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Wang X, Tian R, Liang C, Jia Y, Zhao L, Xie Q, Huang F, Yuan H. Biomimetic nanoplatform with microbiome modulation and antioxidant functions ameliorating insulin resistance and pancreatic β-cell dysfunction for T2DM management. Biomaterials 2024; 313:122804. [PMID: 39236631 DOI: 10.1016/j.biomaterials.2024.122804] [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: 03/20/2024] [Revised: 08/29/2024] [Accepted: 09/01/2024] [Indexed: 09/07/2024]
Abstract
Insulin resistance and pancreatic β-cell dysfunction are the main pathogenesis of type 2 diabetes mellitus (T2DM). However, insulin therapy and diabetes medications do not effectively solve the two problems simultaneously. In this study, a biomimetic oral hydrogen nanogenerator that leverages the benefits of edible plant-derived exosomes and hydrogen therapy was constructed to overcome this dilemma by modulating gut microbiota and ameliorating oxidative stress and inflammatory responses. Hollow mesoporous silica (HMS) nanoparticles encapsulating ammonia borane (A) were used to overcome the inefficiency of H2 delivery in traditional hydrogen therapy, and exosomes originating from ginger (GE) were employed to enhance biocompatibility and regulate intestinal flora. Our study showed that HMS/A@GE not only considerably ameliorated insulin resistance and liver steatosis, but inhibited the dedifferentiation of islet β-cell and enhanced pancreatic β-cell proportion in T2DM model mice. In addition to its antioxidant and anti-inflammatory effects, HMS/A@GE augmented the abundance of Lactobacilli spp. and tryptophan metabolites, such as indole and indole acetic acid, which further activated the AhR/IL-22 pathway to improve intestinal-barrier function and metabolic impairments. This study offers a potentially viable strategy for addressing the current limitations of diabetes treatment by integrating gut-microbiota remodelling with antioxidant therapies.
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Affiliation(s)
- Xiudan Wang
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China
| | - Rui Tian
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China
| | - Chenghong Liang
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China
| | - Yifan Jia
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China
| | - Lingyun Zhao
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China
| | - Qinyuan Xie
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China
| | - Fenglian Huang
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China
| | - Huijuan Yuan
- Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, Henan Provincial People's Hospital, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Zhengzhou University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China; Department of Endocrinology, Henan Provincial Key Medicine Laboratory of Intestinal Microecology and Diabetes, People's Hospital of Henan University, Weiwu Road 7, Zhengzhou, 450003, Henan, PR China.
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2
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Sadok I, Grochowicz M, Krzyszczak-Turczyn A. 4-Vinylpyridine copolymers for improved LC-MS tryptophan and kynurenine determination in human serum. Sci Rep 2024; 14:18622. [PMID: 39128928 PMCID: PMC11317505 DOI: 10.1038/s41598-024-69491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/05/2024] [Indexed: 08/13/2024] Open
Abstract
Tryptophan (an essential amino acid) and its clinically important metabolite-kynurenine contribute to several fundamental biological processes and methods that allow their determination in biological samples are in demand. The novelty of the work was a demonstration of the utility of two polymers: 4-vinylpyridine crosslinked with trimethylolpropane trimethacrylate (poly(4VP-co-TRIM)) or 1,4-dimethacryloyloxybenzene (poly(4VP-co-14DMB))-in terms of human serum clean-up for simultaneous LC-MS determination of tryptophan and kynurenine. The goal was to achieve a reduction of the matrix effect, which is responsible for signal suppression, with minimal capture of analytes. The adsorption properties of the polymeric beads were studied by evaluating the adsorption kinetics and isotherms in model matrices. Therefore, the adsorption capacities of both molecules were not efficient, the tested 4-vinylpyridine-based copolymers have shown great promise (especially poly(4VP-co-TRIM)) as sorbents for serum clean-up. In the model human serum matrix, poly(4VP-co-TRIM) provided good recoveries of tryptophan and kynurenine (76% and 87%, respectively) and allowed for the reduction of the matrix effect. Performances of both copolymers were compared to those of commercially available sorbents (octadecylsilane, activated charcoal, and primary secondary amine).
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Affiliation(s)
- Ilona Sadok
- Department of Chemistry, Institute of Biological Sciences, Faculty of Medicine, the John Paul II Catholic University of Lublin, Konstantynów 1J, 20-708, Lublin, Poland.
| | - Marta Grochowicz
- Department of Polymer Chemistry, Faculty of Chemistry, Maria Curie-Skłodowska University, Gliniana 33, 20-614, Lublin, Poland
| | - Agnieszka Krzyszczak-Turczyn
- Department of Chemistry, Institute of Biological Sciences, Faculty of Medicine, the John Paul II Catholic University of Lublin, Konstantynów 1J, 20-708, Lublin, Poland
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3
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Villani S, Fallarini S, Rezzi SJ, Di Martino RMC, Aprile S, Del Grosso E. Selective inhibition of indoleamine and tryptophan 2,3-dioxygenases: Comparative study on kynurenine pathway in cell lines via LC-MS/MS-based targeted metabolomics. J Pharm Biomed Anal 2024; 237:115750. [PMID: 37804639 DOI: 10.1016/j.jpba.2023.115750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023]
Abstract
In the last decade, the kynurenine pathway, which is the primary metabolic route for tryptophan (TRP) catabolism, has sparked great interest in the pharmaceutical sciences due to its role in immune regulation and cancer immunoediting. In this context, the development of cell-based assays might represent a tool to: i) characterize the cell secretome according to cell types; ii) gain more insight into the role of kynurenines in different disease scenarios; iii) screen hIDO1 (human indoleamine 2,3-dioxygenase) inhibitors and evaluate their effect on downstream TRP-catabolizing enzymes. This paper reports a validated Liquid Chromatography with tandem mass spectrometry (LC-MS/MS) method to simultaneously quantify TRP, L-kynurenine (KYN), xanthurenic acid (XA), 3-hydroxykynurenine (3OHKYN), kynurenic acid (KA), 3-hydroxyanthranilic acid (3OHAA), anthranilic acid (AA), 5-hydroxytryptamine (serotonin, 5HT) and tryptamine (TRYP) in Dulbecco's Modified Eagle and Eagle's Minimum Essential Media (DMEM and EMEM, respectively). The quantitative method was validated according to FDA, ICH and EMA guidelines, later applied: i) to assess the impact of selective inhibition of hIDO1 or hTDO (human tryptophan 2,3-dioxygenase) on the kynurenine pathway in A375 (melanoma), MDA-MB-231 (breast cancer), and U87 (glioblastoma) cell lines using multivariate analysis (MVA); ii) to determine the IC50 values of both well-known (i.e., epacadostat, linrodostat) and the novel hIDO1 inhibitor (i.e., BL5) in the aforementioned cell lines. The proposed LC-MS/MS method is reliable and robust. Furthermore, it is highly versatile and suitable for applications in the preclinical drug research and in vitro assays.
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Affiliation(s)
- Salvatore Villani
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100, Novara, Italy
| | - Silvia Fallarini
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100, Novara, Italy
| | - Sarah Jane Rezzi
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100, Novara, Italy
| | | | - Silvio Aprile
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100, Novara, Italy
| | - Erika Del Grosso
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Largo Donegani 2, 28100, Novara, Italy.
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Mrštná K, Kujovská Krčmová L, Švec F. Advances in kynurenine analysis. Clin Chim Acta 2023:117441. [PMID: 37321530 DOI: 10.1016/j.cca.2023.117441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/17/2023]
Abstract
Kynurenine, the first product of tryptophan degradation via the kynurenine pathway, has become one of the most frequently mentioned biomarkers in recent years. Its levels in the body indicate the state of the human physiology. Human serum and plasma are the main matrixes used to evaluate kynurenine levels and liquid chromatography is the dominant technique for its determination. However, their concentrations in blood do not always correspond to the levels in other matrixes obtained from the affected individuals. It is therefore important to decide when it is appropriate to analyse kynurenine in alternative matrices. However, liquid chromatography may not be the best option for the analysis. This review presents alternatives that can be used and summarizes the features that need to be considered prior to kynurenine determination. Possible approaches to kynurenine analysis in a variety of human matrixes, their challenges, and limitations are critically discussed.
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Affiliation(s)
- K Mrštná
- The Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, 50005 Hradec Králové, Czech Republic; The Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic
| | - L Kujovská Krčmová
- The Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, 50005 Hradec Králové, Czech Republic; The Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic.
| | - F Švec
- The Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203/8, 50005 Hradec Králové, Czech Republic
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Wang S, Feng R, Chen GJ, Sang YR, Kong L, Yu SX, Tao FB, Liu KY. Simultaneous determination of serum tryptophan metabolites in an older Chinese population. Biomed Chromatogr 2023; 37:e5512. [PMID: 36101977 DOI: 10.1002/bmc.5512] [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: 07/10/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 12/15/2022]
Abstract
Tryptophan (TRP) and its metabolites exhibit significant biological effects and are strongly associated with age-related disease and mortality. However, reports on quantitatively analyzing these metabolites in older individuals are not available. We used ultra-high-performance liquid chromatography-tandem mass spectrometry to optimize and validate a method for isotope dilution analysis of TRP metabolites in older individuals. The targeted analytes are TRP, serotonin or 5-hydroxytryptamine, kynurenine, kynurenic acid, xanthurenic acid, indole-3-acetic acid, indole-3-propionic acid, and tryptamine. The serum sample was purified using solid-phase extraction and was separated on a Waters HSS T3 column (100 mm × 2.1 mm, 1.8 μm). The analytes were detected in the multiple reaction monitoring mode under positive ionization. TRP was confirmed and measured after being diluted 100 times. This method exhibited satisfactory linearity (r > 0.99). The intrabatch and interbatch accuracies (85.7-114%) and precisions (<15%) were acceptable. The standard-normalized matrix effects ranged from 51.6 to 145%. This method was successfully applied to a cohort of 1021 older Chinese individuals, and this study may enable further understanding of the metabolic phenotypes associated with TRP in other populations.
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Affiliation(s)
- Sheng Wang
- Center for Scientific Research of Anhui Medical University, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, China
| | - Rui Feng
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, China.,School of Pharmacy, Anhui Medical University, Hefei, China
| | - Guan-Jun Chen
- Center for Scientific Research of Anhui Medical University, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, China
| | - Yan-Ru Sang
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Li Kong
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Shui-Xin Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China
| | - Fang-Biao Tao
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Kai-Yong Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
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Sadok I, Jędruchniewicz K, Staniszewska M. Quantification of nicotinic acid, kynurenine, and kynurenine acid in poultry meat by validated liquid chromatography-single quadrupole mass spectrometry method. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.113582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sadok I, Staniszewska M. Electrochemical Determination of Kynurenine Pathway Metabolites-Challenges and Perspectives. SENSORS (BASEL, SWITZERLAND) 2021; 21:7152. [PMID: 34770460 PMCID: PMC8588338 DOI: 10.3390/s21217152] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 12/23/2022]
Abstract
In recent years, tryptophan metabolism via the kynurenine pathway has become one of the most active research areas thanks to its involvement in a variety of physiological processes, especially in conditions associated with immune dysfunction, central nervous system disorders, autoimmunity, infection, diabetes, and cancer. The kynurenine pathway generates several metabolites with immunosuppressive functions or neuroprotective, antioxidant, or toxic properties. An increasing body of work on this topic uncovers a need for reliable analytical methods to help identify and quantify tryptophan metabolites at physiological concentrations in biological samples of different origins. Recent methodological advances in the fabrication and application of electrochemical sensors promise a rise in the future generation of novel analytical systems. This work summarizes current knowledge and provides important suggestions with respect to direct electrochemical determinations of kynurenine pathway metabolites (kynurenines) in complex biological matrices. Measurement challenges, limitations, and future opportunities of electroanalytical methods to advance study of the implementation of kynurenines in disease conditions are discussed.
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Affiliation(s)
- Ilona Sadok
- Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, 20-708 Lublin, Poland;
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Kędzierski W, Sadok I, Kowalik S, Janczarek I, Staniszewska M. Does the type of exercise affect tryptophan catabolism in horses? Animal 2021; 15:100377. [PMID: 34624767 DOI: 10.1016/j.animal.2021.100377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 01/03/2023] Open
Abstract
Tryptophan (Trp) is an essential amino acid which metabolises via the kynurenine pathway to generate a number of bioactive substances referred to as kynurenines. Among those are 3-hydroxykynurenine (3-HKyn) and quinolinic acid, which are neurotoxic, as well as kynurenic acid (Kyna) and xanthurenic acid (XA), which, similarly to nicotinamide (NAm), show neuroprotective and anti-depressive effects. Routine exercise is known to modulate Trp metabolism in skeletal muscle and is thus believed to reduce the risk of depressive states in humans and laboratory animals. Analogously, it was hypothesised that exercise can influence Trp metabolism in horses as well. The aim of this study was to evaluate the influence of two different types of exercise on Trp metabolism in horses of the same breed. A total of 32 purebred Arabian horses were involved in the study. The 22 three-year-old racehorses were subjected to short-time intense exercise. Ten other horses were made to perform endurance competitions at a distance of 80 km. Blood samples were collected at rest and following the end of the exercise period. Plasma concentrations of Trp, kynurenine (Kyn), Kyna, 3-HKyn, XA and NAm were determined using Ultra-High Performance Liquid Chromatography-Electrospray Ionisation-Tandem Mass Spectrometry. Short-time intense exercise led to an increase in plasma concentrations of Kyn, Kyna and XA. The endurance effort induced an increase in Kyna and a decrease in Trp and NAm levels. Both types of exercise, short-time intensive exercise and endurance exercise induced an increase in Trp metabolites, especially Kyna, and did not induce an increase in Trp level. Thus, from a pathophysiological perspective of the kynurenine pathway's influence on mental state, both types of exercise induced beneficial effects in horses.
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Affiliation(s)
- W Kędzierski
- Department of Biochemistry, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-950 Lublin, Poland
| | - I Sadok
- Centre for Interdisciplinary Research, The John Paul II Catholic University of Lublin, 20-708 Lublin, Poland
| | - S Kowalik
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-950 Lublin, Poland.
| | - I Janczarek
- Department of Horse Breeding and Use, Faculty of Animal Sciences and Bioeconomy, University of Life Sciences in Lublin, 20-950 Lublin, Poland
| | - M Staniszewska
- Centre for Interdisciplinary Research, The John Paul II Catholic University of Lublin, 20-708 Lublin, Poland
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van der Velpen V, Rosenberg N, Maillard V, Teav T, Chatton J, Gallart‐Ayala H, Ivanisevic J. Sex-specific alterations in NAD+ metabolism in 3xTg Alzheimer's disease mouse brain assessed by quantitative targeted LC-MS. J Neurochem 2021; 159:378-388. [PMID: 33829502 PMCID: PMC8596789 DOI: 10.1111/jnc.15362] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/21/2022]
Abstract
Levels of nicotinamide adenine dinucleotide (NAD+) are known to decline with age and have been associated with impaired mitochondrial function leading to neurodegeneration, a key facet of Alzheimer's disease (AD). NAD+synthesis is sustained via tryptophan-kynurenine (Trp-Kyn) pathway as de novo synthesis route, and salvage pathways dependent on the availability of nicotinic acid and nicotinamide. While being currently investigated as a multifactorial disease with a strong metabolic component, AD remains without curative treatment and important sex differences were reported in relation to disease onset and progression. The aim of this study was to reveal the potential deregulation of NAD+metabolism in AD with the direct analysis of NAD+precursors in the mouse brain tissue (wild type (WT) versus triple transgenic (3xTg) AD), using a sex-balanced design. To this end, we developed a quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, which allowed for the measurement of the full spectrum of NAD+precursors and intermediates in all three pathways. In brain tissue of mice with developed AD symptoms, a decrease in kynurenine (Kyn) versus increase in kynurenic acid (KA) levels were observed in both sexes with a significantly higher increment of KA in males. These alterations in Trp-Kyn pathway might be a consequence of neuroinflammation and a compensatory production of neuroprotective kynurenic acid. In the NAD+ salvage pathway, significantly lower levels of nicotinamide mononucleotide (NMN) were measured in the AD brain of males and females. Depletion of NMN implies the deregulation of salvage pathway critical for maintaining optimal NAD+ levels and mitochondrial and neuronal function.
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Affiliation(s)
- Vera van der Velpen
- Metabolomics PlatformFaculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
- Present address:
Clinical Pharmacology and ToxicologyDepartment of General Internal Medicine, InselspitalBern University HospitalBernSwitzerland
| | - Nadia Rosenberg
- Department of Fundamental NeurosciencesFaculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Vanille Maillard
- Metabolomics PlatformFaculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Tony Teav
- Metabolomics PlatformFaculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Jean‐Yves Chatton
- Department of Fundamental NeurosciencesFaculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Hector Gallart‐Ayala
- Metabolomics PlatformFaculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Julijana Ivanisevic
- Metabolomics PlatformFaculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
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Sadok I, Tyszczuk-Rotko K, Mroczka R, Kozak J, Staniszewska M. Improved Voltammetric Determination of Kynurenine at the Nafion Covered Glassy Carbon Electrode - Application in Samples Delivered from Human Cancer Cells. Int J Tryptophan Res 2021; 14:11786469211023468. [PMID: 34276216 PMCID: PMC8256253 DOI: 10.1177/11786469211023468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 05/03/2021] [Indexed: 12/16/2022] Open
Abstract
Nowadays, development of analytical methods responding to a need for rapid and
accurate determination of human metabolites is highly desirable. Herein, an
electrochemical method employing a Nafion-coated glassy carbon electrode
(Nafion/GCE) has been developed for reliable determination of kynurenine (a key
tryptophan metabolite) using a differential pulse adsorptive stripping
voltammetry. To our knowledge, this is the first analytical method to allow for
kynurenine determination at the Nafion-coated electrode. The methodology
involves kynurenine pre-concentration in 0.1 M H2SO4 in
the Nafion film at the potential of +0.5 V and subsequent stripping from the
electrode by differential pulse voltammetry. Under optimal conditions, the
sensor can detect 5 nM kynurenine (for the accumulation time of 60 seconds), but
the limit of detection can be easily lowered to 0.6 nM by prolonging the
accumulation time to 600 seconds. The sensor shows sensitivity of
36.25 μAμM−1cm−2 and
185.50 μAμM−1cm−2 for the accumulation time of 60 and
600 seconds, respectively. The great advantage of the proposed method is easy
sensor preparation, employing drop coating method, high sensitivity, short total
analysis time, and no need for sample preparation. The method was validated for
linearity, precision, accuracy (using a high-performance liquid chromatography),
selectivity (towards tryptophan metabolites and different amino acids), and
recovery. The comprehensive microscopic and electrochemical characterization of
the Nafion/GCE was also conducted with different methods including atomic force
microscopy (AFM), optical profilometry, time-of-flight secondary ion mass
spectrometry (TOF-SIMS), electrochemical impedance spectroscopy (EIS), and
cyclic voltammetry (CV). The method has been applied with satisfactory results
for determination of kynurenine concentration in a culture medium collected from
the human ovarian carcinoma cells SK-OV-3 and to measure IDO enzyme activity in
the cancer cell extracts.
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Affiliation(s)
- Ilona Sadok
- Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Katarzyna Tyszczuk-Rotko
- Institute of Chemical Sciences, Faculty of Chemistry, Maria Curie-Skłodowska University in Lublin, Lublin, Poland
| | - Robert Mroczka
- Laboratory of X-ray Optics, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Jędrzej Kozak
- Institute of Chemical Sciences, Faculty of Chemistry, Maria Curie-Skłodowska University in Lublin, Lublin, Poland
| | - Magdalena Staniszewska
- Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, Lublin, Poland
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Sadok I, Jędruchniewicz K, Rawicz-Pruszyński K, Staniszewska M. UHPLC-ESI-MS/MS Quantification of Relevant Substrates and Metabolites of the Kynurenine Pathway Present in Serum and Peritoneal Fluid from Gastric Cancer Patients-Method Development and Validation. Int J Mol Sci 2021; 22:6972. [PMID: 34203517 PMCID: PMC8269001 DOI: 10.3390/ijms22136972] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022] Open
Abstract
Metabolites and enzymes involved in the kynurenine pathway (KP) are highly promising targets for cancer treatment, including gastrointestinal tract diseases. Thus, accurate quantification of these compounds in body fluids becomes increasingly important. The aim of this study was the development and validation of the UHPLC-ESI-MS/MS methods for targeted quantification of biologically important KP substrates (tryptophan and nicotinamide) and metabolites(kynurenines) in samples of serum and peritoneal fluid from gastric cancer patients. The serum samples were simply pretreated with trichloroacetic acid to precipitate proteins. The peritoneal fluid was purified by solid-phase extraction before analysis. Validation was carried out for both matrices independently. Analysis of the samples from gastric cancer patients showed different accumulations of tryptophan and its metabolites in different biofluids of the same patient. The protocols will be used for the evaluation of tryptophan and kynurenines in blood and peritoneal fluid to determine correlation with the clinicopathological status of gastric cancer or the disease's prognosis.
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Affiliation(s)
- Ilona Sadok
- Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, Konstantynów 1J, 20-708 Lublin, Poland; (I.S.); (K.J.)
| | - Katarzyna Jędruchniewicz
- Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, Konstantynów 1J, 20-708 Lublin, Poland; (I.S.); (K.J.)
| | - Karol Rawicz-Pruszyński
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13, 20-080 Lublin, Poland;
| | - Magdalena Staniszewska
- Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, Faculty of Science and Health, The John Paul II Catholic University of Lublin, Konstantynów 1J, 20-708 Lublin, Poland; (I.S.); (K.J.)
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12
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Sadok I, Rachwał K, Jonik I, Staniszewska M. Reliable chromatographic assay for measuring of indoleamine 2,3-dioxygenase 1 (IDO1) activity in human cancer cells. J Enzyme Inhib Med Chem 2021; 36:581-592. [PMID: 33541164 PMCID: PMC8759722 DOI: 10.1080/14756366.2021.1882451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The kynurenine pathway is the major tryptophan degradation routes generating bioactive compounds important in physiology and diseases. Depending on cell type it is initiated enzymatically by tryptophan-2,3-dioxygenase (TDO) or indoleamine-2,3-dioxygenase 1 and 2 (IDO1 and IDO2) to yield N-formylkynurenine as the precursor of further metabolites. Herein, we describe an accurate high-pressure liquid chromatography coupled with a diode array detector (HPLC-DAD) method to serve for IDO1 activity determination in human cancer cells cultured in vitro. Enzymatic activity was expressed as the rate of ʟ-kynurenine generation by 1 mg of proteins obtained from cancer cells. Our approach shows the limit of detection and limit of quantification at 12.9 and 43.0 nM Kyn, respectively. Applicability of this method was demonstrated in different cells (ovarian and breast cancer)exposed to various conditions and has successfully passed the validation process. This approach presents a useful model to study the role of kynurenine pathway in cancer biology.
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Affiliation(s)
- Ilona Sadok
- Faculty of Science and Health, Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Kamila Rachwał
- Faculty of Science and Health, Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Ilona Jonik
- Faculty of Science and Health, Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Magdalena Staniszewska
- Faculty of Science and Health, Laboratory of Separation and Spectroscopic Method Applications, Centre for Interdisciplinary Research, The John Paul II Catholic University of Lublin, Lublin, Poland
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13
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Tryptophan metabolism drives dynamic immunosuppressive myeloid states in IDH-mutant gliomas. ACTA ACUST UNITED AC 2021; 2:723-740. [DOI: 10.1038/s43018-021-00201-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 03/18/2021] [Indexed: 12/23/2022]
Abstract
AbstractThe dynamics and phenotypes of intratumoral myeloid cells during tumor progression are poorly understood. Here we define myeloid cellular states in gliomas by longitudinal single-cell profiling and demonstrate their strict control by the tumor genotype: in isocitrate dehydrogenase (IDH)-mutant tumors, differentiation of infiltrating myeloid cells is blocked, resulting in an immature phenotype. In late-stage gliomas, monocyte-derived macrophages drive tolerogenic alignment of the microenvironment, thus preventing T cell response. We define the IDH-dependent tumor education of infiltrating macrophages to be causally related to a complex re-orchestration of tryptophan metabolism, resulting in activation of the aryl hydrocarbon receptor. We further show that the altered metabolism of IDH-mutant gliomas maintains this axis in bystander cells and that pharmacological inhibition of tryptophan metabolism can reverse immunosuppression. In conclusion, we provide evidence of a glioma genotype-dependent intratumoral network of resident and recruited myeloid cells and identify tryptophan metabolism as a target for immunotherapy of IDH-mutant tumors.
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Beloborodova NV, Chernevskaya EA, Getsina ML. Indolic Structure Metabolites as Potential Biomarkers of Non-infectious Diseases. Curr Pharm Des 2021; 27:238-249. [PMID: 33092503 DOI: 10.2174/1381612826666201022121653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/09/2020] [Indexed: 11/22/2022]
Abstract
Interest in indolic structure metabolites, including a number of products of microbial biotransformation of the aromatic amino acid tryptophan, is increasingly growing. The review prepared by a team of authors is based on in-depthscrutiny of data available in PubMed, Scopus, Cyberleninka, Clinical Trials, and Cochrane Library, eventually narrowing the search to a set of keywords such as tryptophan metabolites; plasma metabolomics profiling; metabolomics fingerprinting; gas-, liquid chromatography mass spectrometry; serotonin; melatonin; tryptamine; indoxyl sulfate; indole-3-acetic acid; indole-3-propionic acid; 5-hydroxyindole-3-acetic acid; gut microbiota and microbial metabolites. It provides a summary that outlines the pattern of changes in the level of indolic structure metabolites in a number of diseases and deals with the data from the field of human microbiota metabolites. In modern experimental studies, including the use of gnotobiological (germ-free) animals, it has been convincingly proved that the formation of tryptophan metabolites such as indole-3-acetic acid, indole-3-propionic acid, tryptamine, and indoxyl sulfate is associated with gut bacteria. Attention to some concentration changes of indolic compounds is due to the fact that pronounced deviations and a significant decrease of these metabolites in the blood were found in a number of serious cardiovascular, brain or gastrointestinal diseases. The literature-based analysis allowed the authors to conclude that a constant (normal) level of the main metabolites of the indolic structure in the human body is maintained by a few strict anaerobic bacteria from the gut of a healthy body belonging to the species of Clostridium, Bacteroides, Peptostreptococcus, Eubacteria, etc. The authors focus on several metabolites of the indolic structure that can be called clinically significant in certain diseases, such as schizophrenia, depression, atherosclerosis, colorectal cancer, etc. Determining the level of indole metabolites in the blood can be used to diagnose and monitor the effectiveness of a comprehensive treatment approach.
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Affiliation(s)
- Natalia V Beloborodova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Petrovka 25, bild 2, Moscow, 107031, Russian Federation
| | - Ekaterina A Chernevskaya
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Petrovka 25, bild 2, Moscow, 107031, Russian Federation
| | - Maria L Getsina
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Petrovka 25, bild 2, Moscow, 107031, Russian Federation
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15
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Mohapatra SR, Sadik A, Sharma S, Poschet G, Gegner HM, Lanz TV, Lucarelli P, Klingmüller U, Platten M, Heiland I, Opitz CA. Hypoxia Routes Tryptophan Homeostasis Towards Increased Tryptamine Production. Front Immunol 2021; 12:590532. [PMID: 33679737 PMCID: PMC7933006 DOI: 10.3389/fimmu.2021.590532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
The liver is the central hub for processing and maintaining homeostatic levels of dietary nutrients especially essential amino acids such as tryptophan (Trp). Trp is required not only to sustain protein synthesis but also as a precursor for the production of NAD, neurotransmitters and immunosuppressive metabolites. In light of these roles of Trp and its metabolic products, maintaining homeostatic levels of Trp is essential for health and well-being. The liver regulates global Trp supply by the immunosuppressive enzyme tryptophan-2,3-dioxygenase (TDO2), which degrades Trp down the kynurenine pathway (KP). In the current study, we show that isolated primary hepatocytes when exposed to hypoxic environments, extensively rewire their Trp metabolism by reducing constitutive Tdo2 expression and differentially regulating other Trp pathway enzymes and transporters. Mathematical modelling of Trp metabolism in liver cells under hypoxia predicted decreased flux through the KP while metabolic flux through the tryptamine branch significantly increased. In line, the model also revealed an increased accumulation of tryptamines under hypoxia, at the expense of kynurenines. Metabolic measurements in hypoxic hepatocytes confirmed the predicted reduction in KP metabolites as well as accumulation of tryptamine. Tdo2 expression in cultured primary hepatocytes was reduced upon hypoxia inducible factor (HIF) stabilisation by dimethyloxalylglycine (DMOG), demonstrating that HIFs are involved in the hypoxic downregulation of hepatic Tdo2. DMOG abrogated hepatic luciferase signals in Tdo2 reporter mice, indicating that HIF stability also recapitulates hypoxic rewiring of Trp metabolism in vivo. Also in WT mice HIF stabilization drove homeostatic Trp metabolism away from the KP towards enhanced tryptamine production, leading to enhanced levels of tryptamine in liver, serum and brain. As tryptamines are the most potent hallucinogens known, the observed upregulation of tryptamine in response to hypoxic exposure of hepatocytes may be involved in the generation of hallucinations occurring at high altitude. KP metabolites are known to activate the aryl hydrocarbon receptor (AHR). The AHR-activating properties of tryptamines may explain why immunosuppressive AHR activity is maintained under hypoxia despite downregulation of the KP. In summary our results identify hypoxia as an important factor controlling Trp metabolism in the liver with possible implications for immunosuppressive AHR activation and mental disturbances.
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Affiliation(s)
- Soumya R. Mohapatra
- DKTK Brain Cancer Metabolism Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ahmed Sadik
- DKTK Brain Cancer Metabolism Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Suraj Sharma
- Department of Arctic and Marine Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gernot Poschet
- Centre for Organismal Studies (COS), University of Heidelberg, Heidelberg, Germany
| | - Hagen M. Gegner
- Centre for Organismal Studies (COS), University of Heidelberg, Heidelberg, Germany
| | - Tobias V. Lanz
- DKTK Clinical Cooperation Unit Neuroimmunology and Brain Tumor Immunology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology, Medical Faculty Mannheim, Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Philippe Lucarelli
- Division Systems Biology of Signal Transduction, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ursula Klingmüller
- Division Systems Biology of Signal Transduction, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Translational Lung Research Center (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Michael Platten
- DKTK Clinical Cooperation Unit Neuroimmunology and Brain Tumor Immunology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neurology, Medical Faculty Mannheim, Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
| | - Ines Heiland
- Department of Arctic and Marine Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christiane A. Opitz
- DKTK Brain Cancer Metabolism Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Neurology Clinic and National Center for Tumor Diseases, University Hospital of Heidelberg, Heidelberg, Germany
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16
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Su M, Cheng Y, Zhang C, Zhu D, Jia M, Zhang Q, Wu H, Chen G. Determination of the levels of tryptophan and 12 metabolites in milk by liquid chromatography-tandem mass spectrometry with the QuEChERS method. J Dairy Sci 2020; 103:9851-9859. [PMID: 32921461 DOI: 10.3168/jds.2020-18260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 06/26/2020] [Indexed: 12/23/2022]
Abstract
Tryptophan and metabolites have important biological functions in humans. Milk is an important source of tryptophan intake. In this study, we developed a method to detect levels of tryptophan and 12 metabolites in milk. The analytes were extracted by using the QuEChERS (quick, easy, cheap, effective, rugged, and safe) procedure and analyzed by liquid chromatography-tandem mass spectrometry with electrospray ionization. The proposed method resulted in suitable accuracy (standard deviation ≤10.31%) and high sensitivity (the limits of quantification were between 0.05 and 5 ng/mL). Recoveries were in the range of 44 to 126%. Finally, the developed method was successfully applied to compare the content of tryptophan and metabolites in 4 milk products produced by different processes: pasteurized milk, UHT milk, milk powder, and yogurt. The results of partial least squares-discriminant analysis (PLS-DA) showed that different types of processed milk could be distinguished clearly according to the method used here. The determined tryptophan and metabolites levels in milk can provide a new reference for evaluation of milk.
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Affiliation(s)
- Meicheng Su
- Key Laboratory of Agro-product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Products, Chinese Academy of Agricultural Sciences, Beijing, China 100081
| | - Yongyou Cheng
- College of Food and Pharmaceutical Engineering, Guiyang University, Guizhou Province 550004, China
| | - Congcong Zhang
- Key Laboratory of Agro-product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Products, Chinese Academy of Agricultural Sciences, Beijing, China 100081
| | - Dan Zhu
- Key Laboratory of Agro-product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Products, Chinese Academy of Agricultural Sciences, Beijing, China 100081
| | - Man Jia
- Key Laboratory of Agro-product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Products, Chinese Academy of Agricultural Sciences, Beijing, China 100081
| | - Qingyang Zhang
- Key Laboratory of Agro-product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Products, Chinese Academy of Agricultural Sciences, Beijing, China 100081
| | - Huaxing Wu
- R&D Center, New Hope Dairy Co, Ltd. Chengdu 610000, China; Dairy Nutrition and Function, Key Laboratory of Sichuan Province, Chengdu, 610000, China
| | - Gang Chen
- Key Laboratory of Agro-product Quality and Safety, Institute of Quality Standard & Testing Technology for Agro-Products, Chinese Academy of Agricultural Sciences, Beijing, China 100081.
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17
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Sadok I, Tyszczuk-Rotko K, Mroczka R, Staniszewska M. Simultaneous voltammetric analysis of tryptophan and kynurenine in culture medium from human cancer cells. Talanta 2020; 209:120574. [DOI: 10.1016/j.talanta.2019.120574] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 01/06/2023]
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