Reumatologi

Reumatiska sjukdomar är vanliga och orsakas av en oförmåga i immunsystemet att skilja på kroppsegna och kroppsfrämmande ämnen. Detta kan leda till en immunologisk attack på kroppens organ, exempelvis leder, salivkörtlar, hud eller njurar. Det övergripande målet för reumatologins forskargrupp är att förstå de bakomliggande orsakerna till uppkomsten och utvecklingen av olika reumatiska sjukdomar. På sikt kan sådan kunskap leda till bättre diagnostiska metoder och behandlingar och därmed förbättra omhändertagandet och prognosen för dessa patientgrupper.
Beskrivning av vår forskning

Gemensamt för de reumatiska sjukdomarna är att sjukdomsmanifestationerna kan variera stort även inom samma diagnos. Vår forskning syftar bland annat till att identifiera riskfaktorer för de olika organmanifestationerna och de bakomliggande mekanismer som bidrar till att vissa drabbas av svårare sjukdom än andra.
Vi studerar bland annat betydelsen av arvsanlagen, hur dessa regleras och uttrycks i olika celler och vävnader, samt vilka proteiner i blodet som kan vara av betydelse för sjukdomsbilden. Med experimentella analyser studeras sjukdomsmodifierande mekanismer.
Våra huvudsakliga forskningsområden är fokuserade på systemisk lupus erytematosus (SLE), Sjögrens sjukdom, Systemisk skleros samt ANCA-associerade vaskuliter. Mekanismerna bakom den ökade risken för lymfom hos patienter med vissa reumatiska sjukdomar undersöks ur flera aspekter. IgG4-relaterad sjukdom studeras avseende kliniska manifestationer och nya diagnostiska metoder.
Forskargruppen i reumatologi leds av professor Gunnel Nordmark. Seniorprofessor är Lars Rönnblom. Övriga seniora forskare är docenterna Dag Leonard, Maija-Leena Eloranta, Johanna Dahlqvist, Ann Knight och Eva Baecklund. Vidare består forskargruppen av disputerade forskare, post-doktorer, doktorander, studenter, bioinformatiker, forskningsingenjör och en forskningssköterska.
Gruppmedlemmar
Forskningsprojekt
- ANCA-associerade vaskuliter
- Systemisk Lupus Erythematosus (SLE)
- Sjögrens sjukdom
- Systemisk skleros
- Lymfom vid reumatisk sjukdom
- Psoriasisartrit
- IgG4-relaterad sjukdom
Publikationer
Ingår i Arthritis & Rheumatology, s. 212-225, 2025
- DOI för Unraveling the Genetics of Shared Clinical and Serological Manifestations in Patients With Systemic Inflammatory Autoimmune Diseases
- Ladda ner fulltext (pdf) av Unraveling the Genetics of Shared Clinical and Serological Manifestations in Patients With Systemic Inflammatory Autoimmune Diseases
Rheumatoid Arthritis Related B-Cell Changes Are Found Already in the Risk-RA Phase
Ingår i European Journal of Immunology, 2025
- DOI för Rheumatoid Arthritis Related B-Cell Changes Are Found Already in the Risk-RA Phase
- Ladda ner fulltext (pdf) av Rheumatoid Arthritis Related B-Cell Changes Are Found Already in the Risk-RA Phase
Ingår i ACR Open Rheumatology, 2025
- DOI för HLA-B27 has wide clinical impact on juvenile idiopathic arthritis - Eighteen years of follow-up in the population-based Nordic Juvenile Idiopathic Arthritis Cohort
- Ladda ner fulltext (pdf) av HLA-B27 has wide clinical impact on juvenile idiopathic arthritis - Eighteen years of follow-up in the population-based Nordic Juvenile Idiopathic Arthritis Cohort
Ingår i Clinical Immunology, 2025
- DOI för Diffuse large B cell lymphoma in rheumatoid arthritis patients is associated with elevated B-cell driving factors including CXCL13
- Ladda ner fulltext (pdf) av Diffuse large B cell lymphoma in rheumatoid arthritis patients is associated with elevated B-cell driving factors including CXCL13
Ingår i ACR Open Rheumatology, 2025
- DOI för In-Depth Analysis of Disease Manifestations in Antineutrophil Cytoplasmic Antibody-Associated Vasculitides Identifies Distinct Clinical Phenotypes
- Ladda ner fulltext (pdf) av In-Depth Analysis of Disease Manifestations in Antineutrophil Cytoplasmic Antibody-Associated Vasculitides Identifies Distinct Clinical Phenotypes
Ingår i ACR Open Rheumatology, 2025
- DOI för Characteristics That Predict Psoriatic Arthritis by the Classification Criteria for Psoriatic Arthritis in Patients With Juvenile Idiopathic Arthritis 18 Years After Disease Onset
- Ladda ner fulltext (pdf) av Characteristics That Predict Psoriatic Arthritis by the Classification Criteria for Psoriatic Arthritis in Patients With Juvenile Idiopathic Arthritis 18 Years After Disease Onset
Ingår i G3, 2024
- DOI för A chromosome-level assembly of the seed beetle Callosobruchus maculatus genome with annotation of its repetitive elements
- Ladda ner fulltext (pdf) av A chromosome-level assembly of the seed beetle Callosobruchus maculatus genome with annotation of its repetitive elements
Multi-modal single cell sequencing of B cells in primary Sjögren's Syndrome.
Ingår i Arthritis & Rheumatology, s. 255-267, 2024
- DOI för Multi-modal single cell sequencing of B cells in primary Sjögren's Syndrome.
- Ladda ner fulltext (pdf) av Multi-modal single cell sequencing of B cells in primary Sjögren's Syndrome.
Ingår i Annals of the Rheumatic Diseases, s. 88-95, 2024
Ingår i Rheumatology, s. 1104-1112, 2024
- DOI för Glucocorticoid treatment in SLE is associated with infections, comorbidities and mortality-a national cohort study
- Ladda ner fulltext (pdf) av Glucocorticoid treatment in SLE is associated with infections, comorbidities and mortality-a national cohort study
Ingår i Journal of Autoimmunity, 2024
- DOI för A survey of ficolin-3 activity in Systemic Lupus Erythematosus reveals a link to hematological disease manifestations and autoantibody profile
- Ladda ner fulltext (pdf) av A survey of ficolin-3 activity in Systemic Lupus Erythematosus reveals a link to hematological disease manifestations and autoantibody profile
Ingår i Seminars in Arthritis & Rheumatism, 2024
- DOI för Patient global assessment and inflammatory markers in patients with idiopathic inflammatory myopathies: A longitudinal study
- Ladda ner fulltext (pdf) av Patient global assessment and inflammatory markers in patients with idiopathic inflammatory myopathies: A longitudinal study
Ingår i RMD Open, 2024
- DOI för The HLA region in ANCA-associated vasculitis: characterisation of genetic associations in a Scandinavian patient population
- Ladda ner fulltext (pdf) av The HLA region in ANCA-associated vasculitis: characterisation of genetic associations in a Scandinavian patient population
Ingår i Scandinavian Journal of Gastroenterology, s. 425-432, 2024
- DOI för Tofacitinib real-world experience in ulcerative colitis in Finland (FinTofUC): a retrospective non-interventional multicenter patient chart data study
- Ladda ner fulltext (pdf) av Tofacitinib real-world experience in ulcerative colitis in Finland (FinTofUC): a retrospective non-interventional multicenter patient chart data study
Ingår i Genome Biology and Evolution, 2024
- DOI för Comparative Genomic Analysis of the Pattern of Evolution of Male and Female Reproductive Proteins in Seed Beetles
- Ladda ner fulltext (pdf) av Comparative Genomic Analysis of the Pattern of Evolution of Male and Female Reproductive Proteins in Seed Beetles
Ingår i Rheumatology, 2024
- DOI för Plasma interferon-alpha protein levels during pregnancy are associated with lower birth weight in systemic lupus erythematosus.
- Ladda ner fulltext (pdf) av Plasma interferon-alpha protein levels during pregnancy are associated with lower birth weight in systemic lupus erythematosus.
Ingår i Translational Psychiatry, 2024
- DOI för An exploratory study of the damage markers NfL, GFAP, and t-Tau, in cerebrospinal fluid and other findings from a patient cohort enriched for suspected autoimmune psychiatric disease
- Ladda ner fulltext (pdf) av An exploratory study of the damage markers NfL, GFAP, and t-Tau, in cerebrospinal fluid and other findings from a patient cohort enriched for suspected autoimmune psychiatric disease
Genome-wide investigation of persistence with methotrexate treatment in early rheumatoid arthritis
Ingår i Rheumatology, s. 1221-1229, 2024
- DOI för Genome-wide investigation of persistence with methotrexate treatment in early rheumatoid arthritis
- Ladda ner fulltext (pdf) av Genome-wide investigation of persistence with methotrexate treatment in early rheumatoid arthritis
Ingår i Arthritis Research & Therapy, 2024
- DOI för Low CD4+T cell count is related to specific anti-nuclear antibodies, IFNα protein positivity and disease activity in systemic lupus erythematosus pregnancy
- Ladda ner fulltext (pdf) av Low CD4+T cell count is related to specific anti-nuclear antibodies, IFNα protein positivity and disease activity in systemic lupus erythematosus pregnancy
Ingår i RMD Open, 2024
- DOI för Arthritis progressors have a decreased frequency of circulating autoreactive T cells during the at-risk phase of rheumatoid arthritis
- Ladda ner fulltext (pdf) av Arthritis progressors have a decreased frequency of circulating autoreactive T cells during the at-risk phase of rheumatoid arthritis
Rare coding variants in NOX4 link high ROS levels to psoriatic arthritis mutilans
Ingår i EMBO Molecular Medicine, s. 596-615, 2024
- DOI för Rare coding variants in NOX4 link high ROS levels to psoriatic arthritis mutilans
- Ladda ner fulltext (pdf) av Rare coding variants in NOX4 link high ROS levels to psoriatic arthritis mutilans
Exhaled Nitric Oxide Reflects the Immune Reactions of the Airways in Early Rheumatoid Arthritis
Ingår i Biomedicines, 2024
- DOI för Exhaled Nitric Oxide Reflects the Immune Reactions of the Airways in Early Rheumatoid Arthritis
- Ladda ner fulltext (pdf) av Exhaled Nitric Oxide Reflects the Immune Reactions of the Airways in Early Rheumatoid Arthritis
Ingår i Scandinavian Journal of Rheumatology, s. 418-423, 2023
- DOI för Risks and treatment related aspects of COVID-19 infection in patients with ANCA-associated vasculitis
- Ladda ner fulltext (pdf) av Risks and treatment related aspects of COVID-19 infection in patients with ANCA-associated vasculitis
Ingår i RMD Open, 2023
- DOI för Are JAKis more effective among elderly patients with RA, smokers and those with higher cardiovascular risk?: A comparative effectiveness study of b/tsDMARDs in Sweden
- Ladda ner fulltext (pdf) av Are JAKis more effective among elderly patients with RA, smokers and those with higher cardiovascular risk?: A comparative effectiveness study of b/tsDMARDs in Sweden
Multiple Genetic Loci Associated with Pug Dog Thoracolumbar Myelopathy
Ingår i Genes, 2023
- DOI för Multiple Genetic Loci Associated with Pug Dog Thoracolumbar Myelopathy
- Ladda ner fulltext (pdf) av Multiple Genetic Loci Associated with Pug Dog Thoracolumbar Myelopathy
Ingår i Clinical and Experimental Rheumatology, s. 2448-2457, 2023
Mortality risk factors in primary Sjögren syndrome: a real-world, retrospective, cohort study
Ingår i eClinicalMedicine, 2023
- DOI för Mortality risk factors in primary Sjögren syndrome: a real-world, retrospective, cohort study
- Ladda ner fulltext (pdf) av Mortality risk factors in primary Sjögren syndrome: a real-world, retrospective, cohort study
Experiences in implementing immunopsychiatry in real life
Ingår i Journal of Affective Disorders Reports, 2023
- DOI för Experiences in implementing immunopsychiatry in real life
- Ladda ner fulltext (pdf) av Experiences in implementing immunopsychiatry in real life
Stratified genetic analysis reveals sex differences in MPO-ANCA-associated vasculitis
Ingår i Rheumatology, s. 3213-3218, 2023
- DOI för Stratified genetic analysis reveals sex differences in MPO-ANCA-associated vasculitis
- Ladda ner fulltext (pdf) av Stratified genetic analysis reveals sex differences in MPO-ANCA-associated vasculitis
Ingår i Clinical and Experimental Rheumatology, s. 2437-2447, 2023
Ingår i Annals of the Rheumatic Diseases, s. 601-610, 2023
- DOI för Safety of biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis as used in clinical practice: results from the ARTIS programme
- Ladda ner fulltext (pdf) av Safety of biological and targeted synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis as used in clinical practice: results from the ARTIS programme
Ingår i Lupus Science and Medicine, 2023
- DOI för B cell polygenic risk scores associate with anti-dsDNA antibodies and nephritis in systemic lupus erythematosus
- Ladda ner fulltext (pdf) av B cell polygenic risk scores associate with anti-dsDNA antibodies and nephritis in systemic lupus erythematosus
Ingår i Genome Biology and Evolution, 2023
- DOI för Experimental Life History Evolution Results in Sex-specific Evolution of Gene Expression in Seed Beetles
- Ladda ner fulltext (pdf) av Experimental Life History Evolution Results in Sex-specific Evolution of Gene Expression in Seed Beetles
Ingår i Therapeutic Advances in Musculoskeletal Disease, 2023
- DOI för Rheumatoid arthritis disease activity and adverse events in patients receiving tofacitinib or tumor necrosis factor inhibitors: a post hoc analysis of ORAL Surveillance
- Ladda ner fulltext (pdf) av Rheumatoid arthritis disease activity and adverse events in patients receiving tofacitinib or tumor necrosis factor inhibitors: a post hoc analysis of ORAL Surveillance
Distinct HLA associations with autoantibody-defined subgroups in idiopathic inflammatory myopathies
Ingår i EBioMedicine, 2023
- DOI för Distinct HLA associations with autoantibody-defined subgroups in idiopathic inflammatory myopathies
- Ladda ner fulltext (pdf) av Distinct HLA associations with autoantibody-defined subgroups in idiopathic inflammatory myopathies
Ingår i European Journal of Endocrinology, s. 235-241, 2023
- DOI för Relation between HLA and copy number variation of steroid 21-hydroxylase in a Swedish cohort of patients with autoimmune Addison's disease
- Ladda ner fulltext (pdf) av Relation between HLA and copy number variation of steroid 21-hydroxylase in a Swedish cohort of patients with autoimmune Addison's disease
Large-scale phage-based screening reveals extensive pan-viral mimicry of host short linear motifs
Ingår i Nature Communications, 2023
- DOI för Large-scale phage-based screening reveals extensive pan-viral mimicry of host short linear motifs
- Ladda ner fulltext (pdf) av Large-scale phage-based screening reveals extensive pan-viral mimicry of host short linear motifs
Ingår i Annals of the Rheumatic Diseases, s. 1587-1593, 2023
Ingår i Heliyon, 2023
- DOI för Utilizing CD44v6 and V600EBRAF-mutation for in vitro targeted combination therapy of thyroid carcinomas
- Ladda ner fulltext (pdf) av Utilizing CD44v6 and V600EBRAF-mutation for in vitro targeted combination therapy of thyroid carcinomas
Ingår i Annals of the Rheumatic Diseases, s. 754-762, 2023
Ingår i Rheumatology, 2023
- DOI för Serum calprotectin correlates stronger with inflammation and disease activity in ACPA positive than ACPA negative rheumatoid arthritis
- Ladda ner fulltext (pdf) av Serum calprotectin correlates stronger with inflammation and disease activity in ACPA positive than ACPA negative rheumatoid arthritis
Ingår i Arthritis Research & Therapy, 2023
- DOI för Low-density granulocytes are related to shorter pregnancy duration but not to interferon alpha protein blood levels in systemic lupus erythematosus
- Ladda ner fulltext (pdf) av Low-density granulocytes are related to shorter pregnancy duration but not to interferon alpha protein blood levels in systemic lupus erythematosus
A possible genomic footprint of polygenic adaptation on population divergence in seed beetles?
Ingår i Ecology and Evolution, 2022
- DOI för A possible genomic footprint of polygenic adaptation on population divergence in seed beetles?
- Ladda ner fulltext (pdf) av A possible genomic footprint of polygenic adaptation on population divergence in seed beetles?
Ingår i Arthritis & Rheumatology, s. 342-352, 2022
- DOI för Contribution of rare genetic variation to disease susceptibility in a large Scandinavian myositis cohort
- Ladda ner fulltext (pdf) av Contribution of rare genetic variation to disease susceptibility in a large Scandinavian myositis cohort
Ingår i Pharmacogenomics (London), s. 813-820, 2022
- DOI för Genome-wide association study of liver enzyme elevation in an extended cohort of rheumatoid arthritis patients starting low-dose methotrexate
- Ladda ner fulltext (pdf) av Genome-wide association study of liver enzyme elevation in an extended cohort of rheumatoid arthritis patients starting low-dose methotrexate
Ingår i RMD Open, 2022
- DOI för Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: a Nordic cohort study
- Ladda ner fulltext (pdf) av Haematological malignancies in patients with psoriatic arthritis overall and treated with TNF inhibitors: a Nordic cohort study
Ingår i ACR Open Rheumatology, s. 27-39, 2022
- DOI för Four Systemic Lupus Erythematosus Subgroups, Defined by Autoantibodies Status, Differ Regarding HLA-DRB1 Genotype Associations and Immunological and Clinical Manifestations
- Ladda ner fulltext (pdf) av Four Systemic Lupus Erythematosus Subgroups, Defined by Autoantibodies Status, Differ Regarding HLA-DRB1 Genotype Associations and Immunological and Clinical Manifestations
Different chest HRCT scan protocols change the extent of ground glass opacities
Ingår i BMC Pulmonary Medicine, 2022
- DOI för Different chest HRCT scan protocols change the extent of ground glass opacities
- Ladda ner fulltext (pdf) av Different chest HRCT scan protocols change the extent of ground glass opacities
Oral Microbiota Profile in Patients with Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Ingår i Microorganisms, 2022
- DOI för Oral Microbiota Profile in Patients with Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
- Ladda ner fulltext (pdf) av Oral Microbiota Profile in Patients with Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Implementing precision medicine in a regionally organized healthcare system in Sweden.
Ingår i Nature Medicine, s. 1980-1982, 2022
Urval av våra publikationer
Arvidsson G, Czarnewski P, Johansson A, Raine A, Imgenberg-Kreuz J, Nordlund J, Nordmark G, Syvänen AC. Multimodal Single-Cell Sequencing of B Cells in Primary Sjögren's Syndrome. Arthritis Rheumatol. 2024 Feb;76(2):255-267. doi: 10.1002/art.42683. Epub 2023 Dec 18.PMID: 37610265
Hedenstedt A, Reid S, Sayadi A, Eloranta ML, Skoglund E, Bolin K, Frodlund M, Lerang K, Jönsen A, Rantapää-Dahlqvist S, Bengtsson AA, Rudin A, Molberg Ø, Sjöwall C, Sandling JK, Leonard D. B cell polygenic risk scores associate with anti-dsDNA antibodies and nephritis in systemic lupus erythematosus. Lupus Sci Med. 2023 Oct;10(2):e000926. doi: 10.1136/lupus-2023-000926.PMID: 37844960
Ekman D, Sennblad B, Knight A, Karlsson Å, Rantapää-Dahlqvist S, Berglin E, Stegmayr B, Baslund B, Palm Ø, Haukeland H, Gunnarsson I, Bruchfeld A, Segelmark M, Ohlsson S, Mohammad AJ, Svärd A, Pullerits R, Herlitz H, Söderbergh A, Omdal R, Jonsson R, Rönnblom L, Eriksson P, Lindblad-Toh K, Dahlqvist J. Stratified genetic analysis reveals sex differences in MPO-ANCA-associated vasculitis. Rheumatology (Oxford). 2023 Sep 1;62(9):3213-3218. doi: 10.1093/rheumatology/kead152.PMID: 37004177
Dahlqvist J, Ekman D, Sennblad B, Kozyrev SV, Nordin J, Karlsson Å, Meadows JRS, Hellbacher E, Rantapää-Dahlqvist S, Berglin E, Stegmayr B, Baslund B, Palm Ø, Haukeland H, Gunnarsson I, Bruchfeld A, Segelmark M, Ohlsson S, Mohammad AJ, Svärd A, Pullerits R, Herlitz H, Söderbergh A, Rosengren Pielberg G, Hultin Rosenberg L, Bianchi M, Murén E, Omdal R, Jonsson R, Eloranta ML, Rönnblom L, Söderkvist P, Knight A, Eriksson P, Lindblad-Toh K. Identification and functional characterization of a novel susceptibility locus for small vessel vasculitis with MPO-ANCA. Rheumatology (Oxford). 2022 Aug 3;61(8):3461-3470. doi: 10.1093/rheumatology/keab912.PMID: 34888651
Thorlacius GE, Hultin-Rosenberg L, Sandling JK, Bianchi M, Imgenberg-Kreuz J, Pucholt P, Theander E, Kvarnström M, Forsblad-d'Elia H, Bucher SM, Norheim KB, Johnsen SJA, Hammenfors D, Skarstein K, Jonsson MV, Baecklund E, Aqrawi LA, Jensen JL, Palm Ø, Morris AP; DISSECT consortium; the ImmunoArray consortium; Meadows JRS, Rantapää-Dahlqvist S, Mandl T, Eriksson P, Lind L, Omdal R, Jonsson R, Lindblad-Toh K, Rönnblom L, Wahren-Herlenius M, Nordmark G. Genetic and clinical basis for two distinct subtypes of primary Sjögren's syndrome. Rheumatology (Oxford). 2021 Feb 1;60(2):837-848. doi: 10.1093/rheumatology/keaa367.PMID: 32889544
Reid S, Hagberg N, Sandling JK, Alexsson A, Pucholt P, Sjöwall C, Lerang K, Jönsen A, Gunnarsson I, Syvänen AC, Troldborg AM, Voss A, Bengtsson AA, Molberg Ø, Jacobsen S, Svenungsson E, Rönnblom L, Leonard D. Interaction between the STAT4 rs11889341(T) risk allele and smoking confers increased risk of myocardial infarction and nephritis in patients with systemic lupus erythematosus. Ann Rheum Dis. 2021 Sep;80(9):1183-1189. doi: 10.1136/annrheumdis-2020-219727. Epub 2021 Mar 25.PMID: 3376689
Reid S, Alexsson A, Frodlund M, Morris D, Sandling JK, Bolin K, Svenungsson E, Jönsen A, Bengtsson C, Gunnarsson I, Illescas Rodriguez V, Bengtsson A, Arve S, Rantapää-Dahlqvist S, Eloranta ML, Syvänen AC, Sjöwall C, Vyse TJ, Rönnblom L, Leonard D. High genetic risk score is associated with early disease onset, damage accrual and decreased survival in systemic lupus erythematosus. Ann Rheum Dis. 2020 Mar;79(3):363-369. doi: 10.1136/annrheumdis-2019-216227. Epub 2019 Dec 11.PMID: 31826855
Vasaitis L, Nordmark G, Theander E, Backlin C, Smedby KE, Askling J, Rönnblom L, Sundström C, Baecklund E. Population-based study of patients with primary Sjögren's syndrome and lymphoma: lymphoma subtypes, clinical characteristics, and gender differences. Scand J Rheumatol. 2020 May;49(3):225-232. doi: 10.1080/03009742.2019.1696403. Epub 2020 Mar 10.PMID: 32153241
Hellbacher E, Hjorton K, Backlin C, Enblad G, Sundström C, Baecklund E, Knight A. Malignant lymphoma in granulomatosis with polyangiitis: subtypes, clinical characteristics and prognosis. Acta Oncol. 2019 Nov;58(11):1655-1659. doi: 10.1080/0284186X.2019.1634833. Epub 2019 Aug 13.PMID: 31407922
Imgenberg-Kreuz J, Sandling JK, Almlöf JC, Nordlund J, Signér L, Norheim KB, Omdal R, Rönnblom L, Eloranta ML, Syvänen AC, Nordmark G. Genome-wide DNA methylation analysis in multiple tissues in primary Sjögren's syndrome reveals regulatory effects at interferon-induced genes. Ann Rheum Dis. 2016 Nov;75(11):2029-2036. doi: 10.1136/annrheumdis-2015-208659. Epub 2016 Feb 8.PMID: 26857698