BACH2 represses effector programs to stabilize Treg-mediated immune homeostasis
Diverse autoimmune and allergic diseases are associated with polymorphisms in a locus encoding the transcription factor BACH2; here, BACH2 is shown to be a broad regulator of immune activation that stabilizes the differentiation of T reg cells by repressing commitment of CD4 + T cells to alternate c...
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creator | Roychoudhuri, Rahul Hirahara, Kiyoshi Mousavi, Kambiz Clever, David Klebanoff, Christopher A. Bonelli, Michael Sciumè, Giuseppe Zare, Hossein Vahedi, Golnaz Dema, Barbara Yu, Zhiya Liu, Hui Takahashi, Hayato Rao, Mahadev Muranski, Pawel Crompton, Joseph G. Punkosdy, George Bedognetti, Davide Wang, Ena Hoffmann, Victoria Rivera, Juan Marincola, Francesco M. Nakamura, Atsushi Sartorelli, Vittorio Kanno, Yuka Gattinoni, Luca Muto, Akihiko Igarashi, Kazuhiko O’Shea, John J. Restifo, Nicholas P. |
description | Diverse autoimmune and allergic diseases are associated with polymorphisms in a locus encoding the transcription factor BACH2; here, BACH2 is shown to be a broad regulator of immune activation that stabilizes the differentiation of T
reg
cells by repressing commitment of CD4
+
T cells to alternate cell fates.
Anti-inflammatory action of BACH2
Polymorphisms within a locus encoding the transcription factor BACH2 are associated with a number of allergic and autoimmune diseases including asthma, multiple sclerosis, Crohn's disease, coeliac disease and type 1 diabetes. This paper identifies a mechanism by which BACH2 might contribute to autoimmunity. Roychoudhuri
et al
. show how BACH2 limits autoimmunity by repressing alternative cell fates through the stabilization of the differentiation of regulatory T cells. These findings suggest a role for BACH2 as a regulator of CD4
+
T-cell differentiation, preventing inflammatory disease by controlling the balance between tolerance and immunity.
Through their functional diversification, distinct lineages of CD4
+
T cells can act to either drive or constrain immune-mediated pathology. Transcription factors are critical in the generation of cellular diversity, and negative regulators antagonistic to alternate fates often act in conjunction with positive regulators to stabilize lineage commitment
1
. Genetic polymorphisms within a single locus encoding the transcription factor BACH2 are associated with numerous autoimmune and allergic diseases including asthma
2
, Crohn’s disease
3
,
4
, coeliac disease
5
, vitiligo
6
, multiple sclerosis
7
and type 1 diabetes
8
. Although these associations point to a shared mechanism underlying susceptibility to diverse immune-mediated diseases, a function for BACH2 in the maintenance of immune homeostasis has not been established. Here, by studying mice in which the
Bach2
gene is disrupted, we define BACH2 as a broad regulator of immune activation that stabilizes immunoregulatory capacity while repressing the differentiation programs of multiple effector lineages in CD4
+
T cells. BACH2 was required for efficient formation of regulatory (T
reg
) cells and consequently for suppression of lethal inflammation in a manner that was T
reg
-cell-dependent. Assessment of the genome-wide function of BACH2, however, revealed that it represses genes associated with effector cell differentiation. Consequently, its absence during T
reg
polarization resulted in inappropriate diversion to effector li |
doi_str_mv | 10.1038/nature12199 |
format | Article |
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reg
cells by repressing commitment of CD4
+
T cells to alternate cell fates.
Anti-inflammatory action of BACH2
Polymorphisms within a locus encoding the transcription factor BACH2 are associated with a number of allergic and autoimmune diseases including asthma, multiple sclerosis, Crohn's disease, coeliac disease and type 1 diabetes. This paper identifies a mechanism by which BACH2 might contribute to autoimmunity. Roychoudhuri
et al
. show how BACH2 limits autoimmunity by repressing alternative cell fates through the stabilization of the differentiation of regulatory T cells. These findings suggest a role for BACH2 as a regulator of CD4
+
T-cell differentiation, preventing inflammatory disease by controlling the balance between tolerance and immunity.
Through their functional diversification, distinct lineages of CD4
+
T cells can act to either drive or constrain immune-mediated pathology. Transcription factors are critical in the generation of cellular diversity, and negative regulators antagonistic to alternate fates often act in conjunction with positive regulators to stabilize lineage commitment
1
. Genetic polymorphisms within a single locus encoding the transcription factor BACH2 are associated with numerous autoimmune and allergic diseases including asthma
2
, Crohn’s disease
3
,
4
, coeliac disease
5
, vitiligo
6
, multiple sclerosis
7
and type 1 diabetes
8
. Although these associations point to a shared mechanism underlying susceptibility to diverse immune-mediated diseases, a function for BACH2 in the maintenance of immune homeostasis has not been established. Here, by studying mice in which the
Bach2
gene is disrupted, we define BACH2 as a broad regulator of immune activation that stabilizes immunoregulatory capacity while repressing the differentiation programs of multiple effector lineages in CD4
+
T cells. BACH2 was required for efficient formation of regulatory (T
reg
) cells and consequently for suppression of lethal inflammation in a manner that was T
reg
-cell-dependent. Assessment of the genome-wide function of BACH2, however, revealed that it represses genes associated with effector cell differentiation. Consequently, its absence during T
reg
polarization resulted in inappropriate diversion to effector lineages. In addition, BACH2 constrained full effector differentiation within T
H
1, T
H
2 and T
H
17 cell lineages. These findings identify BACH2 as a key regulator of CD4
+
T-cell differentiation that prevents inflammatory disease by controlling the balance between tolerance and immunity.</description><identifier>ISSN: 0028-0836</identifier><identifier>EISSN: 1476-4687</identifier><identifier>DOI: 10.1038/nature12199</identifier><identifier>PMID: 23728300</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/250/1619/554 ; 631/250/1619/554/1898/1271 ; 631/250/249/2510/9 ; 631/250/38 ; Genetic aspects ; Health aspects ; Homeostasis ; Humanities and Social Sciences ; Immune system ; letter ; multidisciplinary ; Science ; T cells ; Transcription factors</subject><ispartof>Nature (London), 2013-06, Vol.498 (7455), p.506-510</ispartof><rights>Springer Nature Limited 2013</rights><rights>COPYRIGHT 2013 Nature Publishing Group</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3739-93f93d10435c0e64a3eadbf1e477b43f8c2522d2338bad268151988dcbad6b2b3</citedby><cites>FETCH-LOGICAL-c3739-93f93d10435c0e64a3eadbf1e477b43f8c2522d2338bad268151988dcbad6b2b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/nature12199$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/nature12199$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Roychoudhuri, Rahul</creatorcontrib><creatorcontrib>Hirahara, Kiyoshi</creatorcontrib><creatorcontrib>Mousavi, Kambiz</creatorcontrib><creatorcontrib>Clever, David</creatorcontrib><creatorcontrib>Klebanoff, Christopher A.</creatorcontrib><creatorcontrib>Bonelli, Michael</creatorcontrib><creatorcontrib>Sciumè, Giuseppe</creatorcontrib><creatorcontrib>Zare, Hossein</creatorcontrib><creatorcontrib>Vahedi, Golnaz</creatorcontrib><creatorcontrib>Dema, Barbara</creatorcontrib><creatorcontrib>Yu, Zhiya</creatorcontrib><creatorcontrib>Liu, Hui</creatorcontrib><creatorcontrib>Takahashi, Hayato</creatorcontrib><creatorcontrib>Rao, Mahadev</creatorcontrib><creatorcontrib>Muranski, Pawel</creatorcontrib><creatorcontrib>Crompton, Joseph G.</creatorcontrib><creatorcontrib>Punkosdy, George</creatorcontrib><creatorcontrib>Bedognetti, Davide</creatorcontrib><creatorcontrib>Wang, Ena</creatorcontrib><creatorcontrib>Hoffmann, Victoria</creatorcontrib><creatorcontrib>Rivera, Juan</creatorcontrib><creatorcontrib>Marincola, Francesco M.</creatorcontrib><creatorcontrib>Nakamura, Atsushi</creatorcontrib><creatorcontrib>Sartorelli, Vittorio</creatorcontrib><creatorcontrib>Kanno, Yuka</creatorcontrib><creatorcontrib>Gattinoni, Luca</creatorcontrib><creatorcontrib>Muto, Akihiko</creatorcontrib><creatorcontrib>Igarashi, Kazuhiko</creatorcontrib><creatorcontrib>O’Shea, John J.</creatorcontrib><creatorcontrib>Restifo, Nicholas P.</creatorcontrib><title>BACH2 represses effector programs to stabilize Treg-mediated immune homeostasis</title><title>Nature (London)</title><addtitle>Nature</addtitle><description>Diverse autoimmune and allergic diseases are associated with polymorphisms in a locus encoding the transcription factor BACH2; here, BACH2 is shown to be a broad regulator of immune activation that stabilizes the differentiation of T
reg
cells by repressing commitment of CD4
+
T cells to alternate cell fates.
Anti-inflammatory action of BACH2
Polymorphisms within a locus encoding the transcription factor BACH2 are associated with a number of allergic and autoimmune diseases including asthma, multiple sclerosis, Crohn's disease, coeliac disease and type 1 diabetes. This paper identifies a mechanism by which BACH2 might contribute to autoimmunity. Roychoudhuri
et al
. show how BACH2 limits autoimmunity by repressing alternative cell fates through the stabilization of the differentiation of regulatory T cells. These findings suggest a role for BACH2 as a regulator of CD4
+
T-cell differentiation, preventing inflammatory disease by controlling the balance between tolerance and immunity.
Through their functional diversification, distinct lineages of CD4
+
T cells can act to either drive or constrain immune-mediated pathology. Transcription factors are critical in the generation of cellular diversity, and negative regulators antagonistic to alternate fates often act in conjunction with positive regulators to stabilize lineage commitment
1
. Genetic polymorphisms within a single locus encoding the transcription factor BACH2 are associated with numerous autoimmune and allergic diseases including asthma
2
, Crohn’s disease
3
,
4
, coeliac disease
5
, vitiligo
6
, multiple sclerosis
7
and type 1 diabetes
8
. Although these associations point to a shared mechanism underlying susceptibility to diverse immune-mediated diseases, a function for BACH2 in the maintenance of immune homeostasis has not been established. Here, by studying mice in which the
Bach2
gene is disrupted, we define BACH2 as a broad regulator of immune activation that stabilizes immunoregulatory capacity while repressing the differentiation programs of multiple effector lineages in CD4
+
T cells. BACH2 was required for efficient formation of regulatory (T
reg
) cells and consequently for suppression of lethal inflammation in a manner that was T
reg
-cell-dependent. Assessment of the genome-wide function of BACH2, however, revealed that it represses genes associated with effector cell differentiation. Consequently, its absence during T
reg
polarization resulted in inappropriate diversion to effector lineages. In addition, BACH2 constrained full effector differentiation within T
H
1, T
H
2 and T
H
17 cell lineages. These findings identify BACH2 as a key regulator of CD4
+
T-cell differentiation that prevents inflammatory disease by controlling the balance between tolerance and immunity.</description><subject>631/250/1619/554</subject><subject>631/250/1619/554/1898/1271</subject><subject>631/250/249/2510/9</subject><subject>631/250/38</subject><subject>Genetic aspects</subject><subject>Health aspects</subject><subject>Homeostasis</subject><subject>Humanities and Social Sciences</subject><subject>Immune system</subject><subject>letter</subject><subject>multidisciplinary</subject><subject>Science</subject><subject>T cells</subject><subject>Transcription factors</subject><issn>0028-0836</issn><issn>1476-4687</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNpt0l1rHCEUBmApDcl2m6v-gaG9Ks2kfsyOehPYLPmCQCBNr8VxjhPDjk51pqT99TFsKVkYvBD18eWgB6FPBJ8SzMR3r8cpAqFEyndoQSpel1Ut-Hu0wJiKEgtWH6EPKT1hjFeEV4foiDJOBcN4ge7O15trWkQYIqQEqQBrwYwhFkMMXdR9KsZQpFE3buv-QvEQoSt7aJ0eoS1c308eisfQQ8gmufQRHVi9TXD8b16in5cXD5vr8vbu6mazvi0N40yWklnJWoIrtjIY6koz0G1jCVScNxWzwtAVpS1lTDS6pbUgKyKFaE1e1Q1t2BKd7XKHqcnlGPBj1Fs1RNfr-EcF7dT-iXePqgu_FeME81zDEn3ZBXR6C8p5GzIzvUtGrSshaialkFmVM6oDDzkzeLAub-_5zzPeDO6XeotOZ1AeLfTOzKZ-3buQzQjPY6enlNTNj_t9-21nTQwpRbD_34Rg9dov6k2_ZH2y0ykr30FUT2GKPv_cLH8BtTfAKQ</recordid><startdate>20130627</startdate><enddate>20130627</enddate><creator>Roychoudhuri, Rahul</creator><creator>Hirahara, Kiyoshi</creator><creator>Mousavi, Kambiz</creator><creator>Clever, David</creator><creator>Klebanoff, Christopher A.</creator><creator>Bonelli, Michael</creator><creator>Sciumè, Giuseppe</creator><creator>Zare, Hossein</creator><creator>Vahedi, Golnaz</creator><creator>Dema, Barbara</creator><creator>Yu, Zhiya</creator><creator>Liu, Hui</creator><creator>Takahashi, Hayato</creator><creator>Rao, Mahadev</creator><creator>Muranski, Pawel</creator><creator>Crompton, Joseph G.</creator><creator>Punkosdy, George</creator><creator>Bedognetti, Davide</creator><creator>Wang, Ena</creator><creator>Hoffmann, Victoria</creator><creator>Rivera, Juan</creator><creator>Marincola, Francesco M.</creator><creator>Nakamura, Atsushi</creator><creator>Sartorelli, Vittorio</creator><creator>Kanno, Yuka</creator><creator>Gattinoni, Luca</creator><creator>Muto, Akihiko</creator><creator>Igarashi, Kazuhiko</creator><creator>O’Shea, John J.</creator><creator>Restifo, Nicholas P.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20130627</creationdate><title>BACH2 represses effector programs to stabilize Treg-mediated immune homeostasis</title><author>Roychoudhuri, Rahul ; Hirahara, Kiyoshi ; Mousavi, Kambiz ; Clever, David ; Klebanoff, Christopher A. ; Bonelli, Michael ; Sciumè, Giuseppe ; Zare, Hossein ; Vahedi, Golnaz ; Dema, Barbara ; Yu, Zhiya ; Liu, Hui ; Takahashi, Hayato ; Rao, Mahadev ; Muranski, Pawel ; Crompton, Joseph G. ; Punkosdy, George ; Bedognetti, Davide ; Wang, Ena ; Hoffmann, Victoria ; Rivera, Juan ; Marincola, Francesco M. ; Nakamura, Atsushi ; Sartorelli, Vittorio ; Kanno, Yuka ; Gattinoni, Luca ; Muto, Akihiko ; Igarashi, Kazuhiko ; O’Shea, John J. ; Restifo, Nicholas P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3739-93f93d10435c0e64a3eadbf1e477b43f8c2522d2338bad268151988dcbad6b2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>631/250/1619/554</topic><topic>631/250/1619/554/1898/1271</topic><topic>631/250/249/2510/9</topic><topic>631/250/38</topic><topic>Genetic aspects</topic><topic>Health aspects</topic><topic>Homeostasis</topic><topic>Humanities and Social Sciences</topic><topic>Immune system</topic><topic>letter</topic><topic>multidisciplinary</topic><topic>Science</topic><topic>T cells</topic><topic>Transcription factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roychoudhuri, Rahul</creatorcontrib><creatorcontrib>Hirahara, Kiyoshi</creatorcontrib><creatorcontrib>Mousavi, Kambiz</creatorcontrib><creatorcontrib>Clever, David</creatorcontrib><creatorcontrib>Klebanoff, Christopher A.</creatorcontrib><creatorcontrib>Bonelli, Michael</creatorcontrib><creatorcontrib>Sciumè, Giuseppe</creatorcontrib><creatorcontrib>Zare, Hossein</creatorcontrib><creatorcontrib>Vahedi, Golnaz</creatorcontrib><creatorcontrib>Dema, Barbara</creatorcontrib><creatorcontrib>Yu, Zhiya</creatorcontrib><creatorcontrib>Liu, Hui</creatorcontrib><creatorcontrib>Takahashi, Hayato</creatorcontrib><creatorcontrib>Rao, Mahadev</creatorcontrib><creatorcontrib>Muranski, Pawel</creatorcontrib><creatorcontrib>Crompton, Joseph G.</creatorcontrib><creatorcontrib>Punkosdy, George</creatorcontrib><creatorcontrib>Bedognetti, Davide</creatorcontrib><creatorcontrib>Wang, Ena</creatorcontrib><creatorcontrib>Hoffmann, Victoria</creatorcontrib><creatorcontrib>Rivera, Juan</creatorcontrib><creatorcontrib>Marincola, Francesco M.</creatorcontrib><creatorcontrib>Nakamura, Atsushi</creatorcontrib><creatorcontrib>Sartorelli, Vittorio</creatorcontrib><creatorcontrib>Kanno, Yuka</creatorcontrib><creatorcontrib>Gattinoni, Luca</creatorcontrib><creatorcontrib>Muto, Akihiko</creatorcontrib><creatorcontrib>Igarashi, Kazuhiko</creatorcontrib><creatorcontrib>O’Shea, John J.</creatorcontrib><creatorcontrib>Restifo, Nicholas P.</creatorcontrib><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Nature (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roychoudhuri, Rahul</au><au>Hirahara, Kiyoshi</au><au>Mousavi, Kambiz</au><au>Clever, David</au><au>Klebanoff, Christopher A.</au><au>Bonelli, Michael</au><au>Sciumè, Giuseppe</au><au>Zare, Hossein</au><au>Vahedi, Golnaz</au><au>Dema, Barbara</au><au>Yu, Zhiya</au><au>Liu, Hui</au><au>Takahashi, Hayato</au><au>Rao, Mahadev</au><au>Muranski, Pawel</au><au>Crompton, Joseph G.</au><au>Punkosdy, George</au><au>Bedognetti, Davide</au><au>Wang, Ena</au><au>Hoffmann, Victoria</au><au>Rivera, Juan</au><au>Marincola, Francesco M.</au><au>Nakamura, Atsushi</au><au>Sartorelli, Vittorio</au><au>Kanno, Yuka</au><au>Gattinoni, Luca</au><au>Muto, Akihiko</au><au>Igarashi, Kazuhiko</au><au>O’Shea, John J.</au><au>Restifo, Nicholas P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>BACH2 represses effector programs to stabilize Treg-mediated immune homeostasis</atitle><jtitle>Nature (London)</jtitle><stitle>Nature</stitle><date>2013-06-27</date><risdate>2013</risdate><volume>498</volume><issue>7455</issue><spage>506</spage><epage>510</epage><pages>506-510</pages><issn>0028-0836</issn><eissn>1476-4687</eissn><abstract>Diverse autoimmune and allergic diseases are associated with polymorphisms in a locus encoding the transcription factor BACH2; here, BACH2 is shown to be a broad regulator of immune activation that stabilizes the differentiation of T
reg
cells by repressing commitment of CD4
+
T cells to alternate cell fates.
Anti-inflammatory action of BACH2
Polymorphisms within a locus encoding the transcription factor BACH2 are associated with a number of allergic and autoimmune diseases including asthma, multiple sclerosis, Crohn's disease, coeliac disease and type 1 diabetes. This paper identifies a mechanism by which BACH2 might contribute to autoimmunity. Roychoudhuri
et al
. show how BACH2 limits autoimmunity by repressing alternative cell fates through the stabilization of the differentiation of regulatory T cells. These findings suggest a role for BACH2 as a regulator of CD4
+
T-cell differentiation, preventing inflammatory disease by controlling the balance between tolerance and immunity.
Through their functional diversification, distinct lineages of CD4
+
T cells can act to either drive or constrain immune-mediated pathology. Transcription factors are critical in the generation of cellular diversity, and negative regulators antagonistic to alternate fates often act in conjunction with positive regulators to stabilize lineage commitment
1
. Genetic polymorphisms within a single locus encoding the transcription factor BACH2 are associated with numerous autoimmune and allergic diseases including asthma
2
, Crohn’s disease
3
,
4
, coeliac disease
5
, vitiligo
6
, multiple sclerosis
7
and type 1 diabetes
8
. Although these associations point to a shared mechanism underlying susceptibility to diverse immune-mediated diseases, a function for BACH2 in the maintenance of immune homeostasis has not been established. Here, by studying mice in which the
Bach2
gene is disrupted, we define BACH2 as a broad regulator of immune activation that stabilizes immunoregulatory capacity while repressing the differentiation programs of multiple effector lineages in CD4
+
T cells. BACH2 was required for efficient formation of regulatory (T
reg
) cells and consequently for suppression of lethal inflammation in a manner that was T
reg
-cell-dependent. Assessment of the genome-wide function of BACH2, however, revealed that it represses genes associated with effector cell differentiation. Consequently, its absence during T
reg
polarization resulted in inappropriate diversion to effector lineages. In addition, BACH2 constrained full effector differentiation within T
H
1, T
H
2 and T
H
17 cell lineages. These findings identify BACH2 as a key regulator of CD4
+
T-cell differentiation that prevents inflammatory disease by controlling the balance between tolerance and immunity.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>23728300</pmid><doi>10.1038/nature12199</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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language | eng |
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source | SpringerLink Journals; Nature Journals Online |
subjects | 631/250/1619/554 631/250/1619/554/1898/1271 631/250/249/2510/9 631/250/38 Genetic aspects Health aspects Homeostasis Humanities and Social Sciences Immune system letter multidisciplinary Science T cells Transcription factors |
title | BACH2 represses effector programs to stabilize Treg-mediated immune homeostasis |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T07%3A48%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=BACH2%20represses%20effector%20programs%20to%20stabilize%20Treg-mediated%20immune%20homeostasis&rft.jtitle=Nature%20(London)&rft.au=Roychoudhuri,%20Rahul&rft.date=2013-06-27&rft.volume=498&rft.issue=7455&rft.spage=506&rft.epage=510&rft.pages=506-510&rft.issn=0028-0836&rft.eissn=1476-4687&rft_id=info:doi/10.1038/nature12199&rft_dat=%3Cgale_pubme%3EA488639989%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/23728300&rft_galeid=A488639989&rfr_iscdi=true |