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Adamik B, Frostell C, Dragan B, Paslawska U, Zielinski S, Paslawski R, Janiszewski A, Zielinska M, Ryniak S, Albert J, Gozdzik W. Abnormalities of Coagulation and Fibrinolysis Assessed by Thromboelastometry in an Endotoxic Shock Model in Piglets Treated with Nitric Oxide and Hydrocortisone. Arch Immunol Ther Exp (Warsz) 2024; 72:aite-2024-0011. [PMID: 38847555 DOI: 10.2478/aite-2024-0011] [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: 09/05/2023] [Accepted: 04/18/2024] [Indexed: 06/24/2024]
Abstract
This is an animal model study to investigate changes in hemostasis during endotoxemic shock and to determine whether the combination of inhaled nitric oxide (iNO) + intravenous hydrocortisone had an effect on clot formation and fibrinolysis. iNO selectively decreases pulmonary artery pressure, without affecting cardiac index or systemic vascular resistance; however, the results of studies on the possible consequences of iNO administration on coagulation are inconsistent and require further research. Thirty-four piglets were included. Administering endotoxin caused severe hypodynamic shock. Half of the animals received iNO (30 ppm) + hydrocortisone, starting 3 h after endotoxin infusion and continuing to the end of the study. All animals developed coagulation disorders, manifested by a tendency to hypocoagulation; at the same time, fibrinolysis was impaired. Coagulation and fibrinolysis disorders persisted after endotoxin infusion was discontinued, with worse severity in the animals that died before the study was terminated. Administering iNO + hydrocortisone did not cause further changes in coagulation and fibrinolysis parameters, either during or after the endotoxin challenge, suggesting that potential therapeutic interventions with iNO to lower pulmonary arterial pressure will not affect hemostasis.
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Affiliation(s)
- Barbara Adamik
- Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Claes Frostell
- Department of Anesthesia and Intensive Care, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden
| | - Barbara Dragan
- Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Urszula Paslawska
- Nicolaus Copernicus University, Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Torun, Poland
- Department of Internal Medicine and Clinic of Horses, Dogs and Cats, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Stanislaw Zielinski
- Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Robert Paslawski
- Nicolaus Copernicus University, Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Torun, Poland
| | - Adrian Janiszewski
- Department of Internal Disease and Diagnostics, Poznan University of Life Sciences, Faculty of Veterinary Medicine and Animal Sciences, Poznan, Poland
| | - Marzena Zielinska
- Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Stanislaw Ryniak
- Department of Anesthesia and Intensive Care, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden
| | - Johanna Albert
- Department of Anesthesia and Intensive Care, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden
| | - Waldemar Gozdzik
- Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
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Kiczak L, Pasławska U, Goździk W, Adamik B, Zielińska M, Zieliński S, Nowak K, Płóciennik M, Bania J, Tabiś A, Nowak M, Pasławski R, Frostell C. Effect of low-dose hydrocortisone and inhaled nitric oxide on inflammatory mediators and local pulmonary metalloproteinases activity in LPS-induced sepsis in piglets. Sci Rep 2023; 13:11369. [PMID: 37443327 PMCID: PMC10344886 DOI: 10.1038/s41598-023-38311-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
Hospital mortality in sepsis varies between 30-45%. It has been shown that administration of inhaled nitric oxide (iNO) and intravenous corticosteroid in a porcine endotoxemia model attenuated the systemic inflammatory response. We explored the anti-inflammatory effect of a double-treatment strategy (iNO + low-dose steroid) on the lungs in a long-term porcine endotoxic shock model. As metalloproteinases (MMPs) are involved in the initiation of multiple organ dysfunction in septic shock, we evaluated the influence of this combination therapy on MMP2 and MMP9 activity and proIL-1β maturation. A shock-like condition was established in 23 animals by continuous infusion of E. coli lipopolysaccharide (LPS) for 10 h. Then the animals were observed for 10 h. Twelve pigs received iNO and hydrocortisone (iNO treatment started 3 h after the initial LPS infusion and continued until the end of the experiment). Eleven pigs were controls. Pigs treated with iNO and hydrocortisone displayed less inflammatory infiltrates in the lungs than the controls and a lower level of IL-1β. The proMMP2 was significantly decreased in the iNO and hydrocortisone group. The amount of an active MMP9 (~ 60 kDa) was decreased in the iNO and hydrocortisone group. Total gelatinolytic activity was lower in the iNO and hydrocortisone group. Reduced MMP activity was accompanied by a 2.5-fold decrease of the active IL-1β form (17 kDa) in the pulmonary tissue of iNO combined with hydrocortisone exposed pigs. We demonstrated that in a porcine endotoxemia model the NO inhalation combined with intravenous hydrocortisone led to the attenuation of the inflammatory cascade induced by bacterial LPS. The decrease in pulmonary MMPs activities was accompanied by reduced proIL-1β processing.
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Affiliation(s)
- Liliana Kiczak
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland.
| | - Urszula Pasławska
- Veterinary Center, Nicoalus Copernicus University in Toruń, 87-100, Toruń, Poland
- Department of Internal Diseases and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-375, Wrocław, Poland
| | - Waldemar Goździk
- Clinical Department of Anesthesiology and Intensive Therapy, Wrocław Medical University, 50-556, Wrocław, Poland
| | - Barbara Adamik
- Clinical Department of Anesthesiology and Intensive Therapy, Wrocław Medical University, 50-556, Wrocław, Poland
| | - Marzena Zielińska
- Clinical Department of Anesthesiology and Intensive Therapy, Wrocław Medical University, 50-556, Wrocław, Poland
| | - Stanisław Zieliński
- Clinical Department of Anesthesiology and Intensive Therapy, Wrocław Medical University, 50-556, Wrocław, Poland
| | - Kacper Nowak
- Department of Internal Diseases and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-375, Wrocław, Poland
| | - Michał Płóciennik
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Norwida 31, 50-375, Wrocław, Poland
| | - Jacek Bania
- Department of Food Hygiene and Consumer Health Protection, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-375, Wrocław, Poland
| | - Aleksandra Tabiś
- Department of Food Hygiene and Consumer Health Protection, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-375, Wrocław, Poland
| | - Marcin Nowak
- Department of Pathology, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-375, Wrocław, Poland
| | - Robert Pasławski
- Veterinary Center, Nicoalus Copernicus University in Toruń, 87-100, Toruń, Poland
| | - Claes Frostell
- Department of Anesthesia and Intensive Care, Karolinska Institutet Danderyd Hospital, 182-88, Stockholm, Sweden
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Skirecki T, Adamik B, Frostell C, Pasławska U, Zieliński S, Glatzel-Plucińska N, Olbromski M, Dzięgiel P, Gozdzik W. Compartment-Specific Differences in the Activation of Monocyte Subpopulations Are Not Affected by Nitric Oxide and Glucocorticoid Treatment in a Model of Resuscitated Porcine Endotoxemic Shock. J Clin Med 2022; 11:2641. [PMID: 35566768 PMCID: PMC9100570 DOI: 10.3390/jcm11092641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Inhaled nitric oxide (iNO) remains one of the treatment modalities in shock, and in addition to its vasoactive properties, iNO exerts immunomodulatory effects. We used a porcine model of endotoxemia with shock resuscitation (control) and additional treatment with iNO and a steroid (treatment group). After 20 h, bone marrow (BM), peripheral blood (PB), and bronchoalveolar lavage fluid (BALF) were collected to analyze the immunophenotype and mitochondrial membrane potential (Δφ) in three subsets of monocytes. In both groups, SLA-DR expression decreased twofold on the circulating CD14+CD163+ and CD14−CD163+ monocytes, while it did not change on the CD14+CD163+. Δφ increased only in the CD14−CD163+ subpopulation (0.8 vs. 2.0, p < 0.001). The analysis of compartment-specific alterations showed that nearly 100% of BALF CD14+CD163+ and CD14−CD163+ monocytes expressed SLA-DR, and it was higher compared to PB (32% and 20%, p < 0.0001) and BM (93% and 67%, p < 0.001, respectively) counterparts. BALF CD14+CD163+ had a threefold higher Δφ than PB and BM monocytes, while the Δφ of the other subsets was highest in PB monocytes. We confirmed the compartmentalization of the monocyte response during endotoxemic shock, which highlights the importance of studying tissue-resident cells in addition to their circulating counterparts. The iNO/steroid treatment did not further impair monocyte fitness.
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Affiliation(s)
- Tomasz Skirecki
- Laboratory of Flow Cytometry, Centre of Postgraduate Medical Education Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Barbara Adamik
- Clinical Department of the Anaesthesiology and Intensive Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.A.); (S.Z.); (W.G.)
| | - Claes Frostell
- Department of Anaesthesia and Intensive Care, Karolinska Institutet, Danderyd Hospital, 182 57 Stockholm, Sweden;
| | - Urszula Pasławska
- Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland;
- Department of Internal Medicine and Clinic for Horses, Dogs and Cats, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Stanisław Zieliński
- Clinical Department of the Anaesthesiology and Intensive Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.A.); (S.Z.); (W.G.)
| | - Natalia Glatzel-Plucińska
- Department of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (N.G.-P.); (M.O.); (P.D.)
| | - Mateusz Olbromski
- Department of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (N.G.-P.); (M.O.); (P.D.)
| | - Piotr Dzięgiel
- Department of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-367 Wroclaw, Poland; (N.G.-P.); (M.O.); (P.D.)
- Department of Physiotherapy, University School of Physical Education, 51-612 Wroclaw, Poland
| | - Waldemar Gozdzik
- Clinical Department of the Anaesthesiology and Intensive Therapy, Wroclaw Medical University, 50-367 Wroclaw, Poland; (B.A.); (S.Z.); (W.G.)
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Crawford D, Lau TC, Frost MC, Hatch NE. Control of Orthodontic Tooth Movement by Nitric Oxide Releasing Nanoparticles in Sprague-Dawley Rats. FRONTIERS IN DENTAL MEDICINE 2022; 9:811251. [PMID: 36081866 PMCID: PMC9451041 DOI: 10.3389/fmats.2022.811251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
UNLABELLED Orthodontic treatment commonly requires the need to prevent movement of some teeth while maximizing movement of other teeth. This study aimed to investigate the influence of locally injected nitric oxide (NO) releasing nanoparticles on orthodontic tooth movement in rats. MATERIALS AND METHODS Experimental tooth movement was achieved with nickel-titanium alloy springs ligated between the maxillary first molar and ipsilateral incisor. 2.2 mg/kg of silica nanoparticles containing S-nitrosothiol groups were injected into the mucosa just mesial to 1st molar teeth immediately prior to orthodontic appliance activation. NO release from nanoparticles was measured in vitro by chemiluminescence. Tooth movement was measured using polyvinyl siloxane impressions. Bones were analyzed by microcomputed tomography. Local tissue was assessed by histomorphometry. RESULTS Nanoparticles released a burst of NO within the first hours at approximately 10 ppb/mg particles that diminished by 10 × to approximately 1 ppb/mg particles over the next 1-4 days, and then diminished again by tenfold from day 4 to day 7, at which point it was no longer measurable. Molar but not incisor tooth movement was inhibited over 50% by injection of the NO releasing nanoparticles. Inhibition of molar tooth movement occurred only during active NO release from nanoparticles, which lasted for approximately 1 week. Molar tooth movement returned to control levels of tooth movement after end of NO release. Alveolar and long bones were not impacted by injection of the NO releasing nanoparticles, and serum cyclic guanosine monophosphate (cGMP) levels were not increased in animals that received the NO releasing nanoparticles. Root resorption was decreased and periodontal blood vessel numbers were increased in animals with appliances that were injected with the NO releasing nanoparticles as compared to animals with appliances that did not receive injections with the nanoparticles. CONCLUSION Nitric oxide (NO) release from S-nitrosothiol containing nanoparticles inhibits movement of teeth adjacent to the site of nanoparticle injection for 1 week. Additional studies are needed to establish biologic mechanisms, optimize efficacy and increase longevity of this orthodontic anchorage effect.
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Affiliation(s)
- Derrick Crawford
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Tommy C. Lau
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Megan C. Frost
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Nan E. Hatch
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
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Packialakshmi B, Stewart IJ, Burmeister DM, Chung KK, Zhou X. Large animal models for translational research in acute kidney injury. Ren Fail 2021; 42:1042-1058. [PMID: 33043785 PMCID: PMC7586719 DOI: 10.1080/0886022x.2020.1830108] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
While extensive research using animal models has improved the understanding of acute kidney injury (AKI), this knowledge has not been translated into effective treatments. Many promising interventions for AKI identified in mice and rats have not been validated in subsequent clinical trials. As a result, the mortality rate of AKI patients remains high. Inflammation plays a fundamental role in the pathogenesis of AKI, and one reason for the failure to translate promising therapeutics may lie in the profound difference between the immune systems of rodents and humans. The immune systems of large animals such as swine, nonhuman primates, sheep, dogs and cats, more closely resemble the human immune system. Therefore, in the absence of a basic understanding of the pathophysiology of human AKI, large animals are attractive models to test novel interventions. However, there is a lack of reviews on large animal models for AKI in the literature. In this review, we will first highlight differences in innate and adaptive immunities among rodents, large animals, and humans in relation to AKI. After illustrating the potential merits of large animals in testing therapies for AKI, we will summarize the current state of the evidence in terms of what therapeutics have been tested in large animal models. The aim of this review is not to suggest that murine models are not valid to study AKI. Instead, our objective is to demonstrate that large animal models can serve as valuable and complementary tools in translating potential therapeutics into clinical practice.
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Affiliation(s)
| | - Ian J Stewart
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - David M Burmeister
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Kevin K Chung
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Xiaoming Zhou
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Abstract
Pigs represent a potentially attractive model for medical research. Similar body size and physiological patterns of kidney injury that more closely mimic those described in humans make larger animals attractive for experimentation. Using larger animals, including pigs, to investigate the pathogenesis of acute kidney injury (AKI) also serves as an experimental bridge, narrowing the gap between clinical disease and preclinical discoveries. This article compares the advantages and disadvantages of large versus small AKI animal models and provides a comprehensive overview of the development and application of porcine models of AKI induced by clinically relevant insults, including ischemia-reperfusion, sepsis, and nephrotoxin exposure. The primary focus of this review is to evaluate the use of pigs for AKI studies by current investigators, including areas where more information is needed.
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Affiliation(s)
- Jianni Huang
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - George Bayliss
- Department of Medicine, Rhode Island Hospital and Alpert Medical School, Brown University, Providence, Rhode Island
| | - Shougang Zhuang
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Medicine, Rhode Island Hospital and Alpert Medical School, Brown University, Providence, Rhode Island
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Liu K, Wang H, Yu SJ, Tu GW, Luo Z. Inhaled pulmonary vasodilators: a narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:597. [PMID: 33987295 PMCID: PMC8105872 DOI: 10.21037/atm-20-4895] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023]
Abstract
Pulmonary hypertension (PH) is a severe disease that affects people of all ages. It can occur as an idiopathic disorder at birth or as part of a variety of cardiovascular and pulmonary disorders. Inhaled pulmonary vasodilators (IPV) can reduce pulmonary vascular resistance (PVR) and improve RV function with minimal systemic effects. IPV includes inhaled nitric oxide (iNO), inhaled aerosolized prostacyclin, or analogs, including epoprostenol, iloprost, treprostinil, and other vasodilators. In addition to pulmonary vasodilating effects, IPV can also be used to improve oxygenation, reduce inflammation, and protect cell. Off-label use of IPV is common in daily clinical practice. However, evidence supporting the inhalational administration of these medications is limited, inconclusive, and controversial regarding their safety and efficacy. We conducted a search for relevant papers published up to May 2020 in four databases: PubMed, Google Scholar, EMBASE and Web of Science. This review demonstrates that the clinical using and updated evidence of IPV. iNO is widely used in neonates, pediatrics, and adults with different cardiopulmonary diseases. The limitations of iNO include high cost, flat dose-response, risk of significant rebound PH after withdrawal, and the requirement of complex technology for monitoring. The literature suggests that inhaled aerosolized epoprostenol, iloprost, treprostinil and others such as milrinone and levosimendan may be similar to iNO. More research of IPV is needed to determine acceptable inclusion criteria, long-term outcomes, and management strategies including time, dose, and duration.
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Affiliation(s)
- Kai Liu
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huan Wang
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shen-Ji Yu
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guo-Wei Tu
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhe Luo
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Critical Care Med, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
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Navati MS, Lucas A, Liong C, Barros M, Jayadeva JT, Friedman JM, Cabrales P. Reducing Ischemia/Reperfusion Injury by the Targeted Delivery of Nitric Oxide from Magnetic-Field-Induced Localization of S-Nitrosothiol-Coated Paramagnetic Nanoparticles. ACS APPLIED BIO MATERIALS 2019; 2:2907-2919. [DOI: 10.1021/acsabm.9b00282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Mahantesh S. Navati
- Department of Albert Einstein College of Medicine Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, United States
| | - Alfredo Lucas
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
| | - Celine Liong
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
| | - Marcelo Barros
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
| | - Jyothishree Tholalu Jayadeva
- Department of Albert Einstein College of Medicine Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, United States
| | - Joel M. Friedman
- Department of Albert Einstein College of Medicine Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, United States
| | - Pedro Cabrales
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
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