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Chen K, Wang M, Long D, Zou D, Li X, Wang R, Wang Y, Yang L. Cerebrospinal Fluid Proteomic Profiles in Patients with Postherpetic Neuralgia. J Proteome Res 2023; 22:3879-3892. [PMID: 37966014 PMCID: PMC10696610 DOI: 10.1021/acs.jproteome.3c00547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023]
Abstract
The intrinsic mechanism of postherpetic neuralgia (PHN) remains unclear. Herein, we aimed to seek the hub proteins in the cerebrospinal fluid (CSF), which display significant changes between the PHN and nonpainful patients (Control). First, the proteomic results showed that compared with the Control-CSF, there were 100 upregulated and 50 downregulated differentially expressed proteins (DEPs) in the PHN-CSF. Besides, functional analyses including gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) revealed that biological processes and pathways including complement activation, infection, coagulation, and lipid metabolism were activated, while synaptic organization was suppressed. Next, the protein-protein interaction (PPI) analysis indicated that increased PLG, F2, APOA1, APOA2, SERPINC1, and KNG1 and reduced APOE, which were all enriched in the top pathways according to the KEGG analysis, were defined as hub proteins. Finally, three of the hub proteins, such as PLG, APOA1, and APOE, were reconfirmed in a larger cohort using both enzyme-linked immunosorbent assay (ELISA) and Western blotting methods. Above all, the results indicated that PLG, APOA1, and APOE and their involved processes such as infection, inflammation, cholesterol metabolism, and coagulation shall be potential therapeutic approaches. (The raw mass spectrometry proteome data and search results have been deposited to the iProx-integrated Proteome Resources (http://www.iprox.cn) with the data set identifier IPX0007372000.).
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Affiliation(s)
- Kai Chen
- Department
of Pain Management, The Second Xiangya Hospital,
Central South University, Changsha 410011, China
- Department
of Anesthesiology, The Second Xiangya Hospital,
Central South University, Changsha, Hunan 410011, China
- Clinical
Research Center for Pain Medicine in Hunan Province, Changsha, Hunan 410011, China
- Hunan
Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, Hunan 410083, China
| | - Meng Wang
- Department
of Pain Management, The Second Xiangya Hospital,
Central South University, Changsha 410011, China
- Department
of Anesthesiology, The Second Xiangya Hospital,
Central South University, Changsha, Hunan 410011, China
- Clinical
Research Center for Pain Medicine in Hunan Province, Changsha, Hunan 410011, China
- Hunan
Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, Hunan 410083, China
| | - Dongju Long
- Department
of Pain Management, The Second Xiangya Hospital,
Central South University, Changsha 410011, China
- Department
of Anesthesiology, The Second Xiangya Hospital,
Central South University, Changsha, Hunan 410011, China
- Clinical
Research Center for Pain Medicine in Hunan Province, Changsha, Hunan 410011, China
- Hunan
Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, Hunan 410083, China
| | - Dingquan Zou
- Department
of Pain Management, The Second Xiangya Hospital,
Central South University, Changsha 410011, China
- Department
of Anesthesiology, The Second Xiangya Hospital,
Central South University, Changsha, Hunan 410011, China
- Clinical
Research Center for Pain Medicine in Hunan Province, Changsha, Hunan 410011, China
- Hunan
Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, Hunan 410083, China
| | - Xin Li
- Department
of Pain Management, The Second Xiangya Hospital,
Central South University, Changsha 410011, China
- Department
of Anesthesiology, The Second Xiangya Hospital,
Central South University, Changsha, Hunan 410011, China
- Clinical
Research Center for Pain Medicine in Hunan Province, Changsha, Hunan 410011, China
- Hunan
Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, Hunan 410083, China
| | - Ruixuan Wang
- Bourns
Engineering, The University of California, Riverside, California 92521, United States
| | - Yaping Wang
- Department
of Pain Management, The Second Xiangya Hospital,
Central South University, Changsha 410011, China
- Department
of Anesthesiology, The Second Xiangya Hospital,
Central South University, Changsha, Hunan 410011, China
- Clinical
Research Center for Pain Medicine in Hunan Province, Changsha, Hunan 410011, China
- Hunan
Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, Hunan 410083, China
| | - Lin Yang
- Department
of Pain Management, The Second Xiangya Hospital,
Central South University, Changsha 410011, China
- Department
of Anesthesiology, The Second Xiangya Hospital,
Central South University, Changsha, Hunan 410011, China
- Clinical
Research Center for Pain Medicine in Hunan Province, Changsha, Hunan 410011, China
- Hunan
Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, Hunan 410083, China
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Hore Z, Royds J, Abuukar Abdullahi R, Lampa J, Al-Kaisy A, Denk F. Cerebrospinal fluid immune cells appear similar across neuropathic and non-neuropathic pain conditions. Wellcome Open Res 2023; 8:493. [PMID: 38707493 PMCID: PMC11069048 DOI: 10.12688/wellcomeopenres.20153.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 05/07/2024] Open
Abstract
Background Microglia have been implicated in the pathophysiology of neuropathic pain. Here, we sought to investigate whether cerebrospinal fluid (CSF) might be used as a proxy-measure of microglial activation in human participants. Methods We preformed fluorescence-activated cell sorting (FACS) of CSF immune cell populations derived from individuals who experienced pain with neuropathic features. We sorted CD4+, CD8+ T cells and monocytes and analyzed their transcriptome using RNA sequencing. We also performed Cellular Indexing of Transcriptomes and Epitopes (CITE) sequencing to characterize the expression of all CSF immune cells in a patient with postherpetic neuralgia and in a patient with neuropathic pain after failed back surgery. Results Immune cell numbers and phenotypes were not obviously different between individuals regardless of the etiology of their pain. This was true when examining our own dataset, as well as when comparing it to previously published single-cell RNA sequencing data of human CSF. In all instances, CSF monocytes showed expression of myeloid cell markers commonly associated with microglia ( P2RY12, TMEM119 and OLFML3), which will make it difficult to ascertain the origin of CSF proteins: do they derive directly from circulating CSF monocytes or could some originate in spinal cord microglia in the parenchyma? Conclusions We conclude that it will not be straightforward to use CSF as a biomarker for microglial function in humans.
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Affiliation(s)
- Zoe Hore
- Wolfson Centre for Age-Related Diseases, King's College London, London, England, UK
| | - Jonathan Royds
- Guy’s and St Thomas’ Chronic Pain Department, St Thomas Hospital, London, UK
| | | | - Jon Lampa
- Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Adnan Al-Kaisy
- Guy’s and St Thomas’ Chronic Pain Department, St Thomas Hospital, London, UK
| | - Franziska Denk
- Wolfson Centre for Age-Related Diseases, King's College London, London, England, UK
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Qian YT, Liu XY, Sun HD, Xu JY, Sun JM, Liu W, Chen T, Liu JW, Tan Y, Sun W, Ma DL. Urinary Proteomics Analysis of Active Vitiligo Patients: Biomarkers for Steroid Treatment Efficacy Prediction and Monitoring. Front Mol Biosci 2022; 9:761562. [PMID: 35252347 PMCID: PMC8891126 DOI: 10.3389/fmolb.2022.761562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/19/2022] [Indexed: 12/16/2022] Open
Abstract
Vitiligo is a common acquired skin disorder caused by immune-mediated destruction of epidermal melanocytes. Systemic glucocorticoids (GCs) have been used to prevent the progression of active vitiligo, with 8.2–56.2% of patients insensitive to this therapy. Currently, there is a lack of biomarkers that can accurately predict and evaluate treatment responses. The goal of this study was to identify candidate urinary protein biomarkers to predict the efficacy of GCs treatment in active vitiligo patients and monitor the disease. Fifty-eight non-segmental vitiligo patients were enrolled, and 116 urine samples were collected before and after GCs treatment. Patients were classified into a treatment-effective group (n = 42) and a treatment-resistant group (n = 16). Each group was divided equally into age- and sex-matched experimental and validation groups, and proteomic analyses were performed. Differentially expressed proteins were identified, and Ingenuity Pathway Analysis was conducted for the functional annotation of these proteins. Receiver operating characteristic curves were used to evaluate the diagnostic value. A total of 245 and 341 differentially expressed proteins between the treatment-resistant and treatment-effective groups were found before and after GCs treatment, respectively. Bioinformatic analysis revealed that the urinary proteome reflected the efficacy of GCs in active vitiligo patients. Eighty and fifty-four candidate biomarkers for treatment response prediction and treatment response evaluation were validated, respectively. By ELISA analysis, retinol binding protein-1 and torsin 1A interacting protein 1 were validated to have the potential to predict the efficacy of GCs with AUC value of 1 and 0.875, respectively. Retinol binding protein-1, torsin 1A interacting protein 1 and protein disulfide-isomerase A4 were validated to have the potential to reflect positive treatment effect to GCs treatment in active vitiligo with AUC value of 0.861, 1 and 0.868, respectively. This report is the first to identify urine biomarkers for GCs treatment efficacy prediction in vitiligo patients. These findings might contribute to the application of GCs in treating active vitiligo patients.
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Affiliation(s)
- Yue-Tong Qian
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Xiao-Yan Liu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Hai-Dan Sun
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Ji-Yu Xu
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Jia-Meng Sun
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Wei Liu
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Tian Chen
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Jia-Wei Liu
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Yan Tan
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Wei Sun
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- *Correspondence: Wei Sun, ; Dong-Lai Ma,
| | - Dong-Lai Ma
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
- *Correspondence: Wei Sun, ; Dong-Lai Ma,
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Gomez-Varela D, Barry AM, Schmidt M. Proteome-based systems biology in chronic pain. J Proteomics 2019; 190:1-11. [DOI: 10.1016/j.jprot.2018.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 03/15/2018] [Accepted: 04/05/2018] [Indexed: 02/07/2023]
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Richner M, Vaegter CB. Glucocorticoids - Efficient analgesics against postherpetic neuralgia? Scand J Pain 2017; 16:61-63. [PMID: 28850413 DOI: 10.1016/j.sjpain.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Mette Richner
- Department of Biomedicine, Aarhus University, Denmark.
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Moore DM, McCrory C. The Proteomics of Intrathecal Analgesic agents for Chronic Pain. Curr Neuropharmacol 2017; 15:198-205. [PMID: 26907496 PMCID: PMC5412698 DOI: 10.2174/1570159x14666160224124446] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 08/21/2015] [Accepted: 08/28/2015] [Indexed: 12/19/2022] Open
Abstract
Chronic pain remains a challenging clinical problem with a growing socio-economic burden for the state. Its prevalence is high and many of the patients are of work age. Our knowledge regarding the pathophysiology of chronic pain is poor. The consensus view is that the central nervous system plays a key role in the persistence of pain after an initiating event has long ceased. However the specifics of this biological response to an initiating event remains unclear. There is a growing body of evidence to support the concept that a central neuroimmune response is initiated and a number of small peptides have been implicated in this process following cerebrospinal fluid analysis in patients with chronic pain. This central biosynthetic peptide response leads to a process called central sensitization. Therapy is aimed at modulating and even inhibiting this response. However current pharmacological therapeutic options are limited in efficacy with significant deleterious side effect profiles. Proteomic studies extend single molecule analysis by identifying the components of biological networks and pathways and defining their interactions. This tool offers the potential to provide a molecular overview of the biological processes involved in chronic pain. It will also facilitate examination of gene-drug interactions. This technique offers a mechanism of defining the central biological responses that result in chronic pain and this information may facilitate the development of better therapies.
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Olausson P, Ghafouri B, Bäckryd E, Gerdle B. Clear differences in cerebrospinal fluid proteome between women with chronic widespread pain and healthy women - a multivariate explorative cross-sectional study. J Pain Res 2017; 10:575-590. [PMID: 28331360 PMCID: PMC5356922 DOI: 10.2147/jpr.s125667] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Frequent chronic local pain can develop into chronic widespread pain (CWP). The spread of pain is correlated with pain intensity, anxiety, and depression, conditions that ultimately lead to a poor quality of life. Knowledge is incomplete about CWP’s etiology, although it has been suggested that both central hyperexcitability and/or a combination with peripheral factors may be involved. Cerebrospinal fluid (CSF) could act as a mirror for the central nervous system as proteins are signal substances that activate the formation of algesics and control nociceptive processes. To this end, this study investigates the CSF protein expression in women with CWP and in female healthy controls. Materials and methods This study included 12 female patients with CWP diagnosed according to the American College of Rheumatology criteria with 13 healthy age- and sex-matched pain-free subjects. All subjects went through a clinical examination and answered a health questionnaire that registered sociodemographic and anthropometric data, pain characteristics, psychological status, and quality of life rating. CSF was collected by lumbar puncture from each subject. Two-dimensional gel electrophoresis in combination with mass spectrometry was used to analyze the CSF proteome. This study identifies proteins that significantly discriminate between the two groups using multivariate data analysis (MVDA) (i.e., orthogonal partial least squares discriminant analysis [OPLS-DA]). Results There were no clinically significant levels of psychological distress and catastrophization presented in subjects with CWP. MVDA revealed a highly significant OPLS-DA model where 48 proteins from CSF explained 91% (R2) of the variation and with a prediction of 90% (Q2). The highest discriminating proteins were metabolic, transport, stress, and inflammatory. Conclusion The highest discriminating proteins (11 proteins), according to the literature, are involved in apoptotic regulations, anti-inflammatory and anti-oxidative processes, the immune system, and endogenous repair. The results of this explorative study may indicate the presence of neuro-inflammation in the central nervous system of CWP patients. Future studies should be larger and control for confounders and determine which alterations are unspecific/general and which are specific changes.
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Affiliation(s)
- Patrik Olausson
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Emmanuel Bäckryd
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Abstract
STUDY DESIGN Prospective study. OBJECTIVE To identify proteins with differential expression in the cerebrospinal fluid (CSF) from 15 clinically normal (control) dogs and 15 dogs with cervical spondylomyelopathy (CSM). SUMMARY OF BACKGROUND DATA Canine CSM is a spontaneous, chronic, compressive cervical myelopathy similar to human cervical spondylotic myelopathy. There is a limited knowledge of the molecular mechanisms underlying these conditions. Differentially expressed CSF proteins may contribute with novel information about the disease pathogenesis in both dogs and humans. METHODS Protein separation was performed with 2-dimensional electrophoresis. A Student t test was used to detect significant differences between groups (P < 0.05). Three comparisons were made: (1) control versus CSM-affected dogs, (2) control versus non-corticosteroid-treated CSM-affected dogs, and (3) non-corticosteroid-treated CSM-affected versus corticosteroid-treated CSM-affected dogs. Protein spots exhibiting at least a statistically significant 1.25-fold change between groups were selected for subsequent identification with capillary-liquid chromatography tandem mass spectrometry. RESULTS A total of 96 spots had a significant average change of at least 1.25-fold in 1 of the 3 comparisons. Compared with the CSF of control dogs, CSM-affected dogs demonstrated increased CSF expression of 8 proteins including vitamin D-binding protein, gelsolin, creatine kinase B-type, angiotensinogen, α-2-HS-glycoprotein, SPARC (secreted protein, acidic, rich in cysteine), calsyntenin-1, and complement C3, and decreased expression of pigment epithelium-derived factor, prostaglandin-H2 D-isomerase, apolipoprotein E, and clusterin. In the CSF of CSM-affected dogs, corticosteroid treatment increased the expression of haptoglobin, transthyretin isoform 2, cystatin C-like, apolipoprotein E, and clusterin, and decreased the expression of angiotensinogen, α-2-HS-glycoprotein, and gelsolin. CONCLUSION Many of the differentially expressed proteins are associated with damaged neural tissue, bone turnover, and/or compromised blood-spinal cord barrier. The knowledge of the protein changes that occur in CSM and upon corticosteroid treatment of CSM-affected patients will aid in further understanding the pathomechanisms underlying this disease. LEVEL OF EVIDENCE N/A.
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Rijsdijk M, van Wijck AJM, Kalkman CJ, Yaksh TL. The effects of glucocorticoids on neuropathic pain: a review with emphasis on intrathecal methylprednisolone acetate delivery. Anesth Analg 2014; 118:1097-112. [PMID: 24781577 DOI: 10.1213/ane.0000000000000161] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Methylprednisolone acetate (MPA) has a long history of use in the treatment of sciatic pain and other neuropathic pain syndromes. In several of these syndromes, MPA is administered in the epidural space. On a limited basis, MPA has also been injected intrathecally in patients suffering from postherpetic neuralgia and complex regional pain syndrome. The reports on efficacy of intrathecal administration of MPA in neuropathic pain patients are contradictory, and safety is debated. In this review, we broadly consider mechanisms whereby glucocorticoids exert their action on spinal cascades relevant to the pain arising after nerve injury and inflammation. We then focus on the characteristics of the actions of MPA in pharmacokinetics, efficacy, and safety when administered in the intrathecal space.
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Affiliation(s)
- Mienke Rijsdijk
- From the *Department of Anesthesiology, Pain Clinic, University Medical Center Utrecht, Utrecht, The Netherlands; and †Department of Anesthesiology, University of California San Diego, San Diego, California
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Zhang J, Corbett JR, Plymire DA, Greenberg BM, Patrie SM. Proteoform analysis of lipocalin-type prostaglandinD-synthase from human cerebrospinal fluid by isoelectric focusing and superficially porous liquid chromatography with Fourier transform mass spectrometry. Proteomics 2014; 14:1223-31. [DOI: 10.1002/pmic.201300368] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 12/31/2013] [Accepted: 02/11/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Junmei Zhang
- Department of Pathology; University of Texas Southwestern Medical Center; TX USA
| | - John R. Corbett
- Department of Bioengineering; University of Texas at Dallas; TX USA
| | - Daniel A. Plymire
- Department of Pathology; University of Texas Southwestern Medical Center; TX USA
| | | | - Steven M. Patrie
- Department of Pathology; University of Texas Southwestern Medical Center; TX USA
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