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Human Cav Mendelian mutations mostly located to segments involved in the mechanism of voltage sensing and gating within the 3D structure, with multiple mutations targeting equivalent 3D structural locations despite eliciting distinct clinical phenotypes.
Alternately, VHL may be a complex disease that can involve multiple mutations targeting different developmental lineages.
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However, the inherent propensity of different mutants to produce aggregated protein varies, even in cases in which multiple mutations target a single amino acid position.
Rodent cells required a single oncogenic mutation coupled with abrogation of the major cell cycle checkpoint regulator p53, while human cells required the addition of multiple oncogenic mutations targeting several intracellular pathways critical to cell cycle progression and survival, which include p53, pRb, and the Ras/MAPK pathway as well as cellular phosphatases [ 3].
However, it is evident that many cancers harbour multiple mutations, frequently targeting well annotated pathways, such as the MAPK and PTEN/PI3K/mTOR pathways, without a clear driver event.
Genome-wide profiling of structural DNA alterations in ALL identified multiple sub-microscopic somatic mutations targeting key cellular pathways and demonstrated evolution in genetic alterations from diagnosis to relapse [ 29].
Thus, mutations targeting a gene with multiple isoforms can have different affects on disease presentation.
In addition to point and other small mutations targeting cancer genes, solid tumors often exhibit aneuploidy as well as multiple chromosomal rearrangements of large fragments of the genome.
Previous studies have shown that drug-resistant M. tuberculosis strains isolated from TB patients with limited previous exposure to first-line anti-TB drugs usually contain single point mutations in resistance conferring genes while strains from previously treated patients usually contain multiple mutations in target genes [ 15, 18, 20, 31- 33].
Novel mutations target distinct subgroups of medulloblastoma.
In mutagenesis, TPCR is primarily advantageous for generation of combinatorial libraries of targeted mutants but could be also applied to generation of variants with specific multiple mutations throughout the target gene.
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