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Ding G, Gong Q, Ma J, Liu X, Wang Y, Cheng X. Immunosuppressive activity is attenuated by Astragalus polysaccharides through remodeling the gut microenvironment in melanoma mice. Cancer Sci 2021; 112:4050-4063. [PMID: 34289209 PMCID: PMC8486201 DOI: 10.1111/cas.15078] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022] Open
Abstract
Astragalus polysaccharides (APS), the main effective component of Astragalus membranaceus, can inhibit tumor growth, but the underlying mechanisms remain unclear. Previous studies have suggested that APS can regulate the gut microenvironment, including the gut microbiota and fecal metabolites. In this work, our results showed that APS could control tumor growth in melanoma-bearing mice. It could reduce the number of myeloid-derived suppressor cells (MDSC), as well as the expression of MDSC-related molecule Arg-1 and cytokines IL-10 and TGF-β, so that CD8+ T cells could kill tumor cells more effectively. However, while APS were administered with an antibiotic cocktail (ABX), MDSC could not be reduced, and the growth rate of tumors was accelerated. Consistent with the changes in MDSC, the serum levels of IL-6 and IL-1β were lowest in the APS group. Meanwhile, we found that fecal suspension from mice in the APS group could also reduce the number of MDSC in tumor tissues. These results revealed that APS regulated the immune function in tumor-bearing mice through remodeling the gut microbiota. Next, we focused on the results of 16S rRNA, which showed that APS significantly regulated most microorganisms, such as Bifidobacterium pseudolongum, Lactobacillus johnsonii and Lactobacillus. According to the Spearman analysis, the changes in abundance of these microorganisms were related to the increase of metabolites like glutamate and creatine, which could control tumor growth. The present study demonstrates that APS attenuate the immunosuppressive activity of MDSC in melanoma-bearing mice by remodeling the gut microbiota and fecal metabolites. Our findings reveal the therapeutic potential of APS to control tumor growth.
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Affiliation(s)
- Guiqing Ding
- Institute of Clinical Immunology, Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qianyi Gong
- Institute of Clinical Immunology, Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jinyun Ma
- Institute of Clinical Immunology, Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaojun Liu
- Institute of Clinical Immunology, Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanhua Wang
- Institute of Clinical Immunology, Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaodong Cheng
- Institute of Clinical Immunology, Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Uchino Y, Goto Y, Konishi Y, Tanabe K, Toda H, Wada M, Kita Y, Beppu M, Mori S, Hijioka H, Otsuka T, Natsugoe S, Hara E, Sugiura T. Colorectal Cancer Patients Have Four Specific Bacterial Species in Oral and Gut Microbiota in Common-A Metagenomic Comparison with Healthy Subjects. Cancers (Basel) 2021; 13:cancers13133332. [PMID: 34283063 PMCID: PMC8268706 DOI: 10.3390/cancers13133332] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary The incidence of colorectal cancer (CRC) has been increasing in recent years, and the gut microbiota is nowadays considered to be involved in the progression of CRC. Recent studies have investigated the involvement of the oral microbiota in CRC development using saliva and stool samples. However, the details regarding how oral bacteria alter the gut microbiota and affect CRC carcinogenesis remain unclear. In the present study, we identified four bacterial species that may affect the carcinogenesis and progression of CRC. These microorganisms may be potential biomarkers in saliva for diagnosing CRC. Abstract Oral microbiota is reportedly associated with gut microbiota and influences colorectal cancer (CRC) progression; however, the details remain unclear. This study aimed to evaluate the role of oral microbiota in CRC progression. Fifty-two patients with CRC and 51 healthy controls were included. Saliva and stool samples were collected, and microbiota were evaluated using 16S rRNA analysis and next-generation sequencing. Comparative analysis was performed on both groups. Linear discriminant analysis effect size (LEfSe) revealed the presence of indigenous oral bacteria, such as Peptostreptococcus, Streptococcus, and Solobacterium spp., at a significantly higher relative abundance in saliva and stool samples of CRC patients compared with controls. Next, CRC patients were divided into early stage (Stage I, II; n = 26; 50%) and advanced stage (Stage III, IV; n = 26; 50%) disease. LEfSe revealed that S. moorei was present at a significantly higher relative abundance in the advanced-stage group compared with the early-stage group, again consistent for both saliva and stool samples. Among bacterial species with significantly higher relative abundance in CRC patients, P. stomatis, S. anginosus, S. koreensis, and S. moorei originated from the oral cavity, suggesting indigenous oral bacteria may have promoted initiation of CRC carcinogenesis. Furthermore, S. moorei may influence CRC progression.
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Affiliation(s)
- Yoshinori Uchino
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.U.); (Y.G.); (M.B.); (H.H.)
| | - Yuichi Goto
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.U.); (Y.G.); (M.B.); (H.H.)
| | - Yusuke Konishi
- Department of Molecular Microbiology, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamadaoka, Suita, Osaka 565-0871, Japan; (Y.K.); (E.H.)
| | - Kan Tanabe
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan; (K.T.); (Y.K.); (S.M.); (T.O.)
| | - Hiroko Toda
- Breast Surgery, Fujita Health University Hospital, 1-98, Dengakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan;
| | - Masumi Wada
- Department of Digestive Surgery, Imakiire General Hospital, 43-25, Korai, Kagoshima 890-0051, Japan;
| | - Yoshiaki Kita
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan; (K.T.); (Y.K.); (S.M.); (T.O.)
| | - Mahiro Beppu
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.U.); (Y.G.); (M.B.); (H.H.)
| | - Shinichiro Mori
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan; (K.T.); (Y.K.); (S.M.); (T.O.)
| | - Hiroshi Hijioka
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.U.); (Y.G.); (M.B.); (H.H.)
| | - Takao Otsuka
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan; (K.T.); (Y.K.); (S.M.); (T.O.)
| | - Shoji Natsugoe
- Kajikionsen Hospital, 4714, Kida, Kajiki, Aira, Kagoshima 899-5241, Japan;
| | - Eiji Hara
- Department of Molecular Microbiology, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamadaoka, Suita, Osaka 565-0871, Japan; (Y.K.); (E.H.)
| | - Tsuyoshi Sugiura
- Department of Maxillofacial Diagnostic and Surgical Science, Field of Oral and Maxillofacial Rehabilitation, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8544, Japan; (Y.U.); (Y.G.); (M.B.); (H.H.)
- Correspondence:
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Isibor PO, Akinduti PA, Aworunse OS, Oyewale JO, Oshamika O, Ugboko HU, Taiwo OS, Ahuekwe EF, Obafemi YD, Onibokun EA, Oziegbe O, Oniha MI, Olopade BK, Atolagbe OM, Adekeye BT, Ajiboye IB, Bello OA, Popoola JO, Ayanda OI, Akinnola OO, Olasehinde GI, Eni AO, Nwinyi OC, Omonhinmin CA, Oranusi SU, Obembe OO. Significance of African Diets in Biotherapeutic Modulation of the Gut Microbiome. Bioinform Biol Insights 2021; 15:11779322211012697. [PMID: 33994782 PMCID: PMC8107938 DOI: 10.1177/11779322211012697] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/04/2021] [Indexed: 12/19/2022] Open
Abstract
Diet plays an essential role in human development and growth, contributing to health and well-being. The socio-economic values, cultural perspectives, and dietary formulation in sub-Saharan Africa can influence gut health and disease prevention. The vast microbial ecosystems in the human gut frequently interrelate to maintain a healthy, well-coordinated cellular and humoral immune signalling to prevent metabolic dysfunction, pathogen dominance, and induction of systemic diseases. The diverse indigenous diets could differentially act as biotherapeutics to modulate microbial abundance and population characteristics. Such modulation could prevent stunted growth, malnutrition, induction of bowel diseases, attenuated immune responses, and mortality, particularly among infants. Understanding the associations between specific indigenous African diets and the predictability of the dynamics of gut bacteria genera promises potential biotherapeutics towards improving the prevention, control, and treatment of microbiome-associated diseases such as cancer, inflammatory bowel disease, obesity, type 2 diabetes, and cardiovascular disease. The dietary influence of many African diets (especially grain-base such as millet, maize, brown rice, sorghum, soya, and tapioca) promotes gut lining integrity, immune tolerance towards the microbiota, and its associated immune and inflammatory responses. A fibre-rich diet is a promising biotherapeutic candidate that could effectively modulate inflammatory mediators' expression associated with immune cell migration, lymphoid tissue maturation, and signalling pathways. It could also modulate the stimulation of cytokines and chemokines involved in ensuring balance for long-term microbiome programming. The interplay between host and gut microbial digestion is complex; microbes using and competing for dietary and endogenous proteins are often attributable to variances in the comparative abundances of Enterobacteriaceae taxa. Many auto-inducers could initiate the process of quorum sensing and mammalian epinephrine host cell signalling system. It could also downregulate inflammatory signals with microbiota tumour taxa that could trigger colorectal cancer initiation, metabolic type 2 diabetes, and inflammatory bowel diseases. The exploitation of essential biotherapeutic molecules derived from fibre-rich indigenous diet promises food substances for the downregulation of inflammatory signalling that could be harmful to gut microbiota ecological balance and improved immune response modulation.
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Affiliation(s)
- PO Isibor
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - PA Akinduti
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OS Aworunse
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - JO Oyewale
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - O Oshamika
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - HU Ugboko
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OS Taiwo
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - EF Ahuekwe
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - YD Obafemi
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - EA Onibokun
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - O Oziegbe
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - MI Oniha
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - BK Olopade
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OM Atolagbe
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - BT Adekeye
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - IB Ajiboye
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OA Bello
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - JO Popoola
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OI Ayanda
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OO Akinnola
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - GI Olasehinde
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - AO Eni
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OC Nwinyi
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - CA Omonhinmin
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - SU Oranusi
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
| | - OO Obembe
- Biotechnology Research Centre, Department of
Biological Sciences, Covenant University, Ota, Nigeria
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Mishra R, Rajsiglová L, Lukáč P, Tenti P, Šima P, Čaja F, Vannucci L. Spontaneous and Induced Tumors in Germ-Free Animals: A General Review. ACTA ACUST UNITED AC 2021; 57:medicina57030260. [PMID: 33799911 PMCID: PMC8002107 DOI: 10.3390/medicina57030260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 12/27/2022]
Abstract
Cancer, bacteria, and immunity relationships are much-debated topics in the last decade. Microbiome’s importance for metabolic and immunologic modulation of the organism adaptation and responses has become progressively evident, and models to study these relationships, especially about carcinogenesis, have acquired primary importance. The availability of germ-free (GF) animals, i.e., animals born and maintained under completely sterile conditions avoiding the microbiome development offers a unique tool to investigate the role that bacteria can have in carcinogenesis and tumor development. The comparison between GF animals with the conventional (CV) counterpart with microbiome can help to evidence conditions and mechanisms directly involving bacterial activities in the modulation of carcinogenesis processes. Here, we review the literature about spontaneous cancer and cancer modeling in GF animals since the early studies, trying to offer a practical overview on the argument.
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Affiliation(s)
- Rajbardhan Mishra
- Laboratory of Immunotherapy, Institute of Microbiology v.v.i., Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic; (R.M.); (L.R.); (P.L.); (P.T.); (P.Š.); (F.Č.)
| | - Lenka Rajsiglová
- Laboratory of Immunotherapy, Institute of Microbiology v.v.i., Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic; (R.M.); (L.R.); (P.L.); (P.T.); (P.Š.); (F.Č.)
- Faculty of Science, Charles University, Albertov 6, 12800 Prague, Czech Republic
| | - Pavol Lukáč
- Laboratory of Immunotherapy, Institute of Microbiology v.v.i., Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic; (R.M.); (L.R.); (P.L.); (P.T.); (P.Š.); (F.Č.)
- Faculty of Science, Charles University, Albertov 6, 12800 Prague, Czech Republic
| | - Paolo Tenti
- Laboratory of Immunotherapy, Institute of Microbiology v.v.i., Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic; (R.M.); (L.R.); (P.L.); (P.T.); (P.Š.); (F.Č.)
- Faculty of Science, Charles University, Albertov 6, 12800 Prague, Czech Republic
| | - Peter Šima
- Laboratory of Immunotherapy, Institute of Microbiology v.v.i., Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic; (R.M.); (L.R.); (P.L.); (P.T.); (P.Š.); (F.Č.)
| | - Fabián Čaja
- Laboratory of Immunotherapy, Institute of Microbiology v.v.i., Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic; (R.M.); (L.R.); (P.L.); (P.T.); (P.Š.); (F.Č.)
- Faculty of Science, Charles University, Albertov 6, 12800 Prague, Czech Republic
| | - Luca Vannucci
- Laboratory of Immunotherapy, Institute of Microbiology v.v.i., Czech Academy of Sciences, Videnska 1083, 14220 Prague, Czech Republic; (R.M.); (L.R.); (P.L.); (P.T.); (P.Š.); (F.Č.)
- Correspondence: ; Tel.: +42-024-106-2394
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Fukuda S, Ito S, Nishikawa J, Takagi T, Kubota N, Otsuyama KI, Tsuneoka H, Nojima J, Harada K, Mishima K, Suehiro Y, Yamasaki T, Sakaida I. Deep Ultraviolet Light-Emitting Diode Light Therapy for Fusobacterium nucleatum. Microorganisms 2021; 9:microorganisms9020430. [PMID: 33669771 PMCID: PMC7922187 DOI: 10.3390/microorganisms9020430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Fusobacterium nucleatum, which is associated with periodontitis and gingivitis, has been detected in colorectal cancer (CRC). Methods: We evaluated the bactericidal effect of deep ultraviolet (DUV) light-emitting diode (LED) light therapy on F. nucleatum both qualitatively and quantitatively. Two DUV-LEDs with peak wavelengths of 265 and 280-nm were used. DNA damage to F. nucleatum was evaluated by the production of cyclobutane pyrimidine dimers (CPD) and pyrimidine (6–4) pyrimidone photoproducts (6–4PP). Results: DUV-LEDs showed a bactericidal effect on F. nucleatum. No colony growth was observed after 3 min of either 265 nm or 280 nm DUV-LED irradiation. The survival rates of F. nucleatum under 265 nm DUV-LED light irradiation dropped to 0.0014% for 10 s and to 0% for 20 s irradiation. Similarly, the survival rate of F. nucleatum under 280 nm DUV-LED light irradiation dropped to 0.00044% for 10 s and 0% for 20 s irradiation. The irradiance at the distance of 35 mm from the DUV-LED was 0.265 mW/cm2 for the 265 nm LED and 0.415 mW/cm2 for the 280 nm LED. Thus, the radiant energy for lethality was 5.3 mJ/cm2 for the 265 nm LED and 8.3 mJ/cm2 for the 280 nm LED. Amounts of CPD and 6–4PP in F. nucleatum irradiated with 265 nm DUV-LED light were 6.548 ng/µg and 1.333 ng/µg, respectively. Conclusions: DUV-LED light exerted a bactericidal effect on F. nucleatum by causing the formation of pyrimidine dimers indicative of DNA damage. Thus, DUV-LED light therapy may have the potential to prevent CRC.
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Affiliation(s)
- Soichiro Fukuda
- Department of Laboratory Science, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.F.); (T.T.); (N.K.); (K.-i.O.); (H.T.); (J.N.)
| | - Shunsuke Ito
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.I.); (I.S.)
| | - Jun Nishikawa
- Department of Laboratory Science, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.F.); (T.T.); (N.K.); (K.-i.O.); (H.T.); (J.N.)
- Correspondence: ; Tel.: +81-836-22-2835
| | - Tatsuya Takagi
- Department of Laboratory Science, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.F.); (T.T.); (N.K.); (K.-i.O.); (H.T.); (J.N.)
| | - Naoto Kubota
- Department of Laboratory Science, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.F.); (T.T.); (N.K.); (K.-i.O.); (H.T.); (J.N.)
| | - Ken-ichiro Otsuyama
- Department of Laboratory Science, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.F.); (T.T.); (N.K.); (K.-i.O.); (H.T.); (J.N.)
| | - Hidehiro Tsuneoka
- Department of Laboratory Science, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.F.); (T.T.); (N.K.); (K.-i.O.); (H.T.); (J.N.)
| | - Junzo Nojima
- Department of Laboratory Science, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.F.); (T.T.); (N.K.); (K.-i.O.); (H.T.); (J.N.)
| | - Koji Harada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (K.H.); (K.M.)
| | - Katsuaki Mishima
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (K.H.); (K.M.)
| | - Yutaka Suehiro
- Department of Oncology and Laboratory Medicine, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (Y.S.); (T.Y.)
| | - Takahiro Yamasaki
- Department of Oncology and Laboratory Medicine, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (Y.S.); (T.Y.)
| | - Isao Sakaida
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Yamaguchi University, Ube 7558505, Japan; (S.I.); (I.S.)
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