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Miller GE, Passarelli V, Chen E, Kloog I, Wright RJ, Amini H. Ambient PM 2.5 and specific sources increase inflammatory cytokine responses to stimulators and reduce sensitivity to inhibitors. ENVIRONMENTAL RESEARCH 2024; 252:118964. [PMID: 38640989 PMCID: PMC11152990 DOI: 10.1016/j.envres.2024.118964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/28/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
Ambient exposure to fine particulate matter (PM2.5) is associated with increased morbidity and mortality from multiple diseases. Recent observations suggest the hypothesis that trained immunity contributes to these risks, by demonstrating that ambient PM2.5 sensitizes innate immune cells to mount larger inflammatory response to subsequent bacterial stimuli. However, little is known about how general and durable this sensitization phenomenon is, and whether specific sources of PM2.5 are responsible. Here we consider these issues in a longitudinal study of children. The sample consisted of 277 children (mean age 13.92 years; 63.8% female; 38.4% Black; 32.2% Latinx) who completed baseline visits and were re-assessed two years later. Fasting whole blood was ex vivo incubated with 4 stimulating agents reflecting microbial and sterile triggers of inflammation, and with 2 inhibitory agents, followed by assays for IL-1β, IL-6, IL-8, and TNF-α. Blood also was assayed for 6 circulating biomarkers of low-grade inflammation: C-reactive protein, interleukin-6, -8, and -10, tumor necrosis factor-α, and soluble urokinase-type plasminogen activator receptor. Using machine learning, levels of 15 p.m.2.5 constituents were estimated for a 50 m grid around children's homes. Models were adjusted for age, sex, race, pubertal status, and household income. In cross-sectional analyses, higher neighborhood PM2.5 was associated with larger cytokine responses to the four stimulating agents. These associations were strongest for constituents released by motor vehicles and soil/crustal dust. In longitudinal analyses, residential PM2.5 was associated with declining sensitivity to inhibitory agents; this pattern was strongest for constituents from fuel/biomass combustion and motor vehicles. By contrast, PM2.5 constituents were not associated with the circulating biomarkers of low-grade inflammation. Overall, these findings suggest the possibility of a trained immunity scenario, where PM2.5 heightens inflammatory cytokine responses to multiple stimulators, and dampens sensitivity to inhibitors which counter-regulate these responses.
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Affiliation(s)
- Gregory E Miller
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, USA.
| | - Veronica Passarelli
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Edith Chen
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Itai Kloog
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Heresh Amini
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
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Wardhani K, Yazzie S, McVeigh C, Edeh O, Grimes M, Jacquez Q, Dixson C, Barr E, Liu R, Bolt AM, Feng C, Zychowski KE. Systemic immunological responses are dependent on sex and ovarian hormone presence following acute inhaled woodsmoke exposure. Part Fibre Toxicol 2024; 21:27. [PMID: 38797836 PMCID: PMC11129474 DOI: 10.1186/s12989-024-00587-5] [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: 12/01/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Rural regions of the western United States have experienced a noticeable surge in both the frequency and severity of acute wildfire events, which brings significant challenges to both public safety and environmental conservation efforts, with impacts felt globally. Identifying factors contributing to immune dysfunction, including endocrinological phenotypes, is essential to understanding how hormones may influence toxicological susceptibility. METHODS This exploratory study utilized male and female C57BL/6 mice as in vivo models to investigate distinct responses to acute woodsmoke (WS) exposure with a focus on sex-based differences. In a second set of investigations, two groups were established within the female mouse cohort. In one group, mice experienced ovariectomy (OVX) to simulate an ovarian hormone-deficient state similar to surgical menopause, while the other group received Sham surgery as controls, to investigate the mechanistic role of ovarian hormone presence in driving immune dysregulation following acute WS exposure. Each experimental cohort followed a consecutive 2-day protocol with daily 4-h exposure intervals under two conditions: control HEPA-filtered air (FA) and acute WS to simulate an acute wildfire episode. RESULTS Metals analysis of WS particulate matter (PM) revealed significantly increased levels of 63Cu, 182W, 208Pb, and 238U, compared to filtered air (FA) controls, providing insights into the specific metal components most impacted by the changing dynamics of wildfire occurrences in the region. Male and female mice exhibited diverse patterns in lung mRNA cytokine expression following WS exposure, with males showing downregulation and females displaying upregulation, notably for IL-1β, TNF-α, CXCL-1, CCL-5, TGF-β, and IL-6. After acute WS exposure, there were notable differences in the responses of macrophages, neutrophils, and bronchoalveolar lavage (BAL) cytokines IL-10, IL-6, IL-1β, and TNF-α. Significant diverse alterations were observed in BAL cytokines, specifically IL-1β, IL-10, IL-6, and TNF-α, as well as in the populations of immune cells, such as macrophages and polymorphonuclear leukocytes, in both Sham and OVX mice, following acute WS exposure. These findings elucidated the profound influence of hormonal changes on inflammatory outcomes, delineating substantial sex-related differences in immune activation and revealing altered immune responses in OVX mice due to ovarian hormone deficiency. In addition, the flow cytometry analysis highlighted the complex interaction between OVX surgery, acute WS exposure, and their collective impact on immune cell populations within the hematopoietic bone marrow niche. CONCLUSIONS In summary, both male and female mice, alongside females subjected to OVX and those who had sham surgery, exhibit significant variations in the expression of proinflammatory cytokines, chemokines, lung mRNA gene expression, and related functional networks linked to signaling pathways. These differences potentially act as mediators of sex-specific and hormonal influences in the systemic inflammatory response to acute WS exposure during a wildfire event. Understanding the regulatory roles of genes expressed differentially under environmental stressors holds considerable implications, aiding in identifying sex-specific therapeutic targets for addressing acute lung inflammation and injury.
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Affiliation(s)
- Kartika Wardhani
- College of Nursing, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
- Biochemistry and Biotechnology Group (B-TEK), Bioscience Division, Los Alamos National Laboratory, Los Alamos, New Mexico, USA
| | - Sydnee Yazzie
- College of Nursing, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Charlotte McVeigh
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Onamma Edeh
- College of Nursing, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Martha Grimes
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Quiteria Jacquez
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Connor Dixson
- College of Nursing, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Edward Barr
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Rui Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Alicia M Bolt
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Changjian Feng
- Department of Pharmaceutical Sciences, College of Pharmacy, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA
| | - Katherine E Zychowski
- College of Nursing, University of New Mexico-Health Sciences Center, Albuquerque, New Mexico, USA.
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3
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Yoon HY, Kim SY, Song JW. Effects of indoor air pollution on clinical outcomes in patients with interstitial lung disease: protocol of a multicentre prospective observational study. BMJ Open Respir Res 2024; 11:e002053. [PMID: 38262669 PMCID: PMC10806566 DOI: 10.1136/bmjresp-2023-002053] [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: 09/05/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibrosing interstitial lung disease with a poor prognosis. While there is evidence suggesting that outdoor air pollution affects the clinical course of IPF, the impact of indoor air pollution on patients with IPF has not been extensively studied. Therefore, this prospective multicentre observational study aims to investigate the association between indoor air pollution and clinical outcomes in patients with IPF. METHODS AND ANALYSIS This study enrolled 140 patients with IPF from 12 medical institutes in the Seoul and Metropolitan areas of the Republic of Korea. Over the course of 1 year, participants visited the institutes every 3 months, during which their clinical data and blood samples were collected. Additionally, indoor exposure to particulate matter ≤2.5 µm (PM2.5) was measured using MicroPEM (RTI International, Research Triangle Park, North Carolina, USA) in each participant's house for 5 days every 3 months. Lung function was assessed using both site spirometry at each institution and portable spirometry at each participant's house every 3 months. The study will analyse the impact of indoor PM2.5 on clinical outcomes, including mortality, acute exacerbation, changes in lung function and health-related quality of life, in the participants. This study represents the first attempt to evaluate the influence of indoor air pollution on the prognosis of patients with IPF. ETHICS AND DISSEMINATION This study has received approval from the institutional review board of all participating institutions, including Asan Medical Center, Seoul, Republic of Korea (2021-0072). TRIAL REGISTRATION NUMBER KCT0006217.
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Affiliation(s)
- Hee-Young Yoon
- Division of Allergy and Respiratory Diseases, Soonchunhyang University Seoul Hospital, Seoul, Korea (the Republic of)
| | - Sun-Young Kim
- Department of Cancer AI & Digital Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea (the Republic of)
| | - Jin Woo Song
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Korea (the Republic of)
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Raqib R, Akhtar E, Ahsanul Haq M, Ahmed S, Haque F, Chowdhury MAH, Shahriar MH, Begum BA, Eunus M, Sarwar G, Parvez F, Sharker Y, Ahsan H, Yunus M. Reduction of household air pollution through clean fuel intervention and recovery of cellular immune balance. ENVIRONMENT INTERNATIONAL 2023; 179:108137. [PMID: 37579572 PMCID: PMC11062205 DOI: 10.1016/j.envint.2023.108137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND We conducted a clean fuel intervention trial (Bangladesh Global Environmental and Occupational Health (GEOHealth) (NCT02824237) with liquefied petroleum gas (LPG) for 26 months among rural Bangladeshi women chronically exposed to household air pollution (HAP) from biomass fuel (BMF) use. We aimed to evaluate the effect of HAP reduction following LPG intervention on immune response outcome. METHODS We supplied LPG cook stove and refills in cylinder in 200 households for 26 months. We measured personal exposure to HAP [particulate matter 2.5 (PM2·5), black carbon (BC) and carbon monoxide (CO)] in 200 women (main cook) by personal monitors at pre- and post-intervention. Immune function was assessed before and after intervention, in blood collected within 2 weeks of HAP measurements. Primary endpoints included reduction in HAP, lymphocyte proliferation and oxidative stress response, and alterations in T and B cell proportions. FINDINGS Exclusive LPG use for 26 months resulted in significant reduction in PM2·5 (43.5%), BC (13%) and CO (48%) exposure in the women. For one unit decrease in BC, Treg cells and memory B cells increased by 7% and 34% respectively, in the peripheral circulation. One unit decrease in CO was significantly associated with increase in early B cells and plasmablasts by 66% and 5% respectively. For one unit decrease in BC, percent-dividing cells, proliferation and expansion indices increased by 2%, 0.4%, and 1%, respectively. INTERPRETATION Reduced personal exposure to HAP through clean fuel intervention was related to a return towards cellular immune balance.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mahbub Eunus
- U-Chicago Research Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - Golam Sarwar
- U-Chicago Research Bangladesh, Mohakhali, Dhaka, Bangladesh
| | - Faruque Parvez
- Mailman School of Public Health, Columbia University, New York, USA
| | | | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, USA; U-Chicago Research Bangladesh, Mohakhali, Dhaka, Bangladesh
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5
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Mechanisms of Lung Damage and Development of COPD Due to Household Biomass-Smoke Exposure: Inflammation, Oxidative Stress, MicroRNAs, and Gene Polymorphisms. Cells 2022; 12:cells12010067. [PMID: 36611860 PMCID: PMC9818405 DOI: 10.3390/cells12010067] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/28/2022] Open
Abstract
Chronic exposure to indoor biomass smoke from the combustion of solid organic fuels is a major cause of disease burden worldwide. Almost 3 billion people use solid fuels such as wood, charcoal, and crop residues for indoor cooking and heating, accounting for approximately 50% of all households and 90% of rural households globally. Biomass smoke contains many hazardous pollutants, resulting in household air pollution (HAP) exposure that often exceeds international standards. Long-term biomass-smoke exposure is associated with Chronic Obstructive Pulmonary Disease (COPD) in adults, a leading cause of morbidity and mortality worldwide, chronic bronchitis, and other lung conditions. Biomass smoke-associated COPD differs from the best-known cigarette smoke-induced COPD in several aspects, such as a slower decline in lung function, greater airway involvement, and less emphysema, which suggests a different phenotype and pathophysiology. Despite the high burden of biomass-associated COPD, the molecular, genetic, and epigenetic mechanisms underlying its pathogenesis are poorly understood. This review describes the pathogenic mechanisms potentially involved in lung damage, the development of COPD associated with wood-derived smoke exposure, and the influence of genetic and epigenetic factors on the development of this disease.
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6
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Qiu AY, Leng S, McCormack M, Peden DB, Sood A. Lung Effects of Household Air Pollution. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2807-2819. [PMID: 36064186 DOI: 10.1016/j.jaip.2022.08.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Biomass fuel smoke, secondhand smoke, and oxides of nitrogen are common causes of household air pollution (HAP). Almost 2.4 billion people worldwide use solid fuels for cooking and heating, mostly in low- and middle-income countries. Wood combustion for household heating is also common in many areas of high-income countries, and minorities are particularly vulnerable. HAP in low- and middle-income countries is associated with asthma, acute respiratory tract infections in adults and children, chronic obstructive pulmonary disease, lung cancer, tuberculosis, and respiratory mortality. Although wood smoke exposure levels in high-income countries are typically lower than in lower-income countries, it is similarly associated with accelerated lung function decline, higher prevalence of airflow obstruction and chronic bronchitis, and higher all-cause and respiratory cause-specific mortality. Household air cleaners with high-efficiency particle filters have mixed effects on asthma and chronic obstructive pulmonary disease outcomes. Biomass fuel interventions in low-income countries include adding chimneys to cookstoves, improving biomass fuel combustion stoves, and switching fuel to liquid petroleum gas. Still, the impact on health outcomes is inconsistent. In high-income countries, strategies for reducing biomass fuel-related HAP are centered on community-level woodstove changeout programs, although the results are again inconsistent. In addition, initiatives to encourage home smoking bans have mixed success in households with children. Environmental solutions to reduce HAP have varying success in reducing pollutants and health problems. Improved understanding of indoor air quality factors and actions that prevent degradation or improve polluted indoor air may lead to enhanced environmental health policies, but health outcomes must be rigorously examined.
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Affiliation(s)
- Anna Y Qiu
- Johns Hopkins University, School of Medicine, Baltimore, Md
| | - Shuguang Leng
- University of New Mexico School of Medicine, Albuquerque, NM; University of New Mexico Comprehensive Cancer Center, Albuquerque, NM
| | | | - David B Peden
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Akshay Sood
- University of New Mexico School of Medicine, Albuquerque, NM; Miners Colfax Medical Center, Raton, NM.
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7
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McCarthy CE, Duffney PF, Nogales A, Post CM, Lawrence BP, Martinez-Sobrido L, Thatcher TH, Phipps RP, Sime PJ. Dung biomass smoke exposure impairs resolution of inflammatory responses to influenza infection. Toxicol Appl Pharmacol 2022; 450:116160. [PMID: 35817128 PMCID: PMC10211473 DOI: 10.1016/j.taap.2022.116160] [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: 05/18/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 01/26/2023]
Abstract
Epidemiological studies associate biomass smoke with an increased risk for respiratory infections in children and adults in the developing world, with 500,000 premature deaths each year attributed to biomass smoke-related acute respiratory infections including infections caused by respiratory viruses. Animal dung is a biomass fuel of particular concern because it generates more toxic compounds per amount burned than wood, and is a fuel of last resort for the poorest households. Currently, there is little biological evidence on the effects of dung biomass smoke exposure on immune responses to respiratory viral infections. Here, we investigated the impact of dung biomass exposure on respiratory infection using a mouse model of dung biomass smoke and cultured primary human small airway epithelial cells (SAECs). Mice infected with influenza A virus (IAV) after dung biomass smoke exposure had increased mortality, lung inflammation and virus mRNA levels, and suppressed expression of innate anti-viral mediators compared to air exposed mice. Importantly, there was still significant tissue inflammation 14 days after infection in dung biomass smoke-exposed mice even after inflammation had resolved in air-exposed mice. Dung biomass smoke exposure also suppressed the production of anti-viral cytokines and interferons in cultured SAECs treated with poly(I:C) or IAV. This study shows that dung biomass smoke exposure impairs the immune response to respiratory viruses and contributes to biomass smoke-related susceptibility to respiratory viral infections, likely due to a failure to resolve the inflammatory effects of biomass smoke exposure.
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Affiliation(s)
| | - Parker F Duffney
- United States Environmental Protection Agency, Integrated Health Assessment Branch, Research Triangle Park, NC, USA
| | - Aitor Nogales
- Centro de Investigación en Sanidad Animal (CISA), INIA-CSIC, Madrid, Spain
| | - Christina M Post
- Department of Environmental Medicine, University of Rochester, Rochester NY, New York, United States
| | - B Paige Lawrence
- Department of Environmental Medicine, University of Rochester, Rochester NY, New York, United States
| | | | - Thomas H Thatcher
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Patricia J Sime
- Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA.
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8
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Li Q, Xu R, Fan H, Xu J, Xu Y, Cao P, Zhang Y, Liang T, Zhang Y, Chen W, Wang Z, Wang L, Chen X. Smart Mushroom-Inspired Imprintable and Lightly Detachable (MILD) Microneedle Patterns for Effective COVID-19 Vaccination and Decentralized Information Storage. ACS NANO 2022; 16:7512-7524. [PMID: 35451839 PMCID: PMC9045675 DOI: 10.1021/acsnano.1c10718] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/15/2022] [Indexed: 05/20/2023]
Abstract
The key to controlling the spread of the coronavirus disease 2019 (COVID-19) and reducing mortality is highly dependent on the safe and effective use of vaccines for the general population. Current COVID-19 vaccination practices (intramuscular injection of solution-based vaccines) are limited by heavy reliance on medical professionals, poor compliance, and laborious vaccination recording procedures, resulting in a waste of health resources and low vaccination coverage, etc. In this study, we developed a smart mushroom-inspired imprintable and lightly detachable (MILD) microneedle platform for the effective and convenient delivery of multidose COVID-19 vaccines and decentralized vaccine information storage. The mushroom-like structure allows the MILD system to be easily pressed into the skin and detached from the patch base, acting as a "tattoo" to record the vaccine counts in situ without any storage equipment, offering quick accessibility and effortless readout, saving a great deal of valuable time and energy for both patients and health professionals. After loading inactivated SARS-CoV-2 virus-based vaccines, MILD system induced a high level of antibodies against the SARS-CoV-2 receptor-binding domain (RBD) in vivo without eliciting systemic toxicity and local damage. Collectively, this smart delivery platform serves as a promising carrier to improve COVID-19 vaccination efficacy through its dual capabilities of vaccine delivery and in situ data storage, thus exhibiting great potential for helping to contain the COVID-19 pandemic or a resurgence.
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Affiliation(s)
- Qilin Li
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Rengui Xu
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Huiling Fan
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Jiarong Xu
- Department of Pharmacology, School of Basic Medicine,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430030, China
- Hubei Key Laboratory for Drug Target Researches and
Pharmacodynamic Evaluation, Huazhong University of Science and
Technology, Wuhan 430030, China
| | - Yunruo Xu
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Peng Cao
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Yan Zhang
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Tao Liang
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Yang Zhang
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Wei Chen
- Department of Pharmacology, School of Basic Medicine,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430030, China
- Hubei Key Laboratory for Drug Target Researches and
Pharmacodynamic Evaluation, Huazhong University of Science and
Technology, Wuhan 430030, China
| | - Zheng Wang
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
- Department of Gastrointestinal Surgery, Union
Hospital, Tongji Medical College, Huazhong, University of Science and
Technology, Wuhan 430022, China
| | - Lin Wang
- Department of Clinical Laboratory, Union Hospital,
Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430022, China
- Research Center for Tissue Engineering and
Regenerative Medicine, Union Hospital, Huazhong University of Science and
Technology, Wuhan 430022, China
| | - Xiaoyuan Chen
- Departments of Diagnostic Radiology and Surgery, Yong Loo Lin
School of Medicine, National University of Singapore, 117597,
Singapore
- Departments of Chemical and Biomolecular Engineering,
and Biomedical Engineering, Faculty of Engineering, National University of
Singapore, 117597, Singapore
- Clinical Imaging Research Centre, Centre for
Translational Medicine, Yong Loo Lin School of Medicine, National University
of Singapore, 117597, Singapore
- Nanomedicine Translational Research Program, NUS
Center for Nanomedicine, Yong Loo Lin School of Medicine, National University
of Singapore, 117597, Singapore
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