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Guffroy A, Jacquel L, Seeleuthner Y, Paul N, Poindron V, Maurier F, Delannoy V, Voegeli AC, Zhang P, Nespola B, Molitor A, Apithy MJ, Soulas-Sprauel P, Martin T, Voll RE, Bahram S, Gies V, Casanova JL, Cobat A, Boisson B, Carapito R, Korganow AS. An immunogenomic exome landscape of triple positive primary antiphospholipid patients. Genes Immun 2024; 25:108-116. [PMID: 38267542 DOI: 10.1038/s41435-024-00255-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
Primary antiphospholipid syndrome is characterized by thrombosis and autoantibodies directed against phospholipids or associated proteins. The genetic etiology of PAPS remains unknown. We enrolled 21 patients with thromboembolic events associated to lupus anticoagulant, anticardiolipin and anti β2 glycoprotein1 autoantibodies. We performed whole exome sequencing and a systematic variant-based analysis in genes associated with thrombosis, in candidate genes previously associated with APS or inborn errors of immunity. Data were compared to public databases and to a control cohort of 873 non-autoimmune patients. Variants were identified following a state-of-the-art pipeline. Enrichment analysis was performed by comparing with the control cohort. We found an absence of significant HLA bias and genetic heterogeneity in these patients, including when testing combinations of rare variants in genes encoding for proteins involved in thrombosis and of variants in genes linked with inborn errors of immunity. These results provide evidence of genetic heterogeneity in PAPS, even in a homogenous series of triple positive patients. At the individual scale, a combination of variants may participate to the breakdown of B cell tolerance and to the vessel damage.
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Affiliation(s)
- A Guffroy
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France.
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France.
- University de Strasbourg, Faculty of Medicine, F-67000, Strasbourg, France.
| | - L Jacquel
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France
- University de Strasbourg, Faculty of Medicine, F-67000, Strasbourg, France
| | - Y Seeleuthner
- University Paris-Cité, Imagine Institute, F-75015, Paris, France
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France
| | - N Paul
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France
| | - V Poindron
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France
| | - F Maurier
- Department of Internal Medicine, Belle-Isle Hospital, Metz, France
| | - V Delannoy
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France
| | - A C Voegeli
- Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital Universitaire, Strasbourg, France
| | - P Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - B Nespola
- Laboratoire d'Immunologie, Plateau technique de Biologie, Hôpital Universitaire, Strasbourg, France
| | - A Molitor
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France
| | - M J Apithy
- Laboratoire d'exploration du HLA, Centre de Transfusion sanguine, Strasbourg, France
| | - P Soulas-Sprauel
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France
- University Strasbourg, Faculty of Pharmacy, F-67400, Illkirch, France
| | - T Martin
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France
- University de Strasbourg, Faculty of Medicine, F-67000, Strasbourg, France
| | - R E Voll
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - S Bahram
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France
| | - V Gies
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France
| | - J L Casanova
- University Paris-Cité, Imagine Institute, F-75015, Paris, France
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - A Cobat
- University Paris-Cité, Imagine Institute, F-75015, Paris, France
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France
| | - B Boisson
- University Paris-Cité, Imagine Institute, F-75015, Paris, France
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - R Carapito
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France
- University de Strasbourg, Faculty of Medicine, F-67000, Strasbourg, France
| | - A S Korganow
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiency, Strasbourg University Hospital, F-67000, Strasbourg, France.
- University Strasbourg, INSERM UMR - S1109, Institut thématique interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), F-67000, Strasbourg, France.
- University de Strasbourg, Faculty of Medicine, F-67000, Strasbourg, France.
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Dieudonné Y, Guffroy A, Poindron V, Sprauel PS, Martin T, Korganow AS, Gies V. B cells in primary antiphospholipid syndrome: Review and remaining challenges. Autoimmun Rev 2021; 20:102798. [PMID: 33722752 DOI: 10.1016/j.autrev.2021.102798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 01/03/2021] [Indexed: 02/03/2023]
Abstract
It is now widely accepted that antiphospholipid antibodies (aPL) have direct pathogenic effects and that B cells, notably through aPL production, play a key role in the development of antiphospholipid syndrome (APS). Recent findings strengthened the implication of B cells with the description of specific B cell phenotype abnormalities and inborn errors of immunity involving B cell signaling in APS patients. In addition, it has been shown in preclinical models that cross-reactivity between APS autoantigens and mimotopes expressed by human gut commensals can lead to B cell tolerance breakdown and are sufficient for APS development. However, B cell targeting therapies are surprisingly not as effective as expected in APS compared to other autoimmune diseases. Elucidation of the B cell tolerance breakdown mechanisms in APS patients may help to develop and guide the use of novel therapeutic agents that target B cells or specific immune pathway.
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Affiliation(s)
- Yannick Dieudonné
- Université de Strasbourg, INSERM UMR - S1109, F-67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, F-67000 Strasbourg, France; Université de Strasbourg, Faculty of Medicine, F-67000 Strasbourg, France.
| | - Aurélien Guffroy
- Université de Strasbourg, INSERM UMR - S1109, F-67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, F-67000 Strasbourg, France; Université de Strasbourg, Faculty of Medicine, F-67000 Strasbourg, France
| | - Vincent Poindron
- Université de Strasbourg, INSERM UMR - S1109, F-67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, F-67000 Strasbourg, France; Université de Strasbourg, Faculty of Medicine, F-67000 Strasbourg, France
| | - Pauline Soulas Sprauel
- Université de Strasbourg, INSERM UMR - S1109, F-67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, F-67000 Strasbourg, France; Université de Strasbourg, Faculty of Pharmacy, F-67400 Illkirch, France
| | - Thierry Martin
- Université de Strasbourg, INSERM UMR - S1109, F-67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, F-67000 Strasbourg, France; Université de Strasbourg, Faculty of Medicine, F-67000 Strasbourg, France
| | - Anne-Sophie Korganow
- Université de Strasbourg, INSERM UMR - S1109, F-67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, F-67000 Strasbourg, France; Université de Strasbourg, Faculty of Medicine, F-67000 Strasbourg, France
| | - Vincent Gies
- Université de Strasbourg, INSERM UMR - S1109, F-67000 Strasbourg, France; Hôpitaux Universitaires de Strasbourg, Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Tertiary Center for Primary Immunodeficiencies, F-67000 Strasbourg, France; Université de Strasbourg, Faculty of Pharmacy, F-67400 Illkirch, France
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Djokovic A, Stojanovich L, Stanisavljevic N, Popovic M, Zdravkovic M. Double trouble: myocardial infarction with non-obstructive coronary arteries as a presentation of Hughes syndrome in monozygotic twins. Lupus 2020; 29:505-508. [PMID: 32041501 DOI: 10.1177/0961203320906267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a recently described, clinically significant entity, with prevalence rates ranging from 1% to 14% and a mean of 6% of all patients with myocardial infarction. Antiphospholipid syndrome (APS; Hughes syndrome) is characterized by the presence of antiphospholipid antibodies associated with thrombosis (arterial and/or venous) and/or pregnancy morbidity and could be the cause of MINOCA. Data on genetic predisposition to APS are scarce. The present study describes a unique case of monozygotic twin brothers who, at a young age, developed the same clinical presentation of APS. The diagnosis of APS was later confirmed, along with a diagnosis of systemic lupus erythematosus in one brother.
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Affiliation(s)
- A Djokovic
- Department of Cardiology, Division of Interventional Cardiology, University Hospital Medical Centre Bezanijska kosa, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - L Stojanovich
- Department of Rheumatology, University Hospital Medical Center Bezanijska kosa, Belgrade, Serbia
| | - N Stanisavljevic
- Department of Haematology, University Hospital Medical Center Bezanijska kosa, Belgrade, Serbia
| | - M Popovic
- Department of Radiology, CMR Lab, University Hospital Medical Center Bezanijska kosa, Belgrade, Serbia
| | - M Zdravkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Cardiology, CMR Lab, University Hospital Medical Center Bezanijska kosa, Belgrade, Serbia
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Abstract
PURPOSE OF REVIEW Antiphospholipid syndrome (APS) is a rare heterogenous disorder associated with the presence of antiphospholipid antibodies and can present in a wide variety of clinical manifestations including thrombosis and pregnancy complications. Although the etiology of APS remains poorly understood, there is strong support for considering APS as a complex genetic disease in which multiple genetic risk factors, in conjunction with environmental factors, affect its onset, progression, and severity. Here, we provide a comprehensive review of the current knowledge of the genetic basis of APS, which remains in its infancy. RECENT FINDINGS Most genetic studies to date in APS were performed in small cohorts of patients. As a result, only few genetic associations reported are convincing. Several reports suggested genetic associations with HLA class II alleles in APS, and only two genetic loci outside of the HLA region (STAT4 and C1D) reached the threshold for genome-wide level of significance (P < 5 × 10-8). In this review, we also shed light on the genetic differences among the diverse clinical subsets of APS and briefly discuss the role that DNA methylation changes might play in the pathophysiology of this disease. The genetic basis of APS remains poorly characterized. Larger collaborative multicenter studies using well-characterized patients are needed to comprehensively understand the role of genetic susceptibility in APS.
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Belizna C, Stojanovich L, Cohen-Tervaert JW, Fassot C, Henrion D, Loufrani L, Nagy G, Muchardt C, Hasan M, Ungeheuer MN, Arnaud L, Alijotas-Reig J, Esteve-Valverde E, Nicoletti F, Saulnier P, Godon A, Reynier P, Chrétien JM, Damian L, Omarjee L, Mahé G, Pistorius MA, Meroni PL, Devreese K. Primary antiphospholipid syndrome and antiphospholipid syndrome associated to systemic lupus: Are they different entities? Autoimmun Rev 2018; 17:739-745. [PMID: 29885541 DOI: 10.1016/j.autrev.2018.01.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 01/12/2018] [Indexed: 11/25/2022]
Abstract
Primary antiphospholipid syndrome (PAPS) and antiphospholipid syndrome associated to lupus (SAPS) have several overlapping characteristics. As systemic manifestations are also reported in patients with PAPS, and as a subgroup of PAPS patients could evaluate to a SAPS, the differentiation between the two types of APS could be performed based on the clinical experience of the medical teams and is related to a variety of clinical, biological, histological and genetic features. Several data are available in the literature with respect to the identification of distinctive features between these two entities. However, there are some limitation in the interpretation of results issued from studies performed prior to updated Sydney criteria. Based on recent data, a certain number of features more frequent in one type of APS as compared to the other could be distinguished. The major differentiation between these two entities is genetical. New genetic data allowing the identification of specific subgroups of APS are ongoing.
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Affiliation(s)
- Cristina Belizna
- Vascular and Coagulation Department, University Hospital Angers, 4 rue Larrey, 49000 Angers, France; MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France..
| | - Ljudmila Stojanovich
- Scientific Research Department, Internal Medicine-Rheumatology, Bezhanijska Kosa, University Medical Center, Belgrade University, Belgrade 11080, Serbia
| | - Jan Willem Cohen-Tervaert
- Internal Medicine and Immunology Department, Maastricht University, P Debyelaan 25, 6229 HX Maastricht, The Netherlands; Rheumatology Department, Kaye Edmonton Clinic University of Alberta, 116 St. and 85 Ave., Edmonton, AB T6G 2R3, Canada
| | - Céline Fassot
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France
| | - Daniel Henrion
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France
| | - Laurent Loufrani
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France
| | - Gyorgy Nagy
- 3rd Department of Internal Medicine, Rheumatology Division, Buda Hospital of the Hospitaller Order of Saint John of God, H-1023 Budapest, P.O.B. 98, Hungary; Semmelweis University, Department of Genetics, Cell- and Immunobiology, Buda Hospital of the Hospitalier Order of Saint John of God, 1089 Budapest, Nagyvárad tér 4, Hungary
| | - Christian Muchardt
- Unit of Epigenetic Regulation, Department of Developmental and Stem Cell Biology, UMR3738 CNRS, Institut Pasteur, 28, Rue Doct Roux, 75015 Paris, France
| | - Milena Hasan
- Cytometry and Biomarkers Unit of Technology and Service, Center for Translational Science, Institut Pasteur, 28, Rue Doct Roux, 75015 Paris, France
| | - Marie Noelle Ungeheuer
- Clinical Investigation and Acces to Bioresources Department, Institut Pasteur, 28, Rue Doct Roux, 75015 Paris, France
| | - Laurent Arnaud
- Rheumatology Department, University Hospital Strasbourg, 1, Place de l'Hôpital, 67091 Strasbourg, France
| | - Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Department of Medicine, Universitat Autonòma, Plaza Civica, 08193 Barcelona, Spain
| | - Enrique Esteve-Valverde
- Internal Medicine Althaia Healthcare Network of Manresa, Calle Pau 44, 08243 Manresa, Barcelona, Spain
| | - Ferdinando Nicoletti
- Department of Biomedicine and Biotechnology, University of Catania, Universita' Square, 2, 95131 Catania, Italy
| | - Patrick Saulnier
- Research Department Unit University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Alban Godon
- Departement of hematology et immunology University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Pascal Reynier
- MITOVASC Institute and CARFI Facility, University of Angers, UMR CNRS 6015, INSERM U1083, rue Haute de Reculée, 49045 Angers, France.; Department of Biochemistry and Genetics University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Jean Marie Chrétien
- Research Department Unit University Hospital Angers, 4 rue Larrey, 49000 Angers, France
| | - Laura Damian
- Department of Rheumatology, County Emergency Hospital Cluj-Napoca, Str. Clinicilor nr.3-5, Cod Postal 400006 Cluj-Napoca, Romania
| | - Loukman Omarjee
- Vascular Medicine Department, University Hospital Rennes, 16, Boulevard de Bulgarie, 35203 Rennes, France; University Rennes, CHU Rennes, INSERM, CIC 1414, 2, rue Henri Le Guilloux, 35000 Rennes Cedex 9, France
| | - Guillaume Mahé
- Vascular Medicine Department, University Hospital Rennes, 16, Boulevard de Bulgarie, 35203 Rennes, France; University Rennes, CHU Rennes, INSERM, CIC 1414, 2, rue Henri Le Guilloux, 35000 Rennes Cedex 9, France
| | - Marc Antoine Pistorius
- Vascular Medicine Department, University Hospital Nantes, 1, Place Alexis Ricordeau, 44093 Nantes, France
| | - Pier Luigi Meroni
- Clinical Immunology and Rhumatology Research Department Auxologico Institute Milan, IRCCS, Via G. Spagnoletto, 3, 20149 Milan, Italy
| | - Katrien Devreese
- Coagulation Laboratory, Department of Clinical Biology, Immunology and Microbiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
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Margery-Muir AA, Bundell C, Nelson D, Groth DM, Wetherall JD. Gender balance in patients with systemic lupus erythematosus. Autoimmun Rev 2017; 16:258-268. [DOI: 10.1016/j.autrev.2017.01.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 11/16/2016] [Indexed: 12/19/2022]
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7
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Abstract
Twin studies are a special type of epidemiological studies designed to measure the contribution of genetics as opposed to the environment, to a given trait. Despite the facts that the classical twin studies are still being guided by assumptions made back in the 1920s and that the inherent limitation lies in the study design itself, the results suggested by earlier twin studies have often been confirmed by molecular genetic studies later. Use of twin registries and various innovative yet complex software packages such as the (SAS) and their extensions (e.g., SAS PROC GENMOD and SAS PROC PHREG) has increased the potential of this epidemiological tool toward contributing significantly to the field of genetics and other life sciences.
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Affiliation(s)
- Monalisha Sahu
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Josyula G Prasuna
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India
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8
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Bierton C, Langlois NEI. Should we be testing for antiphospholipid antibodies in unexplained pulmonary thromboembolism and atherosclerosis at autopsy? Forensic Sci Med Pathol 2013; 9:573-4. [PMID: 23483438 DOI: 10.1007/s12024-013-9412-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2013] [Indexed: 10/27/2022]
Affiliation(s)
- Christopher Bierton
- School of Medicine, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
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