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Yang S, Sun Y, Luo Y, Liu Y, Jiang M, Li J, Zhang Q, Bai J. Hypermethylation of PPARG-encoding gene promoter mediates fine particulate matter-induced pulmonary fibrosis by regulating the HMGB1/NLRP3 axis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116068. [PMID: 38330871 DOI: 10.1016/j.ecoenv.2024.116068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
The inflammatory response induced by fine particulate matter (PM2.5), a common class of air pollutants, is an important trigger for the development of pulmonary fibrosis. However, the specific mechanisms responsible for this phenomenon are yet to be fully understood. To investigate the mechanisms behind the onset and progression of lung fibrosis owing to PM2.5 exposure, both rats and human bronchial epithelial cells were subjected to varying concentrations of PM2.5. The involvement of the PPARG/HMGB1/NLRP3 signaling pathway in developing lung fibrosis caused by PM2.5 was validated through the utilization of a PPARG agonist (rosiglitazone), a PPARG inhibitor (GW9662), and an HMGB1 inhibitor (glycyrrhizin). These outcomes highlighted the downregulation of PPARG expression and activation of the HMGB1/NLRP3 signaling pathway triggered by PM2.5, thereby eliciting inflammatory responses and promoting pulmonary fibrosis. Additionally, PM2.5 exposure-induced DNA hypermethylation of PPARG-encoding gene promoter downregulated PPARG expression. Moreover, the DNA methyltransferase inhibitor 5-azacytidine mitigated the hypermethylation of the PPARG-encoding gene promoter triggered by PM2.5. In conclusion, the HMGB1/NLRP3 signaling pathway was activated in pulmonary fibrosis triggered by PM2.5 through the hypermethylation of the PPARG-encoding gene promoter.
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Affiliation(s)
- Siyu Yang
- Environmental Health Effects and Risk Assessment Key Laboratory of Luzhou, School of Public Health, Southwest Medical University, Luzhou 638000, China; Chongqing Nanan District Center for Disease Control and Prevention, Chongqing 400066, China
| | - Yaochuan Sun
- State Key Laboratory of Coal Mine Disaster Dynamics and Control, Chongqing University, Chongqing 400044, China
| | - Yajun Luo
- Environmental Health Effects and Risk Assessment Key Laboratory of Luzhou, School of Public Health, Southwest Medical University, Luzhou 638000, China
| | - Yingyi Liu
- Environmental Health Effects and Risk Assessment Key Laboratory of Luzhou, School of Public Health, Southwest Medical University, Luzhou 638000, China
| | - Mengyu Jiang
- Environmental Health Effects and Risk Assessment Key Laboratory of Luzhou, School of Public Health, Southwest Medical University, Luzhou 638000, China
| | - Jiayou Li
- Environmental Health Effects and Risk Assessment Key Laboratory of Luzhou, School of Public Health, Southwest Medical University, Luzhou 638000, China
| | - Qibing Zhang
- Department of pharmacy, The Second People's Hospital of Deyang City, Deyang 618000, China.
| | - Jun Bai
- Environmental Health Effects and Risk Assessment Key Laboratory of Luzhou, School of Public Health, Southwest Medical University, Luzhou 638000, China.
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Ji D, Hu C, Ning J, Ying X, Zhang H, Zhang B, Liu B, Liu Q, Ji W, Zhang R. N 6-methyladenosine mediates Nrf2 protein expression involved in PM2.5-induced pulmonary fibrosis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 254:114755. [PMID: 36917877 DOI: 10.1016/j.ecoenv.2023.114755] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/10/2022] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
It has been reported that particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5) could induce epithelial-mesenchymal transition (EMT)- and extracellular matrix (ECM)-related pulmonary fibrosis (PF). The transcription factor Nrf2 alleviated PM2.5-induced PF by antagonizing oxidative stress. The N6-methyladenosine (m6A) modification plays a significant role in the stress response. However, the effect of m6A modification on the mechanisms of Nrf2-mediated defense against PM2.5-induced PF remained unknown. Here, we explored the role and the underlying molecular mechanisms of m6A methylation of Nrf2 mRNA in PM2.5-induced PF. We established filtered air (FA), unfiltered air (UA), and concentrated PM2.5 air (CA) group mice model and 0, 50, and 100 μg/mL PM2.5-treated 16HBE cell models. The extent of lung fibrosis in mice and fibrosis indicators were detected by histopathological analysis, immunohistochemical staining and western blotting. The molecular mechanism of m6A-modified Nrf2 was demonstrated by m6A-methylated RNA immunoprecipitation (MeRIP), RNA immunoprecipitation (RIP), qRT-PCR and T3 ligase-based PCR. Our data showed that PM2.5 exposure for 16 weeks could induce pulmonary fibrosis and activate Nrf2 signaling pathway. m6A methyltransferase METTL3 was upregulated after PM2.5 treatment in vivo and in vitro. Moreover, METTL3 mediated m6A modification of Nrf2 mRNA and promoted Nrf2 translation in mice and 16HBE cells after PM2.5 exposure. Mechanistically, three m6A-modified sites (1317, 1376 and 935; numbered relative to the first nucleotide of 3'UTR) of Nrf2 mRNA were identified in PM2.5-treatment 16HBE cells. Furthermore, the m6A binding proteins YTHDF1/IGF2BP1 promoted Nrf2 translation by binding to m6A residues of Nrf2 mRNA. Our results revealed the mechanism of m6A mediated Nrf2 signaling pathway against oxidative stress, which affected the development of PM2.5-induced PF.
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Affiliation(s)
- Ding Ji
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Chenxi Hu
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, PR China
| | - Jie Ning
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Xiaoling Ying
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Haiqing Zhang
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Bohan Zhang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Bixia Liu
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China
| | - Qingping Liu
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China
| | - Weidong Ji
- Center for Translational Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, PR China.
| | - Rong Zhang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China.
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Gao Y, Sun J, Dong C, Zhao M, Hu Y, Jin F. Extracellular Vesicles Derived from Adipose Mesenchymal Stem Cells Alleviate PM2.5-Induced Lung Injury and Pulmonary Fibrosis. Med Sci Monit 2020; 26:e922782. [PMID: 32304204 PMCID: PMC7191958 DOI: 10.12659/msm.922782] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Exposure to PM2.5 (fine particulate matter ≤2.5 μm in aerodynamic diameter) in air increases the risk of lung injury and pulmonary fibrosis (PF). Extracellular vesicles (EVs) derived from adipose mesenchymal stem cells (ADSCs) have been identified as a potential treatment based on the proteins or RNAs delivery and immunomodulatory properties. Here, we assessed the protective effects and mechanisms of ADSCs-EVs on PM2.5-induced lung injury or PF. Material/Methods Rats (male, 6 weeks old) were exposed to PBS or PM2.5 (1.5 mg/kg/day) for 3 days a week for 4 weeks. ADSCs-EVs were extracted by ultracentrifugation. PBS and ADSCs-EVs were administrated through intratracheal instillation. After the end of exposure, the rats were anesthetized and killed. Lung tissues with different treatments were collected for Western blot analysis and HE, IHC, and IF staining analysis. Cells exposed to PM2.5 or “PM2.5+ADSCs-EVs” in vitro were also collected for further Western blotting, qRT-PCR, and IF staining evaluation. Results The results indicated that the initial response of lungs exposed to PM2.5 was lung injury with oxidative stress and inflammation. Long-term PM2.5 exposure resulted in obvious PF in rats. Treatment with ADSCs-EVs decreased PM2.5-induced apoptosis and necrosis in type II alveolar epithelial cells and alleviated lung injury and PF in rats. ADSCs-EVs suppressed reactive oxygen species (ROS) levels and inflammation induced by PM2.5. Furthermore, ADSCs-EVs inhibited TGF-βRI by transferring let-7d-5p and further mitigated PF. Conclusions Our results suggest that EVs derived from ADSCs can alleviate PM2.5-induced lung injury and PF.
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Affiliation(s)
- Yongheng Gao
- Department of Respiration, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Jinbo Sun
- Department of Urology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Chuan Dong
- Department of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Mingxuan Zhao
- Research Center of Clinical Pharmacology, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, Yunnan, China (mainland)
| | - Ying Hu
- Department of Respiration, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Faguang Jin
- Department of Respiration, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
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Averyanov A, Koroleva I, Konoplyannikov M, Revkova V, Lesnyak V, Kalsin V, Danilevskaya O, Nikitin A, Sotnikova A, Kotova S, Baklaushev V. First-in-human high-cumulative-dose stem cell therapy in idiopathic pulmonary fibrosis with rapid lung function decline. Stem Cells Transl Med 2019; 9:6-16. [PMID: 31613055 PMCID: PMC6954714 DOI: 10.1002/sctm.19-0037] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 08/18/2019] [Indexed: 12/17/2022] Open
Abstract
Previous phase I studies demonstrated safety and some beneficial effects of mesenchymal stem cells (MSCs) in patients with mild to moderate idiopathic pulmonary fibrosis (IPF). The aim of our study was to evaluate the safety, tolerability, and efficacy of a high cumulative dose of bone marrow MSCs in patients with rapid progressive course of severe to moderate IPF. Twenty patients with forced ventilation capacity (FVC) ≥40% and diffusing capacity of the lung for carbon monoxide (DLCO) ≥20% with a decline of both >10% over the previous 12 months were randomized into two groups: one group received two intravenous doses of allogeneic MSCs (2 × 108 cells) every 3 months, and the second group received a placebo. A total amount of 1.6 × 109 MSCs had been administered to each patient after the study completion. There were no significant adverse effects after administration of MSCs in any patients. In the group of MSC therapy, we observed significantly better improvement for the 6‐minute walk distance in 13 weeks, for DLCO in 26 weeks, and for FVC in 39 weeks compared with placebo. FVC for 12 months in the MSCs therapy group increased by 7.8% from baseline, whereas it declined by 5.9% in the placebo group. We did not find differences between the groups in mortality (two patients died in each group) or any changes in the high‐resolution computed tomography fibrosis score. In patients with IPF and a rapid pulmonary function decline, therapy with high doses of allogeneic MSCs is a safe and promising method to reduce disease progression.
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Affiliation(s)
- Alexander Averyanov
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia.,Pulmonology Scientific Research Institute under Federal Medical-Biologic Agency, Moscow, Russia
| | - Irina Koroleva
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia
| | | | - Veronika Revkova
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia
| | - Victor Lesnyak
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia
| | - Vladimir Kalsin
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia
| | - Olesya Danilevskaya
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia.,Pulmonology Scientific Research Institute under Federal Medical-Biologic Agency, Moscow, Russia
| | - Alexey Nikitin
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia.,Pulmonology Scientific Research Institute under Federal Medical-Biologic Agency, Moscow, Russia
| | - Anna Sotnikova
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia.,Pulmonology Scientific Research Institute under Federal Medical-Biologic Agency, Moscow, Russia
| | - Svetlana Kotova
- Institute for Regenerative Medicine, I. M.Sechenov First Moscow State Medical University, Moscow, Russia.,Semenov Institute of Chemical Physics, Moscow
| | - Vladimir Baklaushev
- Federal Research and Clinical Center of Federal Medical-Biologic Agency, Moscow, Russia.,Pulmonology Scientific Research Institute under Federal Medical-Biologic Agency, Moscow, Russia
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Liu G, Zhai H, Zhang T, Li S, Li N, Chen J, Gu M, Qin Z, Liu X. New therapeutic strategies for IPF: Based on the "phagocytosis-secretion-immunization" network regulation mechanism of pulmonary macrophages. Biomed Pharmacother 2019; 118:109230. [PMID: 31351434 DOI: 10.1016/j.biopha.2019.109230] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/19/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
Pulmonary fibrosis is a chronic and progressive interstitial lung disease of known and unknown etiology. Over the past decades, macrophages have been recognized to play a significant role in IPF pathogenesis. According to their anatomical loci, macrophages can be divided to alveolar macrophages (AMs) subtypes and interstitial macrophages subtypes (IMs) with different responsibility in the damage defense response. Depending on diverse chemokines and cytokines in local microenvironments, macrophages can be induced and polarized to either classically activated (M1) or alternatively activated (M2) phenotypes in different stages of immunity. Therefore, we hypothesize that there is a "phagocytosis-secretion-immunization" network regulation of pulmonary macrophages related to a number of chemokines and cytokines. In this paper, we summarize and discuss the role of chemokines and cytokines involved in the "phagocytosis-secretion-immunization" network regulation mechanism of pulmonary macrophages, pointing toward novel therapeutic approaches based on the network target regulation in the field. Therapeutic strategies focused on modifying the chemokines, cytokines and the network are promising for the pharmacotherapy of IPF. Some Traditional Chinese medicines may have more superiorities in delaying the progression of pulmonary fibrosis for their multi-target activities of this network regulation.
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Affiliation(s)
- Guoxiu Liu
- Beijing University of Chinese Medicine, China
| | | | | | - Siyu Li
- Beijing University of Chinese Medicine, China
| | - Ningning Li
- Beijing University of Chinese Medicine, China
| | - Jiajia Chen
- Beijing University of Chinese Medicine, China
| | - Min Gu
- Beijing University of Chinese Medicine, China
| | - Zinan Qin
- Beijing University of Chinese Medicine, China
| | - Xin Liu
- Beijing University of Chinese Medicine, China.
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Song H, Sun D, Ban C, Liu Y, Zhu M, Ye Q, Yan W, Ren Y, Dai H. Independent Clinical Factors Relevant to Prognosis of Patients with Idiopathic Pulmonary Fibrosis. Med Sci Monit 2019; 25:4193-4201. [PMID: 31166938 PMCID: PMC6563649 DOI: 10.12659/msm.914725] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background The prognosis of idiopathic pulmonary fibrosis (IPF) is the worst among all interstitial lung diseases, and is related to the disease itself. Comorbidities or complications can worsen IPF. We assessed the effect of comorbidities on the survival of IPF patients. A retrospective review of patients with IPF was completed. Material/Methods Information on demographic features, clinical examination, and comorbidities at baseline were obtained. Then, median, 1-year, and 5-year survival was calculated. A total of 380 patients with IPF admitted to Beijing Chao-Yang Hospital from 1 April 2002 to 31 March 2015 were followed up until December 2016. Results Of these 380 patients, 71.9% died during the study period. Median survival was 2.25 years and overall 5-year survival was 28.5%. Also, 86.3% of patients were males. A total of 248 cases underwent lung function tests, and 178 patients underwent bronchoalveolar lavage (BAL). Multivariate analyses showed that forced expiratory volume in 1 second/forced vital capacity (FVC), diffusing capacity of the lungs for carbon monoxide percent predicted, FVC% predicted, the number of macrophages, neutrophils, and lymphocytes in BAL fluid, pulmonary hypertension, hypoxemia, and hydropower disorder were independent prognostic indicators of IPF, GAP gender (G), age (A), and 2 pulmonary physiological parameters (P) model can help to predict prognosis of IPF. Conclusions Spirometry, GAP model, and BAL are helpful to forecast the prognosis of IPF. IPF patients also suffering from pulmonary arterial hypertension, hypoxemia, and hydropower disorder have a poor prognosis.
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Affiliation(s)
- Huifang Song
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland).,Department of Pulmonary and Critical Care Medicine, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China (mainland)
| | - Dejun Sun
- Department of Pulmonary and Critical Care Medicine, Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, China (mainland)
| | - Chengjun Ban
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Yan Liu
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Min Zhu
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Qiao Ye
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Wei Yan
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Yanhong Ren
- Department of Respiratory, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Huaping Dai
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland).,Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, China-Japan Friendship Hospital, National Clinical Research Centre for Respiratory Medicine, Capital Medical University, Beijing, China (mainland)
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Xu Z, Li Z, Liao Z, Gao S, Hua L, Ye X, Wang Y, Jiang S, Wang N, Zhou D, Deng X. PM 2.5 induced pulmonary fibrosis in vivo and in vitro. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 171:112-121. [PMID: 30597315 DOI: 10.1016/j.ecoenv.2018.12.061] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
Epidemiological studies have revealed positive correlation between particulate matter with an aerodynamic diameter of < 2.5 µm (PM2.5) and pulmonary fibrosis (PF). As etiology and pathogenesis of PF have not been fully elucidated, this study was to investigate the potential mechanism by which PM2.5 exposure adversely induced PF in vivo and in vitro. In the present study, 6-week-old C57/BL6J mice were intranasally administrated with PM2.5 (100 μg/day) for 4 weeks. Micro-CT and hematoxylin-eosin (HE) staining analysis showed that lung inflammation and incipient fibrosis symptoms were induced after PM2.5 exposure. The expression of Transforming growth factor-β1 (TGF-β1), α-Smooth muscle actin (α-SMA), and Collagen type I (COL1) in mice lung was increased. Upregulation of TGF-β1 in mice serum was also detected by ELISA after exposure to PM2.5. Moreover, chronic PM2.5 exposure on human bronchial epithelial cell line BEAS-2B cells led to activation of TGF-β1/SMAD3 pathway, TGF-β1 excretion and epithelial-mesenchymal transition (EMT), while PM2.5 also triggered the activation of TGF-β1/SMAD3 pathway, TGF-β1 excretion as well as differentiation of human pulmonary fibroblast cell line HFL-1 cells, and TGF-β1 production in mouse macrophage cell line RAW264.7 cells. Furthermore, cell culture medium of PM2.5-treated BEAS-2B and RAW264.7 cells could both activate TGF-β1/SMAD3 signaling, α-SMA and COL1 upregulation in HFL-1 cells. Therefore, we concluded that PM2.5 could induce PF by targeting pulmonary epithelium, macrophages and fibroblasts, suggesting that PM2.5 was a potent initiator of PF.
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Affiliation(s)
- Zihan Xu
- Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zilin Li
- Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ziyi Liao
- Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Sumeng Gao
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Li Hua
- Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaofei Ye
- Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yu Wang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Shan Jiang
- Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Ning Wang
- Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
| | - Dan Zhou
- Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China.
| | - Xiaobei Deng
- Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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