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Figueiredo CS, Roseira ES, Viana TT, Silveira MAD, de Melo RMV, Fernandez MG, Lemos LMG, Passos LCS. Inflammation in Coronary Atherosclerosis: Insights into Pathogenesis and Therapeutic Potential of Anti-Inflammatory Drugs. Pharmaceuticals (Basel) 2023; 16:1242. [PMID: 37765050 PMCID: PMC10534546 DOI: 10.3390/ph16091242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 09/29/2023] Open
Abstract
Atherosclerosis is a lipid-driven immune-inflammatory disease that affects the arteries, leading to multifocal plaque development. The inflammatory process involves the activation of immune cells and various inflammatory pathways. Anti-inflammatory drugs have been shown to be effective in reducing cardiovascular events in individuals with coronary disease. However, their use is still limited due to concerns about long-term follow-up, cost-effectiveness, adverse effects, and the identification of the ideal patient profile to obtain maximum benefits. This review aims to improve the understanding of inflammation in coronary atherosclerosis and explore potential therapeutic interventions, encompassing both traditional and non-traditional anti-inflammatory approaches. By addressing these concepts, we seek to contribute to the advancement of knowledge about this type of treatment for coronary artery disease.
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Affiliation(s)
- Clara Salles Figueiredo
- Programa de Pós Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Federal University of Bahia, Salvador 40110-060, BA, Brazil (L.C.S.P.)
- Hospital Ana Nery, Salvador 40301-155, BA, Brazil; (E.S.R.)
| | | | - Tainá Teixeira Viana
- Programa de Pós Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Federal University of Bahia, Salvador 40110-060, BA, Brazil (L.C.S.P.)
- Hospital Ana Nery, Salvador 40301-155, BA, Brazil; (E.S.R.)
| | - Marcelo Augusto Duarte Silveira
- Programa de Pós Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Federal University of Bahia, Salvador 40110-060, BA, Brazil (L.C.S.P.)
| | - Rodrigo Morel Vieira de Melo
- Programa de Pós Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Federal University of Bahia, Salvador 40110-060, BA, Brazil (L.C.S.P.)
- Hospital Ana Nery, Salvador 40301-155, BA, Brazil; (E.S.R.)
| | | | | | - Luiz Carlos Santana Passos
- Programa de Pós Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Federal University of Bahia, Salvador 40110-060, BA, Brazil (L.C.S.P.)
- Hospital Ana Nery, Salvador 40301-155, BA, Brazil; (E.S.R.)
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de Araújo Moreira MDR, Sales-Campos H, Fontanari C, Galvão Meireles AF, Borges Prado MK, Zoccal KF, Sorgi CA, Tefé da Silva C, Groppo M, Faccioli LH. The ethanolic extract of Terminalia argentea Mart. & Zucc. bark reduces the inflammation through the modulation of cytokines and nitric oxide mediated by the downregulation of NF-κB. JOURNAL OF ETHNOPHARMACOLOGY 2020; 261:113150. [PMID: 32730887 DOI: 10.1016/j.jep.2020.113150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/18/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Terminalia argentea Mart. & Zucc. (Combretaceae), popularly known as "capitão do campo", is native from the Brazilian cerrado, which is used in folk medicine to treat inflammatory diseases. AIM OF THE STUDY We aimed to investigate the anti-inflammatory effects, toxicity and mechanisms of action regarding the use of the hydroalcoholic extract of T. argentea bark. MATERIALS AND METHODS Toxicity was determinate in vitro using the macrophage lineage J774.1 without LPS. Cells were treated with 0.5; 2; 8; 32 and 125 μg/mL of the plant extract. Cell viability was assessed by MTT colorimetric assay. The production of nitrite and cytokines was also determined in the supernatants. A NF-κB reporter assay using RAW macrophages was employed to elucidate the impact of the plant extract on the expression of such molecule. In mice, toxicity was assessed by orally given an intermediate to high concentration of the plant extract on a single dose (1000 or 5000 mg/kg) or low and intermediate doses (300 or 1000 mg/kg) twice daily for 14 days. Blood samples were collected for biochemical analysis. The anti-inflammatory activity was assessed using the air-pouch model with or without pre-inoculation with the inflammatory stimuli LPS (0.5 μg/mL), followed by treatment with plant extract at 5, 60 or 300 mg/kg administered in the air pouch (subcutaneous injection). After 4 h, mice were euthanized and the air pouches washed with 2 mL heparinized PBS (10 IU/mL). Then, the local production in the air pouch wash of cytokines, total proteins and leukocytes was assessed. RESULTS No signals of toxicity were observed either in cells or mice. Regardless the concentration used in vitro, the extract exhibited a significant anti-inflammatory activity, as perceived by the reduction of the inflammatory cytokines IL-1β, TNF-α and IL-6 and nitrites on cell supernatants. This was concomitant with a downregulation in NF-κB and elevated levels of IL-10. In mice, similar effects were observed, especially when the plant extract was given at 300 mg/kg, inhibiting the release of IL-1β, TNF-α, IL-6 and proteins, as well as increasing the release of IL-10. CONCLUSIONS Altogether, our results demonstrated that the hydroalcoholic extract of T. argentea bark has anti-inflammatory activity without inducing toxicity in cells or living animals. This activity seems to be chiefly influenced by a downregulation in NF-κB, inflammatory cytokines and production of nitrite along with augmented concentration of IL-10.
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Affiliation(s)
| | - Helioswilton Sales-Campos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil; Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
| | - Caroline Fontanari
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Alyne Fávero Galvão Meireles
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Morgana Kelly Borges Prado
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Karina Furlani Zoccal
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil; Centro Universitário Barão de Mauá, Ribeirão Preto, São Paulo, Brazil.
| | - Carlos Artério Sorgi
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | | | - Milton Groppo
- Departamento de Biologia, Faculdade de Filosofia Ciências e Letras de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
| | - Lúcia Helena Faccioli
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Das G, Kim DY, Fan C, Gutiérrez-Grijalva EP, Heredia JB, Nissapatorn V, Mitsuwan W, Pereira ML, Nawaz M, Siyadatpanah A, Norouzi R, Sawicka B, Shin HS, Patra JK. Plants of the Genus Terminalia: An Insight on Its Biological Potentials, Pre-Clinical and Clinical Studies. Front Pharmacol 2020; 11:561248. [PMID: 33132909 PMCID: PMC7578430 DOI: 10.3389/fphar.2020.561248] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/07/2020] [Indexed: 12/16/2022] Open
Abstract
The evaluation and confirmation of healing properties of several plant species of genus Terminalia based on their traditional uses and the clinical claims are of utmost importance. Genus Terminalia has received more attention to assess and validate the therapeutic potential and clinical approval due to its immense folk medicinal and traditional applications. Various species of Terminalia genus are used in the form of herbal medicine and formulations, in treatment of diseases, including headache, fever, pneumonia, flu, geriatric, cancer, to improve memory, abdominal and back pain, cough and cold, conjunctivitis, diarrhea, heart disorder, leprosy, sexually transmitted diseases, and urinary tract disorders. These are reported to possess numerous biological properties, counting: antibacterial, antifungal, antiinflammatory, antiviral, antiretroviral, antioxidant, and antipa7rasitic. This current research review aims to update the detailed biological activities, pre-clinical and clinical studies of various extracts and secondary metabolites from several plant species under the genus Terminalia, along with information on the traditional uses and chemical composition to develop a promising strategy for their potential applications in the form of medicine or use in modern drug formulations for treating diseases like pneumonia, flu, and other types of viral infections or controlling human contagions.
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Affiliation(s)
- Gitishree Das
- Research Institute of Biotechnology & Medical Converged Science, Dongguk University-Seoul, Goyangsi, South Korea
| | - Do-Yeong Kim
- Research Institute of Biotechnology & Medical Converged Science, Dongguk University-Seoul, Goyangsi, South Korea
| | - Chen Fan
- Skin Research Institute of Singapore, Agency for Science, Technology and Research, A∗STAR, Singapore, Singapore
| | - Erick P. Gutiérrez-Grijalva
- Laboratorio de Alimentos Funcionales y Nutracéuticos, Cátedras CONACYT–Centro de Investigación en Alimentación y Desarrollo, Culiacán, México
| | - J. Basilio Heredia
- Laboratorio de Alimentos Funcionales y Nutracéuticos, Centro de Investigación en Alimentación y Desarrollo, Culiacán, México
| | - Veeranoot Nissapatorn
- School of Allied Health Sciences, Research Excellence Center for Innovation and Health Products (RECIHP) and World Union for Herbal Drugs Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat, Thailand
| | - Watcharapong Mitsuwan
- School of Allied Health Sciences, Research Excellence Center for Innovation and Health Products (RECIHP) and World Union for Herbal Drugs Discovery (WUHeDD), Walailak University, Nakhon Si Thammarat, Thailand
| | - Maria Lourdes Pereira
- CICECO-Aveiro Institute of Materials and Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Muhammad Nawaz
- Department of Nano-Medicine Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abolghasem Siyadatpanah
- Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Roghayeh Norouzi
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Barbara Sawicka
- Faculty of Agrobioengineering, Department of Plant Production Technology and Commodities Science, University of Life Sciences in Lublin, Lublin, Poland
| | - Han-Seung Shin
- Department of Food Science & Biotechnology, Dongguk University-Seoul, Goyangsi, South Korea
| | - Jayanta Kumar Patra
- Research Institute of Biotechnology & Medical Converged Science, Dongguk University-Seoul, Goyangsi, South Korea
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Srivastava G, Garg A, Misra RC, Chanotiya CS, Ghosh S. Transcriptome analysis and functional characterization of oxidosqualene cyclases of the arjuna triterpene saponin pathway. PLANT SCIENCE : AN INTERNATIONAL JOURNAL OF EXPERIMENTAL PLANT BIOLOGY 2020; 292:110382. [PMID: 32005387 DOI: 10.1016/j.plantsci.2019.110382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 10/25/2019] [Accepted: 12/14/2019] [Indexed: 06/10/2023]
Abstract
Arjuna (Terminalia arjuna) tree has been popular in Indian traditional medicine to treat cardiovascular ailments. The tree accumulates bioactive triterpene glycosides (saponins) and aglycones (sapogenins), in a tissue-preferential manner. Oleanane triterpenes/saponins (derived from β-amyrin) with potential cardioprotective function predominantly accumulate in the bark. However, arjuna triterpene saponin pathway enzymes remain to be identified and biochemically characterized. Here, we employed a combined transcriptomics, metabolomics and biochemical approach to functionally define a suite of oxidosqualene cyclases (OSCs) that catalyzed key reactions towards triterpene scaffold diversification. De novo assembly of 131 millions Illumina NextSeq500 sequencing reads obtained from leaf and stem bark samples led to a total of 156,650 reference transcripts. Four distinct OSCs (TaOSC1-4) with 54-71 % sequence identities were identified and functionally characterized. TaOSC1, TaOSC3 and TaOSC4 were biochemically characterized as β-amyrin synthase, cycloartenol synthase and lupeol synthase, respectively. However, TaOSC2 was found to be a multifunctional OSC producing both α-amyrin and β-amyrin, but showed a preference for α-amyrin product. Both TaOSC1 and TaOSC2 produced β-amyrin, the direct precursor for oleanane triterpene/saponin biosynthesis; but, TaOSC1 transcript expressed preferentially in bark, suggesting a major role of TaOSC1 in the biosynthesis of oleanane triterpenes/saponins in bark.
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Affiliation(s)
- Gaurav Srivastava
- Biotechnology Division, Council of Scientific and Industrial Research-Central Institute of Medicinal and Aromatic Plants, Lucknow, 226015, India
| | - Anchal Garg
- Biotechnology Division, Council of Scientific and Industrial Research-Central Institute of Medicinal and Aromatic Plants, Lucknow, 226015, India
| | - Rajesh Chandra Misra
- Biotechnology Division, Council of Scientific and Industrial Research-Central Institute of Medicinal and Aromatic Plants, Lucknow, 226015, India
| | - Chandan Singh Chanotiya
- Chemical Sciences Division, Council of Scientific and Industrial Research-Central Institute of Medicinal and Aromatic Plants, Lucknow, 226015, India
| | - Sumit Ghosh
- Biotechnology Division, Council of Scientific and Industrial Research-Central Institute of Medicinal and Aromatic Plants, Lucknow, 226015, India.
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Bhansali S, Khatri S, Dhawan V. Terminalia Arjuna bark extract impedes foam cell formation and promotes apoptosis in ox-LDL-stimulated macrophages by enhancing UPR-CHOP pathway. Lipids Health Dis 2019; 18:195. [PMID: 31706299 PMCID: PMC6842518 DOI: 10.1186/s12944-019-1119-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 09/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increased macrophage and foam cell apoptosis during early atherogenesis retards plaque progression by impeding foam cell formation, suppressing inflammation and limiting lesion cellularity. Our previous in vitro study in THP1 macrophages demonstrated that Terminalia Arjuna (TA) attenuates dual-specificity phosphatase1 (DUSP1), a key negative regulator of JNK/P38MAPK signaling cascade, the branch also implicated in the UPR (unfolded protein response)-CHOP-mediated apoptotic pathway; however this pathway has not been explored so far in the presence of TA. Therefore, we aimed to elucidate the pro-apoptotic effect of aqueous bark extract of TA (aqTAE) on macrophage and foam cells and the underlying mechanism associated with it. METHODS THP1 cells were initially differentiated into macrophages with phorbol-12-myristate-13-acetate (PMA) (100 ng/ml) for 24 h, followed by ox-LDL (100 μg/ml) treatment for another 24 h to induce foam cell formation. Thereafter, macrophages and ox-LDL- treated cells were incubated with aqTAE (100 μg/ml) for the next 24 h. Further, Oil Red O (ORO) staining, CD36 expression profiling, apoptotic assay and transcriptional and translational expression of ER-stress markers i.e., X-box binding protein 1 (XBP1) and C/EBP homologous protein (CHOP) were performed for elucidating the potential mechanism underlying TA-induced macrophage and foam cell apoptosis. RESULTS We demonstrated that ox-LDL treatment significantly increased lipid accumulation and upregulated CD36 expression, indicating foam cell formation; while the addition of aqTAE resulted in a significant decline in ORO positive cells, and suppression of CD36 expression in ox-LDL-stimulated macrophages, suggestive of reduced formation of lipid-laden foam cells. Further, aqTAE treatment alone and in combination with oxidized low-density lipoprotein (ox-LDL) stimulus, significantly attenuated CD36 expression; increased apoptosis; and augmented the expression of UPR regulatory proteins including XBP1 and CHOP, and similar observations were noted when cells were treated with ox-LDL alone. These findings indicate that TA promotes macrophage and foam cell apoptosis via enhancing UPR-mediated activation of JNK/p38MAPK-CHOP pathway in a DUSP1-dependent manner, implying a possible interplay between ox-LDL-induced ER stress- and TA-mediated MAPK signaling. CONCLUSION Our data shows that aqTAE inhibits foam cell formation, as well as promotes macrophage and foam cell apoptosis by augmenting UPR- JNK/p38MAPK-CHOP signaling cascade via inhibiting DUSP1. These findings provide novel mechanistic insight into the anti-atherogenic potential of TA, which may prove beneficial against early-stage atherosclerotic lesions.
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Affiliation(s)
- Shipra Bhansali
- Department of Experimental Medicine and Biotechnology, Research Block-B, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Shivani Khatri
- Department of Experimental Medicine and Biotechnology, Research Block-B, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Veena Dhawan
- Department of Experimental Medicine and Biotechnology, Research Block-B, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
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Santos DKDDN, de Almeida VS, de Araujo DRC, Harand W, Soares AKDA, Moreira LR, de Lorena VMB, Magalhães LPM, Ximenes RM, de Sena KXDFR, de Melo CML, Napoleão TH, Lima CSDA, Yara R, Vieira JRC. Evaluation of cytotoxic, immunomodulatory and antibacterial activities of aqueous extract from leaves of Conocarpus erectus Linnaeus (Combretaceae). J Pharm Pharmacol 2018; 70:1092-1101. [DOI: 10.1111/jphp.12930] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/16/2018] [Indexed: 12/18/2022]
Abstract
Abstract
Objectives
This work evaluated the antibacterial activity, cytotoxicity and immunomodulatory effect on human peripheral blood mononuclear cells (PBMCs) promoted by aqueous extract from Conocarpus erectus leaves (AELCe).
Methods
The extract was characterized by thin layer chromatography and ultraperformance liquid chromatography coupled to mass spectrometry (UPLC-MS). Cytotoxicity of AELCe (6.25–50 μg/ml) was investigated using annexin V and propidium iodide. Cytokine and nitric oxide levels in PBMCs culture supernatants exposed or not to AELCe (12.5 μg/ml) were determined, and antibacterial activity was evaluated by disc diffusion and broth microdilution methods.
Key findings
AELCe contained 3′,4′-OH flavonoids, phenylpropanoglycosides, saponins, polymeric proanthocyanidins and hydrolysable tannins. Moreover, 10 other compounds were identified through UPLC-MS technique. AELCe did not affect lymphocyte viability at 6.25 and 12.5 μg/ml. IL-2, IL-10, TNF-α, IFN-γ and nitric oxide was produced in higher levels by cells treated with AELCe. Proliferation and activation of CD8+ T lymphocytes were also stimulated. AELCe showed bacteriostatic activity against clinical and antibiotic-resistant strains of Staphylococcus aureus (MIC between 250 and 1000 μg/ml).
Conclusions
AELCe showed a moderate bacteriostatic activity and promoted an immunomodulatory status through higher production of Th1 cytokines, nitric oxide release and T CD8+ lymphocytes stimulation.
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Affiliation(s)
| | | | | | - Wolfgang Harand
- Instituto Nacional do Semiárido (INSA), Campina Grande, Brazil
| | | | - Leyllane Rafael Moreira
- Centro de Pesquisas Aggeu Magalhães (CPqAM), Fundação Oswaldo Cruz (FIOCRUZ), Recife, Brazil
| | | | | | - Rafael Matos Ximenes
- Departamento de Antibióticos, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | | | | | - Ricardo Yara
- Departamento de Engenharia Biomédica, Universidade Federal de Pernambuco, Recife, Brazil
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Rather RA, Malik VS, Trikha D, Bhat O, Dhawan V. Aqueous Terminalia arjuna extract modulates expression of key atherosclerosis-related proteins in a hypercholesterolemic rabbit: A proteomic-based study. Proteomics Clin Appl 2016; 10:750-759. [PMID: 26934842 DOI: 10.1002/prca.201500114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/15/2016] [Accepted: 02/29/2016] [Indexed: 07/07/2024]
Abstract
PURPOSE The present study evaluates the effect of an aqueous extract of Terminalia arjuna (aqTAE) on protein expression in aortic plaques of hypercholesterolemic rabbits using a proteomic approach. EXPERIMENTAL DESIGN Thirty male New Zealand rabbits (n = 6) were employed as Gp1 (stock diet); Gp2 (high-fat diet [HFD]); Gp3 (stock diet + aqTAE); Gp4 (HFD + aqTAE); and Gp5 (HFD + atorvastatin) and followed for 6 months. Protein lysates of aortic tissues were separated by 2DE and proteins were identified by MALDI-TOF/MS. RESULTS Serum lipids were found to be significantly increased by an HFD and reduced by aqTAE both at 3 and 6 months (Gp4 vs. Gp2; p < 0.05). Total 79 spots were differentially expressed, among which 60 individual proteins were identified, 31 grouped as atherosclerosis-related proteins and 29 classified as others. aqTAE significantly attenuated the protein expression of tumor necrosis factor α, cyclooxygenase-2, MMP-9, HSP60, ICAM-5, Endothelin-3, Vimentin, Protein S100-A9 besides others. Many of the observed proteins are known to be consistently associated with endothelial dysfunction, inflammation, plaque rupture, and immune imbalance. CONCLUSIONS AND CLINICAL RELEVANCE Strong hypolipidemic effects of aqTAE and attenuation of these signature atherogenic biomarkers using proteomics highlights the fact that aqTAE may be useful in the prevention and management of atherosclerosis.
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Affiliation(s)
- Riyaz Ahmad Rather
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh, India
| | - Vivek Singh Malik
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh, India
| | - Dimple Trikha
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh, India
| | - Owais Bhat
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh, India
| | - Veena Dhawan
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh, India
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