Loading…

Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway

Asthma is a common respiratory disease characterized by chronic airway inflammation. Dexmedetomidine (DEX), a highly selective α2 adrenergic receptor agonist, has been shown to participate in regulating inflammatory states and thus exert organ protective actions. However, the potential of DEX in ast...

Full description

Saved in:
Bibliographic Details
Published in:Mediators of inflammation 2023-02, Vol.2023, p.3695469-11
Main Authors: Zhou, Ying, Du, Xiyu, Wang, Qianyu, Xiao, Shilin, Zhi, Juan, Gao, Huibin, Yang, Dong
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c581t-8affbcfba498b01fbdb90867c8e9380800e24e334eeb6e10fc589c1d16317ea73
cites cdi_FETCH-LOGICAL-c581t-8affbcfba498b01fbdb90867c8e9380800e24e334eeb6e10fc589c1d16317ea73
container_end_page 11
container_issue
container_start_page 3695469
container_title Mediators of inflammation
container_volume 2023
creator Zhou, Ying
Du, Xiyu
Wang, Qianyu
Xiao, Shilin
Zhi, Juan
Gao, Huibin
Yang, Dong
description Asthma is a common respiratory disease characterized by chronic airway inflammation. Dexmedetomidine (DEX), a highly selective α2 adrenergic receptor agonist, has been shown to participate in regulating inflammatory states and thus exert organ protective actions. However, the potential of DEX in asthma is still unknown. This study is aimed at investigating the role of DEX in a mouse model of house dust mite- (HDM-) induced asthma and exploring its underlying mechanism. Here, we found that DEX treatment significantly ameliorated airway hyperresponsiveness, airway inflammation, and airway remodeling in the asthmatic mice, which were similar to the efficacy of the reference anti-inflammatory drug dexamethasone. In addition, DEX reversed the increased expression of toll-like receptor 4 (TLR4) and its downstream signaling adaptor molecule nuclear factor-κB (NF-κB) in the lung tissue of asthmatic mice. Furthermore, these protective effects of DEX were abolished by yohimbine, an α2 adrenergic receptor antagonist. These results indicate that DEX is capable of ameliorating airway inflammation and remodeling in asthmatic mice, and this protective effect is associated with the inhibition of the TLR4/NF-κB signaling pathway.
doi_str_mv 10.1155/2023/3695469
format article
fullrecord <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_1f38f09172af4ece95b99d25c520ade4</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A738724097</galeid><doaj_id>oai_doaj_org_article_1f38f09172af4ece95b99d25c520ade4</doaj_id><sourcerecordid>A738724097</sourcerecordid><originalsourceid>FETCH-LOGICAL-c581t-8affbcfba498b01fbdb90867c8e9380800e24e334eeb6e10fc589c1d16317ea73</originalsourceid><addsrcrecordid>eNp9ksFu1DAURSMEomVgxxpZYoME6diJk9ibSsNAYaQpVKWsLcd5TjxK7OIklP4HX8NH8E04nWlhEEJeWH7vvmP76kbRU4KPCMmyeYKTdJ7mPKM5vxcdEprnMWE5uR8dYp4nMU8zchA96vsNxjijlD2MDtKc0Zzw7DD6_ga-dVDB4DpTGQvozLsB1NAjWUtj-wEtjL-S12hldSu7Tg7GWSRtdVs_h85V0BpbIxMa6HT0E-Z0KiKn0bLxzhqFFv3QdBIN4TjWDbpYn9P5h5P454_X6JOprbwhnMmhCdDH0QMt2x6e7PZZ9Pnk7cXyfbz--G61XKxjlTEyxExqXSpdSspZiYkuq5JjlheKAU8ZZhhDQiFNKUCZA8E6jHFFKpKnpABZpLNoteVWTm7EpTed9NfCSSNuCs7XQvrBqBYE0SnTmJMikZqCAp6VnFdJprIEywpoYB1vWZdjGQxVYAcv2z3ofseaRtTuq-Cc5gWdAC92AO--jNAPojO9graVFtzYi6RgmDJahNfPoud_STdu9MHDSVUEIMEp_62qZfiAsdqFe9UEFYsiZUVCMZ88OPqHKqwKOqOcBW1CfW_g1XZAedf3HvTdHwkWUyLFlEixS2SQP_vTlzvxbQSD4OVW0BhbySvzf9wvNFrpcQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2779941039</pqid></control><display><type>article</type><title>Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway</title><source>Wiley Online Library Open Access</source><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Zhou, Ying ; Du, Xiyu ; Wang, Qianyu ; Xiao, Shilin ; Zhi, Juan ; Gao, Huibin ; Yang, Dong</creator><contributor>Dalmarco, Eduardo ; Eduardo Dalmarco</contributor><creatorcontrib>Zhou, Ying ; Du, Xiyu ; Wang, Qianyu ; Xiao, Shilin ; Zhi, Juan ; Gao, Huibin ; Yang, Dong ; Dalmarco, Eduardo ; Eduardo Dalmarco</creatorcontrib><description>Asthma is a common respiratory disease characterized by chronic airway inflammation. Dexmedetomidine (DEX), a highly selective α2 adrenergic receptor agonist, has been shown to participate in regulating inflammatory states and thus exert organ protective actions. However, the potential of DEX in asthma is still unknown. This study is aimed at investigating the role of DEX in a mouse model of house dust mite- (HDM-) induced asthma and exploring its underlying mechanism. Here, we found that DEX treatment significantly ameliorated airway hyperresponsiveness, airway inflammation, and airway remodeling in the asthmatic mice, which were similar to the efficacy of the reference anti-inflammatory drug dexamethasone. In addition, DEX reversed the increased expression of toll-like receptor 4 (TLR4) and its downstream signaling adaptor molecule nuclear factor-κB (NF-κB) in the lung tissue of asthmatic mice. Furthermore, these protective effects of DEX were abolished by yohimbine, an α2 adrenergic receptor antagonist. These results indicate that DEX is capable of ameliorating airway inflammation and remodeling in asthmatic mice, and this protective effect is associated with the inhibition of the TLR4/NF-κB signaling pathway.</description><identifier>ISSN: 0962-9351</identifier><identifier>EISSN: 1466-1861</identifier><identifier>DOI: 10.1155/2023/3695469</identifier><identifier>PMID: 36846195</identifier><language>eng</language><publisher>United States: Hindawi</publisher><subject>Adaptor proteins ; Adrenergic receptors ; Animal models ; Anti-inflammatory agents ; Antibodies ; Asthma ; Dexamethasone ; Dexmedetomidine ; Inflammation ; Laboratory animals ; Lungs ; Medical research ; NF-κB protein ; Ostomy ; Proteins ; Respiratory diseases ; Respiratory tract ; Respiratory tract diseases ; Scientific equipment and supplies industry ; Signal transduction ; Steroids ; TLR4 protein ; Toll-like receptors ; Yohimbine</subject><ispartof>Mediators of inflammation, 2023-02, Vol.2023, p.3695469-11</ispartof><rights>Copyright © 2023 Ying Zhou et al.</rights><rights>COPYRIGHT 2023 John Wiley &amp; Sons, Inc.</rights><rights>Copyright © 2023 Ying Zhou et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2023 Ying Zhou et al. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c581t-8affbcfba498b01fbdb90867c8e9380800e24e334eeb6e10fc589c1d16317ea73</citedby><cites>FETCH-LOGICAL-c581t-8affbcfba498b01fbdb90867c8e9380800e24e334eeb6e10fc589c1d16317ea73</cites><orcidid>0000-0001-6526-4005</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2779941039/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2779941039?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,25734,27905,27906,36993,36994,44571,53772,53774,74875</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36846195$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Dalmarco, Eduardo</contributor><contributor>Eduardo Dalmarco</contributor><creatorcontrib>Zhou, Ying</creatorcontrib><creatorcontrib>Du, Xiyu</creatorcontrib><creatorcontrib>Wang, Qianyu</creatorcontrib><creatorcontrib>Xiao, Shilin</creatorcontrib><creatorcontrib>Zhi, Juan</creatorcontrib><creatorcontrib>Gao, Huibin</creatorcontrib><creatorcontrib>Yang, Dong</creatorcontrib><title>Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway</title><title>Mediators of inflammation</title><addtitle>Mediators Inflamm</addtitle><description>Asthma is a common respiratory disease characterized by chronic airway inflammation. Dexmedetomidine (DEX), a highly selective α2 adrenergic receptor agonist, has been shown to participate in regulating inflammatory states and thus exert organ protective actions. However, the potential of DEX in asthma is still unknown. This study is aimed at investigating the role of DEX in a mouse model of house dust mite- (HDM-) induced asthma and exploring its underlying mechanism. Here, we found that DEX treatment significantly ameliorated airway hyperresponsiveness, airway inflammation, and airway remodeling in the asthmatic mice, which were similar to the efficacy of the reference anti-inflammatory drug dexamethasone. In addition, DEX reversed the increased expression of toll-like receptor 4 (TLR4) and its downstream signaling adaptor molecule nuclear factor-κB (NF-κB) in the lung tissue of asthmatic mice. Furthermore, these protective effects of DEX were abolished by yohimbine, an α2 adrenergic receptor antagonist. These results indicate that DEX is capable of ameliorating airway inflammation and remodeling in asthmatic mice, and this protective effect is associated with the inhibition of the TLR4/NF-κB signaling pathway.</description><subject>Adaptor proteins</subject><subject>Adrenergic receptors</subject><subject>Animal models</subject><subject>Anti-inflammatory agents</subject><subject>Antibodies</subject><subject>Asthma</subject><subject>Dexamethasone</subject><subject>Dexmedetomidine</subject><subject>Inflammation</subject><subject>Laboratory animals</subject><subject>Lungs</subject><subject>Medical research</subject><subject>NF-κB protein</subject><subject>Ostomy</subject><subject>Proteins</subject><subject>Respiratory diseases</subject><subject>Respiratory tract</subject><subject>Respiratory tract diseases</subject><subject>Scientific equipment and supplies industry</subject><subject>Signal transduction</subject><subject>Steroids</subject><subject>TLR4 protein</subject><subject>Toll-like receptors</subject><subject>Yohimbine</subject><issn>0962-9351</issn><issn>1466-1861</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9ksFu1DAURSMEomVgxxpZYoME6diJk9ibSsNAYaQpVKWsLcd5TjxK7OIklP4HX8NH8E04nWlhEEJeWH7vvmP76kbRU4KPCMmyeYKTdJ7mPKM5vxcdEprnMWE5uR8dYp4nMU8zchA96vsNxjijlD2MDtKc0Zzw7DD6_ga-dVDB4DpTGQvozLsB1NAjWUtj-wEtjL-S12hldSu7Tg7GWSRtdVs_h85V0BpbIxMa6HT0E-Z0KiKn0bLxzhqFFv3QdBIN4TjWDbpYn9P5h5P454_X6JOprbwhnMmhCdDH0QMt2x6e7PZZ9Pnk7cXyfbz--G61XKxjlTEyxExqXSpdSspZiYkuq5JjlheKAU8ZZhhDQiFNKUCZA8E6jHFFKpKnpABZpLNoteVWTm7EpTed9NfCSSNuCs7XQvrBqBYE0SnTmJMikZqCAp6VnFdJprIEywpoYB1vWZdjGQxVYAcv2z3ofseaRtTuq-Cc5gWdAC92AO--jNAPojO9graVFtzYi6RgmDJahNfPoud_STdu9MHDSVUEIMEp_62qZfiAsdqFe9UEFYsiZUVCMZ88OPqHKqwKOqOcBW1CfW_g1XZAedf3HvTdHwkWUyLFlEixS2SQP_vTlzvxbQSD4OVW0BhbySvzf9wvNFrpcQ</recordid><startdate>20230215</startdate><enddate>20230215</enddate><creator>Zhou, Ying</creator><creator>Du, Xiyu</creator><creator>Wang, Qianyu</creator><creator>Xiao, Shilin</creator><creator>Zhi, Juan</creator><creator>Gao, Huibin</creator><creator>Yang, Dong</creator><general>Hindawi</general><general>John Wiley &amp; Sons, Inc</general><general>Hindawi Limited</general><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6526-4005</orcidid></search><sort><creationdate>20230215</creationdate><title>Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway</title><author>Zhou, Ying ; Du, Xiyu ; Wang, Qianyu ; Xiao, Shilin ; Zhi, Juan ; Gao, Huibin ; Yang, Dong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c581t-8affbcfba498b01fbdb90867c8e9380800e24e334eeb6e10fc589c1d16317ea73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adaptor proteins</topic><topic>Adrenergic receptors</topic><topic>Animal models</topic><topic>Anti-inflammatory agents</topic><topic>Antibodies</topic><topic>Asthma</topic><topic>Dexamethasone</topic><topic>Dexmedetomidine</topic><topic>Inflammation</topic><topic>Laboratory animals</topic><topic>Lungs</topic><topic>Medical research</topic><topic>NF-κB protein</topic><topic>Ostomy</topic><topic>Proteins</topic><topic>Respiratory diseases</topic><topic>Respiratory tract</topic><topic>Respiratory tract diseases</topic><topic>Scientific equipment and supplies industry</topic><topic>Signal transduction</topic><topic>Steroids</topic><topic>TLR4 protein</topic><topic>Toll-like receptors</topic><topic>Yohimbine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Ying</creatorcontrib><creatorcontrib>Du, Xiyu</creatorcontrib><creatorcontrib>Wang, Qianyu</creatorcontrib><creatorcontrib>Xiao, Shilin</creatorcontrib><creatorcontrib>Zhi, Juan</creatorcontrib><creatorcontrib>Gao, Huibin</creatorcontrib><creatorcontrib>Yang, Dong</creatorcontrib><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</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>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest research library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Mediators of inflammation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Ying</au><au>Du, Xiyu</au><au>Wang, Qianyu</au><au>Xiao, Shilin</au><au>Zhi, Juan</au><au>Gao, Huibin</au><au>Yang, Dong</au><au>Dalmarco, Eduardo</au><au>Eduardo Dalmarco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway</atitle><jtitle>Mediators of inflammation</jtitle><addtitle>Mediators Inflamm</addtitle><date>2023-02-15</date><risdate>2023</risdate><volume>2023</volume><spage>3695469</spage><epage>11</epage><pages>3695469-11</pages><issn>0962-9351</issn><eissn>1466-1861</eissn><abstract>Asthma is a common respiratory disease characterized by chronic airway inflammation. Dexmedetomidine (DEX), a highly selective α2 adrenergic receptor agonist, has been shown to participate in regulating inflammatory states and thus exert organ protective actions. However, the potential of DEX in asthma is still unknown. This study is aimed at investigating the role of DEX in a mouse model of house dust mite- (HDM-) induced asthma and exploring its underlying mechanism. Here, we found that DEX treatment significantly ameliorated airway hyperresponsiveness, airway inflammation, and airway remodeling in the asthmatic mice, which were similar to the efficacy of the reference anti-inflammatory drug dexamethasone. In addition, DEX reversed the increased expression of toll-like receptor 4 (TLR4) and its downstream signaling adaptor molecule nuclear factor-κB (NF-κB) in the lung tissue of asthmatic mice. Furthermore, these protective effects of DEX were abolished by yohimbine, an α2 adrenergic receptor antagonist. These results indicate that DEX is capable of ameliorating airway inflammation and remodeling in asthmatic mice, and this protective effect is associated with the inhibition of the TLR4/NF-κB signaling pathway.</abstract><cop>United States</cop><pub>Hindawi</pub><pmid>36846195</pmid><doi>10.1155/2023/3695469</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6526-4005</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0962-9351
ispartof Mediators of inflammation, 2023-02, Vol.2023, p.3695469-11
issn 0962-9351
1466-1861
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_1f38f09172af4ece95b99d25c520ade4
source Wiley Online Library Open Access; Publicly Available Content Database; PubMed Central
subjects Adaptor proteins
Adrenergic receptors
Animal models
Anti-inflammatory agents
Antibodies
Asthma
Dexamethasone
Dexmedetomidine
Inflammation
Laboratory animals
Lungs
Medical research
NF-κB protein
Ostomy
Proteins
Respiratory diseases
Respiratory tract
Respiratory tract diseases
Scientific equipment and supplies industry
Signal transduction
Steroids
TLR4 protein
Toll-like receptors
Yohimbine
title Dexmedetomidine Protects against Airway Inflammation and Airway Remodeling in a Murine Model of Chronic Asthma through TLR4/NF-κB Signaling Pathway
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T11%3A32%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Dexmedetomidine%20Protects%20against%20Airway%20Inflammation%20and%20Airway%20Remodeling%20in%20a%20Murine%20Model%20of%20Chronic%20Asthma%20through%20TLR4/NF-%CE%BAB%20Signaling%20Pathway&rft.jtitle=Mediators%20of%20inflammation&rft.au=Zhou,%20Ying&rft.date=2023-02-15&rft.volume=2023&rft.spage=3695469&rft.epage=11&rft.pages=3695469-11&rft.issn=0962-9351&rft.eissn=1466-1861&rft_id=info:doi/10.1155/2023/3695469&rft_dat=%3Cgale_doaj_%3EA738724097%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c581t-8affbcfba498b01fbdb90867c8e9380800e24e334eeb6e10fc589c1d16317ea73%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2779941039&rft_id=info:pmid/36846195&rft_galeid=A738724097&rfr_iscdi=true