1 1195 99 CORRUPTED COORDINATION OF EPIGENETIC MODIFICATIONS LEADS TO DIVERGING CHROMATIN STATES AND TRANSCRIPTIONAL HETEROGENEITY IN CLL. CANCER EVOLUTION IS FUELED BY EPIGENETIC AS WELL AS GENETIC DIVERSITY. IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), INTRA-TUMORAL DNA METHYLATION (DNAME) HETEROGENEITY EMPOWERS EVOLUTION. HERE, TO COMPREHENSIVELY STUDY THE EPIGENETIC DIMENSION OF CANCER EVOLUTION, WE INTEGRATE DNAME ANALYSIS WITH HISTONE MODIFICATION MAPPING AND SINGLE CELL ANALYSES OF RNA EXPRESSION AND DNAME IN 22 PRIMARY CLL AND 13 HEALTHY DONOR B LYMPHOCYTE SAMPLES. OUR DATA REVEAL CORRUPTED COHERENCE ACROSS DIFFERENT LAYERS OF THE CLL EPIGENOME. THIS MANIFESTS IN DECREASED MUTUAL INFORMATION ACROSS EPIGENETIC MODIFICATIONS AND GENE EXPRESSION ATTRIBUTED TO CELL-TO-CELL HETEROGENEITY. DISRUPTED EPIGENETIC-TRANSCRIPTIONAL COORDINATION IN CLL IS ALSO REFLECTED IN THE DYSREGULATION OF THE TRANSCRIPTIONAL OUTPUT AS A FUNCTION OF THE COMBINATORIAL CHROMATIN STATES, INCLUDING INCOMPLETE POLYCOMB-MEDIATED GENE SILENCING. NOTABLY, WE OBSERVE UNEXPECTED CO-MAPPING OF TYPICALLY MUTUALLY EXCLUSIVE ACTIVATING AND REPRESSING HISTONE MODIFICATIONS, SUGGESTIVE OF INTRA-TUMORAL EPIGENETIC DIVERSITY. THUS, CLL EPIGENETIC DIVERSIFICATION LEADS TO DECREASED COORDINATION ACROSS LAYERS OF EPIGENETIC INFORMATION, LIKELY REFLECTING AN ADMIXTURE OF CELLS WITH DIVERGING CELLULAR IDENTITIES. 2019 2 2987 19 GENETIC EPIDEMIOLOGY IN KIDNEY DISEASE. FAMILIAL AGGREGATION OF CHRONIC KIDNEY DISEASE AND ITS COMPONENT PHENOTYPES-REDUCED GLOMERULAR FILTRATION RATE, PROTEINURIA AND RENAL HISTOLOGIC CHANGES-HAS LONG BEEN RECOGNIZED. RATES OF SEVERE KIDNEY DISEASE ARE ALSO KNOWN TO DIFFER MARKEDLY BETWEEN POPULATIONS BASED ON ANCESTRY. THESE EPIDEMIOLOGIC OBSERVATIONS SUPPORT THE EXISTENCE OF NEPHROPATHY SUSCEPTIBILITY GENES. SEVERAL MOLECULAR GENETIC TECHNOLOGIES ARE NOW AVAILABLE TO IDENTIFY CAUSATIVE LOCI. THE PRESENT ARTICLE SUMMARIZES AVAILABLE STRATEGIES USEFUL FOR IDENTIFYING NEPHROPATHY SUSCEPTIBILITY GENES, INCLUDING CANDIDATE GENE ASSOCIATION, FAMILY-BASED LINKAGE, GENOME-WIDE ASSOCIATION AND ADMIXTURE MAPPING (MAPPING BY ADMIXTURE LINKAGE DISEQUILIBRIUM) APPROACHES. EXAMPLES OF LOCI DETECTED USING THESE TECHNIQUES ARE PROVIDED. EPIGENETIC STUDIES AND FUTURE DIRECTIONS ARE ALSO DISCUSSED. THE IDENTIFICATION OF NEPHROPATHY SUSCEPTIBILITY GENES, COUPLED WITH MODIFIABLE ENVIRONMENTAL TRIGGERS IMPACTING THEIR FUNCTION, IS LIKELY TO IMPROVE RISK PREDICTION AND TRANSFORM CARE. DEVELOPMENT OF NOVEL THERAPIES TO PREVENT PROGRESSION OF KIDNEY DISEASE WILL FOLLOW. 2017 3 527 20 ASTHMA AND THE MISSING HERITABILITY PROBLEM: NECESSITY FOR MULTIOMICS APPROACHES IN DETERMINING ACCURATE RISK PROFILES. ASTHMA IS RANKED AMONG THE MOST COMMON CHRONIC CONDITIONS AND HAS BECOME A SIGNIFICANT PUBLIC HEALTH ISSUE DUE TO THE RECENT AND RAPID INCREASE IN ITS PREVALENCE. INVESTIGATIONS INTO THE UNDERLYING GENETIC FACTORS PREDICT A HERITABLE COMPONENT FOR ITS INCIDENCE, ESTIMATED BETWEEN 35% AND 90% OF CAUSATION. DESPITE THE APPLICATION OF LARGE-SCALE GENOME-WIDE ASSOCIATION STUDIES (GWAS) AND ADMIXTURE MAPPING APPROACHES, THE PROPORTION OF VARIANTS IDENTIFIED ACCOUNTS FOR LESS THAN 15% OF THE OBSERVED HERITABILITY OF THE DISEASE. THE DISCREPANCY BETWEEN THE PREDICTED HERITABLE COMPONENT OF DISEASE AND THE PROPORTION OF HERITABILITY MAPPED TO THE CURRENTLY IDENTIFIED SUSCEPTIBILITY LOCI HAS BEEN TERMED THE 'MISSING HERITABILITY PROBLEM.' HERE, WE EXAMINE RECENT STUDIES INVOLVING BOTH THE ANALYSIS OF GENETICALLY ENCODED FEATURES THAT CONTRIBUTE TO ASTHMA AND ALSO THE ROLE OF NON-ENCODED HERITABLE CHARACTERISTICS, INCLUDING EPIGENETIC, ENVIRONMENTAL, AND DEVELOPMENTAL ASPECTS OF DISEASE. THE IMPORTANCE OF VERTICAL MATERNAL MICROBIOME TRANSFER AND THE INFLUENCE OF MATERNAL IMMUNE FACTORS ON FETAL CONDITIONING IN THE INHERITANCE OF DISEASE ARE ALSO DISCUSSED. IN ORDER TO HIGHLIGHT THE BROAD ARRAY OF BIOLOGICAL INPUTS THAT CONTRIBUTE TO THE SUM OF HERITABLE RISK FACTORS ASSOCIATED WITH ALLERGIC DISEASE INCIDENCE THAT, TOGETHER, CONTRIBUTE TO THE INDUCTION OF A PRO-ATOPIC STATE. CURRENTLY, THERE IS A NEED TO DEVELOP IN-DEPTH MODELS OF ASTHMA RISK FACTORS TO OVERCOME THE LIMITATIONS ENCOUNTERED IN THE INTERPRETATION OF GWAS RESULTS IN ISOLATION, WHICH HAVE RESULTED IN THE MISSING HERITABILITY PROBLEM. HENCE, MULTIOMICS ANALYSES NEED TO BE ESTABLISHED CONSIDERING GENETIC, EPIGENETIC, AND FUNCTIONAL DATA TO CREATE A TRUE SYSTEMS BIOLOGY-BASED APPROACH FOR ANALYZING THE REGULATORY PATHWAYS THAT UNDERLIE THE INHERITANCE OF ASTHMA AND TO DEVELOP ACCURATE RISK PROFILES FOR DISEASE. 2022 4 1454 30 DISCOVERY OF CANDIDATE DNA METHYLATION CANCER DRIVER GENES. EPIGENETIC ALTERATIONS, SUCH AS PROMOTER HYPERMETHYLATION, MAY DRIVE CANCER THROUGH TUMOR SUPPRESSOR GENE INACTIVATION. HOWEVER, WE HAVE LIMITED ABILITY TO DIFFERENTIATE DRIVER DNA METHYLATION (DNAME) CHANGES FROM PASSENGER EVENTS. WE DEVELOPED DNAME DRIVER INFERENCE-METHSIG-ACCOUNTING FOR THE VARYING STOCHASTIC HYPERMETHYLATION RATE ACROSS THE GENOME AND BETWEEN SAMPLES. WE APPLIED METHSIG TO BISULFITE SEQUENCING DATA OF CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), MULTIPLE MYELOMA, DUCTAL CARCINOMA IN SITU, GLIOBLASTOMA, AND TO METHYLATION ARRAY DATA ACROSS 18 TUMOR TYPES IN TCGA. METHSIG RESULTED IN WELL-CALIBRATED QUANTILE-QUANTILE PLOTS AND REPRODUCIBLE INFERENCE OF LIKELY DNAME DRIVERS WITH INCREASED SENSITIVITY/SPECIFICITY COMPARED WITH BENCHMARKED METHODS. CRISPR/CAS9 KNOCKOUT OF SELECTED CANDIDATE CLL DNAME DRIVERS PROVIDED A FITNESS ADVANTAGE WITH AND WITHOUT THERAPEUTIC INTERVENTION. NOTABLY, DNAME DRIVER RISK SCORE WAS CLOSELY ASSOCIATED WITH ADVERSE OUTCOME IN INDEPENDENT CLL COHORTS. COLLECTIVELY, METHSIG REPRESENTS A NOVEL INFERENCE FRAMEWORK FOR DNAME DRIVER DISCOVERY TO CHART THE ROLE OF ABERRANT DNAME IN CANCER. SIGNIFICANCE: METHSIG PROVIDES A NOVEL STATISTICAL FRAMEWORK FOR THE ANALYSIS OF DNA METHYLATION CHANGES IN CANCER, TO SPECIFICALLY IDENTIFY CANDIDATE DNA METHYLATION DRIVER GENES OF CANCER PROGRESSION AND RELAPSE, EMPOWERING THE DISCOVERY OF EPIGENETIC MECHANISMS THAT ENHANCE CANCER CELL FITNESS.THIS ARTICLE IS HIGHLIGHTED IN THE IN THIS ISSUE FEATURE, P. 2113. 2021 5 2106 43 EPIGENETIC EVOLUTION AND LINEAGE HISTORIES OF CHRONIC LYMPHOCYTIC LEUKAEMIA. GENETIC AND EPIGENETIC INTRA-TUMORAL HETEROGENEITY COOPERATE TO SHAPE THE EVOLUTIONARY COURSE OF CANCER(1). CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL) IS A HIGHLY INFORMATIVE MODEL FOR CANCER EVOLUTION AS IT UNDERGOES SUBSTANTIAL GENETIC DIVERSIFICATION AND EVOLUTION AFTER THERAPY(2,3). THE CLL EPIGENOME IS ALSO AN IMPORTANT DISEASE-DEFINING FEATURE(4,5), AND GROWING POPULATIONS OF CELLS IN CLL DIVERSIFY BY STOCHASTIC CHANGES IN DNA METHYLATION KNOWN AS EPIMUTATIONS(6). HOWEVER, PREVIOUS STUDIES USING BULK SEQUENCING METHODS TO ANALYSE THE PATTERNS OF DNA METHYLATION WERE UNABLE TO DETERMINE WHETHER EPIMUTATIONS AFFECT CLL POPULATIONS HOMOGENEOUSLY. HERE, TO MEASURE THE EPIMUTATION RATE AT SINGLE-CELL RESOLUTION, WE APPLIED MULTIPLEXED SINGLE-CELL REDUCED-REPRESENTATION BISULFITE SEQUENCING TO B CELLS FROM HEALTHY DONORS AND PATIENTS WITH CLL. WE OBSERVED THAT THE COMMON CLONAL ORIGIN OF CLL RESULTS IN A CONSISTENTLY INCREASED EPIMUTATION RATE, WITH LOW VARIABILITY IN THE CELL-TO-CELL EPIMUTATION RATE. BY CONTRAST, VARIABLE EPIMUTATION RATES ACROSS HEALTHY B CELLS REFLECT DIVERSE EVOLUTIONARY AGES ACROSS THE TRAJECTORY OF B CELL DIFFERENTIATION, CONSISTENT WITH EPIMUTATIONS SERVING AS A MOLECULAR CLOCK. HERITABLE EPIMUTATION INFORMATION ALLOWED US TO RECONSTRUCT LINEAGES AT HIGH-RESOLUTION WITH SINGLE-CELL DATA, AND TO APPLY THIS DIRECTLY TO PATIENT SAMPLES. THE CLL LINEAGE TREE SHAPE REVEALED EARLIER BRANCHING AND LONGER BRANCH LENGTHS THAN IN NORMAL B CELLS, REFLECTING RAPID DRIFT AFTER THE INITIAL MALIGNANT TRANSFORMATION AND A GREATER PROLIFERATIVE HISTORY. INTEGRATION OF SINGLE-CELL BISULFITE SEQUENCING ANALYSIS WITH SINGLE-CELL TRANSCRIPTOMES AND GENOTYPING CONFIRMED THAT GENETIC SUBCLONES MAPPED TO DISTINCT CLADES, AS INFERRED SOLELY ON THE BASIS OF EPIMUTATION INFORMATION. FINALLY, TO EXAMINE POTENTIAL LINEAGE BIASES DURING THERAPY, WE PROFILED SERIAL SAMPLES DURING IBRUTINIB-ASSOCIATED LYMPHOCYTOSIS, AND IDENTIFIED CLADES OF CELLS THAT WERE PREFERENTIALLY EXPELLED FROM THE LYMPH NODE AFTER TREATMENT, MARKED BY DISTINCT TRANSCRIPTIONAL PROFILES. THE SINGLE-CELL INTEGRATION OF GENETIC, EPIGENETIC AND TRANSCRIPTIONAL INFORMATION THUS CHARTS THE LINEAGE HISTORY OF CLL AND ITS EVOLUTION WITH THERAPY. 2019 6 1290 22 DECODING THE GENETIC AND EPIGENETIC BASIS OF ASTHMA. ASTHMA IS A COMPLEX AND HETEROGENEOUS CHRONIC INFLAMMATORY DISEASE OF THE AIRWAYS. ALONGSIDE ENVIRONMENTAL FACTORS, ASTHMA SUSCEPTIBILITY IS STRONGLY INFLUENCED BY GENETICS. GIVEN ITS HIGH PREVALENCE AND OUR INCOMPLETE UNDERSTANDING OF THE MECHANISMS UNDERLYING DISEASE SUSCEPTIBILITY, ASTHMA IS FREQUENTLY STUDIED IN GENOME-WIDE ASSOCIATION STUDIES (GWAS), WHICH HAVE IDENTIFIED THOUSANDS OF GENETIC VARIANTS ASSOCIATED WITH ASTHMA DEVELOPMENT. VIRTUALLY ALL THESE GENETIC VARIANTS RESIDE IN NON-CODING GENOMIC REGIONS, WHICH HAS OBSCURED THE FUNCTIONAL IMPACT OF ASTHMA-ASSOCIATED VARIANTS AND THEIR TRANSLATION INTO DISEASE-RELEVANT MECHANISMS. RECENT ADVANCES IN GENOMICS TECHNOLOGY AND EPIGENETICS NOW OFFER METHODS TO LINK GENETIC VARIANTS TO GENE REGULATORY ELEMENTS EMBEDDED WITHIN NON-CODING REGIONS, WHICH HAVE STARTED TO UNRAVEL THE MOLECULAR MECHANISMS UNDERLYING THE COMPLEX (EPI)GENETICS OF ASTHMA. HERE, WE PROVIDE AN INTEGRATED OVERVIEW OF (EPI)GENETIC VARIANTS ASSOCIATED WITH ASTHMA, FOCUSING ON EFFORTS TO LINK THESE DISEASE ASSOCIATIONS TO BIOLOGICAL INSIGHT INTO ASTHMA PATHOPHYSIOLOGY USING STATE-OF-THE-ART GENOMICS METHODOLOGY. FINALLY, WE PROVIDE A PERSPECTIVE AS TO HOW DECODING THE GENETIC AND EPIGENETIC BASIS OF ASTHMA HAS THE POTENTIAL TO TRANSFORM CLINICAL MANAGEMENT OF ASTHMA AND TO PREDICT THE RISK OF ASTHMA DEVELOPMENT. 2023 7 6160 19 THE GENETICS AND PATHOGENESIS OF CAKUT. CONGENITAL ANOMALIES OF THE KIDNEY AND URINARY TRACT (CAKUT) COMPRISE A LARGE VARIETY OF MALFORMATIONS THAT ARISE FROM DEFECTIVE KIDNEY OR URINARY TRACT DEVELOPMENT AND FREQUENTLY LEAD TO KIDNEY FAILURE. THE CLINICAL SPECTRUM RANGES FROM SEVERE MALFORMATIONS, SUCH AS RENAL AGENESIS, TO POTENTIALLY MILDER MANIFESTATIONS, SUCH AS VESICOURETERAL REFLUX. ALMOST 50% OF CASES OF CHRONIC KIDNEY DISEASE THAT MANIFEST WITHIN THE FIRST THREE DECADES OF LIFE ARE CAUSED BY CAKUT. EVIDENCE SUGGESTS THAT A LARGE NUMBER OF CAKUT ARE GENETIC IN ORIGIN. TO DATE, MUTATIONS IN ~54 GENES HAVE BEEN IDENTIFIED AS MONOGENIC CAUSES OF CAKUT, CONTRIBUTING TO 12-20% OF THE AETIOLOGY OF THE DISEASE. PATHOGENIC COPY NUMBER VARIANTS HAVE ALSO BEEN SHOWN TO CAUSE CAKUT AND CAN BE DETECTED IN 4-11% OF PATIENTS. FURTHERMORE, ENVIRONMENTAL AND EPIGENETIC FACTORS CAN INCREASE THE RISK OF CAKUT. THE DISCOVERY OF NOVEL CAKUT-CAUSING GENES IS CHALLENGING OWING TO VARIABLE EXPRESSIVITY, INCOMPLETE PENETRANCE AND VARIABLE GENOTYPE-PHENOTYPE CORRELATION. HOWEVER, SUCH A DISCOVERY COULD ULTIMATELY LEAD TO IMPROVEMENTS IN THE ACCURATE MOLECULAR GENETIC DIAGNOSIS, ASSESSMENT OF PROGNOSIS AND MULTIDISCIPLINARY CLINICAL MANAGEMENT OF PATIENTS WITH CAKUT, POTENTIALLY INCLUDING PERSONALIZED THERAPEUTIC APPROACHES. 2023 8 5371 19 RECENT ADVANCES IN UNDERSTANDING THE GENETIC BASIS OF SYSTEMIC LUPUS ERYTHEMATOSUS. SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IS A POLYGENIC CHRONIC AUTOIMMUNE DISEASE LEADING TO MULTIPLE ORGAN DAMAGE. A LARGE HERITABILITY OF UP TO 66% IS ESTIMATED IN SLE, WITH ROUGHLY 180 REPORTED SUSCEPTIBILITY LOCI THAT HAVE BEEN IDENTIFIED MOSTLY BY GENOME-WIDE ASSOCIATION STUDIES (GWASS) AND ACCOUNT FOR APPROXIMATELY 30% OF GENETIC HERITABILITY. A VAST MAJORITY OF RISK VARIANTS RESIDE IN NON-CODING REGIONS, WHICH MAKES IT QUITE CHALLENGING TO INTERPRET THEIR FUNCTIONAL IMPLICATIONS IN THE SLE-AFFECTED IMMUNE SYSTEM, SUGGESTING THE IMPORTANCE OF UNDERSTANDING CELL TYPE-SPECIFIC EPIGENETIC REGULATION AROUND SLE GWAS VARIANTS. THE LATEST GENETIC STUDIES HAVE BEEN HIGHLY FRUITFUL AS SEVERAL DOZENS OF SLE LOCI WERE NEWLY DISCOVERED IN THE LAST FEW YEARS AND MANY LOCI HAVE COME TO BE UNDERSTOOD IN SYSTEMIC APPROACHES INTEGRATING GWAS SIGNALS WITH OTHER BIOLOGICAL RESOURCES. IN THIS REVIEW, WE SUMMARIZE SLE-ASSOCIATED GENETIC VARIANTS IN BOTH THE MAJOR HISTOCOMPATIBILITY COMPLEX (MHC) AND NON-MHC LOCI, EXAMINING POLYGENETIC RISK SCORES FOR SLE AND THEIR ASSOCIATIONS WITH CLINICAL FEATURES. FINALLY, VARIANT-DRIVEN PATHOGENETIC FUNCTIONS UNDERLYING GENETIC ASSOCIATIONS ARE DESCRIBED, COUPLED WITH DISCUSSION ABOUT CHALLENGES AND FUTURE DIRECTIONS IN GENETIC STUDIES ON SLE. 2022 9 1055 16 CLINICAL INTEGRATION OF GENOME DIAGNOSTICS FOR CONGENITAL ANOMALIES OF THE KIDNEY AND URINARY TRACT. REVOLUTIONS IN GENETICS, EPIGENETICS, AND BIOINFORMATICS ARE CURRENTLY CHANGING THE OUTLINE OF DIAGNOSTICS AND CLINICAL MEDICINE. FROM A NEPHROLOGIST'S PERSPECTIVE, INDIVIDUALS WITH CONGENITAL ANOMALIES OF THE KIDNEY AND URINARY TRACT (CAKUT) ARE AN IMPORTANT PATIENT CATEGORY: NOT ONLY IS CAKUT THE PREDOMINANT CAUSE OF KIDNEY FAILURE IN CHILDREN AND YOUNG ADULTS, BUT THE STRONG PHENOTYPIC AND GENOTYPIC HETEROGENEITY OF KIDNEY AND URINARY TRACT MALFORMATIONS HAS HAMPERED STANDARDIZATION OF CLINICAL DECISION MAKING UNTIL NOW. HOWEVER, PATIENTS WITH CAKUT MAY BENEFIT FROM PRECISION MEDICINE, INCLUDING AN INTEGRATED DIAGNOSTICS TRAJECTORY, GENETIC COUNSELING, AND PERSONALIZED MANAGEMENT TO IMPROVE CLINICAL OUTCOMES OF DEVELOPMENTAL KIDNEY AND URINARY TRACT DEFECTS. IN THIS REVIEW, WE DISCUSS THE PRESENT UNDERSTANDING OF THE MOLECULAR ETIOLOGY OF CAKUT AND THE CURRENTLY AVAILABLE GENOME DIAGNOSTIC MODALITIES IN THE CLINICAL CARE OF PATIENTS WITH CAKUT. FINALLY, WE DISCUSS HOW CLINICAL INTEGRATION OF FINDINGS FROM LARGE-SCALE GENETIC, EPIGENETIC, AND GENE-ENVIRONMENT INTERACTION STUDIES MAY IMPROVE THE PROGNOSIS OF ALL INDIVIDUALS WITH CAKUT. 2020 10 4517 28 MULTI-OMICS FACTOR ANALYSIS-A FRAMEWORK FOR UNSUPERVISED INTEGRATION OF MULTI-OMICS DATA SETS. MULTI-OMICS STUDIES PROMISE THE IMPROVED CHARACTERIZATION OF BIOLOGICAL PROCESSES ACROSS MOLECULAR LAYERS. HOWEVER, METHODS FOR THE UNSUPERVISED INTEGRATION OF THE RESULTING HETEROGENEOUS DATA SETS ARE LACKING. WE PRESENT MULTI-OMICS FACTOR ANALYSIS (MOFA), A COMPUTATIONAL METHOD FOR DISCOVERING THE PRINCIPAL SOURCES OF VARIATION IN MULTI-OMICS DATA SETS. MOFA INFERS A SET OF (HIDDEN) FACTORS THAT CAPTURE BIOLOGICAL AND TECHNICAL SOURCES OF VARIABILITY. IT DISENTANGLES AXES OF HETEROGENEITY THAT ARE SHARED ACROSS MULTIPLE MODALITIES AND THOSE SPECIFIC TO INDIVIDUAL DATA MODALITIES. THE LEARNT FACTORS ENABLE A VARIETY OF DOWNSTREAM ANALYSES, INCLUDING IDENTIFICATION OF SAMPLE SUBGROUPS, DATA IMPUTATION AND THE DETECTION OF OUTLIER SAMPLES. WE APPLIED MOFA TO A COHORT OF 200 PATIENT SAMPLES OF CHRONIC LYMPHOCYTIC LEUKAEMIA, PROFILED FOR SOMATIC MUTATIONS, RNA EXPRESSION, DNA METHYLATION AND EX VIVO DRUG RESPONSES. MOFA IDENTIFIED MAJOR DIMENSIONS OF DISEASE HETEROGENEITY, INCLUDING IMMUNOGLOBULIN HEAVY-CHAIN VARIABLE REGION STATUS, TRISOMY OF CHROMOSOME 12 AND PREVIOUSLY UNDERAPPRECIATED DRIVERS, SUCH AS RESPONSE TO OXIDATIVE STRESS. IN A SECOND APPLICATION, WE USED MOFA TO ANALYSE SINGLE-CELL MULTI-OMICS DATA, IDENTIFYING COORDINATED TRANSCRIPTIONAL AND EPIGENETIC CHANGES ALONG CELL DIFFERENTIATION. 2018 11 2955 22 GENETIC AND EPIGENETIC FACTORS INFLUENCING CHRONIC KIDNEY DISEASE. CHRONIC KIDNEY DISEASE (CKD) HAS BECOME A SERIOUS PUBLIC HEALTH PROBLEM BECAUSE OF ITS ASSOCIATED MORBIDITY, PREMATURE MORTALITY, AND ATTENDANT HEALTHCARE COSTS. THE RISING NUMBER OF PERSONS WITH CKD IS LINKED WITH THE AGING POPULATION STRUCTURE AND AN INCREASED PREVALENCE OF DIABETES, HYPERTENSION, AND OBESITY. THERE IS AN INHERITED RISK ASSOCIATED WITH DEVELOPING CKD, AS EVIDENCED BY FAMILIAL CLUSTERING AND DIFFERING PREVALENCE RATES ACROSS ETHNIC GROUPS. PREVIOUS STUDIES TO DETERMINE THE INHERITED RISK FACTORS FOR CKD RARELY IDENTIFIED GENETIC VARIANTS THAT WERE ROBUSTLY REPLICATED. HOWEVER, IMPROVEMENTS IN GENOTYPING TECHNOLOGIES AND ANALYTIC METHODS ARE NOW HELPING TO IDENTIFY PROMISING GENETIC LOCI AIDED BY INTERNATIONAL COLLABORATION AND MULTICONSORTIA EFFORTS. MORE RECENTLY, EPIGENETIC MODIFICATIONS HAVE BEEN PROPOSED TO PLAY A ROLE IN BOTH THE INHERITED SUSCEPTIBILITY TO CKD AND, IMPORTANTLY, TO EXPLAIN HOW THE ENVIRONMENT DYNAMICALLY INTERACTS WITH THE GENOME TO ALTER AN INDIVIDUAL'S DISEASE RISK. GENOME-WIDE, EPIGENOME-WIDE, AND WHOLE TRANSCRIPTOME STUDIES HAVE BEEN PERFORMED, AND OPTIMAL APPROACHES FOR INTEGRATIVE ANALYSIS ARE BEING DEVELOPED. THIS REVIEW SUMMARIZES RECENT RESEARCH AND THE CURRENT STATUS OF GENETIC AND EPIGENETIC RISK FACTORS INFLUENCING CKD USING POPULATION-BASED INFORMATION. 2014 12 2618 18 EPIGENOME-MODIFYING TOOLS IN ASTHMA. ASTHMA IS A CHRONIC DISEASE WHICH CAUSES RECURRENT BREATHLESSNESS AFFECTING 300 MILLION PEOPLE WORLDWIDE OF WHOM 250,000 DIE ANNUALLY. THE EPIGENOME IS A SET OF HERITABLE MODIFICATIONS AND TAGS THAT AFFECT THE GENOME WITHOUT CHANGING THE INTRINSIC DNA SEQUENCE. THESE MARKS INCLUDE DNA METHYLATION, MODIFICATIONS TO HISTONE PROTEINS AROUND WHICH DNA IS WRAPPED AND EXPRESSION OF NONCODING RNA. ALTERATIONS IN ALL OF THESE PROCESSES HAVE BEEN REPORTED IN PATIENTS WITH ASTHMA. IN SOME CASES THESE DIFFERENCES ARE LINKED TO DISEASE SEVERITY AND SUSCEPTIBILITY AND MAY ACCOUNT FOR THE LIMITED VALUE OF GENETIC STUDIES IN ASTHMA. ANIMAL MODELS OF ASTHMA SUGGEST THAT EPIGENETIC MODIFICATIONS AND PROCESSES ARE LINKED TO ASTHMA AND MAY BE TRACTABLE TARGETS FOR THERAPEUTIC INTERVENTION. 2015 13 3007 22 GENETIC, IMMUNOLOGIC, AND ENVIRONMENTAL BASIS OF SARCOIDOSIS. SARCOIDOSIS IS A MULTISYSTEM DISEASE WITH TREMENDOUS HETEROGENEITY IN DISEASE MANIFESTATIONS, SEVERITY, AND CLINICAL COURSE THAT VARIES AMONG DIFFERENT ETHNIC AND RACIAL GROUPS. TO BETTER UNDERSTAND THIS DISEASE AND TO IMPROVE THE OUTCOMES OF PATIENTS, A NATIONAL HEART, LUNG, AND BLOOD INSTITUTE WORKSHOP WAS CONVENED TO ASSESS THE CURRENT STATE OF KNOWLEDGE, GAPS, AND RESEARCH NEEDS ACROSS THE CLINICAL, GENETIC, ENVIRONMENTAL, AND IMMUNOLOGIC ARENAS. WE ALSO EXPLORED TO WHAT EXTENT THE INTERPLAY OF THE GENETIC, ENVIRONMENTAL, AND IMMUNOLOGIC FACTORS COULD EXPLAIN THE DIFFERENT PHENOTYPES AND OUTCOMES OF PATIENTS WITH SARCOIDOSIS, INCLUDING THE CHRONIC PHENOTYPES THAT HAVE THE GREATEST HEALTHCARE BURDEN. THE POTENTIAL USE OF CURRENT GENETIC, EPIGENETIC, AND IMMUNOLOGIC TOOLS ALONG WITH STUDY APPROACHES THAT INTEGRATE ENVIRONMENTAL EXPOSURES AND PRECISE CLINICAL PHENOTYPING WERE ALSO EXPLORED. FINALLY, WE MADE EXPERT PANEL-BASED CONSENSUS RECOMMENDATIONS FOR RESEARCH APPROACHES AND PRIORITIES TO IMPROVE OUR UNDERSTANDING OF THE EFFECT OF THESE FACTORS ON THE HEALTH OUTCOMES IN SARCOIDOSIS. 2017 14 3768 28 INTEGRATIVE EPIGENOMICS IN CHRONIC LYMPHOCYTIC LEUKAEMIA: BIOLOGICAL INSIGHTS AND CLINICAL APPLICATIONS. CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL) IS NOT ONLY CHARACTERISED BY DRIVER GENETIC ALTERATIONS BUT BY EXTENSIVE EPIGENETIC CHANGES. OVER THE LAST DECADE, EPIGENOMIC STUDIES HAVE DESCRIBED THE DNA METHYLOME, CHROMATIN ACCESSIBILITY, HISTONE MODIFICATIONS AND THE THREE-DIMENSIONAL (3D) GENOME ARCHITECTURE OF CLL. BEYOND ITS REGULATORY ROLE, THE DNA METHYLOME CONTAINS IMPRINTS OF THE CELLULAR ORIGIN AND PROLIFERATIVE HISTORY OF CLL CELLS. THESE TWO ASPECTS ARE STRONG INDEPENDENT PROGNOSTIC FACTORS. INTEGRATIVE ANALYSES OF CHROMATIN MARKS HAVE UNCOVERED NOVEL REGULATORY ELEMENTS AND ALTERED TRANSCRIPTION FACTOR NETWORKS AS NON-GENETIC MEANS MEDIATING GENE DEREGULATION IN CLL. ADDITIONALLY, CLL CELLS DISPLAY A DISEASE-SPECIFIC PATTERN OF 3D GENOME INTERACTIONS. FROM THE TECHNOLOGICAL PERSPECTIVE, WE ARE CURRENTLY WITNESSING A TRANSITION FROM BULK OMICS TO SINGLE-CELL ANALYSES. THIS REVIEW AIMS AT SUMMARISING THE MAJOR FINDINGS FROM THE EPIGENOMICS FIELD AS WELL AS PROVIDING A PROSPECT OF THE PRESENT AND FUTURE OF SINGLE-CELL ANALYSES IN CLL. 2023 15 6843 14 [MEDICAL APPLICATIONS OF GENOME DISCOVERY]. THE DISCOVERY OF THE COMPLETE BASE SEQUENCE OF HUMAN GENOME UNVEILS SEVERAL PERSPECTIVES TO UNDERSTAND HUMAN DISEASES AND DEVELOP NEW THERAPIES. HUMAN GENOME CONTAINS APPROXIMATELY 39,000 GENES OF WHICH 26,000 CODE SPECIFIC PROTEINS THAT HAVE BEEN IDENTIFIED. THERE ARE APPROXIMATELY 1,500 DISEASES WITH IDENTIFIED MOLECULAR DISTURBANCES. GENES CAN MODIFY SIGNS AND SYMPTOMS OF COMMON DISEASES. THUS, THERE ARE NO PURE MONOGENIC DISEASES. CHRONIC DISEASES OF ADULTS ARE COMPLEX AND DEPENDENT ON MULTIPLE FACTORS. SEVERAL GENES THAT PREDISPOSE TO CHRONIC DEGENERATIVE DISEASES HAVE BEEN IDENTIFIED. THIS IS REVEALING THE COMPLEX NATURE AND THE INTERACTION OF THESE AILMENTS WITH THE ENVIRONMENT. THE DISCOVERY OF BACTERIAL AND VIRAL GENOMIC SEQUENCES WILL ALLOW THE MANUFACTURING OF NEW VACCINES AND SPECIFIC MOLECULAR ANTIMICROBIALS. THE NEW PHARMACOGENOMICS WILL DEVISE TREATMENTS FOR EACH SUBJECT ACCORDING TO HER SPECIFIC GENOMIC PROFILE. THE NEW APPLICATIONS OF GENOMIC TECHNOLOGY IS CREATING NEW PARADIGMS IN BIOMEDICAL RESEARCH SUCH AS FUNCTIONAL GENOMICS, PROTEONOMICS, EPIGENETIC REGULATION. GENE DIAGNOSIS AND THERAPY WILL CONSIDERABLY IMPROVE THE FUTURE OF MEDICINE. 2001 16 6303 24 THE PUZZLE OF IMMUNE PHENOTYPES OF CHILDHOOD ASTHMA. ASTHMA REPRESENTS THE MOST COMMON CHRONIC CHILDHOOD DISEASE WORLDWIDE. WHEREAS PRESCHOOL CHILDREN PRESENT WITH WHEEZING TRIGGERED BY DIFFERENT FACTORS (MULTITRIGGER AND VIRAL WHEEZE), CLINICAL ASTHMA MANIFESTATION IN SCHOOL CHILDREN HAS PREVIOUSLY BEEN CLASSIFIED AS ALLERGIC AND NON-ALLERGIC ASTHMA. FOR BOTH, THE UNDERLYING IMMUNOLOGICAL MECHANISMS ARE NOT YET UNDERSTOOD IN DEPTH IN CHILDREN. TREATMENT IS STILL PRESCRIBED REGARDLESS OF UNDERLYING MECHANISMS, AND CHILDREN ARE NOT ALWAYS TREATED SUCCESSFULLY. THIS REVIEW SUMMARIZES RECENT KEY FINDINGS ON THE COMPLEX MECHANISMS OF THE DEVELOPMENT AND MANIFESTATION OF CHILDHOOD ASTHMA. WHEREAS TRADITIONAL CLASSIFICATION OF CHILDHOOD ASTHMA IS PRIMARILY BASED ON CLINICAL SYMPTOMS LIKE WHEEZING AND ATOPY, NOVEL APPROACHES TO SPECIFY ASTHMA PHENOTYPES ARE UNDER WAY AND FACE CHALLENGES SUCH AS INCLUDING THE STABILITY OF PHENOTYPES OVER TIME AND TRANSITION INTO ADULTHOOD. EPIDEMIOLOGICAL STUDIES ENCLOSE MORE INFORMATION ON THE PATIENT'S DISEASE HISTORY AND ENVIRONMENTAL INFLUENCES. LATEST STUDIES DEFINE ENDOTYPES BASED ON MOLECULAR AND CELLULAR MECHANISMS, FOR EXAMPLE DEFINING RISK AND PROTECTIVE SINGLE NUCLEOTIDE POLYMORPHISMS (SNPS) AND NEW IMMUNE PHENOTYPES, SHOWING PROMISING RESULTS. ALSO, REGULATORY T CELLS AND RECENTLY DISCOVERED T HELPER CELL SUBTYPES SUCH AS TH9 AND TH17 CELLS WERE SHOWN TO BE IMPORTANT FOR THE DEVELOPMENT OF ASTHMA. INNATE LYMPHOID CELLS (ILC) COULD PLAY A CRITICAL ROLE IN ASTHMA PATIENTS AS THEY PRODUCE DIFFERENT CYTOKINES ASSOCIATED WITH ASTHMA. EPIGENETIC FINDINGS SHOWED DIFFERENT ACETYLATION AND METHYLATION PATTERNS FOR CHILDREN WITH ALLERGIC AND NON-ALLERGIC ASTHMA. ON A POSTTRANSCRIPTIONAL LEVEL, MIRNAS ARE REGULATING FACTORS IDENTIFIED TO DIFFER BETWEEN ASTHMA PATIENTS AND HEALTHY CONTROLS AND ALSO INDICATE DIFFERENCES WITHIN ASTHMA PHENOTYPES. METABOLOMICS IS ANOTHER EXCITING CHAPTER IMPORTANT FOR ENDOTYPING ASTHMATIC CHILDREN. DESPITE THE DEVELOPMENT OF NEW BIOMARKERS AND THE DISCOVERY OF NEW IMMUNOLOGICAL MOLECULES, THE COMPLEX PUZZLE OF CHILDHOOD ASTHMA IS STILL FAR FROM BEING COMPLETED. ADDRESSING THE CURRENT CHALLENGES OF DISTINCT CLINICAL ASTHMA AND WHEEZE PHENOTYPES, INCLUDING THEIR STABILITY AND UNDERLYING ENDOTYPES, INVOLVES ADDRESSING THE INTERPLAY OF INNATE AND ADAPTIVE IMMUNE REGULATORY MECHANISMS IN LARGE, INTERDISCIPLINARY COHORTS. 2016 17 6162 17 THE GENETICS OF DIABETIC NEPHROPATHY. UP TO 40% OF PATIENTS WITH TYPE 1 AND TYPE 2 DIABETES WILL DEVELOP DIABETIC NEPHROPATHY (DN), RESULTING IN CHRONIC KIDNEY DISEASE AND POTENTIAL ORGAN FAILURE. THERE IS EVIDENCE FOR A HERITABLE GENETIC SUSCEPTIBILITY TO DN, BUT DESPITE INTENSIVE RESEARCH EFFORTS THE CAUSATIVE GENES REMAIN ELUSIVE. RECENTLY, GENOME-WIDE ASSOCIATION STUDIES HAVE DISCOVERED SEVERAL NOVEL GENETIC VARIANTS ASSOCIATED WITH DN. THE IDENTIFICATION OF SUCH VARIANTS MAY POTENTIALLY ALLOW FOR EARLY IDENTIFICATION OF AT RISK PATIENTS. HERE WE REVIEW THE CURRENT UNDERSTANDING OF THE KEY MOLECULAR MECHANISMS AND GENETIC ARCHITECTURE OF DN, AND DISCUSS THE MERITS OF EMPLOYING AN INTEGRATIVE APPROACH TO INCORPORATE DATASETS FROM MULTIPLE SOURCES (GENETICS, TRANSCRIPTOMICS, EPIGENETIC, PROTEOMIC) IN ORDER TO FULLY ELUCIDATE THE GENETIC ELEMENTS CONTRIBUTING TO THIS SERIOUS COMPLICATION OF DIABETES. 2013 18 5482 14 RETHINKING GENETIC MODELS OF ASTHMA: THE ROLE OF ENVIRONMENTAL MODIFIERS. ASTHMA IS A COMMON, CHRONIC DISEASE WITH A COMPLEX ETIOLOGY. TO DATE, MORE THAN 35 GENES HAVE BEEN ASSOCIATED WITH ASTHMA OR RELATED PHENOTYPES IN MULTIPLE POPULATIONS, BUT NONE OF THEM HAS BEEN SHOWN TO CONTRIBUTE TO RISK IN ALL POPULATIONS STUDIED. WE SUGGEST THAT GENETIC SUSCEPTIBILITY IS BOTH CONTEXT DEPENDENT AND DEVELOPMENTALLY REGULATED, AND THAT IGNORING THE ENVIRONMENTAL CONTEXT WILL MISS MANY IMPORTANT ASSOCIATIONS AND CLUES TO PATHOGENESIS. WE DEFINE 'ENVIRONMENT' BROADLY TO INCLUDE THE IN UTERO ENVIRONMENT, MATERNAL AFFECTION STATUS AND SEX, AND PROPOSE THAT EPIGENETIC MECHANISMS ARE THE LINK BETWEEN OUR GENES AND OUR ENVIRONMENT. 2005 19 5256 29 PROGRESSES IN EPIGENETIC STUDIES OF ASTHMA FROM THE PERSPECTIVE OF HIGH-THROUGHPUT ANALYSIS TECHNOLOGIES: A NARRATIVE REVIEW. BACKGROUND AND OBJECTIVE: ASTHMA IS THE MOST COMMON CHRONIC RESPIRATORY DISEASE IN THE WORLD WITH AN ESTIMATED HERITABILITY BETWEEN 50% AND 60%, AND RECENT STUDIES HAVE SHOWN THAT EPIGENETIC MECHANISMS PLAY AN IMPORTANT ROLE IN ITS DEVELOPMENT. MANY CUTTING-EDGE EPIGENETIC RESEARCH TECHNIQUES HAVE BEEN APPLIED TO THE STUDY OF THE PATHOGENESIS OF ASTHMA, WHICH HAS PROMOTED THE DEVELOPMENT OF ASTHMA ETIOLOGY AND BROUGHT NEW POSSIBILITIES FOR TREATMENT. WE SUMMARIZED RECENT ADVANCES IN EPIGENETIC RESEARCH OF THE PATHOGENESIS OF ASTHMA, ESPECIALLY FROM THE PERSPECTIVE OF HIGH-THROUGHPUT ANALYSIS TECHNIQUES, TO FIND POTENTIAL EPIGENETIC BIOMARKERS AND POSSIBLE MOLECULAR TARGETS FOR THE FUTURE INTERVENTION AND TREATMENT OF THE DISEASE. METHODS: WE REVIEWED AND SUMMARIZED RECENT PROGRESS IN EPIGENOMIC STUDIES OF ASTHMA ON A "PRE-TRANSCRIPTIONAL LEVEL", INCLUDING DNA METHYLATION, HISTONE MODIFICATION, AND CHROMATIN REMODELING, AND ON A "POST-TRANSCRIPTIONAL LEVEL" WITH A FOCUS ON NON-CODING RNA, FROM THE PERSPECTIVE OF HIGH-THROUGHPUT ANALYSIS TECHNOLOGIES. KEY CONTENT AND FINDINGS: WE HAVE SUMMARIZED THE PROGRESS OF DIFFERENT KINDS OF RECENT EPIGENETIC STUDIES IN ASTHMA, INCLUDING DNA METHYLATION STUDIES [CANDIDATE GENES METHYLATION STUDIES AND EPIGENOME-WIDE ASSOCIATION STUDY (EWAS)], HISTONE MODIFICATION STUDIES (HISTONE ACETYLATION/DEACETYLATION STUDIES AND HISTONE METHYLATION STUDIES), NON-CODING RNA STUDIES [MICRORNAS (MIRNAS), LONG NON-CODING RNAS (LNCRNAS) AND CIRCULAR RNAS (CIRCRNAS)], TO HELP THE READERS TO GAIN A COMPREHENSIVE INSIGHT INTO THE EPIGENETIC RESEARCH FIELDS FOR ASTHMA. THE APPLICATION OF HIGH-THROUGHPUT ANALYSIS TECHNIQUES IN ASTHMA RESEARCH, INCLUDING EWAS (DNA METHYLATION CHIPS), CHROMATIN IMMUNOPRECIPITATION SEQUENCING (CHIP-SEQ), MICRORNA SEQUENCING, WHOLE TRANSCRIPTOME SEQUENCING, CO-EXPRESSION NETWORK AND COMPETING ENDOGENOUS RNA (CERNA) ANALYSES, WERE INTRODUCED ACCOMPANY WITH THE MAIN FINDINGS. AND THE POTENTIAL EPIGENETIC BIOMARKERS AND POSSIBLE MOLECULAR TARGETS IDENTIFIED VIA HIGH-THROUGHPUT ANALYSES WERE ALSO DISCUSSED. CONCLUSIONS: EPIGENETIC RESEARCH HAS BECOME A HOTSPOT IN RESEARCH ON THE PATHOGENESIS OF ASTHMA. THE COMBINATION OF HIGH-THROUGHPUT EPIGENETIC ANALYSIS TECHNOLOGIES AND TRADITIONAL BIOLOGICAL FUNCTION AND CLINICAL STUDIES WILL BRING NEW BREAKTHROUGH IN THE PATHOGENESIS STUDY OF ASTHMA, WHICH WILL IMPROVE THE GENETIC INTERPRETATION OF THE DISEASE AND BRING MORE POSSIBILITIES FOR THE DEVELOPMENT OF PRECISION MEDICINE TO TREAT IT. 2022 20 459 27 APPLYING SINGLE-CELL TECHNOLOGIES TO CLINICAL PATHOLOGY: PROGRESS IN NEPHROPATHOLOGY. CELLS REPRESENT THE BASIC BUILDING BLOCKS OF LIVING ORGANISMS. ACCURATE CHARACTERISATION OF CELLULAR PHENOTYPE, INTERCELLULAR SIGNALLING NETWORKS, AND THE SPATIAL ORGANISATION OF CELLS WITHIN ORGANS IS CRUCIAL TO DELIVER A BETTER UNDERSTANDING OF THE PROCESSES UNDERPINNING PHYSIOLOGY, AND THE PERTURBATIONS THAT LEAD TO DISEASE. SINGLE-CELL METHODOLOGIES HAVE INCREASED RAPIDLY IN SCALE AND SCOPE IN RECENT YEARS AND ARE SET TO GENERATE IMPORTANT INSIGHTS INTO HUMAN DISEASE. HERE, WE REVIEW CURRENT PRACTICES IN NEPHROPATHOLOGY, WHICH ARE DOMINATED BY RELATIVELY SIMPLE MORPHOLOGICAL DESCRIPTIONS OF TISSUE BIOPSIES BASED ON THEIR APPEARANCE USING LIGHT MICROSCOPY. BULK TRANSCRIPTOMICS HAVE MORE RECENTLY BEEN USED TO EXPLORE GLOMERULAR AND TUBULOINTERSTITIAL KIDNEY DISEASE, RENAL CANCER, AND THE RESPONSES TO INJURY AND ALLOIMMUNITY IN KIDNEY TRANSPLANTATION, GENERATING NOVEL DISEASE INSIGHTS AND PROGNOSTIC BIOMARKERS. THESE STUDIES SET THE STAGE FOR SINGLE-CELL TRANSCRIPTOMIC APPROACHES THAT REVEAL CELL-TYPE-SPECIFIC GENE EXPRESSION PATTERNS IN HEALTH AND DISEASE. THESE TECHNOLOGIES ALLOW GENOME-WIDE DISEASE SUSCEPTIBILITY GENES TO BE INTERPRETED WITH THE KNOWLEDGE OF THE SPECIFIC CELL POPULATIONS WITHIN ORGANS THAT EXPRESS THEM, IDENTIFYING CANDIDATE CELL TYPES FOR FURTHER STUDY. SINGLE-CELL TECHNOLOGIES ARE ALSO MOVING BEYOND ASSAYING INDIVIDUAL CELLULAR TRANSCRIPTOMES, TO MEASURING THE EPIGENETIC LANDSCAPE OF SINGLE CELLS. SINGLE-CELL ANTIGEN-RECEPTOR GENE SEQUENCING ALSO ENABLES SPECIFIC T- AND B-CELL CLONES TO BE TRACKED IN DIFFERENT TISSUES AND DISEASE STATES. IN THE COMING YEARS THESE RICH 'MULTI-OMIC' DESCRIPTIONS OF KIDNEY DISEASE WILL ENABLE HISTOPATHOLOGICAL DESCRIPTIONS TO BE COMPREHENSIVELY INTEGRATED WITH MOLECULAR PHENOTYPES, ENABLING BETTER DISEASE CLASSIFICATION AND PROGNOSTICATION AND THE APPLICATION OF PERSONALISED TREATMENT STRATEGIES. (C) 2020 THE AUTHORS. THE JOURNAL OF PATHOLOGY PUBLISHED BY JOHN WILEY & SONS LTD ON BEHALF OF PATHOLOGICAL SOCIETY OF GREAT BRITAIN AND IRELAND. 2020