Claudin-4 activity in ovarian tumor cell apoptosis resistance and migration

Claudin-4 is a transmembrane protein expressed at high levels in the majority of epithelial ovarian tumors, irrespective of subtype, and has been associated with tumor cells that are both chemoresistant and highly mobile. The objective of this study was to determine the functional role that claudin-...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:BMC cancer 2016-10, Vol.16 (1), p.788-788, Article 788
Hauptverfasser: Hicks, Douglas A, Galimanis, Carly E, Webb, Patricia G, Spillman, Monique A, Behbakht, Kian, Neville, Margaret C, Baumgartner, Heidi K
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 788
container_issue 1
container_start_page 788
container_title BMC cancer
container_volume 16
creator Hicks, Douglas A
Galimanis, Carly E
Webb, Patricia G
Spillman, Monique A
Behbakht, Kian
Neville, Margaret C
Baumgartner, Heidi K
description Claudin-4 is a transmembrane protein expressed at high levels in the majority of epithelial ovarian tumors, irrespective of subtype, and has been associated with tumor cells that are both chemoresistant and highly mobile. The objective of this study was to determine the functional role that claudin-4 plays in apoptosis resistance and migration as well as the therapeutic utility of targeting claudin-4 activity with a small mimic peptide. We examined claudin-4 activity in human ovarian tumor cell lines (SKOV3, OVCAR3, PEO4) using in vitro caspase and scratch assays as well as an in vivo mouse model of ovarian cancer. Claudin-4 activity was disrupted by treating cells with a small peptide that mimics the DFYNP sequence in the second extracellular loop of claudin-4. Claudin-4 expression was also altered using shRNA-mediated gene silencing. Both the disruption of claudin-4 activity and the loss of claudin-4 expression significantly increased tumor cell caspase-3 activation (4 to 10-fold, respectively) in response to the apoptotic inducer staurosporine and reduced tumor cell migration by 50 %. The mimic peptide had no effect on cells that lacked claudin-4 expression. Female athymic nude mice bearing ZsGreen-PEO4 ovarian tumors showed a significant decrease in ovarian tumor burden, due to increased apoptosis, after treatment with intraperitoneal injections of 4 mg/kg mimic peptide every 48 h for three weeks, compared to control peptide treated mice. Claudin-4 functionally contributes to both ovarian tumor cell apoptosis resistance and migration and targeting extracellular loop interactions of claudin-4 may have therapeutic implications for reducing ovarian tumor burden.
doi_str_mv 10.1186/s12885-016-2799-7
format Article
fullrecord <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5057472</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A470589903</galeid><sourcerecordid>A470589903</sourcerecordid><originalsourceid>FETCH-LOGICAL-c586t-80f3122e28458cb1b3067f29460015c95787d385f594ac699846c4443e42d2ca3</originalsourceid><addsrcrecordid>eNpdkkuLHCEUhSUkZB7JD8hmEAJhsqjEZ6mbQNPkMWQgkMdabMvqdqjSHrWazL-PNT2ZdGejgt8913s8ALzC6B3Gsn2fMZGSNwi3DRFKNeIJOMVM4IYwJJ4enE_AWc43CGEhkXwOTogQhCmCT8HX5WCmzoeGQWOL3_lyB32AcWeSNwGWaYwJWjcM0GzjtsTsM0yursUE66AJHRz9OpniY3gBnvVmyO7lw34Ofn36-HP5pbn-9vlqubhuLJdtaSTqKSbEEcm4tCu8oqgVPVGsrQ_kVnEhRUcl77lixrZKSdZaxhh1jHTEGnoOPux1t9NqdJ11oSQz6G3yo0l3Ohqvj2-C3-h13GmOuGCCVIHLB4EUbyeXix59noc0wcUpaywpp62UiFb09X_oTZxSqOPdU_UDqsf_qLUZnPahj7WvnUX1ggnEpVL3Wm-PKBtDcb_L2kw566sf34_ZNwfsxpmhbHIcptnnfAziPWhTzDm5_tEHjPScEr1Pia4p0XNKtKg1F4cGPlb8jQX9A5uCtGE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835128471</pqid></control><display><type>article</type><title>Claudin-4 activity in ovarian tumor cell apoptosis resistance and migration</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>SpringerLink Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><source>Springer Nature OA Free Journals</source><creator>Hicks, Douglas A ; Galimanis, Carly E ; Webb, Patricia G ; Spillman, Monique A ; Behbakht, Kian ; Neville, Margaret C ; Baumgartner, Heidi K</creator><creatorcontrib>Hicks, Douglas A ; Galimanis, Carly E ; Webb, Patricia G ; Spillman, Monique A ; Behbakht, Kian ; Neville, Margaret C ; Baumgartner, Heidi K</creatorcontrib><description>Claudin-4 is a transmembrane protein expressed at high levels in the majority of epithelial ovarian tumors, irrespective of subtype, and has been associated with tumor cells that are both chemoresistant and highly mobile. The objective of this study was to determine the functional role that claudin-4 plays in apoptosis resistance and migration as well as the therapeutic utility of targeting claudin-4 activity with a small mimic peptide. We examined claudin-4 activity in human ovarian tumor cell lines (SKOV3, OVCAR3, PEO4) using in vitro caspase and scratch assays as well as an in vivo mouse model of ovarian cancer. Claudin-4 activity was disrupted by treating cells with a small peptide that mimics the DFYNP sequence in the second extracellular loop of claudin-4. Claudin-4 expression was also altered using shRNA-mediated gene silencing. Both the disruption of claudin-4 activity and the loss of claudin-4 expression significantly increased tumor cell caspase-3 activation (4 to 10-fold, respectively) in response to the apoptotic inducer staurosporine and reduced tumor cell migration by 50 %. The mimic peptide had no effect on cells that lacked claudin-4 expression. Female athymic nude mice bearing ZsGreen-PEO4 ovarian tumors showed a significant decrease in ovarian tumor burden, due to increased apoptosis, after treatment with intraperitoneal injections of 4 mg/kg mimic peptide every 48 h for three weeks, compared to control peptide treated mice. Claudin-4 functionally contributes to both ovarian tumor cell apoptosis resistance and migration and targeting extracellular loop interactions of claudin-4 may have therapeutic implications for reducing ovarian tumor burden.</description><identifier>ISSN: 1471-2407</identifier><identifier>EISSN: 1471-2407</identifier><identifier>DOI: 10.1186/s12885-016-2799-7</identifier><identifier>PMID: 27724921</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Animals ; Apoptosis ; Apoptosis - genetics ; Caspase 3 - metabolism ; Cell culture ; Cell Line, Tumor ; Cell Movement - genetics ; Cell Survival - genetics ; Claudin-4 - genetics ; Claudin-4 - metabolism ; Development and progression ; Disease Models, Animal ; Female ; Gene Expression Regulation, Neoplastic ; Genetic aspects ; Heterografts ; Humans ; Immunohistochemistry ; Laboratories ; Membrane proteins ; Mice ; Miracles ; Motility ; Ovarian cancer ; Ovarian Neoplasms - genetics ; Ovarian Neoplasms - metabolism ; Ovarian Neoplasms - pathology ; Peptides ; Physiological aspects ; Proteins ; RNA Interference ; RNA, Small Interfering - genetics ; Tumor Burden ; Tumors</subject><ispartof>BMC cancer, 2016-10, Vol.16 (1), p.788-788, Article 788</ispartof><rights>COPYRIGHT 2016 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2016</rights><rights>The Author(s). 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c586t-80f3122e28458cb1b3067f29460015c95787d385f594ac699846c4443e42d2ca3</citedby><cites>FETCH-LOGICAL-c586t-80f3122e28458cb1b3067f29460015c95787d385f594ac699846c4443e42d2ca3</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/PMC5057472/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5057472/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27724921$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hicks, Douglas A</creatorcontrib><creatorcontrib>Galimanis, Carly E</creatorcontrib><creatorcontrib>Webb, Patricia G</creatorcontrib><creatorcontrib>Spillman, Monique A</creatorcontrib><creatorcontrib>Behbakht, Kian</creatorcontrib><creatorcontrib>Neville, Margaret C</creatorcontrib><creatorcontrib>Baumgartner, Heidi K</creatorcontrib><title>Claudin-4 activity in ovarian tumor cell apoptosis resistance and migration</title><title>BMC cancer</title><addtitle>BMC Cancer</addtitle><description>Claudin-4 is a transmembrane protein expressed at high levels in the majority of epithelial ovarian tumors, irrespective of subtype, and has been associated with tumor cells that are both chemoresistant and highly mobile. The objective of this study was to determine the functional role that claudin-4 plays in apoptosis resistance and migration as well as the therapeutic utility of targeting claudin-4 activity with a small mimic peptide. We examined claudin-4 activity in human ovarian tumor cell lines (SKOV3, OVCAR3, PEO4) using in vitro caspase and scratch assays as well as an in vivo mouse model of ovarian cancer. Claudin-4 activity was disrupted by treating cells with a small peptide that mimics the DFYNP sequence in the second extracellular loop of claudin-4. Claudin-4 expression was also altered using shRNA-mediated gene silencing. Both the disruption of claudin-4 activity and the loss of claudin-4 expression significantly increased tumor cell caspase-3 activation (4 to 10-fold, respectively) in response to the apoptotic inducer staurosporine and reduced tumor cell migration by 50 %. The mimic peptide had no effect on cells that lacked claudin-4 expression. Female athymic nude mice bearing ZsGreen-PEO4 ovarian tumors showed a significant decrease in ovarian tumor burden, due to increased apoptosis, after treatment with intraperitoneal injections of 4 mg/kg mimic peptide every 48 h for three weeks, compared to control peptide treated mice. Claudin-4 functionally contributes to both ovarian tumor cell apoptosis resistance and migration and targeting extracellular loop interactions of claudin-4 may have therapeutic implications for reducing ovarian tumor burden.</description><subject>Animals</subject><subject>Apoptosis</subject><subject>Apoptosis - genetics</subject><subject>Caspase 3 - metabolism</subject><subject>Cell culture</subject><subject>Cell Line, Tumor</subject><subject>Cell Movement - genetics</subject><subject>Cell Survival - genetics</subject><subject>Claudin-4 - genetics</subject><subject>Claudin-4 - metabolism</subject><subject>Development and progression</subject><subject>Disease Models, Animal</subject><subject>Female</subject><subject>Gene Expression Regulation, Neoplastic</subject><subject>Genetic aspects</subject><subject>Heterografts</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Laboratories</subject><subject>Membrane proteins</subject><subject>Mice</subject><subject>Miracles</subject><subject>Motility</subject><subject>Ovarian cancer</subject><subject>Ovarian Neoplasms - genetics</subject><subject>Ovarian Neoplasms - metabolism</subject><subject>Ovarian Neoplasms - pathology</subject><subject>Peptides</subject><subject>Physiological aspects</subject><subject>Proteins</subject><subject>RNA Interference</subject><subject>RNA, Small Interfering - genetics</subject><subject>Tumor Burden</subject><subject>Tumors</subject><issn>1471-2407</issn><issn>1471-2407</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkkuLHCEUhSUkZB7JD8hmEAJhsqjEZ6mbQNPkMWQgkMdabMvqdqjSHrWazL-PNT2ZdGejgt8913s8ALzC6B3Gsn2fMZGSNwi3DRFKNeIJOMVM4IYwJJ4enE_AWc43CGEhkXwOTogQhCmCT8HX5WCmzoeGQWOL3_lyB32AcWeSNwGWaYwJWjcM0GzjtsTsM0yursUE66AJHRz9OpniY3gBnvVmyO7lw34Ofn36-HP5pbn-9vlqubhuLJdtaSTqKSbEEcm4tCu8oqgVPVGsrQ_kVnEhRUcl77lixrZKSdZaxhh1jHTEGnoOPux1t9NqdJ11oSQz6G3yo0l3Ohqvj2-C3-h13GmOuGCCVIHLB4EUbyeXix59noc0wcUpaywpp62UiFb09X_oTZxSqOPdU_UDqsf_qLUZnPahj7WvnUX1ggnEpVL3Wm-PKBtDcb_L2kw566sf34_ZNwfsxpmhbHIcptnnfAziPWhTzDm5_tEHjPScEr1Pia4p0XNKtKg1F4cGPlb8jQX9A5uCtGE</recordid><startdate>20161011</startdate><enddate>20161011</enddate><creator>Hicks, Douglas A</creator><creator>Galimanis, Carly E</creator><creator>Webb, Patricia G</creator><creator>Spillman, Monique A</creator><creator>Behbakht, Kian</creator><creator>Neville, Margaret C</creator><creator>Baumgartner, Heidi K</creator><general>BioMed Central Ltd</general><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>ISR</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161011</creationdate><title>Claudin-4 activity in ovarian tumor cell apoptosis resistance and migration</title><author>Hicks, Douglas A ; Galimanis, Carly E ; Webb, Patricia G ; Spillman, Monique A ; Behbakht, Kian ; Neville, Margaret C ; Baumgartner, Heidi K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c586t-80f3122e28458cb1b3067f29460015c95787d385f594ac699846c4443e42d2ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Animals</topic><topic>Apoptosis</topic><topic>Apoptosis - genetics</topic><topic>Caspase 3 - metabolism</topic><topic>Cell culture</topic><topic>Cell Line, Tumor</topic><topic>Cell Movement - genetics</topic><topic>Cell Survival - genetics</topic><topic>Claudin-4 - genetics</topic><topic>Claudin-4 - metabolism</topic><topic>Development and progression</topic><topic>Disease Models, Animal</topic><topic>Female</topic><topic>Gene Expression Regulation, Neoplastic</topic><topic>Genetic aspects</topic><topic>Heterografts</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Laboratories</topic><topic>Membrane proteins</topic><topic>Mice</topic><topic>Miracles</topic><topic>Motility</topic><topic>Ovarian cancer</topic><topic>Ovarian Neoplasms - genetics</topic><topic>Ovarian Neoplasms - metabolism</topic><topic>Ovarian Neoplasms - pathology</topic><topic>Peptides</topic><topic>Physiological aspects</topic><topic>Proteins</topic><topic>RNA Interference</topic><topic>RNA, Small Interfering - genetics</topic><topic>Tumor Burden</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hicks, Douglas A</creatorcontrib><creatorcontrib>Galimanis, Carly E</creatorcontrib><creatorcontrib>Webb, Patricia G</creatorcontrib><creatorcontrib>Spillman, Monique A</creatorcontrib><creatorcontrib>Behbakht, Kian</creatorcontrib><creatorcontrib>Neville, Margaret C</creatorcontrib><creatorcontrib>Baumgartner, Heidi K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hicks, Douglas A</au><au>Galimanis, Carly E</au><au>Webb, Patricia G</au><au>Spillman, Monique A</au><au>Behbakht, Kian</au><au>Neville, Margaret C</au><au>Baumgartner, Heidi K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Claudin-4 activity in ovarian tumor cell apoptosis resistance and migration</atitle><jtitle>BMC cancer</jtitle><addtitle>BMC Cancer</addtitle><date>2016-10-11</date><risdate>2016</risdate><volume>16</volume><issue>1</issue><spage>788</spage><epage>788</epage><pages>788-788</pages><artnum>788</artnum><issn>1471-2407</issn><eissn>1471-2407</eissn><abstract>Claudin-4 is a transmembrane protein expressed at high levels in the majority of epithelial ovarian tumors, irrespective of subtype, and has been associated with tumor cells that are both chemoresistant and highly mobile. The objective of this study was to determine the functional role that claudin-4 plays in apoptosis resistance and migration as well as the therapeutic utility of targeting claudin-4 activity with a small mimic peptide. We examined claudin-4 activity in human ovarian tumor cell lines (SKOV3, OVCAR3, PEO4) using in vitro caspase and scratch assays as well as an in vivo mouse model of ovarian cancer. Claudin-4 activity was disrupted by treating cells with a small peptide that mimics the DFYNP sequence in the second extracellular loop of claudin-4. Claudin-4 expression was also altered using shRNA-mediated gene silencing. Both the disruption of claudin-4 activity and the loss of claudin-4 expression significantly increased tumor cell caspase-3 activation (4 to 10-fold, respectively) in response to the apoptotic inducer staurosporine and reduced tumor cell migration by 50 %. The mimic peptide had no effect on cells that lacked claudin-4 expression. Female athymic nude mice bearing ZsGreen-PEO4 ovarian tumors showed a significant decrease in ovarian tumor burden, due to increased apoptosis, after treatment with intraperitoneal injections of 4 mg/kg mimic peptide every 48 h for three weeks, compared to control peptide treated mice. Claudin-4 functionally contributes to both ovarian tumor cell apoptosis resistance and migration and targeting extracellular loop interactions of claudin-4 may have therapeutic implications for reducing ovarian tumor burden.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>27724921</pmid><doi>10.1186/s12885-016-2799-7</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1471-2407
ispartof BMC cancer, 2016-10, Vol.16 (1), p.788-788, Article 788
issn 1471-2407
1471-2407
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5057472
source MEDLINE; DOAJ Directory of Open Access Journals; SpringerLink Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access; Springer Nature OA Free Journals
subjects Animals
Apoptosis
Apoptosis - genetics
Caspase 3 - metabolism
Cell culture
Cell Line, Tumor
Cell Movement - genetics
Cell Survival - genetics
Claudin-4 - genetics
Claudin-4 - metabolism
Development and progression
Disease Models, Animal
Female
Gene Expression Regulation, Neoplastic
Genetic aspects
Heterografts
Humans
Immunohistochemistry
Laboratories
Membrane proteins
Mice
Miracles
Motility
Ovarian cancer
Ovarian Neoplasms - genetics
Ovarian Neoplasms - metabolism
Ovarian Neoplasms - pathology
Peptides
Physiological aspects
Proteins
RNA Interference
RNA, Small Interfering - genetics
Tumor Burden
Tumors
title Claudin-4 activity in ovarian tumor cell apoptosis resistance and migration
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T04%3A31%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Claudin-4%20activity%20in%20ovarian%20tumor%20cell%20apoptosis%20resistance%20and%20migration&rft.jtitle=BMC%20cancer&rft.au=Hicks,%20Douglas%20A&rft.date=2016-10-11&rft.volume=16&rft.issue=1&rft.spage=788&rft.epage=788&rft.pages=788-788&rft.artnum=788&rft.issn=1471-2407&rft.eissn=1471-2407&rft_id=info:doi/10.1186/s12885-016-2799-7&rft_dat=%3Cgale_pubme%3EA470589903%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1835128471&rft_id=info:pmid/27724921&rft_galeid=A470589903&rfr_iscdi=true