Melanocytes as emerging key players in niche regulation of limbal epithelial stem cells
Limbal melanocytes (LMel) represent essential components of the corneal epithelial stem cell niche and are known to protect limbal epithelial stem/progenitor cells (LEPCs) from UV damage by transfer of melanosomes. Here, we explored additional functional roles for LMel in niche homeostasis, immune r...
Gespeichert in:
Veröffentlicht in: | The ocular surface 2021-10, Vol.22, p.172-189 |
---|---|
Hauptverfasser: | , , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 189 |
---|---|
container_issue | |
container_start_page | 172 |
container_title | The ocular surface |
container_volume | 22 |
creator | Polisetti, Naresh Gießl, Andreas Zenkel, Matthias Heger, Lukas Dudziak, Diana Naschberger, Elisabeth Stich, Lena Steinkasserer, Alexander Kruse, Friedrich E. Schlötzer-Schrehardt, Ursula |
description | Limbal melanocytes (LMel) represent essential components of the corneal epithelial stem cell niche and are known to protect limbal epithelial stem/progenitor cells (LEPCs) from UV damage by transfer of melanosomes. Here, we explored additional functional roles for LMel in niche homeostasis, immune regulation and angiostasis.
Human corneoscleral tissues were morphologically analyzed in normal, inflammatory and wound healing conditions. The effects of LMel on LEPCs were analyzed in direct and indirect co-culture models using electron microscopy, immunocytochemistry, qRT-PCR, Western blotting and functional assays; limbal mesenchymal stromal cells and murine embryonic 3T3 fibroblasts served as controls. The immunophenotype of LMel was assessed by flow cytometry before and after interferon-γ stimulation, and their immunomodulatory properties were analyzed by mixed lymphocytes reaction, monocyte adhesion assays and cytometric bead arrays. Their angiostatic effects on human umbilical cord endothelial cells (HUVECs) were evaluated by proliferation, migration, and tube formation assays.
LMel and LEPCs formed structural units in the human limbal stem cell niche in situ, which could be functionally replicated, including melanosome transfer, by co-cultivation in vitro. LMel supported LEPCs during clonal expansion and during epithelial wound healing by stimulating proliferation and migration, and suppressed their differentiation through direct contact and paracrine effects. Under inflammatory conditions, LMel were increased in numbers and upregulated expression of ICAM-1 and MHC II molecules (HLA-DR), but lacked expression of HLA-G, -DP, -DQ and costimulatory molecules CD80 and CD86. They were also found to be potent suppressors of alloreactive T- cell proliferation and cytokine secretion, which largely depended on direct cell-cell interaction. Moreover, the LMel secretome exerted angiostatic activity by inhibiting vascular endothelial cell proliferation and capillary network formation.
These findings suggest that LMel are not only professional melanin-producing cells, but exert various non-canonical functions in limbal niche homeostasis by regulating LEPC maintenance, immune responses, and angiostasis. Their potent regulatory, immunomodulatory and anti-angiogenic properties may have important implications for future regenerative cell therapies.
•This study provides evidence that melanocytes exert various non-canonical functions in limbal niche regulation beyond UV pr |
doi_str_mv | 10.1016/j.jtos.2021.08.006 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2564131146</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1542012421000884</els_id><sourcerecordid>2564131146</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-b0f97ac0be871cd56a763575739935cd9cf2f141e1a1dd9d4c0fdf1ce12626d63</originalsourceid><addsrcrecordid>eNp9kD1v2zAQhomiQZM6-QMZCo5dpNyRFGUBXYog_QASZEmQkaDJk02HklxSDuB_Hwl2O3a6G573xd3D2DVCiYD6ZltuxyGXAgSWsCwB9Ad2gY2si6pB-XHaKyUKQKHO2eectwBSaxCf2LlUSlSiWV6wlweKth_cYaTMbebUUVqHfs1f6cB30R4oZR563ge3IZ5ovY92DEPPh5bH0K1s5LQL44ZimNY8UscdxZgv2VlrY6ar01yw5x93T7e_ivvHn79vv98XTgGMxQraprYOVrSs0flK21rLqq5q2TSycr5xrWhRIaFF7xuvHLS-RUcotNBeywX7euzdpeHPnvJoupDnC2xPwz4bUWmFElHNqDiiLg05J2rNLoXOpoNBMLNQszWzUDMLNbA0k9Ap9OXUv1915P9F_hqcgG9HgKYv3wIlk12g3pEPidxo_BD-1_8OfMuIBw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2564131146</pqid></control><display><type>article</type><title>Melanocytes as emerging key players in niche regulation of limbal epithelial stem cells</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Polisetti, Naresh ; Gießl, Andreas ; Zenkel, Matthias ; Heger, Lukas ; Dudziak, Diana ; Naschberger, Elisabeth ; Stich, Lena ; Steinkasserer, Alexander ; Kruse, Friedrich E. ; Schlötzer-Schrehardt, Ursula</creator><creatorcontrib>Polisetti, Naresh ; Gießl, Andreas ; Zenkel, Matthias ; Heger, Lukas ; Dudziak, Diana ; Naschberger, Elisabeth ; Stich, Lena ; Steinkasserer, Alexander ; Kruse, Friedrich E. ; Schlötzer-Schrehardt, Ursula</creatorcontrib><description>Limbal melanocytes (LMel) represent essential components of the corneal epithelial stem cell niche and are known to protect limbal epithelial stem/progenitor cells (LEPCs) from UV damage by transfer of melanosomes. Here, we explored additional functional roles for LMel in niche homeostasis, immune regulation and angiostasis.
Human corneoscleral tissues were morphologically analyzed in normal, inflammatory and wound healing conditions. The effects of LMel on LEPCs were analyzed in direct and indirect co-culture models using electron microscopy, immunocytochemistry, qRT-PCR, Western blotting and functional assays; limbal mesenchymal stromal cells and murine embryonic 3T3 fibroblasts served as controls. The immunophenotype of LMel was assessed by flow cytometry before and after interferon-γ stimulation, and their immunomodulatory properties were analyzed by mixed lymphocytes reaction, monocyte adhesion assays and cytometric bead arrays. Their angiostatic effects on human umbilical cord endothelial cells (HUVECs) were evaluated by proliferation, migration, and tube formation assays.
LMel and LEPCs formed structural units in the human limbal stem cell niche in situ, which could be functionally replicated, including melanosome transfer, by co-cultivation in vitro. LMel supported LEPCs during clonal expansion and during epithelial wound healing by stimulating proliferation and migration, and suppressed their differentiation through direct contact and paracrine effects. Under inflammatory conditions, LMel were increased in numbers and upregulated expression of ICAM-1 and MHC II molecules (HLA-DR), but lacked expression of HLA-G, -DP, -DQ and costimulatory molecules CD80 and CD86. They were also found to be potent suppressors of alloreactive T- cell proliferation and cytokine secretion, which largely depended on direct cell-cell interaction. Moreover, the LMel secretome exerted angiostatic activity by inhibiting vascular endothelial cell proliferation and capillary network formation.
These findings suggest that LMel are not only professional melanin-producing cells, but exert various non-canonical functions in limbal niche homeostasis by regulating LEPC maintenance, immune responses, and angiostasis. Their potent regulatory, immunomodulatory and anti-angiogenic properties may have important implications for future regenerative cell therapies.
•This study provides evidence that melanocytes exert various non-canonical functions in limbal niche regulation beyond UV protection.•Limbal melanocytes regulate maintenance of limbal stem/progenitor cells by suppressing their differentiation.•Limbal melanocytes support limbal stem/progenitor cells during wound healing by stimulating proliferation and migration.•Limbal melanocytes control local immune reactions by inhibiting T-cell proliferation and inflammatory cytokine secretion.•Limbal melanocytes display angiostatic activity by inhibiting vascular endothelial cell proliferation and capillary formation.</description><identifier>ISSN: 1542-0124</identifier><identifier>EISSN: 1937-5913</identifier><identifier>DOI: 10.1016/j.jtos.2021.08.006</identifier><identifier>PMID: 34425298</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Angiostasis ; Animals ; Cells, Cultured ; Endothelial Cells ; Epithelial Cells ; Epithelium, Corneal ; Humans ; Immune regulation ; Inflammation ; Limbal niche ; Limbal stem cells ; Limbus Corneae ; Melanocytes ; Mice ; Secretome ; Stem Cell Niche ; Stem Cells ; Wound healing</subject><ispartof>The ocular surface, 2021-10, Vol.22, p.172-189</ispartof><rights>2021 The Authors</rights><rights>Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-b0f97ac0be871cd56a763575739935cd9cf2f141e1a1dd9d4c0fdf1ce12626d63</citedby><cites>FETCH-LOGICAL-c400t-b0f97ac0be871cd56a763575739935cd9cf2f141e1a1dd9d4c0fdf1ce12626d63</cites><orcidid>0000-0001-5591-2187 ; 0000-0003-1291-622X ; 0000-0001-9358-134X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34425298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Polisetti, Naresh</creatorcontrib><creatorcontrib>Gießl, Andreas</creatorcontrib><creatorcontrib>Zenkel, Matthias</creatorcontrib><creatorcontrib>Heger, Lukas</creatorcontrib><creatorcontrib>Dudziak, Diana</creatorcontrib><creatorcontrib>Naschberger, Elisabeth</creatorcontrib><creatorcontrib>Stich, Lena</creatorcontrib><creatorcontrib>Steinkasserer, Alexander</creatorcontrib><creatorcontrib>Kruse, Friedrich E.</creatorcontrib><creatorcontrib>Schlötzer-Schrehardt, Ursula</creatorcontrib><title>Melanocytes as emerging key players in niche regulation of limbal epithelial stem cells</title><title>The ocular surface</title><addtitle>Ocul Surf</addtitle><description>Limbal melanocytes (LMel) represent essential components of the corneal epithelial stem cell niche and are known to protect limbal epithelial stem/progenitor cells (LEPCs) from UV damage by transfer of melanosomes. Here, we explored additional functional roles for LMel in niche homeostasis, immune regulation and angiostasis.
Human corneoscleral tissues were morphologically analyzed in normal, inflammatory and wound healing conditions. The effects of LMel on LEPCs were analyzed in direct and indirect co-culture models using electron microscopy, immunocytochemistry, qRT-PCR, Western blotting and functional assays; limbal mesenchymal stromal cells and murine embryonic 3T3 fibroblasts served as controls. The immunophenotype of LMel was assessed by flow cytometry before and after interferon-γ stimulation, and their immunomodulatory properties were analyzed by mixed lymphocytes reaction, monocyte adhesion assays and cytometric bead arrays. Their angiostatic effects on human umbilical cord endothelial cells (HUVECs) were evaluated by proliferation, migration, and tube formation assays.
LMel and LEPCs formed structural units in the human limbal stem cell niche in situ, which could be functionally replicated, including melanosome transfer, by co-cultivation in vitro. LMel supported LEPCs during clonal expansion and during epithelial wound healing by stimulating proliferation and migration, and suppressed their differentiation through direct contact and paracrine effects. Under inflammatory conditions, LMel were increased in numbers and upregulated expression of ICAM-1 and MHC II molecules (HLA-DR), but lacked expression of HLA-G, -DP, -DQ and costimulatory molecules CD80 and CD86. They were also found to be potent suppressors of alloreactive T- cell proliferation and cytokine secretion, which largely depended on direct cell-cell interaction. Moreover, the LMel secretome exerted angiostatic activity by inhibiting vascular endothelial cell proliferation and capillary network formation.
These findings suggest that LMel are not only professional melanin-producing cells, but exert various non-canonical functions in limbal niche homeostasis by regulating LEPC maintenance, immune responses, and angiostasis. Their potent regulatory, immunomodulatory and anti-angiogenic properties may have important implications for future regenerative cell therapies.
•This study provides evidence that melanocytes exert various non-canonical functions in limbal niche regulation beyond UV protection.•Limbal melanocytes regulate maintenance of limbal stem/progenitor cells by suppressing their differentiation.•Limbal melanocytes support limbal stem/progenitor cells during wound healing by stimulating proliferation and migration.•Limbal melanocytes control local immune reactions by inhibiting T-cell proliferation and inflammatory cytokine secretion.•Limbal melanocytes display angiostatic activity by inhibiting vascular endothelial cell proliferation and capillary formation.</description><subject>Angiostasis</subject><subject>Animals</subject><subject>Cells, Cultured</subject><subject>Endothelial Cells</subject><subject>Epithelial Cells</subject><subject>Epithelium, Corneal</subject><subject>Humans</subject><subject>Immune regulation</subject><subject>Inflammation</subject><subject>Limbal niche</subject><subject>Limbal stem cells</subject><subject>Limbus Corneae</subject><subject>Melanocytes</subject><subject>Mice</subject><subject>Secretome</subject><subject>Stem Cell Niche</subject><subject>Stem Cells</subject><subject>Wound healing</subject><issn>1542-0124</issn><issn>1937-5913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1v2zAQhomiQZM6-QMZCo5dpNyRFGUBXYog_QASZEmQkaDJk02HklxSDuB_Hwl2O3a6G573xd3D2DVCiYD6ZltuxyGXAgSWsCwB9Ad2gY2si6pB-XHaKyUKQKHO2eectwBSaxCf2LlUSlSiWV6wlweKth_cYaTMbebUUVqHfs1f6cB30R4oZR563ge3IZ5ovY92DEPPh5bH0K1s5LQL44ZimNY8UscdxZgv2VlrY6ar01yw5x93T7e_ivvHn79vv98XTgGMxQraprYOVrSs0flK21rLqq5q2TSycr5xrWhRIaFF7xuvHLS-RUcotNBeywX7euzdpeHPnvJoupDnC2xPwz4bUWmFElHNqDiiLg05J2rNLoXOpoNBMLNQszWzUDMLNbA0k9Ap9OXUv1915P9F_hqcgG9HgKYv3wIlk12g3pEPidxo_BD-1_8OfMuIBw</recordid><startdate>202110</startdate><enddate>202110</enddate><creator>Polisetti, Naresh</creator><creator>Gießl, Andreas</creator><creator>Zenkel, Matthias</creator><creator>Heger, Lukas</creator><creator>Dudziak, Diana</creator><creator>Naschberger, Elisabeth</creator><creator>Stich, Lena</creator><creator>Steinkasserer, Alexander</creator><creator>Kruse, Friedrich E.</creator><creator>Schlötzer-Schrehardt, Ursula</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</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>7X8</scope><orcidid>https://orcid.org/0000-0001-5591-2187</orcidid><orcidid>https://orcid.org/0000-0003-1291-622X</orcidid><orcidid>https://orcid.org/0000-0001-9358-134X</orcidid></search><sort><creationdate>202110</creationdate><title>Melanocytes as emerging key players in niche regulation of limbal epithelial stem cells</title><author>Polisetti, Naresh ; Gießl, Andreas ; Zenkel, Matthias ; Heger, Lukas ; Dudziak, Diana ; Naschberger, Elisabeth ; Stich, Lena ; Steinkasserer, Alexander ; Kruse, Friedrich E. ; Schlötzer-Schrehardt, Ursula</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-b0f97ac0be871cd56a763575739935cd9cf2f141e1a1dd9d4c0fdf1ce12626d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Angiostasis</topic><topic>Animals</topic><topic>Cells, Cultured</topic><topic>Endothelial Cells</topic><topic>Epithelial Cells</topic><topic>Epithelium, Corneal</topic><topic>Humans</topic><topic>Immune regulation</topic><topic>Inflammation</topic><topic>Limbal niche</topic><topic>Limbal stem cells</topic><topic>Limbus Corneae</topic><topic>Melanocytes</topic><topic>Mice</topic><topic>Secretome</topic><topic>Stem Cell Niche</topic><topic>Stem Cells</topic><topic>Wound healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Polisetti, Naresh</creatorcontrib><creatorcontrib>Gießl, Andreas</creatorcontrib><creatorcontrib>Zenkel, Matthias</creatorcontrib><creatorcontrib>Heger, Lukas</creatorcontrib><creatorcontrib>Dudziak, Diana</creatorcontrib><creatorcontrib>Naschberger, Elisabeth</creatorcontrib><creatorcontrib>Stich, Lena</creatorcontrib><creatorcontrib>Steinkasserer, Alexander</creatorcontrib><creatorcontrib>Kruse, Friedrich E.</creatorcontrib><creatorcontrib>Schlötzer-Schrehardt, Ursula</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><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>The ocular surface</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Polisetti, Naresh</au><au>Gießl, Andreas</au><au>Zenkel, Matthias</au><au>Heger, Lukas</au><au>Dudziak, Diana</au><au>Naschberger, Elisabeth</au><au>Stich, Lena</au><au>Steinkasserer, Alexander</au><au>Kruse, Friedrich E.</au><au>Schlötzer-Schrehardt, Ursula</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Melanocytes as emerging key players in niche regulation of limbal epithelial stem cells</atitle><jtitle>The ocular surface</jtitle><addtitle>Ocul Surf</addtitle><date>2021-10</date><risdate>2021</risdate><volume>22</volume><spage>172</spage><epage>189</epage><pages>172-189</pages><issn>1542-0124</issn><eissn>1937-5913</eissn><abstract>Limbal melanocytes (LMel) represent essential components of the corneal epithelial stem cell niche and are known to protect limbal epithelial stem/progenitor cells (LEPCs) from UV damage by transfer of melanosomes. Here, we explored additional functional roles for LMel in niche homeostasis, immune regulation and angiostasis.
Human corneoscleral tissues were morphologically analyzed in normal, inflammatory and wound healing conditions. The effects of LMel on LEPCs were analyzed in direct and indirect co-culture models using electron microscopy, immunocytochemistry, qRT-PCR, Western blotting and functional assays; limbal mesenchymal stromal cells and murine embryonic 3T3 fibroblasts served as controls. The immunophenotype of LMel was assessed by flow cytometry before and after interferon-γ stimulation, and their immunomodulatory properties were analyzed by mixed lymphocytes reaction, monocyte adhesion assays and cytometric bead arrays. Their angiostatic effects on human umbilical cord endothelial cells (HUVECs) were evaluated by proliferation, migration, and tube formation assays.
LMel and LEPCs formed structural units in the human limbal stem cell niche in situ, which could be functionally replicated, including melanosome transfer, by co-cultivation in vitro. LMel supported LEPCs during clonal expansion and during epithelial wound healing by stimulating proliferation and migration, and suppressed their differentiation through direct contact and paracrine effects. Under inflammatory conditions, LMel were increased in numbers and upregulated expression of ICAM-1 and MHC II molecules (HLA-DR), but lacked expression of HLA-G, -DP, -DQ and costimulatory molecules CD80 and CD86. They were also found to be potent suppressors of alloreactive T- cell proliferation and cytokine secretion, which largely depended on direct cell-cell interaction. Moreover, the LMel secretome exerted angiostatic activity by inhibiting vascular endothelial cell proliferation and capillary network formation.
These findings suggest that LMel are not only professional melanin-producing cells, but exert various non-canonical functions in limbal niche homeostasis by regulating LEPC maintenance, immune responses, and angiostasis. Their potent regulatory, immunomodulatory and anti-angiogenic properties may have important implications for future regenerative cell therapies.
•This study provides evidence that melanocytes exert various non-canonical functions in limbal niche regulation beyond UV protection.•Limbal melanocytes regulate maintenance of limbal stem/progenitor cells by suppressing their differentiation.•Limbal melanocytes support limbal stem/progenitor cells during wound healing by stimulating proliferation and migration.•Limbal melanocytes control local immune reactions by inhibiting T-cell proliferation and inflammatory cytokine secretion.•Limbal melanocytes display angiostatic activity by inhibiting vascular endothelial cell proliferation and capillary formation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34425298</pmid><doi>10.1016/j.jtos.2021.08.006</doi><tpages>18</tpages><orcidid>https://orcid.org/0000-0001-5591-2187</orcidid><orcidid>https://orcid.org/0000-0003-1291-622X</orcidid><orcidid>https://orcid.org/0000-0001-9358-134X</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1542-0124 |
ispartof | The ocular surface, 2021-10, Vol.22, p.172-189 |
issn | 1542-0124 1937-5913 |
language | eng |
recordid | cdi_proquest_miscellaneous_2564131146 |
source | MEDLINE; Alma/SFX Local Collection |
subjects | Angiostasis Animals Cells, Cultured Endothelial Cells Epithelial Cells Epithelium, Corneal Humans Immune regulation Inflammation Limbal niche Limbal stem cells Limbus Corneae Melanocytes Mice Secretome Stem Cell Niche Stem Cells Wound healing |
title | Melanocytes as emerging key players in niche regulation of limbal epithelial stem cells |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T01%3A25%3A40IST&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=Melanocytes%20as%20emerging%20key%20players%20in%20niche%20regulation%20of%20limbal%20epithelial%20stem%20cells&rft.jtitle=The%20ocular%20surface&rft.au=Polisetti,%20Naresh&rft.date=2021-10&rft.volume=22&rft.spage=172&rft.epage=189&rft.pages=172-189&rft.issn=1542-0124&rft.eissn=1937-5913&rft_id=info:doi/10.1016/j.jtos.2021.08.006&rft_dat=%3Cproquest_cross%3E2564131146%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=2564131146&rft_id=info:pmid/34425298&rft_els_id=S1542012421000884&rfr_iscdi=true |