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Nakauchi Y, Azizi A, Thomas D, Corces MR, Reinisch A, Sharma R, Cruz Hernandez D, Kohnke T, Karigane D, Fan A, Martinez-Krams D, Stafford M, Kaur S, Dutta R, Phan P, Ediriwickrema A, McCarthy E, Ning Y, Phillips T, Ellison CK, Guler GD, Bergamaschi A, Ku CJ, Levy S, Majeti R. The cell type specific 5hmC landscape and dynamics of healthy human hematopoiesis and TET2-mutant pre-leukemia. Blood Cancer Discov 2022; 3:346-367. [DOI: 10.1158/2643-3230.bcd-21-0143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/07/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
The conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) is a key step in DNA demethylation that is mediated by ten-eleven-translocation (TET) enzymes, which require ascorbate/vitamin C. Here, we report the 5hmC landscape of normal hematopoiesis and identify cell type-specific 5hmC profiles associated with active transcription and chromatin accessibility of key hematopoietic regulators. We utilized CRISPR/Cas9 to model TET2 loss-of-function mutations in primary human HSPCs. Disrupted cells exhibited increased colonies in serial replating, defective erythroid/megakaryocytic differentiation, and in vivo competitive advantage and myeloid skewing coupled with reduction of 5hmC at erythroid-associated gene loci. Azacitidine and ascorbate restored 5hmC abundance and slowed or reverted the expansion of TET2-mutant clones in vivo. These results demonstrate the key role of 5hmC in normal hematopoiesis and TET2-mutant phenotypes and raise the possibility of utilizing these agents to further our understanding of pre-leukemia/clonal hematopoiesis.
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Affiliation(s)
- Yusuke Nakauchi
- Stanford University School of Medicine, Stanford, California, United States
| | - Armon Azizi
- Stanford University, Stanford, CA, United States
| | - Daniel Thomas
- University of Adelaide, Adelaide, South Australia, Australia
| | - M. Ryan Corces
- Gladstone Institute of Neurological Disease, San Fransisco, California, United States
| | - Andreas Reinisch
- Stanford University School of Medicine, Stanford, CA, United States
| | - Rajiv Sharma
- Stanford University School of Medicine, Stanford, California, United States
| | - David Cruz Hernandez
- MRC Molecular Haematology Unit and Oxford Centre for Haematology, Weatherall Institute of Molecular Medicine,, Oxford, United Kingdom
| | - Thomas Kohnke
- Stanford University School of Medicine, Stanford, California, United States
| | - Daiki Karigane
- Stanford University School of Medicine, Stanford, California, United States
| | - Amy Fan
- Stanford University, Palo Alto, United States
| | | | | | - Satinder Kaur
- Stanford University School of Medicine, Palo Alto, CA, United States
| | - Ritika Dutta
- Stanford University School of Medicine, Palo Alto, CA, United States
| | - Paul Phan
- Stanford University School of Medicine, Stanford, California, United States
| | | | | | - Yuhong Ning
- Bluestar Genomics Inc., San Diego, CA, United States
| | | | | | | | | | | | - Samuel Levy
- Bluestar Genomics, San Diego, California, United States
| | - Ravindra Majeti
- Stanford University School of Medicine, Palo Alto, CA, United States
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2
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Guler GD, Ning Y, Ku CJ, Phillips T, McCarthy E, Ellison CK, Bergamaschi A, Collin F, Lloyd P, Scott A, Antoine M, Wang W, Chau K, Ashworth A, Quake SR, Levy S. Detection of early stage pancreatic cancer using 5-hydroxymethylcytosine signatures in circulating cell free DNA. Nat Commun 2020; 11:5270. [PMID: 33077732 PMCID: PMC7572413 DOI: 10.1038/s41467-020-18965-w] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 09/18/2020] [Indexed: 12/15/2022] Open
Abstract
Pancreatic cancer is often detected late, when curative therapies are no longer possible. Here, we present non-invasive detection of pancreatic ductal adenocarcinoma (PDAC) by 5-hydroxymethylcytosine (5hmC) changes in circulating cell free DNA from a PDAC cohort (n = 64) in comparison with a non-cancer cohort (n = 243). Differential hydroxymethylation is found in thousands of genes, most significantly in genes related to pancreas development or function (GATA4, GATA6, PROX1, ONECUT1, MEIS2), and cancer pathogenesis (YAP1, TEAD1, PROX1, IGF1). cfDNA hydroxymethylome in PDAC cohort is differentially enriched for genes that are commonly de-regulated in PDAC tumors upon activation of KRAS and inactivation of TP53. Regularized regression models built using 5hmC densities in genes perform with AUC of 0.92 (discovery dataset, n = 79) and 0.92-0.94 (two independent test sets, n = 228). Furthermore, tissue-derived 5hmC features can be used to classify PDAC cfDNA (AUC = 0.88). These findings suggest that 5hmC changes enable classification of PDAC even during early stage disease.
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Affiliation(s)
- Gulfem D Guler
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA
| | - Yuhong Ning
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA
| | - Chin-Jen Ku
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA
| | - Tierney Phillips
- Bluestar Genomics, 10578 Science Center Drive Suite 210, San Diego, CA, 92121, USA
| | - Erin McCarthy
- Bluestar Genomics, 10578 Science Center Drive Suite 210, San Diego, CA, 92121, USA
| | | | - Anna Bergamaschi
- Bluestar Genomics, 10578 Science Center Drive Suite 210, San Diego, CA, 92121, USA
| | - Francois Collin
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA
| | - Paul Lloyd
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA
| | - Aaron Scott
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA
| | - Michael Antoine
- Bluestar Genomics, 10578 Science Center Drive Suite 210, San Diego, CA, 92121, USA
| | - Wendy Wang
- Bluestar Genomics, 10578 Science Center Drive Suite 210, San Diego, CA, 92121, USA
| | - Kim Chau
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA
| | - Alan Ashworth
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, 94158, USA
| | - Stephen R Quake
- Departments of Bioengineering and Applied Physics, Stanford University, Stanford, CA, 94304, USA
- Chan Zuckerberg Biohub, San Francisco, CA, 94158, USA
| | - Samuel Levy
- Bluestar Genomics, 185 Berry Street, Lobby 4, Suite 210, San Francisco, CA, 94107, USA.
- Bluestar Genomics, 10578 Science Center Drive Suite 210, San Diego, CA, 92121, USA.
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Collin F, Ning Y, Guler GD, Phillips T, McCarthy E, Scott A, Ellison C, Ku CJ, Chau K, Ashworth A, Quake SR, Levy S. Abstract 1372: Detection of early stage pancreatic cancer using 5–hydroxymethylcytosine signatures in circulating cell free DNA. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-1372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Pancreatic cancers are typically diagnosed at late stage where disease prognosis is poor as exemplified by a 5-year survival rate of 8.2%. Earlier diagnosis would be beneficial by enabling surgical resection or earlier application of therapeutic regimens. We investigated the detection of pancreatic ductal adenocarcinoma (PDAC) in a non-invasive manner by interrogating changes in 5-hydroxymethylated cytosines (5hmC) in circulating cell free DNA in the plasma of a PDAC cohort (n=51) in comparison with a non-cancer cohort (n=41). 5hmC profiles from PDAC and non-cancer samples were generated using a previously published modified hMe-Seal protocol that utilizes chemical labeling of 5hmC by β-glucosyltransferase and allows detection of cell free 5hmC from small amounts of cfDNA (1). We found that 5hmC sites are enriched in a disease and stage specific manner in exons, 3’UTRs and transcription termination sites. Our data show that 5hmC density is reduced in promoters and histone H3K4me3 associated sites with progressive disease suggesting increased transcriptional activity. 5hmC density is differentially represented in thousands of genes, and a stringently filtered set of the most significant genes points to biology related to pancreas (GATA4, GATA6, PROX1, ONECUT1) and/or cancer development (YAP1, TEAD1, PROX1, ONECUT1, ONECUT2, IGF1 and IGF2). Regularized regression models were built using 5hmC densities in a comprehensive set of genes with the most variable 5hmC counts and performed with an AUC = 0.94 - 0.96 on training data. We tested the ability to classify PDAC and non-cancer samples with the Elastic net and Lasso models on three independent pancreatic cancer 5hmC data sets (n = 26, 23 and 7) compared with corresponding independent non-cancer cohorts (n =103, 53 and 10), and found validation performance to be AUC = 0.74 - 0.97. The findings suggest that 5hmC changes enable classification of PDAC patients with high fidelity and are worthy of further investigation on larger cohorts of patient samples. Reference: 1. Song, C. - X. et al. 5 - Hydroxymethylcytosine signatures in cell-free DNA provide information about tumor types and stages. Cell Res 27, 1231 (2017).
Citation Format: Francois Collin, Yuhong Ning, Gulfem D. Guler, Tierney Phillips, Erin McCarthy, Aaron Scott, Chris Ellison, Chin-Jen Ku, Kim Chau, Alan Ashworth, Stephen R. Quake, Samuel Levy. Detection of early stage pancreatic cancer using 5–hydroxymethylcytosine signatures in circulating cell free DNA [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1372.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Alan Ashworth
- 2University of California San Francisco, San Francisco, CA
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Beasley EM, Abramson RD, Alexander GE, Chan D, Bradley K, Collin F, Crager M, Dei Rossi A, Dorado J, Friedman A, Gibb WJ, Jeong J, Jones C, Ku CJ, Ma Y, Morlan J, Qu K, Rao A, Scott A, Tezcan H. Abstract P4-02-08: Global quantitative measures using next-generation sequencing for breast cancer presence outperform individual tumor markers in plasma. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p4-02-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Analytically and clinically validated non-invasive blood tests that quantify breast cancer burden and clinical drug response/resistance are greatly needed. Many groups have successfully detected tumor markers in blood using a variety of technologies, including next generation sequencing (NGS). We performed a comprehensive NGS study on a small number of patients to evaluate the value of global versus individual markers for the quantitation of tumor-derived cell free DNA (cfDNA) in plasma.
Methods: DNA isolated from formalin-fixed primary tumor, buffy coat cells, and plasma from 2 patients with metastatic breast cancer were characterized simultaneously for copy number aberrations (CNAs) and differentially methylated regions (DMRs) using whole genome bisulfite sequencing (WBGS), and targeted sequencing-based genotyping of 346 cancer-associated single nucleotide variations (SNVs). CNA and DMR regions were identified from log normalized, GC content corrected counts and DMR data using Poisson and binomial distribution theory and false discovery rate controlling methods. Percent tumor in cfDNA was estimated from the normalized ratio (plasma: primary tumor) of CNA or DMR compared to buffy coat, aggregating over genomic regions. Sample sets from 8 non-metastatic patients were also profiled using the targeted SNV panel in order to compare SNVs between samples and estimate percent tumor cfDNA.
Results: WGBS detected tumor specific alterations in each primary tumor compared to buffy coat. By analyzing the genome using 100 Kb bins, we observed over 1000 bins with detectable CNA signal and, among 56 million CpG sites, over 30,000 DMRs. As expected, 5 or fewer informative somatic SNVs were detected in each patient. Analysis of these somatic changes in plasma revealed that the tumor fraction estimated from SNV detected in cfDNA varied widely between sites originally discovered in the patient’s primary tumor. In contrast, similar estimates of tumor fraction in cfDNA were obtained using CNA and DMR profiles within each patient; both methods yielded similar estimates of over 50% in one patient and less than 10% in the other. For the patient with high tumor fraction, both CNA and DMR profiles contained examples of individual large genomic regions that displayed additional clear aberrations in the plasma compared to the original tumor, such as a striking loss of a >25 Mb region of chromosome 4.
Conclusions: Although individual somatic SNV in cfDNA can be detected in metastatic disease, calculated allelic fraction based on individual SNVs varies greatly within the same patient. Measuring and integrating CNA or DMR across the genome provided more consistent and reliable estimates of tumor DNA fraction in plasma, and also revealed alterations in plasma from patients with metastatic disease that were not prominent in the primary tumor.
Citation Format: Ellen M Beasley, Richard D Abramson, Gregory E Alexander, David Chan, Kristen Bradley, Francois Collin, Michael Crager, Andrew Dei Rossi, Joseph Dorado, Adam Friedman, William J Gibb, Jennie Jeong, Col Jones, C J Ku, Yan Ma, John Morlan, Kunbin Qu, Aibing Rao, Aaron Scott, Haluk Tezcan. Global quantitative measures using next-generation sequencing for breast cancer presence outperform individual tumor markers in plasma [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-02-08.
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Wang Y, Ku CJ, Zhang ER, Artyukhin AB, Weiner OD, Wu LF, Altschuler SJ. Identifying network motifs that buffer front-to-back signaling in polarized neutrophils. Cell Rep 2013; 3:1607-16. [PMID: 23665220 DOI: 10.1016/j.celrep.2013.04.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 03/05/2013] [Accepted: 04/09/2013] [Indexed: 01/02/2023] Open
Abstract
Neutrophil polarity relies on local, mutual inhibition to segregate incompatible signaling circuits to the leading and trailing edges. Mutual inhibition alone should lead to cells having strong fronts and weak backs or vice versa. However, analysis of cell-to-cell variation in human neutrophils revealed that back polarity remains consistent despite changes in front strength. How is this buffering achieved? Pharmacological perturbations and mathematical modeling revealed a functional role for microtubules in buffering back polarity by mediating positive, long-range crosstalk from front to back; loss of microtubules inhibits buffering and results in anticorrelation between front and back signaling. Furthermore, a systematic, computational search of network topologies found that a long-range, positive front-to-back link is necessary for back buffering. Our studies suggest a design principle that can be employed by polarity networks: short-range mutual inhibition establishes distinct signaling regions, after which directed long-range activation insulates one region from variations in the other.
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Affiliation(s)
- Yanqin Wang
- Green Center for Systems Biology, Department of Pharmacology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Ku CJ, Wang Y, Weiner OD, Altschuler SJ, Wu LF. Network crosstalk dynamically changes during neutrophil polarization. Cell 2012; 149:1073-83. [PMID: 22632971 DOI: 10.1016/j.cell.2012.03.044] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 11/29/2011] [Accepted: 03/21/2012] [Indexed: 01/09/2023]
Abstract
How complex signaling networks shape highly coordinated, multistep cellular responses is poorly understood. Here, we made use of a network-perturbation approach to investigate causal influences, or "crosstalk," among signaling modules involved in the cytoskeletal response of neutrophils to chemoattractant. We quantified the intensity and polarity of cytoskeletal marker proteins over time to characterize stereotyped cellular responses. Analyzing the effects of network disruptions revealed that, not only does crosstalk evolve rapidly during polarization, but also that intensity and polarity responses are influenced by different patterns of crosstalk. Interestingly, persistent crosstalk is arranged in a surprisingly simple circuit: a linear cascade from front to back to microtubules influences intensities, and a feed-forward network in the reverse direction influences polarity. Our approach provided a rational strategy for decomposing a complex, dynamically evolving signaling system and revealed evolving paths of causal influence that shape the neutrophil polarization response.
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Affiliation(s)
- Chin-Jen Ku
- Department of Pharmacology, Green Center for Systems Biology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Wu L, Ku CJ, Wang Y, Weiner O, Altschuler S. Dynamic information flow during neutrophil polarization. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.345.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lani Wu
- Department of PharmacologyGreen center for Systems BiologyUTSWDallasTX
| | - Chin-Jen Ku
- Department of PharmacologyGreen center for Systems BiologyUTSWDallasTX
| | - Yanqin Wang
- Department of PharmacologyGreen center for Systems BiologyUTSWDallasTX
| | - Orion Weiner
- Cardiovascular Research Institute and Department of BiochemistryUCSFSan FranciscoCA
| | - Steven Altschuler
- Department of PharmacologyGreen center for Systems BiologyUTSWDallasTX
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Singh DK, Ku CJ, Wichaidit C, Steininger RJ, Wu LF, Altschuler SJ. Patterns of basal signaling heterogeneity can distinguish cellular populations with different drug sensitivities. Mol Syst Biol 2010; 6:369. [PMID: 20461076 PMCID: PMC2890326 DOI: 10.1038/msb.2010.22] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 03/18/2010] [Indexed: 12/31/2022] Open
Abstract
Phenotypic heterogeneity has been widely observed in cellular populations. However, the extent to which heterogeneity contains biologically or clinically important information is not well understood. Here, we investigated whether patterns of basal signaling heterogeneity, in untreated cancer cell populations, could distinguish cellular populations with different drug sensitivities. We modeled cellular heterogeneity as a mixture of stereotyped signaling states, identified based on colocalization patterns of activated signaling molecules from microscopy images. We found that patterns of heterogeneity could be used to separate the most sensitive and resistant populations to paclitaxel within a set of H460 lung cancer clones and within the NCI-60 panel of cancer cell lines, but not for a set of less heterogeneous, immortalized noncancer human bronchial epithelial cell (HBEC) clones. Our results suggest that patterns of signaling heterogeneity, characterized as ensembles of a small number of distinct phenotypic states, can reveal functional differences among cellular populations.
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Affiliation(s)
- Dinesh Kumar Singh
- Department of Pharmacology, Green Center for Systems Biology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75390-9041, USA
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Ku CJ, Wang Y, Pavie B, Altschuler SJ, Wu LF. ON IDENTIFYING INFORMATION FROM IMAGE-BASED SPATIAL POLARITY PHENOTYPES IN NEUTROPHILS. Proc IEEE Int Symp Biomed Imaging 2010; 14-17:1029-1032. [PMID: 20725643 DOI: 10.1109/isbi.2010.5490165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Cell polarity is involved in many biological functions such as development, wound healing and immune responses. In human neutrophils, polarization is characterized by the translocation of distinct sets of signaling molecules to opposite ends of the cell and the rapid rearrangement of cytoskeleton to initiate migration. While many image-based studies have described cellular morphology and the intensity level of polarity signaling molecules, systematic characterization of the spatial distribution of polarity signaling molecules has been lacking. Here we designed a collection of analytical features to quantify spatial phenotypes of polarity molecules. We compared our features to commonly used polarity readouts and found that they captured additional aspects of the polarization dynamics that were not contained in the existing features. Our work provides a starting point to identify informative features for the study of neutrophil polarization.
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Affiliation(s)
- Chin-Jen Ku
- University of Texas Southwestern Medical Center. Dallas, Texas 75390. U.S.A. Department of Pharmacology, Green Center for Systems Biology
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Ku CJ, Yona G. The distance-profile representation and its application to detection of distantly related protein families. BMC Bioinformatics 2005; 6:282. [PMID: 16316461 PMCID: PMC1345692 DOI: 10.1186/1471-2105-6-282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Accepted: 11/29/2005] [Indexed: 11/11/2022] Open
Abstract
Background Detecting homology between remotely related protein families is an important problem in computational biology since the biological properties of uncharacterized proteins can often be inferred from those of homologous proteins. Many existing approaches address this problem by measuring the similarity between proteins through sequence or structural alignment. However, these methods do not exploit collective aspects of the protein space and the computed scores are often noisy and frequently fail to recognize distantly related protein families. Results We describe an algorithm that improves over the state of the art in homology detection by utilizing global information on the proximity of entities in the protein space. Our method relies on a vectorial representation of proteins and protein families and uses structure-specific association measures between proteins and template structures to form a high-dimensional feature vector for each query protein. These vectors are then processed and transformed to sparse feature vectors that are treated as statistical fingerprints of the query proteins. The new representation induces a new metric between proteins measured by the statistical difference between their corresponding probability distributions. Conclusion Using several performance measures we show that the new tool considerably improves the performance in recognizing distant homologies compared to existing approaches such as PSIBLAST and FUGUE.
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Affiliation(s)
- Chin-Jen Ku
- Department of Computer Science, Cornell University, Ithaca, NY, USA
| | - Golan Yona
- Department of Computer Science, Cornell University, Ithaca, NY, USA
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Abstract
From May to July 2001, 3013 Chinese children, aged 3-6 years old, from 19 kindergartens in Kaohsiung were examined for the prevalence of otitis media. A senior paediatric otolaryngologist performed examinations. Tympanometric and otoscopic records were combined for assessment of middle ear status. The prevalence rate of otitis media was 9.82% for all children, 5.24% for middle ear effusion and 5.34% for retracted tympanic membrane. The prevalence rates of otitis media in different age groups were as follows: 11.3% for 3-year-olds, 12.4% for 4-year-olds, 11.8% for 5-year-olds, and 6.1% for 6-year-olds. Considering the genetic factors and the previous history of otitis media, there was a significant difference between the normal group and the sick group.
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Affiliation(s)
- C H Chen
- Department of Otorhinolaryngology, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan. judith
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