Histamine 1 receptor-Gβγ-cAMP/PKA-CFTR pathway mediates the histamine-induced resetting of the suprachiasmatic circadian clock

Recent evidence indicates that histamine, acting on histamine 1 receptor (H1R), resets the circadian clock in the mouse suprachiasmatic nucleus (SCN) by increasing intracellular Ca(2+) concentration ([Ca(2+)]i) through the activation of CaV1.3 L-type Ca(2+) channels and Ca(2+)-induced Ca(2+) release...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Molecular brain 2016-05, Vol.9 (1), p.49-49, Article 49
Hauptverfasser: Kim, Yoon Sik, Kim, Young-Beom, Kim, Woong Bin, Lee, Seung Won, Oh, Seog Bae, Han, Hee-Chul, Lee, C Justin, Colwell, Christopher S, Kim, Yang In
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 49
container_issue 1
container_start_page 49
container_title Molecular brain
container_volume 9
creator Kim, Yoon Sik
Kim, Young-Beom
Kim, Woong Bin
Lee, Seung Won
Oh, Seog Bae
Han, Hee-Chul
Lee, C Justin
Colwell, Christopher S
Kim, Yang In
description Recent evidence indicates that histamine, acting on histamine 1 receptor (H1R), resets the circadian clock in the mouse suprachiasmatic nucleus (SCN) by increasing intracellular Ca(2+) concentration ([Ca(2+)]i) through the activation of CaV1.3 L-type Ca(2+) channels and Ca(2+)-induced Ca(2+) release from ryanodine receptor-mediated internal stores. In the current study, we explored the underlying mechanisms with various techniques including Ca(2+)- and Cl(-)-imaging and extracellular single-unit recording. Our hypothesis was that histamine causes Cl(-) efflux through cystic fibrosis transmembrane conductance regulator (CFTR) to elicit membrane depolarization needed for the activation of CaV1.3 Ca(2+) channels in SCN neurons. We found that histamine elicited Cl(-) efflux and increased [Ca(2+)]i in dissociated mouse SCN cells. Both of these events were suppressed by bumetanide [Na(+)-K(+)-2Cl(-) cotransporter isotype 1 (NKCC1) blocker], CFTRinh-172 (CFTR inhibitor), gallein (Gβγ protein inhibitor) and H89 [protein kinase A (PKA) inhibitor]. By itself, H1R activation with 2-pyridylethylamine increased the level of cAMP in the SCN and this regulation was prevented by gallein. Finally, histamine-evoked phase shifts of the circadian neural activity rhythm in the mouse SCN slice were blocked by bumetanide, CFTRinh-172, gallein or H89 and were not observed in NKCC1 or CFTR KO mice. Taken together, these results indicate that histamine recruits the H1R-Gβγ-cAMP/PKA pathway in the SCN neurons to activate CaV1.3 channels through CFTR-mediated Cl(-) efflux and ultimately to phase-shift the circadian clock. This pathway and NKCC1 may well be potential targets for agents designed to treat problems resulting from the disturbance of the circadian system.
doi_str_mv 10.1186/s13041-016-0227-1
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4858891</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1787935934</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3801-946e34badceda0632eefd50bdc82f9af8556b97a3f18df03a16f22b254e57e193</originalsourceid><addsrcrecordid>eNpVkc1u1TAQRi0EoqXwAGxQlmxMPXbsOBukqyvaIoqoUFlbjjNuDPnDdkDd8UzwHn0mcrltVVZjab45M9Yh5CWwNwBaHScQrATKQFHGeUXhETmESiqqFFOPH7wPyLOUvjKmuAL5lBzwCqTQrD4kv85CynYIIxZQRHQ45ynS05vfN3-o23y8OL74sKHbk8vPxWxz99NeFwO2wWZMRe6w6O6maRjbxWG7MhLmHMarYvL_ImmZo3VdsGmwObjChejsihgL10_u23PyxNs-4YvbekS-nLy73J7R80-n77ebc-rWQ4HWpUJRNrZdd1imBEf0rWRN6zT3tfVaStXUlRUedOuZsKA85w2XJcoKoRZH5O2eOy_N-gWHY462N3MMg43XZrLB_N8ZQ2euph-m1FLrGlbA61tAnL4vmLIZQnLY93bEaUkGKl3VQtaiXKOwj7o4pRTR368BZnbmzN6cWc2ZnTmzw796eN_9xJ0q8RfhBph9</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1787935934</pqid></control><display><type>article</type><title>Histamine 1 receptor-Gβγ-cAMP/PKA-CFTR pathway mediates the histamine-induced resetting of the suprachiasmatic circadian clock</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central Open Access</source><source>Springer Nature OA Free Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kim, Yoon Sik ; Kim, Young-Beom ; Kim, Woong Bin ; Lee, Seung Won ; Oh, Seog Bae ; Han, Hee-Chul ; Lee, C Justin ; Colwell, Christopher S ; Kim, Yang In</creator><creatorcontrib>Kim, Yoon Sik ; Kim, Young-Beom ; Kim, Woong Bin ; Lee, Seung Won ; Oh, Seog Bae ; Han, Hee-Chul ; Lee, C Justin ; Colwell, Christopher S ; Kim, Yang In</creatorcontrib><description>Recent evidence indicates that histamine, acting on histamine 1 receptor (H1R), resets the circadian clock in the mouse suprachiasmatic nucleus (SCN) by increasing intracellular Ca(2+) concentration ([Ca(2+)]i) through the activation of CaV1.3 L-type Ca(2+) channels and Ca(2+)-induced Ca(2+) release from ryanodine receptor-mediated internal stores. In the current study, we explored the underlying mechanisms with various techniques including Ca(2+)- and Cl(-)-imaging and extracellular single-unit recording. Our hypothesis was that histamine causes Cl(-) efflux through cystic fibrosis transmembrane conductance regulator (CFTR) to elicit membrane depolarization needed for the activation of CaV1.3 Ca(2+) channels in SCN neurons. We found that histamine elicited Cl(-) efflux and increased [Ca(2+)]i in dissociated mouse SCN cells. Both of these events were suppressed by bumetanide [Na(+)-K(+)-2Cl(-) cotransporter isotype 1 (NKCC1) blocker], CFTRinh-172 (CFTR inhibitor), gallein (Gβγ protein inhibitor) and H89 [protein kinase A (PKA) inhibitor]. By itself, H1R activation with 2-pyridylethylamine increased the level of cAMP in the SCN and this regulation was prevented by gallein. Finally, histamine-evoked phase shifts of the circadian neural activity rhythm in the mouse SCN slice were blocked by bumetanide, CFTRinh-172, gallein or H89 and were not observed in NKCC1 or CFTR KO mice. Taken together, these results indicate that histamine recruits the H1R-Gβγ-cAMP/PKA pathway in the SCN neurons to activate CaV1.3 channels through CFTR-mediated Cl(-) efflux and ultimately to phase-shift the circadian clock. This pathway and NKCC1 may well be potential targets for agents designed to treat problems resulting from the disturbance of the circadian system.</description><identifier>ISSN: 1756-6606</identifier><identifier>EISSN: 1756-6606</identifier><identifier>DOI: 10.1186/s13041-016-0227-1</identifier><identifier>PMID: 27153809</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>Animals ; Calcium Channels, L-Type - metabolism ; Chlorides - metabolism ; Circadian Clocks - drug effects ; Cyclic AMP - metabolism ; Cyclic AMP-Dependent Protein Kinases - metabolism ; Cystic Fibrosis Transmembrane Conductance Regulator - metabolism ; GTP-Binding Protein beta Subunits - metabolism ; GTP-Binding Protein gamma Subunits - metabolism ; Histamine - pharmacology ; Ion Channel Gating - drug effects ; Male ; Mice, Inbred C57BL ; Models, Biological ; Neurons - drug effects ; Neurons - metabolism ; Receptors, Histamine H1 - metabolism ; Signal Transduction - drug effects ; Solute Carrier Family 12, Member 2 - metabolism ; Suprachiasmatic Nucleus - metabolism</subject><ispartof>Molecular brain, 2016-05, Vol.9 (1), p.49-49, Article 49</ispartof><rights>Kim et al. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3801-946e34badceda0632eefd50bdc82f9af8556b97a3f18df03a16f22b254e57e193</citedby><cites>FETCH-LOGICAL-c3801-946e34badceda0632eefd50bdc82f9af8556b97a3f18df03a16f22b254e57e193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858891/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858891/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27153809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Yoon Sik</creatorcontrib><creatorcontrib>Kim, Young-Beom</creatorcontrib><creatorcontrib>Kim, Woong Bin</creatorcontrib><creatorcontrib>Lee, Seung Won</creatorcontrib><creatorcontrib>Oh, Seog Bae</creatorcontrib><creatorcontrib>Han, Hee-Chul</creatorcontrib><creatorcontrib>Lee, C Justin</creatorcontrib><creatorcontrib>Colwell, Christopher S</creatorcontrib><creatorcontrib>Kim, Yang In</creatorcontrib><title>Histamine 1 receptor-Gβγ-cAMP/PKA-CFTR pathway mediates the histamine-induced resetting of the suprachiasmatic circadian clock</title><title>Molecular brain</title><addtitle>Mol Brain</addtitle><description>Recent evidence indicates that histamine, acting on histamine 1 receptor (H1R), resets the circadian clock in the mouse suprachiasmatic nucleus (SCN) by increasing intracellular Ca(2+) concentration ([Ca(2+)]i) through the activation of CaV1.3 L-type Ca(2+) channels and Ca(2+)-induced Ca(2+) release from ryanodine receptor-mediated internal stores. In the current study, we explored the underlying mechanisms with various techniques including Ca(2+)- and Cl(-)-imaging and extracellular single-unit recording. Our hypothesis was that histamine causes Cl(-) efflux through cystic fibrosis transmembrane conductance regulator (CFTR) to elicit membrane depolarization needed for the activation of CaV1.3 Ca(2+) channels in SCN neurons. We found that histamine elicited Cl(-) efflux and increased [Ca(2+)]i in dissociated mouse SCN cells. Both of these events were suppressed by bumetanide [Na(+)-K(+)-2Cl(-) cotransporter isotype 1 (NKCC1) blocker], CFTRinh-172 (CFTR inhibitor), gallein (Gβγ protein inhibitor) and H89 [protein kinase A (PKA) inhibitor]. By itself, H1R activation with 2-pyridylethylamine increased the level of cAMP in the SCN and this regulation was prevented by gallein. Finally, histamine-evoked phase shifts of the circadian neural activity rhythm in the mouse SCN slice were blocked by bumetanide, CFTRinh-172, gallein or H89 and were not observed in NKCC1 or CFTR KO mice. Taken together, these results indicate that histamine recruits the H1R-Gβγ-cAMP/PKA pathway in the SCN neurons to activate CaV1.3 channels through CFTR-mediated Cl(-) efflux and ultimately to phase-shift the circadian clock. This pathway and NKCC1 may well be potential targets for agents designed to treat problems resulting from the disturbance of the circadian system.</description><subject>Animals</subject><subject>Calcium Channels, L-Type - metabolism</subject><subject>Chlorides - metabolism</subject><subject>Circadian Clocks - drug effects</subject><subject>Cyclic AMP - metabolism</subject><subject>Cyclic AMP-Dependent Protein Kinases - metabolism</subject><subject>Cystic Fibrosis Transmembrane Conductance Regulator - metabolism</subject><subject>GTP-Binding Protein beta Subunits - metabolism</subject><subject>GTP-Binding Protein gamma Subunits - metabolism</subject><subject>Histamine - pharmacology</subject><subject>Ion Channel Gating - drug effects</subject><subject>Male</subject><subject>Mice, Inbred C57BL</subject><subject>Models, Biological</subject><subject>Neurons - drug effects</subject><subject>Neurons - metabolism</subject><subject>Receptors, Histamine H1 - metabolism</subject><subject>Signal Transduction - drug effects</subject><subject>Solute Carrier Family 12, Member 2 - metabolism</subject><subject>Suprachiasmatic Nucleus - metabolism</subject><issn>1756-6606</issn><issn>1756-6606</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc1u1TAQRi0EoqXwAGxQlmxMPXbsOBukqyvaIoqoUFlbjjNuDPnDdkDd8UzwHn0mcrltVVZjab45M9Yh5CWwNwBaHScQrATKQFHGeUXhETmESiqqFFOPH7wPyLOUvjKmuAL5lBzwCqTQrD4kv85CynYIIxZQRHQ45ynS05vfN3-o23y8OL74sKHbk8vPxWxz99NeFwO2wWZMRe6w6O6maRjbxWG7MhLmHMarYvL_ImmZo3VdsGmwObjChejsihgL10_u23PyxNs-4YvbekS-nLy73J7R80-n77ebc-rWQ4HWpUJRNrZdd1imBEf0rWRN6zT3tfVaStXUlRUedOuZsKA85w2XJcoKoRZH5O2eOy_N-gWHY462N3MMg43XZrLB_N8ZQ2euph-m1FLrGlbA61tAnL4vmLIZQnLY93bEaUkGKl3VQtaiXKOwj7o4pRTR368BZnbmzN6cWc2ZnTmzw796eN_9xJ0q8RfhBph9</recordid><startdate>20160506</startdate><enddate>20160506</enddate><creator>Kim, Yoon Sik</creator><creator>Kim, Young-Beom</creator><creator>Kim, Woong Bin</creator><creator>Lee, Seung Won</creator><creator>Oh, Seog Bae</creator><creator>Han, Hee-Chul</creator><creator>Lee, C Justin</creator><creator>Colwell, Christopher S</creator><creator>Kim, Yang In</creator><general>BioMed Central</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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160506</creationdate><title>Histamine 1 receptor-Gβγ-cAMP/PKA-CFTR pathway mediates the histamine-induced resetting of the suprachiasmatic circadian clock</title><author>Kim, Yoon Sik ; Kim, Young-Beom ; Kim, Woong Bin ; Lee, Seung Won ; Oh, Seog Bae ; Han, Hee-Chul ; Lee, C Justin ; Colwell, Christopher S ; Kim, Yang In</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3801-946e34badceda0632eefd50bdc82f9af8556b97a3f18df03a16f22b254e57e193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Animals</topic><topic>Calcium Channels, L-Type - metabolism</topic><topic>Chlorides - metabolism</topic><topic>Circadian Clocks - drug effects</topic><topic>Cyclic AMP - metabolism</topic><topic>Cyclic AMP-Dependent Protein Kinases - metabolism</topic><topic>Cystic Fibrosis Transmembrane Conductance Regulator - metabolism</topic><topic>GTP-Binding Protein beta Subunits - metabolism</topic><topic>GTP-Binding Protein gamma Subunits - metabolism</topic><topic>Histamine - pharmacology</topic><topic>Ion Channel Gating - drug effects</topic><topic>Male</topic><topic>Mice, Inbred C57BL</topic><topic>Models, Biological</topic><topic>Neurons - drug effects</topic><topic>Neurons - metabolism</topic><topic>Receptors, Histamine H1 - metabolism</topic><topic>Signal Transduction - drug effects</topic><topic>Solute Carrier Family 12, Member 2 - metabolism</topic><topic>Suprachiasmatic Nucleus - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Yoon Sik</creatorcontrib><creatorcontrib>Kim, Young-Beom</creatorcontrib><creatorcontrib>Kim, Woong Bin</creatorcontrib><creatorcontrib>Lee, Seung Won</creatorcontrib><creatorcontrib>Oh, Seog Bae</creatorcontrib><creatorcontrib>Han, Hee-Chul</creatorcontrib><creatorcontrib>Lee, C Justin</creatorcontrib><creatorcontrib>Colwell, Christopher S</creatorcontrib><creatorcontrib>Kim, Yang In</creatorcontrib><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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Molecular brain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Yoon Sik</au><au>Kim, Young-Beom</au><au>Kim, Woong Bin</au><au>Lee, Seung Won</au><au>Oh, Seog Bae</au><au>Han, Hee-Chul</au><au>Lee, C Justin</au><au>Colwell, Christopher S</au><au>Kim, Yang In</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Histamine 1 receptor-Gβγ-cAMP/PKA-CFTR pathway mediates the histamine-induced resetting of the suprachiasmatic circadian clock</atitle><jtitle>Molecular brain</jtitle><addtitle>Mol Brain</addtitle><date>2016-05-06</date><risdate>2016</risdate><volume>9</volume><issue>1</issue><spage>49</spage><epage>49</epage><pages>49-49</pages><artnum>49</artnum><issn>1756-6606</issn><eissn>1756-6606</eissn><abstract>Recent evidence indicates that histamine, acting on histamine 1 receptor (H1R), resets the circadian clock in the mouse suprachiasmatic nucleus (SCN) by increasing intracellular Ca(2+) concentration ([Ca(2+)]i) through the activation of CaV1.3 L-type Ca(2+) channels and Ca(2+)-induced Ca(2+) release from ryanodine receptor-mediated internal stores. In the current study, we explored the underlying mechanisms with various techniques including Ca(2+)- and Cl(-)-imaging and extracellular single-unit recording. Our hypothesis was that histamine causes Cl(-) efflux through cystic fibrosis transmembrane conductance regulator (CFTR) to elicit membrane depolarization needed for the activation of CaV1.3 Ca(2+) channels in SCN neurons. We found that histamine elicited Cl(-) efflux and increased [Ca(2+)]i in dissociated mouse SCN cells. Both of these events were suppressed by bumetanide [Na(+)-K(+)-2Cl(-) cotransporter isotype 1 (NKCC1) blocker], CFTRinh-172 (CFTR inhibitor), gallein (Gβγ protein inhibitor) and H89 [protein kinase A (PKA) inhibitor]. By itself, H1R activation with 2-pyridylethylamine increased the level of cAMP in the SCN and this regulation was prevented by gallein. Finally, histamine-evoked phase shifts of the circadian neural activity rhythm in the mouse SCN slice were blocked by bumetanide, CFTRinh-172, gallein or H89 and were not observed in NKCC1 or CFTR KO mice. Taken together, these results indicate that histamine recruits the H1R-Gβγ-cAMP/PKA pathway in the SCN neurons to activate CaV1.3 channels through CFTR-mediated Cl(-) efflux and ultimately to phase-shift the circadian clock. This pathway and NKCC1 may well be potential targets for agents designed to treat problems resulting from the disturbance of the circadian system.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>27153809</pmid><doi>10.1186/s13041-016-0227-1</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1756-6606
ispartof Molecular brain, 2016-05, Vol.9 (1), p.49-49, Article 49
issn 1756-6606
1756-6606
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4858891
source MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; SpringerLink Journals - AutoHoldings
subjects Animals
Calcium Channels, L-Type - metabolism
Chlorides - metabolism
Circadian Clocks - drug effects
Cyclic AMP - metabolism
Cyclic AMP-Dependent Protein Kinases - metabolism
Cystic Fibrosis Transmembrane Conductance Regulator - metabolism
GTP-Binding Protein beta Subunits - metabolism
GTP-Binding Protein gamma Subunits - metabolism
Histamine - pharmacology
Ion Channel Gating - drug effects
Male
Mice, Inbred C57BL
Models, Biological
Neurons - drug effects
Neurons - metabolism
Receptors, Histamine H1 - metabolism
Signal Transduction - drug effects
Solute Carrier Family 12, Member 2 - metabolism
Suprachiasmatic Nucleus - metabolism
title Histamine 1 receptor-Gβγ-cAMP/PKA-CFTR pathway mediates the histamine-induced resetting of the suprachiasmatic circadian clock
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T05%3A20%3A51IST&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=Histamine%201%20receptor-G%CE%B2%CE%B3-cAMP/PKA-CFTR%20pathway%20mediates%20the%20histamine-induced%20resetting%20of%20the%20suprachiasmatic%20circadian%20clock&rft.jtitle=Molecular%20brain&rft.au=Kim,%20Yoon%20Sik&rft.date=2016-05-06&rft.volume=9&rft.issue=1&rft.spage=49&rft.epage=49&rft.pages=49-49&rft.artnum=49&rft.issn=1756-6606&rft.eissn=1756-6606&rft_id=info:doi/10.1186/s13041-016-0227-1&rft_dat=%3Cproquest_pubme%3E1787935934%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=1787935934&rft_id=info:pmid/27153809&rfr_iscdi=true