The APOB loss-of-function mutation of Holstein dairy cattle does not cause a deficiency of cholesterol but decreases the capacity for cholesterol transport in circulation

The loss-of-function mutation of the apolipoprotein (APO) B gene (APOB) in Holstein cattle accounts for increased losses in calves that are homozygous for this mutation. Heterozygous carriers of the APOB mutation are clinically healthy but show decreased concentrations of plasma cholesterol and lipo...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of dairy science 2019-11, Vol.102 (11), p.10564-10572
Hauptverfasser: Gross, J.J., Schwinn, A.-C., Schmitz-Hsu, F., Barenco, A., Neuenschwander, T. F.-O., Drögemüller, C., Bruckmaier, R.M.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 10572
container_issue 11
container_start_page 10564
container_title Journal of dairy science
container_volume 102
creator Gross, J.J.
Schwinn, A.-C.
Schmitz-Hsu, F.
Barenco, A.
Neuenschwander, T. F.-O.
Drögemüller, C.
Bruckmaier, R.M.
description The loss-of-function mutation of the apolipoprotein (APO) B gene (APOB) in Holstein cattle accounts for increased losses in calves that are homozygous for this mutation. Heterozygous carriers of the APOB mutation are clinically healthy but show decreased concentrations of plasma cholesterol and lipoproteins. So far, the metabolic effects of the mutation have only been investigated in heterozygous calves, bulls, and nonlactating females. In high-yielding dairy cows, a marked decrease in cholesterol concentration in plasma during early lactation is part of the usual metabolic changes. Given the essential role of cholesterol in fatty acid and lipid metabolism, a specific effect of the APOB mutation on metabolism and performance in dairy cows is expected. Therefore, the aim of the present study was to investigate the effects of different APOB genotypes on metabolic parameters, hepatic metabolism, and lactation and reproductive performance. Twenty pairs of full siblings with similar age, performance, and calving were investigated. Both animals of each pair were kept on the same farm and consisted of a heterozygous carrier (CDC) and a noncarrier (CDF) of the APOB mutation associated with cholesterol deficiency. Blood samples were taken in early (25.5 ± 4.7 d in milk) and mid lactation (158.2 ± 11.1 d in milk; mean ± SD), and analyzed for nonesterified fatty acids, β-hydroxybutyrate, glucose, insulin-like growth factor-1, aspartate aminotransferase and gamma-glutamyltransferase activity, total cholesterol, free cholesterol, triacylglycerols, high density lipoprotein-cholesterol, and phospholipids. The evaluation of milk production, milk gross composition, and lactation persistency was based on official Dairy Herd Improvement Association recordings. Cholesterol and lipoprotein concentrations were lower in CDC cows than in CDF cows in early and mid lactation. Metabolic parameters, triacylglycerol concentration in plasma, and lactation and reproductive performance did not differ between CDC cows and CDF cows. The low cholesterol concentrations associated with the APOB mutation in heterozygous carriers are not because of a primary deficiency of cholesterol at a cellular level, as the term “cholesterol deficiency” suggests, but rather a consequence of reduced capacity for its transport in circulation. Overall, the data of the present study suggest that, despite the presence of the APOB mutation, cholesterol is not limiting for animals' metabolic adaptation and perform
doi_str_mv 10.3168/jds.2019-16852
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2283996870</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S002203021930760X</els_id><sourcerecordid>2283996870</sourcerecordid><originalsourceid>FETCH-LOGICAL-c384t-4788d4ddee5bb71f320939d74a4488bea97e89cc6b9e9b7588d1a929f9c4bb393</originalsourceid><addsrcrecordid>eNp1kTtPHDEUha0IFDYkbcrIJc1s_JjZsUtAPCIhQUFqy49rYeQdb2wP0v4lfmW8uwSJIpV95e-ce30PQt8pWXK6Ej-fXVkyQmXXioF9Qgs6sKHjVIojtCCEsY5wwk7Ql1KeW0kZGT6jE077cWRCLtDr4xPg84f7CxxTKV3ynZ8nW0Oa8Hquen9JHt-mWCqECTsd8hZbXWsE7BIUPKXa6rkA1tiBDzbAZLc7kX1KEZosp4jNXNurzaBL09TW1OqNtqFusU_5A1qznsom5YpbPxuyneN-jq_o2OtY4NvbeYp-X189Xt52d_c3vy7P7zrLRV-7fhTC9c4BDMaM1HNGJJdu7HXfC2FAyxGEtHZlJEgzDo2mWjLppe2N4ZKforOD7yanP3ObSq1DsRCjniDNRTEmuJQrMZKGLg-ozW17Gbza5LDWeasoUbt8VMtH7fJR-3ya4Meb92zW4N7xf4E0QBwAaD98CZBV2S8UXMhgq3Ip_M_7L6Wros0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2283996870</pqid></control><display><type>article</type><title>The APOB loss-of-function mutation of Holstein dairy cattle does not cause a deficiency of cholesterol but decreases the capacity for cholesterol transport in circulation</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Gross, J.J. ; Schwinn, A.-C. ; Schmitz-Hsu, F. ; Barenco, A. ; Neuenschwander, T. F.-O. ; Drögemüller, C. ; Bruckmaier, R.M.</creator><creatorcontrib>Gross, J.J. ; Schwinn, A.-C. ; Schmitz-Hsu, F. ; Barenco, A. ; Neuenschwander, T. F.-O. ; Drögemüller, C. ; Bruckmaier, R.M.</creatorcontrib><description>The loss-of-function mutation of the apolipoprotein (APO) B gene (APOB) in Holstein cattle accounts for increased losses in calves that are homozygous for this mutation. Heterozygous carriers of the APOB mutation are clinically healthy but show decreased concentrations of plasma cholesterol and lipoproteins. So far, the metabolic effects of the mutation have only been investigated in heterozygous calves, bulls, and nonlactating females. In high-yielding dairy cows, a marked decrease in cholesterol concentration in plasma during early lactation is part of the usual metabolic changes. Given the essential role of cholesterol in fatty acid and lipid metabolism, a specific effect of the APOB mutation on metabolism and performance in dairy cows is expected. Therefore, the aim of the present study was to investigate the effects of different APOB genotypes on metabolic parameters, hepatic metabolism, and lactation and reproductive performance. Twenty pairs of full siblings with similar age, performance, and calving were investigated. Both animals of each pair were kept on the same farm and consisted of a heterozygous carrier (CDC) and a noncarrier (CDF) of the APOB mutation associated with cholesterol deficiency. Blood samples were taken in early (25.5 ± 4.7 d in milk) and mid lactation (158.2 ± 11.1 d in milk; mean ± SD), and analyzed for nonesterified fatty acids, β-hydroxybutyrate, glucose, insulin-like growth factor-1, aspartate aminotransferase and gamma-glutamyltransferase activity, total cholesterol, free cholesterol, triacylglycerols, high density lipoprotein-cholesterol, and phospholipids. The evaluation of milk production, milk gross composition, and lactation persistency was based on official Dairy Herd Improvement Association recordings. Cholesterol and lipoprotein concentrations were lower in CDC cows than in CDF cows in early and mid lactation. Metabolic parameters, triacylglycerol concentration in plasma, and lactation and reproductive performance did not differ between CDC cows and CDF cows. The low cholesterol concentrations associated with the APOB mutation in heterozygous carriers are not because of a primary deficiency of cholesterol at a cellular level, as the term “cholesterol deficiency” suggests, but rather a consequence of reduced capacity for its transport in circulation. Overall, the data of the present study suggest that, despite the presence of the APOB mutation, cholesterol is not limiting for animals' metabolic adaptation and performance in heterozygous Holstein cows.</description><identifier>ISSN: 0022-0302</identifier><identifier>EISSN: 1525-3198</identifier><identifier>DOI: 10.3168/jds.2019-16852</identifier><identifier>PMID: 31477289</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>3-Hydroxybutyric Acid - blood ; Animals ; APOB mutation ; Apolipoproteins B - genetics ; Biological Transport ; Blood Glucose - metabolism ; Cattle - blood ; Cattle - genetics ; cholesterol ; Cholesterol - blood ; Cholesterol - deficiency ; Cholesterol, HDL - blood ; dairy cow ; Fatty Acids, Nonesterified - blood ; Female ; Lactation ; Lipid Metabolism ; lipoprotein ; Liver - metabolism ; Loss of Function Mutation ; Milk ; Reproduction ; Triglycerides - metabolism</subject><ispartof>Journal of dairy science, 2019-11, Vol.102 (11), p.10564-10572</ispartof><rights>2019 American Dairy Science Association</rights><rights>Copyright © 2019 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-4788d4ddee5bb71f320939d74a4488bea97e89cc6b9e9b7588d1a929f9c4bb393</citedby><cites>FETCH-LOGICAL-c384t-4788d4ddee5bb71f320939d74a4488bea97e89cc6b9e9b7588d1a929f9c4bb393</cites><orcidid>0000-0002-9374-5890 ; 0000-0002-2578-6076</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.3168/jds.2019-16852$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31477289$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gross, J.J.</creatorcontrib><creatorcontrib>Schwinn, A.-C.</creatorcontrib><creatorcontrib>Schmitz-Hsu, F.</creatorcontrib><creatorcontrib>Barenco, A.</creatorcontrib><creatorcontrib>Neuenschwander, T. F.-O.</creatorcontrib><creatorcontrib>Drögemüller, C.</creatorcontrib><creatorcontrib>Bruckmaier, R.M.</creatorcontrib><title>The APOB loss-of-function mutation of Holstein dairy cattle does not cause a deficiency of cholesterol but decreases the capacity for cholesterol transport in circulation</title><title>Journal of dairy science</title><addtitle>J Dairy Sci</addtitle><description>The loss-of-function mutation of the apolipoprotein (APO) B gene (APOB) in Holstein cattle accounts for increased losses in calves that are homozygous for this mutation. Heterozygous carriers of the APOB mutation are clinically healthy but show decreased concentrations of plasma cholesterol and lipoproteins. So far, the metabolic effects of the mutation have only been investigated in heterozygous calves, bulls, and nonlactating females. In high-yielding dairy cows, a marked decrease in cholesterol concentration in plasma during early lactation is part of the usual metabolic changes. Given the essential role of cholesterol in fatty acid and lipid metabolism, a specific effect of the APOB mutation on metabolism and performance in dairy cows is expected. Therefore, the aim of the present study was to investigate the effects of different APOB genotypes on metabolic parameters, hepatic metabolism, and lactation and reproductive performance. Twenty pairs of full siblings with similar age, performance, and calving were investigated. Both animals of each pair were kept on the same farm and consisted of a heterozygous carrier (CDC) and a noncarrier (CDF) of the APOB mutation associated with cholesterol deficiency. Blood samples were taken in early (25.5 ± 4.7 d in milk) and mid lactation (158.2 ± 11.1 d in milk; mean ± SD), and analyzed for nonesterified fatty acids, β-hydroxybutyrate, glucose, insulin-like growth factor-1, aspartate aminotransferase and gamma-glutamyltransferase activity, total cholesterol, free cholesterol, triacylglycerols, high density lipoprotein-cholesterol, and phospholipids. The evaluation of milk production, milk gross composition, and lactation persistency was based on official Dairy Herd Improvement Association recordings. Cholesterol and lipoprotein concentrations were lower in CDC cows than in CDF cows in early and mid lactation. Metabolic parameters, triacylglycerol concentration in plasma, and lactation and reproductive performance did not differ between CDC cows and CDF cows. The low cholesterol concentrations associated with the APOB mutation in heterozygous carriers are not because of a primary deficiency of cholesterol at a cellular level, as the term “cholesterol deficiency” suggests, but rather a consequence of reduced capacity for its transport in circulation. Overall, the data of the present study suggest that, despite the presence of the APOB mutation, cholesterol is not limiting for animals' metabolic adaptation and performance in heterozygous Holstein cows.</description><subject>3-Hydroxybutyric Acid - blood</subject><subject>Animals</subject><subject>APOB mutation</subject><subject>Apolipoproteins B - genetics</subject><subject>Biological Transport</subject><subject>Blood Glucose - metabolism</subject><subject>Cattle - blood</subject><subject>Cattle - genetics</subject><subject>cholesterol</subject><subject>Cholesterol - blood</subject><subject>Cholesterol - deficiency</subject><subject>Cholesterol, HDL - blood</subject><subject>dairy cow</subject><subject>Fatty Acids, Nonesterified - blood</subject><subject>Female</subject><subject>Lactation</subject><subject>Lipid Metabolism</subject><subject>lipoprotein</subject><subject>Liver - metabolism</subject><subject>Loss of Function Mutation</subject><subject>Milk</subject><subject>Reproduction</subject><subject>Triglycerides - metabolism</subject><issn>0022-0302</issn><issn>1525-3198</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kTtPHDEUha0IFDYkbcrIJc1s_JjZsUtAPCIhQUFqy49rYeQdb2wP0v4lfmW8uwSJIpV95e-ce30PQt8pWXK6Ej-fXVkyQmXXioF9Qgs6sKHjVIojtCCEsY5wwk7Ql1KeW0kZGT6jE077cWRCLtDr4xPg84f7CxxTKV3ynZ8nW0Oa8Hquen9JHt-mWCqECTsd8hZbXWsE7BIUPKXa6rkA1tiBDzbAZLc7kX1KEZosp4jNXNurzaBL09TW1OqNtqFusU_5A1qznsom5YpbPxuyneN-jq_o2OtY4NvbeYp-X189Xt52d_c3vy7P7zrLRV-7fhTC9c4BDMaM1HNGJJdu7HXfC2FAyxGEtHZlJEgzDo2mWjLppe2N4ZKforOD7yanP3ObSq1DsRCjniDNRTEmuJQrMZKGLg-ozW17Gbza5LDWeasoUbt8VMtH7fJR-3ya4Meb92zW4N7xf4E0QBwAaD98CZBV2S8UXMhgq3Ip_M_7L6Wros0</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Gross, J.J.</creator><creator>Schwinn, A.-C.</creator><creator>Schmitz-Hsu, F.</creator><creator>Barenco, A.</creator><creator>Neuenschwander, T. F.-O.</creator><creator>Drögemüller, C.</creator><creator>Bruckmaier, R.M.</creator><general>Elsevier 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>7X8</scope><orcidid>https://orcid.org/0000-0002-9374-5890</orcidid><orcidid>https://orcid.org/0000-0002-2578-6076</orcidid></search><sort><creationdate>201911</creationdate><title>The APOB loss-of-function mutation of Holstein dairy cattle does not cause a deficiency of cholesterol but decreases the capacity for cholesterol transport in circulation</title><author>Gross, J.J. ; Schwinn, A.-C. ; Schmitz-Hsu, F. ; Barenco, A. ; Neuenschwander, T. F.-O. ; Drögemüller, C. ; Bruckmaier, R.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-4788d4ddee5bb71f320939d74a4488bea97e89cc6b9e9b7588d1a929f9c4bb393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>3-Hydroxybutyric Acid - blood</topic><topic>Animals</topic><topic>APOB mutation</topic><topic>Apolipoproteins B - genetics</topic><topic>Biological Transport</topic><topic>Blood Glucose - metabolism</topic><topic>Cattle - blood</topic><topic>Cattle - genetics</topic><topic>cholesterol</topic><topic>Cholesterol - blood</topic><topic>Cholesterol - deficiency</topic><topic>Cholesterol, HDL - blood</topic><topic>dairy cow</topic><topic>Fatty Acids, Nonesterified - blood</topic><topic>Female</topic><topic>Lactation</topic><topic>Lipid Metabolism</topic><topic>lipoprotein</topic><topic>Liver - metabolism</topic><topic>Loss of Function Mutation</topic><topic>Milk</topic><topic>Reproduction</topic><topic>Triglycerides - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gross, J.J.</creatorcontrib><creatorcontrib>Schwinn, A.-C.</creatorcontrib><creatorcontrib>Schmitz-Hsu, F.</creatorcontrib><creatorcontrib>Barenco, A.</creatorcontrib><creatorcontrib>Neuenschwander, T. F.-O.</creatorcontrib><creatorcontrib>Drögemüller, C.</creatorcontrib><creatorcontrib>Bruckmaier, R.M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of dairy science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gross, J.J.</au><au>Schwinn, A.-C.</au><au>Schmitz-Hsu, F.</au><au>Barenco, A.</au><au>Neuenschwander, T. F.-O.</au><au>Drögemüller, C.</au><au>Bruckmaier, R.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The APOB loss-of-function mutation of Holstein dairy cattle does not cause a deficiency of cholesterol but decreases the capacity for cholesterol transport in circulation</atitle><jtitle>Journal of dairy science</jtitle><addtitle>J Dairy Sci</addtitle><date>2019-11</date><risdate>2019</risdate><volume>102</volume><issue>11</issue><spage>10564</spage><epage>10572</epage><pages>10564-10572</pages><issn>0022-0302</issn><eissn>1525-3198</eissn><abstract>The loss-of-function mutation of the apolipoprotein (APO) B gene (APOB) in Holstein cattle accounts for increased losses in calves that are homozygous for this mutation. Heterozygous carriers of the APOB mutation are clinically healthy but show decreased concentrations of plasma cholesterol and lipoproteins. So far, the metabolic effects of the mutation have only been investigated in heterozygous calves, bulls, and nonlactating females. In high-yielding dairy cows, a marked decrease in cholesterol concentration in plasma during early lactation is part of the usual metabolic changes. Given the essential role of cholesterol in fatty acid and lipid metabolism, a specific effect of the APOB mutation on metabolism and performance in dairy cows is expected. Therefore, the aim of the present study was to investigate the effects of different APOB genotypes on metabolic parameters, hepatic metabolism, and lactation and reproductive performance. Twenty pairs of full siblings with similar age, performance, and calving were investigated. Both animals of each pair were kept on the same farm and consisted of a heterozygous carrier (CDC) and a noncarrier (CDF) of the APOB mutation associated with cholesterol deficiency. Blood samples were taken in early (25.5 ± 4.7 d in milk) and mid lactation (158.2 ± 11.1 d in milk; mean ± SD), and analyzed for nonesterified fatty acids, β-hydroxybutyrate, glucose, insulin-like growth factor-1, aspartate aminotransferase and gamma-glutamyltransferase activity, total cholesterol, free cholesterol, triacylglycerols, high density lipoprotein-cholesterol, and phospholipids. The evaluation of milk production, milk gross composition, and lactation persistency was based on official Dairy Herd Improvement Association recordings. Cholesterol and lipoprotein concentrations were lower in CDC cows than in CDF cows in early and mid lactation. Metabolic parameters, triacylglycerol concentration in plasma, and lactation and reproductive performance did not differ between CDC cows and CDF cows. The low cholesterol concentrations associated with the APOB mutation in heterozygous carriers are not because of a primary deficiency of cholesterol at a cellular level, as the term “cholesterol deficiency” suggests, but rather a consequence of reduced capacity for its transport in circulation. Overall, the data of the present study suggest that, despite the presence of the APOB mutation, cholesterol is not limiting for animals' metabolic adaptation and performance in heterozygous Holstein cows.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31477289</pmid><doi>10.3168/jds.2019-16852</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-9374-5890</orcidid><orcidid>https://orcid.org/0000-0002-2578-6076</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0022-0302
ispartof Journal of dairy science, 2019-11, Vol.102 (11), p.10564-10572
issn 0022-0302
1525-3198
language eng
recordid cdi_proquest_miscellaneous_2283996870
source MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals
subjects 3-Hydroxybutyric Acid - blood
Animals
APOB mutation
Apolipoproteins B - genetics
Biological Transport
Blood Glucose - metabolism
Cattle - blood
Cattle - genetics
cholesterol
Cholesterol - blood
Cholesterol - deficiency
Cholesterol, HDL - blood
dairy cow
Fatty Acids, Nonesterified - blood
Female
Lactation
Lipid Metabolism
lipoprotein
Liver - metabolism
Loss of Function Mutation
Milk
Reproduction
Triglycerides - metabolism
title The APOB loss-of-function mutation of Holstein dairy cattle does not cause a deficiency of cholesterol but decreases the capacity for cholesterol transport in circulation
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T01%3A51%3A43IST&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=The%20APOB%20loss-of-function%20mutation%20of%20Holstein%20dairy%20cattle%20does%20not%20cause%20a%20deficiency%20of%20cholesterol%20but%20decreases%20the%20capacity%20for%20cholesterol%20transport%20in%20circulation&rft.jtitle=Journal%20of%20dairy%20science&rft.au=Gross,%20J.J.&rft.date=2019-11&rft.volume=102&rft.issue=11&rft.spage=10564&rft.epage=10572&rft.pages=10564-10572&rft.issn=0022-0302&rft.eissn=1525-3198&rft_id=info:doi/10.3168/jds.2019-16852&rft_dat=%3Cproquest_cross%3E2283996870%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=2283996870&rft_id=info:pmid/31477289&rft_els_id=S002203021930760X&rfr_iscdi=true