Understanding the Genomic Structure of Copy‐Number Variation of the Low‐Affinity Fcγ Receptor Region Allows Confirmation of the Association of FCGR3B Deletion with Rheumatoid Arthritis

ABSTRACT Fcγ receptors are a family of cell–surface receptors that are expressed by a host of different innate and adaptive immune cells, and mediate inflammatory responses by binding the Fc portion of immunoglobulin G. In humans, five low‐affinity receptors are encoded by the genes FCGR2A, FCGR2B,...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Human mutation 2017-04, Vol.38 (4), p.390-399
Hauptverfasser: Rahbari, Raheleh, Zuccherato, Luciana W, Tischler, German, Chihota, Belinda, Ozturk, Hasret, Saleem, Sara, Tarazona‐Santos, Eduardo, Machado, Lee R, Hollox, Edward J
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 399
container_issue 4
container_start_page 390
container_title Human mutation
container_volume 38
creator Rahbari, Raheleh
Zuccherato, Luciana W
Tischler, German
Chihota, Belinda
Ozturk, Hasret
Saleem, Sara
Tarazona‐Santos, Eduardo
Machado, Lee R
Hollox, Edward J
description ABSTRACT Fcγ receptors are a family of cell–surface receptors that are expressed by a host of different innate and adaptive immune cells, and mediate inflammatory responses by binding the Fc portion of immunoglobulin G. In humans, five low‐affinity receptors are encoded by the genes FCGR2A, FCGR2B, FCGR2C, FCGR3A, and FCGR3B, which are located in an 82.5‐kb segmental tandem duplication on chromosome 1q23.3, which shows extensive copy‐number variation (CNV). Deletions of FCGR3B have been suggested to increase the risk of inflammatory diseases such as systemic lupus erythematosus and rheumatoid arthritis (RA). In this study, we identify the deletion breakpoints of FCGR3B deletion alleles in the UK population and endogamous native American population, and show that some but not all alleles are likely to be identical‐by‐descent. We also localize a duplication breakpoint, confirming that the mechanism of CNV generation is nonallelic homologous recombination, and identify several alleles with gene conversion events using fosmid sequencing data. We use information on the structure of the deletion alleles to distinguish FCGR3B deletions from FCGR3A deletions in whole‐genome array comparative genomic hybridization (aCGH) data. Reanalysis of published aCGH data using this approach supports association of FCGR3B deletion with increased risk of RA in a large cohort of 1,982 cases and 3,271 controls (odds ratio 1.61, P = 2.9×10−3). In humans, low‐affinity Fc gamma receptors are arranged on an 82.5kb segmental duplication – paralog A and paralog B. There are alleles with gene conversion events upstream of the FCGR2C and FCGR2B genes. Deletions of FCGR3B occur by non‐allelic homologous recombination. In the British population, these deletions have been generated by at least three mutational events. In Native South Americans, this deletion have been generated by a single mutational event. Deletion of FCGR3B is associated with an increased risk of rheumatoid arthritis.
doi_str_mv 10.1002/humu.23159
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5363352</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1881757994</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4179-6afb9f92d2b9d38a4da6ab653dae3ad390e142ea559e321084f8162a581ccaf83</originalsourceid><addsrcrecordid>eNp9kcGO0zAQhiMEYpeFCw-AfERIWew4TuILUim0i1RAKpSr5TiTxiixu7ZD1RuPwLtw5hV4CJ4EZ7ss7IWTRzPffGPpT5LHBJ8TjLPn3TiM5xkljN9JTgnmVRrb-d2pZjwtS56fJA-8_4wxrhij95OTrOSclTk-TX5sTAPOB2kabbYodICWYOygFfoQ3KjC6ADZFs3t7vDr67d341CDQ5-k0zJoa6bRtLOy-zidta02OhzQQv38jtagYBesi8V2Qmd9b_c-mkyr3XBrfea9VX-Ni_lyTV-iV9DDVWuvQ4fWHYxxy-oGzVzonA7aP0zutbL38Oj6PUs2i9cf5xfp6v3yzXy2SlVOSp4Wsq15y7Mmq3lDK5k3spB1wWgjgcqGcgwkz0AyxoFmBFd5W5Eik6wiSsm2omfJi6N3N9YDNApMcLIXO6cH6Q7CSi1uT4zuxNZ-EYwWlLIsCp5eC5y9HMEHMWivoO-lATt6QaqKlCymkkf02RFVznrvoL05Q7CY8hZT3uIq7wg_-fdjN-ifgCNAjsBe93D4j0pcbN5ujtLf526-Fg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1881757994</pqid></control><display><type>article</type><title>Understanding the Genomic Structure of Copy‐Number Variation of the Low‐Affinity Fcγ Receptor Region Allows Confirmation of the Association of FCGR3B Deletion with Rheumatoid Arthritis</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Rahbari, Raheleh ; Zuccherato, Luciana W ; Tischler, German ; Chihota, Belinda ; Ozturk, Hasret ; Saleem, Sara ; Tarazona‐Santos, Eduardo ; Machado, Lee R ; Hollox, Edward J</creator><creatorcontrib>Rahbari, Raheleh ; Zuccherato, Luciana W ; Tischler, German ; Chihota, Belinda ; Ozturk, Hasret ; Saleem, Sara ; Tarazona‐Santos, Eduardo ; Machado, Lee R ; Hollox, Edward J</creatorcontrib><description>ABSTRACT Fcγ receptors are a family of cell–surface receptors that are expressed by a host of different innate and adaptive immune cells, and mediate inflammatory responses by binding the Fc portion of immunoglobulin G. In humans, five low‐affinity receptors are encoded by the genes FCGR2A, FCGR2B, FCGR2C, FCGR3A, and FCGR3B, which are located in an 82.5‐kb segmental tandem duplication on chromosome 1q23.3, which shows extensive copy‐number variation (CNV). Deletions of FCGR3B have been suggested to increase the risk of inflammatory diseases such as systemic lupus erythematosus and rheumatoid arthritis (RA). In this study, we identify the deletion breakpoints of FCGR3B deletion alleles in the UK population and endogamous native American population, and show that some but not all alleles are likely to be identical‐by‐descent. We also localize a duplication breakpoint, confirming that the mechanism of CNV generation is nonallelic homologous recombination, and identify several alleles with gene conversion events using fosmid sequencing data. We use information on the structure of the deletion alleles to distinguish FCGR3B deletions from FCGR3A deletions in whole‐genome array comparative genomic hybridization (aCGH) data. Reanalysis of published aCGH data using this approach supports association of FCGR3B deletion with increased risk of RA in a large cohort of 1,982 cases and 3,271 controls (odds ratio 1.61, P = 2.9×10−3). In humans, low‐affinity Fc gamma receptors are arranged on an 82.5kb segmental duplication – paralog A and paralog B. There are alleles with gene conversion events upstream of the FCGR2C and FCGR2B genes. Deletions of FCGR3B occur by non‐allelic homologous recombination. In the British population, these deletions have been generated by at least three mutational events. In Native South Americans, this deletion have been generated by a single mutational event. Deletion of FCGR3B is associated with an increased risk of rheumatoid arthritis.</description><identifier>ISSN: 1059-7794</identifier><identifier>EISSN: 1098-1004</identifier><identifier>DOI: 10.1002/humu.23159</identifier><identifier>PMID: 27995740</identifier><language>eng</language><publisher>United States: John Wiley and Sons Inc</publisher><subject>Alleles ; Arthritis, Rheumatoid - genetics ; Arthritis, Rheumatoid - metabolism ; CNV ; Cohort Studies ; Comparative Genomic Hybridization - methods ; copy‐number variation ; deletion ; DNA Copy Number Variations ; FCGR3B ; Fcγ receptors ; Genetic Predisposition to Disease - genetics ; GPI-Linked Proteins - genetics ; GPI-Linked Proteins - metabolism ; Haplotypes ; Homologous Recombination ; Humans ; Polymorphism, Single Nucleotide ; Receptors, IgG - genetics ; Receptors, IgG - metabolism ; rheumatoid arthritis ; Risk Factors ; Sequence Deletion</subject><ispartof>Human mutation, 2017-04, Vol.38 (4), p.390-399</ispartof><rights>2016 WILEY PERIODICALS, INC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4179-6afb9f92d2b9d38a4da6ab653dae3ad390e142ea559e321084f8162a581ccaf83</citedby><cites>FETCH-LOGICAL-c4179-6afb9f92d2b9d38a4da6ab653dae3ad390e142ea559e321084f8162a581ccaf83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhumu.23159$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhumu.23159$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27995740$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rahbari, Raheleh</creatorcontrib><creatorcontrib>Zuccherato, Luciana W</creatorcontrib><creatorcontrib>Tischler, German</creatorcontrib><creatorcontrib>Chihota, Belinda</creatorcontrib><creatorcontrib>Ozturk, Hasret</creatorcontrib><creatorcontrib>Saleem, Sara</creatorcontrib><creatorcontrib>Tarazona‐Santos, Eduardo</creatorcontrib><creatorcontrib>Machado, Lee R</creatorcontrib><creatorcontrib>Hollox, Edward J</creatorcontrib><title>Understanding the Genomic Structure of Copy‐Number Variation of the Low‐Affinity Fcγ Receptor Region Allows Confirmation of the Association of FCGR3B Deletion with Rheumatoid Arthritis</title><title>Human mutation</title><addtitle>Hum Mutat</addtitle><description>ABSTRACT Fcγ receptors are a family of cell–surface receptors that are expressed by a host of different innate and adaptive immune cells, and mediate inflammatory responses by binding the Fc portion of immunoglobulin G. In humans, five low‐affinity receptors are encoded by the genes FCGR2A, FCGR2B, FCGR2C, FCGR3A, and FCGR3B, which are located in an 82.5‐kb segmental tandem duplication on chromosome 1q23.3, which shows extensive copy‐number variation (CNV). Deletions of FCGR3B have been suggested to increase the risk of inflammatory diseases such as systemic lupus erythematosus and rheumatoid arthritis (RA). In this study, we identify the deletion breakpoints of FCGR3B deletion alleles in the UK population and endogamous native American population, and show that some but not all alleles are likely to be identical‐by‐descent. We also localize a duplication breakpoint, confirming that the mechanism of CNV generation is nonallelic homologous recombination, and identify several alleles with gene conversion events using fosmid sequencing data. We use information on the structure of the deletion alleles to distinguish FCGR3B deletions from FCGR3A deletions in whole‐genome array comparative genomic hybridization (aCGH) data. Reanalysis of published aCGH data using this approach supports association of FCGR3B deletion with increased risk of RA in a large cohort of 1,982 cases and 3,271 controls (odds ratio 1.61, P = 2.9×10−3). In humans, low‐affinity Fc gamma receptors are arranged on an 82.5kb segmental duplication – paralog A and paralog B. There are alleles with gene conversion events upstream of the FCGR2C and FCGR2B genes. Deletions of FCGR3B occur by non‐allelic homologous recombination. In the British population, these deletions have been generated by at least three mutational events. In Native South Americans, this deletion have been generated by a single mutational event. Deletion of FCGR3B is associated with an increased risk of rheumatoid arthritis.</description><subject>Alleles</subject><subject>Arthritis, Rheumatoid - genetics</subject><subject>Arthritis, Rheumatoid - metabolism</subject><subject>CNV</subject><subject>Cohort Studies</subject><subject>Comparative Genomic Hybridization - methods</subject><subject>copy‐number variation</subject><subject>deletion</subject><subject>DNA Copy Number Variations</subject><subject>FCGR3B</subject><subject>Fcγ receptors</subject><subject>Genetic Predisposition to Disease - genetics</subject><subject>GPI-Linked Proteins - genetics</subject><subject>GPI-Linked Proteins - metabolism</subject><subject>Haplotypes</subject><subject>Homologous Recombination</subject><subject>Humans</subject><subject>Polymorphism, Single Nucleotide</subject><subject>Receptors, IgG - genetics</subject><subject>Receptors, IgG - metabolism</subject><subject>rheumatoid arthritis</subject><subject>Risk Factors</subject><subject>Sequence Deletion</subject><issn>1059-7794</issn><issn>1098-1004</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp9kcGO0zAQhiMEYpeFCw-AfERIWew4TuILUim0i1RAKpSr5TiTxiixu7ZD1RuPwLtw5hV4CJ4EZ7ss7IWTRzPffGPpT5LHBJ8TjLPn3TiM5xkljN9JTgnmVRrb-d2pZjwtS56fJA-8_4wxrhij95OTrOSclTk-TX5sTAPOB2kabbYodICWYOygFfoQ3KjC6ADZFs3t7vDr67d341CDQ5-k0zJoa6bRtLOy-zidta02OhzQQv38jtagYBesi8V2Qmd9b_c-mkyr3XBrfea9VX-Ni_lyTV-iV9DDVWuvQ4fWHYxxy-oGzVzonA7aP0zutbL38Oj6PUs2i9cf5xfp6v3yzXy2SlVOSp4Wsq15y7Mmq3lDK5k3spB1wWgjgcqGcgwkz0AyxoFmBFd5W5Eik6wiSsm2omfJi6N3N9YDNApMcLIXO6cH6Q7CSi1uT4zuxNZ-EYwWlLIsCp5eC5y9HMEHMWivoO-lATt6QaqKlCymkkf02RFVznrvoL05Q7CY8hZT3uIq7wg_-fdjN-ifgCNAjsBe93D4j0pcbN5ujtLf526-Fg</recordid><startdate>201704</startdate><enddate>201704</enddate><creator>Rahbari, Raheleh</creator><creator>Zuccherato, Luciana W</creator><creator>Tischler, German</creator><creator>Chihota, Belinda</creator><creator>Ozturk, Hasret</creator><creator>Saleem, Sara</creator><creator>Tarazona‐Santos, Eduardo</creator><creator>Machado, Lee R</creator><creator>Hollox, Edward J</creator><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</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>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope><scope>5PM</scope></search><sort><creationdate>201704</creationdate><title>Understanding the Genomic Structure of Copy‐Number Variation of the Low‐Affinity Fcγ Receptor Region Allows Confirmation of the Association of FCGR3B Deletion with Rheumatoid Arthritis</title><author>Rahbari, Raheleh ; Zuccherato, Luciana W ; Tischler, German ; Chihota, Belinda ; Ozturk, Hasret ; Saleem, Sara ; Tarazona‐Santos, Eduardo ; Machado, Lee R ; Hollox, Edward J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4179-6afb9f92d2b9d38a4da6ab653dae3ad390e142ea559e321084f8162a581ccaf83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Alleles</topic><topic>Arthritis, Rheumatoid - genetics</topic><topic>Arthritis, Rheumatoid - metabolism</topic><topic>CNV</topic><topic>Cohort Studies</topic><topic>Comparative Genomic Hybridization - methods</topic><topic>copy‐number variation</topic><topic>deletion</topic><topic>DNA Copy Number Variations</topic><topic>FCGR3B</topic><topic>Fcγ receptors</topic><topic>Genetic Predisposition to Disease - genetics</topic><topic>GPI-Linked Proteins - genetics</topic><topic>GPI-Linked Proteins - metabolism</topic><topic>Haplotypes</topic><topic>Homologous Recombination</topic><topic>Humans</topic><topic>Polymorphism, Single Nucleotide</topic><topic>Receptors, IgG - genetics</topic><topic>Receptors, IgG - metabolism</topic><topic>rheumatoid arthritis</topic><topic>Risk Factors</topic><topic>Sequence Deletion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rahbari, Raheleh</creatorcontrib><creatorcontrib>Zuccherato, Luciana W</creatorcontrib><creatorcontrib>Tischler, German</creatorcontrib><creatorcontrib>Chihota, Belinda</creatorcontrib><creatorcontrib>Ozturk, Hasret</creatorcontrib><creatorcontrib>Saleem, Sara</creatorcontrib><creatorcontrib>Tarazona‐Santos, Eduardo</creatorcontrib><creatorcontrib>Machado, Lee R</creatorcontrib><creatorcontrib>Hollox, Edward J</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Human mutation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rahbari, Raheleh</au><au>Zuccherato, Luciana W</au><au>Tischler, German</au><au>Chihota, Belinda</au><au>Ozturk, Hasret</au><au>Saleem, Sara</au><au>Tarazona‐Santos, Eduardo</au><au>Machado, Lee R</au><au>Hollox, Edward J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Understanding the Genomic Structure of Copy‐Number Variation of the Low‐Affinity Fcγ Receptor Region Allows Confirmation of the Association of FCGR3B Deletion with Rheumatoid Arthritis</atitle><jtitle>Human mutation</jtitle><addtitle>Hum Mutat</addtitle><date>2017-04</date><risdate>2017</risdate><volume>38</volume><issue>4</issue><spage>390</spage><epage>399</epage><pages>390-399</pages><issn>1059-7794</issn><eissn>1098-1004</eissn><abstract>ABSTRACT Fcγ receptors are a family of cell–surface receptors that are expressed by a host of different innate and adaptive immune cells, and mediate inflammatory responses by binding the Fc portion of immunoglobulin G. In humans, five low‐affinity receptors are encoded by the genes FCGR2A, FCGR2B, FCGR2C, FCGR3A, and FCGR3B, which are located in an 82.5‐kb segmental tandem duplication on chromosome 1q23.3, which shows extensive copy‐number variation (CNV). Deletions of FCGR3B have been suggested to increase the risk of inflammatory diseases such as systemic lupus erythematosus and rheumatoid arthritis (RA). In this study, we identify the deletion breakpoints of FCGR3B deletion alleles in the UK population and endogamous native American population, and show that some but not all alleles are likely to be identical‐by‐descent. We also localize a duplication breakpoint, confirming that the mechanism of CNV generation is nonallelic homologous recombination, and identify several alleles with gene conversion events using fosmid sequencing data. We use information on the structure of the deletion alleles to distinguish FCGR3B deletions from FCGR3A deletions in whole‐genome array comparative genomic hybridization (aCGH) data. Reanalysis of published aCGH data using this approach supports association of FCGR3B deletion with increased risk of RA in a large cohort of 1,982 cases and 3,271 controls (odds ratio 1.61, P = 2.9×10−3). In humans, low‐affinity Fc gamma receptors are arranged on an 82.5kb segmental duplication – paralog A and paralog B. There are alleles with gene conversion events upstream of the FCGR2C and FCGR2B genes. Deletions of FCGR3B occur by non‐allelic homologous recombination. In the British population, these deletions have been generated by at least three mutational events. In Native South Americans, this deletion have been generated by a single mutational event. Deletion of FCGR3B is associated with an increased risk of rheumatoid arthritis.</abstract><cop>United States</cop><pub>John Wiley and Sons Inc</pub><pmid>27995740</pmid><doi>10.1002/humu.23159</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1059-7794
ispartof Human mutation, 2017-04, Vol.38 (4), p.390-399
issn 1059-7794
1098-1004
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5363352
source MEDLINE; Wiley Online Library All Journals
subjects Alleles
Arthritis, Rheumatoid - genetics
Arthritis, Rheumatoid - metabolism
CNV
Cohort Studies
Comparative Genomic Hybridization - methods
copy‐number variation
deletion
DNA Copy Number Variations
FCGR3B
Fcγ receptors
Genetic Predisposition to Disease - genetics
GPI-Linked Proteins - genetics
GPI-Linked Proteins - metabolism
Haplotypes
Homologous Recombination
Humans
Polymorphism, Single Nucleotide
Receptors, IgG - genetics
Receptors, IgG - metabolism
rheumatoid arthritis
Risk Factors
Sequence Deletion
title Understanding the Genomic Structure of Copy‐Number Variation of the Low‐Affinity Fcγ Receptor Region Allows Confirmation of the Association of FCGR3B Deletion with Rheumatoid Arthritis
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T23%3A47%3A54IST&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=Understanding%20the%20Genomic%20Structure%20of%20Copy%E2%80%90Number%20Variation%20of%20the%20Low%E2%80%90Affinity%20Fc%CE%B3%20Receptor%20Region%20Allows%20Confirmation%20of%20the%20Association%20of%20FCGR3B%20Deletion%20with%20Rheumatoid%20Arthritis&rft.jtitle=Human%20mutation&rft.au=Rahbari,%20Raheleh&rft.date=2017-04&rft.volume=38&rft.issue=4&rft.spage=390&rft.epage=399&rft.pages=390-399&rft.issn=1059-7794&rft.eissn=1098-1004&rft_id=info:doi/10.1002/humu.23159&rft_dat=%3Cproquest_pubme%3E1881757994%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1881757994&rft_id=info:pmid/27995740&rfr_iscdi=true