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Turuvekere Vittala Murthy N, Vlasova K, Renner J, Jozic A, Sahay G. A new era of targeting cystic fibrosis with non-viral delivery of genomic medicines. Adv Drug Deliv Rev 2024; 209:115305. [PMID: 38626860 DOI: 10.1016/j.addr.2024.115305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/27/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
Cystic fibrosis (CF) is a complex genetic respiratory disorder that necessitates innovative gene delivery strategies to address the mutations in the gene. This review delves into the promises and challenges of non-viral gene delivery for CF therapy and explores strategies to overcome these hurdles. Several emerging technologies and nucleic acid cargos for CF gene therapy are discussed. Novel formulation approaches including lipid and polymeric nanoparticles promise enhanced delivery through the CF mucus barrier, augmenting the potential of non-viral strategies. Additionally, safety considerations and regulatory perspectives play a crucial role in navigating the path toward clinical translation of gene therapy.
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Affiliation(s)
| | - Kseniia Vlasova
- Department of Pharmaceutical Sciences, College of Pharmacy at Oregon State University, Corvallis, OR 97331, USA
| | - Jonas Renner
- Department of Pharmaceutical Sciences, College of Pharmacy at Oregon State University, Corvallis, OR 97331, USA
| | - Antony Jozic
- Department of Pharmaceutical Sciences, College of Pharmacy at Oregon State University, Corvallis, OR 97331, USA
| | - Gaurav Sahay
- Department of Pharmaceutical Sciences, College of Pharmacy at Oregon State University, Corvallis, OR 97331, USA; Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR 97201, USA; Department of Biomedical Engineering, Robertson Life Sciences Building, Oregon Health & Science University, Portland, OR 97201, USA.
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Ideozu JE, Liu M, Riley-Gillis BM, Paladugu SR, Rahimov F, Krishnan P, Tripathi R, Dorr P, Levy H, Singh A, Waring JF, Vasanthakumar A. Diversity of CFTR variants across ancestries characterized using 454,727 UK biobank whole exome sequences. Genome Med 2024; 16:43. [PMID: 38515211 PMCID: PMC10956269 DOI: 10.1186/s13073-024-01316-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Limited understanding of the diversity of variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene across ancestries hampers efforts to advance molecular diagnosis of cystic fibrosis (CF). The consequences pose a risk of delayed diagnoses and subsequently worsened health outcomes for patients. Therefore, characterizing the spectrum of CFTR variants across ancestries is critical for revolutionizing molecular diagnoses of CF. METHODS We analyzed 454,727 UK Biobank (UKBB) whole-exome sequences to characterize the diversity of CFTR variants across ancestries. Using the PanUKBB classification, the participants were assigned into six major groups: African (AFR), American/American Admixed (AMR), Central South Asia (CSA), East Asian (EAS), European (EUR), and Middle East (MID). We segregated ancestry-specific CFTR variants, including those that are CF-causing or clinically relevant. The ages of certain CF-causing variants were determined and analyzed for selective pressure effects, and curated phenotype analysis was performed for participants with clinically relevant CFTR genotypes. RESULTS We detected over 4000 CFTR variants, including novel ancestry-specific variants, across six ancestries. Europeans had the most unique CFTR variants [n = 2212], while the American group had the least unique variants [n = 23]. F508del was the most prevalent CF-causing variant found in all ancestries, except in EAS, where V520F was the most prevalent. Common EAS variants such as 3600G > A, V456A, and V520, which appeared approximately 270, 215, and 338 generations ago, respectively, did not show evidence of selective pressure. Sixteen participants had two CF-causing variants, with two being diagnosed with CF. We found 154 participants harboring a CF-causing and varying clinical consequences (VCC) variant. Phenotype analysis performed for participants with multiple clinically relevant variants returned significant associations with CF and its pulmonary phenotypes [Bonferroni-adjusted p < 0.05]. CONCLUSIONS We leveraged the UKBB database to comprehensively characterize the broad spectrum of CFTR variants across ancestries. The detection of over 4000 CFTR variants, including several ancestry-specific and uncharacterized CFTR variants, warrants the need for further characterization of their functional and clinical relevance. Overall, the presentation of classical CF phenotypes seen in non-CF diagnosed participants with more than one CF-causing variant indicates that they may benefit from current CFTR modulator therapies.
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Affiliation(s)
- Justin E Ideozu
- Genomic Medicine, Genomics Research Center, AbbVie, Chicago, IL, USA.
| | - Mengzhen Liu
- Human Genetics, Genomics Research Center, AbbVie, Chicago, IL, USA
| | | | - Sri R Paladugu
- Human Genetics, Genomics Research Center, AbbVie, Chicago, IL, USA
| | - Fedik Rahimov
- Human Genetics, Genomics Research Center, AbbVie, Chicago, IL, USA
| | | | | | | | - Hara Levy
- Department of Pediatrics, Division of Pulmonology and Sleep Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Jeffrey F Waring
- Genomic Medicine, Genomics Research Center, AbbVie, Chicago, IL, USA
- Human Genetics, Genomics Research Center, AbbVie, Chicago, IL, USA
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Glotov AS, Chernykh VB, Solovova OA, Polyakov AV, Donnikov MY, Kovalenko LV, Barbitoff YA, Nasykhova YA, Lazareva TE, Glotov OS. Russian Regional Differences in Allele Frequencies of CFTR Gene Variants: Genetic Monitoring of Infertile Couples. Genes (Basel) 2023; 15:45. [PMID: 38254935 PMCID: PMC10815393 DOI: 10.3390/genes15010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/13/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
A male factor, commonly associated with poor semen quality, is revealed in about 50% of infertile couples. CFTR gene (Cystic Fibrosis Transmembrane Conduction Regulator) variants are one of the common genetic causes of azoospermia-related male infertility. Notably, the spectrum and frequency of pathogenic CFTR variants vary between populations and geographical regions. In this work, we made an attempt to evaluate the allele frequency (AF) of 12 common CFTR variants in infertile Russian men and healthy individuals from different districts of Russia. Because of the limited number of population-based studies on Russian individuals, we characterized the population AFs based on data from the Registry of Russian cystic fibrosis (CF) patients. In addition to the CF patient registry, we estimated the local frequencies of the same set of variants based on the results of genotyping of CF patients in local biocollections (from St. Petersburg and Yugra regions). AFs of common CFTR variants calculated based on registry and biocollection data showed good concordance with directly measured population AFs. The estimated region-specific frequencies of CFTR variants allowed us to uncover statistically significant regional differences in the frequencies of the F508del (c.1521_1523del; p.Phe508del) and CFTRdele2,3(21kb) (c.54-5940_273+10250del21kb; p.Ser18ArgfsX) variants. The data from population-based studies confirmed previous observations that F508del, CFTRdele2,3(21kb), and L138ins (c.413_415dup; p.Leu138dup)variants are the most abundant among infertile patients, and their frequencies are significantly lower in healthy individuals and should be taken into account during genetic monitoring of the reproductive health of Russian individuals.
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Affiliation(s)
- Andrey S. Glotov
- D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, 199034 St. Petersburg, Russia (Y.A.N.); (O.S.G.)
| | | | - Olga A. Solovova
- Research Centre for Medical Genetics, Moskvorechie Street 1, 115522 Moscow, Russia
| | | | - Maksim Yu. Donnikov
- Budgetary Institution of Highest Education of KHMAO-Yugra “Surgut State University”, 628400 Surgut, Russia; (M.Y.D.)
| | - Ludmila V. Kovalenko
- Budgetary Institution of Highest Education of KHMAO-Yugra “Surgut State University”, 628400 Surgut, Russia; (M.Y.D.)
| | - Yury A. Barbitoff
- D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, 199034 St. Petersburg, Russia (Y.A.N.); (O.S.G.)
| | - Yulia A. Nasykhova
- D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, 199034 St. Petersburg, Russia (Y.A.N.); (O.S.G.)
| | - Tatyana E. Lazareva
- D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, 199034 St. Petersburg, Russia (Y.A.N.); (O.S.G.)
| | - Oleg S. Glotov
- D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, 199034 St. Petersburg, Russia (Y.A.N.); (O.S.G.)
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Krasnova M, Efremova A, Bukhonin A, Zhekaite E, Bukharova T, Melyanovskaya Y, Goldshtein D, Kondratyeva E. The Effect of Complex Alleles of the CFTR Gene on the Clinical Manifestations of Cystic Fibrosis and the Effectiveness of Targeted Therapy. Int J Mol Sci 2023; 25:114. [PMID: 38203285 PMCID: PMC10779438 DOI: 10.3390/ijms25010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
The authors of this article analyzed the available literature with the results of studying the prevalence of complex alleles of the CFTR gene among patients with cystic fibrosis, and their pathogenicity and influence on targeted therapy with CFTR modulators. Cystic fibrosis (CF) is a multisystemic autosomal recessive disease caused by a defect in the expression of the CFTR protein, and more than 2000 genetic variants are known. Clinically significant variants are divided into seven classes. Information about the frequency of complex alleles appears in a number of registers, along with the traditional presentation of data on genetic variants. Complex alleles (those with the presence of more than two nucleotide variants on one allele) can complicate the diagnosis of the disease, and change the clinical manifestations of cystic fibrosis and the response to treatment, since each variant in the complex allele can contribute to the functional activity of the CFTR protein, changing it both in terms of increasing and decreasing function. The role of complex alleles is often underestimated, and their frequency has not been studied. At the moment, characteristic frequently encountered complex alleles have been found for several populations of patients with cystic fibrosis, but the prevalence and pathogenicity of newly detected complex alleles require additional research. In this review, more than 35 complex alleles of the CFTR gene from existing research studies were analyzed, and an analysis of their influence on the manifestations of the disease and the effectiveness of CFTR modulators was also described.
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Affiliation(s)
| | - Anna Efremova
- Research Centre for Medical Genetics, Moscow 115522, Russia; (M.K.); (A.B.); (E.Z.); (T.B.); (Y.M.); (D.G.); (E.K.)
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Chernykh V, Krasovsky S, Solovova O, Adyan T, Stepanova A, Marnat E, Shtaut M, Sedova A, Sorokina T, Beskorovainaya T, Kondratyeva E, Shchagina O, Polyakov A. Pathogenic Variants and Genotypes of the CFTR Gene in Russian Men with Cystic Fibrosis and CBAVD Syndrome. Int J Mol Sci 2023; 24:16287. [PMID: 38003474 PMCID: PMC10671388 DOI: 10.3390/ijms242216287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 11/26/2023] Open
Abstract
Pathogenic CFTR variants cause cystic fibrosis (CF), and CF-related disorders (CF-RD), including bilateral aplasia of the vas deferens (CBAVD). The spectrum of clinical manifestations depends on the CFTR genotype. The frequency and spectrum of the CFTR variants vary between populations and clinical groups. CFTR variants and genotypes were analyzed in Russian men with CF (n = 546) and CBAVD syndrome (n = 125). Pathogenic variants were detected in 93.95% and 39.2% of the CF and CBAVD alleles, respectively. The most frequent c.1521_1523del (F508del; p.Phe508del) variant was found in 541 (49.5%) CF alleles. A total of 162 CFTR genotypes were revealed in CF patients, including 152 homozygous and 394 compound-heterozygous. The most common CF-genotype was F508del/F508del (24.9%). Other frequent CF-genotypes were F508del/3849+10kbC>T, F508del/CFTRdele2,3, and F508del/E92K. CF-causing variants and/or 5T allele were found in 88% of CBAVD patients: 5T/CFTRmut (48.0%), CFTRmut/N (17.6%), CFTRmut/CFTRmut (6.4%), 5T/5T (10.4%), 5T/N (5.6%) and N/N (12.0%), with the most common CBAVD-genotype being F508del/5T (29.6%). The allele frequencies of F508del, CFTRdele2,3 394delTT, and 3849+10kbC>T were significantly higher in CF patients. L138ins/L138ins, 2184insA/E92K, and L138ins/N genotypes were found in CBAVD, but not in CF patients. The results indicate certain differences in the frequency of some CFTR variants and genotypes in Russian CF and CBAVD patients.
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Affiliation(s)
- Vyacheslav Chernykh
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
- Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, 117997 Moscow, Russia;
| | - Stanislav Krasovsky
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Olga Solovova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Tagui Adyan
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Anna Stepanova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Ekaterina Marnat
- Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, 117997 Moscow, Russia;
| | - Maria Shtaut
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Anna Sedova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Tatyana Sorokina
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Tatyana Beskorovainaya
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Elena Kondratyeva
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Olga Shchagina
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
| | - Aleksandr Polyakov
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (S.K.); (O.S.); (T.A.); (A.S.); (M.S.); (A.S.); (T.S.); (T.B.); (E.K.); (O.S.); (A.P.)
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Das R, Savina EA, Tatarinova TV, Orlov YL. Editorial: Population and ancestry specific variation in disease susceptibility. Front Genet 2023; 14:1267719. [PMID: 37799142 PMCID: PMC10548457 DOI: 10.3389/fgene.2023.1267719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- Ranajit Das
- Yenepoya Research Centre, Yenepoya University, Mangalore, India
| | - Ekaterina A. Savina
- The Digital Health Institute, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Engelhardt Institute of Molecular Biology RAS, Moscow, Russia
| | | | - Yuriy L. Orlov
- The Digital Health Institute, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Agrarian and Technological Institute, Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
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Chernykh V, Sorokina T, Sedova A, Shtaut M, Solovova O, Marnat E, Adyan T, Beskorovaynaya T, Stepanova A, Shchagina O, Polyakov A. L138ins Variant of the CFTR Gene in Russian Infertile Men. Genes (Basel) 2023; 14:1407. [PMID: 37510311 PMCID: PMC10379041 DOI: 10.3390/genes14071407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/02/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Introduction: Pathogenic variants in the CFTR (Cystic Fibrosis Transmembrane conductance Regulator, OMIM: 602421) gene cause Cystic Fibrosis (CF, OMIM: 219700) and CF-related disorders (CF-RD), often accompanied by obstructive azoospermia due to congenital bilateral aplasia of vas deferens (CBAVD, OMIM: 277180) in male patients. The L138ins (c.413_415dup; p. (Leu138dup)) is a mild variant in the CFTR gene that is relatively common among CF-patients in Slavic populations. The frequency of this variant in Russian infertile men has not been sufficiently studied; (2) Materials and Methods: The sample consisted of 6033 Russian infertile men. The patients were tested for 22 common in Russian populations pathogenic variants of the CFTR gene and the IVS9Tn-polymorphic locus of the intron 9. Molecular-genetic studies were performed using amplified fragment length polymorphism (AFLP-PCR), multiplex ligation-dependent probe amplification (MLPA), and nested PCR (for analysis of the IVS9Tn-polymorphic locus); (3) Results: Pathogenic variants in the CFTR were detected in 3.9% of patients. The most frequent variants were F508del and CFTRdele2.3(21kb), accounted for 61.0% and 7.1% of detected variants, respectively. The L138ins variant was detected in 17 (0.28%) individuals: one of them was homozygous, 10 patients were heterozygous, and 6 patients were compound-heterozygous (F508del/L138ins, n = 4; L138ins/N1303K, n = 1; L138ins/5T, n = 1). Two pathogenic CF-causing variants in the CFTR gene were detected in 8 patients, including 7 compound heterozygous (F508del/L138ins, n = 4; F508del/N1303K, n = 1; 2184insA/E92K, n = 1; 3849+10kbC>T/E92K, n = 1) and one homozygous (L138ins/L138ins). The L138ins variant was found in 7 out of 16 (43.75%) chromosomes in six of these patients. The most common pathogenic variant, F508del, was identified in five out of them, in 5 of 16 (31.25%) chromosomes. The allele frequency (AF) of the L138ins variant in the sample has been found to be 0.0014.; (4) Conclusions: The L138ins variant of the CFTR gene is the third most common variant after F508del and CFTRdele2.3(kb) among Russian infertile men.
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Affiliation(s)
- Vyacheslav Chernykh
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
- Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, 117997 Moscow, Russia;
| | - Tatyana Sorokina
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Anna Sedova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Maria Shtaut
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Olga Solovova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Ekaterina Marnat
- Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian Federation, 117997 Moscow, Russia;
| | - Tagui Adyan
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Tatyana Beskorovaynaya
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Anna Stepanova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Olga Shchagina
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
| | - Aleksandr Polyakov
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (T.S.); (A.S.); (M.S.); (O.S.); (T.A.); (T.B.); (A.S.); (O.S.); (A.P.)
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Clinical and Genetic Characterisation of Cystic Fibrosis Patients in Latvia: A Twenty-Five-Year Experience. Diagnostics (Basel) 2022; 12:diagnostics12112893. [PMID: 36428953 PMCID: PMC9689702 DOI: 10.3390/diagnostics12112893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Cystic fibrosis (CF) is the most common life-limiting genetic disorder in European descent populations. It is caused by pathogenic variants in the CFTR gene, and inheritance is autosomal recessive. This study provides an up-to-date, comprehensive estimation of the distribution of CFTR pathogenic variants in Latvia and their phenotypic characteristics. It also reports the first results of the CF newborn screening programme following its implementation in 2019. We analysed the clinical and molecular data of CF patients treated at the only tertiary hospital in Latvia providing specialised healthcare for the disorder. Between 1997 and 2022, 66 CF patients from 62 families were diagnosed based on symptoms or a molecular confirmation (six patients were diagnosed through the CF newborn screening programme). F508del was identified in 70.5% of all CF chromosomes. Known variants were identified in more than one family: dele2,3, R1006H, L1335P, W57R, R553X, 2143delT and 3849+10kb C>T (legacy names used). Furthermore, two novel variants were identified, namely, c.503C>A p.(Ser168Ter) and c.(743+1_744-1)_(1584+1_1585-1)del p.(?). The available follow-up results indicated that Latvian CF patients demonstrated similar tendencies to CF patients worldwide. The oldest age at diagnosis prior to the implementation of the CF newborn screening programme was 14 years. We provide here, for the first time, a comprehensive description of Latvian CF patients. An improvement in the healthcare of CF patients over time, including access to diagnosis, is evident. Two novel CF-causing variants are reported, and F508del is the most frequently occurring variant in the population, thus suggesting that F508del screening should be followed by the testing of the full CFTR gene.
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Ionova SA, Murtazina AF, Tebieva IS, Getoeva ZK, Dadali EL, Chausova PA, Shchagina OA, Marakhonov AV, Kutsev SI, Zinchenko RA. The Presentation of Two Unrelated Clinical Cases from the Republic of North Ossetia-Alania with the Same Previously Undescribed Variant in the COL6A2 Gene. Int J Mol Sci 2022; 23:ijms232012127. [PMID: 36292982 PMCID: PMC9602836 DOI: 10.3390/ijms232012127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/01/2022] [Accepted: 10/08/2022] [Indexed: 11/16/2022] Open
Abstract
Here, we described three affected boys from two unrelated families of Ossetian-Digor origin from the Republic of North Ossetia-Alania who were admitted to the Research Centre for Medical Genetics with unspecified muscular dystrophy. High-throughput sequencing was performed and revealed two novel frameshift variants in the COL6A2 gene (NM_001849.3) in a heterozygous state each in both cases: c.508_535delinsCTGTGG and c.1659_1660del (case 1) and c.1689del and c.1659_1660del (case 2). In two cases, the same nucleotide variant in the COL6A2 gene (c.1659_1660del) was observed. We have suggested that the variant c.1659_1660del may be common in the Ossetian-Digor population because two analyzed families have the same ancestry from the same subethnic group of Ossetians). The screening for an asymptomatic carriage of the nucleotide variant c.1659_1660del in 54 healthy donors from Ossetian-Digor population revealed that the estimated carrier frequency is 0.0093 (CI: 0.0002–0.0505), which is high for healthy carriers of the pathogenic variant. Molecular genetic, anamnestic data and clinical examination results allowed us to diagnose Ullrich muscular dystrophy in those affected boys. Genetic heterogeneity and phenotypic diversity of muscular dystrophies complicate diagnosis. It is important to make a differential diagnosis of such conditions and use HTS methods to determine the most accurate diagnosis.
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Affiliation(s)
- Sofya A. Ionova
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
- Correspondence: ; Tel.: +7-999-926-73-82
| | - Aysylu F. Murtazina
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
| | - Inna S. Tebieva
- North Ossetian State Medical Academy of the Ministry of Health of the Russian Federation, Pushkinskaya str. 40, 362019 Vladikavkaz, Russia
- Republican Children’s Clinical Hospital, Barbashova str. 33, 362003 Vladikavkaz, Russia
| | - Zalina K. Getoeva
- Pravoberezhnaya Central District Clinical Hospital, Kominterna str. 12, 363020 Beslan, Russia
| | - Elena L. Dadali
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
| | - Polina A. Chausova
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
| | - Olga A. Shchagina
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
| | - Andrey V. Marakhonov
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
| | - Sergey I. Kutsev
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
| | - Rena A. Zinchenko
- Research Centre for Medical Genetics, Moskvorechie str. 1, 115522 Moscow, Russia
- N.A. Semashko National Research Institute of Public Health, Vorontsovo Pole str. 12-1, 105064 Moscow, Russia
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Sui H, Xu X, Su Y, Gong Z, Yao M, Liu X, Zhang T, Jiang Z, Bai T, Wang J, Zhang J, Xu C, Luo M. Gene therapy for cystic fibrosis: Challenges and prospects. Front Pharmacol 2022; 13:1015926. [PMID: 36304167 PMCID: PMC9592762 DOI: 10.3389/fphar.2022.1015926] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/29/2022] [Indexed: 11/25/2022] Open
Abstract
Cystic fibrosis (CF) is a life-threatening autosomal-recessive disease caused by mutations in a single gene encoding cystic fibrosis transmembrane conductance regulator (CFTR). CF effects multiple organs, and lung disease is the primary cause of mortality. The median age at death from CF is in the early forties. CF was one of the first diseases to be considered for gene therapy, and efforts focused on treating CF lung disease began shortly after the CFTR gene was identified in 1989. However, despite the quickly established proof-of-concept for CFTR gene transfer in vitro and in clinical trials in 1990s, to date, 36 CF gene therapy clinical trials involving ∼600 patients with CF have yet to achieve their desired outcomes. The long journey to pursue gene therapy as a cure for CF encountered more difficulties than originally anticipated, but immense progress has been made in the past decade in the developments of next generation airway transduction viral vectors and CF animal models that reproduced human CF disease phenotypes. In this review, we look back at the history for the lessons learned from previous clinical trials and summarize the recent advances in the research for CF gene therapy, including the emerging CRISPR-based gene editing strategies. We also discuss the airway transduction vectors, large animal CF models, the complexity of CF pathogenesis and heterogeneity of CFTR expression in airway epithelium, which are the major challenges to the implementation of a successful CF gene therapy, and highlight the future opportunities and prospects.
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Affiliation(s)
- Hongshu Sui
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
- *Correspondence: Hongshu Sui, ; Changlong Xu, ; Mingjiu Luo,
| | - Xinghua Xu
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
| | - Yanping Su
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
| | - Zhaoqing Gong
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
| | - Minhua Yao
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
| | - Xiaocui Liu
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
| | - Ting Zhang
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
| | - Ziyao Jiang
- Department of Histology and Embryology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, China
| | - Tianhao Bai
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai’an, China
| | - Junzuo Wang
- The Affiliated Tai’an City Central Hospital of Qingdao University, Tai’an, Shandong, China
| | - Jingjun Zhang
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an, Shandong, China
| | - Changlong Xu
- The Reproductive Medical Center of Nanning Second People’s Hospital, Nanning, China
- National Center for International Research of Bio-targeting Theranostics, Guangxi Key Laboratory of Bio-targeting Theranostics, Collaborative Innovation Center for Targeting Tumor Diagnosis and Therapy, Guangxi Talent Highland of Bio-targeting Theranostics, Guangxi Medical University, Nanning, China
- *Correspondence: Hongshu Sui, ; Changlong Xu, ; Mingjiu Luo,
| | - Mingjiu Luo
- Shandong Provincial Key Laboratory of Animal Biotechnology and Disease Control and Prevention, College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai’an, China
- *Correspondence: Hongshu Sui, ; Changlong Xu, ; Mingjiu Luo,
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11
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Niedermayr K, Gasser V, Rueckes-Nilges C, Appelt D, Eder J, Fuchs T, Naehrlich L, Ellemunter H. Personalized medicine with drugs targeting the underlying protein defect in cystic fibrosis: is monitoring of treatment response necessary? Ther Adv Chronic Dis 2022; 13:20406223221108627. [PMID: 35959505 PMCID: PMC9358561 DOI: 10.1177/20406223221108627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
Cystic fibrosis (CF) is caused by two mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene. In the last years, drugs targeting the underlying protein defect like lumacaftor/ivacaftor (LUM/IVA) or tezacaftor/ivacaftor (TEZ/IVA) and more recently elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) were admitted. Outcome parameters evaluating therapy response like forced expiratory pressure in 1 s (FEV1), body mass index (BMI) or the efficacy of CFTR function in sweat glands showed improvement in several cases. Other, CFTR biomarkers were analysed rarely. This prospective observational study was aimed at evaluating CFTR function in patients treated with different CFTR modulators together with common valid clinical outcome parameters at standardized appointments (day 0, week 2, 4, 16). We followed four patients with the same mutation (F508del-CFTR), sex, age and disease severity. Monitoring focused on lung function, gastrointestinal aspects and CFTR function of sweat glands, nasal and intestinal epithelium. Sweat tests were performed by pilocarpine iontophoresis. Nasal potential difference (NPD) measured transepithelial voltage in vivo and potential increased when CFTR function improved. Rectal biopsies were obtained for intestinal current measurements (ICM) ex vivo. Intestinal CFTR function was assessed by stimulating chloride secretion with different reagents. Response to CFTR modulators regarding clinical outcome parameters was rather variable. A sweat chloride reduction of 35.3 mmol/L, nasal CFTR rescue of 4.4% and fivefold higher CFTR function in the intestine was seen at week 16 post-LUM/IVA. Due to our monitoring, we identified a non-responder to LUM/IVA and TEZ/IVA. In case of ELX/TEZ/IVA, clinical parameters and CFTR bioassays improved and were concordant. Although our cohort is small, results emphasize that non-responders exist and conclusions could not be drawn if patients were not monitored. Data on CFTR function can confirm or disprove ongoing CFTR dysfunction and might be helpful selectively. Non-responders need other alternative therapy options as demonstrated with ELX/TEZ/IVA.
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Affiliation(s)
- Katharina Niedermayr
- Department for Child and Adolescent Health, University Clinic for Paediatrics III, Cystic Fibrosis Centre, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Tyrol, Austria
| | - Verena Gasser
- Department for Child and Adolescent Health, University Clinic for Paediatrics III, Cystic Fibrosis Centre, Medical University of Innsbruck, Innsbruck, Austria
| | - Claudia Rueckes-Nilges
- Department of General Pediatrics and Neonatology, University Hospital of Giessen and Marburg, Campus Giessen, Giessen, Germany
| | - Dorothea Appelt
- Department for Child and Adolescent Health, University Clinic for Paediatrics III, Cystic Fibrosis Centre, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes Eder
- Department for Child and Adolescent Health, University Clinic for Paediatrics III, Cystic Fibrosis Centre, Medical University of Innsbruck, Innsbruck, Austria
| | - Teresa Fuchs
- Department for Child and Adolescent Health, University Clinic for Paediatrics III, Cystic Fibrosis Centre, Medical University of Innsbruck, Innsbruck, Austria
| | - Lutz Naehrlich
- Department of General Pediatrics and Neonatology, University Hospital of Giessen and Marburg, Campus Giessen, Giessen, Germany
| | - Helmut Ellemunter
- Department for Child and Adolescent Health, University Clinic for Paediatrics III, Cystic Fibrosis Centre, Medical University of Innsbruck, Innsbruck, Austria
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12
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Sotnikova EA, Kiseleva AV, Kutsenko VA, Zharikova AA, Ramensky VE, Divashuk MG, Vyatkin YV, Klimushina MV, Ershova AI, Revazyan KZ, Skirko OP, Zaicenoka M, Efimova IA, Pokrovskaya MS, Kopylova OV, Glechan AM, Shalnova SA, Meshkov AN, Drapkina OM. Identification of Pathogenic Variant Burden and Selection of Optimal Diagnostic Method Is a Way to Improve Carrier Screening for Autosomal Recessive Diseases. J Pers Med 2022; 12:jpm12071132. [PMID: 35887629 PMCID: PMC9322704 DOI: 10.3390/jpm12071132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022] Open
Abstract
Cystic fibrosis, phenylketonuria, alpha-1 antitrypsin deficiency, and sensorineural hearing loss are among the most common autosomal recessive diseases, which require carrier screening. The evaluation of population allele frequencies (AF) of pathogenic variants in genes associated with these conditions and the choice of the best genotyping method are the necessary steps toward development and practical implementation of carrier-screening programs. We performed custom panel genotyping of 3821 unrelated participants from two Russian population representative samples and three patient groups using real-time polymerase chain reaction (PCR) and next generation sequencing (NGS). The custom panel included 115 known pathogenic variants in the CFTR, PAH, SERPINA1, and GJB2 genes. Overall, 38 variants were detected. The comparison of genotyping platforms revealed the following advantages of real-time PCR: relatively low cost, simple genotyping data analysis, and easier detection of large indels, while NGS showed better accuracy of variants identification and capability for detection of additional pathogenic variants in adjacent regions. A total of 23 variants had significant differences in estimated AF comparing with non-Finnish Europeans from gnomAD. This study provides new AF data for variants associated with the studied disorders and the comparison of genotyping methods for carrier screening.
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Affiliation(s)
- Evgeniia A. Sotnikova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Anna V. Kiseleva
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
- Correspondence:
| | - Vladimir A. Kutsenko
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
- Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, 1-73, Leninskie Gory, 119991 Moscow, Russia
| | - Anastasia A. Zharikova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 1-73, Leninskie Gory, 119991 Moscow, Russia
| | - Vasily E. Ramensky
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, 1-73, Leninskie Gory, 119991 Moscow, Russia
| | - Mikhail G. Divashuk
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
- All-Russia Research Institute of Agricultural Biotechnology, Timiryazevskaya Street, 42, 127550 Moscow, Russia
| | - Yuri V. Vyatkin
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
- Novosibirsk State University, 1, Pirogova Str., 630090 Novosibirsk, Russia
| | - Marina V. Klimushina
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Alexandra I. Ershova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Karina Z. Revazyan
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Olga P. Skirko
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Marija Zaicenoka
- Moscow Institute of Physics and Technology, Dolgoprudny, Institutskiy per.9, 141701 Dolgoprudny, Russia;
| | - Irina A. Efimova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Maria S. Pokrovskaya
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Oksana V. Kopylova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Anush M. Glechan
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Svetlana A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Alexey N. Meshkov
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
| | - Oxana M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Healthcare of the Russian Federation, Petroverigsky per.10, Bld. 3, 101000 Moscow, Russia; (E.A.S.); (V.A.K.); (A.A.Z.); (V.E.R.); (M.G.D.); (Y.V.V.); (M.V.K.); (A.I.E.); (K.Z.R.); (O.P.S.); (I.A.E.); (M.S.P.); (O.V.K.); (A.M.G.); (S.A.S.); (A.N.M.); (O.M.D.)
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