nebulin Elasticity Pre-loads Thin Filaments of Skeletal Muscle: Unfolding of Transient a-helices. Biophys J 2009. [DOI: 10.1016/j.bpj.2008.12.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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21
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Tseng MC, Jean CT, Tsai WL, Chen NC. Distinguishing between two sympatric Acanthopagrus species from Dapeng Bay, Taiwan, using morphometric and genetic characters. J Fish Biol 2009; 74:357-376. [PMID: 20735565 DOI: 10.1111/j.1095-8649.2008.02049.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Morphometric and genetic data were used to compare two sympatric and morphologically similar species, Acanthopagrus berda and Acanthopagrus taiwanensis, in Dapeng Bay, South-western Taiwan. A principle component analysis of morphological data indicated a distinction between the two species, with pectoral fin length and eye diameter accounting for 32.27% of the variation. Interspecific sequence divergence, based on mtDNA cytochrome b (0.118 +/- 0.01), was larger than intraspecific divergences between haplotypes (0.007 for A. taiwanensis and 0.003 for A. berda). Individuals of the two species clustered into different groups in three phylogenetic trees with 100% bootstrap support. The mean observed heterozygosity for eight microsatellite loci was 0.471 +/- 0.202 for A. taiwanensis and 0.637 +/- 0.145 for A. berda. Nei's unbiased measure of interspecific genetic distance (D(S)) was 1.334. F(ST) (0.134) and R(ST) (0.404) values indicated significant differentiation between species. An unrooted neighbour-joining tree was constructed by allele-sharing distances and the factorial correspondence analysis split all specimens into two distinct clusters. The results of morphometric, mtDNA and microsatellite analyses indicated the presence of two species, A. taiwanensis and A. berda.
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Affiliation(s)
- M C Tseng
- Department of Aquaculture, National Pingtung University of Science and Technology, Pingtung 912, Taiwan, Republic of China.
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22
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Tsai WL, Cheng JS, Lai KH, Lin CP, Lo GH, Hsu PI, Yu HC, Lin CK, Chan HH, Chen WC, Chen TA, Li WL, Liang HL. Clinical trial: percutaneous acetic acid injection vs. percutaneous ethanol injection for small hepatocellular carcinoma--a long-term follow-up study. Aliment Pharmacol Ther 2008; 28:304-11. [PMID: 19086330 DOI: 10.1111/j.1365-2036.2008.03702.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The long-term outcome of percutaneous acetic acid injection (PAI) and percutaneous ethanol injection (PEI) for treating small hepatocellular carcinoma (HCC) remains unclear. AIM To compare the long-term outcome of PAI vs. PEI for treating small HCC. METHODS From July 1998 to July 2004, 125 patients with small HCC were enrolled. Seventy patients receiving PAI and 55 patients receiving PEI were enrolled. There were no significant differences in the clinical characteristics between the two groups. Tumour recurrence and survival rates were assessed. RESULTS Mean follow-up time was 43 months. The local recurrence rate and new tumour recurrence rate were similar between the PAI and PEI groups. The PAI group had significantly better survival than the PEI group (P = 0.027). Multivariate analysis revealed that PAI was the significant factor associated with overall survival [PAI vs. PEI, RR: 0.639, 95% CI: (0.419-1.975), P = 0.038]. The treatment sessions required to achieve complete tumour necrosis were significantly fewer in the PAI group than in the PEI group (2.4 +/- 1.0 vs. 2.9 +/- 1.3, P = 0.018). CONCLUSION Percutaneous acetic acid injection required fewer treatment sessions than PEI and provided better survival after long-term follow-up.
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Affiliation(s)
- W L Tsai
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Abstract
BACKGROUND Breast tumour kinase (BRK) is a newly identified non-receptor protein tyrosine kinase from a metastatic breast tumour. Its biological functions are still under extensive investigation. The mouse homologue Sik (Src-related intestinal kinase) has been implicated in mouse keratinocyte differentiation; however, not much is known about the functions of BRK in human cutaneous biology. OBJECTIVES Using HaCaT cells as an experimental model, to explore the mutual relationships between BRK and differentiation of human keratinocytes. METHODS Archival paraffin blocks of normal and pathological skin were retrieved for examining the in vivo distribution of BRK. Its expression and subcellular localization were examined via indirect immunofluorescence, and quantitative changes were analysed by Northern and Western blots. The kinase activity of BRK was determined by its autophosphorylation and phosphorylation of exogenous substrate in the in vitro kinase assay. Using a retroviral infection method, we established stably transfected HaCaT cells expressing vector, wild-type BRK or a kinase-defective mutant (K219M). Expression of the differentiation marker keratin 10 (K10) was compared among these cells using semiquantitative reverse transcription-polymerase chain reaction. Results Histochemical examination showed that BRK was expressed exclusively in suprabasal keratinocytes. Its distribution was both cytoplasmic and intranuclear. An enhanced regional suprabasal expression pattern was observed in the confluent areas of cell cultures. The expression of BRK transcript and protein was up-regulated in prolonged confluence culture in a serum-dependent manner. Its kinase activity was activated shortly after the addition of calcium and ionomycin and returned to the basal level within 30 min. Overexpression of wild-type BRK moderately promoted the expression of K10 transcript while the kinase-defective BRK mutant exerted a prominent suppressive effect. CONCLUSIONS The in vivo distribution of BRK and its up-regulation during in vitro differentiation of HaCaT cells, together with the activation of its kinase activity by calcium/ionomycin and its influence on K10 expression, all indicate a role for BRK in the complex process of keratinocyte differentiation.
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Affiliation(s)
- T C Wang
- Department of Dermatology, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
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Abstract
Coherent x-rays from synchrotron sources are increasingly used in non-conventional radiological techniques ('phase-contrast' radiology). Our experiments demonstrate that by using white (unmonochromatic) radiation and a time-resolving system, it is possible to image microscopic details of moving blood vessels in different live animals without using any contrast agent. The images have excellent contrast plus unprecedented spatial resolution for microangiography (< 10 microm). This result is likely to impact many different areas of biological and medical research and of diagnostic radiology.
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Affiliation(s)
- Y Hwu
- Institute of Physics, Academia Sinica, 128 Academia Rd, Nankang. Taipei, Taiwan
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Hwu Y, Tsai WL, Chang HM, Yeh HI, Hsu PC, Yang YC, Su YT, Tsai HL, Chow GM, Ho PC, Li SC, Moser HO, Yang P, Seol SK, Kim CC, Je JH, Stefanekova E, Groso A, Margaritondo G. Imaging cells and tissues with refractive index radiology. Biophys J 2004; 87:4180-7. [PMID: 15465870 PMCID: PMC1304927 DOI: 10.1529/biophysj.103.034991] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Can individual cells, including live cells, be imaged using hard x rays? Common wisdom until now required sophisticated staining techniques for this task. We show instead that individual cells and cell details can be detected in culture solution and tissues with no staining and no other contrast-enhancing preparation. The sample examined can be much thicker than for many other microscopy techniques without sacrificing the capability to resolve cells. The key factor in our approach is the use of a coherent synchrotron source and of contrast mechanisms based on the refractive index. The first successful tests were conducted on a variety of cell systems including skin and internal leaf cells, mouse neurons, rabbit fibroblast cells, and human tumor cells.
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Affiliation(s)
- Y Hwu
- Institute of Physics, Academia Sinica, Nankang, Taipei, Taiwan
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Lin CK, Lai KH, Chan HH, Tsai WL, Wang EM, Wei MC, Fu MT, Lo CC, Hsu PI, Lo GH. Endoscopic balloon dilatation is a safe method in the management of common bile duct stones. Dig Liver Dis 2004; 36:68-72. [PMID: 14971818 DOI: 10.1016/j.dld.2003.09.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUNDS AND AIMS Endoscopic sphincterotomy is a widely accepted treatment for patients with common bile duct stones. Despite improvement in this technique, endoscopic sphincterotomy is still associated with some biliary complications. Endoscopic balloon dilatation is a less traumatic and sphincter preserving method for removal of common bile duct stones. However, the results of controlled studies in comparison with these two methods are contradictory. The aim of this study is to compare the safety and efficacy of endoscopic balloon dilatation and endoscopic sphincterotomy in Chinese patients. PATIENTS AND METHODS A total of 104 patients with common bile duct stones on endoscopic retrograde cholangiopancreatography were enrolled. They were randomly assigned to endoscopic balloon dilatation or endoscopic sphincterotomy. Endoscopic balloon dilatation was performed by using a balloon dilator to dilate the sphincter for 5 min. The common bile duct stones were then removed by a Dormia basket after endoscopic balloon dilatation or endoscopic sphincterotomy. Mechanical lithotripsy was performed if the stones were difficult to remove by Dormia basket. After discharge, patients were regularly followed up for biliary complications. RESULTS The successful bile duct stone clearance rate was 94.1% in endoscopic balloon dilatation group and 100% in endoscopic sphincterotomy group. Post-procedural significant haemorrhage was higher in endoscopic sphincterotomy group than in endoscopic balloon dilatation group (14/53 versus 1/48, P < 0.001). The bleeding patient from endoscopic balloon dilatation group was a case of uremia and bleeding occurred 48 h after endoscopic balloon dilatation. All the patients with post-procedural haemorrhage were controlled endoscopically. The post-procedural serum amylase level showed no significant difference in both groups and none of them developed clinical pancreatitis. After a mean 16 months follow-up, three patients (6.3%) in endoscopic balloon dilatation group and four patients (7.5%) in endoscopic sphincterotomy group developed recurrent common bile duct stones. The recurrent common bile duct stones were multiple and muddy in consistency. They were successfully removed endoscopically. CONCLUSION Both endoscopic balloon dilatation and endoscopic sphincterotomy are safe and effective techniques for the treatment of common bile duct stones. Endoscopic balloon dilatation can be safely applied in patients with coagulopathy and does not increase the incidence of pancreatitis or bleeding.
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Affiliation(s)
- C K Lin
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang Ming University, 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan
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Jee SH, Chiu HC, Tsai TF, Tsai WL, Liao YH, Chu CY, Kuo ML. The phosphotidyl inositol 3-kinase/Akt signal pathway is involved in interleukin-6-mediated Mcl-1 upregulation and anti-apoptosis activity in basal cell carcinoma cells. J Invest Dermatol 2002; 119:1121-7. [PMID: 12445202 DOI: 10.1046/j.1523-1747.2002.19503.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dysregulation of interleukin-6 has been reported to be associated with various types of tumors, and interleukin-6 plays an important part in regulating apoptosis in many types of cells. Previously, Mcl-1 was shown to be significantly increased in interleukin-6-overexpressed basal cell carcinoma cells and conferred on them anti-apoptotic activity. The aim of this study was to investigate which signaling pathway is involved in the anti-apoptotic effect of interleukin-6 on basal cell carcinoma cells. Here we show that the addition of recombinant 100 ng per ml interleukin-6 to basal cell carcinoma cells induced a 2.3-fold increase in the level of Mcl-1 protein in basal cell carcinoma cells. Transfection with dominant-negative STAT3 (STAT3F) into inter-leukin-6-treated basal cell carcinoma cells caused a decrease of phosphotyrosyl STAT3 but did not alter Mcl-1 protein levels; however, AG490, a Janus tyrosine kinase inhibitor, was capable of inhibiting the interleukin-6-induced elevation of Mcl-1 protein. Next, interleukin-6 stimulation elicited extracellular signal-regulated kinase activation in basal cell carcinoma cells, and the mitogen-activated protein kinase inhibitor, PD98059, could affect this response without affecting the interleukin-6-medi-ated Mcl-1 upregulation. Use of the two phosphotidyl inositol 3-kinase inhibitors, LY294002 and wortmannin, to check whether this pathway is involved in Mcl-1 upregulation by interleukin-6, we found that the phosphotidyl inositol 3-kinase inhibitors completely attenuated the interleukin-6-induced Mcl-1 upregulation. Furthermore, in the interleukin-6-overexpressing basal cell carcinoma cell clone, dominant-negative Akt also significantly reduced the increased level of Mcl-1. Interestingly, Janus tyrosine kinase inhibitor, AG490, treatment strongly blocked the phosphotidyl inositol 3-kinase pathway activation, as evidenced by the decrease in phospho-Akt level. Blockage of phosphotidyl inositol 3-kinase/Akt pathway abolished the interleukin-6-mediated anti-apoptotic activity in ultraviolet B treated cells. Unexpectedly, without ultraviolet B irradiation, STAT3F transfection also induced a significant apoptosis in basal cell carcinoma/interleukin-6 cells. Taken together, our data suggest that both the phosphotidyl inositol 3-kinase/Akt and STAT3 pathways are potentially involved in interleukin-6-mediated cell survival activity in basal cell carcinoma cells; however, the upregulation of the anti-apoptotic Mcl-1 protein by interleukin-6 is mainly through the Janus tyrosine kinase/phosphotidyl inositol 3-kinase/Akt, but not the STAT3 pathway.
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Affiliation(s)
- S H Jee
- Department of Dermatology, National Taiwan University Hospital, Taiwan
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Tsai WL, Hsu PC, Hwu Y, Chen CH, Chang LW, Je JH, Lin HM, Groso A, Margaritondo G. Electrochemistry: building on bubbles in metal electrodeposition. Nature 2002; 417:139. [PMID: 12000951 DOI: 10.1038/417139a] [Citation(s) in RCA: 140] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the electrodeposition of metals, a widely used industrial technique, bubbles of gas generated near the cathode can adversely affect the quality of the metal coating. Here we use phase-contrast radiology with synchrotron radiation to witness directly and in real time the accumulation of zinc on hydrogen bubbles. This process explains the origin of the bubble-shaped defects that are common in electrodeposited coatings.
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Affiliation(s)
- W L Tsai
- Institute of Physics, Academia Sinica, Nankang, Taipei 11529, Taiwan
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Chen CC, Yeh TL, Yang YK, Chen SJ, Lee IH, Fu LS, Yeh CY, Hsu HC, Tsai WL, Cheng SH, Chen LY, Si YC. Psychiatric morbidity and post-traumatic symptoms among survivors in the early stage following the 1999 earthquake in Taiwan. Psychiatry Res 2001; 105:13-22. [PMID: 11740971 DOI: 10.1016/s0165-1781(01)00334-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This study reports the clinical psychiatric presentations and post-traumatic symptoms among 525 survivors at Yu-Chyr District in Nantou County who sought psychiatric service in the first month following the devastating earthquake that struck the central area of Taiwan. All subjects received psychiatric interviews and assessments using the 12-item Chinese Health Questionnaire (CHQ-12) and a checklist for post-traumatic symptoms. The most common psychiatric symptoms reported were insomnia, palpitations, nervousness, and dizziness with headache. Eleven percent of the subjects reported having thought of death or having suicidal ideation. The mean score on the CHQ-12 was 6.43 (S.D.=2.89). The rate of probable psychiatric morbidity as defined by a CHQ-12 score > or =3 was 89.9%. Post-traumatic symptoms were very prevalent, particularly symptoms of re-experiencing the earthquake and hyper-arousal. Factors significantly associated with high psychiatric morbidity were being female, serious destruction of property and house, and personality characteristics of nervousness and obsessiveness. Findings of this study suggest that early psychiatric intervention, including pharmacological treatment for acute stress disorder, is indicated during the early stages following a disastrous earthquake.
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Affiliation(s)
- C C Chen
- Department of Psychiatry, College of Medicine, National Cheng Kung University and University Hospital, 138 Sheng-Li Road, 70428, Tainan, Taiwan, ROC.
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Hsu TY, Ou CY, Chang SY, Cheng BH, Chen JH, Hsu PH, Tsai WL. Waveforms of the ductus venosus blood flow in normal human fetuses aged 8-38 weeks. Chang Gung Med J 2001; 24:717-23. [PMID: 11820652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND We attempted to establish normal Doppler flow velocity waveform patterns in the human fetal ductus venosus (DV), and also to establish a standardized measurement technique. METHODS Ductus venosus blood flow was measured in a prospective study involving 545 fetuses aged between 8 and 38 weeks in utero, the mothers of whom received prenatal care in Kaohsiung Chang Gung Memorial Hospital in a 12-month period in 1998-1999. Several DV hemodynamic parameters were assessed, including peak systolic velocity (DVP), peak systolic/diastolic (S/D) ratio, time-averaged velocity (TAMX), maximum velocity during atrial contraction (DVM), pulsatility index (PI), Pourcelot's resistance index (RI), and fetal heartbeat (FHB). RESULTS Technically acceptable ductus venosus blood flow velocity waveform patterns were collected from 490 of 545 pregnant women (89.9%). The mean +/- SD value for the peak systolic DV velocity during the time period of 8 to 38 weeks in utero was 0.33 +/- 0.11 meters/sec (m/s), the TAMX being 0.24 +/- 0.09 m/s. The maximum velocity during atrial contraction was 0.15 +/- 0.09 m/s, and the peak S/D velocity ratio was 2.5 +/- 1.01. The PI, Pourcelot's RI and fetal heart beat were, 0.67(+/- 0.21), 0.64 (+/- 0.11), and 163.3 (+/- 18.82 bpm), respectively. Significant increases in DVP, TAMX, and DVM with advancing gestational age were established, and decreases in PI, RI, S/D, and FHB with advancing gestational age were also observed. CONCLUSIONS Further investigation of DV hemodynamics throughout pregnancy may enable a greater understanding of normal placental perfusion, the fetal venous return to the heart and associated cardiac function.
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Affiliation(s)
- T Y Hsu
- Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Niaosung, Taiwan, ROC.
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Hsu PI, Lai KH, Lo GH, Lin CK, Lo CC, Wang EM, Wang YY, Tsai WL, Lin CP, Tseng HH, Chen HC, Chen JL. Sequential changes of gastric hyperplastic polyps following endoscopic ligation. Zhonghua Yi Xue Za Zhi (Taipei) 2001; 64:609-14. [PMID: 11853213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Endoscopic ligation has been extensively applied in the management of esophageal and gastric varices with or without bleeding. The varices are automatically eradicated through the use of ligation. However, whether avascular necrosis will occur in a gastrointestinal polyp when the base is ligated remains unclear. The aims of this pilot study were to investigate the sequential changes of gastric hyperplastic polyps following endoscopic detachable snare ligation and to determine the possibility of induction of avascular necrosis in these lesions following ligation. METHODS Eleven patients with eighteen gastric hyperplastic polyps were treated with endoscopic detachable-snare ligation. The polyps were observed for 5 minutes and biopsies were then conducted. At 14 days after endoscopic ligation, follow-up endoscopies were performed to assess the outcome of the strangulated polyps. RESULTS After being strangulated by the detachable snares, a majority of the polyps immediately congested (94%), and then developed cyanotic change (89%) approximately 4 minutes later. Pathological examination revealed severe venous congestion in the lamina propria of the strangulated polyps. On follow-up endoscopy 2 weeks later, all the snares had dropped off, and avascular necrosis occurred in sixteen polyps (89%). All of the polyps with avascular necrosis were detected to have developed cyanotic changes in initial endoscopy. No complications occurred during or following the ligation procedure. CONCLUSIONS Most gastric hyperplastic polyps develop avascular necrosis following ligation by detachable snare. Cyanotic change is an important predictor of the outcomes of the lesions following endoscopic ligation. The application of this ligation technique in treatment of bleeding or non-bleeding gastrointestinal polyps deserves further investigation.
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Affiliation(s)
- P I Hsu
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan, ROC
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Fang FM, Tsai WL, Go SF, Ho MW, Wu JM, Wang CJ, Su CY, Chen WC, Huang EY. Implications of quantitative tumor and nodal regression rates for nasopharyngeal carcinomas after 45 Gy of radiotherapy. Int J Radiat Oncol Biol Phys 2001; 50:961-9. [PMID: 11429224 DOI: 10.1016/s0360-3016(01)01531-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To quantitatively investigate the clinical implications of tumor regression rate (TRR-45) and nodal regression rate (NRR-45) of nasopharyngeal carcinomas (NPC) after receiving 45 Gy of radiotherapy (RT). The values, predictive values, and associated factors of TRR-45 and NRR-45 in NPC are analyzed. METHODS AND MATERIALS One hundred one patients with newly diagnosed NPC and who were curatively treated by RT alone were included in the study. Tumor volume and nodal volume before treatment and after 45 Gy were obtained from computed tomographic (CT) scans performed at those times and calculated with the assistance of a computer-based imaging analyzing system. TRR-45 (NRR-45) was defined as the ratio of reduced tumor (nodal) volume after 45 Gy to the initial tumor (nodal) volume. TRR-45 (NRR-45) values were stratified into three groups of slow (below 50%), moderate (between 50% and 75%), and rapid (above 75%) change. After conventional RT with 45 Gy, conformal RT for primary tumors was boosted to 70.2-72 Gy for T1-2 tumors, and 75.6-81 Gy for T3-T4 tumors. RT for residual neck masses was boosted by electron beam to 61-75 Gy. RESULTS The mean value of TRR-45 for all patients was lower than that of NRR-45 for the 78 patients with metastatic neck nodes (70% +/- 4.8% vs. 81% +/- 5%, p = 0.003). The 3-year actuarial neck control rate was better than the primary tumor control rate with statistical significance (98% vs. 85%, p = 0.009). No significant statistical differences concerning local control probability, nodal control probability, or survival rate were found among patients with slow, moderate, or rapid TRR-45 or NRR-45. T-stage was the only significant prognostic factor for locoregional control after multivariate analysis. Tumor volume and T-stage were found to have a statistically significant negative correlation with TRR-45. No associated factor was found to be significantly correlated with NRR-45. CONCLUSION Slow regression rates of the primary tumor or neck nodes in NPC after receiving 45 Gy of irradiation do not mean ultimately poor radiocurability, but may merely imply slow clearance of the cells damaged during irradiation. The different radiobiological behaviors of the regression rates during treatment, ultimate control probabilities, or associated factors for regression rates of NPC between primary tumors and neck nodes need to be further investigated.
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Affiliation(s)
- F M Fang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
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Hsu TY, Chang SY, Ou CY, Chen ZH, Tsai WL, Chang MS, Soong YK. First trimester diagnosis of holoprosencephaly and cyclopia with triploidy by transvaginal three-dimensional ultrasonography. Eur J Obstet Gynecol Reprod Biol 2001; 96:235-7. [PMID: 11384818 DOI: 10.1016/s0301-2115(00)00453-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We present the prenatal three-dimensional (3D) ultrasound findings in a case of holoprosencephaly and cyclopia at 11 weeks gestation. Only holoprosencephaly with missing cyclopia were initially diagnosed because suboptimal views of the fetal face were obtained with transvaginal two-dimensional (2D) ultrasonography due to fetal position. Chromosomes identified by analysis of a fluid sample from early amniocentesis demonstrated a triploidy (69, XXX), spontaneous fetal demise occurred at 12 weeks and the pregnancy was terminated. This case demonstrated the usefulness of transvaginal 3D ultrasonography in establishing the final diagnosis.
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Affiliation(s)
- T Y Hsu
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung, Taiwan, ROC
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Jee SH, Shen SC, Chiu HC, Tsai WL, Kuo ML. Overexpression of interleukin-6 in human basal cell carcinoma cell lines increases anti-apoptotic activity and tumorigenic potency. Oncogene 2001; 20:198-208. [PMID: 11313947 DOI: 10.1038/sj.onc.1204076] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2000] [Revised: 10/13/2000] [Accepted: 11/01/2000] [Indexed: 01/24/2023]
Abstract
Interleukin-6 (IL-6) is a pleiotropic cytokine that is capable of modulating the diverse functions of cells such as acute phase responses and inflammation. Excessive or insufficient production of IL-6 may contribute to certain diseases of the skin. The aim of this study was to investigate the possible role of IL-6 in the tumorigenesis of basal cell carcinoma (BCC). Initially, we transfected IL-6 expression vector, under the control of a CMV promoter, into human BCC cells and successfully obtained IL-6-overexpressing clones (BCC/IL-6-c1 and BCC/IL-6-c2) and a mixture (BCC/IL-6). DNA synthesis assay determined using (3)H-thymidine pulse incorporation revealed that IL-6-expressing BCC cells exhibited a much higher DNA synthesis rate than the neo control or parental BCC cells. We also detected a greater abundance of IL-6-expressing cell colonies formed in soft agar than in the vector control cells. Furthermore, BCC/IL-6 cells, but not vector control cells, were resistant to UV and photodynamic therapy (PDT)-induced apoptosis, as confirmed using DNA fragmentation and morphologic change analyses. Immunoblot analysis showed that Mcl-1, an anti-apoptotic protein, was specifically up-regulated IL-6 transfectants but not in the control cells. Transient transfection of IL-6 transfectants with antisense mcl-1 greatly enhanced their apoptosis frequency by UV treatment. In tumorigenesis assay, IL-6 transfected clones formed tumors in nude mice more rapidly than the control cells. These tumors appeared to be highly vascularized using pathological examination. Supportive of this finding, we found that IL-6 transfected cells expressed elevated levels of two angiogenic factors, cyclooxygenase (Cox)-2 and vascular endothelial growth factor (VEGF). These results suggest that overexpression of IL-6 enhances the tumorigenic activity of BCC cells by both suppressing apoptosis and actively promoting angiogenesis.
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Affiliation(s)
- S H Jee
- Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan
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Tsai WL, Miller CE, Richter ER. Determination of the sensitivity of a rapid Escherichia coli O157:H7 assay for testing 375-gram composite samples. Appl Environ Microbiol 2000; 66:4149-51. [PMID: 10966446 PMCID: PMC92276 DOI: 10.1128/aem.66.9.4149-4151.2000] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/1999] [Accepted: 06/16/2000] [Indexed: 11/20/2022] Open
Abstract
Both 25-g single-size ground beef samples and 375-g composite ground beef samples were tested by a method combining an immunomagnetic separation (IMS) technique with a sandwich enzyme-linked immunosorbent assay (ELISA) system (IMS-ELISA). The results demonstrated that IMS-ELISA could detect the target, Escherichia coli O157:H7, at the level of 10(-1) CFU/g of sample in either the 25- or 375-g sample size.
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Affiliation(s)
- W L Tsai
- Richter International, Inc., Columbus, Ohio 43201, USA
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Abstract
AIM To evaluate the effect of nasogastric lansoprazole on acid suppression in critically ill patients. METHODS Patients were eligible for the study if they had a nasogastric tube in place and had not received acid-suppressive agents for 3 days prior to enrolment into the study. Patients with active gastrointestinal bleeding or a baseline gastric pH > 4.0 were excluded. Patients served as their own controls during a 24 h lead-in period. Lansoprazole 30 mg was administered once daily with water through a nasogastric tube for 2 days. Intragastric pH was measured by continuous 24 h pH-metry for 3 days. RESULTS Fifteen patients were enrolled into the study. The baseline median 24 h intragastric pH was 2.25 +/- 1.01, and increased to 6.70 +/- 0.82 (P= 0.001) after 2 days of lansoprazole. Mean percentage of time intragastric pH was > or = 4.0 was 25 +/- 13% at baseline, and increased to 84 +/- 14% (P=0. 001) after 2 days of lansoprazole. CONCLUSIONS Nasogastric lansoprazole 30 mg daily is effective in suppressing gastric acid secretion in critically ill patients.
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Affiliation(s)
- W L Tsai
- Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
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Jee SH, Tsai TF, Tsai WL, Liaw SH, Chang CH, Hu CY. HLA-DRB1*0701 and DRB1*1401 are associated with genetic susceptibility to psoriasis vulgaris in a Taiwanese population. Br J Dermatol 1998; 139:978-83. [PMID: 9990359 DOI: 10.1046/j.1365-2133.1998.02552.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We analysed the allelic frequencies of class II human leucocyte antigen (HLA)-DRB1, DQA1, DQB1 and DPB1 by polymerase chain reaction/sequence-specific oligonucleotide probe hybridization typing in 76 Taiwanese psoriasis vulgaris (PSV) patients and 238 Taiwanese non-psoriatic controls. The analysis revealed the following: (i) the DRB1*0701 allele was positively associated with PSV (relative risk, RR = 6.4, corrected P-value, Pc < or = 0.001); (ii) the DRB1*1401 allele was positively associated with type I PSV (age at onset < 40 years) (RR = 3.5, Pc < or = 0.001); (iii) the DQA1*0501 allele was negatively associated with PSV (RR = 0.4, Pc < or = 0.001); (iv) there was no significant association of HLA-DP genes with PSV; and (v) there was a strong association of beta-chain phenylalanine at position 37 (Phe 37) and glutamate or glutamine at position 74 (Glu 74/Gln 74) with PSV (RR = 3.5, Pc < or = 0.001 for the association of Phe 37 with PSV: RR = 2.2, Pc < or = 0.001 for the association of Glu 74/Gln 74 with PSV). The positive association between PSV and the DRB1*0701 allele is consistent with previous reports. The negative association of the DQA1*0501 allele is reported only in Finland, whereas the positive association between PSV and the DRB1*1401 allele has never been described before. Trans-racial studies may shed further light on the association of class II HLA alleles or other closely linked genes with the development of PSV. Phe 37 (a large, non-polar amino acid) and Glu 74/Gln 74 (both negatively charged amino acids) were the polymorphic residues in pockets 9 and 4, respectively, of the beta-chain, which may have increased their affinity for the small non-polar amino acids and basic amino acids of the psoriatic antigen peptide, thereby activating the T lymphocytes. This finding may facilitate the identification of a psoriatic antigen.
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Affiliation(s)
- S H Jee
- Department of Dermatology, National Taiwan University College of Medicine, Taipei, Taiwan
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