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Tian Y, Wu X, Li Y, He W, Liu Z, Myers FL, Zhou L. Case report: Unilateral panuveitis as a manifestation of Alport syndrome in a Chinese pediatric patient. Front Genet 2022; 13:934829. [DOI: 10.3389/fgene.2022.934829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose: The study aimed to report a rare case of a patient with Alport syndrome, which was manifested as unilateral non-infectious uveitis after bilateral cataract surgery.Methods: A case report.Results: A 2-year-old boy was diagnosed with unilateral panuveitis based on the clinical and multimodal imaging findings. Intraocular fluid samples for metagenomic next-generation sequencing (mNGS) and microbial culture were negative. However, urine tests found proteinuria and microscopic hematuria. Pathologic findings of the kidney revealed a thickened membrane, and a diagnosis of Alport syndrome was considered. Gene analysis found deletions in exon 1 of COL4A5 and exons 1 and 2 of COL4A6. The uveitis resolved gradually, following the administration of oral steroids.Conclusion: Uveitis may be an ocular manifestation of Alport syndrome.
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Sannomiya Y, Kaseda S, Kamura M, Yamamoto H, Yamada H, Inamoto M, Kuwazuru J, Niino S, Shuto T, Suico MA, Kai H. The role of discoidin domain receptor 2 in the renal dysfunction of alport syndrome mouse model. Ren Fail 2021; 43:510-519. [PMID: 33706638 PMCID: PMC7971217 DOI: 10.1080/0886022x.2021.1896548] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/09/2021] [Accepted: 02/19/2021] [Indexed: 02/08/2023] Open
Abstract
Alport syndrome (AS) is a hereditary glomerular nephritis caused by mutation in one of the type IV collagen genes α3/α4/α5 that encode the heterotrimer COL4A3/4/5. Failure to form a heterotrimer due to mutation leads to the dysfunction of the glomerular basement membrane, and end-stage renal disease. Previous reports have suggested the involvement of the receptor tyrosine kinase discoidin domain receptor (DDR) 1 in the progression of AS pathology. However, due to the similarity between DDR1 and DDR2, the role of DDR2 in AS pathology is unclear. Here, we investigated the involvement of DDR2 in AS using the X-linked AS mouse model. Mice were treated subcutaneously with saline or antisense oligonucleotide (ASO; 5 mg/kg or 15 mg/kg per week) for 8 weeks. Renal function parameters and renal histology were analyzed, and the gene expressions of inflammatory cytokines were determined in renal tissues. The expression level of DDR2 was highly elevated in kidney tissues of AS mice. Knockdown of Ddr2 using Ddr2-specific ASO decreased the Ddr2 expression. However, the DDR2 ASO treatment did not improve the proteinuria or decrease the BUN level. DDR2 ASO also did not significantly ameliorate the renal injury, inflammation and fibrosis in AS mice. These results showed that Ddr2 knockdown by ASO had no notable effect on the progression of AS indicating that DDR2 may not be critically involved in AS pathology. This finding may provide useful information and further understanding of the role of DDRs in AS.
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Affiliation(s)
- Yuya Sannomiya
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
| | - Shota Kaseda
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
- Program for Leading Graduate Schools “HIGO (Health life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, Kumamoto, Japan
| | - Misato Kamura
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
- Program for Leading Graduate Schools “HIGO (Health life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, Kumamoto, Japan
| | | | | | | | - Jun Kuwazuru
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
| | - Saki Niino
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
| | - Tsuyoshi Shuto
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
- Global Center for Natural Resources Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mary Ann Suico
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
- Global Center for Natural Resources Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirofumi Kai
- Department of Molecular Medicine Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
- Program for Leading Graduate Schools “HIGO (Health life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, Kumamoto, Japan
- Global Center for Natural Resources Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Tardy OR, Armitage EL, Prince LR, Evans IR. The Epidermal Growth Factor Ligand Spitz Modulates Macrophage Efferocytosis, Wound Responses and Migration Dynamics During Drosophila Embryogenesis. Front Cell Dev Biol 2021; 9:636024. [PMID: 33898424 PMCID: PMC8060507 DOI: 10.3389/fcell.2021.636024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/19/2021] [Indexed: 12/31/2022] Open
Abstract
How multifunctional cells such as macrophages interpret the different cues within their environment and undertake an appropriate response is a key question in developmental biology. Understanding how cues are prioritized is critical to answering this - both the clearance of apoptotic cells (efferocytosis) and the migration toward damaged tissue is dependent on macrophages being able to interpret and prioritize multiple chemoattractants, polarize, and then undertake an appropriate migratory response. Here, we investigate the role of Spitz, the cardinal Drosophila epidermal growth factor (EGF) ligand, in regulation of macrophage behavior in the developing fly embryo, using activated variants with differential diffusion properties. Our results show that misexpression of activated Spitz can impact macrophage polarity and lead to clustering of cells in a variant-specific manner, when expressed either in macrophages or the developing fly heart. Spitz can also alter macrophage distribution and perturb apoptotic cell clearance undertaken by these phagocytic cells without affecting the overall levels of apoptosis within the embryo. Expression of active Spitz, but not a membrane-bound variant, can also increase macrophage migration speeds and impair their inflammatory responses to injury. The fact that the presence of Spitz specifically undermines the recruitment of more distal cells to wound sites suggests that Spitz desensitizes macrophages to wounds or is able to compete for their attention where wound signals are weaker. Taken together these results suggest this molecule regulates macrophage migration and their ability to dispose of apoptotic cells. This work identifies a novel regulator of Drosophila macrophage function and provides insights into signal prioritization and integration in vivo. Given the importance of apoptotic cell clearance and inflammation in human disease, this work may help us to understand the role EGF ligands play in immune cell recruitment during development and at sites of disease pathology.
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Affiliation(s)
- Olivier R. Tardy
- Department of Infection, Immunity and Cardiovascular Disease, The Bateson Centre, The University of Sheffield, Sheffield, United Kingdom
- The Bateson Centre, The University of Sheffield, Sheffield, United Kingdom
| | - Emma L. Armitage
- Department of Infection, Immunity and Cardiovascular Disease, The Bateson Centre, The University of Sheffield, Sheffield, United Kingdom
- The Bateson Centre, The University of Sheffield, Sheffield, United Kingdom
| | - Lynne R. Prince
- Department of Infection, Immunity and Cardiovascular Disease, The Bateson Centre, The University of Sheffield, Sheffield, United Kingdom
| | - Iwan R. Evans
- Department of Infection, Immunity and Cardiovascular Disease, The Bateson Centre, The University of Sheffield, Sheffield, United Kingdom
- The Bateson Centre, The University of Sheffield, Sheffield, United Kingdom
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Torra R, Furlano M. New therapeutic options for Alport syndrome. Nephrol Dial Transplant 2020; 34:1272-1279. [PMID: 31190059 DOI: 10.1093/ndt/gfz131] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/31/2019] [Indexed: 12/12/2022] Open
Abstract
Alport syndrome (AS) is the most frequent inherited kidney disease after autosomal dominant polycystic kidney disease. It has three different patterns of inheritance-autosomal dominant, autosomal recessive and X-linked-which in part explains the wide spectrum of disease, ranging from isolated microhaematuria to end-stage renal disease early in life. The search for a treatment for AS is being pursued vigorously, not only because of the obvious unmet need but also because AS is a rare disease and any drug approved will have an orphan drug designation with its various benefits. Moreover, AS patients are quite young with very few comorbidities, which facilitates clinical trials. This review identifies the particularities of each pattern of inheritance but focuses mainly on new drugs or therapeutic targets for the disease. Most treatment-related investigations are directed not at the main abnormality in AS, namely collagen IV composition, but rather at the associated inflammation and fibrosis. Thus, AS may serve as a proof of concept for numerous drugs of potential value in many diseases that cause chronic kidney disease.
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Affiliation(s)
- Roser Torra
- Inherited Renal Disorders, Nephrology Department, Fundació Puigvert, REDINREN, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mónica Furlano
- Inherited Renal Disorders, Nephrology Department, Fundació Puigvert, REDINREN, IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Liu X, Bai Y, Zhou X, Gu X, Zhao L. Complete remission of membranous nephropathy in a patient with lung adenocarcinoma treated with erlotinib. J Clin Pharm Ther 2019; 45:388-393. [PMID: 31730733 DOI: 10.1111/jcpt.13078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Membranous nephrotic syndrome is one of the most commonly seen paraneoplastic nephropathies. CASE DESCRIPTION We describe a 59-year-old man who was referred with massive unilateral pleural effusion and was subsequently diagnosed with lung adenocarcinoma. Routine physical and laboratory examinations revealed lower limb oedema, hypoproteinaemia and proteinuria. Examination of a kidney biopsy aspirate confirmed the diagnosis of membranous nephropathy. Aetiological investigations of the kidney pathology ruled out causes other than paraneoplastic nephropathy. Since an epidermal growth factor receptor mutation was identified by analysis of the exfoliated tumour cells in pleural effusion, erlotinib was administered, without further treatment of the membranous nephropathy. Upon control of the patient's lung cancer, the membranous nephropathy completely disappeared, and at the time of this writing, had not recurred over a 4-year follow-up period. WHAT IS NEW AND CONCLUSION For patients with EGFR-mutation-positive lung adenocarcinoma associated with paraneoplastic membranous nephropathy, erlotinib might serve as a treatment option for both the tumour and the membranous nephropathy.
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Affiliation(s)
- Xiaodong Liu
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu Bai
- Department of Nephropathy, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaoming Zhou
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiu Gu
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Zhao
- Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China
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Zhang Y, Ding J. Renal, auricular, and ocular outcomes of Alport syndrome and their current management. Pediatr Nephrol 2018; 33:1309-1316. [PMID: 28864840 DOI: 10.1007/s00467-017-3784-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 08/01/2017] [Accepted: 08/10/2017] [Indexed: 01/27/2023]
Abstract
Alport syndrome is a hereditary glomerular basement membrane disease caused by mutations in the COL4A3/4/5 genes encoding the type IV collagen alpha 3-5 chains. Most cases of Alport syndrome are inherited as X-linked dominant, and some as autosomal recessive or autosomal dominant. The primary manifestations are hematuria, proteinuria, and progressive renal failure, whereas some patients present with sensorineural hearing loss and ocular abnormalities. Renin-angiotensin-aldosterone system blockade is proven to delay the onset of renal failure by reducing proteinuria. Renal transplantation is a curative treatment for patients who have progressed to end-stage renal disease. However, only supportive measures can be used to improve hearing loss and visual loss. Although both stem cell therapy and gene therapy aim to repair the basement membrane defects, technical difficulties require more research in Alport mice before clinical studies. Here, we review the renal, auricular, and ocular manifestations and outcomes of Alport syndrome and their current management.
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Affiliation(s)
- Yanqin Zhang
- Pediatric Department, Peking University First Hospital, Beijing, China
| | - Jie Ding
- Pediatric Department, Peking University First Hospital, Beijing, China.
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Yokota T, Omachi K, Suico MA, Kojima H, Kamura M, Teramoto K, Kaseda S, Kuwazuru J, Shuto T, Kai H. Bromide supplementation exacerbated the renal dysfunction, injury and fibrosis in a mouse model of Alport syndrome. PLoS One 2017; 12:e0183959. [PMID: 28873450 PMCID: PMC5584969 DOI: 10.1371/journal.pone.0183959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 08/15/2017] [Indexed: 11/18/2022] Open
Abstract
A seminal study recently demonstrated that bromide (Br-) has a critical function in the assembly of type IV collagen in basement membrane (BM), and suggested that Br- supplementation has therapeutic potential for BM diseases. Because salts of bromide (KBr and NaBr) have been used as antiepileptic drugs for several decades, repositioning of Br- for BM diseases is probable. However, the effects of Br- on glomerular basement membrane (GBM) disease such as Alport syndrome (AS) and its impact on the kidney are still unknown. In this study, we administered daily for 16 weeks 75 mg/kg or 250 mg/kg (within clinical dosage) NaBr or NaCl (control) via drinking water to 6-week-old AS mice (mouse model of X-linked AS). Treatment with 75 mg/kg NaBr had no effect on AS progression. Surprisingly, compared with 250 mg/kg NaCl, 250 mg/kg NaBr exacerbated the progressive proteinuria and increased the serum creatinine and blood urea nitrogen in AS mice. Histological analysis revealed that glomerular injury, renal inflammation and fibrosis were exacerbated in mice treated with 250 mg/kg NaBr compared with NaCl. The expressions of renal injury markers (Lcn2, Lysozyme), matrix metalloproteinase (Mmp-12), pro-inflammatory cytokines (Il-6, Il-8, Tnf-α, Il-1β) and pro-fibrotic genes (Tgf-β, Col1a1, α-Sma) were also exacerbated by 250 mg/kg NaBr treatment. Notably, the exacerbating effects of Br- were not observed in wild-type mice. These findings suggest that Br- supplementation needs to be carefully evaluated for real positive health benefits and for the absence of adverse side effects especially in GBM diseases such as AS.
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Affiliation(s)
- Tsubasa Yokota
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Kohei Omachi
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School “HIGO (Health Life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Mary Ann Suico
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Haruka Kojima
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Misato Kamura
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School “HIGO (Health Life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Keisuke Teramoto
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School “HIGO (Health Life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Shota Kaseda
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School “HIGO (Health Life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Jun Kuwazuru
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Tsuyoshi Shuto
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
| | - Hirofumi Kai
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School “HIGO (Health Life science: Interdisciplinary and Glocal Oriented) Program”, Kumamoto University, 5–1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, Japan
- * E-mail:
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Yokota T, Omachi K, Suico MA, Kamura M, Kojima H, Fukuda R, Motomura K, Teramoto K, Kaseda S, Kuwazuru J, Takeo T, Nakagata N, Shuto T, Kai H. STAT3 inhibition attenuates the progressive phenotypes of Alport syndrome mouse model. Nephrol Dial Transplant 2017; 33:214-223. [DOI: 10.1093/ndt/gfx246] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 06/26/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tsubasa Yokota
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Kohei Omachi
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School Health Life Science: Interdisciplinary and Glocal Oriented Program, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Mary Ann Suico
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Misato Kamura
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School Health Life Science: Interdisciplinary and Glocal Oriented Program, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Haruka Kojima
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Ryosuke Fukuda
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Keishi Motomura
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Keisuke Teramoto
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School Health Life Science: Interdisciplinary and Glocal Oriented Program, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Shota Kaseda
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School Health Life Science: Interdisciplinary and Glocal Oriented Program, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Jun Kuwazuru
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Toru Takeo
- Division of Reproductive Engineering, Center for Animal Resources and Development, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Naomi Nakagata
- Division of Reproductive Engineering, Center for Animal Resources and Development, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Tsuyoshi Shuto
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
| | - Hirofumi Kai
- Department of Molecular Medicine, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan
- Program for Leading Graduate School Health Life Science: Interdisciplinary and Glocal Oriented Program, Kumamoto University, Kumamoto City, Kumamoto, Japan
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