Fluvastatin Induces Apoptosis in Primary and Transformed Mast Cells

Statin drugs are widely employed in the clinic to reduce serum cholesterol. Because of their hydroxymethylglutaryl coenzyme A reductase antagonism, statins also reduce isoprenyl lipids necessary for the membrane anchorage and signaling of small G-proteins in the Ras superfamily. We previously found...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Journal of pharmacology and experimental therapeutics 2020-07, Vol.374 (1), p.104-112
Hauptverfasser: Paez, Patrick A., Kolawole, Motunrayo, Taruselli, Marcela T., Ajith, Siddarth, Dailey, Jordan M., Kee, Sydney A., Haque, Tamara T., Barnstein, Brian O., McLeod, Jamie Josephine Avila, Caslin, Heather L., Kiwanuka, Kasalina N., Fukuoka, Yoshihiro, Le, Quang T., Schwartz, Lawrence B., Straus, David B., Gewirtz, David A., Martin, Rebecca K., Ryan, John J.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 112
container_issue 1
container_start_page 104
container_title The Journal of pharmacology and experimental therapeutics
container_volume 374
creator Paez, Patrick A.
Kolawole, Motunrayo
Taruselli, Marcela T.
Ajith, Siddarth
Dailey, Jordan M.
Kee, Sydney A.
Haque, Tamara T.
Barnstein, Brian O.
McLeod, Jamie Josephine Avila
Caslin, Heather L.
Kiwanuka, Kasalina N.
Fukuoka, Yoshihiro
Le, Quang T.
Schwartz, Lawrence B.
Straus, David B.
Gewirtz, David A.
Martin, Rebecca K.
Ryan, John J.
description Statin drugs are widely employed in the clinic to reduce serum cholesterol. Because of their hydroxymethylglutaryl coenzyme A reductase antagonism, statins also reduce isoprenyl lipids necessary for the membrane anchorage and signaling of small G-proteins in the Ras superfamily. We previously found that statins suppress immunoglobulin E (IgE)-mediated mast cell activation, suggesting these drugs might be useful in treating allergic disease. Although IgE-induced function is critical to allergic inflammation, mast cell proliferation and survival also impact atopic disease and mast cell neoplasia. In this study, we describe fluvastatin-mediated apoptosis in primary and transformed mast cells. An IC50 was achieved between 0.8 and 3.5 μM in both cell types, concentrations similar to the reported fluvastatin serum Cmax value. Apoptosis was correlated with reduced stem cell factor (SCF)-mediated signal transduction, mitochondrial dysfunction, and caspase activation. Complementing these data, we found that p53 deficiency or Bcl-2 overexpression reduced fluvastatin-induced apoptosis. We also noted evidence of cytoprotective autophagy in primary mast cells treated with fluvastatin. Finally, we found that intraperitoneal fluvastatin treatment reduced peritoneal mast cell numbers in vivo. These findings offer insight into the mechanisms of mast cell survival and support the possible utility of statins in mast cell–associated allergic and neoplastic diseases. Fluvastatin, a statin drug used to lower cholesterol, induces apoptosis in primary and transformed mast cells by antagonizing protein isoprenylation, effectively inhibiting stem cell factor (SCF)-induced survival signals. This drug may be an effective means of suppressing mast cell survival.
doi_str_mv 10.1124/jpet.119.264234
format Article
fullrecord <record><control><sourceid>elsevier_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7306917</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022356524257967</els_id><sourcerecordid>S0022356524257967</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-4c99fb1fe022c8af0b5ff3e908ad3c5bd32647a44f7b5c72ac0a9701fc03b1a43</originalsourceid><addsrcrecordid>eNp1UMtOwzAQtBCIlsKZG8oPpPVjk9QXpCqiUKkIDuVsOY4NrtI4stNK_D2uAhUcOO1qd2Z2dhC6JXhKCIXZttN97PiU5kAZnKExyShJMcHsHI0xpjRlWZ6N0FUIW4wJQM4u0YhRYMABxqhcNvuDDL3sbZus2nqvdEgWnet6F2xI4vDV2530n4ls62TjZRuM8ztdJ8-RlZS6acI1ujCyCfrmu07Q2_JhUz6l65fHVblYpwqA9Skozk1FjI6u1FwaXGXGMM3xXNZMZVXN4hOFBDBFlamCSoUlLzAxCrOKSGATdD_odvsqOlC67b1sRDcYFE5a8XfT2g_x7g6iYDjnpIgCs0FAeReC1-bEJVgc8xTHPGPHxZBnZNz9PnnC_wQYAXwA6Pj4wWovgrK6Vbq2Xqte1M7-K_4F0BWHAQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Fluvastatin Induces Apoptosis in Primary and Transformed Mast Cells</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Paez, Patrick A. ; Kolawole, Motunrayo ; Taruselli, Marcela T. ; Ajith, Siddarth ; Dailey, Jordan M. ; Kee, Sydney A. ; Haque, Tamara T. ; Barnstein, Brian O. ; McLeod, Jamie Josephine Avila ; Caslin, Heather L. ; Kiwanuka, Kasalina N. ; Fukuoka, Yoshihiro ; Le, Quang T. ; Schwartz, Lawrence B. ; Straus, David B. ; Gewirtz, David A. ; Martin, Rebecca K. ; Ryan, John J.</creator><creatorcontrib>Paez, Patrick A. ; Kolawole, Motunrayo ; Taruselli, Marcela T. ; Ajith, Siddarth ; Dailey, Jordan M. ; Kee, Sydney A. ; Haque, Tamara T. ; Barnstein, Brian O. ; McLeod, Jamie Josephine Avila ; Caslin, Heather L. ; Kiwanuka, Kasalina N. ; Fukuoka, Yoshihiro ; Le, Quang T. ; Schwartz, Lawrence B. ; Straus, David B. ; Gewirtz, David A. ; Martin, Rebecca K. ; Ryan, John J.</creatorcontrib><description>Statin drugs are widely employed in the clinic to reduce serum cholesterol. Because of their hydroxymethylglutaryl coenzyme A reductase antagonism, statins also reduce isoprenyl lipids necessary for the membrane anchorage and signaling of small G-proteins in the Ras superfamily. We previously found that statins suppress immunoglobulin E (IgE)-mediated mast cell activation, suggesting these drugs might be useful in treating allergic disease. Although IgE-induced function is critical to allergic inflammation, mast cell proliferation and survival also impact atopic disease and mast cell neoplasia. In this study, we describe fluvastatin-mediated apoptosis in primary and transformed mast cells. An IC50 was achieved between 0.8 and 3.5 μM in both cell types, concentrations similar to the reported fluvastatin serum Cmax value. Apoptosis was correlated with reduced stem cell factor (SCF)-mediated signal transduction, mitochondrial dysfunction, and caspase activation. Complementing these data, we found that p53 deficiency or Bcl-2 overexpression reduced fluvastatin-induced apoptosis. We also noted evidence of cytoprotective autophagy in primary mast cells treated with fluvastatin. Finally, we found that intraperitoneal fluvastatin treatment reduced peritoneal mast cell numbers in vivo. These findings offer insight into the mechanisms of mast cell survival and support the possible utility of statins in mast cell–associated allergic and neoplastic diseases. Fluvastatin, a statin drug used to lower cholesterol, induces apoptosis in primary and transformed mast cells by antagonizing protein isoprenylation, effectively inhibiting stem cell factor (SCF)-induced survival signals. This drug may be an effective means of suppressing mast cell survival.</description><identifier>ISSN: 0022-3565</identifier><identifier>EISSN: 1521-0103</identifier><identifier>DOI: 10.1124/jpet.119.264234</identifier><identifier>PMID: 32434944</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Animals ; Apoptosis - drug effects ; Bone Marrow Cells - cytology ; Cell Line ; Cell Survival - drug effects ; Fluvastatin - pharmacology ; Humans ; Inflammation, Immunopharmacology, and Asthma ; Lipid Metabolism - drug effects ; Mast Cells - cytology ; Mast Cells - drug effects ; Mast Cells - metabolism ; Mice</subject><ispartof>The Journal of pharmacology and experimental therapeutics, 2020-07, Vol.374 (1), p.104-112</ispartof><rights>2020 American Society for Pharmacology and Experimental Therapeutics</rights><rights>Copyright © 2020 by The American Society for Pharmacology and Experimental Therapeutics.</rights><rights>Copyright © 2020 by The American Society for Pharmacology and Experimental Therapeutics 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-4c99fb1fe022c8af0b5ff3e908ad3c5bd32647a44f7b5c72ac0a9701fc03b1a43</citedby><cites>FETCH-LOGICAL-c443t-4c99fb1fe022c8af0b5ff3e908ad3c5bd32647a44f7b5c72ac0a9701fc03b1a43</cites><orcidid>0000-0002-7471-6779 ; 0000-0002-7965-4335 ; 0000-0003-4436-9558</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,778,782,883,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32434944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paez, Patrick A.</creatorcontrib><creatorcontrib>Kolawole, Motunrayo</creatorcontrib><creatorcontrib>Taruselli, Marcela T.</creatorcontrib><creatorcontrib>Ajith, Siddarth</creatorcontrib><creatorcontrib>Dailey, Jordan M.</creatorcontrib><creatorcontrib>Kee, Sydney A.</creatorcontrib><creatorcontrib>Haque, Tamara T.</creatorcontrib><creatorcontrib>Barnstein, Brian O.</creatorcontrib><creatorcontrib>McLeod, Jamie Josephine Avila</creatorcontrib><creatorcontrib>Caslin, Heather L.</creatorcontrib><creatorcontrib>Kiwanuka, Kasalina N.</creatorcontrib><creatorcontrib>Fukuoka, Yoshihiro</creatorcontrib><creatorcontrib>Le, Quang T.</creatorcontrib><creatorcontrib>Schwartz, Lawrence B.</creatorcontrib><creatorcontrib>Straus, David B.</creatorcontrib><creatorcontrib>Gewirtz, David A.</creatorcontrib><creatorcontrib>Martin, Rebecca K.</creatorcontrib><creatorcontrib>Ryan, John J.</creatorcontrib><title>Fluvastatin Induces Apoptosis in Primary and Transformed Mast Cells</title><title>The Journal of pharmacology and experimental therapeutics</title><addtitle>J Pharmacol Exp Ther</addtitle><description>Statin drugs are widely employed in the clinic to reduce serum cholesterol. Because of their hydroxymethylglutaryl coenzyme A reductase antagonism, statins also reduce isoprenyl lipids necessary for the membrane anchorage and signaling of small G-proteins in the Ras superfamily. We previously found that statins suppress immunoglobulin E (IgE)-mediated mast cell activation, suggesting these drugs might be useful in treating allergic disease. Although IgE-induced function is critical to allergic inflammation, mast cell proliferation and survival also impact atopic disease and mast cell neoplasia. In this study, we describe fluvastatin-mediated apoptosis in primary and transformed mast cells. An IC50 was achieved between 0.8 and 3.5 μM in both cell types, concentrations similar to the reported fluvastatin serum Cmax value. Apoptosis was correlated with reduced stem cell factor (SCF)-mediated signal transduction, mitochondrial dysfunction, and caspase activation. Complementing these data, we found that p53 deficiency or Bcl-2 overexpression reduced fluvastatin-induced apoptosis. We also noted evidence of cytoprotective autophagy in primary mast cells treated with fluvastatin. Finally, we found that intraperitoneal fluvastatin treatment reduced peritoneal mast cell numbers in vivo. These findings offer insight into the mechanisms of mast cell survival and support the possible utility of statins in mast cell–associated allergic and neoplastic diseases. Fluvastatin, a statin drug used to lower cholesterol, induces apoptosis in primary and transformed mast cells by antagonizing protein isoprenylation, effectively inhibiting stem cell factor (SCF)-induced survival signals. This drug may be an effective means of suppressing mast cell survival.</description><subject>Animals</subject><subject>Apoptosis - drug effects</subject><subject>Bone Marrow Cells - cytology</subject><subject>Cell Line</subject><subject>Cell Survival - drug effects</subject><subject>Fluvastatin - pharmacology</subject><subject>Humans</subject><subject>Inflammation, Immunopharmacology, and Asthma</subject><subject>Lipid Metabolism - drug effects</subject><subject>Mast Cells - cytology</subject><subject>Mast Cells - drug effects</subject><subject>Mast Cells - metabolism</subject><subject>Mice</subject><issn>0022-3565</issn><issn>1521-0103</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UMtOwzAQtBCIlsKZG8oPpPVjk9QXpCqiUKkIDuVsOY4NrtI4stNK_D2uAhUcOO1qd2Z2dhC6JXhKCIXZttN97PiU5kAZnKExyShJMcHsHI0xpjRlWZ6N0FUIW4wJQM4u0YhRYMABxqhcNvuDDL3sbZus2nqvdEgWnet6F2xI4vDV2530n4ls62TjZRuM8ztdJ8-RlZS6acI1ujCyCfrmu07Q2_JhUz6l65fHVblYpwqA9Skozk1FjI6u1FwaXGXGMM3xXNZMZVXN4hOFBDBFlamCSoUlLzAxCrOKSGATdD_odvsqOlC67b1sRDcYFE5a8XfT2g_x7g6iYDjnpIgCs0FAeReC1-bEJVgc8xTHPGPHxZBnZNz9PnnC_wQYAXwA6Pj4wWovgrK6Vbq2Xqte1M7-K_4F0BWHAQ</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Paez, Patrick A.</creator><creator>Kolawole, Motunrayo</creator><creator>Taruselli, Marcela T.</creator><creator>Ajith, Siddarth</creator><creator>Dailey, Jordan M.</creator><creator>Kee, Sydney A.</creator><creator>Haque, Tamara T.</creator><creator>Barnstein, Brian O.</creator><creator>McLeod, Jamie Josephine Avila</creator><creator>Caslin, Heather L.</creator><creator>Kiwanuka, Kasalina N.</creator><creator>Fukuoka, Yoshihiro</creator><creator>Le, Quang T.</creator><creator>Schwartz, Lawrence B.</creator><creator>Straus, David B.</creator><creator>Gewirtz, David A.</creator><creator>Martin, Rebecca K.</creator><creator>Ryan, John J.</creator><general>Elsevier Inc</general><general>The American Society for Pharmacology and Experimental Therapeutics</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>5PM</scope><orcidid>https://orcid.org/0000-0002-7471-6779</orcidid><orcidid>https://orcid.org/0000-0002-7965-4335</orcidid><orcidid>https://orcid.org/0000-0003-4436-9558</orcidid></search><sort><creationdate>202007</creationdate><title>Fluvastatin Induces Apoptosis in Primary and Transformed Mast Cells</title><author>Paez, Patrick A. ; Kolawole, Motunrayo ; Taruselli, Marcela T. ; Ajith, Siddarth ; Dailey, Jordan M. ; Kee, Sydney A. ; Haque, Tamara T. ; Barnstein, Brian O. ; McLeod, Jamie Josephine Avila ; Caslin, Heather L. ; Kiwanuka, Kasalina N. ; Fukuoka, Yoshihiro ; Le, Quang T. ; Schwartz, Lawrence B. ; Straus, David B. ; Gewirtz, David A. ; Martin, Rebecca K. ; Ryan, John J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-4c99fb1fe022c8af0b5ff3e908ad3c5bd32647a44f7b5c72ac0a9701fc03b1a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Animals</topic><topic>Apoptosis - drug effects</topic><topic>Bone Marrow Cells - cytology</topic><topic>Cell Line</topic><topic>Cell Survival - drug effects</topic><topic>Fluvastatin - pharmacology</topic><topic>Humans</topic><topic>Inflammation, Immunopharmacology, and Asthma</topic><topic>Lipid Metabolism - drug effects</topic><topic>Mast Cells - cytology</topic><topic>Mast Cells - drug effects</topic><topic>Mast Cells - metabolism</topic><topic>Mice</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paez, Patrick A.</creatorcontrib><creatorcontrib>Kolawole, Motunrayo</creatorcontrib><creatorcontrib>Taruselli, Marcela T.</creatorcontrib><creatorcontrib>Ajith, Siddarth</creatorcontrib><creatorcontrib>Dailey, Jordan M.</creatorcontrib><creatorcontrib>Kee, Sydney A.</creatorcontrib><creatorcontrib>Haque, Tamara T.</creatorcontrib><creatorcontrib>Barnstein, Brian O.</creatorcontrib><creatorcontrib>McLeod, Jamie Josephine Avila</creatorcontrib><creatorcontrib>Caslin, Heather L.</creatorcontrib><creatorcontrib>Kiwanuka, Kasalina N.</creatorcontrib><creatorcontrib>Fukuoka, Yoshihiro</creatorcontrib><creatorcontrib>Le, Quang T.</creatorcontrib><creatorcontrib>Schwartz, Lawrence B.</creatorcontrib><creatorcontrib>Straus, David B.</creatorcontrib><creatorcontrib>Gewirtz, David A.</creatorcontrib><creatorcontrib>Martin, Rebecca K.</creatorcontrib><creatorcontrib>Ryan, John J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of pharmacology and experimental therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paez, Patrick A.</au><au>Kolawole, Motunrayo</au><au>Taruselli, Marcela T.</au><au>Ajith, Siddarth</au><au>Dailey, Jordan M.</au><au>Kee, Sydney A.</au><au>Haque, Tamara T.</au><au>Barnstein, Brian O.</au><au>McLeod, Jamie Josephine Avila</au><au>Caslin, Heather L.</au><au>Kiwanuka, Kasalina N.</au><au>Fukuoka, Yoshihiro</au><au>Le, Quang T.</au><au>Schwartz, Lawrence B.</au><au>Straus, David B.</au><au>Gewirtz, David A.</au><au>Martin, Rebecca K.</au><au>Ryan, John J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fluvastatin Induces Apoptosis in Primary and Transformed Mast Cells</atitle><jtitle>The Journal of pharmacology and experimental therapeutics</jtitle><addtitle>J Pharmacol Exp Ther</addtitle><date>2020-07</date><risdate>2020</risdate><volume>374</volume><issue>1</issue><spage>104</spage><epage>112</epage><pages>104-112</pages><issn>0022-3565</issn><eissn>1521-0103</eissn><abstract>Statin drugs are widely employed in the clinic to reduce serum cholesterol. Because of their hydroxymethylglutaryl coenzyme A reductase antagonism, statins also reduce isoprenyl lipids necessary for the membrane anchorage and signaling of small G-proteins in the Ras superfamily. We previously found that statins suppress immunoglobulin E (IgE)-mediated mast cell activation, suggesting these drugs might be useful in treating allergic disease. Although IgE-induced function is critical to allergic inflammation, mast cell proliferation and survival also impact atopic disease and mast cell neoplasia. In this study, we describe fluvastatin-mediated apoptosis in primary and transformed mast cells. An IC50 was achieved between 0.8 and 3.5 μM in both cell types, concentrations similar to the reported fluvastatin serum Cmax value. Apoptosis was correlated with reduced stem cell factor (SCF)-mediated signal transduction, mitochondrial dysfunction, and caspase activation. Complementing these data, we found that p53 deficiency or Bcl-2 overexpression reduced fluvastatin-induced apoptosis. We also noted evidence of cytoprotective autophagy in primary mast cells treated with fluvastatin. Finally, we found that intraperitoneal fluvastatin treatment reduced peritoneal mast cell numbers in vivo. These findings offer insight into the mechanisms of mast cell survival and support the possible utility of statins in mast cell–associated allergic and neoplastic diseases. Fluvastatin, a statin drug used to lower cholesterol, induces apoptosis in primary and transformed mast cells by antagonizing protein isoprenylation, effectively inhibiting stem cell factor (SCF)-induced survival signals. This drug may be an effective means of suppressing mast cell survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32434944</pmid><doi>10.1124/jpet.119.264234</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7471-6779</orcidid><orcidid>https://orcid.org/0000-0002-7965-4335</orcidid><orcidid>https://orcid.org/0000-0003-4436-9558</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0022-3565
ispartof The Journal of pharmacology and experimental therapeutics, 2020-07, Vol.374 (1), p.104-112
issn 0022-3565
1521-0103
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7306917
source MEDLINE; Alma/SFX Local Collection
subjects Animals
Apoptosis - drug effects
Bone Marrow Cells - cytology
Cell Line
Cell Survival - drug effects
Fluvastatin - pharmacology
Humans
Inflammation, Immunopharmacology, and Asthma
Lipid Metabolism - drug effects
Mast Cells - cytology
Mast Cells - drug effects
Mast Cells - metabolism
Mice
title Fluvastatin Induces Apoptosis in Primary and Transformed Mast Cells
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T12%3A56%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-elsevier_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Fluvastatin%20Induces%20Apoptosis%20in%20Primary%20and%20Transformed%20Mast%20Cells&rft.jtitle=The%20Journal%20of%20pharmacology%20and%20experimental%20therapeutics&rft.au=Paez,%20Patrick%20A.&rft.date=2020-07&rft.volume=374&rft.issue=1&rft.spage=104&rft.epage=112&rft.pages=104-112&rft.issn=0022-3565&rft.eissn=1521-0103&rft_id=info:doi/10.1124/jpet.119.264234&rft_dat=%3Celsevier_pubme%3ES0022356524257967%3C/elsevier_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/32434944&rft_els_id=S0022356524257967&rfr_iscdi=true