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The N-terminal region of DNMT3A engages the nucleosome surface to aid chromatin recruitment
DNA methyltransferase 3A (DNMT3A) plays a critical role in establishing and maintaining DNA methylation patterns in vertebrates. Here we structurally and biochemically explore the interaction of DNMT3A1 with diverse modified nucleosomes indicative of different chromatin environments. A cryo-EM struc...
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Published in: | EMBO reports 2024-11, Vol.25 (12), p.5743-5779 |
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creator | Wapenaar, Hannah Clifford, Gillian Rolls, Willow Pasquier, Moira Burdett, Hayden Zhang, Yujie Deák, Gauri Zou, Juan Spanos, Christos Taylor, Mark R D Mills, Jacquie Watson, James A Kumar, Dhananjay Clark, Richard Das, Alakta Valsakumar, Devisree Bramham, Janice Voigt, Philipp Sproul, Duncan Wilson, Marcus D |
description | DNA methyltransferase 3A (DNMT3A) plays a critical role in establishing and maintaining DNA methylation patterns in vertebrates. Here we structurally and biochemically explore the interaction of DNMT3A1 with diverse modified nucleosomes indicative of different chromatin environments. A cryo-EM structure of the full-length DNMT3A1-DNMT3L complex with a H2AK119ub nucleosome reveals that the DNMT3A1 ubiquitin-dependent recruitment (UDR) motif interacts specifically with H2AK119ub and makes extensive contacts with the core nucleosome histone surface. This interaction facilitates robust DNMT3A1 binding to nucleosomes, and previously unexplained DNMT3A disease-associated mutations disrupt this interface. Furthermore, the UDR-nucleosome interaction synergises with other DNMT3A chromatin reading elements in the absence of histone ubiquitylation. H2AK119ub does not stimulate DNMT3A DNA methylation activity, as observed for the previously described H3K36me2 mark, which may explain low levels of DNA methylation on H2AK119ub marked facultative heterochromatin. This study highlights the importance of multivalent binding of DNMT3A to histone modifications and the nucleosome surface and increases our understanding of how DNMT3A1 chromatin recruitment occurs.
Synopsis
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity.
In addition to DNMT3A’s previously characterised chromatin reader domains, a UDR motif forms contacts with the nucleosome surface. These all work multivalently to ensure correct intragenic recruitment.
The UDR motif interacts with multiple interfaces on the nucleosome promoting direct specific reading of H2A Lys-119 ubiquitylation.
DNMT3A shows a disconnect between nucleosome recruitment and methylation activity: H2AK119ub nucleosomes bind more tightly but are less efficient substrates than H3K36me2-modified nucleosomes.
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity. |
doi_str_mv | 10.1038/s44319-024-00306-3 |
format | article |
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Synopsis
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity.
In addition to DNMT3A’s previously characterised chromatin reader domains, a UDR motif forms contacts with the nucleosome surface. These all work multivalently to ensure correct intragenic recruitment.
The UDR motif interacts with multiple interfaces on the nucleosome promoting direct specific reading of H2A Lys-119 ubiquitylation.
DNMT3A shows a disconnect between nucleosome recruitment and methylation activity: H2AK119ub nucleosomes bind more tightly but are less efficient substrates than H3K36me2-modified nucleosomes.
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity.</description><identifier>ISSN: 1469-3178</identifier><identifier>ISSN: 1469-221X</identifier><identifier>EISSN: 1469-3178</identifier><identifier>DOI: 10.1038/s44319-024-00306-3</identifier><identifier>PMID: 39528729</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Animals ; Biomedical and Life Sciences ; Chromatin - genetics ; Chromatin - metabolism ; Cryoelectron Microscopy ; DNA (Cytosine-5-)-Methyltransferases - chemistry ; DNA (Cytosine-5-)-Methyltransferases - genetics ; DNA (Cytosine-5-)-Methyltransferases - metabolism ; DNA Methylation ; DNA Methyltransferase 3A - metabolism ; EMBO09 ; EMBO40 ; Histones - metabolism ; Humans ; Life Sciences ; Models, Molecular ; Nucleosomes - metabolism ; Protein Binding ; Ubiquitination</subject><ispartof>EMBO reports, 2024-11, Vol.25 (12), p.5743-5779</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c284t-5119077bf07a11d7bb936e650fb70fb255da5e496ced211e4516bc0f5cd617ad3</cites><orcidid>0000-0001-6168-4563 ; 0000-0002-8279-6369 ; 0000-0003-2594-6217 ; 0000-0002-2697-4212 ; 0000-0002-4376-8242 ; 0000-0002-0066-1541 ; 0000-0003-4366-0490 ; 0009-0007-4597-0800 ; 0000-0002-5691-1829 ; 0000-0001-9551-5514 ; 0000-0002-7591-6553</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624362/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624362/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39528729$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wapenaar, Hannah</creatorcontrib><creatorcontrib>Clifford, Gillian</creatorcontrib><creatorcontrib>Rolls, Willow</creatorcontrib><creatorcontrib>Pasquier, Moira</creatorcontrib><creatorcontrib>Burdett, Hayden</creatorcontrib><creatorcontrib>Zhang, Yujie</creatorcontrib><creatorcontrib>Deák, Gauri</creatorcontrib><creatorcontrib>Zou, Juan</creatorcontrib><creatorcontrib>Spanos, Christos</creatorcontrib><creatorcontrib>Taylor, Mark R D</creatorcontrib><creatorcontrib>Mills, Jacquie</creatorcontrib><creatorcontrib>Watson, James A</creatorcontrib><creatorcontrib>Kumar, Dhananjay</creatorcontrib><creatorcontrib>Clark, Richard</creatorcontrib><creatorcontrib>Das, Alakta</creatorcontrib><creatorcontrib>Valsakumar, Devisree</creatorcontrib><creatorcontrib>Bramham, Janice</creatorcontrib><creatorcontrib>Voigt, Philipp</creatorcontrib><creatorcontrib>Sproul, Duncan</creatorcontrib><creatorcontrib>Wilson, Marcus D</creatorcontrib><title>The N-terminal region of DNMT3A engages the nucleosome surface to aid chromatin recruitment</title><title>EMBO reports</title><addtitle>EMBO Rep</addtitle><addtitle>EMBO Rep</addtitle><description>DNA methyltransferase 3A (DNMT3A) plays a critical role in establishing and maintaining DNA methylation patterns in vertebrates. Here we structurally and biochemically explore the interaction of DNMT3A1 with diverse modified nucleosomes indicative of different chromatin environments. A cryo-EM structure of the full-length DNMT3A1-DNMT3L complex with a H2AK119ub nucleosome reveals that the DNMT3A1 ubiquitin-dependent recruitment (UDR) motif interacts specifically with H2AK119ub and makes extensive contacts with the core nucleosome histone surface. This interaction facilitates robust DNMT3A1 binding to nucleosomes, and previously unexplained DNMT3A disease-associated mutations disrupt this interface. Furthermore, the UDR-nucleosome interaction synergises with other DNMT3A chromatin reading elements in the absence of histone ubiquitylation. H2AK119ub does not stimulate DNMT3A DNA methylation activity, as observed for the previously described H3K36me2 mark, which may explain low levels of DNA methylation on H2AK119ub marked facultative heterochromatin. This study highlights the importance of multivalent binding of DNMT3A to histone modifications and the nucleosome surface and increases our understanding of how DNMT3A1 chromatin recruitment occurs.
Synopsis
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity.
In addition to DNMT3A’s previously characterised chromatin reader domains, a UDR motif forms contacts with the nucleosome surface. These all work multivalently to ensure correct intragenic recruitment.
The UDR motif interacts with multiple interfaces on the nucleosome promoting direct specific reading of H2A Lys-119 ubiquitylation.
DNMT3A shows a disconnect between nucleosome recruitment and methylation activity: H2AK119ub nucleosomes bind more tightly but are less efficient substrates than H3K36me2-modified nucleosomes.
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity.</description><subject>Animals</subject><subject>Biomedical and Life Sciences</subject><subject>Chromatin - genetics</subject><subject>Chromatin - metabolism</subject><subject>Cryoelectron Microscopy</subject><subject>DNA (Cytosine-5-)-Methyltransferases - chemistry</subject><subject>DNA (Cytosine-5-)-Methyltransferases - genetics</subject><subject>DNA (Cytosine-5-)-Methyltransferases - metabolism</subject><subject>DNA Methylation</subject><subject>DNA Methyltransferase 3A - metabolism</subject><subject>EMBO09</subject><subject>EMBO40</subject><subject>Histones - metabolism</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Models, Molecular</subject><subject>Nucleosomes - metabolism</subject><subject>Protein Binding</subject><subject>Ubiquitination</subject><issn>1469-3178</issn><issn>1469-221X</issn><issn>1469-3178</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kUtv1TAQRi1ERUvhD7BAXrIJePxMVqgqT6ktm8uKheU4k1xXiV3sBIl_j9tbqrJhYdnSfHNm5EPIK2BvgYn2XZFSQNcwLhvGBNONeEJOQOquEWDap4_ex-R5KdeMMdWZ9hk5Fp3ireHdCfmx2yO9albMS4huphmnkCJNI_1wdbkTZxTj5CYsdK25uPkZU0kL0rLl0Xmka6IuDNTvc1rcGmIF-LyFdcG4viBHo5sLvry_T8n3Tx9351-ai2-fv56fXTSet3JtFEDHjOlHZhzAYPq-Exq1YmNv6uFKDU6h7LTHgQOgVKB7z0blBw3GDeKUvD9wb7Z-wcHX0dnN9iaHxeXfNrlg_63EsLdT-mUBNJdC80p4c0_I6eeGZbVLKB7n2UVMW7EC6nepVoCsUX6I-pxKyTg-zAFmb7XYgxZbtdg7LVbUptePN3xo-euhBsQhUGopTpjtddpyFVL-h_0D6_WZjQ</recordid><startdate>20241111</startdate><enddate>20241111</enddate><creator>Wapenaar, Hannah</creator><creator>Clifford, Gillian</creator><creator>Rolls, Willow</creator><creator>Pasquier, Moira</creator><creator>Burdett, Hayden</creator><creator>Zhang, Yujie</creator><creator>Deák, Gauri</creator><creator>Zou, Juan</creator><creator>Spanos, Christos</creator><creator>Taylor, Mark R D</creator><creator>Mills, Jacquie</creator><creator>Watson, James A</creator><creator>Kumar, Dhananjay</creator><creator>Clark, Richard</creator><creator>Das, Alakta</creator><creator>Valsakumar, Devisree</creator><creator>Bramham, Janice</creator><creator>Voigt, Philipp</creator><creator>Sproul, Duncan</creator><creator>Wilson, Marcus D</creator><general>Nature Publishing Group UK</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6168-4563</orcidid><orcidid>https://orcid.org/0000-0002-8279-6369</orcidid><orcidid>https://orcid.org/0000-0003-2594-6217</orcidid><orcidid>https://orcid.org/0000-0002-2697-4212</orcidid><orcidid>https://orcid.org/0000-0002-4376-8242</orcidid><orcidid>https://orcid.org/0000-0002-0066-1541</orcidid><orcidid>https://orcid.org/0000-0003-4366-0490</orcidid><orcidid>https://orcid.org/0009-0007-4597-0800</orcidid><orcidid>https://orcid.org/0000-0002-5691-1829</orcidid><orcidid>https://orcid.org/0000-0001-9551-5514</orcidid><orcidid>https://orcid.org/0000-0002-7591-6553</orcidid></search><sort><creationdate>20241111</creationdate><title>The N-terminal region of DNMT3A engages the nucleosome surface to aid chromatin recruitment</title><author>Wapenaar, Hannah ; Clifford, Gillian ; Rolls, Willow ; Pasquier, Moira ; Burdett, Hayden ; Zhang, Yujie ; Deák, Gauri ; Zou, Juan ; Spanos, Christos ; Taylor, Mark R D ; Mills, Jacquie ; Watson, James A ; Kumar, Dhananjay ; Clark, Richard ; Das, Alakta ; Valsakumar, Devisree ; Bramham, Janice ; Voigt, Philipp ; Sproul, Duncan ; Wilson, Marcus D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c284t-5119077bf07a11d7bb936e650fb70fb255da5e496ced211e4516bc0f5cd617ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Animals</topic><topic>Biomedical and Life Sciences</topic><topic>Chromatin - genetics</topic><topic>Chromatin - metabolism</topic><topic>Cryoelectron Microscopy</topic><topic>DNA (Cytosine-5-)-Methyltransferases - chemistry</topic><topic>DNA (Cytosine-5-)-Methyltransferases - genetics</topic><topic>DNA (Cytosine-5-)-Methyltransferases - metabolism</topic><topic>DNA Methylation</topic><topic>DNA Methyltransferase 3A - metabolism</topic><topic>EMBO09</topic><topic>EMBO40</topic><topic>Histones - metabolism</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Models, Molecular</topic><topic>Nucleosomes - metabolism</topic><topic>Protein Binding</topic><topic>Ubiquitination</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wapenaar, Hannah</creatorcontrib><creatorcontrib>Clifford, Gillian</creatorcontrib><creatorcontrib>Rolls, Willow</creatorcontrib><creatorcontrib>Pasquier, Moira</creatorcontrib><creatorcontrib>Burdett, Hayden</creatorcontrib><creatorcontrib>Zhang, Yujie</creatorcontrib><creatorcontrib>Deák, Gauri</creatorcontrib><creatorcontrib>Zou, Juan</creatorcontrib><creatorcontrib>Spanos, Christos</creatorcontrib><creatorcontrib>Taylor, Mark R D</creatorcontrib><creatorcontrib>Mills, Jacquie</creatorcontrib><creatorcontrib>Watson, James A</creatorcontrib><creatorcontrib>Kumar, Dhananjay</creatorcontrib><creatorcontrib>Clark, Richard</creatorcontrib><creatorcontrib>Das, Alakta</creatorcontrib><creatorcontrib>Valsakumar, Devisree</creatorcontrib><creatorcontrib>Bramham, Janice</creatorcontrib><creatorcontrib>Voigt, Philipp</creatorcontrib><creatorcontrib>Sproul, Duncan</creatorcontrib><creatorcontrib>Wilson, Marcus D</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>EMBO reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wapenaar, Hannah</au><au>Clifford, Gillian</au><au>Rolls, Willow</au><au>Pasquier, Moira</au><au>Burdett, Hayden</au><au>Zhang, Yujie</au><au>Deák, Gauri</au><au>Zou, Juan</au><au>Spanos, Christos</au><au>Taylor, Mark R D</au><au>Mills, Jacquie</au><au>Watson, James A</au><au>Kumar, Dhananjay</au><au>Clark, Richard</au><au>Das, Alakta</au><au>Valsakumar, Devisree</au><au>Bramham, Janice</au><au>Voigt, Philipp</au><au>Sproul, Duncan</au><au>Wilson, Marcus D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The N-terminal region of DNMT3A engages the nucleosome surface to aid chromatin recruitment</atitle><jtitle>EMBO reports</jtitle><stitle>EMBO Rep</stitle><addtitle>EMBO Rep</addtitle><date>2024-11-11</date><risdate>2024</risdate><volume>25</volume><issue>12</issue><spage>5743</spage><epage>5779</epage><pages>5743-5779</pages><issn>1469-3178</issn><issn>1469-221X</issn><eissn>1469-3178</eissn><abstract>DNA methyltransferase 3A (DNMT3A) plays a critical role in establishing and maintaining DNA methylation patterns in vertebrates. Here we structurally and biochemically explore the interaction of DNMT3A1 with diverse modified nucleosomes indicative of different chromatin environments. A cryo-EM structure of the full-length DNMT3A1-DNMT3L complex with a H2AK119ub nucleosome reveals that the DNMT3A1 ubiquitin-dependent recruitment (UDR) motif interacts specifically with H2AK119ub and makes extensive contacts with the core nucleosome histone surface. This interaction facilitates robust DNMT3A1 binding to nucleosomes, and previously unexplained DNMT3A disease-associated mutations disrupt this interface. Furthermore, the UDR-nucleosome interaction synergises with other DNMT3A chromatin reading elements in the absence of histone ubiquitylation. H2AK119ub does not stimulate DNMT3A DNA methylation activity, as observed for the previously described H3K36me2 mark, which may explain low levels of DNA methylation on H2AK119ub marked facultative heterochromatin. This study highlights the importance of multivalent binding of DNMT3A to histone modifications and the nucleosome surface and increases our understanding of how DNMT3A1 chromatin recruitment occurs.
Synopsis
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity.
In addition to DNMT3A’s previously characterised chromatin reader domains, a UDR motif forms contacts with the nucleosome surface. These all work multivalently to ensure correct intragenic recruitment.
The UDR motif interacts with multiple interfaces on the nucleosome promoting direct specific reading of H2A Lys-119 ubiquitylation.
DNMT3A shows a disconnect between nucleosome recruitment and methylation activity: H2AK119ub nucleosomes bind more tightly but are less efficient substrates than H3K36me2-modified nucleosomes.
A UDR motif in DNMT3A acts in concert with other chromatin reading regions to promote chromatin recruitment. A cryo-EM structure reveals that DNMT3A1 binds to H2AK119ub-marked nucleosomes through its UDR motif, although this mark does not enhance DNA methylation activity.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>39528729</pmid><doi>10.1038/s44319-024-00306-3</doi><tpages>37</tpages><orcidid>https://orcid.org/0000-0001-6168-4563</orcidid><orcidid>https://orcid.org/0000-0002-8279-6369</orcidid><orcidid>https://orcid.org/0000-0003-2594-6217</orcidid><orcidid>https://orcid.org/0000-0002-2697-4212</orcidid><orcidid>https://orcid.org/0000-0002-4376-8242</orcidid><orcidid>https://orcid.org/0000-0002-0066-1541</orcidid><orcidid>https://orcid.org/0000-0003-4366-0490</orcidid><orcidid>https://orcid.org/0009-0007-4597-0800</orcidid><orcidid>https://orcid.org/0000-0002-5691-1829</orcidid><orcidid>https://orcid.org/0000-0001-9551-5514</orcidid><orcidid>https://orcid.org/0000-0002-7591-6553</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Animals Biomedical and Life Sciences Chromatin - genetics Chromatin - metabolism Cryoelectron Microscopy DNA (Cytosine-5-)-Methyltransferases - chemistry DNA (Cytosine-5-)-Methyltransferases - genetics DNA (Cytosine-5-)-Methyltransferases - metabolism DNA Methylation DNA Methyltransferase 3A - metabolism EMBO09 EMBO40 Histones - metabolism Humans Life Sciences Models, Molecular Nucleosomes - metabolism Protein Binding Ubiquitination |
title | The N-terminal region of DNMT3A engages the nucleosome surface to aid chromatin recruitment |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T15%3A34%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20N-terminal%20region%20of%20DNMT3A%20engages%20the%20nucleosome%20surface%20to%20aid%20chromatin%20recruitment&rft.jtitle=EMBO%20reports&rft.au=Wapenaar,%20Hannah&rft.date=2024-11-11&rft.volume=25&rft.issue=12&rft.spage=5743&rft.epage=5779&rft.pages=5743-5779&rft.issn=1469-3178&rft.eissn=1469-3178&rft_id=info:doi/10.1038/s44319-024-00306-3&rft_dat=%3Cproquest_pubme%3E3128758314%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c284t-5119077bf07a11d7bb936e650fb70fb255da5e496ced211e4516bc0f5cd617ad3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3128758314&rft_id=info:pmid/39528729&rfr_iscdi=true |