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Focal disruption of DNA methylation dynamics at enhancers in IDH-mutant AML cells
Recurrent mutations in IDH1 or IDH2 in acute myeloid leukemia (AML) are associated with increased DNA methylation, but the genome-wide patterns of this hypermethylation phenotype have not been comprehensively studied in AML samples. We analyzed whole-genome bisulfite sequencing data from 15 primary...
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Published in: | Leukemia 2022-04, Vol.36 (4), p.935-945 |
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creator | Wilson, Elisabeth R. Helton, Nichole M. Heath, Sharon E. Fulton, Robert S. Payton, Jacqueline E. Welch, John S. Walter, Matthew J. Westervelt, Peter DiPersio, John F. Link, Daniel C. Miller, Christopher A. Ley, Timothy J. Spencer, David H. |
description | Recurrent mutations in
IDH1
or
IDH2
in acute myeloid leukemia (AML) are associated with increased DNA methylation, but the genome-wide patterns of this hypermethylation phenotype have not been comprehensively studied in AML samples. We analyzed whole-genome bisulfite sequencing data from 15 primary AML samples with
IDH1
or
IDH2
mutations, which identified ~4000 focal regions that were uniquely hypermethylated in
IDH
mut
samples vs. normal CD34+ cells and other AMLs. These regions had modest hypermethylation in AMLs with biallelic
TET2
mutations, and levels of 5-hydroxymethylation that were diminished in
IDH
and
TET
-mutant samples, indicating that this hypermethylation results from inhibition of TET-mediated demethylation. Focal hypermethylation in
IDH
mut
AMLs occurred at regions with low methylation in CD34+ cells, implying that DNA methylation and demethylation are active at these loci. AML samples containing
IDH
and
DNMT3A
R882
mutations were significantly less hypermethylated, suggesting that
IDH
mut
-associated hypermethylation is mediated by DNMT3A.
IDH
mut
-specific hypermethylation was highly enriched for enhancers that form direct interactions with genes involved in normal hematopoiesis and AML, including
MYC
and
ETV6
. These results suggest that focal hypermethylation in
IDH
-mutant AML occurs by altering the balance between DNA methylation and demethylation, and that disruption of these pathways at enhancers may contribute to AML pathogenesis. |
doi_str_mv | 10.1038/s41375-021-01476-y |
format | article |
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IDH1
or
IDH2
in acute myeloid leukemia (AML) are associated with increased DNA methylation, but the genome-wide patterns of this hypermethylation phenotype have not been comprehensively studied in AML samples. We analyzed whole-genome bisulfite sequencing data from 15 primary AML samples with
IDH1
or
IDH2
mutations, which identified ~4000 focal regions that were uniquely hypermethylated in
IDH
mut
samples vs. normal CD34+ cells and other AMLs. These regions had modest hypermethylation in AMLs with biallelic
TET2
mutations, and levels of 5-hydroxymethylation that were diminished in
IDH
and
TET
-mutant samples, indicating that this hypermethylation results from inhibition of TET-mediated demethylation. Focal hypermethylation in
IDH
mut
AMLs occurred at regions with low methylation in CD34+ cells, implying that DNA methylation and demethylation are active at these loci. AML samples containing
IDH
and
DNMT3A
R882
mutations were significantly less hypermethylated, suggesting that
IDH
mut
-associated hypermethylation is mediated by DNMT3A.
IDH
mut
-specific hypermethylation was highly enriched for enhancers that form direct interactions with genes involved in normal hematopoiesis and AML, including
MYC
and
ETV6
. These results suggest that focal hypermethylation in
IDH
-mutant AML occurs by altering the balance between DNA methylation and demethylation, and that disruption of these pathways at enhancers may contribute to AML pathogenesis.</description><identifier>ISSN: 0887-6924</identifier><identifier>ISSN: 1476-5551</identifier><identifier>EISSN: 1476-5551</identifier><identifier>DOI: 10.1038/s41375-021-01476-y</identifier><identifier>PMID: 34873300</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>38/23 ; 38/39 ; 45/15 ; 45/91 ; 631/208/69 ; 631/67/1990/283/1897 ; Acute myeloid leukemia ; Bisulfite ; Cancer Research ; CD34 antigen ; Critical Care Medicine ; Demethylation ; Deoxyribonucleic acid ; Disruption ; DNA ; DNA Methylation ; Enhancers ; Gene sequencing ; Genomes ; Hematology ; Hematopoiesis ; Humans ; Intensive ; Internal Medicine ; Isocitrate Dehydrogenase - genetics ; Leukemia ; Leukemia, Myeloid, Acute - genetics ; Leukemia, Myeloid, Acute - pathology ; Medicine ; Medicine & Public Health ; Mutants ; Mutation ; Myc protein ; Oncology ; Pathogenesis ; Phenotypes ; Regulatory Sequences, Nucleic Acid</subject><ispartof>Leukemia, 2022-04, Vol.36 (4), p.935-945</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-dce2e8264e492f99246660bab858b106beffd3795b6e1297e003ad0d2560179b3</citedby><cites>FETCH-LOGICAL-c474t-dce2e8264e492f99246660bab858b106beffd3795b6e1297e003ad0d2560179b3</cites><orcidid>0000-0002-5314-3043 ; 0000-0002-0429-3133 ; 0000-0002-9913-0520 ; 0000-0002-7753-1091 ; 0000-0002-3170-7581 ; 0000-0001-8832-3661</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34873300$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilson, Elisabeth R.</creatorcontrib><creatorcontrib>Helton, Nichole M.</creatorcontrib><creatorcontrib>Heath, Sharon E.</creatorcontrib><creatorcontrib>Fulton, Robert S.</creatorcontrib><creatorcontrib>Payton, Jacqueline E.</creatorcontrib><creatorcontrib>Welch, John S.</creatorcontrib><creatorcontrib>Walter, Matthew J.</creatorcontrib><creatorcontrib>Westervelt, Peter</creatorcontrib><creatorcontrib>DiPersio, John F.</creatorcontrib><creatorcontrib>Link, Daniel C.</creatorcontrib><creatorcontrib>Miller, Christopher A.</creatorcontrib><creatorcontrib>Ley, Timothy J.</creatorcontrib><creatorcontrib>Spencer, David H.</creatorcontrib><title>Focal disruption of DNA methylation dynamics at enhancers in IDH-mutant AML cells</title><title>Leukemia</title><addtitle>Leukemia</addtitle><addtitle>Leukemia</addtitle><description>Recurrent mutations in
IDH1
or
IDH2
in acute myeloid leukemia (AML) are associated with increased DNA methylation, but the genome-wide patterns of this hypermethylation phenotype have not been comprehensively studied in AML samples. We analyzed whole-genome bisulfite sequencing data from 15 primary AML samples with
IDH1
or
IDH2
mutations, which identified ~4000 focal regions that were uniquely hypermethylated in
IDH
mut
samples vs. normal CD34+ cells and other AMLs. These regions had modest hypermethylation in AMLs with biallelic
TET2
mutations, and levels of 5-hydroxymethylation that were diminished in
IDH
and
TET
-mutant samples, indicating that this hypermethylation results from inhibition of TET-mediated demethylation. Focal hypermethylation in
IDH
mut
AMLs occurred at regions with low methylation in CD34+ cells, implying that DNA methylation and demethylation are active at these loci. AML samples containing
IDH
and
DNMT3A
R882
mutations were significantly less hypermethylated, suggesting that
IDH
mut
-associated hypermethylation is mediated by DNMT3A.
IDH
mut
-specific hypermethylation was highly enriched for enhancers that form direct interactions with genes involved in normal hematopoiesis and AML, including
MYC
and
ETV6
. These results suggest that focal hypermethylation in
IDH
-mutant AML occurs by altering the balance between DNA methylation and demethylation, and that disruption of these pathways at enhancers may contribute to AML pathogenesis.</description><subject>38/23</subject><subject>38/39</subject><subject>45/15</subject><subject>45/91</subject><subject>631/208/69</subject><subject>631/67/1990/283/1897</subject><subject>Acute myeloid leukemia</subject><subject>Bisulfite</subject><subject>Cancer Research</subject><subject>CD34 antigen</subject><subject>Critical Care Medicine</subject><subject>Demethylation</subject><subject>Deoxyribonucleic acid</subject><subject>Disruption</subject><subject>DNA</subject><subject>DNA Methylation</subject><subject>Enhancers</subject><subject>Gene sequencing</subject><subject>Genomes</subject><subject>Hematology</subject><subject>Hematopoiesis</subject><subject>Humans</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Isocitrate Dehydrogenase - genetics</subject><subject>Leukemia</subject><subject>Leukemia, Myeloid, Acute - genetics</subject><subject>Leukemia, Myeloid, Acute - pathology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mutants</subject><subject>Mutation</subject><subject>Myc protein</subject><subject>Oncology</subject><subject>Pathogenesis</subject><subject>Phenotypes</subject><subject>Regulatory Sequences, Nucleic Acid</subject><issn>0887-6924</issn><issn>1476-5551</issn><issn>1476-5551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kUtrGzEUhUVISVy3fyCLIMimm2n1Gj02AWM3scFtCLRroZnRxBNmJEeaCcy_r2I7bptFtJHQ_e6593AAuMDoK0ZUfosMU5FniOAMYSZ4Np6Aye6R5zk-BRMkpci4IuwcfIzxEe0ofgbOKZOCUoQm4P7Gl6aFVRPDsO0b76Cv4eLnDHa234yt2X1VozNdU0ZoemjdxrjShggbB1eLZdYNvXE9nP1Yw9K2bfwEPtSmjfbz4Z6C3zfff82X2frudjWfrbOSCdZnVWmJlYQzyxSpVVqSc44KU8hcFhjxwtZ1RYXKC24xUcIiRE2FKpJzhIUq6BRc73W3Q9HZJOf6YFq9DU1nwqi9afT_Fdds9IN_1lIJJbFIAl8OAsE_DTb2umviiwXjrB-iJhyJXCqazhRcvUEf_RBcspcoxiVlhPJEkT1VBh9jsPVxGYz0S2J6n5hOieldFnpMTZf_2ji2vEaUALoHYiq5Bxv-zn5H9g-pgKFW</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Wilson, Elisabeth R.</creator><creator>Helton, Nichole M.</creator><creator>Heath, Sharon E.</creator><creator>Fulton, Robert S.</creator><creator>Payton, Jacqueline E.</creator><creator>Welch, John S.</creator><creator>Walter, Matthew J.</creator><creator>Westervelt, Peter</creator><creator>DiPersio, John F.</creator><creator>Link, Daniel C.</creator><creator>Miller, Christopher A.</creator><creator>Ley, Timothy J.</creator><creator>Spencer, David H.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</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>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5314-3043</orcidid><orcidid>https://orcid.org/0000-0002-0429-3133</orcidid><orcidid>https://orcid.org/0000-0002-9913-0520</orcidid><orcidid>https://orcid.org/0000-0002-7753-1091</orcidid><orcidid>https://orcid.org/0000-0002-3170-7581</orcidid><orcidid>https://orcid.org/0000-0001-8832-3661</orcidid></search><sort><creationdate>20220401</creationdate><title>Focal disruption of DNA methylation dynamics at enhancers in IDH-mutant AML cells</title><author>Wilson, Elisabeth R. ; Helton, Nichole M. ; Heath, Sharon E. ; Fulton, Robert S. ; Payton, Jacqueline E. ; Welch, John S. ; Walter, Matthew J. ; Westervelt, Peter ; DiPersio, John F. ; Link, Daniel C. ; Miller, Christopher A. ; Ley, Timothy J. ; Spencer, David H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-dce2e8264e492f99246660bab858b106beffd3795b6e1297e003ad0d2560179b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>38/23</topic><topic>38/39</topic><topic>45/15</topic><topic>45/91</topic><topic>631/208/69</topic><topic>631/67/1990/283/1897</topic><topic>Acute myeloid leukemia</topic><topic>Bisulfite</topic><topic>Cancer Research</topic><topic>CD34 antigen</topic><topic>Critical Care Medicine</topic><topic>Demethylation</topic><topic>Deoxyribonucleic acid</topic><topic>Disruption</topic><topic>DNA</topic><topic>DNA Methylation</topic><topic>Enhancers</topic><topic>Gene sequencing</topic><topic>Genomes</topic><topic>Hematology</topic><topic>Hematopoiesis</topic><topic>Humans</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Isocitrate Dehydrogenase - genetics</topic><topic>Leukemia</topic><topic>Leukemia, Myeloid, Acute - genetics</topic><topic>Leukemia, Myeloid, Acute - pathology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mutants</topic><topic>Mutation</topic><topic>Myc protein</topic><topic>Oncology</topic><topic>Pathogenesis</topic><topic>Phenotypes</topic><topic>Regulatory Sequences, Nucleic Acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilson, Elisabeth R.</creatorcontrib><creatorcontrib>Helton, Nichole M.</creatorcontrib><creatorcontrib>Heath, Sharon E.</creatorcontrib><creatorcontrib>Fulton, Robert S.</creatorcontrib><creatorcontrib>Payton, Jacqueline E.</creatorcontrib><creatorcontrib>Welch, John S.</creatorcontrib><creatorcontrib>Walter, Matthew J.</creatorcontrib><creatorcontrib>Westervelt, Peter</creatorcontrib><creatorcontrib>DiPersio, John F.</creatorcontrib><creatorcontrib>Link, Daniel C.</creatorcontrib><creatorcontrib>Miller, Christopher A.</creatorcontrib><creatorcontrib>Ley, Timothy J.</creatorcontrib><creatorcontrib>Spencer, David H.</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>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Leukemia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilson, Elisabeth R.</au><au>Helton, Nichole M.</au><au>Heath, Sharon E.</au><au>Fulton, Robert S.</au><au>Payton, Jacqueline E.</au><au>Welch, John S.</au><au>Walter, Matthew J.</au><au>Westervelt, Peter</au><au>DiPersio, John F.</au><au>Link, Daniel C.</au><au>Miller, Christopher A.</au><au>Ley, Timothy J.</au><au>Spencer, David H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Focal disruption of DNA methylation dynamics at enhancers in IDH-mutant AML cells</atitle><jtitle>Leukemia</jtitle><stitle>Leukemia</stitle><addtitle>Leukemia</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>36</volume><issue>4</issue><spage>935</spage><epage>945</epage><pages>935-945</pages><issn>0887-6924</issn><issn>1476-5551</issn><eissn>1476-5551</eissn><abstract>Recurrent mutations in
IDH1
or
IDH2
in acute myeloid leukemia (AML) are associated with increased DNA methylation, but the genome-wide patterns of this hypermethylation phenotype have not been comprehensively studied in AML samples. We analyzed whole-genome bisulfite sequencing data from 15 primary AML samples with
IDH1
or
IDH2
mutations, which identified ~4000 focal regions that were uniquely hypermethylated in
IDH
mut
samples vs. normal CD34+ cells and other AMLs. These regions had modest hypermethylation in AMLs with biallelic
TET2
mutations, and levels of 5-hydroxymethylation that were diminished in
IDH
and
TET
-mutant samples, indicating that this hypermethylation results from inhibition of TET-mediated demethylation. Focal hypermethylation in
IDH
mut
AMLs occurred at regions with low methylation in CD34+ cells, implying that DNA methylation and demethylation are active at these loci. AML samples containing
IDH
and
DNMT3A
R882
mutations were significantly less hypermethylated, suggesting that
IDH
mut
-associated hypermethylation is mediated by DNMT3A.
IDH
mut
-specific hypermethylation was highly enriched for enhancers that form direct interactions with genes involved in normal hematopoiesis and AML, including
MYC
and
ETV6
. These results suggest that focal hypermethylation in
IDH
-mutant AML occurs by altering the balance between DNA methylation and demethylation, and that disruption of these pathways at enhancers may contribute to AML pathogenesis.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>34873300</pmid><doi>10.1038/s41375-021-01476-y</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-5314-3043</orcidid><orcidid>https://orcid.org/0000-0002-0429-3133</orcidid><orcidid>https://orcid.org/0000-0002-9913-0520</orcidid><orcidid>https://orcid.org/0000-0002-7753-1091</orcidid><orcidid>https://orcid.org/0000-0002-3170-7581</orcidid><orcidid>https://orcid.org/0000-0001-8832-3661</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
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ispartof | Leukemia, 2022-04, Vol.36 (4), p.935-945 |
issn | 0887-6924 1476-5551 1476-5551 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8979817 |
source | Nexis UK; Springer Link |
subjects | 38/23 38/39 45/15 45/91 631/208/69 631/67/1990/283/1897 Acute myeloid leukemia Bisulfite Cancer Research CD34 antigen Critical Care Medicine Demethylation Deoxyribonucleic acid Disruption DNA DNA Methylation Enhancers Gene sequencing Genomes Hematology Hematopoiesis Humans Intensive Internal Medicine Isocitrate Dehydrogenase - genetics Leukemia Leukemia, Myeloid, Acute - genetics Leukemia, Myeloid, Acute - pathology Medicine Medicine & Public Health Mutants Mutation Myc protein Oncology Pathogenesis Phenotypes Regulatory Sequences, Nucleic Acid |
title | Focal disruption of DNA methylation dynamics at enhancers in IDH-mutant AML cells |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T12%3A41%3A28IST&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=Focal%20disruption%20of%20DNA%20methylation%20dynamics%20at%20enhancers%20in%20IDH-mutant%20AML%20cells&rft.jtitle=Leukemia&rft.au=Wilson,%20Elisabeth%20R.&rft.date=2022-04-01&rft.volume=36&rft.issue=4&rft.spage=935&rft.epage=945&rft.pages=935-945&rft.issn=0887-6924&rft.eissn=1476-5551&rft_id=info:doi/10.1038/s41375-021-01476-y&rft_dat=%3Cproquest_pubme%3E2646834236%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c474t-dce2e8264e492f99246660bab858b106beffd3795b6e1297e003ad0d2560179b3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2646834236&rft_id=info:pmid/34873300&rfr_iscdi=true |