Humoral Responses to Diverse Autoimmune Disease-Associated Antigens in Multiple Sclerosis
To compare frequencies of autoreactive antibody responses to endogenous disease-associated antigens in healthy controls (HC), relapsing and progressive MS and to assess their associations with clinical and MRI measures of MS disease progression. The study analyzed 969 serum samples from 315 HC, 411...
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description | To compare frequencies of autoreactive antibody responses to endogenous disease-associated antigens in healthy controls (HC), relapsing and progressive MS and to assess their associations with clinical and MRI measures of MS disease progression.
The study analyzed 969 serum samples from 315 HC, 411 relapsing remitting MS (RR-MS), 128 secondary progressive MS (SP-MS), 33 primary progressive MS (PP-MS) and 82 patients with other neurological diseases for autoantibodies against two putative MS antigens CSF114(Glc) and KIR4.1a and KIR4.1b and against 24 key endogenous antigens linked to diseases such as vasculitis, systemic sclerosis, rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, polymyositis, scleroderma, polymyositis, dermatomyositis, mixed connective tissue disease and primary biliary cirrhosis. Associations with disability and MRI measures of lesional injury and neurodegeneration were assessed.
The frequencies of anti-KIR4.1a and anti-KIR4.1b peptide IgG positivity were 9.8% and 11.4% in HC compared to 4.9% and 7.5% in RR-MS, 8.6% for both peptides in SP-MS and 6.1% for both peptides in PP-MS (p = 0.13 for KIR4.1a and p = 0.34 for KIR4.1b), respectively. Antibodies against CSF114(Glc), KIR4.1a and KIR4.1b peptides were not associated with MS compared to HC, or with MS disease progression. HLA DRB1*15:01 positivity and anti-Epstein Barr virus antibodies, which are MS risk factors, were not associated with these putative MS antibodies.
Antibody responses to KIR4.1a and KIR4.1b peptides are not increased in MS compared to HC nor associated with MS disease progression. The frequencies of the diverse autoreactive antibodies investigated are similar in MS and HC. |
doi_str_mv | 10.1371/journal.pone.0129503 |
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The study analyzed 969 serum samples from 315 HC, 411 relapsing remitting MS (RR-MS), 128 secondary progressive MS (SP-MS), 33 primary progressive MS (PP-MS) and 82 patients with other neurological diseases for autoantibodies against two putative MS antigens CSF114(Glc) and KIR4.1a and KIR4.1b and against 24 key endogenous antigens linked to diseases such as vasculitis, systemic sclerosis, rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, polymyositis, scleroderma, polymyositis, dermatomyositis, mixed connective tissue disease and primary biliary cirrhosis. Associations with disability and MRI measures of lesional injury and neurodegeneration were assessed.
The frequencies of anti-KIR4.1a and anti-KIR4.1b peptide IgG positivity were 9.8% and 11.4% in HC compared to 4.9% and 7.5% in RR-MS, 8.6% for both peptides in SP-MS and 6.1% for both peptides in PP-MS (p = 0.13 for KIR4.1a and p = 0.34 for KIR4.1b), respectively. Antibodies against CSF114(Glc), KIR4.1a and KIR4.1b peptides were not associated with MS compared to HC, or with MS disease progression. HLA DRB1*15:01 positivity and anti-Epstein Barr virus antibodies, which are MS risk factors, were not associated with these putative MS antibodies.
Antibody responses to KIR4.1a and KIR4.1b peptides are not increased in MS compared to HC nor associated with MS disease progression. The frequencies of the diverse autoreactive antibodies investigated are similar in MS and HC.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0129503</identifier><identifier>PMID: 26065913</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Antibodies ; Antigens ; Antigens - blood ; Antigens - immunology ; Arthritis ; Autoantibodies ; Autoantibodies - blood ; Autoantibodies - immunology ; Autoimmune diseases ; Autoimmune Diseases - immunology ; Autoimmunity ; Case-Control Studies ; Chronic conditions ; Cirrhosis ; Connective tissues ; Cytomegalovirus - immunology ; Dermatomyositis ; Disease control ; Drb1 protein ; Epstein-Barr virus ; Female ; Herpesvirus 4, Human - immunology ; Histocompatibility antigen HLA ; HLA-DRB1 Chains - genetics ; HLA-DRB1 Chains - immunology ; Humans ; Immunity, Humoral ; Immunoglobulin G ; Immunoglobulins ; Immunology ; Liver cirrhosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mixed connective tissue disease ; Multiple sclerosis ; Multiple Sclerosis - immunology ; Multiple Sclerosis, Relapsing-Remitting - immunology ; Neurodegeneration ; Neurological diseases ; Neurology ; Pathogenesis ; Peptides ; Pharmaceutical sciences ; Polymyositis ; Potassium ; Potassium channels (inwardly-rectifying) ; Potassium Channels, Inwardly Rectifying - blood ; Potassium Channels, Inwardly Rectifying - immunology ; Primary biliary cirrhosis ; Reference Values ; Rheumatoid arthritis ; Risk analysis ; Risk factors ; Scleroderma ; Scleroderma (Disease) ; Sjogren's syndrome ; Studies ; Systemic lupus erythematosus ; Systemic sclerosis ; Vasculitis ; Viruses</subject><ispartof>PloS one, 2015-06, Vol.10 (6), p.e0129503-e0129503</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Malyavantham et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Malyavantham et al 2015 Malyavantham et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-fdee76c3b69dd608ca4fa1444dc3b361a4395488a662bbc58c5489dd818cac73</citedby><cites>FETCH-LOGICAL-c692t-fdee76c3b69dd608ca4fa1444dc3b361a4395488a662bbc58c5489dd818cac73</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/PMC4466031/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466031/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26065913$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Malyavantham, Kishore</creatorcontrib><creatorcontrib>Weinstock-Guttman, Bianca</creatorcontrib><creatorcontrib>Suresh, Lakshmanan</creatorcontrib><creatorcontrib>Zivadinov, Robert</creatorcontrib><creatorcontrib>Shanahan, Thomas</creatorcontrib><creatorcontrib>Badgett, Darlene</creatorcontrib><creatorcontrib>Ramanathan, Murali</creatorcontrib><title>Humoral Responses to Diverse Autoimmune Disease-Associated Antigens in Multiple Sclerosis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To compare frequencies of autoreactive antibody responses to endogenous disease-associated antigens in healthy controls (HC), relapsing and progressive MS and to assess their associations with clinical and MRI measures of MS disease progression.
The study analyzed 969 serum samples from 315 HC, 411 relapsing remitting MS (RR-MS), 128 secondary progressive MS (SP-MS), 33 primary progressive MS (PP-MS) and 82 patients with other neurological diseases for autoantibodies against two putative MS antigens CSF114(Glc) and KIR4.1a and KIR4.1b and against 24 key endogenous antigens linked to diseases such as vasculitis, systemic sclerosis, rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, polymyositis, scleroderma, polymyositis, dermatomyositis, mixed connective tissue disease and primary biliary cirrhosis. Associations with disability and MRI measures of lesional injury and neurodegeneration were assessed.
The frequencies of anti-KIR4.1a and anti-KIR4.1b peptide IgG positivity were 9.8% and 11.4% in HC compared to 4.9% and 7.5% in RR-MS, 8.6% for both peptides in SP-MS and 6.1% for both peptides in PP-MS (p = 0.13 for KIR4.1a and p = 0.34 for KIR4.1b), respectively. Antibodies against CSF114(Glc), KIR4.1a and KIR4.1b peptides were not associated with MS compared to HC, or with MS disease progression. HLA DRB1*15:01 positivity and anti-Epstein Barr virus antibodies, which are MS risk factors, were not associated with these putative MS antibodies.
Antibody responses to KIR4.1a and KIR4.1b peptides are not increased in MS compared to HC nor associated with MS disease progression. The frequencies of the diverse autoreactive antibodies investigated are similar in MS and HC.</description><subject>Adult</subject><subject>Antibodies</subject><subject>Antigens</subject><subject>Antigens - blood</subject><subject>Antigens - immunology</subject><subject>Arthritis</subject><subject>Autoantibodies</subject><subject>Autoantibodies - blood</subject><subject>Autoantibodies - immunology</subject><subject>Autoimmune diseases</subject><subject>Autoimmune Diseases - immunology</subject><subject>Autoimmunity</subject><subject>Case-Control Studies</subject><subject>Chronic conditions</subject><subject>Cirrhosis</subject><subject>Connective tissues</subject><subject>Cytomegalovirus - immunology</subject><subject>Dermatomyositis</subject><subject>Disease control</subject><subject>Drb1 protein</subject><subject>Epstein-Barr virus</subject><subject>Female</subject><subject>Herpesvirus 4, Human - immunology</subject><subject>Histocompatibility antigen HLA</subject><subject>HLA-DRB1 Chains - genetics</subject><subject>HLA-DRB1 Chains - immunology</subject><subject>Humans</subject><subject>Immunity, Humoral</subject><subject>Immunoglobulin G</subject><subject>Immunoglobulins</subject><subject>Immunology</subject><subject>Liver cirrhosis</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mixed connective tissue disease</subject><subject>Multiple sclerosis</subject><subject>Multiple Sclerosis - immunology</subject><subject>Multiple Sclerosis, Relapsing-Remitting - immunology</subject><subject>Neurodegeneration</subject><subject>Neurological diseases</subject><subject>Neurology</subject><subject>Pathogenesis</subject><subject>Peptides</subject><subject>Pharmaceutical sciences</subject><subject>Polymyositis</subject><subject>Potassium</subject><subject>Potassium channels (inwardly-rectifying)</subject><subject>Potassium Channels, Inwardly Rectifying - blood</subject><subject>Potassium Channels, Inwardly Rectifying - immunology</subject><subject>Primary biliary cirrhosis</subject><subject>Reference Values</subject><subject>Rheumatoid arthritis</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Scleroderma</subject><subject>Scleroderma (Disease)</subject><subject>Sjogren's syndrome</subject><subject>Studies</subject><subject>Systemic lupus erythematosus</subject><subject>Systemic sclerosis</subject><subject>Vasculitis</subject><subject>Viruses</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99r2zAQx83YWLtu_8HYDIOxPSSTLFmRXgam-9FAR6Etgz0JWT4nCraV-uSy_fdTGrfEow9DD5JOn_vqdLpLkteUzClb0E8bP_SdaeZb38Gc0EzlhD1Jjqli2UxkhD09WB8lLxA3hORMCvE8OcoEEbmi7Dj5dTa0vjdNegkYlRAwDT794m6hR0iLIXjXtkMH0YRgEGYForfOBKjSogtuBR2mrkt_DE1w2wbSK9tA79Hhy-RZbRqEV-N8klx_-3p9ejY7v_i-PC3OZ1aoLMzqCmAhLCuFqipBpDW8NpRzXkUbE9RwpnIupREiK0ubSxt3EZU0onbBTpK3e9lt41GPSUFNhVwIpmiWR2K5JypvNnrbu9b0f7Q3Tt8ZfL_Spg8uxq1FKWrISkG4JLw0RlZ1pYgEWyspVG2j1ufxtqFsobLQhZi8iej0pHNrvfK3mnMhCKNR4MMo0PubATDo1qGFpjEd-OEubsUoyeUu7nf_oI-_bqRWJj7AdbWP99qdqC44XeScq0xEav4IFUcFrbOxgmoX7ROHjxOHyAT4HVZmQNTLq8v_Zy9-Ttn3B-waTBPW6JshuFh8U5DvQRurCXuoH5JMid41wH029K4B9NgA0e3N4Qc9ON1XPPsL-wkBgg</recordid><startdate>20150611</startdate><enddate>20150611</enddate><creator>Malyavantham, Kishore</creator><creator>Weinstock-Guttman, Bianca</creator><creator>Suresh, Lakshmanan</creator><creator>Zivadinov, Robert</creator><creator>Shanahan, Thomas</creator><creator>Badgett, Darlene</creator><creator>Ramanathan, Murali</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>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150611</creationdate><title>Humoral Responses to Diverse Autoimmune Disease-Associated Antigens in Multiple Sclerosis</title><author>Malyavantham, Kishore ; Weinstock-Guttman, Bianca ; Suresh, Lakshmanan ; Zivadinov, Robert ; Shanahan, Thomas ; Badgett, Darlene ; Ramanathan, Murali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-fdee76c3b69dd608ca4fa1444dc3b361a4395488a662bbc58c5489dd818cac73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Antibodies</topic><topic>Antigens</topic><topic>Antigens - blood</topic><topic>Antigens - immunology</topic><topic>Arthritis</topic><topic>Autoantibodies</topic><topic>Autoantibodies - blood</topic><topic>Autoantibodies - immunology</topic><topic>Autoimmune diseases</topic><topic>Autoimmune Diseases - immunology</topic><topic>Autoimmunity</topic><topic>Case-Control Studies</topic><topic>Chronic conditions</topic><topic>Cirrhosis</topic><topic>Connective tissues</topic><topic>Cytomegalovirus - immunology</topic><topic>Dermatomyositis</topic><topic>Disease control</topic><topic>Drb1 protein</topic><topic>Epstein-Barr virus</topic><topic>Female</topic><topic>Herpesvirus 4, Human - immunology</topic><topic>Histocompatibility antigen HLA</topic><topic>HLA-DRB1 Chains - genetics</topic><topic>HLA-DRB1 Chains - immunology</topic><topic>Humans</topic><topic>Immunity, Humoral</topic><topic>Immunoglobulin G</topic><topic>Immunoglobulins</topic><topic>Immunology</topic><topic>Liver cirrhosis</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mixed connective tissue disease</topic><topic>Multiple sclerosis</topic><topic>Multiple Sclerosis - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Malyavantham, Kishore</au><au>Weinstock-Guttman, Bianca</au><au>Suresh, Lakshmanan</au><au>Zivadinov, Robert</au><au>Shanahan, Thomas</au><au>Badgett, Darlene</au><au>Ramanathan, Murali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Humoral Responses to Diverse Autoimmune Disease-Associated Antigens in Multiple Sclerosis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-06-11</date><risdate>2015</risdate><volume>10</volume><issue>6</issue><spage>e0129503</spage><epage>e0129503</epage><pages>e0129503-e0129503</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare frequencies of autoreactive antibody responses to endogenous disease-associated antigens in healthy controls (HC), relapsing and progressive MS and to assess their associations with clinical and MRI measures of MS disease progression.
The study analyzed 969 serum samples from 315 HC, 411 relapsing remitting MS (RR-MS), 128 secondary progressive MS (SP-MS), 33 primary progressive MS (PP-MS) and 82 patients with other neurological diseases for autoantibodies against two putative MS antigens CSF114(Glc) and KIR4.1a and KIR4.1b and against 24 key endogenous antigens linked to diseases such as vasculitis, systemic sclerosis, rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus, polymyositis, scleroderma, polymyositis, dermatomyositis, mixed connective tissue disease and primary biliary cirrhosis. Associations with disability and MRI measures of lesional injury and neurodegeneration were assessed.
The frequencies of anti-KIR4.1a and anti-KIR4.1b peptide IgG positivity were 9.8% and 11.4% in HC compared to 4.9% and 7.5% in RR-MS, 8.6% for both peptides in SP-MS and 6.1% for both peptides in PP-MS (p = 0.13 for KIR4.1a and p = 0.34 for KIR4.1b), respectively. Antibodies against CSF114(Glc), KIR4.1a and KIR4.1b peptides were not associated with MS compared to HC, or with MS disease progression. HLA DRB1*15:01 positivity and anti-Epstein Barr virus antibodies, which are MS risk factors, were not associated with these putative MS antibodies.
Antibody responses to KIR4.1a and KIR4.1b peptides are not increased in MS compared to HC nor associated with MS disease progression. The frequencies of the diverse autoreactive antibodies investigated are similar in MS and HC.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26065913</pmid><doi>10.1371/journal.pone.0129503</doi><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1932-6203 |
ispartof | PloS one, 2015-06, Vol.10 (6), p.e0129503-e0129503 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_1687639125 |
source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
subjects | Adult Antibodies Antigens Antigens - blood Antigens - immunology Arthritis Autoantibodies Autoantibodies - blood Autoantibodies - immunology Autoimmune diseases Autoimmune Diseases - immunology Autoimmunity Case-Control Studies Chronic conditions Cirrhosis Connective tissues Cytomegalovirus - immunology Dermatomyositis Disease control Drb1 protein Epstein-Barr virus Female Herpesvirus 4, Human - immunology Histocompatibility antigen HLA HLA-DRB1 Chains - genetics HLA-DRB1 Chains - immunology Humans Immunity, Humoral Immunoglobulin G Immunoglobulins Immunology Liver cirrhosis Magnetic Resonance Imaging Male Middle Aged Mixed connective tissue disease Multiple sclerosis Multiple Sclerosis - immunology Multiple Sclerosis, Relapsing-Remitting - immunology Neurodegeneration Neurological diseases Neurology Pathogenesis Peptides Pharmaceutical sciences Polymyositis Potassium Potassium channels (inwardly-rectifying) Potassium Channels, Inwardly Rectifying - blood Potassium Channels, Inwardly Rectifying - immunology Primary biliary cirrhosis Reference Values Rheumatoid arthritis Risk analysis Risk factors Scleroderma Scleroderma (Disease) Sjogren's syndrome Studies Systemic lupus erythematosus Systemic sclerosis Vasculitis Viruses |
title | Humoral Responses to Diverse Autoimmune Disease-Associated Antigens in Multiple Sclerosis |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T07%3A38%3A54IST&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=Humoral%20Responses%20to%20Diverse%20Autoimmune%20Disease-Associated%20Antigens%20in%20Multiple%20Sclerosis&rft.jtitle=PloS%20one&rft.au=Malyavantham,%20Kishore&rft.date=2015-06-11&rft.volume=10&rft.issue=6&rft.spage=e0129503&rft.epage=e0129503&rft.pages=e0129503-e0129503&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0129503&rft_dat=%3Cgale_plos_%3EA417544926%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1687639125&rft_id=info:pmid/26065913&rft_galeid=A417544926&rft_doaj_id=oai_doaj_org_article_6b6fe2b604804baa8dfd908ecf9869fc&rfr_iscdi=true |