Binding with HSP90β, cimifugin ameliorates fibrotic cataracts in vitro and in vivo by inhibiting TGFβ signaling pathways

Fibrotic cataracts, the most frequent complications after phacoemulsification, cannot be cured by drugs in clinic. The primary mechanism underlying the disease is the epithelial-mesenchymal transition (EMT). Cimifugin is a natural monomer component of traditional Chinese medicines. Previous research...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Experimental eye research 2024-12, Vol.249, p.110127, Article 110127
Hauptverfasser: Ding, Xuefei, Liu, Zhaochuan, Li, Hailong, Yue, Peilin, Jia, Yuxuan, Li, Enjie, Lv, Ningxin, Chen, Ting, Fang, Rui, Zhou, Honggang, Song, Xudong
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue
container_start_page 110127
container_title Experimental eye research
container_volume 249
creator Ding, Xuefei
Liu, Zhaochuan
Li, Hailong
Yue, Peilin
Jia, Yuxuan
Li, Enjie
Lv, Ningxin
Chen, Ting
Fang, Rui
Zhou, Honggang
Song, Xudong
description Fibrotic cataracts, the most frequent complications after phacoemulsification, cannot be cured by drugs in clinic. The primary mechanism underlying the disease is the epithelial-mesenchymal transition (EMT). Cimifugin is a natural monomer component of traditional Chinese medicines. Previous researches have demonstrated the effect of cimifugin inhibiting EMT in the lung. The purpose of this work is to evaluate the impact of cimifugin on EMT in the lens and elucidate its precise mechanism. The pathogenesis of fibrotic cataracts was simulated using TGFβ2-induced cell model of EMT and the injury-induced anterior subcapsular cataract animal model. Through H&E staining and immunofluorescence of mice eyeballs, we discovered that cimifugin can inhibit the expansion of fibrotic lesions in vivo. Furthermore, at mRNA and protein levels, we confirmed that cimifugin can allay EMT of lens epithelial cells (LECs) in vitro and in vivo. Additionally, the inhibition of cimifugin on the activation of TGFβ-related signaling pathways was certified by immunoblot. HSP90β, the target of cimifugin, was predicted by network pharmacology and verified by drug affinity responsive target stability, the cellular thermal shift assay, and microscale thermophoresis. Moreover, co-immunoprecipitation revealed the interaction between HSP90β and TGFβ receptor (TGFβR) II. Together, our findings showed that by weakening the binding of HSP90β and TGFβRII, cimifugin suppressed the TGFβ signaling pathways to alleviate fibrotic cataracts. Cimifugin is a promising medication for the treatment of fibrotic cataracts. [Display omitted] •HSP90β is the target of cimifugin.•Binding with HSP90β, cimifugin can inhibit the activation of TGFβ-related signaling pathways.•By inhibition of TGFβ-related signaling pathways, cimifugin can alleviate EMT of lens epithelial cells.
doi_str_mv 10.1016/j.exer.2024.110127
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3118304485</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S001448352400349X</els_id><sourcerecordid>3118304485</sourcerecordid><originalsourceid>FETCH-LOGICAL-c237t-7cb70e1592dec27c6dde4a79053db8cc12b653e150899f1dfa5fce8df23eef203</originalsourceid><addsrcrecordid>eNp9kMtuEzEUhi0EoqH0BVggL1kwwbfJzEhsoKItUqVWol1bHvs4OdFcgu2khMfqg_SZ8GgKS1b2Ofr-XzofIe84W3LGV5-2S_gFYSmYUEueN6J6QRacNauCMVa9JAvGuCpULcsT8ibGbd5KVanX5EQ2Sigh-IL8_oqDw2FNHzBt6NWP24Y9PX6kFnv0-zUO1PTQ4RhMgkg9tmFMaKk1yQRjU6SZOGAKIzWDm4fDSNtj_m6wxTQ1311ePD3SiOvBdNO8M2nzYI7xLXnlTRfh7Pk9JfcX3-7Or4rrm8vv51-uCytklYrKthUDXjbCgRWVXTkHylQNK6Vra2u5aFelzACrm8Zz503pLdTOCwngBZOn5MPcuwvjzz3EpHuMFrrODDDuo5ac15IpVZcZFTNqwxhjAK93AXsTjpozPTnXWz0515NzPTvPoffP_fu2B_cv8ldyBj7PAOQrD5jj0SIMFhwGsEm7Ef_X_wfh_5Wr</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3118304485</pqid></control><display><type>article</type><title>Binding with HSP90β, cimifugin ameliorates fibrotic cataracts in vitro and in vivo by inhibiting TGFβ signaling pathways</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Ding, Xuefei ; Liu, Zhaochuan ; Li, Hailong ; Yue, Peilin ; Jia, Yuxuan ; Li, Enjie ; Lv, Ningxin ; Chen, Ting ; Fang, Rui ; Zhou, Honggang ; Song, Xudong</creator><creatorcontrib>Ding, Xuefei ; Liu, Zhaochuan ; Li, Hailong ; Yue, Peilin ; Jia, Yuxuan ; Li, Enjie ; Lv, Ningxin ; Chen, Ting ; Fang, Rui ; Zhou, Honggang ; Song, Xudong</creatorcontrib><description>Fibrotic cataracts, the most frequent complications after phacoemulsification, cannot be cured by drugs in clinic. The primary mechanism underlying the disease is the epithelial-mesenchymal transition (EMT). Cimifugin is a natural monomer component of traditional Chinese medicines. Previous researches have demonstrated the effect of cimifugin inhibiting EMT in the lung. The purpose of this work is to evaluate the impact of cimifugin on EMT in the lens and elucidate its precise mechanism. The pathogenesis of fibrotic cataracts was simulated using TGFβ2-induced cell model of EMT and the injury-induced anterior subcapsular cataract animal model. Through H&amp;E staining and immunofluorescence of mice eyeballs, we discovered that cimifugin can inhibit the expansion of fibrotic lesions in vivo. Furthermore, at mRNA and protein levels, we confirmed that cimifugin can allay EMT of lens epithelial cells (LECs) in vitro and in vivo. Additionally, the inhibition of cimifugin on the activation of TGFβ-related signaling pathways was certified by immunoblot. HSP90β, the target of cimifugin, was predicted by network pharmacology and verified by drug affinity responsive target stability, the cellular thermal shift assay, and microscale thermophoresis. Moreover, co-immunoprecipitation revealed the interaction between HSP90β and TGFβ receptor (TGFβR) II. Together, our findings showed that by weakening the binding of HSP90β and TGFβRII, cimifugin suppressed the TGFβ signaling pathways to alleviate fibrotic cataracts. Cimifugin is a promising medication for the treatment of fibrotic cataracts. [Display omitted] •HSP90β is the target of cimifugin.•Binding with HSP90β, cimifugin can inhibit the activation of TGFβ-related signaling pathways.•By inhibition of TGFβ-related signaling pathways, cimifugin can alleviate EMT of lens epithelial cells.</description><identifier>ISSN: 0014-4835</identifier><identifier>ISSN: 1096-0007</identifier><identifier>EISSN: 1096-0007</identifier><identifier>DOI: 10.1016/j.exer.2024.110127</identifier><identifier>PMID: 39424221</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Animals ; Blotting, Western ; Cataract - drug therapy ; Cataract - metabolism ; Cataract - pathology ; Cells, Cultured ; Cimifugin ; Disease Models, Animal ; Epithelial Cells - drug effects ; Epithelial Cells - metabolism ; Epithelial-mesenchymal transition ; Epithelial-Mesenchymal Transition - drug effects ; Fibrosis ; HSP90 Heat-Shock Proteins - antagonists &amp; inhibitors ; HSP90 Heat-Shock Proteins - metabolism ; HSP90β ; Lens, Crystalline - drug effects ; Lens, Crystalline - metabolism ; Lens, Crystalline - pathology ; Male ; Mice ; Mice, Inbred C57BL ; Receptors, Transforming Growth Factor beta - antagonists &amp; inhibitors ; Receptors, Transforming Growth Factor beta - metabolism ; Signal Transduction ; TGFβRII ; Transforming Growth Factor beta - metabolism</subject><ispartof>Experimental eye research, 2024-12, Vol.249, p.110127, Article 110127</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-7cb70e1592dec27c6dde4a79053db8cc12b653e150899f1dfa5fce8df23eef203</cites><orcidid>0000-0002-8036-5936</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.exer.2024.110127$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39424221$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ding, Xuefei</creatorcontrib><creatorcontrib>Liu, Zhaochuan</creatorcontrib><creatorcontrib>Li, Hailong</creatorcontrib><creatorcontrib>Yue, Peilin</creatorcontrib><creatorcontrib>Jia, Yuxuan</creatorcontrib><creatorcontrib>Li, Enjie</creatorcontrib><creatorcontrib>Lv, Ningxin</creatorcontrib><creatorcontrib>Chen, Ting</creatorcontrib><creatorcontrib>Fang, Rui</creatorcontrib><creatorcontrib>Zhou, Honggang</creatorcontrib><creatorcontrib>Song, Xudong</creatorcontrib><title>Binding with HSP90β, cimifugin ameliorates fibrotic cataracts in vitro and in vivo by inhibiting TGFβ signaling pathways</title><title>Experimental eye research</title><addtitle>Exp Eye Res</addtitle><description>Fibrotic cataracts, the most frequent complications after phacoemulsification, cannot be cured by drugs in clinic. The primary mechanism underlying the disease is the epithelial-mesenchymal transition (EMT). Cimifugin is a natural monomer component of traditional Chinese medicines. Previous researches have demonstrated the effect of cimifugin inhibiting EMT in the lung. The purpose of this work is to evaluate the impact of cimifugin on EMT in the lens and elucidate its precise mechanism. The pathogenesis of fibrotic cataracts was simulated using TGFβ2-induced cell model of EMT and the injury-induced anterior subcapsular cataract animal model. Through H&amp;E staining and immunofluorescence of mice eyeballs, we discovered that cimifugin can inhibit the expansion of fibrotic lesions in vivo. Furthermore, at mRNA and protein levels, we confirmed that cimifugin can allay EMT of lens epithelial cells (LECs) in vitro and in vivo. Additionally, the inhibition of cimifugin on the activation of TGFβ-related signaling pathways was certified by immunoblot. HSP90β, the target of cimifugin, was predicted by network pharmacology and verified by drug affinity responsive target stability, the cellular thermal shift assay, and microscale thermophoresis. Moreover, co-immunoprecipitation revealed the interaction between HSP90β and TGFβ receptor (TGFβR) II. Together, our findings showed that by weakening the binding of HSP90β and TGFβRII, cimifugin suppressed the TGFβ signaling pathways to alleviate fibrotic cataracts. Cimifugin is a promising medication for the treatment of fibrotic cataracts. [Display omitted] •HSP90β is the target of cimifugin.•Binding with HSP90β, cimifugin can inhibit the activation of TGFβ-related signaling pathways.•By inhibition of TGFβ-related signaling pathways, cimifugin can alleviate EMT of lens epithelial cells.</description><subject>Animals</subject><subject>Blotting, Western</subject><subject>Cataract - drug therapy</subject><subject>Cataract - metabolism</subject><subject>Cataract - pathology</subject><subject>Cells, Cultured</subject><subject>Cimifugin</subject><subject>Disease Models, Animal</subject><subject>Epithelial Cells - drug effects</subject><subject>Epithelial Cells - metabolism</subject><subject>Epithelial-mesenchymal transition</subject><subject>Epithelial-Mesenchymal Transition - drug effects</subject><subject>Fibrosis</subject><subject>HSP90 Heat-Shock Proteins - antagonists &amp; inhibitors</subject><subject>HSP90 Heat-Shock Proteins - metabolism</subject><subject>HSP90β</subject><subject>Lens, Crystalline - drug effects</subject><subject>Lens, Crystalline - metabolism</subject><subject>Lens, Crystalline - pathology</subject><subject>Male</subject><subject>Mice</subject><subject>Mice, Inbred C57BL</subject><subject>Receptors, Transforming Growth Factor beta - antagonists &amp; inhibitors</subject><subject>Receptors, Transforming Growth Factor beta - metabolism</subject><subject>Signal Transduction</subject><subject>TGFβRII</subject><subject>Transforming Growth Factor beta - metabolism</subject><issn>0014-4835</issn><issn>1096-0007</issn><issn>1096-0007</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtuEzEUhi0EoqH0BVggL1kwwbfJzEhsoKItUqVWol1bHvs4OdFcgu2khMfqg_SZ8GgKS1b2Ofr-XzofIe84W3LGV5-2S_gFYSmYUEueN6J6QRacNauCMVa9JAvGuCpULcsT8ibGbd5KVanX5EQ2Sigh-IL8_oqDw2FNHzBt6NWP24Y9PX6kFnv0-zUO1PTQ4RhMgkg9tmFMaKk1yQRjU6SZOGAKIzWDm4fDSNtj_m6wxTQ1311ePD3SiOvBdNO8M2nzYI7xLXnlTRfh7Pk9JfcX3-7Or4rrm8vv51-uCytklYrKthUDXjbCgRWVXTkHylQNK6Vra2u5aFelzACrm8Zz503pLdTOCwngBZOn5MPcuwvjzz3EpHuMFrrODDDuo5ac15IpVZcZFTNqwxhjAK93AXsTjpozPTnXWz0515NzPTvPoffP_fu2B_cv8ldyBj7PAOQrD5jj0SIMFhwGsEm7Ef_X_wfh_5Wr</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Ding, Xuefei</creator><creator>Liu, Zhaochuan</creator><creator>Li, Hailong</creator><creator>Yue, Peilin</creator><creator>Jia, Yuxuan</creator><creator>Li, Enjie</creator><creator>Lv, Ningxin</creator><creator>Chen, Ting</creator><creator>Fang, Rui</creator><creator>Zhou, Honggang</creator><creator>Song, Xudong</creator><general>Elsevier Ltd</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/0000-0002-8036-5936</orcidid></search><sort><creationdate>202412</creationdate><title>Binding with HSP90β, cimifugin ameliorates fibrotic cataracts in vitro and in vivo by inhibiting TGFβ signaling pathways</title><author>Ding, Xuefei ; Liu, Zhaochuan ; Li, Hailong ; Yue, Peilin ; Jia, Yuxuan ; Li, Enjie ; Lv, Ningxin ; Chen, Ting ; Fang, Rui ; Zhou, Honggang ; Song, Xudong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-7cb70e1592dec27c6dde4a79053db8cc12b653e150899f1dfa5fce8df23eef203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Animals</topic><topic>Blotting, Western</topic><topic>Cataract - drug therapy</topic><topic>Cataract - metabolism</topic><topic>Cataract - pathology</topic><topic>Cells, Cultured</topic><topic>Cimifugin</topic><topic>Disease Models, Animal</topic><topic>Epithelial Cells - drug effects</topic><topic>Epithelial Cells - metabolism</topic><topic>Epithelial-mesenchymal transition</topic><topic>Epithelial-Mesenchymal Transition - drug effects</topic><topic>Fibrosis</topic><topic>HSP90 Heat-Shock Proteins - antagonists &amp; inhibitors</topic><topic>HSP90 Heat-Shock Proteins - metabolism</topic><topic>HSP90β</topic><topic>Lens, Crystalline - drug effects</topic><topic>Lens, Crystalline - metabolism</topic><topic>Lens, Crystalline - pathology</topic><topic>Male</topic><topic>Mice</topic><topic>Mice, Inbred C57BL</topic><topic>Receptors, Transforming Growth Factor beta - antagonists &amp; inhibitors</topic><topic>Receptors, Transforming Growth Factor beta - metabolism</topic><topic>Signal Transduction</topic><topic>TGFβRII</topic><topic>Transforming Growth Factor beta - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ding, Xuefei</creatorcontrib><creatorcontrib>Liu, Zhaochuan</creatorcontrib><creatorcontrib>Li, Hailong</creatorcontrib><creatorcontrib>Yue, Peilin</creatorcontrib><creatorcontrib>Jia, Yuxuan</creatorcontrib><creatorcontrib>Li, Enjie</creatorcontrib><creatorcontrib>Lv, Ningxin</creatorcontrib><creatorcontrib>Chen, Ting</creatorcontrib><creatorcontrib>Fang, Rui</creatorcontrib><creatorcontrib>Zhou, Honggang</creatorcontrib><creatorcontrib>Song, Xudong</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>Experimental eye research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ding, Xuefei</au><au>Liu, Zhaochuan</au><au>Li, Hailong</au><au>Yue, Peilin</au><au>Jia, Yuxuan</au><au>Li, Enjie</au><au>Lv, Ningxin</au><au>Chen, Ting</au><au>Fang, Rui</au><au>Zhou, Honggang</au><au>Song, Xudong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Binding with HSP90β, cimifugin ameliorates fibrotic cataracts in vitro and in vivo by inhibiting TGFβ signaling pathways</atitle><jtitle>Experimental eye research</jtitle><addtitle>Exp Eye Res</addtitle><date>2024-12</date><risdate>2024</risdate><volume>249</volume><spage>110127</spage><pages>110127-</pages><artnum>110127</artnum><issn>0014-4835</issn><issn>1096-0007</issn><eissn>1096-0007</eissn><abstract>Fibrotic cataracts, the most frequent complications after phacoemulsification, cannot be cured by drugs in clinic. The primary mechanism underlying the disease is the epithelial-mesenchymal transition (EMT). Cimifugin is a natural monomer component of traditional Chinese medicines. Previous researches have demonstrated the effect of cimifugin inhibiting EMT in the lung. The purpose of this work is to evaluate the impact of cimifugin on EMT in the lens and elucidate its precise mechanism. The pathogenesis of fibrotic cataracts was simulated using TGFβ2-induced cell model of EMT and the injury-induced anterior subcapsular cataract animal model. Through H&amp;E staining and immunofluorescence of mice eyeballs, we discovered that cimifugin can inhibit the expansion of fibrotic lesions in vivo. Furthermore, at mRNA and protein levels, we confirmed that cimifugin can allay EMT of lens epithelial cells (LECs) in vitro and in vivo. Additionally, the inhibition of cimifugin on the activation of TGFβ-related signaling pathways was certified by immunoblot. HSP90β, the target of cimifugin, was predicted by network pharmacology and verified by drug affinity responsive target stability, the cellular thermal shift assay, and microscale thermophoresis. Moreover, co-immunoprecipitation revealed the interaction between HSP90β and TGFβ receptor (TGFβR) II. Together, our findings showed that by weakening the binding of HSP90β and TGFβRII, cimifugin suppressed the TGFβ signaling pathways to alleviate fibrotic cataracts. Cimifugin is a promising medication for the treatment of fibrotic cataracts. [Display omitted] •HSP90β is the target of cimifugin.•Binding with HSP90β, cimifugin can inhibit the activation of TGFβ-related signaling pathways.•By inhibition of TGFβ-related signaling pathways, cimifugin can alleviate EMT of lens epithelial cells.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>39424221</pmid><doi>10.1016/j.exer.2024.110127</doi><orcidid>https://orcid.org/0000-0002-8036-5936</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0014-4835
ispartof Experimental eye research, 2024-12, Vol.249, p.110127, Article 110127
issn 0014-4835
1096-0007
1096-0007
language eng
recordid cdi_proquest_miscellaneous_3118304485
source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Animals
Blotting, Western
Cataract - drug therapy
Cataract - metabolism
Cataract - pathology
Cells, Cultured
Cimifugin
Disease Models, Animal
Epithelial Cells - drug effects
Epithelial Cells - metabolism
Epithelial-mesenchymal transition
Epithelial-Mesenchymal Transition - drug effects
Fibrosis
HSP90 Heat-Shock Proteins - antagonists & inhibitors
HSP90 Heat-Shock Proteins - metabolism
HSP90β
Lens, Crystalline - drug effects
Lens, Crystalline - metabolism
Lens, Crystalline - pathology
Male
Mice
Mice, Inbred C57BL
Receptors, Transforming Growth Factor beta - antagonists & inhibitors
Receptors, Transforming Growth Factor beta - metabolism
Signal Transduction
TGFβRII
Transforming Growth Factor beta - metabolism
title Binding with HSP90β, cimifugin ameliorates fibrotic cataracts in vitro and in vivo by inhibiting TGFβ signaling pathways
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T10%3A02%3A28IST&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=Binding%20with%20HSP90%CE%B2,%20cimifugin%20ameliorates%20fibrotic%20cataracts%20in%20vitro%20and%20in%20vivo%20by%20inhibiting%20TGF%CE%B2%20signaling%20pathways&rft.jtitle=Experimental%20eye%20research&rft.au=Ding,%20Xuefei&rft.date=2024-12&rft.volume=249&rft.spage=110127&rft.pages=110127-&rft.artnum=110127&rft.issn=0014-4835&rft.eissn=1096-0007&rft_id=info:doi/10.1016/j.exer.2024.110127&rft_dat=%3Cproquest_cross%3E3118304485%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=3118304485&rft_id=info:pmid/39424221&rft_els_id=S001448352400349X&rfr_iscdi=true