<?xml version='1.0' encoding='utf-8'?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2 20190208//EN" "http://jats.nlm.nih.gov/publishing/1.2/JATS-journalpublishing1.dtd">
<article article-type="research-article" dtd-version="1.2" xml:lang="ru" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><front><journal-meta><journal-id journal-id-type="issn">2658-6533</journal-id><journal-title-group><journal-title>Научные результаты биомедицинских исследований</journal-title></journal-title-group><issn pub-type="epub">2658-6533</issn></journal-meta><article-meta><article-id pub-id-type="doi">10.18413/2658-6533-2023-9-2-0-4</article-id><article-id pub-id-type="publisher-id">3075</article-id><article-categories><subj-group subj-group-type="heading"><subject>Генетика</subject></subj-group></article-categories><title-group><article-title>&lt;strong&gt;Генетические маркеры остеоартроза коленного сустава у женщин Центрального Черноземья России&lt;/strong&gt;</article-title><trans-title-group xml:lang="en"><trans-title>&lt;strong&gt;Genetic markers of knee osteoarthritis in women of the Central Chernozem region of Russia&lt;/strong&gt;</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Новаков</surname><given-names>Виталий Борисович</given-names></name><name xml:lang="en"><surname>Novakov</surname><given-names>Vitaly B.</given-names></name></name-alternatives><email>v.novakov@bk.ru</email></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Новакова</surname><given-names>Ольга Николаевна</given-names></name><name xml:lang="en"><surname>Novakova</surname><given-names>Olga N.</given-names></name></name-alternatives><email>litovkina@bsu.edu.ru</email></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Сорокина</surname><given-names>Инна Николаевна</given-names></name><name xml:lang="en"><surname>Sorokina</surname><given-names>Inna N.</given-names></name></name-alternatives><email>Sorokina@bsu.edu.ru</email></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Батлуцкая</surname><given-names>Ирина Витальевна</given-names></name><name xml:lang="en"><surname>Batlutskaya</surname><given-names>Irina V.</given-names></name></name-alternatives><email>bat@bsu.edu.ru</email></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Ефремова</surname><given-names>Ольга Алексеевна</given-names></name><name xml:lang="en"><surname>Efremova</surname><given-names>Olga A.</given-names></name></name-alternatives><email>efremova@bsu.edu.ru</email></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Орлова</surname><given-names>Валентина Семеновна</given-names></name><name xml:lang="en"><surname>Orlova</surname><given-names>Valentina S.</given-names></name></name-alternatives><email>orlova@bsu.edu.ru</email></contrib></contrib-group><pub-date pub-type="epub"><year>2023</year></pub-date><volume>9</volume><issue>2</issue><fpage>0</fpage><lpage>0</lpage><self-uri content-type="pdf" xlink:href="/media/medicine/2023/2/Биомед_исследования-39-53.pdf" /><abstract xml:lang="ru"><p>Актуальность: Остеоартроз (ОА) коленного сустава является многофакторным заболеванием. Среди множества факторов риска заболевания несомненна роль наследственной компоненты. Доля генетических факторов в развитии ОА составляет около 50%. Цель исследования: Изучить роль полиморфных локусов генов-кандидатов в развитии остеоартроза коленного сустава у женщин Центрально-Чернозёмного региона России. Материалы и методы: В выборку для исследования были включены 590 женщин, из них 292 пациента с диагнозом ОА коленного сустава и 298 женщин контрольной группы. Всем участникам исследования проведено генотипирование четырёх полиморфных локусов генов-кандидатов (rs2820443 LYPLAL1, rs11177 GNL3, rs56116847 SBNO1 и rs34195470 WWP2), показавших связь с ОА коленного сустава в ранее проведённых полногеномных исследованиях. Проведен логистический регрессионный анализ (тестировались аллельная, аддитивная, рецессивная, доминантная генетические модели) с учётом ковариат (возраст, ИМТ, наследственная отягощенность, наличие заболеваний сердечно-сосудистой, эндокринной, опорно-двигательной систем). Результаты: Установлено, что минорный аллель А rs11177 гена GNL3 ассоциирован с развитием ОА коленного сустава у женщин согласно аллельной (ОR=0,74, рperm=0,011), аддитивной (ОR=0,65, рperm=0,009), доминантной (ОR=0,58, рperm=0,025) и рецессивной (ОR=0,56, рperm=0,042) генетическим моделям. Генотип GG rs11177 гена GNL3 является фактором риска развития ОА коленного сустава (OR=1,53, p=0,026). Выявленные ассоциации rs11177 гена GNL3 с развитием заболевания у женщин могут быть связаны с выраженными функциональными эффектами данного SNP: определяет миссенс-мутацию (Arg39Gln в полипептиде GNL3), локализуется в эволюционно консервативном регионе, в области гиперчувствительности к ДНКазе-1, в области гистонов, маркирующих промоторы в 10 тканях и энхансеры в 14 тканях, в регионе связывания с регуляторным белком ZNF263 и регионе регуляторного мотива ДНК &amp;ndash; RXRA, связан с уровнем экспрессии 24 генов и альтернативного сплайсинга 12 генов в различных тканях и органах, вовлечённых в патогенез ОА коленного сустава (жировая ткань, щитовидная железа, скелетные мышцы и др.). Заключение: Аллельный вариант А rs11177 гена GNL3 имеет протективное значение в развитии ОА коленного сустава у женщин Центрального Черноземья России (OR=0,56-0,74), генотип GG rs11177 имеет рисковую роль для заболевания (OR=1,53)</p></abstract><trans-abstract xml:lang="en"><p>Background:&amp;nbsp;Knee osteoarthritis (KO) is a multifactorial disease. Among the many risk factors for the disease, the role of the hereditary component is undeniable. The share of genetic factors in the development of OA is about 50%. The aim of the study:&amp;nbsp;To study the role of polymorphic loci of candidate genes in the development of knee osteoarthritis in women from the Central Chernozem region of Russia.&amp;nbsp;Materials and methods:&amp;nbsp;The sample for the study included 590 women, including 292 patients diagnosed with KO and 298 women in the control group. All study participants underwent genotyping of four polymorphic loci of candidate genes (rs2820443 LYPLAL1, rs11177 GNL3, rs56116847 SBNO1 and rs34195470 WWP2), which showed an association with KO in previous genome-wide studies. A logistic regression analysis was carried out (allelic, additive, recessive, dominant genetic models were tested), taking into account covariates (age, BMI, hereditary burden, the presence of diseases of the cardiovascular, endocrine, musculoskeletal systems). Results:&amp;nbsp;The minor allele A rs11177 of the GNL3 gene was found to be associated with the development of KO in women according to allelic (OR=0.74, pperm=0.011), additive (OR=0.65, pperm=0.009), dominant (OR=0.58, рperm=0.025) and recessive (OR=0.56, рperm=0.042) genetic models. The GG genotype rs11177 of the GNL3 gene is a risk factor for the development of KO (OR=1.53, p=0.026). The identified associations of rs11177 of the GNL3 gene with the development of the disease in females may be associated with the pronounced functional effects of this SNP: it determines the missense mutation (Arg39Gln in the GNL3 polypeptide); it is localized in an evolutionarily conservative region, in the area of hypersensitivity to DNase-1, in the area of histones, marking promoters in 10 tissues and enhancers in 14 tissues, in the region of binding to the regulatory protein ZNF263 and in the region of the regulatory DNA motif &amp;ndash; RXRA; it is associated with the level of expression of 24 genes and alternative splicing of 12 genes in various tissues and organs involved in the pathogenesis of KO (adipose tissue, thyroid gland, skeletal muscles, etc.). Conclusion:&amp;nbsp;The A allelic rs11177 variant of the GNL3 gene has a protective role in the development of KO in women of the Central Chernozem Region of Russia (OR=0.56-0.74), the GG genotype rs11177 has a risk role for the disease (OR=1.53).</p></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартроз коленного сустава</kwd><kwd>ассоциации</kwd><kwd>гены-кандидаты</kwd><kwd>полиморфизм генов</kwd><kwd>GNL3</kwd></kwd-group><kwd-group xml:lang="en"><kwd>knee osteoarthritis</kwd><kwd>associations</kwd><kwd>candidate genes</kwd><kwd>gene polymorphism</kwd><kwd>GNL3</kwd></kwd-group></article-meta></front><back><ref-list><title>Список литературы</title><ref id="B1"><mixed-citation>Балабанова РМ, Дубинина ТВ, Демина АБ, и др. Заболеваемость болезнями костно-мышечной системы в Российской Федерации за 2015-2016 гг. Научно-практическая ревматология. 2018;56(1):15-21. DOI: https://doi.org/10.14412/1995-4484-2018-15-21</mixed-citation></ref><ref id="B2"><mixed-citation>Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. International Journal of Molecular Sciences. 2021;22(5):2619. DOI: https://doi.org/10.3390/ijms22052619</mixed-citation></ref><ref id="B3"><mixed-citation>Madry H, Luyten FP, Facchini A. Biological aspects of early osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy. 2012;20(3):407-22. DOI: https://doi.org/10.1007/s00167-011-1705-8</mixed-citation></ref><ref id="B4"><mixed-citation>Pape D, Tischer T. Kniearthrose des jungen Patienten [Osteoarthritis of the knee in young patients]. Der Orthopade. 2021;50(5):345. DOI: https://doi.org/10.1007/s00132-021-04095-8</mixed-citation></ref><ref id="B5"><mixed-citation>Галушко ЕА, Насонов ЕЛ. Распространённость ревматических заболеваний в России. Альманах клинической медицины. 2018;46(1):32-39. DOI: https://doi.org/10.18786/2072-0505-2018-46-1-32-39</mixed-citation></ref><ref id="B6"><mixed-citation>Deshpande BR, Katz JN, Solomon DH, et al. Number of Persons With Symptomatic Knee Osteoarthritis in the US: Impact of Race and Ethnicity, Age, Sex, and Obesity. Arthritis Care and Research (Hoboken). 2016;68(12):1743-1750. DOI: https://doi.org/10.1002/acr.22897</mixed-citation></ref><ref id="B7"><mixed-citation>Gaudreault N, Maillette P, Coutu MF, et al. Work disability among workers with osteoarthritis of the knee: risks factors, assessment scales, and interventions. International Journal of Rehabilitation Research. 2014;37(4):290-296. DOI: https://doi.org/10.1097/MRR.0000000000000082</mixed-citation></ref><ref id="B8"><mixed-citation>Tan JS, Tikoft E, O&amp;#39;Sullivan P, et al. The Relationship Between Changes in Movement and Activity Limitation or Pain in People With Knee Osteoarthritis: A Systematic Review. Journal of Orthopaedic and Sports Physical Therapy. 2021;51(10):492-502. DOI: https://doi.org/10.2519/jospt.2021.10418</mixed-citation></ref><ref id="B9"><mixed-citation>Weinstein AM, Rome BN, Reichmann WM, et al. Estimating the burden of total knee replacement in the United States. Journal of Bone and Joint Surgery. 2013;95(5):385-92. DOI: https://doi.org/10.2106/JBJS.L.00206</mixed-citation></ref><ref id="B10"><mixed-citation>Корнилов НН, Куляба ТА, Филь АС, и др. Данные регистра эндопротезирования коленного сустава РНИИТО им. Р.Р. Вредена за 2011&amp;ndash;2013 годы. Травматология и ортопедия России. 2015;21(1):136-151. DOI: https://doi.org/10.21823/2311-2905-2015-0-1-136-151</mixed-citation></ref><ref id="B11"><mixed-citation>Hardenberg M, Spekl&amp;eacute; EM, Coenen P, et al. The economic burden of knee and hip osteoarthritis: absenteeism and costs in the Dutch workforce. BMC Musculoskeletal Disorders. 2022;23(1):364. DOI: https://doi.org/10.1186/s12891-022-05306-9</mixed-citation></ref><ref id="B12"><mixed-citation>Leung K, Zhang B, Tan J, et al. Prediction of Total Knee Replacement and Diagnosis of Osteoarthritis by Using Deep Learning on Knee Radiographs: Data from the Osteoarthritis Initiative. Radiology. 2020;296(3):584-593. DOI: https://doi.org/10.1148/radiol.2020192091</mixed-citation></ref><ref id="B13"><mixed-citation>Marsh J, Joshi I, Somerville L, et al. Health care costs after total knee arthroplasty for satisfied and dissatisfied patients. Canadian Journal of Surgery. 2022;65(5):E562-E566. DOI: https://doi.org/10.1503/cjs.006721</mixed-citation></ref><ref id="B14"><mixed-citation>Hussain SM, Neilly DW, Baliga S, et al. Knee osteoarthritis: a review of management options. Scottish Medical Journal. 2016;61(1):7-16. DOI: https://doi.org/10.1177/0036933015619588</mixed-citation></ref><ref id="B15"><mixed-citation>Haider MZ, Bhuiyan R, Ahmed S, et al. Risk factors of knee osteoarthritis in Bangladeshi adults: a national survey. BMC Musculoskelet Disord. 2022;23(1):333. DOI: https://doi.org/10.1186/s12891-022-05253-5</mixed-citation></ref><ref id="B16"><mixed-citation>Новаков ВБ, Новакова ОН, Чурносов МИ. Факторы риска и молекулярные основы этиопатогенеза остеоартроза коленного сустава (обзор литературы). Гений ортопедии. 2021;27(1):112-120. DOI: https://doi.org/10.18019/1028-4427-2021-27-1-112-120</mixed-citation></ref><ref id="B17"><mixed-citation>Curry ZA, Beling A, Borg-Stein J. Knee osteoarthritis in midlife women: unique considerations and comprehensive management. Menopause. 2022;29(6):748-755. DOI: https://doi.org/10.1097/GME.0000000000001966</mixed-citation></ref><ref id="B18"><mixed-citation>Werner DM, Golightly YM, Tao M, et al. Environmental Risk Factors for Osteoarthritis: The Impact on Individuals with Knee Joint Injury. Rheumatic Disease Clinics of North America. 2022;48(4):907-930. DOI: https://doi.org/1010.1016/j.rdc.2022.06.010</mixed-citation></ref><ref id="B19"><mixed-citation>Мадянов ИВ, Мадянова ТС. Менопаузальная гормональная терапия при отдельных заболеваниях терапевтического профиля. Лечащий Врач. 2018;3:50.</mixed-citation></ref><ref id="B20"><mixed-citation>Поворознюк ВВ, Григорьева НВ. Остеоартроз у женщин в постменопаузе: факторы риска и связь с костной тканью. Репродуктивная эндокринология. 2012;6(8):64-71. DOI: https://doi.org/10.18370/2309-4117.2012.8.64-71</mixed-citation></ref><ref id="B21"><mixed-citation>Kremers HM, Larson DR, Crowson CS, et al. Prevalence of Total Hip and Knee Replacement in the United States. Journal of Bone and Joint Surgery. 2015;97(17):1386-97. DOI: https://doi.org/10.2106/JBJS.N.01141</mixed-citation></ref><ref id="B22"><mixed-citation>Skousgaard SG, Skytthe A, M&amp;ouml;ller S, et al. Sex differences in risk and heritability estimates on primary knee osteoarthritis leading to total knee arthroplasty: a nationwide population based follow up study in Danish twins. Arthritis Research and Therapy. 2016;18:46. DOI: https://doi.org/10.1186/s13075-016-0939-8</mixed-citation></ref><ref id="B23"><mixed-citation>Zengini E, Finan C, Wilkinson JM. The Genetic Epidemiological Landscape of Hip and Knee Osteoarthritis: Where Are We Now and Where Are We Going? The Journal of Rheumatology. 2016;43(2):260-266. DOI: https://doi.org/10.3899/jrheum.150710</mixed-citation></ref><ref id="B24"><mixed-citation>Новаков ВБ, Новакова ОН, Чурносов МИ. Полногеномные исследования остеоартроза коленного сустава: обзор литературы. Травматология и ортопедия России. 2021;27(4):131-144. DOI: https://doi.org/10.21823/2311-2905-2021-27-1580</mixed-citation></ref><ref id="B25"><mixed-citation>Novakov V, Novakova O, Churnosova M, et al. Intergenic interactions of SBNO1, NFAT5 and GLT8D1 determine the susceptibility to knee osteoarthritis among Europeans of Russia. Life. 2022;13(2):405. DOI: https://doi.org/10.3390/life13020405</mixed-citation></ref><ref id="B26"><mixed-citation>MacGregor AJ, Li Q, Spector TD, et al. The genetic influence on radiographic osteoarthritis is site specific at the hand, hip and knee. Rheumatology. 2009;48(3):277-280. DOI: https://doi.org/10.1093/rheumatology/ken475</mixed-citation></ref><ref id="B27"><mixed-citation>Zhai G, Ding C, Stankovich J, et al. The genetic contribution to longitudinal changes in knee structure and muscle strength: a sibpair study. Arthritis and Rheumatism. 2005;52(9):2830-2834. DOI: https://doi.org/10.1002/art.21267</mixed-citation></ref><ref id="B28"><mixed-citation>Novakov V, Novakova O, Churnosova M, et al. The pronounced effect of obesity on the association of the rs143384 GDF5 with knee osteoarthritis. Life. 2022;12:x. DOI: https://doi.org/10.3390/xxxxx</mixed-citation></ref><ref id="B29"><mixed-citation>Алексеева ЛИ. Обновление клинических рекомендаций по лечению больных остеоартритом 2019 года. Русский медицинский журнал. 2019;4:2-6.</mixed-citation></ref><ref id="B30"><mixed-citation>Altman RD. Criteria for classification of clinical osteoarthritis. The Journal of rheumatology. Supplement. 1991;27:10-12.</mixed-citation></ref><ref id="B31"><mixed-citation>Абрамова МЮ. Генетические маркеры тяжелого течения преэклампсии. Научные результаты биомедицинских исследований. 2022;8(3):305-316. DOI: https://doi.org/10.18413/2658- 6533-2022-8-3-0-4</mixed-citation></ref><ref id="B32"><mixed-citation>Zeggini E, Panoutsopoulou K, Southam L, et al. Identification of new susceptibility loci for osteoarthritis (arcOGEN): a genome-wide association study. The Lancet. 2012;380(9844):815-823. DOI: https://doi.org/10.1016/S0140-6736(12)60681-3</mixed-citation></ref><ref id="B33"><mixed-citation>Styrkarsdottir U, Lund SH, Thorleifsson G, et al. Meta-analysis of Icelandic and UK data sets identifies missense variants in SMO, IL11, COL11A1 and 13 more new loci associated with osteoarthritis. Nature Genetics. 2018;50(12):1681-1687. DOI: https://doi.org/10.1038/s41588-018-0247-0</mixed-citation></ref><ref id="B34"><mixed-citation>Tachmazidou I, Hatzikotoulas K, Southam L, et al. Identification of new therapeutic targets for osteoarthritis through genome-wide analyses of UK Biobank data. Nature Genetics. 2019;51(2):230-236. DOI: https://doi.org/10.1038/s41588-018-0327-1</mixed-citation></ref><ref id="B35"><mixed-citation>Boer CG, Hatzikotoulas K, Southam L, et al.&amp;nbsp; Deciphering osteoarthritis genetics across 826,690 individuals from 9 populations. Cell. 2021;184(18):4784-4818.e17. DOI: https://doi.org/10.1016/j.cell.2021.07.038</mixed-citation></ref><ref id="B36"><mixed-citation>Ward LD, Kellis M. HaploReg v4: systematic mining of putative causal variants, cell types, regulators and target genes for human complex traits and disease. Nucleic Acids Research. 2016;44(D1):D877-D881. DOI: https://doi.org/10.1093/nar/gkv1340</mixed-citation></ref><ref id="B37"><mixed-citation>Yarosh SL, Kokhtenko EV, Starodubova NI, et al. Smoking status modifies the relation between CYP1A1*2C gene polymorphism and idiopathic male infertility: the importance of gene-environment interaction analysis for genetic studies of the disease. Reproductive Sciences. 2013;20(11):1302-1307. DOI: https://doi.org/10.1177/1933719113483013</mixed-citation></ref><ref id="B38"><mixed-citation>Yarosh SL, Kokhtenko EV, Churnosov MI, et al. Joint effect of glutathione S-transferase genotypes and cigarette smoking on idiopathic male infertility. Andrologia. 2015;47(9):980-986. DOI: https://doi.org/10.1111/and.12367</mixed-citation></ref><ref id="B39"><mixed-citation>Polonikov A, Bykanova M, Ponomarenko I, et al. The contribution of CYP2C gene subfamily involved in epoxygenase pathway of arachidonic acids metabolism to hypertension susceptibility in Russian population. Clinical and Experimental Hypertension. 2017;39(4):306-311. DOI: https://doi.org/10.1080/10641963.2016.1246562</mixed-citation></ref><ref id="B40"><mixed-citation>Пономаренко ИВ, Полоников АВ, Чурносов МИ. Ассоциация полиморфизма rs4986938 гена ESR2 с развитием гиперплазии эндометрия. Акушерство и гинекология. 2019;4:66-72. DOI: https://dx.doi.org/10.18565/aig.2019.4.66-72</mixed-citation></ref><ref id="B41"><mixed-citation>Purcell S, Neale B, Todd-Brown K, et al. PLINK: a tool set for whole-genome association and population-based linkage analyses. American Journal of Human Genetics. 2007;81(3):559-75. DOI: https://doi.org/10.1086/519795</mixed-citation></ref><ref id="B42"><mixed-citation>Решетников ЕА. Поиск ассоциаций генов-кандидатов, дифференциально экспрессирующихся в плаценте, с риском развития плацентарной недостаточности с синдромом задержки роста плода. Научные результаты биомедицинских исследований. 2020;6(3):338-349. DOI: 10.18413/2658- 6533-2020-6-3-0-5</mixed-citation></ref><ref id="B43"><mixed-citation>GTEx Consortium. The GTEx Consortium atlas of genetic regulatory effects across human tissues. Science. 2020;369(6509):1318-1330. DOI: https://doi.org/10.1126/science.aaz1776</mixed-citation></ref><ref id="B44"><mixed-citation>Yau MS, Yerges-Armstrong LM, Liu Y, et al. Genome-Wide Association Study of Radiographic Knee Osteoarthritis in North American Caucasians. Arthritis and Rheumatology. 2017;69(2):343-351. DOI: https://doi.org/10.1002/art.39932</mixed-citation></ref><ref id="B45"><mixed-citation>Liu B, Cheng H, Ma W, et al. Common variants in the GNL3 contribute to the increasing risk of knee osteoarthritis in Han Chinese population. Scientific Reports. 2018;8(1):9610. DOI: https://doi.org/10.1038/s41598-018-27971-4</mixed-citation></ref><ref id="B46"><mixed-citation>Шаповалова ДА. Изучение молекулярно-генетических основ остеоартрита у женщин с недифференцированной дисплазией соединительной [диссертация]. Уфа; 2020.</mixed-citation></ref><ref id="B47"><mixed-citation>Panoutsopoulou K, Thiagarajah S, Zengini E, et al. Radiographic endophenotyping in hip osteoarthritis improves the precision of genetic association analysis. Annals of The Rheumatic Diseases. 2017;76(7):1199-1206. DOI: https://doi.org/10.1136/annrheumdis-2016-210373</mixed-citation></ref><ref id="B48"><mixed-citation>Romanova L, Kellner S, Katoku-Kikyo N, et al. Novel role of nucleostemin in the maintenance of nucleolar architecture and integrity of small nucleolar ribonucleoproteins and the telomerase complex. Journal of Biological Chemistry. 2009;284(39):26685-94. DOI: https://doi.org/10.1074/jbc.M109.013342</mixed-citation></ref><ref id="B49"><mixed-citation>Gee F, Clubbs CF, Raine EV, et al. Allelic expression analysis of the osteoarthritis susceptibility locus that maps to chromosome 3p21 reveals cis-acting eQTLs at GNL3 and SPCS1. BMC Medical Genetics. 2014;15:53. DOI: https://doi.org/10.1074/10.1186/1471-2350-15-53</mixed-citation></ref><ref id="B50"><mixed-citation>Louka ML, Zakaria ZM, Nagaty MM, et al. Expression of nucleostemin gene in primary osteoarthritis. Gene. 2016;587(1):27-32. DOI: https://doi.org/10.1016/j.gene.2016.04.019</mixed-citation></ref></ref-list></back></article>