Cytotoxic chromosomal targeting by CRISPR/Cas systems can reshape bacterial genomes and expel or remodel pathogenicity islands

In prokaryotes, clustered regularly interspaced short palindromic repeats (CRISPRs) and their associated (Cas) proteins constitute a defence system against bacteriophages and plasmids. CRISPR/Cas systems acquire short spacer sequences from foreign genetic elements and incorporate these into their CR...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:PLoS genetics 2013-04, Vol.9 (4), p.e1003454
Hauptverfasser: Vercoe, Reuben B, Chang, James T, Dy, Ron L, Taylor, Corinda, Gristwood, Tamzin, Clulow, James S, Richter, Corinna, Przybilski, Rita, Pitman, Andrew R, Fineran, Peter C
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 4
container_start_page e1003454
container_title PLoS genetics
container_volume 9
creator Vercoe, Reuben B
Chang, James T
Dy, Ron L
Taylor, Corinda
Gristwood, Tamzin
Clulow, James S
Richter, Corinna
Przybilski, Rita
Pitman, Andrew R
Fineran, Peter C
description In prokaryotes, clustered regularly interspaced short palindromic repeats (CRISPRs) and their associated (Cas) proteins constitute a defence system against bacteriophages and plasmids. CRISPR/Cas systems acquire short spacer sequences from foreign genetic elements and incorporate these into their CRISPR arrays, generating a memory of past invaders. Defence is provided by short non-coding RNAs that guide Cas proteins to cleave complementary nucleic acids. While most spacers are acquired from phages and plasmids, there are examples of spacers that match genes elsewhere in the host bacterial chromosome. In Pectobacterium atrosepticum the type I-F CRISPR/Cas system has acquired a self-complementary spacer that perfectly matches a protospacer target in a horizontally acquired island (HAI2) involved in plant pathogenicity. Given the paucity of experimental data about CRISPR/Cas-mediated chromosomal targeting, we examined this process by developing a tightly controlled system. Chromosomal targeting was highly toxic via targeting of DNA and resulted in growth inhibition and cellular filamentation. The toxic phenotype was avoided by mutations in the cas operon, the CRISPR repeats, the protospacer target, and protospacer-adjacent motif (PAM) beside the target. Indeed, the natural self-targeting spacer was non-toxic due to a single nucleotide mutation adjacent to the target in the PAM sequence. Furthermore, we show that chromosomal targeting can result in large-scale genomic alterations, including the remodelling or deletion of entire pre-existing pathogenicity islands. These features can be engineered for the targeted deletion of large regions of bacterial chromosomes. In conclusion, in DNA-targeting CRISPR/Cas systems, chromosomal interference is deleterious by causing DNA damage and providing a strong selective pressure for genome alterations, which may have consequences for bacterial evolution and pathogenicity.
doi_str_mv 10.1371/journal.pgen.1003454
format Article
fullrecord <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1351901789</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A330251537</galeid><doaj_id>oai_doaj_org_article_1ca8c083e7304659ae3af02bdfbfea2b</doaj_id><sourcerecordid>A330251537</sourcerecordid><originalsourceid>FETCH-LOGICAL-c698t-5bd7cbfa7fa4377b66ae0a477c2a0a325c8187bd2d846f4752f24e261966dfd53</originalsourceid><addsrcrecordid>eNqVk12L1DAUhoso7jr6D0QDguDFzCZN0nRuhGXwY2BxZVa9Dadp0mZpm5JkZObG327WmV2m4IWSi4ST531POCcny14SvCBUkItbt_UDdIux0cOCYEwZZ4-yc8I5nQuG2eOT81n2LITbxPByKZ5mZzktqChydp79Wu2ji25nFVKtd70LrocORfCNjnZoULVHq8365uvmYgUBhX2Iug9IwYC8Di2MGlWgovY2qdJLXK8DgqFGejfqDjmfsN7V6ThCbF0irLJxj2zoEhWeZ08MdEG_OO6z7PvHD99Wn-dX15_Wq8uruSqWZZzzqhaqMiAMMCpEVRSgMTAhVA4YaM5VSUpR1XldssIwwXOTM50XZFkUtak5nWWvD75j54I8li5IQjlZYiLKZSLWB6J2cCtHb3vwe-nAyj8B5xsJPlrVaUkUlAqXVAuKWcGXoCkYnFe1qYyGvEpe74_ZtlWva6WH6KGbmE5vBtvKxv2UqS2YJOdZ9uZg0EDKZwfjEqZ6G5S8pBTnnHAqErX4C5VWrXur3KCNTfGJ4N1EkJiod7GBbQhyfbP5D_bLv7PXP6bs2xO21dDFNrhuG60bwhRkB1B5F4LX5qF-BMu7Cbhvo7ybAHmcgCR7dVr7B9H9l6e_AbCUA1E</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Cytotoxic chromosomal targeting by CRISPR/Cas systems can reshape bacterial genomes and expel or remodel pathogenicity islands</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Public Library of Science (PLoS)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Vercoe, Reuben B ; Chang, James T ; Dy, Ron L ; Taylor, Corinda ; Gristwood, Tamzin ; Clulow, James S ; Richter, Corinna ; Przybilski, Rita ; Pitman, Andrew R ; Fineran, Peter C</creator><contributor>Hughes, Diarmaid</contributor><creatorcontrib>Vercoe, Reuben B ; Chang, James T ; Dy, Ron L ; Taylor, Corinda ; Gristwood, Tamzin ; Clulow, James S ; Richter, Corinna ; Przybilski, Rita ; Pitman, Andrew R ; Fineran, Peter C ; Hughes, Diarmaid</creatorcontrib><description>In prokaryotes, clustered regularly interspaced short palindromic repeats (CRISPRs) and their associated (Cas) proteins constitute a defence system against bacteriophages and plasmids. CRISPR/Cas systems acquire short spacer sequences from foreign genetic elements and incorporate these into their CRISPR arrays, generating a memory of past invaders. Defence is provided by short non-coding RNAs that guide Cas proteins to cleave complementary nucleic acids. While most spacers are acquired from phages and plasmids, there are examples of spacers that match genes elsewhere in the host bacterial chromosome. In Pectobacterium atrosepticum the type I-F CRISPR/Cas system has acquired a self-complementary spacer that perfectly matches a protospacer target in a horizontally acquired island (HAI2) involved in plant pathogenicity. Given the paucity of experimental data about CRISPR/Cas-mediated chromosomal targeting, we examined this process by developing a tightly controlled system. Chromosomal targeting was highly toxic via targeting of DNA and resulted in growth inhibition and cellular filamentation. The toxic phenotype was avoided by mutations in the cas operon, the CRISPR repeats, the protospacer target, and protospacer-adjacent motif (PAM) beside the target. Indeed, the natural self-targeting spacer was non-toxic due to a single nucleotide mutation adjacent to the target in the PAM sequence. Furthermore, we show that chromosomal targeting can result in large-scale genomic alterations, including the remodelling or deletion of entire pre-existing pathogenicity islands. These features can be engineered for the targeted deletion of large regions of bacterial chromosomes. In conclusion, in DNA-targeting CRISPR/Cas systems, chromosomal interference is deleterious by causing DNA damage and providing a strong selective pressure for genome alterations, which may have consequences for bacterial evolution and pathogenicity.</description><identifier>ISSN: 1553-7404</identifier><identifier>ISSN: 1553-7390</identifier><identifier>EISSN: 1553-7404</identifier><identifier>DOI: 10.1371/journal.pgen.1003454</identifier><identifier>PMID: 23637624</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Arrays ; Bacteria ; Bacterial genetics ; Bacteriophages ; Biology ; Chromosomes ; Clustered Regularly Interspaced Short Palindromic Repeats ; Colleges &amp; universities ; CRISPR-Cas Systems ; Cytotoxicity ; Deoxyribonucleic acid ; DNA ; Genetic aspects ; Genome, Bacterial ; Genomes ; Genomic Islands ; Health aspects ; Immune system ; Islands ; Microbiology ; Mutation ; Physiological aspects ; Plasmids ; Prokaryotes</subject><ispartof>PLoS genetics, 2013-04, Vol.9 (4), p.e1003454</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Vercoe et al 2013 Vercoe et al</rights><rights>2013 Vercoe et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Vercoe RB, Chang JT, Dy RL, Taylor C, Gristwood T, et al. (2013) Cytotoxic Chromosomal Targeting by CRISPR/Cas Systems Can Reshape Bacterial Genomes and Expel or Remodel Pathogenicity Islands. PLoS Genet 9(4): e1003454. doi:10.1371/journal.pgen.1003454</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c698t-5bd7cbfa7fa4377b66ae0a477c2a0a325c8187bd2d846f4752f24e261966dfd53</citedby><cites>FETCH-LOGICAL-c698t-5bd7cbfa7fa4377b66ae0a477c2a0a325c8187bd2d846f4752f24e261966dfd53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630108/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630108/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23864,27922,27923,53789,53791,79370,79371</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23637624$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hughes, Diarmaid</contributor><creatorcontrib>Vercoe, Reuben B</creatorcontrib><creatorcontrib>Chang, James T</creatorcontrib><creatorcontrib>Dy, Ron L</creatorcontrib><creatorcontrib>Taylor, Corinda</creatorcontrib><creatorcontrib>Gristwood, Tamzin</creatorcontrib><creatorcontrib>Clulow, James S</creatorcontrib><creatorcontrib>Richter, Corinna</creatorcontrib><creatorcontrib>Przybilski, Rita</creatorcontrib><creatorcontrib>Pitman, Andrew R</creatorcontrib><creatorcontrib>Fineran, Peter C</creatorcontrib><title>Cytotoxic chromosomal targeting by CRISPR/Cas systems can reshape bacterial genomes and expel or remodel pathogenicity islands</title><title>PLoS genetics</title><addtitle>PLoS Genet</addtitle><description>In prokaryotes, clustered regularly interspaced short palindromic repeats (CRISPRs) and their associated (Cas) proteins constitute a defence system against bacteriophages and plasmids. CRISPR/Cas systems acquire short spacer sequences from foreign genetic elements and incorporate these into their CRISPR arrays, generating a memory of past invaders. Defence is provided by short non-coding RNAs that guide Cas proteins to cleave complementary nucleic acids. While most spacers are acquired from phages and plasmids, there are examples of spacers that match genes elsewhere in the host bacterial chromosome. In Pectobacterium atrosepticum the type I-F CRISPR/Cas system has acquired a self-complementary spacer that perfectly matches a protospacer target in a horizontally acquired island (HAI2) involved in plant pathogenicity. Given the paucity of experimental data about CRISPR/Cas-mediated chromosomal targeting, we examined this process by developing a tightly controlled system. Chromosomal targeting was highly toxic via targeting of DNA and resulted in growth inhibition and cellular filamentation. The toxic phenotype was avoided by mutations in the cas operon, the CRISPR repeats, the protospacer target, and protospacer-adjacent motif (PAM) beside the target. Indeed, the natural self-targeting spacer was non-toxic due to a single nucleotide mutation adjacent to the target in the PAM sequence. Furthermore, we show that chromosomal targeting can result in large-scale genomic alterations, including the remodelling or deletion of entire pre-existing pathogenicity islands. These features can be engineered for the targeted deletion of large regions of bacterial chromosomes. In conclusion, in DNA-targeting CRISPR/Cas systems, chromosomal interference is deleterious by causing DNA damage and providing a strong selective pressure for genome alterations, which may have consequences for bacterial evolution and pathogenicity.</description><subject>Arrays</subject><subject>Bacteria</subject><subject>Bacterial genetics</subject><subject>Bacteriophages</subject><subject>Biology</subject><subject>Chromosomes</subject><subject>Clustered Regularly Interspaced Short Palindromic Repeats</subject><subject>Colleges &amp; universities</subject><subject>CRISPR-Cas Systems</subject><subject>Cytotoxicity</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>Genetic aspects</subject><subject>Genome, Bacterial</subject><subject>Genomes</subject><subject>Genomic Islands</subject><subject>Health aspects</subject><subject>Immune system</subject><subject>Islands</subject><subject>Microbiology</subject><subject>Mutation</subject><subject>Physiological aspects</subject><subject>Plasmids</subject><subject>Prokaryotes</subject><issn>1553-7404</issn><issn>1553-7390</issn><issn>1553-7404</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNqVk12L1DAUhoso7jr6D0QDguDFzCZN0nRuhGXwY2BxZVa9Dadp0mZpm5JkZObG327WmV2m4IWSi4ST531POCcny14SvCBUkItbt_UDdIux0cOCYEwZZ4-yc8I5nQuG2eOT81n2LITbxPByKZ5mZzktqChydp79Wu2ji25nFVKtd70LrocORfCNjnZoULVHq8365uvmYgUBhX2Iug9IwYC8Di2MGlWgovY2qdJLXK8DgqFGejfqDjmfsN7V6ThCbF0irLJxj2zoEhWeZ08MdEG_OO6z7PvHD99Wn-dX15_Wq8uruSqWZZzzqhaqMiAMMCpEVRSgMTAhVA4YaM5VSUpR1XldssIwwXOTM50XZFkUtak5nWWvD75j54I8li5IQjlZYiLKZSLWB6J2cCtHb3vwe-nAyj8B5xsJPlrVaUkUlAqXVAuKWcGXoCkYnFe1qYyGvEpe74_ZtlWva6WH6KGbmE5vBtvKxv2UqS2YJOdZ9uZg0EDKZwfjEqZ6G5S8pBTnnHAqErX4C5VWrXur3KCNTfGJ4N1EkJiod7GBbQhyfbP5D_bLv7PXP6bs2xO21dDFNrhuG60bwhRkB1B5F4LX5qF-BMu7Cbhvo7ybAHmcgCR7dVr7B9H9l6e_AbCUA1E</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Vercoe, Reuben B</creator><creator>Chang, James T</creator><creator>Dy, Ron L</creator><creator>Taylor, Corinda</creator><creator>Gristwood, Tamzin</creator><creator>Clulow, James S</creator><creator>Richter, Corinna</creator><creator>Przybilski, Rita</creator><creator>Pitman, Andrew R</creator><creator>Fineran, Peter C</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><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>IOV</scope><scope>ISN</scope><scope>ISR</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130401</creationdate><title>Cytotoxic chromosomal targeting by CRISPR/Cas systems can reshape bacterial genomes and expel or remodel pathogenicity islands</title><author>Vercoe, Reuben B ; Chang, James T ; Dy, Ron L ; Taylor, Corinda ; Gristwood, Tamzin ; Clulow, James S ; Richter, Corinna ; Przybilski, Rita ; Pitman, Andrew R ; Fineran, Peter C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c698t-5bd7cbfa7fa4377b66ae0a477c2a0a325c8187bd2d846f4752f24e261966dfd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Arrays</topic><topic>Bacteria</topic><topic>Bacterial genetics</topic><topic>Bacteriophages</topic><topic>Biology</topic><topic>Chromosomes</topic><topic>Clustered Regularly Interspaced Short Palindromic Repeats</topic><topic>Colleges &amp; universities</topic><topic>CRISPR-Cas Systems</topic><topic>Cytotoxicity</topic><topic>Deoxyribonucleic acid</topic><topic>DNA</topic><topic>Genetic aspects</topic><topic>Genome, Bacterial</topic><topic>Genomes</topic><topic>Genomic Islands</topic><topic>Health aspects</topic><topic>Immune system</topic><topic>Islands</topic><topic>Microbiology</topic><topic>Mutation</topic><topic>Physiological aspects</topic><topic>Plasmids</topic><topic>Prokaryotes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vercoe, Reuben B</creatorcontrib><creatorcontrib>Chang, James T</creatorcontrib><creatorcontrib>Dy, Ron L</creatorcontrib><creatorcontrib>Taylor, Corinda</creatorcontrib><creatorcontrib>Gristwood, Tamzin</creatorcontrib><creatorcontrib>Clulow, James S</creatorcontrib><creatorcontrib>Richter, Corinna</creatorcontrib><creatorcontrib>Przybilski, Rita</creatorcontrib><creatorcontrib>Pitman, Andrew R</creatorcontrib><creatorcontrib>Fineran, Peter C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS genetics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vercoe, Reuben B</au><au>Chang, James T</au><au>Dy, Ron L</au><au>Taylor, Corinda</au><au>Gristwood, Tamzin</au><au>Clulow, James S</au><au>Richter, Corinna</au><au>Przybilski, Rita</au><au>Pitman, Andrew R</au><au>Fineran, Peter C</au><au>Hughes, Diarmaid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cytotoxic chromosomal targeting by CRISPR/Cas systems can reshape bacterial genomes and expel or remodel pathogenicity islands</atitle><jtitle>PLoS genetics</jtitle><addtitle>PLoS Genet</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>9</volume><issue>4</issue><spage>e1003454</spage><pages>e1003454-</pages><issn>1553-7404</issn><issn>1553-7390</issn><eissn>1553-7404</eissn><abstract>In prokaryotes, clustered regularly interspaced short palindromic repeats (CRISPRs) and their associated (Cas) proteins constitute a defence system against bacteriophages and plasmids. CRISPR/Cas systems acquire short spacer sequences from foreign genetic elements and incorporate these into their CRISPR arrays, generating a memory of past invaders. Defence is provided by short non-coding RNAs that guide Cas proteins to cleave complementary nucleic acids. While most spacers are acquired from phages and plasmids, there are examples of spacers that match genes elsewhere in the host bacterial chromosome. In Pectobacterium atrosepticum the type I-F CRISPR/Cas system has acquired a self-complementary spacer that perfectly matches a protospacer target in a horizontally acquired island (HAI2) involved in plant pathogenicity. Given the paucity of experimental data about CRISPR/Cas-mediated chromosomal targeting, we examined this process by developing a tightly controlled system. Chromosomal targeting was highly toxic via targeting of DNA and resulted in growth inhibition and cellular filamentation. The toxic phenotype was avoided by mutations in the cas operon, the CRISPR repeats, the protospacer target, and protospacer-adjacent motif (PAM) beside the target. Indeed, the natural self-targeting spacer was non-toxic due to a single nucleotide mutation adjacent to the target in the PAM sequence. Furthermore, we show that chromosomal targeting can result in large-scale genomic alterations, including the remodelling or deletion of entire pre-existing pathogenicity islands. These features can be engineered for the targeted deletion of large regions of bacterial chromosomes. In conclusion, in DNA-targeting CRISPR/Cas systems, chromosomal interference is deleterious by causing DNA damage and providing a strong selective pressure for genome alterations, which may have consequences for bacterial evolution and pathogenicity.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23637624</pmid><doi>10.1371/journal.pgen.1003454</doi><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1553-7404
ispartof PLoS genetics, 2013-04, Vol.9 (4), p.e1003454
issn 1553-7404
1553-7390
1553-7404
language eng
recordid cdi_plos_journals_1351901789
source MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central
subjects Arrays
Bacteria
Bacterial genetics
Bacteriophages
Biology
Chromosomes
Clustered Regularly Interspaced Short Palindromic Repeats
Colleges & universities
CRISPR-Cas Systems
Cytotoxicity
Deoxyribonucleic acid
DNA
Genetic aspects
Genome, Bacterial
Genomes
Genomic Islands
Health aspects
Immune system
Islands
Microbiology
Mutation
Physiological aspects
Plasmids
Prokaryotes
title Cytotoxic chromosomal targeting by CRISPR/Cas systems can reshape bacterial genomes and expel or remodel pathogenicity islands
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T08%3A17%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cytotoxic%20chromosomal%20targeting%20by%20CRISPR/Cas%20systems%20can%20reshape%20bacterial%20genomes%20and%20expel%20or%20remodel%20pathogenicity%20islands&rft.jtitle=PLoS%20genetics&rft.au=Vercoe,%20Reuben%20B&rft.date=2013-04-01&rft.volume=9&rft.issue=4&rft.spage=e1003454&rft.pages=e1003454-&rft.issn=1553-7404&rft.eissn=1553-7404&rft_id=info:doi/10.1371/journal.pgen.1003454&rft_dat=%3Cgale_plos_%3EA330251537%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/23637624&rft_galeid=A330251537&rft_doaj_id=oai_doaj_org_article_1ca8c083e7304659ae3af02bdfbfea2b&rfr_iscdi=true