Loading…

Conjugation of the 9-kDa Isoform of Granulysin with Liposomes Potentiates Its Cytotoxicity

Nine kDa granulysin (GRNLY) is a human cytolytic protein secreted by cytotoxic T lymphocytes (CTL) and NK cells of the immune system whose demonstrated physiological function is the elimination of bacteria and parasites. In previous studies by our group, the anti-tumor capacity of recombinant granul...

Full description

Saved in:
Bibliographic Details
Published in:International journal of molecular sciences 2022-08, Vol.23 (15), p.8705
Main Authors: Soler-Agesta, Ruth, Guerrero-Ochoa, Patricia, Marco-Brualla, Joaquín, Ibáñez-Pérez, Raquel, Marzo, Isabel, Martínez-Lostao, Luis, Anel, Alberto
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-c389t-79c31869815e74a6ce6f6939dca64bf4ff2b1e35a8cd52b335c7b8567362a43b3
cites cdi_FETCH-LOGICAL-c389t-79c31869815e74a6ce6f6939dca64bf4ff2b1e35a8cd52b335c7b8567362a43b3
container_end_page
container_issue 15
container_start_page 8705
container_title International journal of molecular sciences
container_volume 23
creator Soler-Agesta, Ruth
Guerrero-Ochoa, Patricia
Marco-Brualla, Joaquín
Ibáñez-Pérez, Raquel
Marzo, Isabel
Martínez-Lostao, Luis
Anel, Alberto
description Nine kDa granulysin (GRNLY) is a human cytolytic protein secreted by cytotoxic T lymphocytes (CTL) and NK cells of the immune system whose demonstrated physiological function is the elimination of bacteria and parasites. In previous studies by our group, the anti-tumor capacity of recombinant granulysin was demonstrated, both in vitro and in vivo. In the present work, we developed lipid nanoparticles whose surfaces can bind recombinant granulysin through the formation of a complex of coordination between the histidine tail of the protein and Ni2+ provided by a chelating lipid in the liposome composition and termed them LUV-GRNLY, for granulysin-bound large unilamellar vesicles. The objective of this formulation is to increase the granulysin concentration at the site of contact with the target cell and to increase the cytotoxicity of the administered dose. The results obtained in this work indicate that recombinant granulysin binds to the surface of the liposome with high efficiency and that its cytotoxicity is significantly increased when it is in association with liposomes. In addition, it has been demonstrated that the main mechanism of death induced by both granulysin and LUV-GRNLY is apoptosis. Jurkat-shBak cells are resistant to GRNLY and also to LUV-GRNLY, showing that LUV-GRNLY uses the mitochondrial apoptotic pathway to induce cell death. On the other hand, we show that LUV-GRNLY induces the expression of the pro-apoptotic members of the Bcl-2 family Bim and especially PUMA, although it also induced the expression of anti-apoptotic Bcl-xL. In conclusion, we demonstrate that binding of GRNLY to the surfaces of liposomes clearly augments its cytotoxic potential, with cell death executed mainly by the mitochondrial apoptotic pathway.
doi_str_mv 10.3390/ijms23158705
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9369117</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2700750291</sourcerecordid><originalsourceid>FETCH-LOGICAL-c389t-79c31869815e74a6ce6f6939dca64bf4ff2b1e35a8cd52b335c7b8567362a43b3</originalsourceid><addsrcrecordid>eNpdkU9LxDAQxYMo_r_5AQpePFhNMk3SXARZdV1Y0INevIQ0m7pZ22ZNUnW_vV0UUU_zmPnxeMND6IjgMwCJz92ijRQIKwVmG2iXFJTmGHOx-UvvoL0YFxhToExuox1gkrES5C56Gvlu0T_r5HyX-TpLc5vJ_OVKZ5Poax_a9XIcdNc3q-i67N2leTZ1Sx99a2N275PtktNp0JMUs9Eq-eQ_nHFpdYC2at1Ee_g999HjzfXD6Daf3o0no8tpbqCUKRfSACm5LAmzotDcWF5zCXJmNC-quqhrWhELTJdmxmgFwIyoSsYFcKoLqGAfXXz5LvuqtTMzBAq6UcvgWh1Wymun_l46N1fP_k1J4JIQMRicfBsE_9rbmFTrorFNozvr-6iowHRIyAoyoMf_0IXvQze8t6awYJjKNXX6RZngYwy2_glDsFqXpn6XBp909InX</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2700750291</pqid></control><display><type>article</type><title>Conjugation of the 9-kDa Isoform of Granulysin with Liposomes Potentiates Its Cytotoxicity</title><source>Publicly Available Content Database</source><source>PubMed Central</source><creator>Soler-Agesta, Ruth ; Guerrero-Ochoa, Patricia ; Marco-Brualla, Joaquín ; Ibáñez-Pérez, Raquel ; Marzo, Isabel ; Martínez-Lostao, Luis ; Anel, Alberto</creator><creatorcontrib>Soler-Agesta, Ruth ; Guerrero-Ochoa, Patricia ; Marco-Brualla, Joaquín ; Ibáñez-Pérez, Raquel ; Marzo, Isabel ; Martínez-Lostao, Luis ; Anel, Alberto</creatorcontrib><description>Nine kDa granulysin (GRNLY) is a human cytolytic protein secreted by cytotoxic T lymphocytes (CTL) and NK cells of the immune system whose demonstrated physiological function is the elimination of bacteria and parasites. In previous studies by our group, the anti-tumor capacity of recombinant granulysin was demonstrated, both in vitro and in vivo. In the present work, we developed lipid nanoparticles whose surfaces can bind recombinant granulysin through the formation of a complex of coordination between the histidine tail of the protein and Ni2+ provided by a chelating lipid in the liposome composition and termed them LUV-GRNLY, for granulysin-bound large unilamellar vesicles. The objective of this formulation is to increase the granulysin concentration at the site of contact with the target cell and to increase the cytotoxicity of the administered dose. The results obtained in this work indicate that recombinant granulysin binds to the surface of the liposome with high efficiency and that its cytotoxicity is significantly increased when it is in association with liposomes. In addition, it has been demonstrated that the main mechanism of death induced by both granulysin and LUV-GRNLY is apoptosis. Jurkat-shBak cells are resistant to GRNLY and also to LUV-GRNLY, showing that LUV-GRNLY uses the mitochondrial apoptotic pathway to induce cell death. On the other hand, we show that LUV-GRNLY induces the expression of the pro-apoptotic members of the Bcl-2 family Bim and especially PUMA, although it also induced the expression of anti-apoptotic Bcl-xL. In conclusion, we demonstrate that binding of GRNLY to the surfaces of liposomes clearly augments its cytotoxic potential, with cell death executed mainly by the mitochondrial apoptotic pathway.</description><identifier>ISSN: 1422-0067</identifier><identifier>ISSN: 1661-6596</identifier><identifier>EISSN: 1422-0067</identifier><identifier>DOI: 10.3390/ijms23158705</identifier><identifier>PMID: 35955839</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Antigens ; Apoptosis ; Bcl-2 protein ; Bcl-x protein ; BIM protein ; Biocompatibility ; Cell death ; Chelation ; Conjugation ; Cytotoxicity ; Experiments ; Flow cytometry ; Histidine ; Immune system ; Leukemia ; Lipids ; Liposomes ; Lymphocytes ; Lymphocytes T ; Mitochondria ; Molecular weight ; Nanoparticles ; Natural killer cells ; Population ; Proteins ; Tumors</subject><ispartof>International journal of molecular sciences, 2022-08, Vol.23 (15), p.8705</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-79c31869815e74a6ce6f6939dca64bf4ff2b1e35a8cd52b335c7b8567362a43b3</citedby><cites>FETCH-LOGICAL-c389t-79c31869815e74a6ce6f6939dca64bf4ff2b1e35a8cd52b335c7b8567362a43b3</cites><orcidid>0000-0002-1657-4792 ; 0000-0002-5175-8394 ; 0000-0002-1710-4821 ; 0000-0003-3153-389X ; 0000-0002-2315-9079</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2700750291/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2700750291?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25744,27915,27916,37003,37004,44581,53782,53784,74887</link.rule.ids></links><search><creatorcontrib>Soler-Agesta, Ruth</creatorcontrib><creatorcontrib>Guerrero-Ochoa, Patricia</creatorcontrib><creatorcontrib>Marco-Brualla, Joaquín</creatorcontrib><creatorcontrib>Ibáñez-Pérez, Raquel</creatorcontrib><creatorcontrib>Marzo, Isabel</creatorcontrib><creatorcontrib>Martínez-Lostao, Luis</creatorcontrib><creatorcontrib>Anel, Alberto</creatorcontrib><title>Conjugation of the 9-kDa Isoform of Granulysin with Liposomes Potentiates Its Cytotoxicity</title><title>International journal of molecular sciences</title><description>Nine kDa granulysin (GRNLY) is a human cytolytic protein secreted by cytotoxic T lymphocytes (CTL) and NK cells of the immune system whose demonstrated physiological function is the elimination of bacteria and parasites. In previous studies by our group, the anti-tumor capacity of recombinant granulysin was demonstrated, both in vitro and in vivo. In the present work, we developed lipid nanoparticles whose surfaces can bind recombinant granulysin through the formation of a complex of coordination between the histidine tail of the protein and Ni2+ provided by a chelating lipid in the liposome composition and termed them LUV-GRNLY, for granulysin-bound large unilamellar vesicles. The objective of this formulation is to increase the granulysin concentration at the site of contact with the target cell and to increase the cytotoxicity of the administered dose. The results obtained in this work indicate that recombinant granulysin binds to the surface of the liposome with high efficiency and that its cytotoxicity is significantly increased when it is in association with liposomes. In addition, it has been demonstrated that the main mechanism of death induced by both granulysin and LUV-GRNLY is apoptosis. Jurkat-shBak cells are resistant to GRNLY and also to LUV-GRNLY, showing that LUV-GRNLY uses the mitochondrial apoptotic pathway to induce cell death. On the other hand, we show that LUV-GRNLY induces the expression of the pro-apoptotic members of the Bcl-2 family Bim and especially PUMA, although it also induced the expression of anti-apoptotic Bcl-xL. In conclusion, we demonstrate that binding of GRNLY to the surfaces of liposomes clearly augments its cytotoxic potential, with cell death executed mainly by the mitochondrial apoptotic pathway.</description><subject>Antigens</subject><subject>Apoptosis</subject><subject>Bcl-2 protein</subject><subject>Bcl-x protein</subject><subject>BIM protein</subject><subject>Biocompatibility</subject><subject>Cell death</subject><subject>Chelation</subject><subject>Conjugation</subject><subject>Cytotoxicity</subject><subject>Experiments</subject><subject>Flow cytometry</subject><subject>Histidine</subject><subject>Immune system</subject><subject>Leukemia</subject><subject>Lipids</subject><subject>Liposomes</subject><subject>Lymphocytes</subject><subject>Lymphocytes T</subject><subject>Mitochondria</subject><subject>Molecular weight</subject><subject>Nanoparticles</subject><subject>Natural killer cells</subject><subject>Population</subject><subject>Proteins</subject><subject>Tumors</subject><issn>1422-0067</issn><issn>1661-6596</issn><issn>1422-0067</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkU9LxDAQxYMo_r_5AQpePFhNMk3SXARZdV1Y0INevIQ0m7pZ22ZNUnW_vV0UUU_zmPnxeMND6IjgMwCJz92ijRQIKwVmG2iXFJTmGHOx-UvvoL0YFxhToExuox1gkrES5C56Gvlu0T_r5HyX-TpLc5vJ_OVKZ5Poax_a9XIcdNc3q-i67N2leTZ1Sx99a2N275PtktNp0JMUs9Eq-eQ_nHFpdYC2at1Ee_g999HjzfXD6Daf3o0no8tpbqCUKRfSACm5LAmzotDcWF5zCXJmNC-quqhrWhELTJdmxmgFwIyoSsYFcKoLqGAfXXz5LvuqtTMzBAq6UcvgWh1Wymun_l46N1fP_k1J4JIQMRicfBsE_9rbmFTrorFNozvr-6iowHRIyAoyoMf_0IXvQze8t6awYJjKNXX6RZngYwy2_glDsFqXpn6XBp909InX</recordid><startdate>20220805</startdate><enddate>20220805</enddate><creator>Soler-Agesta, Ruth</creator><creator>Guerrero-Ochoa, Patricia</creator><creator>Marco-Brualla, Joaquín</creator><creator>Ibáñez-Pérez, Raquel</creator><creator>Marzo, Isabel</creator><creator>Martínez-Lostao, Luis</creator><creator>Anel, Alberto</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</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>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</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><orcidid>https://orcid.org/0000-0002-1657-4792</orcidid><orcidid>https://orcid.org/0000-0002-5175-8394</orcidid><orcidid>https://orcid.org/0000-0002-1710-4821</orcidid><orcidid>https://orcid.org/0000-0003-3153-389X</orcidid><orcidid>https://orcid.org/0000-0002-2315-9079</orcidid></search><sort><creationdate>20220805</creationdate><title>Conjugation of the 9-kDa Isoform of Granulysin with Liposomes Potentiates Its Cytotoxicity</title><author>Soler-Agesta, Ruth ; Guerrero-Ochoa, Patricia ; Marco-Brualla, Joaquín ; Ibáñez-Pérez, Raquel ; Marzo, Isabel ; Martínez-Lostao, Luis ; Anel, Alberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-79c31869815e74a6ce6f6939dca64bf4ff2b1e35a8cd52b335c7b8567362a43b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antigens</topic><topic>Apoptosis</topic><topic>Bcl-2 protein</topic><topic>Bcl-x protein</topic><topic>BIM protein</topic><topic>Biocompatibility</topic><topic>Cell death</topic><topic>Chelation</topic><topic>Conjugation</topic><topic>Cytotoxicity</topic><topic>Experiments</topic><topic>Flow cytometry</topic><topic>Histidine</topic><topic>Immune system</topic><topic>Leukemia</topic><topic>Lipids</topic><topic>Liposomes</topic><topic>Lymphocytes</topic><topic>Lymphocytes T</topic><topic>Mitochondria</topic><topic>Molecular weight</topic><topic>Nanoparticles</topic><topic>Natural killer cells</topic><topic>Population</topic><topic>Proteins</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Soler-Agesta, Ruth</creatorcontrib><creatorcontrib>Guerrero-Ochoa, Patricia</creatorcontrib><creatorcontrib>Marco-Brualla, Joaquín</creatorcontrib><creatorcontrib>Ibáñez-Pérez, Raquel</creatorcontrib><creatorcontrib>Marzo, Isabel</creatorcontrib><creatorcontrib>Martínez-Lostao, Luis</creatorcontrib><creatorcontrib>Anel, Alberto</creatorcontrib><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>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)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</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>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Research Library</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><jtitle>International journal of molecular sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Soler-Agesta, Ruth</au><au>Guerrero-Ochoa, Patricia</au><au>Marco-Brualla, Joaquín</au><au>Ibáñez-Pérez, Raquel</au><au>Marzo, Isabel</au><au>Martínez-Lostao, Luis</au><au>Anel, Alberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Conjugation of the 9-kDa Isoform of Granulysin with Liposomes Potentiates Its Cytotoxicity</atitle><jtitle>International journal of molecular sciences</jtitle><date>2022-08-05</date><risdate>2022</risdate><volume>23</volume><issue>15</issue><spage>8705</spage><pages>8705-</pages><issn>1422-0067</issn><issn>1661-6596</issn><eissn>1422-0067</eissn><abstract>Nine kDa granulysin (GRNLY) is a human cytolytic protein secreted by cytotoxic T lymphocytes (CTL) and NK cells of the immune system whose demonstrated physiological function is the elimination of bacteria and parasites. In previous studies by our group, the anti-tumor capacity of recombinant granulysin was demonstrated, both in vitro and in vivo. In the present work, we developed lipid nanoparticles whose surfaces can bind recombinant granulysin through the formation of a complex of coordination between the histidine tail of the protein and Ni2+ provided by a chelating lipid in the liposome composition and termed them LUV-GRNLY, for granulysin-bound large unilamellar vesicles. The objective of this formulation is to increase the granulysin concentration at the site of contact with the target cell and to increase the cytotoxicity of the administered dose. The results obtained in this work indicate that recombinant granulysin binds to the surface of the liposome with high efficiency and that its cytotoxicity is significantly increased when it is in association with liposomes. In addition, it has been demonstrated that the main mechanism of death induced by both granulysin and LUV-GRNLY is apoptosis. Jurkat-shBak cells are resistant to GRNLY and also to LUV-GRNLY, showing that LUV-GRNLY uses the mitochondrial apoptotic pathway to induce cell death. On the other hand, we show that LUV-GRNLY induces the expression of the pro-apoptotic members of the Bcl-2 family Bim and especially PUMA, although it also induced the expression of anti-apoptotic Bcl-xL. In conclusion, we demonstrate that binding of GRNLY to the surfaces of liposomes clearly augments its cytotoxic potential, with cell death executed mainly by the mitochondrial apoptotic pathway.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>35955839</pmid><doi>10.3390/ijms23158705</doi><orcidid>https://orcid.org/0000-0002-1657-4792</orcidid><orcidid>https://orcid.org/0000-0002-5175-8394</orcidid><orcidid>https://orcid.org/0000-0002-1710-4821</orcidid><orcidid>https://orcid.org/0000-0003-3153-389X</orcidid><orcidid>https://orcid.org/0000-0002-2315-9079</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1422-0067
ispartof International journal of molecular sciences, 2022-08, Vol.23 (15), p.8705
issn 1422-0067
1661-6596
1422-0067
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9369117
source Publicly Available Content Database; PubMed Central
subjects Antigens
Apoptosis
Bcl-2 protein
Bcl-x protein
BIM protein
Biocompatibility
Cell death
Chelation
Conjugation
Cytotoxicity
Experiments
Flow cytometry
Histidine
Immune system
Leukemia
Lipids
Liposomes
Lymphocytes
Lymphocytes T
Mitochondria
Molecular weight
Nanoparticles
Natural killer cells
Population
Proteins
Tumors
title Conjugation of the 9-kDa Isoform of Granulysin with Liposomes Potentiates Its Cytotoxicity
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T06%3A06%3A05IST&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=Conjugation%20of%20the%209-kDa%20Isoform%20of%20Granulysin%20with%20Liposomes%20Potentiates%20Its%20Cytotoxicity&rft.jtitle=International%20journal%20of%20molecular%20sciences&rft.au=Soler-Agesta,%20Ruth&rft.date=2022-08-05&rft.volume=23&rft.issue=15&rft.spage=8705&rft.pages=8705-&rft.issn=1422-0067&rft.eissn=1422-0067&rft_id=info:doi/10.3390/ijms23158705&rft_dat=%3Cproquest_pubme%3E2700750291%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c389t-79c31869815e74a6ce6f6939dca64bf4ff2b1e35a8cd52b335c7b8567362a43b3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2700750291&rft_id=info:pmid/35955839&rfr_iscdi=true