2-Deoxy-D-glucose-induced cytotoxicity and radiosensitization in tumor cells is mediated via disruptions in thiol metabolism

Exposure to ionizing radiation is believed to cause cell injury via the production of free radicals that are thought to induce oxidative damage. It has been proposed that exposure to agents that enhance oxidative stress-induced injury by disrupting thiol metabolism may sensitize cells to the cytotox...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Cancer research (Chicago, Ill.) Ill.), 2003-06, Vol.63 (12), p.3413-3417
Hauptverfasser: XIAO LIN, FANJIE ZHANG, BRADBURY, C. Matthew, KAUSHAL, Aradhana, LING LI, SPITZ, Douglas R, AFT, Rebecca L, GIUS, David
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 3417
container_issue 12
container_start_page 3413
container_title Cancer research (Chicago, Ill.)
container_volume 63
creator XIAO LIN
FANJIE ZHANG
BRADBURY, C. Matthew
KAUSHAL, Aradhana
LING LI
SPITZ, Douglas R
AFT, Rebecca L
GIUS, David
description Exposure to ionizing radiation is believed to cause cell injury via the production of free radicals that are thought to induce oxidative damage. It has been proposed that exposure to agents that enhance oxidative stress-induced injury by disrupting thiol metabolism may sensitize cells to the cytotoxic effects of ionizing radiation. Recently, it has been shown that glucose deprivation selectively induces cell injury in transformed human cells via metabolic oxidative stress (J. Biol. Chem., 273: 5294-5299; Ann. N.Y. Acad. Sci., 899: 349-362), resulting in profound disruptions in thiol metabolism. Because 2-deoxy-D-glucose (2DG) is a potent inhibitor of glucose metabolism thought to mimic glucose deprivation in vivo, the hypothesis that exposure to 2DG might be capable of inducing radiosensitization in transformed cells via perturbations in thiol metabolism was tested. When HeLa cells were exposed to 2DG (4-10 mM) for 4-72 h, cell survival decreased (20-90%) in a dose- and time-dependent fashion. When HeLa cells were treated with 6 mM 2DG for 16 h before ionizing radiation exposure, radiosensitization was observed with a sensitizer enhancement ratio of 1.4 at 10% isosurvival. Treatment with 2DG was also found to cause decreases in intracellular total glutathione content (50%). Simultaneous treatment with the thiol antioxidant N-acetylcysteine (NAC; 30 mM) protected HeLa cells against the cytotoxicity and radiosensitizing effects of 2DG, without altering radiosensitivity in the absence of 2DG. Furthermore, treatment with NAC partially reversed the 2DG-induced decreases in total glutathione content, as well as augmented intracellular cysteine content. Finally, the cytotoxicity and radiosensitizing effects of 2DG were more pronounced in v-Fos-transformed versus nontransformed immortalized rat cells, and this radiosensitization was also inhibited by treatment with NAC. These results support the hypothesis that exposure to 2DG causes cytotoxicity and radiosensitization via a mechanism involving perturbations in thiol metabolism and allows for the speculation that these effects may be more pronounced in transformed versus normal cells.
format Article
fullrecord <record><control><sourceid>pubmed_pasca</sourceid><recordid>TN_cdi_pubmed_primary_12810678</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>12810678</sourcerecordid><originalsourceid>FETCH-LOGICAL-h271t-4626b9c2d60dc0a13be5ba0a8533428db00f7ad60d962edf1e43f876b6d344f93</originalsourceid><addsrcrecordid>eNpF0N9LwzAQB_AgipvTf0Hy4mMgTdI0fZTNXzDwRZ_HNUndSduMJpVV_OPtdOLTcdznjuN7QuZZLg0rlMpPyZxzbliuCjEjFzG-T22e8fyczDJhMq4LMydfgq182I9sxd6awYboGXZusN5RO6aQwh4tppFC52gPDifQRUz4CQlDR7GjaWhDT61vmkgx0tY7hDStfyBQh7EfdgcZf-gWQzOJBFVoMLaX5KyGJvqrY12Q1_u7l-UjWz8_PC1v12wriiwxpYWuSiuc5s5yyGTl8wo4mFxKJYyrOK8LOExLLbyrM69kbQpdaSeVqku5INe_d3dDNf232fXYQj9u_mKYwM0RQLTQ1D10FuO_U8ZoIUr5DaGeaiE</addsrcrecordid><sourcetype>Index Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>2-Deoxy-D-glucose-induced cytotoxicity and radiosensitization in tumor cells is mediated via disruptions in thiol metabolism</title><source>MEDLINE</source><source>American Association for Cancer Research</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>XIAO LIN ; FANJIE ZHANG ; BRADBURY, C. Matthew ; KAUSHAL, Aradhana ; LING LI ; SPITZ, Douglas R ; AFT, Rebecca L ; GIUS, David</creator><creatorcontrib>XIAO LIN ; FANJIE ZHANG ; BRADBURY, C. Matthew ; KAUSHAL, Aradhana ; LING LI ; SPITZ, Douglas R ; AFT, Rebecca L ; GIUS, David</creatorcontrib><description>Exposure to ionizing radiation is believed to cause cell injury via the production of free radicals that are thought to induce oxidative damage. It has been proposed that exposure to agents that enhance oxidative stress-induced injury by disrupting thiol metabolism may sensitize cells to the cytotoxic effects of ionizing radiation. Recently, it has been shown that glucose deprivation selectively induces cell injury in transformed human cells via metabolic oxidative stress (J. Biol. Chem., 273: 5294-5299; Ann. N.Y. Acad. Sci., 899: 349-362), resulting in profound disruptions in thiol metabolism. Because 2-deoxy-D-glucose (2DG) is a potent inhibitor of glucose metabolism thought to mimic glucose deprivation in vivo, the hypothesis that exposure to 2DG might be capable of inducing radiosensitization in transformed cells via perturbations in thiol metabolism was tested. When HeLa cells were exposed to 2DG (4-10 mM) for 4-72 h, cell survival decreased (20-90%) in a dose- and time-dependent fashion. When HeLa cells were treated with 6 mM 2DG for 16 h before ionizing radiation exposure, radiosensitization was observed with a sensitizer enhancement ratio of 1.4 at 10% isosurvival. Treatment with 2DG was also found to cause decreases in intracellular total glutathione content (50%). Simultaneous treatment with the thiol antioxidant N-acetylcysteine (NAC; 30 mM) protected HeLa cells against the cytotoxicity and radiosensitizing effects of 2DG, without altering radiosensitivity in the absence of 2DG. Furthermore, treatment with NAC partially reversed the 2DG-induced decreases in total glutathione content, as well as augmented intracellular cysteine content. Finally, the cytotoxicity and radiosensitizing effects of 2DG were more pronounced in v-Fos-transformed versus nontransformed immortalized rat cells, and this radiosensitization was also inhibited by treatment with NAC. These results support the hypothesis that exposure to 2DG causes cytotoxicity and radiosensitization via a mechanism involving perturbations in thiol metabolism and allows for the speculation that these effects may be more pronounced in transformed versus normal cells.</description><identifier>ISSN: 0008-5472</identifier><identifier>EISSN: 1538-7445</identifier><identifier>PMID: 12810678</identifier><identifier>CODEN: CNREA8</identifier><language>eng</language><publisher>Philadelphia, PA: American Association for Cancer Research</publisher><subject>Acetylcysteine - pharmacology ; Animals ; Antineoplastic agents ; Antioxidants - pharmacology ; Biological and medical sciences ; Cell Line, Transformed - drug effects ; Cell Line, Transformed - radiation effects ; Cell Transformation, Viral ; Chemotherapy ; Cysteine - metabolism ; Deoxyglucose - pharmacology ; Deoxyglucose - toxicity ; Dose-Response Relationship, Drug ; Fibroblasts - drug effects ; Fibroblasts - metabolism ; Fibroblasts - radiation effects ; Free Radicals ; Genes, fos ; Glucose - antagonists &amp; inhibitors ; Glucose - metabolism ; Glutathione - metabolism ; HeLa Cells - drug effects ; HeLa Cells - metabolism ; HeLa Cells - radiation effects ; Humans ; Medical sciences ; Oncogene Proteins v-fos - physiology ; Oxidation-Reduction ; Oxidative Stress ; Pharmacology. Drug treatments ; Radiation-Protective Agents - pharmacology ; Radiation-Sensitizing Agents - pharmacology ; Radiation-Sensitizing Agents - toxicity ; Rats ; Sulfhydryl Compounds - metabolism ; Tumor Stem Cell Assay</subject><ispartof>Cancer research (Chicago, Ill.), 2003-06, Vol.63 (12), p.3413-3417</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=14886229$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12810678$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>XIAO LIN</creatorcontrib><creatorcontrib>FANJIE ZHANG</creatorcontrib><creatorcontrib>BRADBURY, C. Matthew</creatorcontrib><creatorcontrib>KAUSHAL, Aradhana</creatorcontrib><creatorcontrib>LING LI</creatorcontrib><creatorcontrib>SPITZ, Douglas R</creatorcontrib><creatorcontrib>AFT, Rebecca L</creatorcontrib><creatorcontrib>GIUS, David</creatorcontrib><title>2-Deoxy-D-glucose-induced cytotoxicity and radiosensitization in tumor cells is mediated via disruptions in thiol metabolism</title><title>Cancer research (Chicago, Ill.)</title><addtitle>Cancer Res</addtitle><description>Exposure to ionizing radiation is believed to cause cell injury via the production of free radicals that are thought to induce oxidative damage. It has been proposed that exposure to agents that enhance oxidative stress-induced injury by disrupting thiol metabolism may sensitize cells to the cytotoxic effects of ionizing radiation. Recently, it has been shown that glucose deprivation selectively induces cell injury in transformed human cells via metabolic oxidative stress (J. Biol. Chem., 273: 5294-5299; Ann. N.Y. Acad. Sci., 899: 349-362), resulting in profound disruptions in thiol metabolism. Because 2-deoxy-D-glucose (2DG) is a potent inhibitor of glucose metabolism thought to mimic glucose deprivation in vivo, the hypothesis that exposure to 2DG might be capable of inducing radiosensitization in transformed cells via perturbations in thiol metabolism was tested. When HeLa cells were exposed to 2DG (4-10 mM) for 4-72 h, cell survival decreased (20-90%) in a dose- and time-dependent fashion. When HeLa cells were treated with 6 mM 2DG for 16 h before ionizing radiation exposure, radiosensitization was observed with a sensitizer enhancement ratio of 1.4 at 10% isosurvival. Treatment with 2DG was also found to cause decreases in intracellular total glutathione content (50%). Simultaneous treatment with the thiol antioxidant N-acetylcysteine (NAC; 30 mM) protected HeLa cells against the cytotoxicity and radiosensitizing effects of 2DG, without altering radiosensitivity in the absence of 2DG. Furthermore, treatment with NAC partially reversed the 2DG-induced decreases in total glutathione content, as well as augmented intracellular cysteine content. Finally, the cytotoxicity and radiosensitizing effects of 2DG were more pronounced in v-Fos-transformed versus nontransformed immortalized rat cells, and this radiosensitization was also inhibited by treatment with NAC. These results support the hypothesis that exposure to 2DG causes cytotoxicity and radiosensitization via a mechanism involving perturbations in thiol metabolism and allows for the speculation that these effects may be more pronounced in transformed versus normal cells.</description><subject>Acetylcysteine - pharmacology</subject><subject>Animals</subject><subject>Antineoplastic agents</subject><subject>Antioxidants - pharmacology</subject><subject>Biological and medical sciences</subject><subject>Cell Line, Transformed - drug effects</subject><subject>Cell Line, Transformed - radiation effects</subject><subject>Cell Transformation, Viral</subject><subject>Chemotherapy</subject><subject>Cysteine - metabolism</subject><subject>Deoxyglucose - pharmacology</subject><subject>Deoxyglucose - toxicity</subject><subject>Dose-Response Relationship, Drug</subject><subject>Fibroblasts - drug effects</subject><subject>Fibroblasts - metabolism</subject><subject>Fibroblasts - radiation effects</subject><subject>Free Radicals</subject><subject>Genes, fos</subject><subject>Glucose - antagonists &amp; inhibitors</subject><subject>Glucose - metabolism</subject><subject>Glutathione - metabolism</subject><subject>HeLa Cells - drug effects</subject><subject>HeLa Cells - metabolism</subject><subject>HeLa Cells - radiation effects</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Oncogene Proteins v-fos - physiology</subject><subject>Oxidation-Reduction</subject><subject>Oxidative Stress</subject><subject>Pharmacology. Drug treatments</subject><subject>Radiation-Protective Agents - pharmacology</subject><subject>Radiation-Sensitizing Agents - pharmacology</subject><subject>Radiation-Sensitizing Agents - toxicity</subject><subject>Rats</subject><subject>Sulfhydryl Compounds - metabolism</subject><subject>Tumor Stem Cell Assay</subject><issn>0008-5472</issn><issn>1538-7445</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0N9LwzAQB_AgipvTf0Hy4mMgTdI0fZTNXzDwRZ_HNUndSduMJpVV_OPtdOLTcdznjuN7QuZZLg0rlMpPyZxzbliuCjEjFzG-T22e8fyczDJhMq4LMydfgq182I9sxd6awYboGXZusN5RO6aQwh4tppFC52gPDifQRUz4CQlDR7GjaWhDT61vmkgx0tY7hDStfyBQh7EfdgcZf-gWQzOJBFVoMLaX5KyGJvqrY12Q1_u7l-UjWz8_PC1v12wriiwxpYWuSiuc5s5yyGTl8wo4mFxKJYyrOK8LOExLLbyrM69kbQpdaSeVqku5INe_d3dDNf232fXYQj9u_mKYwM0RQLTQ1D10FuO_U8ZoIUr5DaGeaiE</recordid><startdate>20030615</startdate><enddate>20030615</enddate><creator>XIAO LIN</creator><creator>FANJIE ZHANG</creator><creator>BRADBURY, C. Matthew</creator><creator>KAUSHAL, Aradhana</creator><creator>LING LI</creator><creator>SPITZ, Douglas R</creator><creator>AFT, Rebecca L</creator><creator>GIUS, David</creator><general>American Association for Cancer Research</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20030615</creationdate><title>2-Deoxy-D-glucose-induced cytotoxicity and radiosensitization in tumor cells is mediated via disruptions in thiol metabolism</title><author>XIAO LIN ; FANJIE ZHANG ; BRADBURY, C. Matthew ; KAUSHAL, Aradhana ; LING LI ; SPITZ, Douglas R ; AFT, Rebecca L ; GIUS, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h271t-4626b9c2d60dc0a13be5ba0a8533428db00f7ad60d962edf1e43f876b6d344f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Acetylcysteine - pharmacology</topic><topic>Animals</topic><topic>Antineoplastic agents</topic><topic>Antioxidants - pharmacology</topic><topic>Biological and medical sciences</topic><topic>Cell Line, Transformed - drug effects</topic><topic>Cell Line, Transformed - radiation effects</topic><topic>Cell Transformation, Viral</topic><topic>Chemotherapy</topic><topic>Cysteine - metabolism</topic><topic>Deoxyglucose - pharmacology</topic><topic>Deoxyglucose - toxicity</topic><topic>Dose-Response Relationship, Drug</topic><topic>Fibroblasts - drug effects</topic><topic>Fibroblasts - metabolism</topic><topic>Fibroblasts - radiation effects</topic><topic>Free Radicals</topic><topic>Genes, fos</topic><topic>Glucose - antagonists &amp; inhibitors</topic><topic>Glucose - metabolism</topic><topic>Glutathione - metabolism</topic><topic>HeLa Cells - drug effects</topic><topic>HeLa Cells - metabolism</topic><topic>HeLa Cells - radiation effects</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Oncogene Proteins v-fos - physiology</topic><topic>Oxidation-Reduction</topic><topic>Oxidative Stress</topic><topic>Pharmacology. Drug treatments</topic><topic>Radiation-Protective Agents - pharmacology</topic><topic>Radiation-Sensitizing Agents - pharmacology</topic><topic>Radiation-Sensitizing Agents - toxicity</topic><topic>Rats</topic><topic>Sulfhydryl Compounds - metabolism</topic><topic>Tumor Stem Cell Assay</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>XIAO LIN</creatorcontrib><creatorcontrib>FANJIE ZHANG</creatorcontrib><creatorcontrib>BRADBURY, C. Matthew</creatorcontrib><creatorcontrib>KAUSHAL, Aradhana</creatorcontrib><creatorcontrib>LING LI</creatorcontrib><creatorcontrib>SPITZ, Douglas R</creatorcontrib><creatorcontrib>AFT, Rebecca L</creatorcontrib><creatorcontrib>GIUS, David</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Cancer research (Chicago, Ill.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>XIAO LIN</au><au>FANJIE ZHANG</au><au>BRADBURY, C. Matthew</au><au>KAUSHAL, Aradhana</au><au>LING LI</au><au>SPITZ, Douglas R</au><au>AFT, Rebecca L</au><au>GIUS, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>2-Deoxy-D-glucose-induced cytotoxicity and radiosensitization in tumor cells is mediated via disruptions in thiol metabolism</atitle><jtitle>Cancer research (Chicago, Ill.)</jtitle><addtitle>Cancer Res</addtitle><date>2003-06-15</date><risdate>2003</risdate><volume>63</volume><issue>12</issue><spage>3413</spage><epage>3417</epage><pages>3413-3417</pages><issn>0008-5472</issn><eissn>1538-7445</eissn><coden>CNREA8</coden><abstract>Exposure to ionizing radiation is believed to cause cell injury via the production of free radicals that are thought to induce oxidative damage. It has been proposed that exposure to agents that enhance oxidative stress-induced injury by disrupting thiol metabolism may sensitize cells to the cytotoxic effects of ionizing radiation. Recently, it has been shown that glucose deprivation selectively induces cell injury in transformed human cells via metabolic oxidative stress (J. Biol. Chem., 273: 5294-5299; Ann. N.Y. Acad. Sci., 899: 349-362), resulting in profound disruptions in thiol metabolism. Because 2-deoxy-D-glucose (2DG) is a potent inhibitor of glucose metabolism thought to mimic glucose deprivation in vivo, the hypothesis that exposure to 2DG might be capable of inducing radiosensitization in transformed cells via perturbations in thiol metabolism was tested. When HeLa cells were exposed to 2DG (4-10 mM) for 4-72 h, cell survival decreased (20-90%) in a dose- and time-dependent fashion. When HeLa cells were treated with 6 mM 2DG for 16 h before ionizing radiation exposure, radiosensitization was observed with a sensitizer enhancement ratio of 1.4 at 10% isosurvival. Treatment with 2DG was also found to cause decreases in intracellular total glutathione content (50%). Simultaneous treatment with the thiol antioxidant N-acetylcysteine (NAC; 30 mM) protected HeLa cells against the cytotoxicity and radiosensitizing effects of 2DG, without altering radiosensitivity in the absence of 2DG. Furthermore, treatment with NAC partially reversed the 2DG-induced decreases in total glutathione content, as well as augmented intracellular cysteine content. Finally, the cytotoxicity and radiosensitizing effects of 2DG were more pronounced in v-Fos-transformed versus nontransformed immortalized rat cells, and this radiosensitization was also inhibited by treatment with NAC. These results support the hypothesis that exposure to 2DG causes cytotoxicity and radiosensitization via a mechanism involving perturbations in thiol metabolism and allows for the speculation that these effects may be more pronounced in transformed versus normal cells.</abstract><cop>Philadelphia, PA</cop><pub>American Association for Cancer Research</pub><pmid>12810678</pmid><tpages>5</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0008-5472
ispartof Cancer research (Chicago, Ill.), 2003-06, Vol.63 (12), p.3413-3417
issn 0008-5472
1538-7445
language eng
recordid cdi_pubmed_primary_12810678
source MEDLINE; American Association for Cancer Research; EZB-FREE-00999 freely available EZB journals
subjects Acetylcysteine - pharmacology
Animals
Antineoplastic agents
Antioxidants - pharmacology
Biological and medical sciences
Cell Line, Transformed - drug effects
Cell Line, Transformed - radiation effects
Cell Transformation, Viral
Chemotherapy
Cysteine - metabolism
Deoxyglucose - pharmacology
Deoxyglucose - toxicity
Dose-Response Relationship, Drug
Fibroblasts - drug effects
Fibroblasts - metabolism
Fibroblasts - radiation effects
Free Radicals
Genes, fos
Glucose - antagonists & inhibitors
Glucose - metabolism
Glutathione - metabolism
HeLa Cells - drug effects
HeLa Cells - metabolism
HeLa Cells - radiation effects
Humans
Medical sciences
Oncogene Proteins v-fos - physiology
Oxidation-Reduction
Oxidative Stress
Pharmacology. Drug treatments
Radiation-Protective Agents - pharmacology
Radiation-Sensitizing Agents - pharmacology
Radiation-Sensitizing Agents - toxicity
Rats
Sulfhydryl Compounds - metabolism
Tumor Stem Cell Assay
title 2-Deoxy-D-glucose-induced cytotoxicity and radiosensitization in tumor cells is mediated via disruptions in thiol metabolism
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T05%3A19%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed_pasca&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=2-Deoxy-D-glucose-induced%20cytotoxicity%20and%20radiosensitization%20in%20tumor%20cells%20is%20mediated%20via%20disruptions%20in%20thiol%20metabolism&rft.jtitle=Cancer%20research%20(Chicago,%20Ill.)&rft.au=XIAO%20LIN&rft.date=2003-06-15&rft.volume=63&rft.issue=12&rft.spage=3413&rft.epage=3417&rft.pages=3413-3417&rft.issn=0008-5472&rft.eissn=1538-7445&rft.coden=CNREA8&rft_id=info:doi/&rft_dat=%3Cpubmed_pasca%3E12810678%3C/pubmed_pasca%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/12810678&rfr_iscdi=true