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Jenkinson EM, Rodero MP, Kasher PR, Uggenti C, Oojageer A, Goosey LC, Rose Y, Kershaw CJ, Urquhart JE, Williams SG, Bhaskar SS, O'Sullivan J, Baerlocher GM, Haubitz M, Aubert G, Barañano KW, Barnicoat AJ, Battini R, Berger A, Blair EM, Brunstrom-Hernandez JE, Buckard JA, Cassiman DM, Caumes R, Cordelli DM, De Waele LM, Fay AJ, Ferreira P, Fletcher NA, Fryer AE, Goel H, Hemingway CA, Henneke M, Hughes I, Jefferson RJ, Kumar R, Lagae L, Landrieu PG, Lourenço CM, Malpas TJ, Mehta SG, Metz I, Naidu S, Õunap K, Panzer A, Prabhakar P, Quaghebeur G, Schiffmann R, Sherr EH, Sinnathuray KR, Soh C, Stewart HS, Stone J, Van Esch H, Van Mol CEG, Vanderver A, Wakeling EL, Whitney A, Pavitt GD, Griffiths-Jones S, Rice GI, Revy P, van der Knaap MS, Livingston JH, O'Keefe RT, Crow YJ. Erratum: Corrigendum: Mutations in SNORD118 cause the cerebral microangiopathy leukoencephalopathy with calcifications and cysts. Nat Genet 2017; 49:317. [DOI: 10.1038/ng0217-317b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Munoz J, Rodière M, Jeremiah N, Rieux-Laucat F, Oojageer A, Rice GI, Rozenberg F, Crow YJ, Bessis D. Stimulator of Interferon Genes-Associated Vasculopathy With Onset in Infancy: A Mimic of Childhood Granulomatosis With Polyangiitis. JAMA Dermatol 2015; 151:872-7. [PMID: 25992765 DOI: 10.1001/jamadermatol.2015.0251] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The type I interferonopathies comprise a recently recognized group of mendelian diseases characterized by an upregulation of type I interferon signaling. These monogenic phenotypes include classic Aicardi-Goutières syndrome and syndromic forms of systemic lupus erythematosus, including familial chilblain lupus and spondyloenchondrodysplasia. Dermatologic features provide a major diagnostic clue to this disease grouping, as exemplified by the recently described stimulator of interferon genes-associated vasculopathy with onset in infancy (SAVI) caused by gain-of-function mutations in TMEM173. OBSERVATIONS We describe a male child who, from the age of 2 months, had significant cutaneous disease that manifested as red violaceous plaques of the cheeks, nose, ears, fingers, and toes that progressed to gangrenous necrosis. In addition to his severe cutaneous vasculopathy, he experienced recurrent fevers, interstitial lung disease, and failure to thrive. His clinical syndrome was refractory to multiple immunosuppressive therapies. Evidence of marked upregulation of type I interferon signaling was observed in peripheral blood, and genetic testing identified a de novo germline mutation in TMEM173, confirming a diagnosis of SAVI 7 years after the onset of his disease. CONCLUSIONS AND RELEVANCE This observational report describes a new case of SAVI, a recently defined monogenic inflammatory phenotype, that exemplifies an emerging group of disorders related to primary upregulation of type I interferon signaling.
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Affiliation(s)
- Justine Munoz
- Department of Dermatology, St Eloi Hospital, CHRU Montpellier, Montpellier, France2University of Montpellier I, Montpellier, France
| | - Michel Rodière
- University of Montpellier I, Montpellier, France3Department of Pediatrics, Arnaud de Villeneuve Hospital, CHRU Montpellier, Montpellier, France
| | - Nadia Jeremiah
- Institut Imagine, Necker Hospital for Sick Children, Paris, France5Paris Descartes University, Paris, France6INSERM UMR 1163, Paris, France
| | - Frédéric Rieux-Laucat
- Institut Imagine, Necker Hospital for Sick Children, Paris, France5Paris Descartes University, Paris, France6INSERM UMR 1163, Paris, France
| | - Anthony Oojageer
- Manchester Centre for Genomic Medicine, Institute of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Gillian I Rice
- Manchester Centre for Genomic Medicine, Institute of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Flore Rozenberg
- Paris Descartes University, Paris, France8Department of Virology, Cochin Hospital AP-HP, Paris, France
| | - Yanick J Crow
- Institut Imagine, Necker Hospital for Sick Children, Paris, France5Paris Descartes University, Paris, France6INSERM UMR 1163, Paris, France7Manchester Centre for Genomic Medicine, Institute of Human Development Faculty of Medical and Human Sciences, Manch
| | - Didier Bessis
- Department of Dermatology, St Eloi Hospital, CHRU Montpellier, Montpellier, France2University of Montpellier I, Montpellier, France9INSERM U1058, Montpellier, France
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Bursztejn AC, Briggs TA, del Toro Duany Y, Anderson BH, O'Sullivan J, Williams SG, Bodemer C, Fraitag S, Gebhard F, Leheup B, Lemelle I, Oojageer A, Raffo E, Schmitt E, Rice GI, Hur S, Crow YJ. Unusual cutaneous features associated with a heterozygous gain-of-function mutation in IFIH1: overlap between Aicardi-Goutières and Singleton-Merten syndromes. Br J Dermatol 2015; 173:1505-13. [PMID: 26284909 DOI: 10.1111/bjd.14073] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2015] [Indexed: 12/17/2022]
Abstract
Cutaneous lesions described as chilblain lupus occur in the context of familial chilblain lupus or Aicardi-Goutières syndrome. To date, seven genes related to Aicardi-Goutières syndrome have been described. The most recently described encodes the cytosolic double-stranded RNA receptor IFIH1 (also known as MDA5), a key component of the antiviral type I interferon-mediated innate immune response. Enhanced type I interferon signalling secondary to gain-of-function mutations in IFIH1 can result in a range of neuroinflammatory phenotypes including classical Aicardi-Goutières syndrome. It is of note that none of the patients with a neurological phenotype so far described with mutations in this gene was reported to demonstrate cutaneous involvement. We present a family segregating a heterozygous pathogenic mutation in IFIH1 showing dermatological involvement as a prominent feature, variably associated with neurological disturbance and premature tooth loss. All three affected individuals exhibited increased expression of interferon-stimulated genes in whole blood, and the mutant protein resulted in enhanced interferon signalling in vitro, both in the basal state and following ligand stimulation. Our results further extend the phenotypic spectrum associated with mutations in IFIH1, indicating that the disease can be confined predominantly to the skin, while also highlighting phenotypic overlap with both Aicardi-Goutières syndrome and Singleton-Merten syndrome.
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Affiliation(s)
- A-C Bursztejn
- Dermatology Department, CHU Nancy, 5 Allée du Morvan, 54500 Vandoeuvre les Nancy, France
| | - T A Briggs
- Manchester Academic Health Science Centre, University of Manchester, Genetic Medicine, Manchester, U.K
| | - Y del Toro Duany
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, U.S.A
| | - B H Anderson
- Manchester Academic Health Science Centre, University of Manchester, Genetic Medicine, Manchester, U.K
| | - J O'Sullivan
- Manchester Academic Health Science Centre, University of Manchester, Genetic Medicine, Manchester, U.K
| | - S G Williams
- Manchester Academic Health Science Centre, University of Manchester, Genetic Medicine, Manchester, U.K
| | - C Bodemer
- Dermatology Department, Imagine Institute, APHP, Université Sorbonne-Paris Cité - Hôpital Necker-Enfants Malades, 149 Rue de Sèvres, 75743 Paris, France
| | - S Fraitag
- Pathology Department, Hôpital Necker-Enfants Malades, APHP, Université Paris-Descartes, 149 Rue de Sèvres, 75743 Paris, France
| | - F Gebhard
- Medical Office, 150 Rue de Nancy, 54390 Frouard, France
| | - B Leheup
- Paediatric and Clinical Genetic Department, CHU Nancy, 5 Allée du Morvan, 54500 Vandoeuvre les Nancy, France
| | - I Lemelle
- Paediatric Onco-Haematology Department, CHU Nancy, 5 Allée du Morvan, 54500 Vandoeuvre les Nancy, France
| | - A Oojageer
- Manchester Academic Health Science Centre, University of Manchester, Genetic Medicine, Manchester, U.K
| | - E Raffo
- Paediatric and Clinical Genetic Department, CHU Nancy, 5 Allée du Morvan, 54500 Vandoeuvre les Nancy, France
| | - E Schmitt
- Neuroradiology Department, CHU Nancy, 29 Avenue du Maréchal de Lattre de Tassigny, 54000 Nancy, France
| | - G I Rice
- Manchester Academic Health Science Centre, University of Manchester, Genetic Medicine, Manchester, U.K
| | - S Hur
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, MA, U.S.A
| | - Y J Crow
- Manchester Academic Health Science Centre, University of Manchester, Genetic Medicine, Manchester, U.K.,Laboratory of Neurogenetics and Neuroinflammation, Imagine Institute, 24 Boulevard du Montparnasse, 75015 Paris, France
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Crow YJ, Chase DS, Lowenstein Schmidt J, Szynkiewicz M, Forte GMA, Gornall HL, Oojageer A, Anderson B, Pizzino A, Helman G, Abdel-Hamid MS, Abdel-Salam GM, Ackroyd S, Aeby A, Agosta G, Albin C, Allon-Shalev S, Arellano M, Ariaudo G, Aswani V, Babul-Hirji R, Baildam EM, Bahi-Buisson N, Bailey KM, Barnerias C, Barth M, Battini R, Beresford MW, Bernard G, Bianchi M, Billette de Villemeur T, Blair EM, Bloom M, Burlina AB, Carpanelli ML, Carvalho DR, Castro-Gago M, Cavallini A, Cereda C, Chandler KE, Chitayat DA, Collins AE, Sierra Corcoles C, Cordeiro NJV, Crichiutti G, Dabydeen L, Dale RC, D'Arrigo S, De Goede CGEL, De Laet C, De Waele LMH, Denzler I, Desguerre I, Devriendt K, Di Rocco M, Fahey MC, Fazzi E, Ferrie CD, Figueiredo A, Gener B, Goizet C, Gowrinathan NR, Gowrishankar K, Hanrahan D, Isidor B, Kara B, Khan N, King MD, Kirk EP, Kumar R, Lagae L, Landrieu P, Lauffer H, Laugel V, La Piana R, Lim MJ, Lin JPSM, Linnankivi T, Mackay MT, Marom DR, Marques Lourenço C, McKee SA, Moroni I, Morton JEV, Moutard ML, Murray K, Nabbout R, Nampoothiri S, Nunez-Enamorado N, Oades PJ, Olivieri I, Ostergaard JR, Pérez-Dueñas B, Prendiville JS, Ramesh V, Rasmussen M, Régal L, Ricci F, Rio M, Rodriguez D, Roubertie A, Salvatici E, Segers KA, Sinha GP, Soler D, Spiegel R, Stödberg TI, Straussberg R, Swoboda KJ, Suri M, Tacke U, Tan TY, te Water Naude J, Wee Teik K, Thomas MM, Till M, Tonduti D, Valente EM, Van Coster RN, van der Knaap MS, Vassallo G, Vijzelaar R, Vogt J, Wallace GB, Wassmer E, Webb HJ, Whitehouse WP, Whitney RN, Zaki MS, Zuberi SM, Livingston JH, Rozenberg F, Lebon P, Vanderver A, Orcesi S, Rice GI. Characterization of human disease phenotypes associated with mutations in TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR, and IFIH1. Am J Med Genet A 2015; 167A:296-312. [PMID: 25604658 DOI: 10.1002/ajmg.a.36887] [Citation(s) in RCA: 393] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/31/2014] [Indexed: 01/14/2023]
Abstract
Aicardi-Goutières syndrome is an inflammatory disease occurring due to mutations in any of TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR or IFIH1. We report on 374 patients from 299 families with mutations in these seven genes. Most patients conformed to one of two fairly stereotyped clinical profiles; either exhibiting an in utero disease-onset (74 patients; 22.8% of all patients where data were available), or a post-natal presentation, usually within the first year of life (223 patients; 68.6%), characterized by a sub-acute encephalopathy and a loss of previously acquired skills. Other clinically distinct phenotypes were also observed; particularly, bilateral striatal necrosis (13 patients; 3.6%) and non-syndromic spastic paraparesis (12 patients; 3.4%). We recorded 69 deaths (19.3% of patients with follow-up data). Of 285 patients for whom data were available, 210 (73.7%) were profoundly disabled, with no useful motor, speech and intellectual function. Chilblains, glaucoma, hypothyroidism, cardiomyopathy, intracerebral vasculitis, peripheral neuropathy, bowel inflammation and systemic lupus erythematosus were seen frequently enough to be confirmed as real associations with the Aicardi-Goutieres syndrome phenotype. We observed a robust relationship between mutations in all seven genes with increased type I interferon activity in cerebrospinal fluid and serum, and the increased expression of interferon-stimulated gene transcripts in peripheral blood. We recorded a positive correlation between the level of cerebrospinal fluid interferon activity assayed within one year of disease presentation and the degree of subsequent disability. Interferon-stimulated gene transcripts remained high in most patients, indicating an ongoing disease process. On the basis of substantial morbidity and mortality, our data highlight the urgent need to define coherent treatment strategies for the phenotypes associated with mutations in the Aicardi-Goutières syndrome-related genes. Our findings also make it clear that a window of therapeutic opportunity exists relevant to the majority of affected patients and indicate that the assessment of type I interferon activity might serve as a useful biomarker in future clinical trials.
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Affiliation(s)
- Yanick J Crow
- INSERM UMR 1163, Laboratory of Neurogenetics and Neuroinflammation, Paris Descartes - Sorbonne Paris Cité University, Institut Imagine, Hôpital Necker, Paris, France; Manchester Centre for Genomic Medicine, Institute of Human Development, Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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5
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Belot A, Wassmer E, Twilt M, Lega JC, Zeef LAH, Oojageer A, Kasher PR, Mathieu AL, Malcus C, Demaret J, Fabien N, Collardeau-Frachon S, Mechtouff L, Derex L, Walzer T, Rice GI, Durieu I, Crow YJ. Mutations in CECR1 associated with a neutrophil signature in peripheral blood. Pediatr Rheumatol Online J 2014; 12:44. [PMID: 25278816 PMCID: PMC4181355 DOI: 10.1186/1546-0096-12-44] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/19/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A reduction of ADA2 activity due to autosomal recessive loss of function mutations in CECR1 results in a newly described vasculopathic phenotype reminiscent of polyarteritis nodosa, with manifestations ranging from fatal systemic vasculitis with multiple strokes in children to limited cutaneous disease in middle-aged individuals. Evidence indicates that ADA2 is essential for the endothelial integrity of small vessels. However, CECR1 is not expressed, nor is the ADA2 protein detectable, in cultured human endothelial cells, thus implicating additional cell types or circulating factors in disease pathogenesis. METHODS Considering the phenotypic overlap of ADA2 deficiency with the type I interferonopathy Aicardi-Goutières syndrome due to mutations in SAMHD1, we looked for the presence of an interferon signature in the peripheral blood of two newly ascertained ADA2-deficient patients. RESULTS We identified biallelic CECR1 mutations in two patients consistent with ADA2 deficiency. Both patients demonstrated an upregulation of interferon stimulated gene transcripts in peripheral blood. More strikingly however, genome-wide analysis revealed a marked overexpression of neutrophil-derived genes, suggesting that the vasculitis seen in ADA2 deficiency may be an indirect effect resulting from chronic and marked activity of neutrophils. CONCLUSIONS We hypothesise that ADA2 may act as a regulator of neutrophil activation, and that a reduction of ADA2 activity results in significant endothelial damage via a neutrophil-driven process.
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Affiliation(s)
- Alexandre Belot
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,CIRI, International Center for Infectiology Research, Inserm, U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308 Lyon, France ,Centre de Référence des maladies Rénales Rares, Service de Néphrologie, Rhumatologie & Dermatologie Pédiatriques, Lyon, France
| | - Evangeline Wassmer
- Department of Paediatric Neurology, Birmingham Children’s Hospital, Birmingham, UK
| | - Marinka Twilt
- Department of Adolescent and Pediatric Rheumatology, Birmingham Children’s Hospital, Birmingham, UK ,Department of Pediatrics, Division of rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Jean-Christophe Lega
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Service de Médecine Interne et Vasculaire, Centre Hospitalier Lyon Sud, Lyon, France
| | - Leo AH Zeef
- Faculty of Life Sciences, University of Manchester, Manchester, UK
| | - Anthony Oojageer
- Manchester Centre for Genomic Médecine Interne et Vasculaire of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Paul R Kasher
- Manchester Centre for Genomic Médecine Interne et Vasculaire of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Anne-Laure Mathieu
- CIRI, International Center for Infectiology Research, Inserm, U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308 Lyon, France
| | - Christophe Malcus
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Laboratoire d’Immunologie, Hôpital E. Herriot Lyon, Lyon, France
| | - Julie Demaret
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Laboratoire d’Immunologie, Hôpital E. Herriot Lyon, Lyon, France
| | - Nicole Fabien
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Laboratoire d’Immunologie, Centre Hospitalier Lyon Sud, Lyon, France
| | - Sophie Collardeau-Frachon
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Centre de Pathologie Est, Groupement Hospitalier EST, Lyon, France
| | - Laura Mechtouff
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Service de Neurologie Vasculaire, Hôpital Pierre Wertheimer, Lyon, France
| | - Laurent Derex
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Service de Neurologie Vasculaire, Hôpital Pierre Wertheimer, Lyon, France
| | - Thierry Walzer
- CIRI, International Center for Infectiology Research, Inserm, U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS, UMR5308 Lyon, France
| | - Gillian I Rice
- Manchester Centre for Genomic Médecine Interne et Vasculaire of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Isabelle Durieu
- Hospices Civils de Lyon, et Université de Lyon, Lyon, France ,Service de Médecine Interne et Vasculaire, Centre Hospitalier Lyon Sud, Lyon, France
| | - Yanick J Crow
- Manchester Centre for Genomic Médecine Interne et Vasculaire of Human Development Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK ,INSERM UMR 1163, Laboratory of Neurogenetics and Neuroinflammation, Paris Descartes – Sorbonne Paris Cité University, Institut Imagine, Hôpital Necker, Paris, France ,Paris Descartes University, Paris, France ,Laboratory of Neurogenetics and Neuroinflammation, Institut Imagine, 3rd Floor, Room 309, 24 boulevard du Montparnasse, 75015 Paris, France
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Taylor M, Cieslak M, Rees GS, Oojageer A, Leith C, Bristow C, Tawn EJ, Winther JF, Boice JD. Comparison of germ line minisatellite mutation detection at the CEB1 locus by Southern blotting and PCR amplification. Mutagenesis 2010; 25:343-9. [PMID: 20228094 DOI: 10.1093/mutage/geq011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Identification of de novo minisatellite mutations in the offspring of parents exposed to mutagenic agents offers a potentially sensitive measure of germ line genetic events induced by ionizing radiation and genotoxic chemicals. Germ line minisatellite mutations (GMM) are usually detected by hybridizing Southern blots of unamplified size-fractionated genomic DNA with minisatellite probes. However, this consumes a relatively large amount of DNA, requires several steps and may lack sensitivity. We have developed a polymerase chain reaction (PCR)-based GMM assay, which we applied to the hypermutable minisatellite, CEB1. Here, we compare the sensitivity and specificity of this assay with the conventional Southern hybridization method using DNA from 10 spouse pairs, one parent of each pair being a survivor of cancer in childhood, and their 20 offspring. We report that both methods have similar specificity but that the PCR method uses 250 times less DNA, has fewer steps and is better at detecting GMM with single repeats provided that specific guidelines for allele sizing are followed. The PCR GMM method is easier to apply to families where the amount of offspring DNA sample is limited.
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Affiliation(s)
- Malcolm Taylor
- School of Cancer and Enabling Sciences, University of Manchester, St Mary's Hospital, Manchester, UK.
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