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PD-L1 blockade TAM-dependently potentiates mild photothermal therapy against triple-negative breast cancer
The present work was an endeavor to shed light on how mild photothermia possibly synergizes with immune checkpoint inhibition for tumor therapy. We established mild photothermal heating protocols to generate temperatures of 43 °C and 45 °C in both in vitro and in vivo mouse 4T1 triple-negative breas...
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Published in: | Journal of nanobiotechnology 2023-12, Vol.21 (1), p.476-476, Article 476 |
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description | The present work was an endeavor to shed light on how mild photothermia possibly synergizes with immune checkpoint inhibition for tumor therapy. We established mild photothermal heating protocols to generate temperatures of 43 °C and 45 °C in both in vitro and in vivo mouse 4T1 triple-negative breast cancer (TNBC) models using polyglycerol-coated carbon nanohorns (CNH-PG) and 808 nm laser irradiation. Next, we found that 1) CNH-PG-mediated mild photothermia (CNH-PG-mPT) significantly increased expression of the immune checkpoint PD-L1 and type-1 macrophage (M1) markers in the TNBC tumors; 2) CNH-PG-mPT had a lower level of anti-tumor efficacy which was markedly potentiated by BMS-1, a PD-L1 blocker. These observations prompted us to explore the synergetic mechanisms of CNH-PG-mPT and BMS-1 in the context of tumor cell-macrophage interactions mediated by PD-L1 since tumor-associated macrophages (TAMs) are a major source of PD-L1 expression in tumors. In vitro, the study then identified two dimensions where BMS-1 potentiated CNH-PG-mPT. First, CNH-PG-mPT induced PD-L1 upregulation in the tumor cells and showed a low level of cytotoxicity which was potentiated by BMS-1. Second, CNH-PG-mPT skewed TAMs towards an M1-like anti-tumor phenotype with upregulated PD-L1, and BMS-1 bolstered the M1-like phenotype. The synergistic effects of BMS-1 and CNH-PG-mPT both on the tumor cells and TAMs were more pronounced when the two cell populations were in co-culture. Further in vivo study confirmed PD-L1 upregulation both in tumor cells and TAMs in the TNBC tumors following treatment of CNH-PG-mPT. Significantly, TAMs depletion largely abolished the anti-TNBC efficacy of CNH-PG-mPT alone and in synergy with BMS-1. Collectively, our findings reveal PD-L1 upregulation to be a key response of TNBC to mild photothermal stress, which plays a pro-survival role in the tumor cells while also acting as a brake on the M1-like activation of the TAMs. Blockade of mPT‑induced PD‑L1 achieves synergistic anti-TNBC efficacy by taking the intrinsic survival edge off the tumor cells on one hand and taking the brakes off the M1-like TAMs on the other. Our findings reveal a novel way (i.e. mild thermia plus PD-L1 blockade) to modulate the TAMs-tumor cell interaction to instigate a mutiny of the TAMs against their host tumor cells. |
doi_str_mv | 10.1186/s12951-023-02240-3 |
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We established mild photothermal heating protocols to generate temperatures of 43 °C and 45 °C in both in vitro and in vivo mouse 4T1 triple-negative breast cancer (TNBC) models using polyglycerol-coated carbon nanohorns (CNH-PG) and 808 nm laser irradiation. Next, we found that 1) CNH-PG-mediated mild photothermia (CNH-PG-mPT) significantly increased expression of the immune checkpoint PD-L1 and type-1 macrophage (M1) markers in the TNBC tumors; 2) CNH-PG-mPT had a lower level of anti-tumor efficacy which was markedly potentiated by BMS-1, a PD-L1 blocker. These observations prompted us to explore the synergetic mechanisms of CNH-PG-mPT and BMS-1 in the context of tumor cell-macrophage interactions mediated by PD-L1 since tumor-associated macrophages (TAMs) are a major source of PD-L1 expression in tumors. In vitro, the study then identified two dimensions where BMS-1 potentiated CNH-PG-mPT. First, CNH-PG-mPT induced PD-L1 upregulation in the tumor cells and showed a low level of cytotoxicity which was potentiated by BMS-1. Second, CNH-PG-mPT skewed TAMs towards an M1-like anti-tumor phenotype with upregulated PD-L1, and BMS-1 bolstered the M1-like phenotype. The synergistic effects of BMS-1 and CNH-PG-mPT both on the tumor cells and TAMs were more pronounced when the two cell populations were in co-culture. Further in vivo study confirmed PD-L1 upregulation both in tumor cells and TAMs in the TNBC tumors following treatment of CNH-PG-mPT. Significantly, TAMs depletion largely abolished the anti-TNBC efficacy of CNH-PG-mPT alone and in synergy with BMS-1. Collectively, our findings reveal PD-L1 upregulation to be a key response of TNBC to mild photothermal stress, which plays a pro-survival role in the tumor cells while also acting as a brake on the M1-like activation of the TAMs. Blockade of mPT‑induced PD‑L1 achieves synergistic anti-TNBC efficacy by taking the intrinsic survival edge off the tumor cells on one hand and taking the brakes off the M1-like TAMs on the other. Our findings reveal a novel way (i.e. mild thermia plus PD-L1 blockade) to modulate the TAMs-tumor cell interaction to instigate a mutiny of the TAMs against their host tumor cells.</description><identifier>ISSN: 1477-3155</identifier><identifier>EISSN: 1477-3155</identifier><identifier>DOI: 10.1186/s12951-023-02240-3</identifier><identifier>PMID: 38082443</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Ablation ; Animals ; Anticancer properties ; B7-H1 Antigen - metabolism ; Biocompatibility ; Breast cancer ; Cancer therapies ; Cell culture ; Cell Line, Tumor ; Cells ; Chemotherapy ; Cytokines ; Cytotoxicity ; Effectiveness ; Genotype & phenotype ; Health aspects ; Humans ; Immune checkpoint inhibition ; Immune checkpoint inhibitors ; In vivo methods and tests ; Irradiation ; Laser radiation ; Lasers ; Low level ; Lymphoma ; Macrophages ; Macrophages - metabolism ; Mice ; Mild photothermia ; Monoclonal antibodies ; PD-L1 ; PD-L1 protein ; Phenotype ; Phenotypes ; Phototherapy ; Photothermal Therapy ; Polyglycerols ; Radiation therapy ; Survival ; Synergistic effect ; Temperature ; Testing ; Thermotherapy ; Triple Negative Breast Neoplasms - drug therapy ; Triple-negative breast cancer ; Tumor cells ; Tumor-associated macrophages ; Tumors ; Up-regulation</subject><ispartof>Journal of nanobiotechnology, 2023-12, Vol.21 (1), p.476-476, Article 476</ispartof><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><rights>2023. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c598t-81fea99e27f5aaae88ba4a9a4ce292c9d72b2cf2bd530b718394cedae004f73f3</citedby><cites>FETCH-LOGICAL-c598t-81fea99e27f5aaae88ba4a9a4ce292c9d72b2cf2bd530b718394cedae004f73f3</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/PMC10712197/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2902132210?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25751,27922,27923,37010,37011,44588,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38082443$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Chao</creatorcontrib><creatorcontrib>Xu, Yong-Hong</creatorcontrib><creatorcontrib>Xu, Hua-Zhen</creatorcontrib><creatorcontrib>Li, Ke</creatorcontrib><creatorcontrib>Zhang, Quan</creatorcontrib><creatorcontrib>Shi, Lin</creatorcontrib><creatorcontrib>Zhao, Li</creatorcontrib><creatorcontrib>Chen, Xiao</creatorcontrib><title>PD-L1 blockade TAM-dependently potentiates mild photothermal therapy against triple-negative breast cancer</title><title>Journal of nanobiotechnology</title><addtitle>J Nanobiotechnology</addtitle><description>The present work was an endeavor to shed light on how mild photothermia possibly synergizes with immune checkpoint inhibition for tumor therapy. We established mild photothermal heating protocols to generate temperatures of 43 °C and 45 °C in both in vitro and in vivo mouse 4T1 triple-negative breast cancer (TNBC) models using polyglycerol-coated carbon nanohorns (CNH-PG) and 808 nm laser irradiation. Next, we found that 1) CNH-PG-mediated mild photothermia (CNH-PG-mPT) significantly increased expression of the immune checkpoint PD-L1 and type-1 macrophage (M1) markers in the TNBC tumors; 2) CNH-PG-mPT had a lower level of anti-tumor efficacy which was markedly potentiated by BMS-1, a PD-L1 blocker. These observations prompted us to explore the synergetic mechanisms of CNH-PG-mPT and BMS-1 in the context of tumor cell-macrophage interactions mediated by PD-L1 since tumor-associated macrophages (TAMs) are a major source of PD-L1 expression in tumors. In vitro, the study then identified two dimensions where BMS-1 potentiated CNH-PG-mPT. First, CNH-PG-mPT induced PD-L1 upregulation in the tumor cells and showed a low level of cytotoxicity which was potentiated by BMS-1. Second, CNH-PG-mPT skewed TAMs towards an M1-like anti-tumor phenotype with upregulated PD-L1, and BMS-1 bolstered the M1-like phenotype. The synergistic effects of BMS-1 and CNH-PG-mPT both on the tumor cells and TAMs were more pronounced when the two cell populations were in co-culture. Further in vivo study confirmed PD-L1 upregulation both in tumor cells and TAMs in the TNBC tumors following treatment of CNH-PG-mPT. Significantly, TAMs depletion largely abolished the anti-TNBC efficacy of CNH-PG-mPT alone and in synergy with BMS-1. Collectively, our findings reveal PD-L1 upregulation to be a key response of TNBC to mild photothermal stress, which plays a pro-survival role in the tumor cells while also acting as a brake on the M1-like activation of the TAMs. Blockade of mPT‑induced PD‑L1 achieves synergistic anti-TNBC efficacy by taking the intrinsic survival edge off the tumor cells on one hand and taking the brakes off the M1-like TAMs on the other. Our findings reveal a novel way (i.e. mild thermia plus PD-L1 blockade) to modulate the TAMs-tumor cell interaction to instigate a mutiny of the TAMs against their host tumor cells.</description><subject>Ablation</subject><subject>Animals</subject><subject>Anticancer properties</subject><subject>B7-H1 Antigen - metabolism</subject><subject>Biocompatibility</subject><subject>Breast cancer</subject><subject>Cancer therapies</subject><subject>Cell culture</subject><subject>Cell Line, Tumor</subject><subject>Cells</subject><subject>Chemotherapy</subject><subject>Cytokines</subject><subject>Cytotoxicity</subject><subject>Effectiveness</subject><subject>Genotype & phenotype</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immune checkpoint inhibition</subject><subject>Immune checkpoint inhibitors</subject><subject>In vivo methods and tests</subject><subject>Irradiation</subject><subject>Laser radiation</subject><subject>Lasers</subject><subject>Low level</subject><subject>Lymphoma</subject><subject>Macrophages</subject><subject>Macrophages - metabolism</subject><subject>Mice</subject><subject>Mild photothermia</subject><subject>Monoclonal antibodies</subject><subject>PD-L1</subject><subject>PD-L1 protein</subject><subject>Phenotype</subject><subject>Phenotypes</subject><subject>Phototherapy</subject><subject>Photothermal Therapy</subject><subject>Polyglycerols</subject><subject>Radiation therapy</subject><subject>Survival</subject><subject>Synergistic effect</subject><subject>Temperature</subject><subject>Testing</subject><subject>Thermotherapy</subject><subject>Triple Negative Breast Neoplasms - drug therapy</subject><subject>Triple-negative breast cancer</subject><subject>Tumor cells</subject><subject>Tumor-associated macrophages</subject><subject>Tumors</subject><subject>Up-regulation</subject><issn>1477-3155</issn><issn>1477-3155</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkltv1DAQhSMEoqXwB3hAkXiBhxTfcvETWpXbSotAUJ6tiTNOvSRxansr9t_j3S2li5BleTT-5lg-Oln2nJJzSpvqTaBMlrQgjKfNBCn4g-yUirouOC3Lh_fqk-xJCGuyo5h4nJ3whjRMCH6arb--K1Y0bwenf0KH-eXic9HhjFOHUxy2-exiKixEDPlohy6fr1x08Qr9CEO-O2He5tCDnULMo7fzgMWEPUR7g3nrEVJbw6TRP80eGRgCPrs9z7IfH95fXnwqVl8-Li8Wq0KXsolFQw2ClMhqUwIANk0LAiQIjUwyLbuatUwb1nYlJ21NGy7TVQdIiDA1N_wsWx50OwdrNXs7gt8qB1btG873Cny0ekDVlQZlC4TXphEt1SAaTg00yCtjTMWT1tuD1rxpR-x08sLDcCR6fDPZK9W7G0VJTRmVdVJ4davg3fUGQ1SjDRqHASZ0m6CYJEyKWlZlQl_-g67dxk_Jqz1FOWOU_KV6SD-wk3HpYb0TVYu6roioZCUSdf4fKq0OR6vdhMam_tHA66OBxET8FXvYhKCW378ds-zAau9C8GjuDKFE7aKpDtFUKZpqH021s_LFfSvvRv5kkf8GO9jfEQ</recordid><startdate>20231211</startdate><enddate>20231211</enddate><creator>Wang, Chao</creator><creator>Xu, Yong-Hong</creator><creator>Xu, Hua-Zhen</creator><creator>Li, Ke</creator><creator>Zhang, Quan</creator><creator>Shi, Lin</creator><creator>Zhao, Li</creator><creator>Chen, Xiao</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</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>7QO</scope><scope>7TB</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>P64</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20231211</creationdate><title>PD-L1 blockade TAM-dependently potentiates mild photothermal therapy against triple-negative breast cancer</title><author>Wang, Chao ; Xu, Yong-Hong ; Xu, Hua-Zhen ; Li, Ke ; Zhang, Quan ; Shi, Lin ; Zhao, Li ; Chen, Xiao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c598t-81fea99e27f5aaae88ba4a9a4ce292c9d72b2cf2bd530b718394cedae004f73f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ablation</topic><topic>Animals</topic><topic>Anticancer properties</topic><topic>B7-H1 Antigen - metabolism</topic><topic>Biocompatibility</topic><topic>Breast cancer</topic><topic>Cancer therapies</topic><topic>Cell culture</topic><topic>Cell Line, Tumor</topic><topic>Cells</topic><topic>Chemotherapy</topic><topic>Cytokines</topic><topic>Cytotoxicity</topic><topic>Effectiveness</topic><topic>Genotype & phenotype</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immune checkpoint inhibition</topic><topic>Immune checkpoint inhibitors</topic><topic>In vivo methods and tests</topic><topic>Irradiation</topic><topic>Laser radiation</topic><topic>Lasers</topic><topic>Low level</topic><topic>Lymphoma</topic><topic>Macrophages</topic><topic>Macrophages - metabolism</topic><topic>Mice</topic><topic>Mild photothermia</topic><topic>Monoclonal antibodies</topic><topic>PD-L1</topic><topic>PD-L1 protein</topic><topic>Phenotype</topic><topic>Phenotypes</topic><topic>Phototherapy</topic><topic>Photothermal Therapy</topic><topic>Polyglycerols</topic><topic>Radiation therapy</topic><topic>Survival</topic><topic>Synergistic effect</topic><topic>Temperature</topic><topic>Testing</topic><topic>Thermotherapy</topic><topic>Triple Negative Breast Neoplasms - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of nanobiotechnology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Chao</au><au>Xu, Yong-Hong</au><au>Xu, Hua-Zhen</au><au>Li, Ke</au><au>Zhang, Quan</au><au>Shi, Lin</au><au>Zhao, Li</au><au>Chen, Xiao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>PD-L1 blockade TAM-dependently potentiates mild photothermal therapy against triple-negative breast cancer</atitle><jtitle>Journal of nanobiotechnology</jtitle><addtitle>J Nanobiotechnology</addtitle><date>2023-12-11</date><risdate>2023</risdate><volume>21</volume><issue>1</issue><spage>476</spage><epage>476</epage><pages>476-476</pages><artnum>476</artnum><issn>1477-3155</issn><eissn>1477-3155</eissn><abstract>The present work was an endeavor to shed light on how mild photothermia possibly synergizes with immune checkpoint inhibition for tumor therapy. We established mild photothermal heating protocols to generate temperatures of 43 °C and 45 °C in both in vitro and in vivo mouse 4T1 triple-negative breast cancer (TNBC) models using polyglycerol-coated carbon nanohorns (CNH-PG) and 808 nm laser irradiation. Next, we found that 1) CNH-PG-mediated mild photothermia (CNH-PG-mPT) significantly increased expression of the immune checkpoint PD-L1 and type-1 macrophage (M1) markers in the TNBC tumors; 2) CNH-PG-mPT had a lower level of anti-tumor efficacy which was markedly potentiated by BMS-1, a PD-L1 blocker. These observations prompted us to explore the synergetic mechanisms of CNH-PG-mPT and BMS-1 in the context of tumor cell-macrophage interactions mediated by PD-L1 since tumor-associated macrophages (TAMs) are a major source of PD-L1 expression in tumors. In vitro, the study then identified two dimensions where BMS-1 potentiated CNH-PG-mPT. First, CNH-PG-mPT induced PD-L1 upregulation in the tumor cells and showed a low level of cytotoxicity which was potentiated by BMS-1. Second, CNH-PG-mPT skewed TAMs towards an M1-like anti-tumor phenotype with upregulated PD-L1, and BMS-1 bolstered the M1-like phenotype. The synergistic effects of BMS-1 and CNH-PG-mPT both on the tumor cells and TAMs were more pronounced when the two cell populations were in co-culture. Further in vivo study confirmed PD-L1 upregulation both in tumor cells and TAMs in the TNBC tumors following treatment of CNH-PG-mPT. Significantly, TAMs depletion largely abolished the anti-TNBC efficacy of CNH-PG-mPT alone and in synergy with BMS-1. Collectively, our findings reveal PD-L1 upregulation to be a key response of TNBC to mild photothermal stress, which plays a pro-survival role in the tumor cells while also acting as a brake on the M1-like activation of the TAMs. Blockade of mPT‑induced PD‑L1 achieves synergistic anti-TNBC efficacy by taking the intrinsic survival edge off the tumor cells on one hand and taking the brakes off the M1-like TAMs on the other. Our findings reveal a novel way (i.e. mild thermia plus PD-L1 blockade) to modulate the TAMs-tumor cell interaction to instigate a mutiny of the TAMs against their host tumor cells.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>38082443</pmid><doi>10.1186/s12951-023-02240-3</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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recordid | cdi_doaj_primary_oai_doaj_org_article_d5fe9ba037f84b1ca4831fa8e36fff63 |
source | Publicly Available Content Database; PubMed Central |
subjects | Ablation Animals Anticancer properties B7-H1 Antigen - metabolism Biocompatibility Breast cancer Cancer therapies Cell culture Cell Line, Tumor Cells Chemotherapy Cytokines Cytotoxicity Effectiveness Genotype & phenotype Health aspects Humans Immune checkpoint inhibition Immune checkpoint inhibitors In vivo methods and tests Irradiation Laser radiation Lasers Low level Lymphoma Macrophages Macrophages - metabolism Mice Mild photothermia Monoclonal antibodies PD-L1 PD-L1 protein Phenotype Phenotypes Phototherapy Photothermal Therapy Polyglycerols Radiation therapy Survival Synergistic effect Temperature Testing Thermotherapy Triple Negative Breast Neoplasms - drug therapy Triple-negative breast cancer Tumor cells Tumor-associated macrophages Tumors Up-regulation |
title | PD-L1 blockade TAM-dependently potentiates mild photothermal therapy against triple-negative breast cancer |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T10%3A28%3A17IST&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=PD-L1%20blockade%20TAM-dependently%20potentiates%20mild%20photothermal%20therapy%20against%20triple-negative%20breast%20cancer&rft.jtitle=Journal%20of%20nanobiotechnology&rft.au=Wang,%20Chao&rft.date=2023-12-11&rft.volume=21&rft.issue=1&rft.spage=476&rft.epage=476&rft.pages=476-476&rft.artnum=476&rft.issn=1477-3155&rft.eissn=1477-3155&rft_id=info:doi/10.1186/s12951-023-02240-3&rft_dat=%3Cgale_doaj_%3EA776046964%3C/gale_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c598t-81fea99e27f5aaae88ba4a9a4ce292c9d72b2cf2bd530b718394cedae004f73f3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2902132210&rft_id=info:pmid/38082443&rft_galeid=A776046964&rfr_iscdi=true |