Synthesis of Novel Hybrids of Thymoquinone and Artemisinin with High Activity and Selectivity Against Colon Cancer

Colorectal cancer causes 0.5 million deaths each year. To combat this type of cancer the development of new specific drug candidates is urgently needed. In the present work seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their in vitro anticancer a...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:ChemMedChem 2017-02, Vol.12 (3), p.226-234
Hauptverfasser: Fröhlich, Tony, Ndreshkjana, Benardina, Muenzner, Julienne K., Reiter, Christoph, Hofmeister, Elisabeth, Mederer, Sandra, Fatfat, Maamoun, El‐Baba, Chirine, Gali‐Muhtasib, Hala, Schneider‐Stock, Regine, Tsogoeva, Svetlana B.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 234
container_issue 3
container_start_page 226
container_title ChemMedChem
container_volume 12
creator Fröhlich, Tony
Ndreshkjana, Benardina
Muenzner, Julienne K.
Reiter, Christoph
Hofmeister, Elisabeth
Mederer, Sandra
Fatfat, Maamoun
El‐Baba, Chirine
Gali‐Muhtasib, Hala
Schneider‐Stock, Regine
Tsogoeva, Svetlana B.
description Colorectal cancer causes 0.5 million deaths each year. To combat this type of cancer the development of new specific drug candidates is urgently needed. In the present work seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their in vitro anticancer activity against a panel of various tumor cell lines. The thymoquinone–artesunic acid hybrid 7 a, in which both subunits are connected via an ester bond, was found to be the most active compound and selectively decreased the viability of colorectal cancer cells with an IC50 value of 2.4 μm (HCT116) and 2.8 μm (HT29). Remarkably, hybrid 7 a was up to 20‐fold more active than its parent compounds (thymoquinone and artesunic acid), while not affecting nonmalignant colon epithelial HCEC cells (IC50>100 μm). Moreover, the activity of hybrid 7 a was superior to that of various 1:1 mixtures of thymoquinone and artesunic acid. Furthermore, hybrid 7 a was even more potent against both colon cancer cell lines than the clinically used drug 5‐fluorouracil. These results are another excellent proof of the hybridization concept and confirm that the type and length of the linker play a crucial role for the biological activity of a hybrid drug. Besides an increase in reactive oxygen species (ROS), elevated levels of the DNA‐damage marker γ‐H2AX were observed. Both effects seem to be involved in the molecular mechanism of action for hybrid 7 a in colorectal cancer cells. Half a million deaths are caused annually by colorectal cancer. Therefore, the development of new drug candidates is urgently needed. In this study, seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their activity against various tumor cell lines. One hybrid emerged as being particularly potent (outperforming the clinical reference drug 5‐fluorouracil) and specific for colon tumor cells, confirming that the nature and length of the linker play crucial roles for the biological activity of a hybrid drug.
doi_str_mv 10.1002/cmdc.201600594
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868306584</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4311891281</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4064-f925361f99a075015e0f3cd057397f8ad17f51be9c68511de8c29bac4e5db6ac3</originalsourceid><addsrcrecordid>eNqFkctP3DAQxq2Kqrx67bGyxIXLLuPEju3jKn0sEpQD9Bw5zoQ1Smyws6D892RZWCQunOah33yamY-QHwzmDCA7s31j5xmwAkBo_oUcMFXATDIl93a51PvkMKU7AM4VU9_Ifia1zGUmDki8Hv2wwuQSDS39Fx6xo8uxjq55adysxj48rJ0PHqnxDV3EAXuXnHeePrlhRZfudkUXdnCPbhhfkGvs8K1e3Brn00DL0AVPS-MtxmPytTVdwu-v8Yj8__P7plzOLq7-npeLi5nlUPBZqzORF6zV2oAUwARCm9sGhMy1bJVpmGwFq1HbQgnGGlQ207WxHEVTF8bmR-R0q3sfpxMwDdW0uMWuMx7DOlXTd1QOhVB8Qk8-oHdhHf203YbikGW82FDzLWVjSCliW91H15s4VgyqjRvVxo1q58Y08PNVdl332Ozwt_dPgN4CT67D8RO5qrz8Vb6LPwNpVJba</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1864022464</pqid></control><display><type>article</type><title>Synthesis of Novel Hybrids of Thymoquinone and Artemisinin with High Activity and Selectivity Against Colon Cancer</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Fröhlich, Tony ; Ndreshkjana, Benardina ; Muenzner, Julienne K. ; Reiter, Christoph ; Hofmeister, Elisabeth ; Mederer, Sandra ; Fatfat, Maamoun ; El‐Baba, Chirine ; Gali‐Muhtasib, Hala ; Schneider‐Stock, Regine ; Tsogoeva, Svetlana B.</creator><creatorcontrib>Fröhlich, Tony ; Ndreshkjana, Benardina ; Muenzner, Julienne K. ; Reiter, Christoph ; Hofmeister, Elisabeth ; Mederer, Sandra ; Fatfat, Maamoun ; El‐Baba, Chirine ; Gali‐Muhtasib, Hala ; Schneider‐Stock, Regine ; Tsogoeva, Svetlana B.</creatorcontrib><description>Colorectal cancer causes 0.5 million deaths each year. To combat this type of cancer the development of new specific drug candidates is urgently needed. In the present work seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their in vitro anticancer activity against a panel of various tumor cell lines. The thymoquinone–artesunic acid hybrid 7 a, in which both subunits are connected via an ester bond, was found to be the most active compound and selectively decreased the viability of colorectal cancer cells with an IC50 value of 2.4 μm (HCT116) and 2.8 μm (HT29). Remarkably, hybrid 7 a was up to 20‐fold more active than its parent compounds (thymoquinone and artesunic acid), while not affecting nonmalignant colon epithelial HCEC cells (IC50&gt;100 μm). Moreover, the activity of hybrid 7 a was superior to that of various 1:1 mixtures of thymoquinone and artesunic acid. Furthermore, hybrid 7 a was even more potent against both colon cancer cell lines than the clinically used drug 5‐fluorouracil. These results are another excellent proof of the hybridization concept and confirm that the type and length of the linker play a crucial role for the biological activity of a hybrid drug. Besides an increase in reactive oxygen species (ROS), elevated levels of the DNA‐damage marker γ‐H2AX were observed. Both effects seem to be involved in the molecular mechanism of action for hybrid 7 a in colorectal cancer cells. Half a million deaths are caused annually by colorectal cancer. Therefore, the development of new drug candidates is urgently needed. In this study, seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their activity against various tumor cell lines. One hybrid emerged as being particularly potent (outperforming the clinical reference drug 5‐fluorouracil) and specific for colon tumor cells, confirming that the nature and length of the linker play crucial roles for the biological activity of a hybrid drug.</description><identifier>ISSN: 1860-7179</identifier><identifier>EISSN: 1860-7187</identifier><identifier>DOI: 10.1002/cmdc.201600594</identifier><identifier>PMID: 27973725</identifier><language>eng</language><publisher>Germany: Wiley Subscription Services, Inc</publisher><subject>anticancer activity ; Antineoplastic Agents - chemical synthesis ; Antineoplastic Agents - chemistry ; Antineoplastic Agents - toxicity ; artemisinin ; Artemisinins - chemistry ; artesunic acid ; Benzoquinones - chemistry ; Cell Survival - drug effects ; Colonic Neoplasms - metabolism ; Colonic Neoplasms - pathology ; HCT116 Cells ; Histones - metabolism ; HT29 Cells ; Humans ; natural product hybrids ; Reactive Oxygen Species - metabolism ; thymoquinone</subject><ispartof>ChemMedChem, 2017-02, Vol.12 (3), p.226-234</ispartof><rights>2017 Wiley‐VCH Verlag GmbH &amp; Co. KGaA, Weinheim</rights><rights>2017 Wiley-VCH Verlag GmbH &amp; Co. KGaA, Weinheim.</rights><rights>2017 Wiley-VCH Verlag GmbH &amp; Co. KGaA, Weinheim</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4064-f925361f99a075015e0f3cd057397f8ad17f51be9c68511de8c29bac4e5db6ac3</citedby><cites>FETCH-LOGICAL-c4064-f925361f99a075015e0f3cd057397f8ad17f51be9c68511de8c29bac4e5db6ac3</cites><orcidid>0000-0001-6840-3015 ; 0000-0002-9015-5115 ; 0000-0003-4845-0951</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcmdc.201600594$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcmdc.201600594$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27973725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fröhlich, Tony</creatorcontrib><creatorcontrib>Ndreshkjana, Benardina</creatorcontrib><creatorcontrib>Muenzner, Julienne K.</creatorcontrib><creatorcontrib>Reiter, Christoph</creatorcontrib><creatorcontrib>Hofmeister, Elisabeth</creatorcontrib><creatorcontrib>Mederer, Sandra</creatorcontrib><creatorcontrib>Fatfat, Maamoun</creatorcontrib><creatorcontrib>El‐Baba, Chirine</creatorcontrib><creatorcontrib>Gali‐Muhtasib, Hala</creatorcontrib><creatorcontrib>Schneider‐Stock, Regine</creatorcontrib><creatorcontrib>Tsogoeva, Svetlana B.</creatorcontrib><title>Synthesis of Novel Hybrids of Thymoquinone and Artemisinin with High Activity and Selectivity Against Colon Cancer</title><title>ChemMedChem</title><addtitle>ChemMedChem</addtitle><description>Colorectal cancer causes 0.5 million deaths each year. To combat this type of cancer the development of new specific drug candidates is urgently needed. In the present work seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their in vitro anticancer activity against a panel of various tumor cell lines. The thymoquinone–artesunic acid hybrid 7 a, in which both subunits are connected via an ester bond, was found to be the most active compound and selectively decreased the viability of colorectal cancer cells with an IC50 value of 2.4 μm (HCT116) and 2.8 μm (HT29). Remarkably, hybrid 7 a was up to 20‐fold more active than its parent compounds (thymoquinone and artesunic acid), while not affecting nonmalignant colon epithelial HCEC cells (IC50&gt;100 μm). Moreover, the activity of hybrid 7 a was superior to that of various 1:1 mixtures of thymoquinone and artesunic acid. Furthermore, hybrid 7 a was even more potent against both colon cancer cell lines than the clinically used drug 5‐fluorouracil. These results are another excellent proof of the hybridization concept and confirm that the type and length of the linker play a crucial role for the biological activity of a hybrid drug. Besides an increase in reactive oxygen species (ROS), elevated levels of the DNA‐damage marker γ‐H2AX were observed. Both effects seem to be involved in the molecular mechanism of action for hybrid 7 a in colorectal cancer cells. Half a million deaths are caused annually by colorectal cancer. Therefore, the development of new drug candidates is urgently needed. In this study, seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their activity against various tumor cell lines. One hybrid emerged as being particularly potent (outperforming the clinical reference drug 5‐fluorouracil) and specific for colon tumor cells, confirming that the nature and length of the linker play crucial roles for the biological activity of a hybrid drug.</description><subject>anticancer activity</subject><subject>Antineoplastic Agents - chemical synthesis</subject><subject>Antineoplastic Agents - chemistry</subject><subject>Antineoplastic Agents - toxicity</subject><subject>artemisinin</subject><subject>Artemisinins - chemistry</subject><subject>artesunic acid</subject><subject>Benzoquinones - chemistry</subject><subject>Cell Survival - drug effects</subject><subject>Colonic Neoplasms - metabolism</subject><subject>Colonic Neoplasms - pathology</subject><subject>HCT116 Cells</subject><subject>Histones - metabolism</subject><subject>HT29 Cells</subject><subject>Humans</subject><subject>natural product hybrids</subject><subject>Reactive Oxygen Species - metabolism</subject><subject>thymoquinone</subject><issn>1860-7179</issn><issn>1860-7187</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctP3DAQxq2Kqrx67bGyxIXLLuPEju3jKn0sEpQD9Bw5zoQ1Smyws6D892RZWCQunOah33yamY-QHwzmDCA7s31j5xmwAkBo_oUcMFXATDIl93a51PvkMKU7AM4VU9_Ifia1zGUmDki8Hv2wwuQSDS39Fx6xo8uxjq55adysxj48rJ0PHqnxDV3EAXuXnHeePrlhRZfudkUXdnCPbhhfkGvs8K1e3Brn00DL0AVPS-MtxmPytTVdwu-v8Yj8__P7plzOLq7-npeLi5nlUPBZqzORF6zV2oAUwARCm9sGhMy1bJVpmGwFq1HbQgnGGlQ207WxHEVTF8bmR-R0q3sfpxMwDdW0uMWuMx7DOlXTd1QOhVB8Qk8-oHdhHf203YbikGW82FDzLWVjSCliW91H15s4VgyqjRvVxo1q58Y08PNVdl332Ozwt_dPgN4CT67D8RO5qrz8Vb6LPwNpVJba</recordid><startdate>20170203</startdate><enddate>20170203</enddate><creator>Fröhlich, Tony</creator><creator>Ndreshkjana, Benardina</creator><creator>Muenzner, Julienne K.</creator><creator>Reiter, Christoph</creator><creator>Hofmeister, Elisabeth</creator><creator>Mederer, Sandra</creator><creator>Fatfat, Maamoun</creator><creator>El‐Baba, Chirine</creator><creator>Gali‐Muhtasib, Hala</creator><creator>Schneider‐Stock, Regine</creator><creator>Tsogoeva, Svetlana B.</creator><general>Wiley Subscription Services, Inc</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>7QO</scope><scope>7TK</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><orcidid>https://orcid.org/0000-0001-6840-3015</orcidid><orcidid>https://orcid.org/0000-0002-9015-5115</orcidid><orcidid>https://orcid.org/0000-0003-4845-0951</orcidid></search><sort><creationdate>20170203</creationdate><title>Synthesis of Novel Hybrids of Thymoquinone and Artemisinin with High Activity and Selectivity Against Colon Cancer</title><author>Fröhlich, Tony ; Ndreshkjana, Benardina ; Muenzner, Julienne K. ; Reiter, Christoph ; Hofmeister, Elisabeth ; Mederer, Sandra ; Fatfat, Maamoun ; El‐Baba, Chirine ; Gali‐Muhtasib, Hala ; Schneider‐Stock, Regine ; Tsogoeva, Svetlana B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4064-f925361f99a075015e0f3cd057397f8ad17f51be9c68511de8c29bac4e5db6ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>anticancer activity</topic><topic>Antineoplastic Agents - chemical synthesis</topic><topic>Antineoplastic Agents - chemistry</topic><topic>Antineoplastic Agents - toxicity</topic><topic>artemisinin</topic><topic>Artemisinins - chemistry</topic><topic>artesunic acid</topic><topic>Benzoquinones - chemistry</topic><topic>Cell Survival - drug effects</topic><topic>Colonic Neoplasms - metabolism</topic><topic>Colonic Neoplasms - pathology</topic><topic>HCT116 Cells</topic><topic>Histones - metabolism</topic><topic>HT29 Cells</topic><topic>Humans</topic><topic>natural product hybrids</topic><topic>Reactive Oxygen Species - metabolism</topic><topic>thymoquinone</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fröhlich, Tony</creatorcontrib><creatorcontrib>Ndreshkjana, Benardina</creatorcontrib><creatorcontrib>Muenzner, Julienne K.</creatorcontrib><creatorcontrib>Reiter, Christoph</creatorcontrib><creatorcontrib>Hofmeister, Elisabeth</creatorcontrib><creatorcontrib>Mederer, Sandra</creatorcontrib><creatorcontrib>Fatfat, Maamoun</creatorcontrib><creatorcontrib>El‐Baba, Chirine</creatorcontrib><creatorcontrib>Gali‐Muhtasib, Hala</creatorcontrib><creatorcontrib>Schneider‐Stock, Regine</creatorcontrib><creatorcontrib>Tsogoeva, Svetlana B.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><jtitle>ChemMedChem</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fröhlich, Tony</au><au>Ndreshkjana, Benardina</au><au>Muenzner, Julienne K.</au><au>Reiter, Christoph</au><au>Hofmeister, Elisabeth</au><au>Mederer, Sandra</au><au>Fatfat, Maamoun</au><au>El‐Baba, Chirine</au><au>Gali‐Muhtasib, Hala</au><au>Schneider‐Stock, Regine</au><au>Tsogoeva, Svetlana B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Synthesis of Novel Hybrids of Thymoquinone and Artemisinin with High Activity and Selectivity Against Colon Cancer</atitle><jtitle>ChemMedChem</jtitle><addtitle>ChemMedChem</addtitle><date>2017-02-03</date><risdate>2017</risdate><volume>12</volume><issue>3</issue><spage>226</spage><epage>234</epage><pages>226-234</pages><issn>1860-7179</issn><eissn>1860-7187</eissn><abstract>Colorectal cancer causes 0.5 million deaths each year. To combat this type of cancer the development of new specific drug candidates is urgently needed. In the present work seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their in vitro anticancer activity against a panel of various tumor cell lines. The thymoquinone–artesunic acid hybrid 7 a, in which both subunits are connected via an ester bond, was found to be the most active compound and selectively decreased the viability of colorectal cancer cells with an IC50 value of 2.4 μm (HCT116) and 2.8 μm (HT29). Remarkably, hybrid 7 a was up to 20‐fold more active than its parent compounds (thymoquinone and artesunic acid), while not affecting nonmalignant colon epithelial HCEC cells (IC50&gt;100 μm). Moreover, the activity of hybrid 7 a was superior to that of various 1:1 mixtures of thymoquinone and artesunic acid. Furthermore, hybrid 7 a was even more potent against both colon cancer cell lines than the clinically used drug 5‐fluorouracil. These results are another excellent proof of the hybridization concept and confirm that the type and length of the linker play a crucial role for the biological activity of a hybrid drug. Besides an increase in reactive oxygen species (ROS), elevated levels of the DNA‐damage marker γ‐H2AX were observed. Both effects seem to be involved in the molecular mechanism of action for hybrid 7 a in colorectal cancer cells. Half a million deaths are caused annually by colorectal cancer. Therefore, the development of new drug candidates is urgently needed. In this study, seven novel thymoquinone–artemisinin hybrids with different linkers were synthesized and tested for their activity against various tumor cell lines. One hybrid emerged as being particularly potent (outperforming the clinical reference drug 5‐fluorouracil) and specific for colon tumor cells, confirming that the nature and length of the linker play crucial roles for the biological activity of a hybrid drug.</abstract><cop>Germany</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27973725</pmid><doi>10.1002/cmdc.201600594</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6840-3015</orcidid><orcidid>https://orcid.org/0000-0002-9015-5115</orcidid><orcidid>https://orcid.org/0000-0003-4845-0951</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 1860-7179
ispartof ChemMedChem, 2017-02, Vol.12 (3), p.226-234
issn 1860-7179
1860-7187
language eng
recordid cdi_proquest_miscellaneous_1868306584
source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects anticancer activity
Antineoplastic Agents - chemical synthesis
Antineoplastic Agents - chemistry
Antineoplastic Agents - toxicity
artemisinin
Artemisinins - chemistry
artesunic acid
Benzoquinones - chemistry
Cell Survival - drug effects
Colonic Neoplasms - metabolism
Colonic Neoplasms - pathology
HCT116 Cells
Histones - metabolism
HT29 Cells
Humans
natural product hybrids
Reactive Oxygen Species - metabolism
thymoquinone
title Synthesis of Novel Hybrids of Thymoquinone and Artemisinin with High Activity and Selectivity Against Colon Cancer
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T16%3A18%3A59IST&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=Synthesis%20of%20Novel%20Hybrids%20of%20Thymoquinone%20and%20Artemisinin%20with%20High%20Activity%20and%20Selectivity%20Against%20Colon%20Cancer&rft.jtitle=ChemMedChem&rft.au=Fr%C3%B6hlich,%20Tony&rft.date=2017-02-03&rft.volume=12&rft.issue=3&rft.spage=226&rft.epage=234&rft.pages=226-234&rft.issn=1860-7179&rft.eissn=1860-7187&rft_id=info:doi/10.1002/cmdc.201600594&rft_dat=%3Cproquest_cross%3E4311891281%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=1864022464&rft_id=info:pmid/27973725&rfr_iscdi=true