Effect of Rosmarinic Acid on Experimental Diabetic Nephropathy

:  Connective tissue growth factor (CTGF) plays a pathogenic role in diabetic nephropathy (DN). Rosmarinic acid (RA) is a naturally occurring phenolic acid. This study was conducted to investigate the efficacy of RA on DN and to elucidate the potential mechanism. High glucose (HG)‐stimulated culture...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Basic & clinical pharmacology & toxicology 2012-04, Vol.110 (4), p.390-395
Hauptverfasser: Jiang, Wang-Lin, Xu, Yong, Zhang, Shu-Ping, Hou, Jian, Zhu, Hai-Bo
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 395
container_issue 4
container_start_page 390
container_title Basic & clinical pharmacology & toxicology
container_volume 110
creator Jiang, Wang-Lin
Xu, Yong
Zhang, Shu-Ping
Hou, Jian
Zhu, Hai-Bo
description :  Connective tissue growth factor (CTGF) plays a pathogenic role in diabetic nephropathy (DN). Rosmarinic acid (RA) is a naturally occurring phenolic acid. This study was conducted to investigate the efficacy of RA on DN and to elucidate the potential mechanism. High glucose (HG)‐stimulated cultured human renal proximal tubular epithelial cells (HK‐2) analysed CTGF expression by western blotting, and it was investigated whether extracellular signal‐regulated kinase (ERK) signalling pathway was involved. Using streptozotocin (STZ)‐induced rat animal models, diabetic rats were randomized to receive intragastric (i.g.) doses of RA. Renal tissue, blood and urine samples were collected to determine biochemical index and analyse protein expression. In vitro study, RA reduced CTGF excretion in HG‐induced HK‐2 cells through the ERK signalling pathway. In an in vivo study, I.g. of RA 7.5 or 15 mg/kg significantly ameliorated renal function and increased body‐weight. Meanwhile, RA reduced renal CTGF expression by immunohistochemical staining and reduced serum levels of CTGF. Besides, there were no significant differences in glycaemia levels between the RA groups compared with the STZ‐treated group. Furthermore, RA ameliorated renal pathology. These results suggest that RA exerts an early renal protective role to DN. Inhibition of CTGF may be a potential target in DN therapy, which highlights the possibility of using RA in the treatment of DN.
doi_str_mv 10.1111/j.1742-7843.2011.00828.x
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1008841192</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1008841192</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4698-7aa6c43b7e0fb4c6fb3afad9889ebc855906ba051c36717d7a7d5e7c7ef12e233</originalsourceid><addsrcrecordid>eNqNkE2P0zAQhi0EYpfCX0C5IHFJ8Fdi5wDSUkpBrArsLuJoTZyx1iVNgp2K9t_j0lKu-OKR5nln7IeQjNGCpfNqXTAlea60FAWnjBWUaq6L3QNyeW48PNeivCBPYlxTypVk9DG54JyWQgl6Sd4snEM7ZYPLboa4geB7b7Mr69ts6LPFbsTgN9hP0GXvPDQ4pe4Kx_swjDDd75-SRw66iM9O94x8e7-4m3_Irz8vP86vrnMrq1rnCqCyUjQKqWukrVwjwEFba11jY3VZ1rRqgJbMikox1SpQbYnKKnSMIxdiRl4e545h-LnFOJmNjxa7DnocttGwJEBLxmqeUH1EbRhiDOjMmL4AYZ8gc7Bn1uYgxhwkmYM988ee2aXo89OWbbPB9hz8qysBL04ARAudC9BbH_9xZcW0TGNn5PWR--U73P_3A8zb-Ze7VKV8fsz7OOHunIfww1RKqNJ8Xy0Nvf0kb5Zfb81K_Ab0eplV</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1008841192</pqid></control><display><type>article</type><title>Effect of Rosmarinic Acid on Experimental Diabetic Nephropathy</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Alma/SFX Local Collection</source><creator>Jiang, Wang-Lin ; Xu, Yong ; Zhang, Shu-Ping ; Hou, Jian ; Zhu, Hai-Bo</creator><creatorcontrib>Jiang, Wang-Lin ; Xu, Yong ; Zhang, Shu-Ping ; Hou, Jian ; Zhu, Hai-Bo</creatorcontrib><description>:  Connective tissue growth factor (CTGF) plays a pathogenic role in diabetic nephropathy (DN). Rosmarinic acid (RA) is a naturally occurring phenolic acid. This study was conducted to investigate the efficacy of RA on DN and to elucidate the potential mechanism. High glucose (HG)‐stimulated cultured human renal proximal tubular epithelial cells (HK‐2) analysed CTGF expression by western blotting, and it was investigated whether extracellular signal‐regulated kinase (ERK) signalling pathway was involved. Using streptozotocin (STZ)‐induced rat animal models, diabetic rats were randomized to receive intragastric (i.g.) doses of RA. Renal tissue, blood and urine samples were collected to determine biochemical index and analyse protein expression. In vitro study, RA reduced CTGF excretion in HG‐induced HK‐2 cells through the ERK signalling pathway. In an in vivo study, I.g. of RA 7.5 or 15 mg/kg significantly ameliorated renal function and increased body‐weight. Meanwhile, RA reduced renal CTGF expression by immunohistochemical staining and reduced serum levels of CTGF. Besides, there were no significant differences in glycaemia levels between the RA groups compared with the STZ‐treated group. Furthermore, RA ameliorated renal pathology. These results suggest that RA exerts an early renal protective role to DN. Inhibition of CTGF may be a potential target in DN therapy, which highlights the possibility of using RA in the treatment of DN.</description><identifier>ISSN: 1742-7835</identifier><identifier>EISSN: 1742-7843</identifier><identifier>DOI: 10.1111/j.1742-7843.2011.00828.x</identifier><identifier>PMID: 22053730</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Animal models ; Animals ; Associated diseases and complications ; Biological and medical sciences ; Blood ; Body Weight - drug effects ; Cells, Cultured ; Cinnamates - administration &amp; dosage ; Cinnamates - pharmacology ; Connective tissue growth factor ; Connective Tissue Growth Factor - metabolism ; Depsides - administration &amp; dosage ; Depsides - pharmacology ; Diabetes mellitus ; Diabetes Mellitus, Experimental - complications ; Diabetes. Impaired glucose tolerance ; Diabetic Nephropathies - drug therapy ; Diabetic Nephropathies - pathology ; Dose-Response Relationship, Drug ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Epithelial cells ; Epithelial Cells - drug effects ; Epithelial Cells - metabolism ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Excretion ; Extracellular signal-regulated kinase ; Glucose ; Humans ; Kidney Tubules, Proximal - drug effects ; Kidney Tubules, Proximal - metabolism ; Kidneys ; Male ; Medical sciences ; Nephrology. Urinary tract diseases ; Nephropathy ; Pharmacology. Drug treatments ; phenolic acids ; Pilot Projects ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Renal function ; Rosmarinic Acid ; Serum levels ; Signal transduction ; Streptozocin ; Urinary system involvement in other diseases. Miscellaneous ; Urine ; Western blotting</subject><ispartof>Basic &amp; clinical pharmacology &amp; toxicology, 2012-04, Vol.110 (4), p.390-395</ispartof><rights>2011 The Authors. Basic &amp; Clinical Pharmacology &amp; Toxicology © 2011 Nordic Pharmacological Society</rights><rights>2015 INIST-CNRS</rights><rights>2011 The Authors. Basic &amp; Clinical Pharmacology &amp; Toxicology © 2011 Nordic Pharmacological Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4698-7aa6c43b7e0fb4c6fb3afad9889ebc855906ba051c36717d7a7d5e7c7ef12e233</citedby><cites>FETCH-LOGICAL-c4698-7aa6c43b7e0fb4c6fb3afad9889ebc855906ba051c36717d7a7d5e7c7ef12e233</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1742-7843.2011.00828.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1742-7843.2011.00828.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=25618484$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22053730$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiang, Wang-Lin</creatorcontrib><creatorcontrib>Xu, Yong</creatorcontrib><creatorcontrib>Zhang, Shu-Ping</creatorcontrib><creatorcontrib>Hou, Jian</creatorcontrib><creatorcontrib>Zhu, Hai-Bo</creatorcontrib><title>Effect of Rosmarinic Acid on Experimental Diabetic Nephropathy</title><title>Basic &amp; clinical pharmacology &amp; toxicology</title><addtitle>Basic Clin Pharmacol Toxicol</addtitle><description>:  Connective tissue growth factor (CTGF) plays a pathogenic role in diabetic nephropathy (DN). Rosmarinic acid (RA) is a naturally occurring phenolic acid. This study was conducted to investigate the efficacy of RA on DN and to elucidate the potential mechanism. High glucose (HG)‐stimulated cultured human renal proximal tubular epithelial cells (HK‐2) analysed CTGF expression by western blotting, and it was investigated whether extracellular signal‐regulated kinase (ERK) signalling pathway was involved. Using streptozotocin (STZ)‐induced rat animal models, diabetic rats were randomized to receive intragastric (i.g.) doses of RA. Renal tissue, blood and urine samples were collected to determine biochemical index and analyse protein expression. In vitro study, RA reduced CTGF excretion in HG‐induced HK‐2 cells through the ERK signalling pathway. In an in vivo study, I.g. of RA 7.5 or 15 mg/kg significantly ameliorated renal function and increased body‐weight. Meanwhile, RA reduced renal CTGF expression by immunohistochemical staining and reduced serum levels of CTGF. Besides, there were no significant differences in glycaemia levels between the RA groups compared with the STZ‐treated group. Furthermore, RA ameliorated renal pathology. These results suggest that RA exerts an early renal protective role to DN. Inhibition of CTGF may be a potential target in DN therapy, which highlights the possibility of using RA in the treatment of DN.</description><subject>Animal models</subject><subject>Animals</subject><subject>Associated diseases and complications</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Body Weight - drug effects</subject><subject>Cells, Cultured</subject><subject>Cinnamates - administration &amp; dosage</subject><subject>Cinnamates - pharmacology</subject><subject>Connective tissue growth factor</subject><subject>Connective Tissue Growth Factor - metabolism</subject><subject>Depsides - administration &amp; dosage</subject><subject>Depsides - pharmacology</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Experimental - complications</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Nephropathies - drug therapy</subject><subject>Diabetic Nephropathies - pathology</subject><subject>Dose-Response Relationship, Drug</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Epithelial cells</subject><subject>Epithelial Cells - drug effects</subject><subject>Epithelial Cells - metabolism</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Excretion</subject><subject>Extracellular signal-regulated kinase</subject><subject>Glucose</subject><subject>Humans</subject><subject>Kidney Tubules, Proximal - drug effects</subject><subject>Kidney Tubules, Proximal - metabolism</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathy</subject><subject>Pharmacology. Drug treatments</subject><subject>phenolic acids</subject><subject>Pilot Projects</subject><subject>Random Allocation</subject><subject>Rats</subject><subject>Rats, Sprague-Dawley</subject><subject>Renal function</subject><subject>Rosmarinic Acid</subject><subject>Serum levels</subject><subject>Signal transduction</subject><subject>Streptozocin</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urine</subject><subject>Western blotting</subject><issn>1742-7835</issn><issn>1742-7843</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE2P0zAQhi0EYpfCX0C5IHFJ8Fdi5wDSUkpBrArsLuJoTZyx1iVNgp2K9t_j0lKu-OKR5nln7IeQjNGCpfNqXTAlea60FAWnjBWUaq6L3QNyeW48PNeivCBPYlxTypVk9DG54JyWQgl6Sd4snEM7ZYPLboa4geB7b7Mr69ts6LPFbsTgN9hP0GXvPDQ4pe4Kx_swjDDd75-SRw66iM9O94x8e7-4m3_Irz8vP86vrnMrq1rnCqCyUjQKqWukrVwjwEFba11jY3VZ1rRqgJbMikox1SpQbYnKKnSMIxdiRl4e545h-LnFOJmNjxa7DnocttGwJEBLxmqeUH1EbRhiDOjMmL4AYZ8gc7Bn1uYgxhwkmYM988ee2aXo89OWbbPB9hz8qysBL04ARAudC9BbH_9xZcW0TGNn5PWR--U73P_3A8zb-Ze7VKV8fsz7OOHunIfww1RKqNJ8Xy0Nvf0kb5Zfb81K_Ab0eplV</recordid><startdate>201204</startdate><enddate>201204</enddate><creator>Jiang, Wang-Lin</creator><creator>Xu, Yong</creator><creator>Zhang, Shu-Ping</creator><creator>Hou, Jian</creator><creator>Zhu, Hai-Bo</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><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>7U7</scope><scope>C1K</scope></search><sort><creationdate>201204</creationdate><title>Effect of Rosmarinic Acid on Experimental Diabetic Nephropathy</title><author>Jiang, Wang-Lin ; Xu, Yong ; Zhang, Shu-Ping ; Hou, Jian ; Zhu, Hai-Bo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4698-7aa6c43b7e0fb4c6fb3afad9889ebc855906ba051c36717d7a7d5e7c7ef12e233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Animal models</topic><topic>Animals</topic><topic>Associated diseases and complications</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Body Weight - drug effects</topic><topic>Cells, Cultured</topic><topic>Cinnamates - administration &amp; dosage</topic><topic>Cinnamates - pharmacology</topic><topic>Connective tissue growth factor</topic><topic>Connective Tissue Growth Factor - metabolism</topic><topic>Depsides - administration &amp; dosage</topic><topic>Depsides - pharmacology</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Experimental - complications</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Nephropathies - drug therapy</topic><topic>Diabetic Nephropathies - pathology</topic><topic>Dose-Response Relationship, Drug</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Epithelial cells</topic><topic>Epithelial Cells - drug effects</topic><topic>Epithelial Cells - metabolism</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Excretion</topic><topic>Extracellular signal-regulated kinase</topic><topic>Glucose</topic><topic>Humans</topic><topic>Kidney Tubules, Proximal - drug effects</topic><topic>Kidney Tubules, Proximal - metabolism</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathy</topic><topic>Pharmacology. Drug treatments</topic><topic>phenolic acids</topic><topic>Pilot Projects</topic><topic>Random Allocation</topic><topic>Rats</topic><topic>Rats, Sprague-Dawley</topic><topic>Renal function</topic><topic>Rosmarinic Acid</topic><topic>Serum levels</topic><topic>Signal transduction</topic><topic>Streptozocin</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urine</topic><topic>Western blotting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jiang, Wang-Lin</creatorcontrib><creatorcontrib>Xu, Yong</creatorcontrib><creatorcontrib>Zhang, Shu-Ping</creatorcontrib><creatorcontrib>Hou, Jian</creatorcontrib><creatorcontrib>Zhu, Hai-Bo</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Basic &amp; clinical pharmacology &amp; toxicology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jiang, Wang-Lin</au><au>Xu, Yong</au><au>Zhang, Shu-Ping</au><au>Hou, Jian</au><au>Zhu, Hai-Bo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Rosmarinic Acid on Experimental Diabetic Nephropathy</atitle><jtitle>Basic &amp; clinical pharmacology &amp; toxicology</jtitle><addtitle>Basic Clin Pharmacol Toxicol</addtitle><date>2012-04</date><risdate>2012</risdate><volume>110</volume><issue>4</issue><spage>390</spage><epage>395</epage><pages>390-395</pages><issn>1742-7835</issn><eissn>1742-7843</eissn><abstract>:  Connective tissue growth factor (CTGF) plays a pathogenic role in diabetic nephropathy (DN). Rosmarinic acid (RA) is a naturally occurring phenolic acid. This study was conducted to investigate the efficacy of RA on DN and to elucidate the potential mechanism. High glucose (HG)‐stimulated cultured human renal proximal tubular epithelial cells (HK‐2) analysed CTGF expression by western blotting, and it was investigated whether extracellular signal‐regulated kinase (ERK) signalling pathway was involved. Using streptozotocin (STZ)‐induced rat animal models, diabetic rats were randomized to receive intragastric (i.g.) doses of RA. Renal tissue, blood and urine samples were collected to determine biochemical index and analyse protein expression. In vitro study, RA reduced CTGF excretion in HG‐induced HK‐2 cells through the ERK signalling pathway. In an in vivo study, I.g. of RA 7.5 or 15 mg/kg significantly ameliorated renal function and increased body‐weight. Meanwhile, RA reduced renal CTGF expression by immunohistochemical staining and reduced serum levels of CTGF. Besides, there were no significant differences in glycaemia levels between the RA groups compared with the STZ‐treated group. Furthermore, RA ameliorated renal pathology. These results suggest that RA exerts an early renal protective role to DN. Inhibition of CTGF may be a potential target in DN therapy, which highlights the possibility of using RA in the treatment of DN.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22053730</pmid><doi>10.1111/j.1742-7843.2011.00828.x</doi><tpages>6</tpages></addata></record>
fulltext fulltext
identifier ISSN: 1742-7835
ispartof Basic & clinical pharmacology & toxicology, 2012-04, Vol.110 (4), p.390-395
issn 1742-7835
1742-7843
language eng
recordid cdi_proquest_miscellaneous_1008841192
source MEDLINE; Access via Wiley Online Library; Alma/SFX Local Collection
subjects Animal models
Animals
Associated diseases and complications
Biological and medical sciences
Blood
Body Weight - drug effects
Cells, Cultured
Cinnamates - administration & dosage
Cinnamates - pharmacology
Connective tissue growth factor
Connective Tissue Growth Factor - metabolism
Depsides - administration & dosage
Depsides - pharmacology
Diabetes mellitus
Diabetes Mellitus, Experimental - complications
Diabetes. Impaired glucose tolerance
Diabetic Nephropathies - drug therapy
Diabetic Nephropathies - pathology
Dose-Response Relationship, Drug
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Epithelial cells
Epithelial Cells - drug effects
Epithelial Cells - metabolism
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Excretion
Extracellular signal-regulated kinase
Glucose
Humans
Kidney Tubules, Proximal - drug effects
Kidney Tubules, Proximal - metabolism
Kidneys
Male
Medical sciences
Nephrology. Urinary tract diseases
Nephropathy
Pharmacology. Drug treatments
phenolic acids
Pilot Projects
Random Allocation
Rats
Rats, Sprague-Dawley
Renal function
Rosmarinic Acid
Serum levels
Signal transduction
Streptozocin
Urinary system involvement in other diseases. Miscellaneous
Urine
Western blotting
title Effect of Rosmarinic Acid on Experimental Diabetic Nephropathy
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-15T20%3A44%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20Rosmarinic%20Acid%20on%20Experimental%20Diabetic%20Nephropathy&rft.jtitle=Basic%20&%20clinical%20pharmacology%20&%20toxicology&rft.au=Jiang,%20Wang-Lin&rft.date=2012-04&rft.volume=110&rft.issue=4&rft.spage=390&rft.epage=395&rft.pages=390-395&rft.issn=1742-7835&rft.eissn=1742-7843&rft_id=info:doi/10.1111/j.1742-7843.2011.00828.x&rft_dat=%3Cproquest_cross%3E1008841192%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1008841192&rft_id=info:pmid/22053730&rfr_iscdi=true