Cell type-specific activation of mitogen-activated protein kinases by CpG-DNA controls interleukin-12 release from antigen-presenting cells

Activation of antigen‐presenting cells (APCs) by invariant constituents of pathogens such as lipopolysaccharide (LPS) or bacterial DNA (CpG‐DNA) initiates immune responses. We have analyzed the mitogen‐activated protein kinase (MAPK) pathways triggered by CpG‐DNA and their significance for cytokine...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The EMBO journal 1999-12, Vol.18 (24), p.6973-6982
Hauptverfasser: Häcker, Hans, Mischak, Harald, Häcker, Georg, Eser, Sema, Prenzel, Norbert, Ullrich, Axel, Wagner, Hermann
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 6982
container_issue 24
container_start_page 6973
container_title The EMBO journal
container_volume 18
creator Häcker, Hans
Mischak, Harald
Häcker, Georg
Eser, Sema
Prenzel, Norbert
Ullrich, Axel
Wagner, Hermann
description Activation of antigen‐presenting cells (APCs) by invariant constituents of pathogens such as lipopolysaccharide (LPS) or bacterial DNA (CpG‐DNA) initiates immune responses. We have analyzed the mitogen‐activated protein kinase (MAPK) pathways triggered by CpG‐DNA and their significance for cytokine production in two subsets of APCs, i.e. macrophages and dendritic cells (DCs). We found that CpG‐DNA induced extracellular signal‐regulated kinase (ERK) activity in macrophages in a classic MEK‐dependent way. This pathway up‐regulated tumor necrosis factor production but down‐regulated interleukin (IL)‐12 production. However, in DCs, which produce large amounts of IL‐12, CpG‐DNA and LPS failed to induce ERK activity. Consistent with a specific negative regulatory role for ERK in macrophages, chemical activation of this pathway in DCs suppressed CpG‐DNA‐induced IL‐12 production. Overall, these results imply that differential activation of MAP kinase pathways is a basic mechanism by which distinct subsets of innate immune cells regulate their effector functions.
doi_str_mv 10.1093/emboj/18.24.6973
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1171760</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>372986261</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6468-96b9c1cd6641e1ae476cfb2c20357d85d0e5bc9b9bc3d902032713db3d229f6d3</originalsourceid><addsrcrecordid>eNqFks1u1DAUhSMEoqWwZ4UsFuwy9XUSO94gtUMZGJUiVfwsrcS5GTxN7GBnCvMMvDQeMqoGJNSVLfs7x-daJ0meA50Bldkp9rVbn0I5Y_mMS5E9SI4h5zRlVBQPk2PKOKQ5lPIoeRLCmlJalAIeJ0dAOQUK8jj5NceuI-N2wDQMqE1rNKn0aG6r0ThLXEt6M7oV2nR_ig0ZvBvRWHJjbBUwkHpL5sMifXN1RrSzo3ddIMaO6DvcRCYFRjx2GFnSeteTyo5m5zh4DBj3dkV0TBGeJo_aqgv4bL-eJJ_fXnyav0svPy7ez88uU81zXqaS11KDbjjPAaHCXHDd1kwzmhWiKYuGYlFrWctaZ42k8ZgJyJo6axiTLW-yk-T15Dts6h4bHTP4qlODN33lt8pVRv19Y803tXK3CkCA4DQavNobePd9g2FUvQm7ESqLbhMUlxmnJch7QRC5YIJnEXz5D7h2G2_jLyiQBSsKznmE6ARp70Lw2N5FBqp2fVB_-qCgVCxXuz5EyYvDUQ8EUwEiICfgh-lwe6-huvhwvhSFZFSWUQuTNkSZXaE_CP3_QOmkMWHEn3fvVf5GcZGJQn29WqjrL0sul9dzlWW_AQcM5i4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>195255666</pqid></control><display><type>article</type><title>Cell type-specific activation of mitogen-activated protein kinases by CpG-DNA controls interleukin-12 release from antigen-presenting cells</title><source>MEDLINE</source><source>Wiley Online Library</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Häcker, Hans ; Mischak, Harald ; Häcker, Georg ; Eser, Sema ; Prenzel, Norbert ; Ullrich, Axel ; Wagner, Hermann</creator><creatorcontrib>Häcker, Hans ; Mischak, Harald ; Häcker, Georg ; Eser, Sema ; Prenzel, Norbert ; Ullrich, Axel ; Wagner, Hermann</creatorcontrib><description>Activation of antigen‐presenting cells (APCs) by invariant constituents of pathogens such as lipopolysaccharide (LPS) or bacterial DNA (CpG‐DNA) initiates immune responses. We have analyzed the mitogen‐activated protein kinase (MAPK) pathways triggered by CpG‐DNA and their significance for cytokine production in two subsets of APCs, i.e. macrophages and dendritic cells (DCs). We found that CpG‐DNA induced extracellular signal‐regulated kinase (ERK) activity in macrophages in a classic MEK‐dependent way. This pathway up‐regulated tumor necrosis factor production but down‐regulated interleukin (IL)‐12 production. However, in DCs, which produce large amounts of IL‐12, CpG‐DNA and LPS failed to induce ERK activity. Consistent with a specific negative regulatory role for ERK in macrophages, chemical activation of this pathway in DCs suppressed CpG‐DNA‐induced IL‐12 production. Overall, these results imply that differential activation of MAP kinase pathways is a basic mechanism by which distinct subsets of innate immune cells regulate their effector functions.</description><identifier>ISSN: 0261-4189</identifier><identifier>ISSN: 1460-2075</identifier><identifier>EISSN: 1460-2075</identifier><identifier>DOI: 10.1093/emboj/18.24.6973</identifier><identifier>PMID: 10601019</identifier><identifier>CODEN: EMJODG</identifier><language>eng</language><publisher>Chichester, UK: John Wiley &amp; Sons, Ltd</publisher><subject>Animals ; Antigen-Presenting Cells - drug effects ; Antigen-Presenting Cells - immunology ; Antigen-Presenting Cells - physiology ; Bone Marrow Cells - cytology ; Bone Marrow Cells - immunology ; Cell Line ; Cells, Cultured ; CpG-DNA ; Dendritic Cells - drug effects ; Dendritic Cells - immunology ; Dendritic Cells - physiology ; Deoxyribonucleic acid ; Dinucleoside Phosphates ; DNA ; ERK kinase ; ERK protein ; Gene Expression Regulation - immunology ; IL-12 ; innate immunity ; Interleukin-12 - biosynthesis ; Interleukin-12 - genetics ; lipopolysaccharides ; Lipopolysaccharides - pharmacology ; Luciferases - genetics ; Macrophages - drug effects ; Macrophages - immunology ; Macrophages - physiology ; MAP kinase ; MEK protein ; Mice ; Mice, Inbred C57BL ; Mitogen-Activated Protein Kinases - metabolism ; Oligodeoxyribonucleotides - pharmacology ; Recombinant Proteins - biosynthesis ; Thionucleotides ; TNF ; Transfection ; Tumor Necrosis Factor-alpha - genetics</subject><ispartof>The EMBO journal, 1999-12, Vol.18 (24), p.6973-6982</ispartof><rights>European Molecular Biology Organization 1999</rights><rights>Copyright © 1999 European Molecular Biology Organization</rights><rights>Copyright Oxford University Press(England) Dec 15, 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6468-96b9c1cd6641e1ae476cfb2c20357d85d0e5bc9b9bc3d902032713db3d229f6d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1171760/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1171760/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10601019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Häcker, Hans</creatorcontrib><creatorcontrib>Mischak, Harald</creatorcontrib><creatorcontrib>Häcker, Georg</creatorcontrib><creatorcontrib>Eser, Sema</creatorcontrib><creatorcontrib>Prenzel, Norbert</creatorcontrib><creatorcontrib>Ullrich, Axel</creatorcontrib><creatorcontrib>Wagner, Hermann</creatorcontrib><title>Cell type-specific activation of mitogen-activated protein kinases by CpG-DNA controls interleukin-12 release from antigen-presenting cells</title><title>The EMBO journal</title><addtitle>EMBO J</addtitle><addtitle>EMBO J</addtitle><description>Activation of antigen‐presenting cells (APCs) by invariant constituents of pathogens such as lipopolysaccharide (LPS) or bacterial DNA (CpG‐DNA) initiates immune responses. We have analyzed the mitogen‐activated protein kinase (MAPK) pathways triggered by CpG‐DNA and their significance for cytokine production in two subsets of APCs, i.e. macrophages and dendritic cells (DCs). We found that CpG‐DNA induced extracellular signal‐regulated kinase (ERK) activity in macrophages in a classic MEK‐dependent way. This pathway up‐regulated tumor necrosis factor production but down‐regulated interleukin (IL)‐12 production. However, in DCs, which produce large amounts of IL‐12, CpG‐DNA and LPS failed to induce ERK activity. Consistent with a specific negative regulatory role for ERK in macrophages, chemical activation of this pathway in DCs suppressed CpG‐DNA‐induced IL‐12 production. Overall, these results imply that differential activation of MAP kinase pathways is a basic mechanism by which distinct subsets of innate immune cells regulate their effector functions.</description><subject>Animals</subject><subject>Antigen-Presenting Cells - drug effects</subject><subject>Antigen-Presenting Cells - immunology</subject><subject>Antigen-Presenting Cells - physiology</subject><subject>Bone Marrow Cells - cytology</subject><subject>Bone Marrow Cells - immunology</subject><subject>Cell Line</subject><subject>Cells, Cultured</subject><subject>CpG-DNA</subject><subject>Dendritic Cells - drug effects</subject><subject>Dendritic Cells - immunology</subject><subject>Dendritic Cells - physiology</subject><subject>Deoxyribonucleic acid</subject><subject>Dinucleoside Phosphates</subject><subject>DNA</subject><subject>ERK kinase</subject><subject>ERK protein</subject><subject>Gene Expression Regulation - immunology</subject><subject>IL-12</subject><subject>innate immunity</subject><subject>Interleukin-12 - biosynthesis</subject><subject>Interleukin-12 - genetics</subject><subject>lipopolysaccharides</subject><subject>Lipopolysaccharides - pharmacology</subject><subject>Luciferases - genetics</subject><subject>Macrophages - drug effects</subject><subject>Macrophages - immunology</subject><subject>Macrophages - physiology</subject><subject>MAP kinase</subject><subject>MEK protein</subject><subject>Mice</subject><subject>Mice, Inbred C57BL</subject><subject>Mitogen-Activated Protein Kinases - metabolism</subject><subject>Oligodeoxyribonucleotides - pharmacology</subject><subject>Recombinant Proteins - biosynthesis</subject><subject>Thionucleotides</subject><subject>TNF</subject><subject>Transfection</subject><subject>Tumor Necrosis Factor-alpha - genetics</subject><issn>0261-4189</issn><issn>1460-2075</issn><issn>1460-2075</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks1u1DAUhSMEoqWwZ4UsFuwy9XUSO94gtUMZGJUiVfwsrcS5GTxN7GBnCvMMvDQeMqoGJNSVLfs7x-daJ0meA50Bldkp9rVbn0I5Y_mMS5E9SI4h5zRlVBQPk2PKOKQ5lPIoeRLCmlJalAIeJ0dAOQUK8jj5NceuI-N2wDQMqE1rNKn0aG6r0ThLXEt6M7oV2nR_ig0ZvBvRWHJjbBUwkHpL5sMifXN1RrSzo3ddIMaO6DvcRCYFRjx2GFnSeteTyo5m5zh4DBj3dkV0TBGeJo_aqgv4bL-eJJ_fXnyav0svPy7ez88uU81zXqaS11KDbjjPAaHCXHDd1kwzmhWiKYuGYlFrWctaZ42k8ZgJyJo6axiTLW-yk-T15Dts6h4bHTP4qlODN33lt8pVRv19Y803tXK3CkCA4DQavNobePd9g2FUvQm7ESqLbhMUlxmnJch7QRC5YIJnEXz5D7h2G2_jLyiQBSsKznmE6ARp70Lw2N5FBqp2fVB_-qCgVCxXuz5EyYvDUQ8EUwEiICfgh-lwe6-huvhwvhSFZFSWUQuTNkSZXaE_CP3_QOmkMWHEn3fvVf5GcZGJQn29WqjrL0sul9dzlWW_AQcM5i4</recordid><startdate>19991215</startdate><enddate>19991215</enddate><creator>Häcker, Hans</creator><creator>Mischak, Harald</creator><creator>Häcker, Georg</creator><creator>Eser, Sema</creator><creator>Prenzel, Norbert</creator><creator>Ullrich, Axel</creator><creator>Wagner, Hermann</creator><general>John Wiley &amp; Sons, Ltd</general><general>Nature Publishing Group UK</general><general>Springer Nature B.V</general><scope>BSCLL</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>7QG</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19991215</creationdate><title>Cell type-specific activation of mitogen-activated protein kinases by CpG-DNA controls interleukin-12 release from antigen-presenting cells</title><author>Häcker, Hans ; Mischak, Harald ; Häcker, Georg ; Eser, Sema ; Prenzel, Norbert ; Ullrich, Axel ; Wagner, Hermann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6468-96b9c1cd6641e1ae476cfb2c20357d85d0e5bc9b9bc3d902032713db3d229f6d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Animals</topic><topic>Antigen-Presenting Cells - drug effects</topic><topic>Antigen-Presenting Cells - immunology</topic><topic>Antigen-Presenting Cells - physiology</topic><topic>Bone Marrow Cells - cytology</topic><topic>Bone Marrow Cells - immunology</topic><topic>Cell Line</topic><topic>Cells, Cultured</topic><topic>CpG-DNA</topic><topic>Dendritic Cells - drug effects</topic><topic>Dendritic Cells - immunology</topic><topic>Dendritic Cells - physiology</topic><topic>Deoxyribonucleic acid</topic><topic>Dinucleoside Phosphates</topic><topic>DNA</topic><topic>ERK kinase</topic><topic>ERK protein</topic><topic>Gene Expression Regulation - immunology</topic><topic>IL-12</topic><topic>innate immunity</topic><topic>Interleukin-12 - biosynthesis</topic><topic>Interleukin-12 - genetics</topic><topic>lipopolysaccharides</topic><topic>Lipopolysaccharides - pharmacology</topic><topic>Luciferases - genetics</topic><topic>Macrophages - drug effects</topic><topic>Macrophages - immunology</topic><topic>Macrophages - physiology</topic><topic>MAP kinase</topic><topic>MEK protein</topic><topic>Mice</topic><topic>Mice, Inbred C57BL</topic><topic>Mitogen-Activated Protein Kinases - metabolism</topic><topic>Oligodeoxyribonucleotides - pharmacology</topic><topic>Recombinant Proteins - biosynthesis</topic><topic>Thionucleotides</topic><topic>TNF</topic><topic>Transfection</topic><topic>Tumor Necrosis Factor-alpha - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Häcker, Hans</creatorcontrib><creatorcontrib>Mischak, Harald</creatorcontrib><creatorcontrib>Häcker, Georg</creatorcontrib><creatorcontrib>Eser, Sema</creatorcontrib><creatorcontrib>Prenzel, Norbert</creatorcontrib><creatorcontrib>Ullrich, Axel</creatorcontrib><creatorcontrib>Wagner, Hermann</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The EMBO journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Häcker, Hans</au><au>Mischak, Harald</au><au>Häcker, Georg</au><au>Eser, Sema</au><au>Prenzel, Norbert</au><au>Ullrich, Axel</au><au>Wagner, Hermann</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cell type-specific activation of mitogen-activated protein kinases by CpG-DNA controls interleukin-12 release from antigen-presenting cells</atitle><jtitle>The EMBO journal</jtitle><stitle>EMBO J</stitle><addtitle>EMBO J</addtitle><date>1999-12-15</date><risdate>1999</risdate><volume>18</volume><issue>24</issue><spage>6973</spage><epage>6982</epage><pages>6973-6982</pages><issn>0261-4189</issn><issn>1460-2075</issn><eissn>1460-2075</eissn><coden>EMJODG</coden><abstract>Activation of antigen‐presenting cells (APCs) by invariant constituents of pathogens such as lipopolysaccharide (LPS) or bacterial DNA (CpG‐DNA) initiates immune responses. We have analyzed the mitogen‐activated protein kinase (MAPK) pathways triggered by CpG‐DNA and their significance for cytokine production in two subsets of APCs, i.e. macrophages and dendritic cells (DCs). We found that CpG‐DNA induced extracellular signal‐regulated kinase (ERK) activity in macrophages in a classic MEK‐dependent way. This pathway up‐regulated tumor necrosis factor production but down‐regulated interleukin (IL)‐12 production. However, in DCs, which produce large amounts of IL‐12, CpG‐DNA and LPS failed to induce ERK activity. Consistent with a specific negative regulatory role for ERK in macrophages, chemical activation of this pathway in DCs suppressed CpG‐DNA‐induced IL‐12 production. Overall, these results imply that differential activation of MAP kinase pathways is a basic mechanism by which distinct subsets of innate immune cells regulate their effector functions.</abstract><cop>Chichester, UK</cop><pub>John Wiley &amp; Sons, Ltd</pub><pmid>10601019</pmid><doi>10.1093/emboj/18.24.6973</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0261-4189
ispartof The EMBO journal, 1999-12, Vol.18 (24), p.6973-6982
issn 0261-4189
1460-2075
1460-2075
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1171760
source MEDLINE; Wiley Online Library; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry
subjects Animals
Antigen-Presenting Cells - drug effects
Antigen-Presenting Cells - immunology
Antigen-Presenting Cells - physiology
Bone Marrow Cells - cytology
Bone Marrow Cells - immunology
Cell Line
Cells, Cultured
CpG-DNA
Dendritic Cells - drug effects
Dendritic Cells - immunology
Dendritic Cells - physiology
Deoxyribonucleic acid
Dinucleoside Phosphates
DNA
ERK kinase
ERK protein
Gene Expression Regulation - immunology
IL-12
innate immunity
Interleukin-12 - biosynthesis
Interleukin-12 - genetics
lipopolysaccharides
Lipopolysaccharides - pharmacology
Luciferases - genetics
Macrophages - drug effects
Macrophages - immunology
Macrophages - physiology
MAP kinase
MEK protein
Mice
Mice, Inbred C57BL
Mitogen-Activated Protein Kinases - metabolism
Oligodeoxyribonucleotides - pharmacology
Recombinant Proteins - biosynthesis
Thionucleotides
TNF
Transfection
Tumor Necrosis Factor-alpha - genetics
title Cell type-specific activation of mitogen-activated protein kinases by CpG-DNA controls interleukin-12 release from antigen-presenting cells
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T17%3A39%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cell%20type-specific%20activation%20of%20mitogen-activated%20protein%20kinases%20by%20CpG-DNA%20controls%20interleukin-12%20release%20from%20antigen-presenting%20cells&rft.jtitle=The%20EMBO%20journal&rft.au=H%C3%A4cker,%20Hans&rft.date=1999-12-15&rft.volume=18&rft.issue=24&rft.spage=6973&rft.epage=6982&rft.pages=6973-6982&rft.issn=0261-4189&rft.eissn=1460-2075&rft.coden=EMJODG&rft_id=info:doi/10.1093/emboj/18.24.6973&rft_dat=%3Cproquest_pubme%3E372986261%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=195255666&rft_id=info:pmid/10601019&rfr_iscdi=true