MyD88 mediates in vivo effector functions of alveolar macrophages in acute lung inflammatory responses to carbon nanotube exposure
Carbon nanotubes (CNTs) are rapidly emerging as high-priority occupational toxicants. CNT powders contain fibrous particles that aerosolize readily in places of manufacture and handling, posing an inhalation risk for workers. Studies using animal models indicate that lung exposure to CNTs causes pro...
Gespeichert in:
Veröffentlicht in: | Toxicology and applied pharmacology 2015-11, Vol.288 (3), p.322-329 |
---|---|
Hauptverfasser: | , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 329 |
---|---|
container_issue | 3 |
container_start_page | 322 |
container_title | Toxicology and applied pharmacology |
container_volume | 288 |
creator | Frank, Evan A. Birch, M. Eileen Yadav, Jagjit S. |
description | Carbon nanotubes (CNTs) are rapidly emerging as high-priority occupational toxicants. CNT powders contain fibrous particles that aerosolize readily in places of manufacture and handling, posing an inhalation risk for workers. Studies using animal models indicate that lung exposure to CNTs causes prolonged inflammatory responses and diffuse alveolar injury. The mechanisms governing CNT-induced lung inflammation are not fully understood but have been suggested to involve alveolar macrophages (AMs). In the current study, we sought to systematically assess the effector role of AMs in vivo in the induction of lung inflammatory responses to CNT exposures and investigate their cell type-specific mechanisms. Multi-wall CNTs characterized for various physicochemical attributes were used as the CNT type. Using an AM-specific depletion and repopulation approach in a mouse model, we unambiguously demonstrated that AMs are major effector cells necessary for the in vivo elaboration of CNT-induced lung inflammation. We further investigated in vitro AM responses and identified molecular targets which proved critical to pro-inflammatory responses in this model, namely MyD88 as well as MAPKs and Ca2+/CamKII. We further demonstrated that MyD88 inhibition in donor AMs abrogated their capacity to reconstitute CNT-induced inflammation when adoptively transferred into AM-depleted mice. Taken together, this is the first in vivo demonstration that AMs act as critical effector cell types in CNT-induced lung inflammation and that MyD88 is required for this in vivo effector function. AMs and their cell type-specific mechanisms may therefore represent potential targets for future therapeutic intervention of CNT-related lung injury.
[Display omitted]
•Demonstrated in vivo effector role of alveolar macrophages (AMs) in CNT toxicity•MyD88, MAPKs, and Ca2+/CamKII are required for AM inflammatory responses in vitro.•MyD88 signaling is required for in vivo effector function of AMs.•MyD88 may be a potential target for intervention in CNT lung exposures. |
doi_str_mv | 10.1016/j.taap.2015.08.004 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4623709</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0041008X15300569</els_id><sourcerecordid>1727684028</sourcerecordid><originalsourceid>FETCH-LOGICAL-c586t-3e0670af2c1f5bce0cffdfaf46b00a74c46f072a1756b946bade39e9c9efc8f23</originalsourceid><addsrcrecordid>eNp9UU2LFDEQbURxZ1f_gAcJePEyYyXdk-4GEWRdP2DFi4K3UJ2pzGToTtok3ThXf7lpZl304iGEVN579apeUTzjsOHA5avjJiGOGwF8u4FmA1A9KFYcWrmGsiwfFqtc4WuA5vtFcRnjEQDaquKPiwshRZ2PWBW_Pp_eNQ0baGcxUWTWsdnOnpExpJMPzExOJ-tdZN4w7GfyPQY2oA5-POD-TEE9JWL95Pb5ZXocBszcEwsUx0zNoOSZxtB5xxw6n6aOGP0cfZwCPSkeGewjPb27r4pv72--Xn9c33758On67e1abxuZ1iWBrAGN0NxsO02gjdkZNJXsALCudCUN1AJ5vZVdm6u4o7KlVrdkdGNEeVW8OeuOU5fn1eRSwF6NwQ4YTsqjVf_-OHtQez-rSoqyhjYLvDgL-Jisitom0gftncubUkLIpq7bpc3LuzbB_5goJjXYqKnv0ZGfouK1qGVTgWgyVJyheZkxBjL3ZjioJWJ1VEvEaolYQaNyoJn0_O8x7il_Ms2A12cA5WXOlsJilZzOEYfF6c7b_-n_BuIvvJU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1727684028</pqid></control><display><type>article</type><title>MyD88 mediates in vivo effector functions of alveolar macrophages in acute lung inflammatory responses to carbon nanotube exposure</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Frank, Evan A. ; Birch, M. Eileen ; Yadav, Jagjit S.</creator><creatorcontrib>Frank, Evan A. ; Birch, M. Eileen ; Yadav, Jagjit S.</creatorcontrib><description>Carbon nanotubes (CNTs) are rapidly emerging as high-priority occupational toxicants. CNT powders contain fibrous particles that aerosolize readily in places of manufacture and handling, posing an inhalation risk for workers. Studies using animal models indicate that lung exposure to CNTs causes prolonged inflammatory responses and diffuse alveolar injury. The mechanisms governing CNT-induced lung inflammation are not fully understood but have been suggested to involve alveolar macrophages (AMs). In the current study, we sought to systematically assess the effector role of AMs in vivo in the induction of lung inflammatory responses to CNT exposures and investigate their cell type-specific mechanisms. Multi-wall CNTs characterized for various physicochemical attributes were used as the CNT type. Using an AM-specific depletion and repopulation approach in a mouse model, we unambiguously demonstrated that AMs are major effector cells necessary for the in vivo elaboration of CNT-induced lung inflammation. We further investigated in vitro AM responses and identified molecular targets which proved critical to pro-inflammatory responses in this model, namely MyD88 as well as MAPKs and Ca2+/CamKII. We further demonstrated that MyD88 inhibition in donor AMs abrogated their capacity to reconstitute CNT-induced inflammation when adoptively transferred into AM-depleted mice. Taken together, this is the first in vivo demonstration that AMs act as critical effector cell types in CNT-induced lung inflammation and that MyD88 is required for this in vivo effector function. AMs and their cell type-specific mechanisms may therefore represent potential targets for future therapeutic intervention of CNT-related lung injury.
[Display omitted]
•Demonstrated in vivo effector role of alveolar macrophages (AMs) in CNT toxicity•MyD88, MAPKs, and Ca2+/CamKII are required for AM inflammatory responses in vitro.•MyD88 signaling is required for in vivo effector function of AMs.•MyD88 may be a potential target for intervention in CNT lung exposures.</description><identifier>ISSN: 0041-008X</identifier><identifier>EISSN: 1096-0333</identifier><identifier>DOI: 10.1016/j.taap.2015.08.004</identifier><identifier>PMID: 26272622</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>60 APPLIED LIFE SCIENCES ; Acute Disease ; AEROSOLS ; Animals ; Calcium - metabolism ; CARBON NANOTUBES ; Cells, Cultured ; Chemical Phenomena ; Disease Models, Animal ; IN VITRO ; IN VIVO ; INFLAMMATION ; INJURIES ; Interleukin-1beta - genetics ; Interleukin-1beta - metabolism ; JNK Mitogen-Activated Protein Kinases - genetics ; JNK Mitogen-Activated Protein Kinases - metabolism ; Lung - cytology ; Lung - drug effects ; Lung - metabolism ; LUNGS ; Macrophage depletion ; MACROPHAGES ; Macrophages, Alveolar - drug effects ; Macrophages, Alveolar - metabolism ; MICE ; Molecular toxicology ; Myeloid Differentiation Factor 88 - genetics ; Myeloid Differentiation Factor 88 - metabolism ; Nanotoxicology ; Nanotubes, Carbon - toxicity ; p38 Mitogen-Activated Protein Kinases - genetics ; p38 Mitogen-Activated Protein Kinases - metabolism ; Particle Size ; Particle toxicology ; Pneumonia - pathology ; Signal Transduction ; Tumor Necrosis Factor-alpha - genetics ; Tumor Necrosis Factor-alpha - metabolism</subject><ispartof>Toxicology and applied pharmacology, 2015-11, Vol.288 (3), p.322-329</ispartof><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c586t-3e0670af2c1f5bce0cffdfaf46b00a74c46f072a1756b946bade39e9c9efc8f23</citedby><cites>FETCH-LOGICAL-c586t-3e0670af2c1f5bce0cffdfaf46b00a74c46f072a1756b946bade39e9c9efc8f23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.taap.2015.08.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26272622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22687792$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Frank, Evan A.</creatorcontrib><creatorcontrib>Birch, M. Eileen</creatorcontrib><creatorcontrib>Yadav, Jagjit S.</creatorcontrib><title>MyD88 mediates in vivo effector functions of alveolar macrophages in acute lung inflammatory responses to carbon nanotube exposure</title><title>Toxicology and applied pharmacology</title><addtitle>Toxicol Appl Pharmacol</addtitle><description>Carbon nanotubes (CNTs) are rapidly emerging as high-priority occupational toxicants. CNT powders contain fibrous particles that aerosolize readily in places of manufacture and handling, posing an inhalation risk for workers. Studies using animal models indicate that lung exposure to CNTs causes prolonged inflammatory responses and diffuse alveolar injury. The mechanisms governing CNT-induced lung inflammation are not fully understood but have been suggested to involve alveolar macrophages (AMs). In the current study, we sought to systematically assess the effector role of AMs in vivo in the induction of lung inflammatory responses to CNT exposures and investigate their cell type-specific mechanisms. Multi-wall CNTs characterized for various physicochemical attributes were used as the CNT type. Using an AM-specific depletion and repopulation approach in a mouse model, we unambiguously demonstrated that AMs are major effector cells necessary for the in vivo elaboration of CNT-induced lung inflammation. We further investigated in vitro AM responses and identified molecular targets which proved critical to pro-inflammatory responses in this model, namely MyD88 as well as MAPKs and Ca2+/CamKII. We further demonstrated that MyD88 inhibition in donor AMs abrogated their capacity to reconstitute CNT-induced inflammation when adoptively transferred into AM-depleted mice. Taken together, this is the first in vivo demonstration that AMs act as critical effector cell types in CNT-induced lung inflammation and that MyD88 is required for this in vivo effector function. AMs and their cell type-specific mechanisms may therefore represent potential targets for future therapeutic intervention of CNT-related lung injury.
[Display omitted]
•Demonstrated in vivo effector role of alveolar macrophages (AMs) in CNT toxicity•MyD88, MAPKs, and Ca2+/CamKII are required for AM inflammatory responses in vitro.•MyD88 signaling is required for in vivo effector function of AMs.•MyD88 may be a potential target for intervention in CNT lung exposures.</description><subject>60 APPLIED LIFE SCIENCES</subject><subject>Acute Disease</subject><subject>AEROSOLS</subject><subject>Animals</subject><subject>Calcium - metabolism</subject><subject>CARBON NANOTUBES</subject><subject>Cells, Cultured</subject><subject>Chemical Phenomena</subject><subject>Disease Models, Animal</subject><subject>IN VITRO</subject><subject>IN VIVO</subject><subject>INFLAMMATION</subject><subject>INJURIES</subject><subject>Interleukin-1beta - genetics</subject><subject>Interleukin-1beta - metabolism</subject><subject>JNK Mitogen-Activated Protein Kinases - genetics</subject><subject>JNK Mitogen-Activated Protein Kinases - metabolism</subject><subject>Lung - cytology</subject><subject>Lung - drug effects</subject><subject>Lung - metabolism</subject><subject>LUNGS</subject><subject>Macrophage depletion</subject><subject>MACROPHAGES</subject><subject>Macrophages, Alveolar - drug effects</subject><subject>Macrophages, Alveolar - metabolism</subject><subject>MICE</subject><subject>Molecular toxicology</subject><subject>Myeloid Differentiation Factor 88 - genetics</subject><subject>Myeloid Differentiation Factor 88 - metabolism</subject><subject>Nanotoxicology</subject><subject>Nanotubes, Carbon - toxicity</subject><subject>p38 Mitogen-Activated Protein Kinases - genetics</subject><subject>p38 Mitogen-Activated Protein Kinases - metabolism</subject><subject>Particle Size</subject><subject>Particle toxicology</subject><subject>Pneumonia - pathology</subject><subject>Signal Transduction</subject><subject>Tumor Necrosis Factor-alpha - genetics</subject><subject>Tumor Necrosis Factor-alpha - metabolism</subject><issn>0041-008X</issn><issn>1096-0333</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU2LFDEQbURxZ1f_gAcJePEyYyXdk-4GEWRdP2DFi4K3UJ2pzGToTtok3ThXf7lpZl304iGEVN579apeUTzjsOHA5avjJiGOGwF8u4FmA1A9KFYcWrmGsiwfFqtc4WuA5vtFcRnjEQDaquKPiwshRZ2PWBW_Pp_eNQ0baGcxUWTWsdnOnpExpJMPzExOJ-tdZN4w7GfyPQY2oA5-POD-TEE9JWL95Pb5ZXocBszcEwsUx0zNoOSZxtB5xxw6n6aOGP0cfZwCPSkeGewjPb27r4pv72--Xn9c33758On67e1abxuZ1iWBrAGN0NxsO02gjdkZNJXsALCudCUN1AJ5vZVdm6u4o7KlVrdkdGNEeVW8OeuOU5fn1eRSwF6NwQ4YTsqjVf_-OHtQez-rSoqyhjYLvDgL-Jisitom0gftncubUkLIpq7bpc3LuzbB_5goJjXYqKnv0ZGfouK1qGVTgWgyVJyheZkxBjL3ZjioJWJ1VEvEaolYQaNyoJn0_O8x7il_Ms2A12cA5WXOlsJilZzOEYfF6c7b_-n_BuIvvJU</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Frank, Evan A.</creator><creator>Birch, M. Eileen</creator><creator>Yadav, Jagjit S.</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>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>OTOTI</scope><scope>5PM</scope></search><sort><creationdate>20151101</creationdate><title>MyD88 mediates in vivo effector functions of alveolar macrophages in acute lung inflammatory responses to carbon nanotube exposure</title><author>Frank, Evan A. ; Birch, M. Eileen ; Yadav, Jagjit S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c586t-3e0670af2c1f5bce0cffdfaf46b00a74c46f072a1756b946bade39e9c9efc8f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>60 APPLIED LIFE SCIENCES</topic><topic>Acute Disease</topic><topic>AEROSOLS</topic><topic>Animals</topic><topic>Calcium - metabolism</topic><topic>CARBON NANOTUBES</topic><topic>Cells, Cultured</topic><topic>Chemical Phenomena</topic><topic>Disease Models, Animal</topic><topic>IN VITRO</topic><topic>IN VIVO</topic><topic>INFLAMMATION</topic><topic>INJURIES</topic><topic>Interleukin-1beta - genetics</topic><topic>Interleukin-1beta - metabolism</topic><topic>JNK Mitogen-Activated Protein Kinases - genetics</topic><topic>JNK Mitogen-Activated Protein Kinases - metabolism</topic><topic>Lung - cytology</topic><topic>Lung - drug effects</topic><topic>Lung - metabolism</topic><topic>LUNGS</topic><topic>Macrophage depletion</topic><topic>MACROPHAGES</topic><topic>Macrophages, Alveolar - drug effects</topic><topic>Macrophages, Alveolar - metabolism</topic><topic>MICE</topic><topic>Molecular toxicology</topic><topic>Myeloid Differentiation Factor 88 - genetics</topic><topic>Myeloid Differentiation Factor 88 - metabolism</topic><topic>Nanotoxicology</topic><topic>Nanotubes, Carbon - toxicity</topic><topic>p38 Mitogen-Activated Protein Kinases - genetics</topic><topic>p38 Mitogen-Activated Protein Kinases - metabolism</topic><topic>Particle Size</topic><topic>Particle toxicology</topic><topic>Pneumonia - pathology</topic><topic>Signal Transduction</topic><topic>Tumor Necrosis Factor-alpha - genetics</topic><topic>Tumor Necrosis Factor-alpha - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Frank, Evan A.</creatorcontrib><creatorcontrib>Birch, M. Eileen</creatorcontrib><creatorcontrib>Yadav, Jagjit S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>OSTI.GOV</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Toxicology and applied pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Frank, Evan A.</au><au>Birch, M. Eileen</au><au>Yadav, Jagjit S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MyD88 mediates in vivo effector functions of alveolar macrophages in acute lung inflammatory responses to carbon nanotube exposure</atitle><jtitle>Toxicology and applied pharmacology</jtitle><addtitle>Toxicol Appl Pharmacol</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>288</volume><issue>3</issue><spage>322</spage><epage>329</epage><pages>322-329</pages><issn>0041-008X</issn><eissn>1096-0333</eissn><abstract>Carbon nanotubes (CNTs) are rapidly emerging as high-priority occupational toxicants. CNT powders contain fibrous particles that aerosolize readily in places of manufacture and handling, posing an inhalation risk for workers. Studies using animal models indicate that lung exposure to CNTs causes prolonged inflammatory responses and diffuse alveolar injury. The mechanisms governing CNT-induced lung inflammation are not fully understood but have been suggested to involve alveolar macrophages (AMs). In the current study, we sought to systematically assess the effector role of AMs in vivo in the induction of lung inflammatory responses to CNT exposures and investigate their cell type-specific mechanisms. Multi-wall CNTs characterized for various physicochemical attributes were used as the CNT type. Using an AM-specific depletion and repopulation approach in a mouse model, we unambiguously demonstrated that AMs are major effector cells necessary for the in vivo elaboration of CNT-induced lung inflammation. We further investigated in vitro AM responses and identified molecular targets which proved critical to pro-inflammatory responses in this model, namely MyD88 as well as MAPKs and Ca2+/CamKII. We further demonstrated that MyD88 inhibition in donor AMs abrogated their capacity to reconstitute CNT-induced inflammation when adoptively transferred into AM-depleted mice. Taken together, this is the first in vivo demonstration that AMs act as critical effector cell types in CNT-induced lung inflammation and that MyD88 is required for this in vivo effector function. AMs and their cell type-specific mechanisms may therefore represent potential targets for future therapeutic intervention of CNT-related lung injury.
[Display omitted]
•Demonstrated in vivo effector role of alveolar macrophages (AMs) in CNT toxicity•MyD88, MAPKs, and Ca2+/CamKII are required for AM inflammatory responses in vitro.•MyD88 signaling is required for in vivo effector function of AMs.•MyD88 may be a potential target for intervention in CNT lung exposures.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26272622</pmid><doi>10.1016/j.taap.2015.08.004</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0041-008X |
ispartof | Toxicology and applied pharmacology, 2015-11, Vol.288 (3), p.322-329 |
issn | 0041-008X 1096-0333 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4623709 |
source | MEDLINE; Elsevier ScienceDirect Journals Complete |
subjects | 60 APPLIED LIFE SCIENCES Acute Disease AEROSOLS Animals Calcium - metabolism CARBON NANOTUBES Cells, Cultured Chemical Phenomena Disease Models, Animal IN VITRO IN VIVO INFLAMMATION INJURIES Interleukin-1beta - genetics Interleukin-1beta - metabolism JNK Mitogen-Activated Protein Kinases - genetics JNK Mitogen-Activated Protein Kinases - metabolism Lung - cytology Lung - drug effects Lung - metabolism LUNGS Macrophage depletion MACROPHAGES Macrophages, Alveolar - drug effects Macrophages, Alveolar - metabolism MICE Molecular toxicology Myeloid Differentiation Factor 88 - genetics Myeloid Differentiation Factor 88 - metabolism Nanotoxicology Nanotubes, Carbon - toxicity p38 Mitogen-Activated Protein Kinases - genetics p38 Mitogen-Activated Protein Kinases - metabolism Particle Size Particle toxicology Pneumonia - pathology Signal Transduction Tumor Necrosis Factor-alpha - genetics Tumor Necrosis Factor-alpha - metabolism |
title | MyD88 mediates in vivo effector functions of alveolar macrophages in acute lung inflammatory responses to carbon nanotube exposure |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T06%3A09%3A27IST&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=MyD88%20mediates%20in%20vivo%20effector%20functions%20of%20alveolar%20macrophages%20in%20acute%20lung%20inflammatory%20responses%20to%20carbon%20nanotube%20exposure&rft.jtitle=Toxicology%20and%20applied%20pharmacology&rft.au=Frank,%20Evan%20A.&rft.date=2015-11-01&rft.volume=288&rft.issue=3&rft.spage=322&rft.epage=329&rft.pages=322-329&rft.issn=0041-008X&rft.eissn=1096-0333&rft_id=info:doi/10.1016/j.taap.2015.08.004&rft_dat=%3Cproquest_pubme%3E1727684028%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=1727684028&rft_id=info:pmid/26272622&rft_els_id=S0041008X15300569&rfr_iscdi=true |