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Klopsch C, Skorska A, Ludwig M, Lemcke H, Maass G, Gaebel R, Beyer M, Lux C, Toelk A, Müller K, Maschmeier C, Rohde S, Mela P, Müller-Hilke B, Jockenhoevel S, Vollmar B, Jaster R, David R, Steinhoff G. Intramyocardial angiogenetic stem cells and epicardial erythropoietin save the acute ischemic heart. Dis Model Mech 2018; 11:dmm.033282. [PMID: 29752300 PMCID: PMC6031356 DOI: 10.1242/dmm.033282] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/26/2018] [Indexed: 12/14/2022] Open
Abstract
Ischemic heart failure is the leading cause of mortality worldwide. An early boost of intracardiac regenerative key mechanisms and angiogenetic niche signaling in cardiac mesenchymal stem cells (MSCs) could improve myocardial infarction (MI) healing. Epicardial erythropoietin (EPO; 300 U kg-1) was compared with intraperitoneal and intramyocardial EPO treatments after acute MI in rats (n=156). Real-time PCR and confocal microscopy revealed that epicardial EPO treatment enhanced levels of intracardiac regenerative key indicators (SDF-1, CXCR4, CD34, Bcl-2, cyclin D1, Cdc2 and MMP2), induced transforming growth factor β (TGF-β)/WNT signaling in intramyocardial MSC niches through the direct activation of AKT and upregulation of upstream signals FOS and Fzd7, and augmented intracardiac mesenchymal proliferation 24 h after MI. Cardiac catheterization and tissue analysis showed superior cardiac functions, beneficial remodeling and increased capillary density 6 weeks after MI. Concomitant fluorescence-activated cell sorting, co-cultures with neonatal cardiomyocytes, angiogenesis assays, ELISA, western blotting and RAMAN spectroscopy demonstrated that EPO could promote cardiomyogenic differentiation that was specific of tissue origin and enhance paracrine angiogenetic activity in cardiac CD45-CD44+DDR2+ MSCs. Epicardial EPO delivery might be the optimal route for efficient upregulation of regenerative key signals after acute MI. Early EPO-mediated stimulation of mesenchymal proliferation, synergistic angiogenesis with cardiac MSCs and direct induction of TGF-β/WNT signaling in intramyocardial cardiac MSCs could initiate an accelerated healing process that enhances cardiac recovery.
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Affiliation(s)
- Christian Klopsch
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany .,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Anna Skorska
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Marion Ludwig
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Heiko Lemcke
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Gabriela Maass
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Ralf Gaebel
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Martin Beyer
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Cornelia Lux
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Anita Toelk
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Karina Müller
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Christian Maschmeier
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Sarah Rohde
- Division of Gastroenterology, Department of Medicine II, Rostock University Medical Center, 18055 Rostock, Germany
| | - Petra Mela
- Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany
| | - Brigitte Müller-Hilke
- Institute of Immunology & Core Facility for Cell Sorting and Cell Analysis, Rostock University Medical Center, 18055 Rostock, Germany
| | - Stefan Jockenhoevel
- Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany
| | - Brigitte Vollmar
- Institute for Experimental Surgery, Rostock University Medical Center, 18055 Rostock, Germany
| | - Robert Jaster
- Division of Gastroenterology, Department of Medicine II, Rostock University Medical Center, 18055 Rostock, Germany
| | - Robert David
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
| | - Gustav Steinhoff
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.,Department of Cardiac Surgery, Heart Center Rostock, University of Rostock, 18055 Rostock, Germany
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Klopsch C, Skorska A, Ludwig M, Gaebel R, Lemcke H, Kleiner G, Beyer M, Vollmar B, David R, Steinhoff G. Cardiac Mesenchymal Stem Cells Proliferate Early in the Ischemic Heart. Eur Surg Res 2017; 58:341-353. [PMID: 29073604 DOI: 10.1159/000480730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/28/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND/PURPOSE Cardiac mesenchymal stem cells (MSCs) could stimulate cell-specific regenerative mechanisms after myocardial infarction (MI) depending on spatial origin, distribution, and niche regulation. We aimed at identifying and isolating tissue-specific cardiac MSCs that could contribute to regeneration. METHODS Following permanent ligation of the left anterior descending coronary artery in rats (n = 16), early cardiac tissues and cardiac mononuclear cells (MNCs) were analyzed by immunohistology, confocal laser scanning microscopy, and flow cytometry, respectively. Early postischemic specific MSCs were purified by fluorescence-activated cell sorting, cultivated under standardized culture conditions, and tested for multipotent differentiation in functional identification kits. RESULTS Cardiac MSC niches were detected intramyocardially in cell clusters after MI and characterized by positive expression for vimentin, CD29, CD44, CD90, CD105, PDGFRα, and DDR2. Following myocardial ischemia, proliferation was induced early and proliferation density was approximately 11% in intramyocardial MSC clusters of the peri-infarction border zone. Cluster sizes increased by 157 and 64% in the peri-infarction and noninfarcted areas of infarcted hearts compared with noninfarcted hearts 24 h following MI, respectively. Coincidentally, flow cytometry analyses illustrated postischemic moderate enrichments of CD45-CD44+ and CD45-DDR2+ cardiac MNCs. We enabled isolation of early postischemic culturable cardiac CD45-CD44+DDR2+ MSCs that demonstrated typical clonogenicity with colony-forming unit-fibroblast formation as well as adipogenic, chondrogenic, and osteogenic differentiation. CONCLUSIONS MI triggered early proliferation in specific cardiac MSC niches that were organized in intramyocardial clusters. Following targeted isolation, early postischemic cardiac CD45-CD44+DDR2+ MSCs exhibited typical characteristics with multipotent differentiation capacity and clonogenic expansion.
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Affiliation(s)
- Christian Klopsch
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany
| | - Anna Skorska
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany
| | - Marion Ludwig
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany
| | - Ralf Gaebel
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany
| | - Heiko Lemcke
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany
| | - Gabriela Kleiner
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany
| | - Martin Beyer
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany
| | - Brigitte Vollmar
- Institute of Experimental Surgery, Rostock University Medical Center, Rostock, Germany
| | - Robert David
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany.,Department Life, Light and Matter, University of Rostock, Rostock, Germany
| | - Gustav Steinhoff
- Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, Rostock, Germany.,Department of Cardiac Surgery, Rostock University Medical Center, Rostock, Germany.,Department Life, Light and Matter, University of Rostock, Rostock, Germany
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Wang Y, Lu X, He J, Zhao W. Influence of erythropoietin on microvesicles derived from mesenchymal stem cells protecting renal function of chronic kidney disease. Stem Cell Res Ther 2015; 6:100. [PMID: 25998259 PMCID: PMC4469245 DOI: 10.1186/s13287-015-0095-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 05/12/2015] [Indexed: 01/05/2023] Open
Abstract
Introduction Mesenchymal stem cells (MSCs) play a central role in the remediation of cell and tissue damage. Erythropoietin (EPO) may enhance the beneficial influence of MSCs during recovery from tissue and organ injuries. Microvesicles (MVs) released from MSCs contribute to the restoration of kidney damage. We studied the influence of EPO on MVs derived from MSCs, and the protective effects of these factors in subjects with chronic kidney disease (CKD). Methods The MVs derived from untreated MSCs (MSC-MVs) or from MSCs incubated in different concentrations of EPO (1, 10, 100, and 500 IU/ml EPO-MVs) were used to treat renal injury of unilateral ureteral obstruction (UUO) in vivo, and transforming growth factor-β1 (TGF-β1)-induced fibrosis in a human renal proximal tubular epithelial (HK2) cell line in vitro. Western blot and reverse transcription polymerase chain reaction (RT-PCR) analyses were used to evaluate the expression of epithelial and mesenchymal markers in the renal tissue and HK2 cells. Flow cytometry was used to assess apoptosis within the HK2 cells, and microRNA (miRNA) microarray assays were used to determine the expression profiles of miRNA in the MSC-MVs and EPO-MVs. Results Compared to MSC-MVs (untreated), there was a significant increase in the number of EPO-MVs derived from MSCs treated with 1–100 IU/ml EPO, and these EPO-MVs had a greater benefit in UUO mice on days 7 and 14. Moreover, the EPO-MVs had a better restorative effect following TGF-β1-induced fibrosis in HK2 cells at 24 h and 48 h. The flow cytometry results revealed that both types of MVs, especially EPO-MVs, play an important anti-apoptotic role in HK2 cells treated with TGF-β1. The miRNA profiles of the MVs revealed that EPO-MVs changed 212 miRNAs (fold-change ≥ 1.5), including miR-299, miR-499, miR-302, and miRNA-200, and that 70.28 % of these changes involved upregulation. The changed miRNA in EPO-MVs may have contributed to their enhanced protective effects following renal injury compared to MSC-MVs. Conclusions There was a dose-dependent increase in the level of EPO-MVs within the range of 1–100 IU/ml EPO. Although both MSC-MVs and EPO-MVs protect the kidney from fibrosis-related damage, there is a superior effect of EPO-MVs. Electronic supplementary material The online version of this article (doi:10.1186/s13287-015-0095-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yan Wang
- Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Xingyan Lu
- Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Juan He
- Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Weihong Zhao
- Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
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Tavakoli F, Ostad SN, Khori V, Alizadeh AM, Sadeghpour A, Darbandi Azar A, Haghjoo M, Zare A, Nayebpour M. Outcome improvement of cellular cardiomyoplasty using triple therapy: mesenchymal stem cell+erythropoietin+vascular endothelial growth factor. Eur J Pharmacol 2013; 714:456-63. [PMID: 23850947 DOI: 10.1016/j.ejphar.2013.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 06/20/2013] [Accepted: 07/02/2013] [Indexed: 11/27/2022]
Abstract
To improve cellular cardiomyoplasty efficacy after myocardial infarction (MI), we postulated that combining mesenchymal stem cells (MSCs) transplantation with anti-apoptotic and angiogenic effects of erythropoietin (EPO) and vascular endothelial growth factor (VEGF) may provide better prognosis in an infarcted heart 48 rats, underwent left anterior descending artery ligation, were divided into eight groups and treated as follows: Group 1: MSC+EPO+VEGF, Group 2: MSC+EPO, Group 3: MSC+VEGF, Group 4: MSC, Group 5: EPO+VEGF, Group 6: EPO, Group 7: VEGF and Group 8: Control. After MI induction, EPO and VEGF were injected subcutaneously at the dose of 3000 U/kg and 3 µg/kg respectively. MSCs were transplanted one week after MI. In the fourteenth and sixteenth days after infarction, EPO was injected again. Echocardiography demonstrated that all treatments improved left ventricular function significantly (before vs. after treatment) but in control group ejection fraction deteriorated over the 2-months period. Percent of ejection fraction recovery in all treatment groups were significantly greater than control (P<0.05). Compared with the control group, all treatments attenuated cell death in peri-infarct areas significantly, except groups 6 and 7. Vascular density of all treatment groups were more than control group but this superiority was statistically significant only in group 1 (P<0.01). All of our treatments had beneficial effects to some extent but MSC transplantation combined with EPO and VEGF administration resulted in superior therapeutic outcome in enhancing cell survival and neovascularization.
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Affiliation(s)
- Fatemeh Tavakoli
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran-1417614411, Iran
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Klopsch C, Gäbel R, Kaminski A, Mark P, Wang W, Toelk A, Delyagina E, Kleiner G, Koch L, Chichkov B, Mela P, Jockenhoevel S, Ma N, Steinhoff G. Spray- and laser-assisted biomaterial processing for fast and efficient autologous cell-plus-matrix tissue engineering. J Tissue Eng Regen Med 2012. [DOI: 10.1002/term.1657] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christian Klopsch
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Ralf Gäbel
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Alexander Kaminski
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Peter Mark
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Weiwei Wang
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Anita Toelk
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Evgenya Delyagina
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Gabriela Kleiner
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | | | | | - Petra Mela
- Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering; RWTH Aachen University; Germany
| | - Stefan Jockenhoevel
- Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering; RWTH Aachen University; Germany
| | - Nan Ma
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
| | - Gustav Steinhoff
- Reference and Translation Centre for Cardiac Stem Cell Therapy; University of Rostock; Germany
- Department of Cardiac Surgery, Medical Faculty; University of Rostock; Germany
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Simvastatin augments the efficacy of therapeutic angiogenesis induced by bone marrow-derived mesenchymal stem cells in a murine model of hindlimb ischemia. Mol Biol Rep 2011; 39:285-93. [PMID: 21553056 DOI: 10.1007/s11033-011-0737-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 04/23/2011] [Indexed: 12/14/2022]
Abstract
Many studies showed beneficial effects of either statin or bone marrow-derived mesenchymal stem cells (MSC) treatment in ischemic disease. In an attempt to further improve postischemic tissue repair, we investigated the effect of a local administration of MSC, in the presence or not of low-dose simvastatin, on angiogenesis and functional recovery in a mouse model of hindlimb ischemia. In vitro, the proliferation, migration, apoptosis, and tube formation of bone marrow MSC derived from transgenic mice expressing green fluorescent protein (GFP) were detected in the presence or not of 0.01 μmol/l simvastatin, respectively. In vivo, immediately after hindlimb ischemia, the mice were divided into four groups, namely control, MSC, statin, and statin-MSC, and received a single local injection of MSC (2×10(6) cells) and/or a repeated gavages' administration of simvastatin (0.2 mg/kg) for 21 days. The blood flow was measured by laser Doppler imaging, the capillary density was detected by alkaline phosphatase staining and, the MSC differentiation was assessed by immunofluorescent staining at 21 days after the ischemia. In vitro, the MSC proliferation rate, migration ability and tube formation number were increased significantly in simvastatin group relative to control group. Whereas, the H2O2 induced-apoptosis was inhibited significantly in simvastatin group relative to control group. In vivo, hindlimb blood reperfusion was significantly improved (MSC 0.55±0.08, statin 0.57±0.05, vs. control 0.47±0.07, P<0.05) and capillary density was obviously higher at day 21 post-ischemia by Laser Doppler Imaging in the MSC group and the Statin group when compared with control group. The combined use of statin and MSC further improved revascularization (perfusion ratio of 0.70±0.09; P<0.001 verse other groups) and resulted in the highest capillary density (P<0.05 vs. all other groups). GFP-labeled transplanted cells were more frequently observed in the Statin-MSC group than in the MSC group (6.8±0.5-3.1±0.7, P<0.05). Low-dose simvastatin could act in a synergistic way with MSC to potentiate the functional neovascularization in a mouse model of hind limb ischemia.
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Klopsch C, Donndorf P, Kaminski A, Ma N, Steinhoff G. Zellquellen für kardiovaskuläres Tissue Engineering. Chirurg 2011; 82:295-302. [DOI: 10.1007/s00104-010-2030-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Klopsch C, Furlani D, Gäbel R, Pittermann E, Yerebakan C, Kaminski A, Ma N, Liebold A, Steinhoff G. Kardiale Protektion und Regeneration. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2010. [DOI: 10.1007/s00398-010-0806-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cho GW, Koh SH, Kim MH, Yoo AR, Noh MY, Oh S, Kim SH. The neuroprotective effect of erythropoietin-transduced human mesenchymal stromal cells in an animal model of ischemic stroke. Brain Res 2010; 1353:1-13. [DOI: 10.1016/j.brainres.2010.06.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 06/03/2010] [Accepted: 06/07/2010] [Indexed: 10/19/2022]
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