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Prange CJ, Hu X, Tang L. Smart chemistry for traceless release of anticancer therapeutics. Biomaterials 2023; 303:122353. [PMID: 37925794 DOI: 10.1016/j.biomaterials.2023.122353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023]
Abstract
In the design of delivery strategies for anticancer therapeutics, the controlled release of intact cargo at the destined tumor and metastasis locations is of particular importance. To this end, stimuli-responsive chemical linkers have been extensively investigated owing to their ability to respond to tumor-specific physiological stimuli, such as lowered pH, altered redox conditions, increased radical oxygen species and pathological enzymatic activities. To prevent premature action and off-target effects, anticancer therapeutics are chemically modified to be transiently inactivated, a strategy known as prodrug development. Prodrugs are reactivated upon stimuli-dependent release at the sites of interest. As most drugs and therapeutic proteins have the optimal activity when released from carriers in their native and original forms, traceless release mechanisms are increasingly investigated. In this review, we summarize the chemical toolkit for developing innovative traceless prodrug strategies for stimuli-responsive drug delivery and discuss the applications of these chemical modifications in anticancer treatment including cancer immunotherapy.
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Affiliation(s)
- Céline Jasmin Prange
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, CH-1015, Switzerland; Institute of Chemical Sciences and Engineering, EPFL, Lausanne, CH-1015, Switzerland
| | - Xile Hu
- Institute of Chemical Sciences and Engineering, EPFL, Lausanne, CH-1015, Switzerland.
| | - Li Tang
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, CH-1015, Switzerland; Institute of Materials Science & Engineering, EPFL, Lausanne, CH-1015, Switzerland.
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2
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Riporto F, Dhouib A, Gheata A, Beauquis S, Molina E, Guené-Girard S, Galez C, Bornet A, Gautier-Luneau I, Gerber-Lemaire S, Monnier V, Le Dantec R, Mugnier Y. Nonclassical Nucleation and Crystallization of LiNbO 3 Nanoparticles from the Aqueous Solvothermal Alkoxide Route. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023:e2306417. [PMID: 37968253 DOI: 10.1002/smll.202306417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/09/2023] [Indexed: 11/17/2023]
Abstract
The exact molecular reaction pathway and crystallization mechanisms of LiNbO3 nanoparticles under solvothermal conditions are derived through extensive time- and temperature-resolved experiments allowing to track all the transient molecular and solid species. Starting with a simple mixing of Li/Nb ethoxides, water addition is used to promote condensation after ligand exchange with different co-solvents including alcohols and glycols of variable carbon-chain length. A nonclassical nucleation scheme is first demonstrated after the identification of new octanuclear complexes with a {Li4 Nb4 O10 } core whose solvophobic interactions mediate their aggregation, thus, resulting in a colloidal gel at room-temperature. Upon heating, a more or less frustrated aggregation-mediated crystallization process is then evidenced leading to LiNbO3 nanocrystals of adjustable mean size between 20 and 100 nm. Such a fine control can be attributed to the variable Nb-OR (R = alkoxy/glycoxy ligand) binding interactions at the surface of crystalline intermediates. Demonstration of such a nonclassical nucleation process and crystallization mechanism for LiNbO3 not only sheds light on the entire growth process of multifunctional nanomaterials with non-perovskite crystalline structures, but also opens new avenues for the identification of novel bimetallic oxoclusters involved in the formation of several mixed oxides from the aqueous alkoxide route.
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Affiliation(s)
- Florian Riporto
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
| | - Ameni Dhouib
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
| | - Adrian Gheata
- Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, Group for Functionalized Biomaterials, Lausanne, 1015, Switzerland
| | | | - Emilie Molina
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
| | - Simon Guené-Girard
- Université Grenoble Alpes, CNRS, Grenoble INP, Institut Néel, Grenoble, 38000, France
| | - Christine Galez
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
| | - Aurélien Bornet
- Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, Nuclear Magnetic Resonance Platform, EPFL SB ISIC-NMRP, Batochime, Lausanne, 1015, Switzerland
| | | | - Sandrine Gerber-Lemaire
- Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, Group for Functionalized Biomaterials, Lausanne, 1015, Switzerland
| | - Virginie Monnier
- Univ Lyon, Ecole Centrale de Lyon, CNRS, INSA Lyon, Université Claude Bernard Lyon 1, CPE Lyon, CNRS, INL, UMR5270, Ecully, 69130, France
| | - Ronan Le Dantec
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
| | - Yannick Mugnier
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
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3
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Gheata A, Gaulier G, Campargue G, Vuilleumier J, Kaiser S, Gautschi I, Riporto F, Beauquis S, Staedler D, Diviani D, Bonacina L, Gerber-Lemaire S. Photoresponsive Nanocarriers Based on Lithium Niobate Nanoparticles for Harmonic Imaging and On-Demand Release of Anticancer Chemotherapeutics. ACS NANOSCIENCE AU 2022; 2:355-366. [PMID: 35996436 PMCID: PMC9389616 DOI: 10.1021/acsnanoscienceau.1c00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
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Nanoparticle-based
drug delivery systems have the potential for
increasing the efficiency of chemotherapeutics by enhancing the drug
accumulation at specific target sites, thereby reducing adverse side
effects and mitigating patient acquired resistance. In particular,
photo-responsive nanomaterials have attracted much interest due to
their ability to release molecular cargos on demand upon light irradiation.
In some settings, they can also provide complementary information
by optical imaging on the (sub)cellular scale. We herein present a
system based on lithium niobate harmonic nanoparticles (LNO HNPs)
for the decoupled multi-harmonic cell imaging and near-infrared light-triggered
delivery of an erlotinib derivative (ELA) for the treatment
of epidermal growth factor receptor (EGFR)-overexpressing carcinomas.
The ELA cargo was covalently conjugated to the surface
of silica-coated LNO HNPs through a coumarinyl photo-cleavable linker,
achieving a surface loading of the active molecule of 27 nmol/mg NPs.
The resulting nanoconjugates (LNO-CM-ELA NPs) were successfully
imaged upon pulsed laser excitation at 1250 nm in EGFR-overexpressing
human prostate cancer cells DU145 by detecting the second harmonic
emission at 625 nm, in the tissue transparency window. Tuning the
laser at 790 nm resulted in the uncaging of the ELA cargo
as a result of the second harmonic emission of the inorganic HNP core
at 395 nm. This protocol induced a significant growth inhibition in
DU145 cells, which was only observed upon specific irradiation at
790 nm, highlighting the promising capabilities of LNO-CM-ELA NPs for theranostic applications.
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Affiliation(s)
- Adrian Gheata
- Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, Group for Functionalized Biomaterials, EPFL SB ISIC SCI-SB-SG, Station 6, Lausanne CH-1015, Switzerland
| | - Geoffrey Gaulier
- Department of Applied Physics, Université de Genève, 22 Chemin de Pinchat, Genève CH-1211, Switzerland
| | - Gabriel Campargue
- Department of Applied Physics, Université de Genève, 22 Chemin de Pinchat, Genève CH-1211, Switzerland
| | - Jérémy Vuilleumier
- Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, Group for Functionalized Biomaterials, EPFL SB ISIC SCI-SB-SG, Station 6, Lausanne CH-1015, Switzerland
| | - Simon Kaiser
- Department of Biomedical Sciences, Université de Lausanne, 7 Rue du Bugnon, Lausanne CH-1005, Switzerland
| | - Ivan Gautschi
- Department of Biomedical Sciences, Université de Lausanne, 7 Rue du Bugnon, Lausanne CH-1005, Switzerland
| | | | | | - Davide Staedler
- Department of Biomedical Sciences, Université de Lausanne, 7 Rue du Bugnon, Lausanne CH-1005, Switzerland
| | - Dario Diviani
- Department of Biomedical Sciences, Université de Lausanne, 7 Rue du Bugnon, Lausanne CH-1005, Switzerland
| | - Luigi Bonacina
- Department of Applied Physics, Université de Genève, 22 Chemin de Pinchat, Genève CH-1211, Switzerland
| | - Sandrine Gerber-Lemaire
- Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, Group for Functionalized Biomaterials, EPFL SB ISIC SCI-SB-SG, Station 6, Lausanne CH-1015, Switzerland
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Zhang H, Wu J, Zhou J, Liu W, Liang L, Xia S, Yan J, Sun X. Photolysis study of two indene-fused coumarin-based photoremovable protecting groups for potential biological applications. J Photochem Photobiol A Chem 2022. [DOI: 10.1016/j.jphotochem.2022.114200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dantelle G, Beauquis S, Le Dantec R, Monnier V, Galez C, Mugnier Y. Solution-Based Synthesis Routes for the Preparation of Noncentrosymmetric 0-D Oxide Nanocrystals with Perovskite and Nonperovskite Structures. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2200992. [PMID: 35691941 DOI: 10.1002/smll.202200992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/21/2022] [Indexed: 06/15/2023]
Abstract
With the miniaturization of electronic-based devices, the foreseen potential of new optical nanoprobes and the assessment of eventual size and shape effects, elaboration of multifunctional noncentrosymmetric nanocrystals with ferroelectric, pyroelectric, piezoelectric, and nonlinear optical properties are the subject of an increasing research interest. Here, the recent achievements from the solution-based methods (coprecipitation in homogeneous and nanostructured media, sol-gel processes including various chemistries and hydro/solvothermal techniques) to prepare 0-D perovskite and nonperovskite oxides in the 5-500 nm size range are critically reviewed. To cover a representative list of covalent- and ionic-type materials, BaTiO3 and its derivatives, niobate compounds (i.e., K/Na/LiNbO3 ), multiferroic BiFeO3, and crystals of lower symmetry including KTiOPO4 and some iodate compounds such as Fe(IO3 )3 and La(IO3 )3 are systematically in focus. The resulting size, morphology, and aggregation state are discussed in light of the proposed formation mechanisms. Because of a higher complexity related to their chemical composition and crystalline structures, improving the rational design of these multifunctional oxides in terms of finely-tuned compositions, crystalline hosts and structure-property relationships still need in the future a special attention of the research community to the detailed understanding of the reaction pathways and crystallization mechanisms.
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Affiliation(s)
- Géraldine Dantelle
- Université Grenoble Alpes, CNRS, Grenoble INP, Institut Néel, Grenoble, 38000, France
| | | | - Ronan Le Dantec
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
| | - Virginie Monnier
- Univ Lyon, Ecole Centrale de Lyon, CNRS, INSA Lyon, Université Claude Bernard Lyon 1, CPE Lyon, CNRS, INL, UMR5270, Ecully, 69130, France
| | - Christine Galez
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
| | - Yannick Mugnier
- Université Savoie Mont Blanc, SYMME, Annecy, F-74000, France
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NIR-to-NIR Imaging: Extended Excitation Up to 2.2 μm Using Harmonic Nanoparticles with a Tunable hIGh EneRgy (TIGER) Widefield Microscope. NANOMATERIALS 2021; 11:nano11123193. [PMID: 34947542 PMCID: PMC8706685 DOI: 10.3390/nano11123193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/22/2022]
Abstract
Near-infrared (NIR) marker-based imaging is of growing importance for deep tissue imaging and is based on a considerable reduction of optical losses at large wavelengths. We aim to extend the range of NIR excitation wavelengths particularly to values beyond 1.6 μm in order to profit from the low loss biological windows NIR-III and NIR-IV. We address this task by studying NIR-excitation to NIR-emission conversion and imaging in the range of 1200 up to 2400 nm at the example of harmonic Mg-doped lithium niobate nanoparticles (i) using a nonlinear diffuse femtosecond-pulse reflectometer and (ii) a Tunable hIGh EneRgy (TIGER) widefield microscope. We successfully demonstrate the existence of appropriate excitation/emission configurations in this spectral region taking harmonic generation into account. Moreover, NIR-imaging using the most striking configurations NIR-III to NIR-I, based on second harmonic generation (SHG), and NIR-IV to NIR-I, based on third harmonic generation (THG), is demonstrated with excitation wavelengths from 1.6–1.8 μm and from 2.1–2.2 μm, respectively. The advantages of the approach and the potential to additionally extend the emission range up to 2400 nm, making use of sum frequency generation (SFG) and difference frequency generation (DFG), are discussed.
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Gold-seeded Lithium Niobate Nanoparticles: Influence of Gold Surface Coverage on Second Harmonic Properties. NANOMATERIALS 2021; 11:nano11040950. [PMID: 33917921 PMCID: PMC8068263 DOI: 10.3390/nano11040950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 12/19/2022]
Abstract
Hybrid nanoparticles composed of an efficient nonlinear optical core and a gold shell can enhance and tune the nonlinear optical emission thanks to the plasmonic effect. However the influence of an incomplete gold shell, i.e., isolated gold nano-islands, is still not well studied. Here LiNbO3 (LN) core nanoparticles of 45 nm were coated with various densities of gold nano-seeds (AuSeeds). As both LN and AuSeeds bear negative surface charge, a positively-charged polymer was first coated onto LN. The number of polymer chains per LN was evaluated at 1210 by XPS and confirmed by fluorescence titration. Then, the surface coverage percentage of AuSeeds onto LN was estimated to a maximum of 30% using ICP-AES. The addition of AuSeeds was also accompanied with surface charge reversal, the negative charge increasing with the higher amount of AuSeeds. Finally, the first hyperpolarizability decreased with the increase of AuSeeds density while depolarization values for Au-seeded LN were close to the one of bare LN, showing a predominance of the second harmonic volumic contribution.
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Urbain M, Riporto F, Beauquis S, Monnier V, Marty JC, Galez C, Durand C, Chevolot Y, Dantec RL, Mugnier Y. On the Reaction Pathways and Growth Mechanisms of LiNbO 3 Nanocrystals from the Non-Aqueous Solvothermal Alkoxide Route. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:E154. [PMID: 33435460 PMCID: PMC7828100 DOI: 10.3390/nano11010154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/03/2021] [Accepted: 01/06/2021] [Indexed: 12/31/2022]
Abstract
Phase-pure, highly crystalline sub-50 nm LiNbO3 nanocrystals were prepared from a non-aqueous solvothermal process for 72 h at 230 °C and a commercial precursor solution of mixed lithium niobium ethoxide in its parent alcohol. A systematic variation of the reaction medium composition with the addition of different amounts of co-solvent including butanol, 1,3-propanediol, 1,4-butanediol, and 1,5-pentanediol resulted in the formation of nanocrystals of adjustable mean size and shape anisotropy, as demonstrated from XRD measurements and TEM imaging. Colloidal stability of ethanol- and water-based suspensions was evaluated from dynamic light scattering (DLS)/zeta potential studies and correlated with FTIR data. Thanks to the evolution in the nanocrystal size and shape distribution we observed, as well as to the available literature on the alkoxide chemistry, the reaction pathways and growth mechanisms were finally discussed with a special attention on the monomer formation rate, leading to the nucleation step. The polar, non-perovskite crystalline structure of LiNbO3 was also evidenced to play a major role in the nanocrystal shape anisotropy.
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Affiliation(s)
- Mathias Urbain
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
| | - Florian Riporto
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
| | - Sandrine Beauquis
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
| | - Virginie Monnier
- Institut des Nanotechnologies de Lyon (INL), UMR CNRS 5270, Ecole Centrale de Lyon, Université de Lyon, F-69134 Ecully CEDEX, France; (V.M.); (Y.C.)
| | - Jean-Christophe Marty
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
| | - Christine Galez
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
| | - Christiane Durand
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
| | - Yann Chevolot
- Institut des Nanotechnologies de Lyon (INL), UMR CNRS 5270, Ecole Centrale de Lyon, Université de Lyon, F-69134 Ecully CEDEX, France; (V.M.); (Y.C.)
| | - Ronan Le Dantec
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
| | - Yannick Mugnier
- SYMME, University of Savoie Mont Blanc, F-74000 Annecy, France; (M.U.); (F.R.); (S.B.); (J.-C.M.); (C.G.); (C.D.); (R.L.D.)
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Weinstain R, Slanina T, Kand D, Klán P. Visible-to-NIR-Light Activated Release: From Small Molecules to Nanomaterials. Chem Rev 2020; 120:13135-13272. [PMID: 33125209 PMCID: PMC7833475 DOI: 10.1021/acs.chemrev.0c00663] [Citation(s) in RCA: 293] [Impact Index Per Article: 73.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 02/08/2023]
Abstract
Photoactivatable (alternatively, photoremovable, photoreleasable, or photocleavable) protecting groups (PPGs), also known as caged or photocaged compounds, are used to enable non-invasive spatiotemporal photochemical control over the release of species of interest. Recent years have seen the development of PPGs activatable by biologically and chemically benign visible and near-infrared (NIR) light. These long-wavelength-absorbing moieties expand the applicability of this powerful method and its accessibility to non-specialist users. This review comprehensively covers organic and transition metal-containing photoactivatable compounds (complexes) that absorb in the visible- and NIR-range to release various leaving groups and gasotransmitters (carbon monoxide, nitric oxide, and hydrogen sulfide). The text also covers visible- and NIR-light-induced photosensitized release using molecular sensitizers, quantum dots, and upconversion and second-harmonic nanoparticles, as well as release via photodynamic (photooxygenation by singlet oxygen) and photothermal effects. Release from photoactivatable polymers, micelles, vesicles, and photoswitches, along with the related emerging field of photopharmacology, is discussed at the end of the review.
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Affiliation(s)
- Roy Weinstain
- School
of Plant Sciences and Food Security, Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Tomáš Slanina
- Institute
of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Flemingovo nám. 2, 166 10 Prague, Czech Republic
| | - Dnyaneshwar Kand
- School
of Plant Sciences and Food Security, Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Petr Klán
- Department
of Chemistry and RECETOX, Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
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Abstract
Therapeutic nanomaterials serve as an important platform for drug delivery under image guidance. Despite significant growth and broad applications, their design specifics remain a subject of continued interest primarily due to multifunctional factors involved, ranging from nanomaterial properties, imaging modalities, and therapeutic agents to activation strategies. This review article summarizes key findings on their design characteristics with a particular interest in strategies developed for therapeutic activation (release). First, their activation can be controlled using either an endogenous factor including low pH and glutathione or an external stimulation by light, ultrasound, or electromagnetic field. The former is passively controlled from a spatiotemporal aspect compared to the latter, which is otherwise actively controlled through drug linker photolysis, nanomaterial disassembly, or gate opening. Second, light stimulation serves a most notable strategy due to its essential role in controlled drug release, photothermal activation (hyperthermia), and photodynamic production of reactive oxygen species (ROS). Third, some of those activation strategies that rely on ultrasound, photothermal, photoacoustic, magnetic field, or X-ray radiation are dually functional due to their role in imaging modalities. In summary, this review article presents recent advances and new insights that pertain to nanotherapeutic delivery systems. It also addresses their technical limitations associated with tissue penetration (light), spatial resolution (ultrasound, hyperthermia), and occurrence of cellular resistance (ROS).
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11
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Choi SK. Photoactivation Strategies for Therapeutic Release in Nanodelivery Systems. ADVANCED THERAPEUTICS 2020. [DOI: 10.1002/adtp.202000117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Seok Ki Choi
- Michigan Nanotechnology Institute for Medicine and Biological Sciences University of Michigan Medical School Ann Arbor MI 48109 USA
- Department of Internal Medicine University of Michigan Medical School Ann Arbor MI 48109 USA
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