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Yongprayoon V, Wattanakul N, Khomate W, Apithanangsiri N, Kasitipradit T, Nantajit D, Tavassoli M. Targeting BRD4: Potential therapeutic strategy for head and neck squamous cell carcinoma (Review). Oncol Rep 2024; 51:74. [PMID: 38606512 DOI: 10.3892/or.2024.8733] [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: 02/08/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024] Open
Abstract
As a member of BET (bromodomain and extra-terminal) protein family, BRD4 (bromodomain‑containing protein 4) is a chromatin‑associated protein that interacts with acetylated histones and actively recruits regulatory proteins, leading to the modulation of gene expression and chromatin remodeling. The cellular and epigenetic functions of BRD4 implicate normal development, fibrosis and inflammation. BRD4 has been suggested as a potential therapeutic target as it is often overexpressed and plays a critical role in regulating gene expression programs that drive tumor cell proliferation, survival, migration and drug resistance. To address the roles of BRD4 in cancer, several drugs that specifically target BRD4 have been developed. Inhibition of BRD4 has shown promising results in preclinical models, with several BRD4 inhibitors undergoing clinical trials for the treatment of various cancers. Head and neck squamous cell carcinoma (HNSCC), a heterogeneous group of cancers, remains a health challenge with a high incidence rate and poor prognosis. Conventional therapies for HNSCC often cause adverse effects to the patients. Targeting BRD4, therefore, represents a promising strategy to sensitize HNSCC to chemo‑ and radiotherapy allowing de‑intensification of the current therapeutic regime and subsequent reduced side effects. However, further studies are required to fully understand the underlying mechanisms of action of BRD4 in HNSCC in order to determine the optimal dosing and administration of BRD4‑targeted drugs for the treatment of patients with HNSCC.
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Affiliation(s)
- Voraporn Yongprayoon
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Napasporn Wattanakul
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Winnada Khomate
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Nathakrit Apithanangsiri
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Tarathip Kasitipradit
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Danupon Nantajit
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand
| | - Mahvash Tavassoli
- Centre for Host Microbiome Interactions, King's College London, London SE1 1UL, UK
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He Z, Wilson A, Rich F, Kenwright D, Stevens A, Low YS, Thunders M. Chromosomal instability and its effect on cell lines. Cancer Rep (Hoboken) 2023:e1822. [PMID: 37095005 DOI: 10.1002/cnr2.1822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Cancer cell lines are invaluable model systems for biomedical research because they provide an almost unlimited supply of biological materials. However, there is considerable skepticism regarding the reproducibility of data derived from these in vitro models. RECENT FINDINGS Chromosomal instability (CIN) is one of the primary issues associated with cell lines, which can cause genetic heterogeneity and unstable cell properties within a cell population. Many of these problems can be avoided with some precautions. Here we review the underlying causes of CIN, including merotelic attachment, telomere dysfunction, DNA damage response defects, mitotic checkpoint defects and cell cycle disturbances. CONCLUSION In this review we summarize studies highlighting the consequences of CIN in various cell lines and provide suggestions on monitoring and controlling CIN during cell culture.
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Affiliation(s)
- Zichen He
- Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
| | - Andrew Wilson
- Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
| | - Fenella Rich
- Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
| | - Diane Kenwright
- Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
| | - Aaron Stevens
- Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
| | - Yee Syuen Low
- Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
| | - Michelle Thunders
- Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand
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Yang F, Zhou L, Chen J, Luo Y, Wang Y. Survival association of XRCC1 for patients with head and neck squamous cell carcinoma: A systematic review and meta-analysis. Front Genet 2023; 13:1035910. [PMID: 36685969 PMCID: PMC9849232 DOI: 10.3389/fgene.2022.1035910] [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: 09/03/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
Background: Epidemiologic studies have demonstrated that X-ray repair cross-complementary group 1 (XRCC1) is one of the susceptibility factors in head and neck squamous cell carcinoma (HNSCC) patients. However, its clinical prognostic impact remains controversial. Thus, a meta-analysis was performed to clarify the association between XRCC1 and the survival outcomes in HNSCC patients. Methods: Following the Preferred Reporting Items or Systematic Reviews Meta Analyses (PRISMA) 2020 guidelines, literature searches were systematically performed in PubMed, EMBASE, Web of Science, Wanfang, and Chinese National Knowledge Infrastructure (CNKI) databases with manual retrieval. Hazard ratios (HRs) and 95% confidence intervals (CIs) were collected to estimate the correlation between XRCC1 and the survival outcomes of HNSCC patients. Results: Ten studies including 1995 HNSCC patients who satisfied the inclusion and exclusion criteria were included in this meta-analysis. Pooled analysis indicated that XRCC1 Arg399Gln and XRCC1 high protein expression were significantly correlated with poor overall survival with HR of 1.31 (95% CIs: 1.03-1.66, p = 0.027) and 2.32 (95% CIs: 1.55-3.48 p = 0.000) in HNSCC patients. In addition, our results demonstrated that XRCC1 was significantly associated with poor progression-free survival (HR = 1.42, 95% CIs: 1.15-1.75, p = 0.001) in HNSCC patients. ConclusionThis meta-analysis demonstrated that XRCC1 Arg399Gln and XRCC1 high protein expression increase the risk of poor survival for HNSCC patients. XRCC1 is a potential therapeutic target for HNSCC.
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Liu Y, Lin Y, Yang W, Lin Y, Wu Y, Zhang Z, Lin N, Wang X, Tong M, Yu R. Application of individualized differential expression analysis in human cancer proteome. Brief Bioinform 2022; 23:6562685. [DOI: 10.1093/bib/bbac096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/06/2022] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Liquid chromatography–mass spectrometry-based quantitative proteomics can measure the expression of thousands of proteins from biological samples and has been increasingly applied in cancer research. Identifying differentially expressed proteins (DEPs) between tumors and normal controls is commonly used to investigate carcinogenesis mechanisms. While differential expression analysis (DEA) at an individual level is desired to identify patient-specific molecular defects for better patient stratification, most statistical DEP analysis methods only identify deregulated proteins at the population level. To date, robust individualized DEA algorithms have been proposed for ribonucleic acid data, but their performance on proteomics data is underexplored. Herein, we performed a systematic evaluation on five individualized DEA algorithms for proteins on cancer proteomic datasets from seven cancer types. Results show that the within-sample relative expression orderings (REOs) of protein pairs in normal tissues were highly stable, providing the basis for individualized DEA for proteins using REOs. Moreover, individualized DEA algorithms achieve higher precision in detecting sample-specific deregulated proteins than population-level methods. To facilitate the utilization of individualized DEA algorithms in proteomics for prognostic biomarker discovery and personalized medicine, we provide Individualized DEP Analysis IDEPAXMBD (XMBD: Xiamen Big Data, a biomedical open software initiative in the National Institute for Data Science in Health and Medicine, Xiamen University, China.) (https://github.com/xmuyulab/IDEPA-XMBD), which is a user-friendly and open-source Python toolkit that integrates individualized DEA algorithms for DEP-associated deregulation pattern recognition.
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Affiliation(s)
- Yachen Liu
- School of Informatics, Xiamen University, Xiamen, Fujian 316000, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian 316005, China
| | - Yalan Lin
- School of Informatics, Xiamen University, Xiamen, Fujian 316000, China
| | - Wenxian Yang
- Aginome Scientific, Xiamen, Fujian 316005, China
| | - Yuxiang Lin
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian 316005, China
- State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, School of Life Sciences, Xiamen University, Xiamen, Fujian 361102, China
| | - Yujuan Wu
- School of Informatics, Xiamen University, Xiamen, Fujian 316000, China
| | - Zheyang Zhang
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian 316005, China
- State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, School of Life Sciences, Xiamen University, Xiamen, Fujian 361102, China
| | - Nuoqi Lin
- State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, School of Life Sciences, Xiamen University, Xiamen, Fujian 361102, China
| | - Xianlong Wang
- Department of Bioinformatics, School of Medical Technology and Engineering, Key Laboratory of Medical Bioinformatics, Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian 350122, China
| | - Mengsha Tong
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian 316005, China
- State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, School of Life Sciences, Xiamen University, Xiamen, Fujian 361102, China
| | - Rongshan Yu
- School of Informatics, Xiamen University, Xiamen, Fujian 316000, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian 316005, China
- Aginome Scientific, Xiamen, Fujian 316005, China
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Truchard E, Bertolus C, Martinez P, Thomas E, Saintigny P, Foy JP. Identification of a Gene-Expression-Based Surrogate of Genomic Instability during Oral Carcinogenesis. Cancers (Basel) 2022; 14:cancers14030834. [PMID: 35159101 PMCID: PMC8834046 DOI: 10.3390/cancers14030834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary New personalized cancer prevention strategies may decrease the mortality of oral cancer that can arise from oral potentially malignant disorders (OPMD). A major cancer hallmark is the acquisition of multiple deletions or amplifications of genomic material fragments leading to genomic instability (GI). Our goal was to identify a set of genes whose expression was associated with GI. A total of 20 genes correlated with GI were identified in two independent datasets of head and neck cancer (including oral cancer). We computed a score of those genes, referred to as the GIN score, in with each sample from multiple validation datasets. We show that the GIN score: (i) was correlated with GI, (ii) increased at different stages of oral carcinogenesis from normal mucosa to oral cancer, and (iii) was associated with malignant transformation of OPMD. The GIN score is a promising biomarker for identifying patients suffering from OPMD with high risk of oral cancer. Abstract Background: Our goal was to identify a gene-expression-based surrogate of genomic instability (GI) associated with the transformation of oral potentially malignant disorder (OPMD) into oral squamous cell carcinoma (OSCC). Methods: GI was defined as the fraction of genome altered (FGA). Training sets included the CCLE and TCGA databases. The relevance of the enrichment score of the top correlated genes, referred to as the GIN score, was evaluated in eight independent public datasets from the GEO repository, including a cohort of patients with OPMD with available outcome. Results: A set of 20 genes correlated with FGA in head and neck SCC were identified. A significant correlation was found between the 20-gene based GIN score and FGA in 95 esophagus SCC (r = 0.59) and 501 lung SCC (r = 0.63), and in 33 OPMD/OSCC (r = 0.38). A significantly increased GIN score was observed at different stages of oral carcinogenesis (normal–dysplasia –OSCC) in five independent datasets. The GIN score was higher in 10 OPMD that transformed into oral cancer compared to 10 nontransforming OPMD (p = 0.0288), and was associated with oral-cancer-free survival in 86 patients with OPMD (p = 0.0081). Conclusions: The GIN score is a gene-expression surrogate of GI, and is associated with oral carcinogenesis and OPMD malignant transformation.
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Affiliation(s)
- Eléonore Truchard
- Sorbonne Université, Department of Maxillo-Facial Surgery, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (E.T.); (C.B.)
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
| | - Chloé Bertolus
- Sorbonne Université, Department of Maxillo-Facial Surgery, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (E.T.); (C.B.)
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
| | - Pierre Martinez
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
| | - Emilie Thomas
- Synergie Lyon Cancer-Platform of Bioinformatics Gilles Thomas, 69008 Lyon, France;
| | - Pierre Saintigny
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
- Department of Medical Oncology, Centre Léon Bérard, 69008 Lyon, France
| | - Jean-Philippe Foy
- Sorbonne Université, Department of Maxillo-Facial Surgery, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France; (E.T.); (C.B.)
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de recherche en cancérologie de Lyon, 69008 Lyon, France; (P.M.); (P.S.)
- Department of Translational Medicine, Centre Léon Bérard, 69008 Lyon, France
- Correspondence: ; Tel.: +33-(0)1421-61448; Fax: +33-(0)1421-61449
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Beyond the Double-Strand Breaks: The Role of DNA Repair Proteins in Cancer Stem-Cell Regulation. Cancers (Basel) 2021; 13:cancers13194818. [PMID: 34638302 PMCID: PMC8508278 DOI: 10.3390/cancers13194818] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Cancer stem cells (CSCs) are a tumor cell population maintaining tumor growth and promoting tumor relapse if not wholly eradicated during treatment. CSCs are often equipped with molecular mechanisms making them resistant to conventional anti-cancer therapies whose curative potential depends on DNA damage-induced cell death. An elevated expression of some key DNA repair proteins is one of such defense mechanisms. However, new research reveals that the role of critical DNA repair proteins is extending far beyond the DNA repair mechanisms. This review discusses the diverse biological functions of DNA repair proteins in CSC maintenance and the adaptation to replication and oxidative stress, anti-cancer immune response, epigenetic reprogramming, and intracellular signaling mechanisms. It also provides an overview of their potential therapeutic targeting. Abstract Cancer stem cells (CSCs) are pluripotent and highly tumorigenic cells that can re-populate a tumor and cause relapses even after initially successful therapy. As with tissue stem cells, CSCs possess enhanced DNA repair mechanisms. An active DNA damage response alleviates the increased oxidative and replicative stress and leads to therapy resistance. On the other hand, mutations in DNA repair genes cause genomic instability, therefore driving tumor evolution and developing highly aggressive CSC phenotypes. However, the role of DNA repair proteins in CSCs extends beyond the level of DNA damage. In recent years, more and more studies have reported the unexpected role of DNA repair proteins in the regulation of transcription, CSC signaling pathways, intracellular levels of reactive oxygen species (ROS), and epithelial–mesenchymal transition (EMT). Moreover, DNA damage signaling plays an essential role in the immune response towards tumor cells. Due to its high importance for the CSC phenotype and treatment resistance, the DNA damage response is a promising target for individualized therapies. Furthermore, understanding the dependence of CSC on DNA repair pathways can be therapeutically exploited to induce synthetic lethality and sensitize CSCs to anti-cancer therapies. This review discusses the different roles of DNA repair proteins in CSC maintenance and their potential as therapeutic targets.
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Burcher KM, Faucheux AT, Lantz JW, Wilson HL, Abreu A, Salafian K, Patel MJ, Song AH, Petro RM, Lycan T, Furdui CM, Topaloglu U, D’Agostino RB, Zhang W, Porosnicu M. Prevalence of DNA Repair Gene Mutations in Blood and Tumor Tissue and Impact on Prognosis and Treatment in HNSCC. Cancers (Basel) 2021; 13:3118. [PMID: 34206538 PMCID: PMC8267691 DOI: 10.3390/cancers13133118] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/13/2021] [Accepted: 06/16/2021] [Indexed: 02/07/2023] Open
Abstract
PARP inhibitors are currently approved for a limited number of cancers and targetable mutations in DNA damage repair (DDR) genes. In this single-institution retrospective study, the profiles of 170 patients with head and neck squamous cell cancer (HNSCC) and available tumor tissue DNA (tDNA) and circulating tumor DNA (ctDNA) results were analyzed for mutations in a set of 18 DDR genes as well as in gene subsets defined by technical and clinical significance. Mutations were correlated with demographic and outcome data. The addition of ctDNA to the standard tDNA analysis contributed to identification of a significantly increased incidence of patients with mutations in one or more genes in each of the study subsets of DDR genes in groups of patients older than 60 years, patients with laryngeal primaries, patients with advanced stage at diagnosis and patients previously treated with chemotherapy and/or radiotherapy. Patients with DDR gene mutations were found to be significantly less likely to have primary tumors within the in oropharynx or HPV-positive disease. Patients with ctDNA mutations in all subsets of DDR genes analyzed had significantly worse overall survival in univariate and adjusted multivariate analysis. This study underscores the utility of ctDNA analysis, alone, and in combination with tDNA, for defining the prevalence and the role of DDR gene mutations in HNSCC. Furthermore, this study fosters research promoting the utilization of PARP inhibitors in HNSCC precision oncology treatments.
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Affiliation(s)
- Kimberly M. Burcher
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Andrew T. Faucheux
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Jeffrey W. Lantz
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Harper L. Wilson
- University of Kentucky Medical Center, Lexington, KY 40536, USA;
| | - Arianne Abreu
- Campbell University School of Osteopathic Medicine (CUSOM), Lillington, NC 27546, USA;
| | - Kiarash Salafian
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Manisha J. Patel
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Alexander H. Song
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Robin M. Petro
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Thomas Lycan
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Cristina M. Furdui
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Umit Topaloglu
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Ralph B. D’Agostino
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Wei Zhang
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
| | - Mercedes Porosnicu
- Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA; (K.M.B.); (A.T.F.); (J.W.L.); (K.S.); (M.J.P.); (A.H.S.); (R.M.P.); (T.L.J.); (C.M.F.); (U.T.); (R.B.D.J.); (W.Z.)
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