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1.
Genome Biol ; 25(1): 21, 2024 Jan 15.
Article in English | MEDLINE | ID: mdl-38225662

ABSTRACT

BACKGROUND: Current evidence suggests that cis-regulatory elements controlling gene expression may be the predominant target of natural selection in humans and other species. Detecting selection acting on these elements is critical to understanding evolution but remains challenging because we do not know which mutations will affect gene regulation. RESULTS: To address this, we devise an approach to search for lineage-specific selection on three critical steps in transcriptional regulation: chromatin activity, transcription factor binding, and chromosomal looping. Applying this approach to lymphoblastoid cells from 831 individuals of either European or African descent, we find strong signals of differential chromatin activity linked to gene expression differences between ancestries in numerous contexts, but no evidence of functional differences in chromosomal looping. Moreover, we show that enhancers rather than promoters display the strongest signs of selection associated with sites of differential transcription factor binding. CONCLUSIONS: Overall, our study indicates that some cis-regulatory adaptation may be more easily detected at the level of chromatin than DNA sequence. This work provides a vast resource of genomic interaction data from diverse human populations and establishes a novel selection test that will benefit future study of regulatory evolution in humans and other species.


Subject(s)
Chromatin , Enhancer Elements, Genetic , Humans , Chromatin/genetics , Gene Expression Regulation , Promoter Regions, Genetic , Transcription Factors/genetics , Transcription Factors/metabolism
2.
J Clin Invest ; 132(1)2022 01 04.
Article in English | MEDLINE | ID: mdl-34981779

ABSTRACT

The rising incidence of food allergy in children underscores the importance of environmental exposures; however, genetic factors play a major role. How the environment and genetics interact to cause food allergy remains unclear. The landmark Learning Early About Peanut Allergy (LEAP) clinical trial established that early peanut introduction protects high-risk infants, consistent with the tolerizing effects of gut exposure. In this issue of the JCI, Kanchan et al. leveraged the LEAP trial data to examine molecular genetic mechanisms of early sensitization. A previously identified HLA risk allele for peanut allergy (DQA1*01:02) was associated with peanut-specific IgG4 levels in consumers. Notably, IgG4 antibodies likely provide protection by reducing the binding of allergen to IgE. The association of the same allele with peanut allergy in avoiders while potentially conferring protection in consumers reinforces the need to integrate genetic information toward a personalized therapeutic strategy for the best outcome in addressing food allergies.


Subject(s)
Arachis , Peanut Hypersensitivity , Alleles , Allergens , Arachis/genetics , Arachis/immunology , Child , HLA-DQ alpha-Chains , Humans , Infant , Peanut Hypersensitivity/genetics
3.
Nat Commun ; 12(1): 5732, 2021 09 30.
Article in English | MEDLINE | ID: mdl-34593797

ABSTRACT

Although alterations in chromatin structure are known to exist in tumors, how these alterations relate to molecular phenotypes in cancer remains to be demonstrated. Multi-omics profiling of human tumors can provide insight into how alterations in chromatin structure are propagated through the pathway of gene expression to result in malignant protein expression. We applied multi-omics profiling of chromatin accessibility, RNA abundance, and protein abundance to 36 human thyroid cancer primary tumors, metastases, and patient-match normal tissue. Through quantification of chromatin accessibility associated with active transcription units and global protein expression, we identify a local chromatin structure that is highly correlated with coordinated RNA and protein expression. In particular, we identify enhancers located within gene-bodies as predictive of correlated RNA and protein expression, that is independent of overall transcriptional activity. To demonstrate the generalizability of these findings we also identify similar results in an independent cohort of human breast cancers. Taken together, these analyses suggest that local enhancers, rather than distal enhancers, are likely most predictive of cancer gene expression phenotypes. This allows for identification of potential targets for cancer therapeutic approaches and reinforces the utility of multi-omics profiling as a methodology to understand human disease.


Subject(s)
Breast Neoplasms/genetics , Chromatin/metabolism , Gene Expression Regulation, Neoplastic , Thyroid Cancer, Papillary/genetics , Thyroid Neoplasms/genetics , Breast Neoplasms/pathology , Chromatin Immunoprecipitation Sequencing , Cohort Studies , Datasets as Topic , Enhancer Elements, Genetic , Epigenesis, Genetic , Female , Gene Regulatory Networks , Humans , Male , Promoter Regions, Genetic , Proteomics , RNA/metabolism , RNA-Seq , Thyroid Cancer, Papillary/pathology , Thyroid Cancer, Papillary/surgery , Thyroid Gland/pathology , Thyroid Gland/surgery , Thyroid Neoplasms/pathology , Thyroid Neoplasms/surgery , Thyroidectomy , Transcription Factors/metabolism
4.
Genome Med ; 13(1): 98, 2021 06 01.
Article in English | MEDLINE | ID: mdl-34074327

ABSTRACT

BACKGROUND: Metagenomic next-generation sequencing (mNGS) of body fluids is an emerging approach to identify occult pathogens in undiagnosed patients. We hypothesized that metagenomic testing can be simultaneously used to detect malignant neoplasms in addition to infectious pathogens. METHODS: From two independent studies (n = 205), we used human data generated from a metagenomic sequencing pipeline to simultaneously screen for malignancies by copy number variation (CNV) detection. In the first case-control study, we analyzed body fluid samples (n = 124) from patients with a clinical diagnosis of either malignancy (positive cases, n = 65) or infection (negative controls, n = 59). In a second verification cohort, we analyzed a series of consecutive cases (n = 81) sent to cytology for malignancy workup that included malignant positives (n = 32), negatives (n = 18), or cases with an unclear gold standard (n = 31). RESULTS: The overall CNV test sensitivity across all studies was 87% (55 of 63) in patients with malignancies confirmed by conventional cytology and/or flow cytometry testing and 68% (23 of 34) in patients who were ultimately diagnosed with cancer but negative by conventional testing. Specificity was 100% (95% CI 95-100%) with no false positives detected in 77 negative controls. In one example, a patient hospitalized with an unknown pulmonary illness had non-diagnostic lung biopsies, while CNVs implicating a malignancy were detectable from bronchoalveolar fluid. CONCLUSIONS: Metagenomic sequencing of body fluids can be used to identify undetected malignant neoplasms through copy number variation detection. This study illustrates the potential clinical utility of a single metagenomic test to uncover the cause of undiagnosed acute illnesses due to cancer or infection using the same specimen.


Subject(s)
Body Fluids , Liquid Biopsy/methods , Metagenome , Metagenomics/methods , Neoplasms/diagnosis , Neoplasms/etiology , Body Fluids/microbiology , Case-Control Studies , Computational Biology/methods , Cytogenetic Analysis , Disease Management , Disease Susceptibility , Flow Cytometry , Histocytochemistry , Humans , In Situ Hybridization, Fluorescence , Liquid Biopsy/standards , Metagenomics/standards , Neoplasms/metabolism , Reproducibility of Results , Sensitivity and Specificity
5.
Nature ; 583(7818): 737-743, 2020 07.
Article in English | MEDLINE | ID: mdl-32728247

ABSTRACT

Physical interactions between distal regulatory elements have a key role in regulating gene expression, but the extent to which these interactions vary between cell types and contribute to cell-type-specific gene expression remains unclear. Here, to address these questions as part of phase III of the Encyclopedia of DNA Elements (ENCODE), we mapped cohesin-mediated chromatin loops, using chromatin interaction analysis by paired-end tag sequencing (ChIA-PET), and analysed gene expression in 24 diverse human cell types, including core ENCODE cell lines. Twenty-eight per cent of all chromatin loops vary across cell types; these variations modestly correlate with changes in gene expression and are effective at grouping cell types according to their tissue of origin. The connectivity of genes corresponds to different functional classes, with housekeeping genes having few contacts, and dosage-sensitive genes being more connected to enhancer elements. This atlas of chromatin loops complements the diverse maps of regulatory architecture that comprise the ENCODE Encyclopedia, and will help to support emerging analyses of genome structure and function.


Subject(s)
Cell Cycle Proteins/metabolism , Chromatin/chemistry , Chromatin/genetics , Chromosomal Proteins, Non-Histone/metabolism , Genome, Human/genetics , Molecular Sequence Annotation , Alternative Splicing/genetics , Cell Differentiation/genetics , Cell Line , Cells/metabolism , Chromatin/metabolism , Chromatin Immunoprecipitation Sequencing , Enhancer Elements, Genetic/genetics , Gene Expression Regulation , Humans , Molecular Conformation , Promoter Regions, Genetic/genetics , Cohesins
6.
Mol Genet Metab ; 130(4): 230-238, 2020 08.
Article in English | MEDLINE | ID: mdl-32457018

ABSTRACT

Acute myeloid leukemia (AML) is a complex, heterogenous hematological malignancy caused by mutations in myeloid differentiation and proliferation. Response to therapy and long-term outcomes vary widely based on chromosomal and molecular aberrations. Many platforms have been used to characterize and stratify AML. Metabolomics, the global profiling of small molecules in a biological sample, has emerged in the last decade as an important tool for studying the metabolic dependency of cancer cells. Metabolic reprogramming is not only an important manifestation of AML but clinically relevant for diagnosis, risk stratification and targeted drug development. In this review, we discuss notable metabolic studies of the last decade and their application to novel therapies.


Subject(s)
Biomarkers, Tumor/metabolism , Leukemia, Myeloid, Acute/pathology , Metabolome , Animals , Humans , Leukemia, Myeloid, Acute/metabolism , Leukemia, Myeloid, Acute/therapy
7.
Nat Commun ; 11(1): 1673, 2020 04 03.
Article in English | MEDLINE | ID: mdl-32245974

ABSTRACT

Environmental and epigenetic factors often play an important role in polygenic disorders. However, how such factors affect disease-specific tissues at the molecular level remains to be understood. Here, we address this in pulmonary arterial hypertension (PAH). We obtain pulmonary arterial endothelial cells (PAECs) from lungs of patients and controls (n = 19), and perform chromatin, transcriptomic and interaction profiling. Overall, we observe extensive remodeling at active enhancers in PAH PAECs and identify hundreds of differentially active TFs, yet find very little transcriptomic changes in steady-state. We devise a disease-specific enhancer-gene regulatory network and predict that primed enhancers in PAH PAECs are activated by the differentially active TFs, resulting in an aberrant response to endothelial signals, which could lead to disturbed angiogenesis and endothelial-to-mesenchymal-transition. We validate these predictions for a selection of target genes in PAECs stimulated with TGF-ß, VEGF or serotonin. Our study highlights the role of chromatin state and enhancers in disease-relevant cell types of PAH.


Subject(s)
Enhancer Elements, Genetic , Gene Regulatory Networks , Pulmonary Arterial Hypertension/genetics , Pulmonary Artery/pathology , Vascular Remodeling/genetics , Adult , Biopsy , Case-Control Studies , Cells, Cultured , Chromatin/metabolism , Endothelial Cells/pathology , Endothelium, Vascular/cytology , Epigenesis, Genetic , Epithelial-Mesenchymal Transition/genetics , Female , Histone Code/genetics , Histones/genetics , Humans , Infant , Lung/blood supply , Male , Middle Aged , Primary Cell Culture , Pulmonary Arterial Hypertension/pathology , Pulmonary Artery/cytology , RNA-Seq , Serotonin/metabolism , Transcription Factors/metabolism , Transforming Growth Factor beta/metabolism , Vascular Endothelial Growth Factor A/metabolism , Young Adult
8.
Nat Methods ; 14(10): 959-962, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28846090

ABSTRACT

We present Omni-ATAC, an improved ATAC-seq protocol for chromatin accessibility profiling that works across multiple applications with substantial improvement of signal-to-background ratio and information content. The Omni-ATAC protocol generates chromatin accessibility profiles from archival frozen tissue samples and 50-µm sections, revealing the activities of disease-associated DNA elements in distinct human brain structures. The Omni-ATAC protocol enables the interrogation of personal regulomes in tissue context and translational studies.


Subject(s)
DNA/genetics , Freezing , Genome , Specimen Handling/methods , Animals , Brain , Cell Line , Erythrocytes , Gene Expression Regulation, Enzymologic , Genome-Wide Association Study , Humans , Keratinocytes , Mice , Self-Sustained Sequence Replication , Thyroid Neoplasms , Transposases/metabolism
9.
Cell ; 162(5): 1051-65, 2015 Aug 27.
Article in English | MEDLINE | ID: mdl-26300125

ABSTRACT

Deciphering the impact of genetic variants on gene regulation is fundamental to understanding human disease. Although gene regulation often involves long-range interactions, it is unknown to what extent non-coding genetic variants influence distal molecular phenotypes. Here, we integrate chromatin profiling for three histone marks in lymphoblastoid cell lines (LCLs) from 75 sequenced individuals with LCL-specific Hi-C and ChIA-PET-based chromatin contact maps to uncover one of the largest collections of local and distal histone quantitative trait loci (hQTLs). Distal QTLs are enriched within topologically associated domains and exhibit largely concordant variation of chromatin state coordinated by proximal and distal non-coding genetic variants. Histone QTLs are enriched for common variants associated with autoimmune diseases and enable identification of putative target genes of disease-associated variants from genome-wide association studies. These analyses provide insights into how genetic variation can affect human disease phenotypes by coordinated changes in chromatin at interacting regulatory elements.


Subject(s)
Chromatin/metabolism , Chromosomes, Human/metabolism , Human Genome Project , Cell Line , Chromosomes, Human/chemistry , Cohort Studies , Female , Gene Regulatory Networks , Genome-Wide Association Study , Histones/metabolism , Humans , Lymphocytes/metabolism , Male , Quantitative Trait Loci , Regulatory Elements, Transcriptional
10.
Genome Res ; 24(12): 1905-17, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25228660

ABSTRACT

Increasing evidence suggests that interactions between regulatory genomic elements play an important role in regulating gene expression. We generated a genome-wide interaction map of regulatory elements in human cells (ENCODE tier 1 cells, K562, GM12878) using Chromatin Interaction Analysis by Paired-End Tag sequencing (ChIA-PET) experiments targeting six broadly distributed factors. Bound regions covered 80% of DNase I hypersensitive sites including 99.7% of TSS and 98% of enhancers. Correlating this map with ChIP-seq and RNA-seq data sets revealed cohesin, CTCF, and ZNF143 as key components of three-dimensional chromatin structure and revealed how the distal chromatin state affects gene transcription. Comparison of interactions between cell types revealed that enhancer-promoter interactions were highly cell-type-specific. Construction and comparison of distal and proximal regulatory networks revealed stark differences in structure and biological function. Proximal binding events are enriched at genes with housekeeping functions, while distal binding events interact with genes involved in dynamic biological processes including response to stimulus. This study reveals new mechanistic and functional insights into regulatory region organization in the nucleus.


Subject(s)
Chromosome Mapping , Epistasis, Genetic , Genome, Human , Genome-Wide Association Study , Regulatory Sequences, Nucleic Acid , CCCTC-Binding Factor , Cell Cycle Proteins/genetics , Cell Line , Chromatin/genetics , Chromatin/metabolism , Chromatin Immunoprecipitation , Chromosomal Proteins, Non-Histone/genetics , Cluster Analysis , Computational Biology , Datasets as Topic , Enhancer Elements, Genetic , Gene Expression Regulation , Gene Regulatory Networks , Genetic Loci , Genomics/methods , Humans , Organ Specificity/genetics , Promoter Regions, Genetic , Repressor Proteins/genetics , Trans-Activators/genetics , Transcription Factors/metabolism , Cohesins
11.
Science ; 342(6159): 750-2, 2013 Nov 08.
Article in English | MEDLINE | ID: mdl-24136358

ABSTRACT

The majority of disease-associated variants lie outside protein-coding regions, suggesting a link between variation in regulatory regions and disease predisposition. We studied differences in chromatin states using five histone modifications, cohesin, and CTCF in lymphoblastoid lines from 19 individuals of diverse ancestry. We found extensive signal variation in regulatory regions, which often switch between active and repressed states across individuals. Enhancer activity is particularly diverse among individuals, whereas gene expression remains relatively stable. Chromatin variability shows genetic inheritance in trios, correlates with genetic variation and population divergence, and is associated with disruptions of transcription factor binding motifs. Overall, our results provide insights into chromatin variation among humans.


Subject(s)
Chromatin/genetics , Chromatin/metabolism , Gene Expression Regulation , Genetic Predisposition to Disease/genetics , Binding Sites , CCCTC-Binding Factor , Cell Cycle Proteins/genetics , Cell Cycle Proteins/metabolism , Cell Line, Tumor , Chromosomal Proteins, Non-Histone/genetics , Chromosomal Proteins, Non-Histone/metabolism , Enhancer Elements, Genetic/genetics , Genetic Variation , Histones/genetics , Histones/metabolism , Humans , Repressor Proteins/genetics , Repressor Proteins/metabolism , Transcription Factors/genetics , Transcription Factors/metabolism , Cohesins
12.
Nature ; 489(7414): 91-100, 2012 Sep 06.
Article in English | MEDLINE | ID: mdl-22955619

ABSTRACT

Transcription factors bind in a combinatorial fashion to specify the on-and-off states of genes; the ensemble of these binding events forms a regulatory network, constituting the wiring diagram for a cell. To examine the principles of the human transcriptional regulatory network, we determined the genomic binding information of 119 transcription-related factors in over 450 distinct experiments. We found the combinatorial, co-association of transcription factors to be highly context specific: distinct combinations of factors bind at specific genomic locations. In particular, there are significant differences in the binding proximal and distal to genes. We organized all the transcription factor binding into a hierarchy and integrated it with other genomic information (for example, microRNA regulation), forming a dense meta-network. Factors at different levels have different properties; for instance, top-level transcription factors more strongly influence expression and middle-level ones co-regulate targets to mitigate information-flow bottlenecks. Moreover, these co-regulations give rise to many enriched network motifs (for example, noise-buffering feed-forward loops). Finally, more connected network components are under stronger selection and exhibit a greater degree of allele-specific activity (that is, differential binding to the two parental alleles). The regulatory information obtained in this study will be crucial for interpreting personal genome sequences and understanding basic principles of human biology and disease.


Subject(s)
DNA/genetics , Encyclopedias as Topic , Gene Regulatory Networks/genetics , Genome, Human/genetics , Molecular Sequence Annotation , Regulatory Sequences, Nucleic Acid/genetics , Transcription Factors/metabolism , Alleles , Cell Line , GATA1 Transcription Factor/metabolism , Gene Expression Profiling , Genomics , Humans , K562 Cells , Organ Specificity , Phosphorylation/genetics , Polymorphism, Single Nucleotide/genetics , Protein Interaction Maps , RNA, Untranslated/genetics , RNA, Untranslated/metabolism , Selection, Genetic/genetics , Transcription Initiation Site
13.
Genome Res ; 22(9): 1790-7, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22955989

ABSTRACT

As the sequencing of healthy and disease genomes becomes more commonplace, detailed annotation provides interpretation for individual variation responsible for normal and disease phenotypes. Current approaches focus on direct changes in protein coding genes, particularly nonsynonymous mutations that directly affect the gene product. However, most individual variation occurs outside of genes and, indeed, most markers generated from genome-wide association studies (GWAS) identify variants outside of coding segments. Identification of potential regulatory changes that perturb these sites will lead to a better localization of truly functional variants and interpretation of their effects. We have developed a novel approach and database, RegulomeDB, which guides interpretation of regulatory variants in the human genome. RegulomeDB includes high-throughput, experimental data sets from ENCODE and other sources, as well as computational predictions and manual annotations to identify putative regulatory potential and identify functional variants. These data sources are combined into a powerful tool that scores variants to help separate functional variants from a large pool and provides a small set of putative sites with testable hypotheses as to their function. We demonstrate the applicability of this tool to the annotation of noncoding variants from 69 full sequenced genomes as well as that of a personal genome, where thousands of functionally associated variants were identified. Moreover, we demonstrate a GWAS where the database is able to quickly identify the known associated functional variant and provide a hypothesis as to its function. Overall, we expect this approach and resource to be valuable for the annotation of human genome sequences.


Subject(s)
Databases, Genetic , Genetic Variation , Genome, Human , Molecular Sequence Annotation , DNA-Binding Proteins/genetics , Genome-Wide Association Study , Genotype , Humans , Internet , Intracellular Signaling Peptides and Proteins/genetics , Lupus Erythematosus, Systemic/genetics , Nuclear Proteins/genetics , Open Reading Frames , Polymorphism, Single Nucleotide , Regulatory Sequences, Nucleic Acid , Tumor Necrosis Factor alpha-Induced Protein 3
14.
Cell ; 148(6): 1293-307, 2012 Mar 16.
Article in English | MEDLINE | ID: mdl-22424236

ABSTRACT

Personalized medicine is expected to benefit from combining genomic information with regular monitoring of physiological states by multiple high-throughput methods. Here, we present an integrative personal omics profile (iPOP), an analysis that combines genomic, transcriptomic, proteomic, metabolomic, and autoantibody profiles from a single individual over a 14 month period. Our iPOP analysis revealed various medical risks, including type 2 diabetes. It also uncovered extensive, dynamic changes in diverse molecular components and biological pathways across healthy and diseased conditions. Extremely high-coverage genomic and transcriptomic data, which provide the basis of our iPOP, revealed extensive heteroallelic changes during healthy and diseased states and an unexpected RNA editing mechanism. This study demonstrates that longitudinal iPOP can be used to interpret healthy and diseased states by connecting genomic information with additional dynamic omics activity.


Subject(s)
Genome, Human , Genomics , Precision Medicine , Diabetes Mellitus, Type 2/genetics , Female , Gene Expression Profiling , Humans , Male , Metabolomics , Middle Aged , Mutation , Proteomics , Respiratory Syncytial Viruses/isolation & purification , Rhinovirus/isolation & purification
15.
Science ; 328(5975): 232-5, 2010 Apr 09.
Article in English | MEDLINE | ID: mdl-20299548

ABSTRACT

Differences in gene expression may play a major role in speciation and phenotypic diversity. We examined genome-wide differences in transcription factor (TF) binding in several humans and a single chimpanzee by using chromatin immunoprecipitation followed by sequencing. The binding sites of RNA polymerase II (PolII) and a key regulator of immune responses, nuclear factor kappaB (p65), were mapped in 10 lymphoblastoid cell lines, and 25 and 7.5% of the respective binding regions were found to differ between individuals. Binding differences were frequently associated with single-nucleotide polymorphisms and genomic structural variants, and these differences were often correlated with differences in gene expression, suggesting functional consequences of binding variation. Furthermore, comparing PolII binding between humans and chimpanzee suggests extensive divergence in TF binding. Our results indicate that many differences in individuals and species occur at the level of TF binding, and they provide insight into the genetic events responsible for these differences.


Subject(s)
Gene Expression Regulation , Polymorphism, Single Nucleotide , RNA Polymerase II/metabolism , Transcription Factor RelA/metabolism , Animals , Binding Sites , Cell Line , Chromatin Immunoprecipitation , DNA Copy Number Variations , DNA, Intergenic , Female , Humans , Male , Pan troglodytes/genetics , Protein Binding , RNA Polymerase II/genetics , Sequence Analysis, DNA , Species Specificity , Transcription Factor RelA/genetics , Transcription Initiation Site
16.
Proc Natl Acad Sci U S A ; 106(29): 12031-6, 2009 Jul 21.
Article in English | MEDLINE | ID: mdl-19597142

ABSTRACT

Down syndrome (DS), or trisomy 21, is a common disorder associated with several complex clinical phenotypes. Although several hypotheses have been put forward, it is unclear as to whether particular gene loci on chromosome 21 (HSA21) are sufficient to cause DS and its associated features. Here we present a high-resolution genetic map of DS phenotypes based on an analysis of 30 subjects carrying rare segmental trisomies of various regions of HSA21. By using state-of-the-art genomics technologies we mapped segmental trisomies at exon-level resolution and identified discrete regions of 1.8-16.3 Mb likely to be involved in the development of 8 DS phenotypes, 4 of which are congenital malformations, including acute megakaryocytic leukemia, transient myeloproliferative disorder, Hirschsprung disease, duodenal stenosis, imperforate anus, severe mental retardation, DS-Alzheimer Disease, and DS-specific congenital heart disease (DSCHD). Our DS-phenotypic maps located DSCHD to a <2-Mb interval. Furthermore, the map enabled us to present evidence against the necessary involvement of other loci as well as specific hypotheses that have been put forward in relation to the etiology of DS-i.e., the presence of a single DS consensus region and the sufficiency of DSCR1 and DYRK1A, or APP, in causing several severe DS phenotypes. Our study demonstrates the value of combining advanced genomics with cohorts of rare patients for studying DS, a prototype for the role of copy-number variation in complex disease.


Subject(s)
Chromosome Mapping , Chromosomes, Human, Pair 21/genetics , Down Syndrome/genetics , Trisomy/genetics , Humans , Infant , Meta-Analysis as Topic , Phenotype
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