Interferon-gamma promotes iron export in human macrophages to limit intracellular bacterial replication
Salmonellosis and listeriosis together accounted for more than one third of foodborne illnesses in the United States and almost half the hospitalizations for gastrointestinal diseases in 2018 while tuberculosis afflicted over 10 million people worldwide causing almost 2 million deaths. Regardless of...
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description | Salmonellosis and listeriosis together accounted for more than one third of foodborne illnesses in the United States and almost half the hospitalizations for gastrointestinal diseases in 2018 while tuberculosis afflicted over 10 million people worldwide causing almost 2 million deaths. Regardless of the intrinsic virulence differences among Listeria monocytogenes, Salmonella enterica and Mycobacterium tuberculosis, these intracellular pathogens share the ability to survive and persist inside the macrophage and other cells and thrive in iron rich environments. Interferon-gamma (IFN-γ) is a central cytokine in host defense against intracellular pathogens and has been shown to promote iron export in macrophages. We hypothesize that IFN-γ decreases iron availability to intracellular pathogens consequently limiting replication in these cells. In this study, we show that IFN-γ regulates the expression of iron-related proteins hepcidin, ferroportin, and ferritin to induce iron export from macrophages. Listeria monocytogenes, S. enterica, and M. tuberculosis infections significantly induce iron sequestration in human macrophages. In contrast, IFN-γ significantly reduces hepcidin secretion in S. enterica and M. tuberculosis infected macrophages. Similarly, IFN-γ-activated macrophages express higher ferroportin levels than untreated controls even after infection with L. monocytogenes bacilli; bacterial infection greatly down-regulates ferroportin expression. Collectively, IFN-γ significantly inhibits pathogen-associated intracellular iron sequestration in macrophages and consequently retards the growth of intracellular bacterial pathogens by decreasing iron availability. |
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Regardless of the intrinsic virulence differences among Listeria monocytogenes, Salmonella enterica and Mycobacterium tuberculosis, these intracellular pathogens share the ability to survive and persist inside the macrophage and other cells and thrive in iron rich environments. Interferon-gamma (IFN-γ) is a central cytokine in host defense against intracellular pathogens and has been shown to promote iron export in macrophages. We hypothesize that IFN-γ decreases iron availability to intracellular pathogens consequently limiting replication in these cells. In this study, we show that IFN-γ regulates the expression of iron-related proteins hepcidin, ferroportin, and ferritin to induce iron export from macrophages. Listeria monocytogenes, S. enterica, and M. tuberculosis infections significantly induce iron sequestration in human macrophages. In contrast, IFN-γ significantly reduces hepcidin secretion in S. enterica and M. tuberculosis infected macrophages. Similarly, IFN-γ-activated macrophages express higher ferroportin levels than untreated controls even after infection with L. monocytogenes bacilli; bacterial infection greatly down-regulates ferroportin expression. Collectively, IFN-γ significantly inhibits pathogen-associated intracellular iron sequestration in macrophages and consequently retards the growth of intracellular bacterial pathogens by decreasing iron availability.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0240949</identifier><identifier>PMID: 33290416</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Availability ; Bacilli ; Bacteria ; Bacterial diseases ; Bacterial infections ; Biological transport ; Biological Transport, Active - drug effects ; Biology and Life Sciences ; Cation Transport Proteins - metabolism ; Cytokines ; Drug therapy ; Exports ; Ferritin ; Ferritins - metabolism ; Foodborne diseases ; Gastrointestinal diseases ; Genes ; Genetic engineering ; Health aspects ; Hepcidin ; Hepcidins - antagonists & inhibitors ; Hepcidins - metabolism ; Host Microbial Interactions - drug effects ; Host Microbial Interactions - immunology ; Host Microbial Interactions - physiology ; Humans ; Immunity, Innate ; Infections ; Infectious diseases ; Interferon ; Interferon gamma ; Interferon-gamma - immunology ; Interferon-gamma - pharmacology ; Intracellular ; Iron ; Iron (Nutrient) ; Iron - metabolism ; Listeria ; Listeria monocytogenes ; Listeria monocytogenes - growth & development ; Listeria monocytogenes - pathogenicity ; Listeriosis ; Macrophages ; Macrophages - drug effects ; Macrophages - metabolism ; Macrophages - microbiology ; Medicine and Health Sciences ; Mycobacterium tuberculosis ; Mycobacterium tuberculosis - growth & development ; Mycobacterium tuberculosis - pathogenicity ; Pathogens ; Proteins ; Recombinant Proteins - pharmacology ; Replication ; Salmonella ; Salmonella enterica ; Salmonella enterica - growth & development ; Salmonella enterica - pathogenicity ; Salmonellosis ; THP-1 Cells ; Tuberculosis ; Virulence ; γ-Interferon</subject><ispartof>PloS one, 2020-12, Vol.15 (12), p.e0240949</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Abreu 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>2020 Abreu et al 2020 Abreu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-53abca95482c332008e02fd86ec03649ef8aaca63bba98f10a53dab84c29fde73</citedby><cites>FETCH-LOGICAL-c692t-53abca95482c332008e02fd86ec03649ef8aaca63bba98f10a53dab84c29fde73</cites><orcidid>0000-0002-6413-0184</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723272/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723272/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33290416$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Rottenberg, Martin E.</contributor><creatorcontrib>Abreu, Rodrigo</creatorcontrib><creatorcontrib>Essler, Lauren</creatorcontrib><creatorcontrib>Giri, Pramod</creatorcontrib><creatorcontrib>Quinn, Frederick</creatorcontrib><title>Interferon-gamma promotes iron export in human macrophages to limit intracellular bacterial replication</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Salmonellosis and listeriosis together accounted for more than one third of foodborne illnesses in the United States and almost half the hospitalizations for gastrointestinal diseases in 2018 while tuberculosis afflicted over 10 million people worldwide causing almost 2 million deaths. Regardless of the intrinsic virulence differences among Listeria monocytogenes, Salmonella enterica and Mycobacterium tuberculosis, these intracellular pathogens share the ability to survive and persist inside the macrophage and other cells and thrive in iron rich environments. Interferon-gamma (IFN-γ) is a central cytokine in host defense against intracellular pathogens and has been shown to promote iron export in macrophages. We hypothesize that IFN-γ decreases iron availability to intracellular pathogens consequently limiting replication in these cells. In this study, we show that IFN-γ regulates the expression of iron-related proteins hepcidin, ferroportin, and ferritin to induce iron export from macrophages. Listeria monocytogenes, S. enterica, and M. tuberculosis infections significantly induce iron sequestration in human macrophages. In contrast, IFN-γ significantly reduces hepcidin secretion in S. enterica and M. tuberculosis infected macrophages. Similarly, IFN-γ-activated macrophages express higher ferroportin levels than untreated controls even after infection with L. monocytogenes bacilli; bacterial infection greatly down-regulates ferroportin expression. Collectively, IFN-γ significantly inhibits pathogen-associated intracellular iron sequestration in macrophages and consequently retards the growth of intracellular bacterial pathogens by decreasing iron availability.</description><subject>Availability</subject><subject>Bacilli</subject><subject>Bacteria</subject><subject>Bacterial diseases</subject><subject>Bacterial infections</subject><subject>Biological transport</subject><subject>Biological Transport, Active - drug effects</subject><subject>Biology and Life Sciences</subject><subject>Cation Transport Proteins - metabolism</subject><subject>Cytokines</subject><subject>Drug therapy</subject><subject>Exports</subject><subject>Ferritin</subject><subject>Ferritins - metabolism</subject><subject>Foodborne diseases</subject><subject>Gastrointestinal diseases</subject><subject>Genes</subject><subject>Genetic engineering</subject><subject>Health aspects</subject><subject>Hepcidin</subject><subject>Hepcidins - antagonists & inhibitors</subject><subject>Hepcidins - 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growth & development</subject><subject>Mycobacterium tuberculosis - pathogenicity</subject><subject>Pathogens</subject><subject>Proteins</subject><subject>Recombinant Proteins - pharmacology</subject><subject>Replication</subject><subject>Salmonella</subject><subject>Salmonella enterica</subject><subject>Salmonella enterica - growth & development</subject><subject>Salmonella enterica - pathogenicity</subject><subject>Salmonellosis</subject><subject>THP-1 Cells</subject><subject>Tuberculosis</subject><subject>Virulence</subject><subject>γ-Interferon</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl2L1DAUhoso7jr6D0QLguDFjGmSps2NsCx-DCws-HUbTtOkkyVtapLK-u9Nne4yBQUJIeHkOW8OL2-WPS_QriBV8fbGTX4AuxvdoHYIU8Qpf5CdF5zgLcOIPDy5n2VPQrhBqCQ1Y4-zM0IwR7Rg51m3H6LyWnk3bDvoe8hH73oXVchNquXqdnQ-5mbID1MPQ96D9G48QJeA6HJrejO_Rg9SWTtZ8HkDMkkasLlXozUSonHD0-yRBhvUs-XcZN8-vP96-Wl7df1xf3lxtZWM47gtCTQSeElrLNOQCNUKYd3WTElEGOVK1wASGGka4LUuEJSkhaamEnPdqopsspdH3dG6IBaPgsCU1RjVJeOJ2B-J1sGNGL3pwf8SDoz4U3C-E-CjkVYJpQrGKJS0lJQCbhoEjaYSVQWvCqRJ0nq3_DY1vWqlmo2wK9H1y2AOonM_RVVhgtPeZK8WAe9-TCrEf4y8UB2kqcyg3ex3b4IUF4xSXBKK52F2f6HSalVvZEqJNqm-anizakhMVLexgykEsf_y-f_Z6-9r9vUJe1Bg4yE4O805CGuQHsGUqRC80vfOFUjMIb9zQ8whF0vIU9uLU9fvm-5STX4DfEP5hg</recordid><startdate>20201208</startdate><enddate>20201208</enddate><creator>Abreu, Rodrigo</creator><creator>Essler, Lauren</creator><creator>Giri, Pramod</creator><creator>Quinn, Frederick</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>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>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-6413-0184</orcidid></search><sort><creationdate>20201208</creationdate><title>Interferon-gamma promotes iron export in human macrophages to limit intracellular bacterial replication</title><author>Abreu, Rodrigo ; Essler, Lauren ; Giri, Pramod ; Quinn, Frederick</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-53abca95482c332008e02fd86ec03649ef8aaca63bba98f10a53dab84c29fde73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Availability</topic><topic>Bacilli</topic><topic>Bacteria</topic><topic>Bacterial diseases</topic><topic>Bacterial infections</topic><topic>Biological transport</topic><topic>Biological Transport, Active - drug effects</topic><topic>Biology and Life Sciences</topic><topic>Cation Transport Proteins - metabolism</topic><topic>Cytokines</topic><topic>Drug therapy</topic><topic>Exports</topic><topic>Ferritin</topic><topic>Ferritins - metabolism</topic><topic>Foodborne diseases</topic><topic>Gastrointestinal diseases</topic><topic>Genes</topic><topic>Genetic engineering</topic><topic>Health aspects</topic><topic>Hepcidin</topic><topic>Hepcidins - antagonists & inhibitors</topic><topic>Hepcidins - metabolism</topic><topic>Host Microbial Interactions - drug effects</topic><topic>Host Microbial Interactions - immunology</topic><topic>Host Microbial Interactions - physiology</topic><topic>Humans</topic><topic>Immunity, Innate</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Interferon</topic><topic>Interferon gamma</topic><topic>Interferon-gamma - immunology</topic><topic>Interferon-gamma - pharmacology</topic><topic>Intracellular</topic><topic>Iron</topic><topic>Iron (Nutrient)</topic><topic>Iron - metabolism</topic><topic>Listeria</topic><topic>Listeria monocytogenes</topic><topic>Listeria monocytogenes - growth & development</topic><topic>Listeria monocytogenes - pathogenicity</topic><topic>Listeriosis</topic><topic>Macrophages</topic><topic>Macrophages - drug effects</topic><topic>Macrophages - metabolism</topic><topic>Macrophages - microbiology</topic><topic>Medicine and Health Sciences</topic><topic>Mycobacterium tuberculosis</topic><topic>Mycobacterium tuberculosis - growth & development</topic><topic>Mycobacterium tuberculosis - pathogenicity</topic><topic>Pathogens</topic><topic>Proteins</topic><topic>Recombinant Proteins - pharmacology</topic><topic>Replication</topic><topic>Salmonella</topic><topic>Salmonella enterica</topic><topic>Salmonella enterica - growth & development</topic><topic>Salmonella enterica - pathogenicity</topic><topic>Salmonellosis</topic><topic>THP-1 Cells</topic><topic>Tuberculosis</topic><topic>Virulence</topic><topic>γ-Interferon</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abreu, Rodrigo</creatorcontrib><creatorcontrib>Essler, Lauren</creatorcontrib><creatorcontrib>Giri, Pramod</creatorcontrib><creatorcontrib>Quinn, Frederick</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: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Regardless of the intrinsic virulence differences among Listeria monocytogenes, Salmonella enterica and Mycobacterium tuberculosis, these intracellular pathogens share the ability to survive and persist inside the macrophage and other cells and thrive in iron rich environments. Interferon-gamma (IFN-γ) is a central cytokine in host defense against intracellular pathogens and has been shown to promote iron export in macrophages. We hypothesize that IFN-γ decreases iron availability to intracellular pathogens consequently limiting replication in these cells. In this study, we show that IFN-γ regulates the expression of iron-related proteins hepcidin, ferroportin, and ferritin to induce iron export from macrophages. Listeria monocytogenes, S. enterica, and M. tuberculosis infections significantly induce iron sequestration in human macrophages. In contrast, IFN-γ significantly reduces hepcidin secretion in S. enterica and M. tuberculosis infected macrophages. Similarly, IFN-γ-activated macrophages express higher ferroportin levels than untreated controls even after infection with L. monocytogenes bacilli; bacterial infection greatly down-regulates ferroportin expression. Collectively, IFN-γ significantly inhibits pathogen-associated intracellular iron sequestration in macrophages and consequently retards the growth of intracellular bacterial pathogens by decreasing iron availability.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33290416</pmid><doi>10.1371/journal.pone.0240949</doi><tpages>e0240949</tpages><orcidid>https://orcid.org/0000-0002-6413-0184</orcidid><oa>free_for_read</oa></addata></record> |
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source | PubMed Central Free; MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; Free Full-Text Journals in Chemistry |
subjects | Availability Bacilli Bacteria Bacterial diseases Bacterial infections Biological transport Biological Transport, Active - drug effects Biology and Life Sciences Cation Transport Proteins - metabolism Cytokines Drug therapy Exports Ferritin Ferritins - metabolism Foodborne diseases Gastrointestinal diseases Genes Genetic engineering Health aspects Hepcidin Hepcidins - antagonists & inhibitors Hepcidins - metabolism Host Microbial Interactions - drug effects Host Microbial Interactions - immunology Host Microbial Interactions - physiology Humans Immunity, Innate Infections Infectious diseases Interferon Interferon gamma Interferon-gamma - immunology Interferon-gamma - pharmacology Intracellular Iron Iron (Nutrient) Iron - metabolism Listeria Listeria monocytogenes Listeria monocytogenes - growth & development Listeria monocytogenes - pathogenicity Listeriosis Macrophages Macrophages - drug effects Macrophages - metabolism Macrophages - microbiology Medicine and Health Sciences Mycobacterium tuberculosis Mycobacterium tuberculosis - growth & development Mycobacterium tuberculosis - pathogenicity Pathogens Proteins Recombinant Proteins - pharmacology Replication Salmonella Salmonella enterica Salmonella enterica - growth & development Salmonella enterica - pathogenicity Salmonellosis THP-1 Cells Tuberculosis Virulence γ-Interferon |
title | Interferon-gamma promotes iron export in human macrophages to limit intracellular bacterial replication |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T03%3A40%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=Interferon-gamma%20promotes%20iron%20export%20in%20human%20macrophages%20to%20limit%20intracellular%20bacterial%20replication&rft.jtitle=PloS%20one&rft.au=Abreu,%20Rodrigo&rft.date=2020-12-08&rft.volume=15&rft.issue=12&rft.spage=e0240949&rft.pages=e0240949-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0240949&rft_dat=%3Cgale_plos_%3EA644253423%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=2468208569&rft_id=info:pmid/33290416&rft_galeid=A644253423&rft_doaj_id=oai_doaj_org_article_ee1664a545c44a2bb0abf4c0719710f3&rfr_iscdi=true |