Loading…

Depigmenting action of platycodin D depends on the cAMP/Rho-dependent signalling pathway

:  The overproduction and accumulation of melanin in the skin could lead to a pigmentary disorders, such as melasma, freckle, postinflammatory melanoderma and solar lentigo. Therefore, this study was conducted to investigate the effects of platycodin D (PD) on melanogenesis and its action mechanisms...

Full description

Saved in:
Bibliographic Details
Published in:Experimental dermatology 2011-12, Vol.20 (12), p.986-991
Main Authors: Jung, Eunsun, Hwang, Wangtaek, Kim, Seungbeom, Kim, Young-Soo, Kim, Yeong-Shik, Lee, Jongsung, Park, Deokhoon
Format: Article
Language:English
Subjects:
Citations: 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-c3879-4b08deb333e329fc332c86909f016004e7f6a7596363c9e426ab1991eb72b25f3
cites
container_end_page 991
container_issue 12
container_start_page 986
container_title Experimental dermatology
container_volume 20
creator Jung, Eunsun
Hwang, Wangtaek
Kim, Seungbeom
Kim, Young-Soo
Kim, Yeong-Shik
Lee, Jongsung
Park, Deokhoon
description :  The overproduction and accumulation of melanin in the skin could lead to a pigmentary disorders, such as melasma, freckle, postinflammatory melanoderma and solar lentigo. Therefore, this study was conducted to investigate the effects of platycodin D (PD) on melanogenesis and its action mechanisms. In this study, we found that PD significantly inhibited melanin synthesis at low concentrations. These effects were further demonstrated by the PD‐induced inhibition of cAMP production, phosphorylation of the cAMP‐response element‐binding protein and expression of microphthalmia‐associated transcription factor and its downstream genes, tyrosinase, tyrosinase‐related proteins‐1 and Dct/tyrosinase‐related proteins‐2, suggesting that PD inhibits melanogenesis through the downregulation of cAMP signalling. Furthermore, PD induced significant morphological changes in melanocytes, namely, the retraction of dendrites. A small GTPase assays revealed that PD stimulated an increase in GTP‐bound Rho content, one of downstream molecules of cAMP, but not in Rac or CDC42 content. Moreover, a Rho inhibitor (C3 exoenzyme) and a Rho kinase inhibitor (Y27632) attenuated the dendrite retraction induced by PD. Taken together, these findings indicate that PD inhibits melanogenesis by inhibiting the cAMP‐protein kinase A pathway and also suppresses melanocyte dendricity through activation of the Rho signal that is mediated by PD‐induced reduction in cAMP production. Therefore, these results suggest that PD exerts its inhibitory effects on melanogenesis and melanocyte dendricity via suppression of cAMP signalling and may be introduced as an inhibitor of hyperpigmentation caused by UV irradiation or pigmented skin disorders.
doi_str_mv 10.1111/j.1600-0625.2011.01379.x
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_905677627</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>905677627</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3879-4b08deb333e329fc332c86909f016004e7f6a7596363c9e426ab1991eb72b25f3</originalsourceid><addsrcrecordid>eNpFkV1P2zAUhq0JNArsL0y-mXaV4I_Yji92gVq-pALTxDTuLMc5ad2lSYhT0f57ElKKb47k93mPj8-LEKYkpv25WMVUEhIRyUTMCKUxoVzpePsFTQ7CEZoQTWQkFREn6DSEFSFUcSW-ohNGtRa9Y4KeZ9D4xRqqzlcLbF3n6wrXBW5K2-1cnfsKz3AODVR5wL3ULQG7y_vfF3-WdTTe914c_KKyZTn0aGy3fLW7c3Rc2DLAt309Q3-vr56mt9H88eZuejmPHE-VjpKMpDlknHPgTBeOc-ZSqYkuyPCTBFQhrRJacsmdhoRJm_XDU8gUy5go-Bn6OfZt2vplA6Ezax8clKWtoN4Eo4mQSkmmevL7ntxka8hN0_q1bXfmYxk98GMP2OBsWbS2cj58coIlQrC0536N3KsvYXfQKTFDOGZlhsnNkIEZwjHv4ZituXqe0fGdaPT70MH24LftfyOHgMy_hxszTZOEzq-Vuedv0piPpg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>905677627</pqid></control><display><type>article</type><title>Depigmenting action of platycodin D depends on the cAMP/Rho-dependent signalling pathway</title><source>Wiley-Blackwell Read &amp; Publish Collection</source><creator>Jung, Eunsun ; Hwang, Wangtaek ; Kim, Seungbeom ; Kim, Young-Soo ; Kim, Yeong-Shik ; Lee, Jongsung ; Park, Deokhoon</creator><creatorcontrib>Jung, Eunsun ; Hwang, Wangtaek ; Kim, Seungbeom ; Kim, Young-Soo ; Kim, Yeong-Shik ; Lee, Jongsung ; Park, Deokhoon</creatorcontrib><description>:  The overproduction and accumulation of melanin in the skin could lead to a pigmentary disorders, such as melasma, freckle, postinflammatory melanoderma and solar lentigo. Therefore, this study was conducted to investigate the effects of platycodin D (PD) on melanogenesis and its action mechanisms. In this study, we found that PD significantly inhibited melanin synthesis at low concentrations. These effects were further demonstrated by the PD‐induced inhibition of cAMP production, phosphorylation of the cAMP‐response element‐binding protein and expression of microphthalmia‐associated transcription factor and its downstream genes, tyrosinase, tyrosinase‐related proteins‐1 and Dct/tyrosinase‐related proteins‐2, suggesting that PD inhibits melanogenesis through the downregulation of cAMP signalling. Furthermore, PD induced significant morphological changes in melanocytes, namely, the retraction of dendrites. A small GTPase assays revealed that PD stimulated an increase in GTP‐bound Rho content, one of downstream molecules of cAMP, but not in Rac or CDC42 content. Moreover, a Rho inhibitor (C3 exoenzyme) and a Rho kinase inhibitor (Y27632) attenuated the dendrite retraction induced by PD. Taken together, these findings indicate that PD inhibits melanogenesis by inhibiting the cAMP‐protein kinase A pathway and also suppresses melanocyte dendricity through activation of the Rho signal that is mediated by PD‐induced reduction in cAMP production. Therefore, these results suggest that PD exerts its inhibitory effects on melanogenesis and melanocyte dendricity via suppression of cAMP signalling and may be introduced as an inhibitor of hyperpigmentation caused by UV irradiation or pigmented skin disorders.</description><identifier>ISSN: 0906-6705</identifier><identifier>EISSN: 1600-0625</identifier><identifier>DOI: 10.1111/j.1600-0625.2011.01379.x</identifier><identifier>PMID: 21995379</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>ADP Ribose Transferases - pharmacology ; Amides - pharmacology ; Apoptosis - drug effects ; Biological and medical sciences ; Botulinum Toxins - pharmacology ; cAMP ; cdc42 GTP-Binding Protein - metabolism ; Cell Shape - drug effects ; Cells, Cultured ; Cyclic AMP - metabolism ; Cyclic AMP Response Element-Binding Protein - metabolism ; dendrite ; Dendrites - drug effects ; Dermatology ; Epidermis - cytology ; GTP-binding protein ; Humans ; Intramolecular Oxidoreductases - metabolism ; Medical sciences ; Melanins - biosynthesis ; Melanocytes - cytology ; Melanocytes - drug effects ; Melanocytes - metabolism ; melanogenesis ; Membrane Glycoproteins - metabolism ; Microphthalmia-Associated Transcription Factor - metabolism ; Monophenol Monooxygenase - metabolism ; Oxidoreductases - metabolism ; platycodin D ; Pyridines - pharmacology ; rac GTP-Binding Proteins - metabolism ; rho GTP-Binding Proteins - antagonists &amp; inhibitors ; rho GTP-Binding Proteins - metabolism ; rho-Associated Kinases - antagonists &amp; inhibitors ; Saponins - pharmacology ; Signal Transduction - drug effects ; Signal Transduction - physiology ; Skin Pigmentation - drug effects ; Triterpenes - pharmacology</subject><ispartof>Experimental dermatology, 2011-12, Vol.20 (12), p.986-991</ispartof><rights>2011 John Wiley &amp; Sons A/S</rights><rights>2015 INIST-CNRS</rights><rights>2011 John Wiley &amp; Sons A/S.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3879-4b08deb333e329fc332c86909f016004e7f6a7596363c9e426ab1991eb72b25f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=25245528$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21995379$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Eunsun</creatorcontrib><creatorcontrib>Hwang, Wangtaek</creatorcontrib><creatorcontrib>Kim, Seungbeom</creatorcontrib><creatorcontrib>Kim, Young-Soo</creatorcontrib><creatorcontrib>Kim, Yeong-Shik</creatorcontrib><creatorcontrib>Lee, Jongsung</creatorcontrib><creatorcontrib>Park, Deokhoon</creatorcontrib><title>Depigmenting action of platycodin D depends on the cAMP/Rho-dependent signalling pathway</title><title>Experimental dermatology</title><addtitle>Exp Dermatol</addtitle><description>:  The overproduction and accumulation of melanin in the skin could lead to a pigmentary disorders, such as melasma, freckle, postinflammatory melanoderma and solar lentigo. Therefore, this study was conducted to investigate the effects of platycodin D (PD) on melanogenesis and its action mechanisms. In this study, we found that PD significantly inhibited melanin synthesis at low concentrations. These effects were further demonstrated by the PD‐induced inhibition of cAMP production, phosphorylation of the cAMP‐response element‐binding protein and expression of microphthalmia‐associated transcription factor and its downstream genes, tyrosinase, tyrosinase‐related proteins‐1 and Dct/tyrosinase‐related proteins‐2, suggesting that PD inhibits melanogenesis through the downregulation of cAMP signalling. Furthermore, PD induced significant morphological changes in melanocytes, namely, the retraction of dendrites. A small GTPase assays revealed that PD stimulated an increase in GTP‐bound Rho content, one of downstream molecules of cAMP, but not in Rac or CDC42 content. Moreover, a Rho inhibitor (C3 exoenzyme) and a Rho kinase inhibitor (Y27632) attenuated the dendrite retraction induced by PD. Taken together, these findings indicate that PD inhibits melanogenesis by inhibiting the cAMP‐protein kinase A pathway and also suppresses melanocyte dendricity through activation of the Rho signal that is mediated by PD‐induced reduction in cAMP production. Therefore, these results suggest that PD exerts its inhibitory effects on melanogenesis and melanocyte dendricity via suppression of cAMP signalling and may be introduced as an inhibitor of hyperpigmentation caused by UV irradiation or pigmented skin disorders.</description><subject>ADP Ribose Transferases - pharmacology</subject><subject>Amides - pharmacology</subject><subject>Apoptosis - drug effects</subject><subject>Biological and medical sciences</subject><subject>Botulinum Toxins - pharmacology</subject><subject>cAMP</subject><subject>cdc42 GTP-Binding Protein - metabolism</subject><subject>Cell Shape - drug effects</subject><subject>Cells, Cultured</subject><subject>Cyclic AMP - metabolism</subject><subject>Cyclic AMP Response Element-Binding Protein - metabolism</subject><subject>dendrite</subject><subject>Dendrites - drug effects</subject><subject>Dermatology</subject><subject>Epidermis - cytology</subject><subject>GTP-binding protein</subject><subject>Humans</subject><subject>Intramolecular Oxidoreductases - metabolism</subject><subject>Medical sciences</subject><subject>Melanins - biosynthesis</subject><subject>Melanocytes - cytology</subject><subject>Melanocytes - drug effects</subject><subject>Melanocytes - metabolism</subject><subject>melanogenesis</subject><subject>Membrane Glycoproteins - metabolism</subject><subject>Microphthalmia-Associated Transcription Factor - metabolism</subject><subject>Monophenol Monooxygenase - metabolism</subject><subject>Oxidoreductases - metabolism</subject><subject>platycodin D</subject><subject>Pyridines - pharmacology</subject><subject>rac GTP-Binding Proteins - metabolism</subject><subject>rho GTP-Binding Proteins - antagonists &amp; inhibitors</subject><subject>rho GTP-Binding Proteins - metabolism</subject><subject>rho-Associated Kinases - antagonists &amp; inhibitors</subject><subject>Saponins - pharmacology</subject><subject>Signal Transduction - drug effects</subject><subject>Signal Transduction - physiology</subject><subject>Skin Pigmentation - drug effects</subject><subject>Triterpenes - pharmacology</subject><issn>0906-6705</issn><issn>1600-0625</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNpFkV1P2zAUhq0JNArsL0y-mXaV4I_Yji92gVq-pALTxDTuLMc5ad2lSYhT0f57ElKKb47k93mPj8-LEKYkpv25WMVUEhIRyUTMCKUxoVzpePsFTQ7CEZoQTWQkFREn6DSEFSFUcSW-ohNGtRa9Y4KeZ9D4xRqqzlcLbF3n6wrXBW5K2-1cnfsKz3AODVR5wL3ULQG7y_vfF3-WdTTe914c_KKyZTn0aGy3fLW7c3Rc2DLAt309Q3-vr56mt9H88eZuejmPHE-VjpKMpDlknHPgTBeOc-ZSqYkuyPCTBFQhrRJacsmdhoRJm_XDU8gUy5go-Bn6OfZt2vplA6Ezax8clKWtoN4Eo4mQSkmmevL7ntxka8hN0_q1bXfmYxk98GMP2OBsWbS2cj58coIlQrC0536N3KsvYXfQKTFDOGZlhsnNkIEZwjHv4ZituXqe0fGdaPT70MH24LftfyOHgMy_hxszTZOEzq-Vuedv0piPpg</recordid><startdate>201112</startdate><enddate>201112</enddate><creator>Jung, Eunsun</creator><creator>Hwang, Wangtaek</creator><creator>Kim, Seungbeom</creator><creator>Kim, Young-Soo</creator><creator>Kim, Yeong-Shik</creator><creator>Lee, Jongsung</creator><creator>Park, Deokhoon</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201112</creationdate><title>Depigmenting action of platycodin D depends on the cAMP/Rho-dependent signalling pathway</title><author>Jung, Eunsun ; Hwang, Wangtaek ; Kim, Seungbeom ; Kim, Young-Soo ; Kim, Yeong-Shik ; Lee, Jongsung ; Park, Deokhoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3879-4b08deb333e329fc332c86909f016004e7f6a7596363c9e426ab1991eb72b25f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>ADP Ribose Transferases - pharmacology</topic><topic>Amides - pharmacology</topic><topic>Apoptosis - drug effects</topic><topic>Biological and medical sciences</topic><topic>Botulinum Toxins - pharmacology</topic><topic>cAMP</topic><topic>cdc42 GTP-Binding Protein - metabolism</topic><topic>Cell Shape - drug effects</topic><topic>Cells, Cultured</topic><topic>Cyclic AMP - metabolism</topic><topic>Cyclic AMP Response Element-Binding Protein - metabolism</topic><topic>dendrite</topic><topic>Dendrites - drug effects</topic><topic>Dermatology</topic><topic>Epidermis - cytology</topic><topic>GTP-binding protein</topic><topic>Humans</topic><topic>Intramolecular Oxidoreductases - metabolism</topic><topic>Medical sciences</topic><topic>Melanins - biosynthesis</topic><topic>Melanocytes - cytology</topic><topic>Melanocytes - drug effects</topic><topic>Melanocytes - metabolism</topic><topic>melanogenesis</topic><topic>Membrane Glycoproteins - metabolism</topic><topic>Microphthalmia-Associated Transcription Factor - metabolism</topic><topic>Monophenol Monooxygenase - metabolism</topic><topic>Oxidoreductases - metabolism</topic><topic>platycodin D</topic><topic>Pyridines - pharmacology</topic><topic>rac GTP-Binding Proteins - metabolism</topic><topic>rho GTP-Binding Proteins - antagonists &amp; inhibitors</topic><topic>rho GTP-Binding Proteins - metabolism</topic><topic>rho-Associated Kinases - antagonists &amp; inhibitors</topic><topic>Saponins - pharmacology</topic><topic>Signal Transduction - drug effects</topic><topic>Signal Transduction - physiology</topic><topic>Skin Pigmentation - drug effects</topic><topic>Triterpenes - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Eunsun</creatorcontrib><creatorcontrib>Hwang, Wangtaek</creatorcontrib><creatorcontrib>Kim, Seungbeom</creatorcontrib><creatorcontrib>Kim, Young-Soo</creatorcontrib><creatorcontrib>Kim, Yeong-Shik</creatorcontrib><creatorcontrib>Lee, Jongsung</creatorcontrib><creatorcontrib>Park, Deokhoon</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Experimental dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Eunsun</au><au>Hwang, Wangtaek</au><au>Kim, Seungbeom</au><au>Kim, Young-Soo</au><au>Kim, Yeong-Shik</au><au>Lee, Jongsung</au><au>Park, Deokhoon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Depigmenting action of platycodin D depends on the cAMP/Rho-dependent signalling pathway</atitle><jtitle>Experimental dermatology</jtitle><addtitle>Exp Dermatol</addtitle><date>2011-12</date><risdate>2011</risdate><volume>20</volume><issue>12</issue><spage>986</spage><epage>991</epage><pages>986-991</pages><issn>0906-6705</issn><eissn>1600-0625</eissn><abstract>:  The overproduction and accumulation of melanin in the skin could lead to a pigmentary disorders, such as melasma, freckle, postinflammatory melanoderma and solar lentigo. Therefore, this study was conducted to investigate the effects of platycodin D (PD) on melanogenesis and its action mechanisms. In this study, we found that PD significantly inhibited melanin synthesis at low concentrations. These effects were further demonstrated by the PD‐induced inhibition of cAMP production, phosphorylation of the cAMP‐response element‐binding protein and expression of microphthalmia‐associated transcription factor and its downstream genes, tyrosinase, tyrosinase‐related proteins‐1 and Dct/tyrosinase‐related proteins‐2, suggesting that PD inhibits melanogenesis through the downregulation of cAMP signalling. Furthermore, PD induced significant morphological changes in melanocytes, namely, the retraction of dendrites. A small GTPase assays revealed that PD stimulated an increase in GTP‐bound Rho content, one of downstream molecules of cAMP, but not in Rac or CDC42 content. Moreover, a Rho inhibitor (C3 exoenzyme) and a Rho kinase inhibitor (Y27632) attenuated the dendrite retraction induced by PD. Taken together, these findings indicate that PD inhibits melanogenesis by inhibiting the cAMP‐protein kinase A pathway and also suppresses melanocyte dendricity through activation of the Rho signal that is mediated by PD‐induced reduction in cAMP production. Therefore, these results suggest that PD exerts its inhibitory effects on melanogenesis and melanocyte dendricity via suppression of cAMP signalling and may be introduced as an inhibitor of hyperpigmentation caused by UV irradiation or pigmented skin disorders.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21995379</pmid><doi>10.1111/j.1600-0625.2011.01379.x</doi><tpages>6</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0906-6705
ispartof Experimental dermatology, 2011-12, Vol.20 (12), p.986-991
issn 0906-6705
1600-0625
language eng
recordid cdi_proquest_miscellaneous_905677627
source Wiley-Blackwell Read & Publish Collection
subjects ADP Ribose Transferases - pharmacology
Amides - pharmacology
Apoptosis - drug effects
Biological and medical sciences
Botulinum Toxins - pharmacology
cAMP
cdc42 GTP-Binding Protein - metabolism
Cell Shape - drug effects
Cells, Cultured
Cyclic AMP - metabolism
Cyclic AMP Response Element-Binding Protein - metabolism
dendrite
Dendrites - drug effects
Dermatology
Epidermis - cytology
GTP-binding protein
Humans
Intramolecular Oxidoreductases - metabolism
Medical sciences
Melanins - biosynthesis
Melanocytes - cytology
Melanocytes - drug effects
Melanocytes - metabolism
melanogenesis
Membrane Glycoproteins - metabolism
Microphthalmia-Associated Transcription Factor - metabolism
Monophenol Monooxygenase - metabolism
Oxidoreductases - metabolism
platycodin D
Pyridines - pharmacology
rac GTP-Binding Proteins - metabolism
rho GTP-Binding Proteins - antagonists & inhibitors
rho GTP-Binding Proteins - metabolism
rho-Associated Kinases - antagonists & inhibitors
Saponins - pharmacology
Signal Transduction - drug effects
Signal Transduction - physiology
Skin Pigmentation - drug effects
Triterpenes - pharmacology
title Depigmenting action of platycodin D depends on the cAMP/Rho-dependent signalling pathway
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T10%3A25%3A02IST&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=Depigmenting%20action%20of%20platycodin%20D%20depends%20on%20the%20cAMP/Rho-dependent%20signalling%20pathway&rft.jtitle=Experimental%20dermatology&rft.au=Jung,%20Eunsun&rft.date=2011-12&rft.volume=20&rft.issue=12&rft.spage=986&rft.epage=991&rft.pages=986-991&rft.issn=0906-6705&rft.eissn=1600-0625&rft_id=info:doi/10.1111/j.1600-0625.2011.01379.x&rft_dat=%3Cproquest_pubme%3E905677627%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3879-4b08deb333e329fc332c86909f016004e7f6a7596363c9e426ab1991eb72b25f3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=905677627&rft_id=info:pmid/21995379&rfr_iscdi=true