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Tutino VM, Poppenberg KE, Li L, Shallwani H, Jiang K, Jarvis JN, Sun Y, Snyder KV, Levy EI, Siddiqui AH, Kolega J, Meng H. Biomarkers from circulating neutrophil transcriptomes have potential to detect unruptured intracranial aneurysms. J Transl Med 2018; 16:373. [PMID: 30593281 PMCID: PMC6310942 DOI: 10.1186/s12967-018-1749-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/17/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Intracranial aneurysms (IAs) are dangerous because of their potential to rupture and cause deadly subarachnoid hemorrhages. Previously, we found significant RNA expression differences in circulating neutrophils between patients with unruptured IAs and aneurysm-free controls. Searching for circulating biomarkers for unruptured IAs, we tested the feasibility of developing classification algorithms that use neutrophil RNA expression levels from blood samples to predict the presence of an IA. METHODS Neutrophil RNA extracted from blood samples from 40 patients (20 with angiography-confirmed unruptured IA, 20 angiography-confirmed IA-free controls) was subjected to next-generation RNA sequencing to obtain neutrophil transcriptomes. In a randomly-selected training cohort of 30 of the 40 samples (15 with IA, 15 controls), we performed differential expression analysis. Significantly differentially expressed transcripts (false discovery rate < 0.05, fold change ≥ 1.5) were used to construct prediction models for IA using four well-known supervised machine-learning approaches (diagonal linear discriminant analysis, cosine nearest neighbors, nearest shrunken centroids, and support vector machines). These models were tested in a testing cohort of the remaining 10 neutrophil samples from the 40 patients (5 with IA, 5 controls), and model performance was assessed by receiver-operating-characteristic (ROC) curves. Real-time quantitative polymerase chain reaction (PCR) was used to corroborate expression differences of a subset of model transcripts in neutrophil samples from a new, separate validation cohort of 10 patients (5 with IA, 5 controls). RESULTS The training cohort yielded 26 highly significantly differentially expressed neutrophil transcripts. Models using these transcripts identified IA patients in the testing cohort with accuracy ranging from 0.60 to 0.90. The best performing model was the diagonal linear discriminant analysis classifier (area under the ROC curve = 0.80 and accuracy = 0.90). Six of seven differentially expressed genes we tested were confirmed by quantitative PCR using isolated neutrophils from the separate validation cohort. CONCLUSIONS Our findings demonstrate the potential of machine-learning methods to classify IA cases and create predictive models for unruptured IAs using circulating neutrophil transcriptome data. Future studies are needed to replicate these findings in larger cohorts.
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Affiliation(s)
- Vincent M. Tutino
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY 14214 USA
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY USA
| | - Kerry E. Poppenberg
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY 14214 USA
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY USA
| | - Lu Li
- Department of Computer Science and Engineering, University at Buffalo, Buffalo, NY USA
| | - Hussain Shallwani
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
| | - Kaiyu Jiang
- Genetics, Genomics, and Bioinformatics Program, University at Buffalo, Buffalo, NY USA
| | - James N. Jarvis
- Genetics, Genomics, and Bioinformatics Program, University at Buffalo, Buffalo, NY USA
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
| | - Yijun Sun
- Genetics, Genomics, and Bioinformatics Program, University at Buffalo, Buffalo, NY USA
- Department of Microbiology and Immunology, University at Buffalo, Buffalo, NY USA
| | - Kenneth V. Snyder
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY 14214 USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
| | - Elad I. Levy
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY 14214 USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
| | - Adnan H. Siddiqui
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY 14214 USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
| | - John Kolega
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY 14214 USA
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
| | - Hui Meng
- Canon Stroke and Vascular Research Center, University at Buffalo, Clinical and Translational Research Center, 875 Ellicott Street, Buffalo, NY 14214 USA
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY USA
- Department of Mechanical & Aerospace Engineering, University at Buffalo, Buffalo, NY USA
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Privratsky JR, Zhang J, Lu X, Rudemiller N, Wei Q, Yu YR, Gunn MD, Crowley SD. Interleukin 1 receptor (IL-1R1) activation exacerbates toxin-induced acute kidney injury. Am J Physiol Renal Physiol 2018; 315:F682-F691. [PMID: 29790392 PMCID: PMC6172579 DOI: 10.1152/ajprenal.00104.2018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 12/30/2022] Open
Abstract
Acute kidney injury (AKI) is a leading cause of morbidity and mortality. Drug-induced/toxic AKI can be caused by a number of therapeutic agents. Cisplatin is an effective chemotherapeutic agent whose administration is limited by significant nephrotoxicity. Therapies to prevent cisplatin-induced AKI are lacking. Although tumor necrosis factor-α (TNF) plays a key role in the pathogenesis of cisplatin nephrotoxicity, the innate immune signaling pathways that trigger TNF generation in this context require elucidation. In this regard, sterile injury triggers the release and activation of both isoforms of interleukin(IL)-1, IL-1α and IL-1β. In turn, stimulation of the interleukin-1 receptor (IL-1R1) by these ligands engages a proinflammatory signaling cascade that induces TNF induction. We therefore hypothesized that IL-1R1 activation exacerbates cisplatin-induced AKI by inducing TNF production, thereby augmenting inflammatory signals between kidney parenchymal cells and infiltrating myeloid cells. IL-1R1+/+ (WT) and IL-1R1-/- (KO) mice were subjected to cisplatin-induced AKI. Compared with WT mice, IL-1R1 KO mice had attenuated AKI as measured by serum creatinine and BUN, renal NGAL mRNA levels, and blinded histological analysis of kidney pathology. In the cisplatin-injured kidney, IL-1R1 KO mice had diminished levels of whole kidney TNF, and fewer Ly6G-expressing neutrophils. In addition, an unbiased machine learning analysis of intrarenal immune cells revealed a diminished number of CD11bint/CD11cint myeloid cells in IL-1R1 KO injured kidneys compared with IL-1R1 WT kidneys. Following cisplatin, IL-1R1 KO kidneys, compared with WTs, had fewer TNF-producing: macrophages, CD11bint/CD11cint cells, and neutrophils, consistent with an effect of IL-1R1 to polarize intrarenal myeloid cells toward a proinflammatory phenotype. Interruption of IL-1-dependent signaling pathways warrants further evaluation to decrease nephrotoxicity during cisplatin therapy.
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Affiliation(s)
- Jamie R Privratsky
- Department of Anesthesiology, Duke University Medical Center , Durham, North Carolina
| | - Jiandong Zhang
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Xiaohan Lu
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Nathan Rudemiller
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Qingqing Wei
- Department of Cellular Biology and Anatomy, Augusta University , Augusta, Georgia
| | - Yen-Rei Yu
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Michael D Gunn
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
| | - Steven D Crowley
- Department of Medicine, Duke University Medical Center , Durham, North Carolina
- Durham Veterans Affairs Medical Center , Durham, North Carolina
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Postnikoff C, Gorbet M. The Effect of Closed-Eye Tear Film Conditions on Blood-Isolated Neutrophils, In Vitro. Ocul Immunol Inflamm 2017; 26:706-716. [PMID: 28323491 DOI: 10.1080/09273948.2017.1281423] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Eyelid closure results in influx of neutrophils onto the ocular surface, which are non-responsive to inflammatory stimuli. This investigation examined whether incubation of blood-isolated neutrophils in closed-eye conditions induce a tear-film neutrophil phenotype. METHODS Blood-isolated neutrophils were incubated combining various conditions: hypoxia, corneal epithelial cells (HCEC), artificial tear solution (ATS). RESULTS A hypoxic environment induced no differential effect on membrane receptor expression. Incubation in the presence of HCEC resulted in membrane receptor upregulation and increase in caspase activation. CONCLUSIONS Hypoxia, corneal epithelial cell exposure, or artificial tear fluid are insufficient to replicate a tear-film neutrophil phenotype using blood-isolated neutrophils.
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Affiliation(s)
- Cameron Postnikoff
- a Systems Design Engineering , University of Waterloo , Waterloo , Ontario , Canada
| | - Maud Gorbet
- a Systems Design Engineering , University of Waterloo , Waterloo , Ontario , Canada.,b School of Optometry and Vision Science , University of Waterloo , Waterloo , Ontario , Canada
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Llorián-Salvador M, González-Rodríguez S, Lastra A, Fernández-García MT, Hidalgo A, Menéndez L, Baamonde A. Involvement of CC Chemokine Receptor 1 and CCL3 in Acute and Chronic Inflammatory Pain in Mice. Basic Clin Pharmacol Toxicol 2016; 119:32-40. [DOI: 10.1111/bcpt.12543] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/06/2015] [Indexed: 12/22/2022]
Affiliation(s)
- María Llorián-Salvador
- Laboratory of Pharmacology; School of Medicine; University Institute of Oncology of Asturias (IUOPA); University of Oviedo; Asturias Spain
| | - Sara González-Rodríguez
- Laboratory of Pharmacology; School of Medicine; University Institute of Oncology of Asturias (IUOPA); University of Oviedo; Asturias Spain
| | - Ana Lastra
- Laboratory of Pharmacology; School of Medicine; University Institute of Oncology of Asturias (IUOPA); University of Oviedo; Asturias Spain
| | | | - Agustín Hidalgo
- Laboratory of Pharmacology; School of Medicine; University Institute of Oncology of Asturias (IUOPA); University of Oviedo; Asturias Spain
| | - Luis Menéndez
- Laboratory of Pharmacology; School of Medicine; University Institute of Oncology of Asturias (IUOPA); University of Oviedo; Asturias Spain
| | - Ana Baamonde
- Laboratory of Pharmacology; School of Medicine; University Institute of Oncology of Asturias (IUOPA); University of Oviedo; Asturias Spain
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Sadeghi H, Lockmann A, Hund AC, Samavedam UKSRL, Pipi E, Vafia K, Hauenschild E, Kalies K, Pas HH, Jonkman MF, Iwata H, Recke A, Schön MP, Zillikens D, Schmidt E, Ludwig RJ. Caspase-1–Independent IL-1 Release Mediates Blister Formation in Autoantibody-Induced Tissue Injury through Modulation of Endothelial Adhesion Molecules. THE JOURNAL OF IMMUNOLOGY 2015; 194:3656-63. [DOI: 10.4049/jimmunol.1402688] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/15/2015] [Indexed: 12/29/2022]
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Early matrix metalloproteinase-12 inhibition worsens post-myocardial infarction cardiac dysfunction by delaying inflammation resolution. Int J Cardiol 2015; 185:198-208. [PMID: 25797678 DOI: 10.1016/j.ijcard.2015.03.054] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 01/17/2015] [Accepted: 03/03/2015] [Indexed: 01/01/2023]
Abstract
RATIONALE Matrix metalloproteinases (MMPs) regulate remodeling of the left ventricle (LV) post-myocardial infarction (MI). MMP-12 has potent macrophage-dependent remodeling properties in the atherosclerotic plaque; however, post-MI roles have not been examined. OBJECTIVE The goal was to determine MMP-12 post-MI mechanisms. METHODS AND RESULTS Male C57BL/6J mice (3-6 months old) were subjected to left coronary artery ligation. Saline or the RXP 470.1 MMP-12 inhibitor (MMP-12i; 0.5mg/kg/day) was delivered by osmotic mini-pump beginning 3h post-MI, and mice were sacrificed at day (d)1, 3, 5 or 7 post-MI and compared to d0 controls (mice without MI; n=6-12/group/time). MMP-12 expression increased early post-MI, and contrary to expected, neutrophils were a surprising early cellular source for MMP-12. MMP-12i reduced MMP-12 activity 33 ± 1% at d1 post-MI. Despite similar infarct areas and survival rates, MMP-12i led to greater LV dilation and worsened LV function. At d7 post-MI, MMP-12i prolonged pro-inflammatory cytokine upregulation (IL1r1, IL6ra, IL11, and Cxcr5) and decreased CD44 (both gene and protein levels). Hyaluronan (HA), a CD44 ligand, was elevated at d1 and d7 post-MI with MMP12i, as a result of decreased fragmentation. Because CD44-HA regulates neutrophil removal, apoptosis markers were evaluated. Caspase 3 increased, while cleaved caspase 3 levels decreased in MMP-12i group at d7 post-MI, indicating reduced neutrophil apoptosis. In isolated neutrophils, active MMP-12 directly stimulated CD44, caspase 3, and caspase 8 expression. CONCLUSION Our results reveal a novel protective mechanism for MMP-12 in neutrophil biology. Post-MI, MMP-12i impaired CD44-HA interactions to suppress neutrophil apoptosis and prolong inflammation, which worsened LV function.
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Wallquist C, Paulson JM, Hylander B, Lundahl J, Jacobson SH. Increased accumulation of CD16+ monocytes at local sites of inflammation in patients with chronic kidney disease. Scand J Immunol 2014; 78:538-44. [PMID: 24111715 DOI: 10.1111/sji.12115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 09/19/2013] [Indexed: 01/13/2023]
Abstract
Patients with chronic kidney disease (CKD) display a high prevalence of cardiovascular events and acute infections. Potential effector cells are the CD16(+) monocytes, known to be increased in the peripheral circulation in CKD. The aim of this study was to assess the expression of CD16 and CX3 CR1 on peripheral and in vivo extravasated monocytes in patients with CKD (GFR < 20 ml/min × 1.73 m²) using flow cytometry. In vivo extravasated monocytes were collected from a local inflammatory site, induced by a skin blistering technique. Soluble markers were assessed by Luminex. The number of CD16(+) monocytes was significantly higher in patients with CKD compared with healthy subjects, both in the peripheral circulation (P < 0.05) and at the site of induced inflammation (P < 0.001). Patients with CKD displayed significantly higher concentration of soluble CX3 CL1 both in the peripheral circulation (P < 0.01) and in the interstitial fluid (P < 0.001). In addition, patients with CKD had a significantly higher concentration of TNF-α in the peripheral circulation (P < 0.001). On the contrary, at the inflammatory site, concentrations of both TNF-α and IL-10 were significantly lower in patients with CKD compared with healthy controls (P < 0.05 for both). In conclusion, patients with CKD have an increased percentage of CD16(+) monocytes in both circulation and at the inflammatory site, and this finding is in concurrence with simultaneous changes in CX3 CR1. Together with distorted TNF-α and IL-10 levels, this may have potential impact on the altered inflammatory response in CKD.
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Affiliation(s)
- C Wallquist
- Department of Nephrology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Division of Nephrology, Department of Medicine, Västmanlands Hospital, Västerås, Sweden
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Christenson K, Björkman L, Davidsson L, Karlsson A, Follin P, Dahlgren C, Bylund J. Collection of in vivo transmigrated neutrophils from human skin. Methods Mol Biol 2014; 1124:39-52. [PMID: 24504945 DOI: 10.1007/978-1-62703-845-4_4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A wealth of knowledge on the life and death of human neutrophils has been obtained by the in vitro study of isolated cells derived from peripheral blood. However, neutrophils are of main importance, physiologically as well as pathologically, after they have left circulation and transmigrated to extravascular tissues. The journey from blood to tissue is complex and eventful, and tissue neutrophils are in many aspects distinct from the cells left in circulation. Here we describe how to obtain human tissue neutrophils in a controlled experimental setting from aseptic skin lesions created by the application of negative pressure. One protocol enables the direct analysis of the blister content, infiltrating leukocytes as well as exudate fluid, and is a simple method to follow multiple parameters of aseptic inflammation in vivo. Also described is the skin chamber technique, a method based on denuded skin blisters which are subsequently covered by collection chambers filled with autologous serum. Although slightly more artificial as compared to analysis of the blister content directly, the cellular yield of this skin chamber method is sufficient to perform a large number of functional analyses of in vivo transmigrated cells.
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Affiliation(s)
- Karin Christenson
- Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden
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Neubauer O, Sabapathy S, Lazarus R, Jowett JBM, Desbrow B, Peake JM, Cameron-Smith D, Haseler LJ, Wagner KH, Bulmer AC. Transcriptome analysis of neutrophils after endurance exercise reveals novel signaling mechanisms in the immune response to physiological stress. J Appl Physiol (1985) 2013; 114:1677-88. [DOI: 10.1152/japplphysiol.00143.2013] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Neutrophils serve as an intriguing model for the study of innate immune cellular activity induced by physiological stress. We measured changes in the transcriptome of circulating neutrophils following an experimental exercise trial (EXTRI) consisting of 1 h of intense cycling immediately followed by 1 h of intense running. Blood samples were taken at baseline, 3 h, 48 h, and 96 h post-EXTRI from eight healthy, endurance-trained, male subjects. RNA was extracted from isolated neutrophils. Differential gene expression was evaluated using Illumina microarrays and validated with quantitative PCR. Gene set enrichment analysis identified enriched molecular signatures chosen from the Molecular Signatures Database. Blood concentrations of muscle damage indexes, neutrophils, interleukin (IL)-6 and IL-10 were increased ( P < 0.05) 3 h post-EXTRI. Upregulated groups of functionally related genes 3 h post-EXTRI included gene sets associated with the recognition of tissue damage, the IL-1 receptor, and Toll-like receptor (TLR) pathways (familywise error rate, P value < 0.05). The core enrichment for these pathways included TLRs, low-affinity immunoglobulin receptors, S100 calcium binding protein A12, and negative regulators of innate immunity, e.g., IL-1 receptor antagonist, and IL-1 receptor associated kinase-3. Plasma myoglobin changes correlated with neutrophil TLR4 gene expression ( r = 0.74; P < 0.05). Neutrophils had returned to their nonactivated state 48 h post-EXTRI, indicating that their initial proinflammatory response was transient and rapidly counterregulated. This study provides novel insight into the signaling mechanisms underlying the neutrophil responses to endurance exercise, suggesting that their transcriptional activity was particularly induced by damage-associated molecule patterns, hypothetically originating from the leakage of muscle components into the circulation.
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Affiliation(s)
- Oliver Neubauer
- Emerging Field Oxidative Stress and DNA Stability, and Research Platform Active Aging, Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Surendran Sabapathy
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Ross Lazarus
- Genomics & Systems Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Harvard Medical School, Boston, Massachusetts
| | - Jeremy B. M. Jowett
- Genomics & Systems Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Ben Desbrow
- School of Public Health and Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Jonathan M. Peake
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia; and
| | | | - Luke J. Haseler
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Karl-Heinz Wagner
- Emerging Field Oxidative Stress and DNA Stability, and Research Platform Active Aging, Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Andrew C. Bulmer
- Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
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Lenaghan SC, Yongzhong Wang, Ning Xi, Fukuda T, Tarn T, Hamel WR, Mingjun Zhang. Grand Challenges in Bioengineered Nanorobotics for Cancer Therapy. IEEE Trans Biomed Eng 2013; 60:667-73. [DOI: 10.1109/tbme.2013.2244599] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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