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Abstract
Through detailed interrogation of the molecular pathways that contribute to the development of pulmonary arterial hypertension (PAH), the separate but related processes of oxidative stress and cellular metabolic dysfunction have emerged as being critical pathogenic mechanisms that are as yet relatively untargeted therapeutically. In this review, we have attempted to summarize some of the important existing studies, to point out areas of overlap between oxidative stress and metabolic dysfunction, and to do so under the unifying heading of redox biology. We discuss the importance of precision in assessing oxidant signaling versus oxidant injury and why this distinction matters. We endeavor to advance the discussion of carbon-substrate metabolism beyond a focus on glucose and its fate in the cell to encompass other carbon substrates and some of the murkiness surrounding our understanding of how they are handled in different cell types. Finally, we try to bring these ideas together at the level of the mitochondrion and to point out some additional points of possible cognitive dissonance that warrant further experimental probing. The body of beautiful science regarding the molecular and cellular details of redox biology in PAH points to a future that includes clinically useful therapies that target these pathways. To fully realize the potential of these future interventions, we hope that some of the issues raised in this review can be addressed proactively.
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Affiliation(s)
- Joshua P Fessel
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - James D West
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
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Ryan JJ, Archer SL. Emerging concepts in the molecular basis of pulmonary arterial hypertension: part I: metabolic plasticity and mitochondrial dynamics in the pulmonary circulation and right ventricle in pulmonary arterial hypertension. Circulation 2015; 131:1691-702. [PMID: 25964279 DOI: 10.1161/circulationaha.114.006979] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- John J Ryan
- From Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City (J.J.R.); and Department of Medicine, Queen's University, Kingston, ON, Canada (S.L.A.)
| | - Stephen L Archer
- From Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City (J.J.R.); and Department of Medicine, Queen's University, Kingston, ON, Canada (S.L.A.).
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53
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Carroll-Turpin M, Hebert V, Chotibut T, Wensler H, Krentzel D, Varner KJ, Burn BR, Chen YF, Abreo F, Dugas TR. 4,4'-Methylenedianiline Alters Serotonergic Transport in a Novel, Sex-Specific Model of Pulmonary Arterial Hypertension in Rats. Toxicol Sci 2015; 147:235-45. [PMID: 26116029 DOI: 10.1093/toxsci/kfv126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a cardiovascular disorder characterized by elevated pulmonary artery pressure as a result of arterial wall thickening. Patients are 3-4 times more likely to be women than men. This gender discrepancy demonstrates a need for an animal model with similar sex differences. 4,4'-Methylenedianiline (DAPM) is an aromatic amine used industrially in the synthesis of polyurethanes. Chronic, intermittent treatment of male and female rats with DAPM resulted in medial hyperplasia of pulmonary arterioles, exclusively in females, coupled to increases in pulmonary arterial pressures. Significant increases in plasma levels of endothelin-1 (ET-1) and serotonin, but decreases in nitrite [Formula: see text], were observed in females treated with DAPM. A decrease was observed in the serum ratio of the estrogen metabolites 2-hydroxyestradiol (2-OHE1)/16α-hydroxyestrogen (16α-OHE1). In females, ET-1,[Formula: see text] , and 2-OHE1/16α-OHE1 were significantly correlated with peak pressure gradient, an indirect measure of pulmonary arterial pressure. Expression of the serotonin transport protein (SERT) was significantly higher in the arteries of DAPM-treated females. In vitro, DAPM induced human pulmonary vascular smooth muscle cell proliferation and serotonin uptake, both of which were inhibited by treatment with the estrogen receptor antagonist ICI 182,780 or the selective serotonin reuptake inhibitor fluoxetine. DAPM also induced the release of serotonin from human pulmonary endothelial cells in culture, which is blocked by ICI 182,780. Taken together, this suggests that DAPM-mediated dysregulation of serotonin transport is estrogen-receptor dependent. Thus, DAPM-induced PAH pathology may be a new tool to clarify the sex selectivity of PAH disease pathogenesis.
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Affiliation(s)
- Michelle Carroll-Turpin
- *Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130
| | - Valeria Hebert
- *Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130
| | - Tanya Chotibut
- *Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130
| | - Heather Wensler
- *Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130
| | - Dallas Krentzel
- *Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130
| | - Kurt James Varner
- Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans 70112
| | - Brendan R Burn
- Department of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans 70112
| | - Yi-Fan Chen
- Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana 70803; and
| | - Fleurette Abreo
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport 71130
| | - Tammy Renee Dugas
- *Department of Pharmacology, Toxicology and Neuroscience, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130;
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54
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Goveia J, Stapor P, Carmeliet P. Principles of targeting endothelial cell metabolism to treat angiogenesis and endothelial cell dysfunction in disease. EMBO Mol Med 2015; 6:1105-20. [PMID: 25063693 PMCID: PMC4197858 DOI: 10.15252/emmm.201404156] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The endothelium is the orchestral conductor of blood vessel function. Pathological blood vessel formation (a process termed pathological angiogenesis) or the inability of endothelial cells (ECs) to perform their physiological function (a condition known as EC dysfunction) are defining features of various diseases. Therapeutic intervention to inhibit aberrant angiogenesis or ameliorate EC dysfunction could be beneficial in diseases such as cancer and cardiovascular disease, respectively, but current strategies have limited efficacy. Based on recent findings that pathological angiogenesis and EC dysfunction are accompanied by EC-specific metabolic alterations, targeting EC metabolism is emerging as a novel therapeutic strategy. Here, we review recent progress in our understanding of how EC metabolism is altered in disease and discuss potential metabolic targets and strategies to reverse EC dysfunction and inhibit pathological angiogenesis.
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Affiliation(s)
- Jermaine Goveia
- Laboratory of Angiogenesis and Neurovascular Link, Vesalius Research Center, Department of Oncology, University of Leuven, Leuven, Belgium Laboratory of Angiogenesis and Neurovascular Link, Vesalius Research Center VIB, Leuven, Belgium
| | - Peter Stapor
- Laboratory of Angiogenesis and Neurovascular Link, Vesalius Research Center, Department of Oncology, University of Leuven, Leuven, Belgium Laboratory of Angiogenesis and Neurovascular Link, Vesalius Research Center VIB, Leuven, Belgium
| | - Peter Carmeliet
- Laboratory of Angiogenesis and Neurovascular Link, Vesalius Research Center, Department of Oncology, University of Leuven, Leuven, Belgium Laboratory of Angiogenesis and Neurovascular Link, Vesalius Research Center VIB, Leuven, Belgium
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55
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Haslip M, Dostanic I, Huang Y, Zhang Y, Russell KS, Jurczak MJ, Mannam P, Giordano F, Erzurum SC, Lee PJ. Endothelial uncoupling protein 2 regulates mitophagy and pulmonary hypertension during intermittent hypoxia. Arterioscler Thromb Vasc Biol 2015; 35:1166-78. [PMID: 25814675 DOI: 10.1161/atvbaha.114.304865] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 03/10/2015] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Pulmonary hypertension (PH) is a process of lung vascular remodeling, which can lead to right heart dysfunction and significant morbidity. The underlying mechanisms leading to PH are not well understood, and therapies are limited. Using intermittent hypoxia (IH) as a model of oxidant-induced PH, we identified an important role for endothelial cell mitophagy via mitochondrial uncoupling protein 2 (Ucp2) in the development of IH-induced PH. APPROACH AND RESULTS Ucp2 endothelial knockout (VE-KO) and Ucp2 Flox (Flox) mice were subjected to 5 weeks of IH. Ucp2 VE-KO mice exhibited higher right ventricular systolic pressure and worse right heart hypertrophy, as measured by increased right ventricle weight/left ventricle plus septal weight (RV/LV+S) ratio, at baseline and after IH. These changes were accompanied by increased mitophagy. Primary mouse lung endothelial cells transfected with Ucp2 siRNA and subjected to cyclic exposures to CoCl2 (chemical hypoxia) showed increased mitophagy, as measured by PTEN-induced putative kinase 1 and LC3BII/I ratios, decreased mitochondrial biogenesis, and increased apoptosis. Similar results were obtained in primary lung endothelial cells isolated from VE-KO mice. Moreover, silencing PTEN-induced putative kinase 1 in the endothelium of Ucp2 knockout mice, using endothelial-targeted lentiviral silencing RNA in vivo, prevented IH-induced PH. Human pulmonary artery endothelial cells from people with PH demonstrated changes similar to Ucp2-silenced mouse lung endothelial cells. CONCLUSIONS The loss of endothelial Ucp2 leads to excessive PTEN-induced putative kinase 1-induced mitophagy, inadequate mitochondrial biosynthesis, and increased apoptosis in endothelium. An endothelial Ucp2-PTEN-induced putative kinase 1 axis may be effective therapeutic targets in PH.
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Affiliation(s)
- Maria Haslip
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Iva Dostanic
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Yan Huang
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Yi Zhang
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Kerry S Russell
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Michael J Jurczak
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Praveen Mannam
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Frank Giordano
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Serpil C Erzurum
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.)
| | - Patty J Lee
- From the Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine (M.H., I.D., Y.Z., P.M., P.J.L.), Section of Cardiovascular Disease (Y.H., K.S.R, F.G.), and Section of Endocrinology and Metabolism (M.J.J.), Yale University School of Medicine, New Haven, CT; and Department of Pathobiology, Lerner Research Institute and Respiratory Institute, Cleveland Clinic, OH (S.C.E.).
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56
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Chen J, Tang H, Sysol JR, Moreno-Vinasco L, Shioura KM, Chen T, Gorshkova I, Wang L, Huang LS, Usatyuk PV, Sammani S, Zhou G, Raj JU, Garcia JGN, Berdyshev E, Yuan JXJ, Natarajan V, Machado RF. The sphingosine kinase 1/sphingosine-1-phosphate pathway in pulmonary arterial hypertension. Am J Respir Crit Care Med 2014; 190:1032-43. [PMID: 25180446 DOI: 10.1164/rccm.201401-0121oc] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Sphingosine kinases (SphKs) 1 and 2 regulate the synthesis of the bioactive sphingolipid sphingosine-1-phosphate (S1P), an important lipid mediator that promotes cell proliferation, migration, and angiogenesis. OBJECTIVES We aimed to examine whether SphKs and their product, S1P, play a role in the development of pulmonary arterial hypertension (PAH). METHODS SphK1(-/-), SphK2(-/-), and S1P lyase heterozygous (Sgpl1(+/-)) mice, a pharmacologic SphK inhibitor (SKI2), and a S1P receptor 2 (S1PR2) antagonist (JTE013) were used in rodent models of hypoxia-mediated pulmonary hypertension (HPH). S1P levels in lung tissues from patients with PAH and pulmonary arteries (PAs) from rodent models of HPH were measured. MEASUREMENTS AND MAIN RESULTS mRNA and protein levels of SphK1, but not SphK2, were significantly increased in the lungs and isolated PA smooth muscle cells (PASMCs) from patients with PAH, and in lungs of experimental rodent models of HPH. S1P levels were increased in lungs of patients with PAH and PAs from rodent models of HPH. Unlike SphK2(-/-) mice, SphK1(-/-) mice were protected against HPH, whereas Sgpl1(+/-) mice were more susceptible to HPH. Pharmacologic SphK1 and S1PR2 inhibition prevented the development of HPH in rodent models of HPH. Overexpression of SphK1 and stimulation with S1P potentially via ligation of S1PR2 promoted PASMC proliferation in vitro, whereas SphK1 deficiency inhibited PASMC proliferation. CONCLUSIONS The SphK1/S1P axis is a novel pathway in PAH that promotes PASMC proliferation, a major contributor to pulmonary vascular remodeling. Our results suggest that this pathway is a potential therapeutic target in PAH.
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Affiliation(s)
- Jiwang Chen
- 1 Section of Pulmonary, Critical Care Medicine, Sleep and Allergy, Department of Medicine
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57
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Sharp J, Farha S, Park MM, Comhair SA, Lundgrin EL, Tang WHW, Bongard RD, Merker MP, Erzurum SC. Coenzyme Q supplementation in pulmonary arterial hypertension. Redox Biol 2014; 2:884-91. [PMID: 25180165 PMCID: PMC4143816 DOI: 10.1016/j.redox.2014.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 06/15/2014] [Accepted: 06/17/2014] [Indexed: 12/18/2022] Open
Abstract
Mitochondrial dysfunction is a fundamental abnormality in the vascular endothelium and smooth muscle of patients with pulmonary arterial hypertension (PAH). Because coenzyme Q (CoQ) is essential for mitochondrial function and efficient oxygen utilization as the electron carrier in the inner mitochondrial membrane, we hypothesized that CoQ would improve mitochondrial function and benefit PAH patients. To test this, oxidized and reduced levels of CoQ, cardiac function by echocardiogram, mitochondrial functions of heme synthesis and cellular metabolism were evaluated in PAH patients (N=8) in comparison to healthy controls (N=7), at baseline and after 12 weeks oral CoQ supplementation. CoQ levels were similar among PAH and control individuals, and increased in all subjects with CoQ supplementation. PAH patients had higher CoQ levels than controls with supplementation, and a tendency to a higher reduced-to-oxidized CoQ ratio. Cardiac parameters improved with CoQ supplementation, although 6-minute walk distances and BNP levels did not significantly change. Consistent with improved mitochondrial synthetic function, hemoglobin increased and red cell distribution width (RDW) decreased in PAH patients with CoQ, while hemoglobin declined slightly and RDW did not change in healthy controls. In contrast, metabolic and redox parameters, including lactate, pyruvate and reduced or oxidized gluthathione, did not change in PAH patients with CoQ. In summary, CoQ improved hemoglobin and red cell maturation in PAH, but longer studies and/or higher doses with a randomized placebo-controlled controlled design are necessary to evaluate the clinical benefit of this simple nutritional supplement.
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Affiliation(s)
- Jacqueline Sharp
- Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - Samar Farha
- Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - Margaret M Park
- Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - Suzy A Comhair
- Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - Erika L Lundgrin
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - W H Wilson Tang
- Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - Robert D Bongard
- Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
| | - Marilyn P Merker
- Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States ; Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, 53226, United States ; Zablocki VAMC, 5000 W National Ave., Milwaukee, WI 53295, United States
| | - Serpil C Erzurum
- Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States ; Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
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