1
|
Rajendran R, Suman S, Divakaran SJ, Swatikrishna S, Tripathi P, Jain R, Sagar K, Rajakumari S. Sesaminol alters phospholipid metabolism and alleviates obesity-induced NAFLD. FASEB J 2024; 38:e23835. [PMID: 39037555 DOI: 10.1096/fj.202400412rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/04/2024] [Accepted: 07/10/2024] [Indexed: 07/23/2024]
Abstract
The prevalence of obesity-induced non-alcoholic fatty liver disease (NAFLD) and insulin resistance is increasing worldwide. We previously demonstrated that sesaminol increases thermogenesis in adipocytes, improves insulin sensitivity, and mitigates obesity in mice. In this study, we demonstrated that sesaminol increased mitochondrial activity and reduced ROS production in hepatocytes. Therefore, we delve into the metabolic action of sesaminol in obesity-induced NAFLD or metabolic dysfunction-associated liver disease (MAFLD). Here, we report that sesaminol induces OXPHOS proteins and mitochondrial function in vivo. Further, our data suggest that sesaminol administration reduces hepatic triacylglycerol accumulation and LDL-C levels. Prominently, the lipidomics analyses revealed that sesaminol administration decreased the major phospholipids such as PC, PE, PI, CL, and PS to maintain membrane lipid homeostasis in the liver upon HFD challenge. Besides, SML reduced ePC and SM molecular species and increased PA levels in the HFD-fed mice. Also, sesaminol renders anti-inflammatory properties and dampens fibrosis markers in the liver. Remarkably, SML lowers the hepatic levels of ALT and AST enzymes and alleviates NAFLD in diet-induced obese mice. The molecular docking analysis identifies peroxisome proliferator-activated receptors as potential endogenous receptors for sesaminol. Together, our study demonstrates plant lignan sesaminol as a potential small molecule that alters the molecular species of major phospholipids, including sphingomyelin and ether-linked PCs in the liver tissue, improves metabolic parameters, and alleviates obesity-induced fatty liver disease in mice.
Collapse
Affiliation(s)
- Rajprabu Rajendran
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Sanskriti Suman
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Soumya Jaya Divakaran
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Sahu Swatikrishna
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Purnima Tripathi
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Rashi Jain
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Karan Sagar
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| | - Sona Rajakumari
- Department of Developmental Biology and Genetics, Indian Institute of Science, Bengaluru, Karnataka, India
| |
Collapse
|
2
|
Majdalawieh AF, Ahari SH, Yousef SM, Nasrallah GK. Sesamol: A lignan in sesame seeds with potent anti-inflammatory and immunomodulatory properties. Eur J Pharmacol 2023; 960:176163. [PMID: 37925135 DOI: 10.1016/j.ejphar.2023.176163] [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: 07/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023]
Abstract
Inflammation is associated with the development and progression of a plethora of diseases including joint, metabolic, neurological, hepatic, and renal disorders. Sesamol, derived from the seeds of Sesamum indicum L., has received considerable attention due to its well-documented multipotent phytotherapeutic effects, including its anti-inflammatory and immunomodulatory properties. However, to date, no comprehensive review has been established to highlight or summarize the anti-inflammatory and immunomodulatory properties of sesamol. Herein, we aim to address this gap in the literature by presenting a thorough review encapsulating evidence surrounding the range of inflammatory mediators and cytokines shown to be targeted by sesamol in modulating its anti-inflammatory actions against a range of inflammatory disorders. Additionally, evidence highlighting the role that sesamol has in modulating components of adaptive immunity including cellular immune responses and Th1/Th2 balance is underscored. Moreover, the molecular mechanisms and the signaling pathways underlying such effects are also highlighted. Findings indicate that this seemingly potent lignan mediates its anti-inflammatory actions, at least in part, via suppression of various pro-inflammatory cytokines like IL-1β and TNFα, and downregulation of a multitude of signaling pathways including NF-κB and MAPK. In conclusion, we anticipate that sesamol may be employed in future therapeutic regimens to aid in more effective drug development to alleviate immune-related and inflammatory conditions.
Collapse
Affiliation(s)
- Amin F Majdalawieh
- Department of Biology, Chemistry, and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, Sharjah, P.O. Box 26666, United Arab Emirates.
| | - Sogand H Ahari
- Department of Biology, Chemistry, and Environmental Sciences, College of Arts and Sciences, American University of Sharjah, Sharjah, P.O. Box 26666, United Arab Emirates
| | - Sarah M Yousef
- Department of Psychology, College of Arts and Sciences, American University of Sharjah, Sharjah, P.O. Box 26666, United Arab Emirates
| | - Gheyath K Nasrallah
- Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar; Biomedical Research Center, Qatar University, Doha, Qatar
| |
Collapse
|
3
|
Neuroprotective Effects of Some Nutraceuticals against Manganese-Induced Parkinson's Disease in Rats: Possible Modulatory Effects on TLR4/NLRP3/NF-κB, GSK-3β, Nrf2/HO-1, and Apoptotic Pathways. Pharmaceuticals (Basel) 2022; 15:ph15121554. [PMID: 36559006 PMCID: PMC9785377 DOI: 10.3390/ph15121554] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder affecting the substantia nigra where functions controlling body movement take place. Manganese (Mn) overexposure is linked to a neurologic syndrome resembling PD. Sesamol, thymol, wheat grass (WG), and coenzyme Q10 (CoQ10) are potent antioxidants, anti-inflammatory, and anti-apoptotic nutraceuticals. We investigated the potential protective effects of these nutraceuticals alone or in combinations against MnCl2-induced PD in rats. Seven groups of adult male Sprague Dawley rats were categorized as follows: group (I) was the control, while groups 2-7 received MnCl2 either alone (Group II) or in conjunction with oral doses of sesamol (Group III), thymol (Group IV), CoQ10 (Group V), WG (Group VI), or their combination (Group VII). All rats were subjected to four behavioral tests (open-field, swimming, Y-maze, and catalepsy tests). Biochemical changes in brain levels of monoamines, ACHE, BDNF, GSK-3β, GABA/glutamate, as well as oxidative stress, and apoptotic and neuroinflammatory biomarkers were evaluated, together with histopathological examinations of different brain regions. Mn increased catalepsy scores, while decreasing neuromuscular co-ordination, and locomotor and exploratory activity. It also impaired vigilance, spatial memory, and decision making. Most behavioral impairments induced by Mn were improved by sesamol, thymol, WG, or CoQ10, with prominent effect by sesamol and thymol. Notably, the combination group showed more pronounced improvements, which were confirmed by biochemical, molecular, as well as histopathological findings. Sesamol or thymol showed better protection against neuronal degeneration and some behavioral impairments induced by Mn than WG or CoQ10, partly via interplay between Nrf2/HO-1, TLR4/NLRP3/NF-κB, GSK-3β and Bax/Bcl2 pathways.
Collapse
|
4
|
Xia B, Liu X, Li X, Wang Y, Wang D, Kou R, Zhang L, Shi R, Ye J, Bo X, Liu Q, Zhao B, Liu X. Sesamol Ameliorates Dextran Sulfate Sodium-induced Depression-like and Anxiety-like Behaviors in Colitis Mice:The potential involvement of Gut-Brain Axis. Food Funct 2022; 13:2865-2883. [DOI: 10.1039/d1fo03888e] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Inflammatory bowel disease (IBD) is accompanied by some psychiatric disorders, including anxiety and depression. Sesamol has been reported to alleviate colitis symptoms and depression-like behaviors caused by chronic unpredictable mild...
Collapse
|
5
|
Ren B, Yuan T, Zhang X, Wang L, Pan J, Liu Y, Zhao B, Zhao W, Liu Z, Liu X. Protective Effects of Sesamol on Systemic Inflammation and Cognitive Impairment in Aging Mice. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2020; 68:3099-3111. [PMID: 32067456 DOI: 10.1021/acs.jafc.9b07598] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sesamol, a lignan in sesame, possesses several bioactivities, such as antioxidation, anti-inflammation, and neuroprotective capability. In this study, the effects of sesamol on aging-caused cognitive defects are investigated. Twelve-month-old mice were treated with sesamol (0.1%, w/w) as dietary supplementation for 12 weeks. Behavioral tests revealed that sesamol improved aging-associated cognitive impairments. Sesamol decreased aging-induced oxidative stress via suppression of malondialdehyde production and increased antioxidant enzymes. Histological staining showed that sesamol treatment improved aging-induced neuronal damage and synaptic dysfunction in the hippocampus. Furthermore, sesamol significantly reduced aging-induced neuroinflammation by inhibiting the microglial overactivation and inflammatory cytokine expressions. Meanwhile, the accumulation of Aβ1-42 was reduced by sesamol treatment. Moreover, sesamol protected the gut barrier integrity and reduced LPS release, which was highly associated with its beneficial effects on behavioral and inflammatory changes. In conclusion, our findings indicated that the use of sesamol is feasible in the treatment of aging-related diseases.
Collapse
Affiliation(s)
- Bo Ren
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Tian Yuan
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Xinglin Zhang
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Luanfeng Wang
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Junru Pan
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Yan Liu
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Beita Zhao
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| | - Weiyang Zhao
- Department of Food Science, College of Agriculture and Life Sciences, Cornell University, Ithaca, New York 14850, United States
| | - Zhigang Liu
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
- Department of Food Science, College of Agriculture and Life Sciences, Cornell University, Ithaca, New York 14850, United States
| | - Xuebo Liu
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Xianyang 712100, China
| |
Collapse
|
6
|
Liu Z, Chen Y, Qiao Q, Sun Y, Liu Q, Ren B, Liu X. Sesamol supplementation prevents systemic inflammation-induced memory impairment and amyloidogenesis via inhibition of nuclear factor kappaB. Mol Nutr Food Res 2016; 61. [DOI: 10.1002/mnfr.201600734] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 11/06/2016] [Accepted: 11/08/2016] [Indexed: 02/04/2023]
Affiliation(s)
- Zhigang Liu
- Laboratory of Functional Chemistry and Nutrition of Food; College of Food Science and Engineering; Northwest A&F University; Yangling China
| | - Yuwei Chen
- Laboratory of Functional Chemistry and Nutrition of Food; College of Food Science and Engineering; Northwest A&F University; Yangling China
| | - Qinglian Qiao
- Laboratory of Functional Chemistry and Nutrition of Food; College of Food Science and Engineering; Northwest A&F University; Yangling China
| | - Yali Sun
- Laboratory of Functional Chemistry and Nutrition of Food; College of Food Science and Engineering; Northwest A&F University; Yangling China
| | - Qian Liu
- Laboratory of Functional Chemistry and Nutrition of Food; College of Food Science and Engineering; Northwest A&F University; Yangling China
| | - Bo Ren
- Laboratory of Functional Chemistry and Nutrition of Food; College of Food Science and Engineering; Northwest A&F University; Yangling China
| | - Xuebo Liu
- Laboratory of Functional Chemistry and Nutrition of Food; College of Food Science and Engineering; Northwest A&F University; Yangling China
| |
Collapse
|
7
|
Periasamy S, Chu PY, Li YH, Hsu DZ, Liu MY. Sesamol ameliorates hypotension by modulating cytokines and PPAR-gamma in systemic inflammatory response. EXCLI JOURNAL 2016; 14:948-57. [PMID: 26839527 PMCID: PMC4732502 DOI: 10.17179/excli2015-367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 07/10/2015] [Indexed: 01/24/2023]
Abstract
Sepsis is one of the major causes of death reported in intensive care units. Acute kidney injury (AKI) and hypotension are important in the pathogenesis and mortality of systemic inflammatory response (SIR). Sesamol delays mortality in sepsis; however, its effects on AKI and hypotension and the role of peroxisome proliferator-activated receptor-ɣ (PPAR-γ) activation have not been established. We investigated the effect of sesamol on SIR in cecal ligation and puncture (CLP)-induced acute kidney injury and lipopolysaccharide (LPS)-induced hypotension in rats. Sesamol was subcutaneously injected 1 h after SIR. Renal function (BUN and CRE) and proinflammatory mediators interleukin (IL)-1β and IL-6 were increased after CLP. Tumor necrosis factor (TNF)-α, IL-1β, IL-10, and nitrite production were significantly increased 6 h after LPS-induced hypotension (mean arterial pressure was significantly decreased). Sesamol significantly inhibited BUN, CRE, IL-1β, IL-6, and nitrite after CLP-induced acute renal injury. In addition, sesamol increased mean arterial pressure and IL-10, inhibited TNF-α and IL-1β, but did not affect nitrite production in LPS-induced hypotension. Sesamol increased PPAR-γ in the leucocytes and peritoneal macrophages in LPS-induced SIR. We conclude that sesamol regulates leucocyte and macrophage PPAR-γ-associated systemic cytokines expression, thereby ameliorates acute kidney injury and hypotension in rats.
Collapse
Affiliation(s)
- Srinivasan Periasamy
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Yi Chu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Hui Li
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Dur-Zong Hsu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Yie Liu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
8
|
Geetha T, Singh N, Deol PK, Kaur IP. Biopharmaceutical profiling of sesamol: physiochemical characterization, gastrointestinal permeability and pharmacokinetic evaluation. RSC Adv 2015. [DOI: 10.1039/c4ra10926k] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Well established biological activity of sesamol in diverse pathologies coupled with favorable solubility, log P, GIT permeability, pharmacokinetics and small size indicate great potential for clinical application.
Collapse
Affiliation(s)
- T. Geetha
- University Institute of Pharmaceutical Sciences
- UGC Centre for Advance Study, Panjab University
- Chandigarh-160014
- India
| | - Neha Singh
- Department of Biotechnology
- Panjab University
- Chandigarh-160014
- India
| | - Parneet Kaur Deol
- University Institute of Pharmaceutical Sciences
- UGC Centre for Advance Study, Panjab University
- Chandigarh-160014
- India
| | - Indu Pal Kaur
- University Institute of Pharmaceutical Sciences
- UGC Centre for Advance Study, Panjab University
- Chandigarh-160014
- India
| |
Collapse
|
9
|
Periasamy S, Hsu DZ, Chen SY, Yang SS, Chandrasekaran VRM, Liu MY. Therapeutic sesamol attenuates monocrotaline-induced sinusoidal obstruction syndrome in rats by inhibiting matrix metalloproteinase-9. Cell Biochem Biophys 2012; 61:327-36. [PMID: 21681587 DOI: 10.1007/s12013-011-9215-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We investigated the therapeutic effect of sesamol against monocrotaline-induced sinusoidal obstruction syndrome (SOS) in rats. Male Sprague-Dawley rats were gavaged with a single dose of monocrotaline (90 mg/kg) to induce SOS. Sesamol (5, 10, 20, and 40 mg/kg) was subcutaneously injected 24 h after monocrotaline treatment. Control rats were given saline only. Aspartate transaminase, alanine transaminase, mast cells, CD 68(+) Kupffer cells, neutrophils, myeloperoxidase, matrix metalloproteinase-9 (MMP-9), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), laminin, and collagen were assessed 48 h after monocrotaline treatment. All tested parameters, except for TIMP-1, laminin, and collagen, were significantly higher in monocrotaline-treated rats than in control rats, and, except for TIMP-1, laminin, and collagen, significantly lower in sesamol-treated rats than in monocrotaline-treated rats. In addition, liver pathology revealed that sesamol offered significant protection against SOS. We conclude that a single dose of sesamol therapeutically attenuated SOS by decreasing the recruitment of inflammatory cells, downregulating MMP-9, and upregulating TIMP-1 expression.
Collapse
Affiliation(s)
- Srinivasan Periasamy
- Department of Environmental and Occupational Health, National Cheng Kung University Medical College, Tainan, Taiwan
| | | | | | | | | | | |
Collapse
|
10
|
Hsu DZ, Chu PY, Liu MY. Sesame Seed ( Sesamum indicumL.) Extracts and Their Anti-Inflammatory Effect. ACS SYMPOSIUM SERIES 2012. [DOI: 10.1021/bk-2012-1093.ch019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Dur-Zong Hsu
- Department of Environmental and Occupational Health, National Cheng Kung University, 138 ShengLi Road, Tainan, Taiwan
| | - Pei-Yi Chu
- Department of Environmental and Occupational Health, National Cheng Kung University, 138 ShengLi Road, Tainan, Taiwan
| | - Ming-Yie Liu
- Department of Environmental and Occupational Health, National Cheng Kung University, 138 ShengLi Road, Tainan, Taiwan
| |
Collapse
|
11
|
Chandrasekaran VRM, Chien SP, Hsu DZ, Liu MY. Anti-hepatotoxic effects of 3,4-methylenedioxyphenol and N-acetylcysteine in acutely acetaminophen-overdosed mice. Hum Exp Toxicol 2011; 30:1609-15. [DOI: 10.1177/0960327110394226] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
3,4-Methylenedioxyphenol (sesamol) is effective against acetaminophen-induced liver injury in rats. Whether sesamol’s anti-hepatotoxic effect is comparable to that of N-acetylcysteine has never been studied. We investigated the anti-hepatotoxic effects of sesamol and N-acetylcysteine on acetaminophen-induced hepatotoxicity in mice. Equimolar doses (1 mmol/kg) of sesamol and N-acetylcysteine significantly inhibited acetaminophen (300 mg/kg)-increased serum aspartate transaminase and alanine transaminase levels 6 h post-administration. Sesamol and N-acetylcysteine maintained hepatic glutathione levels and inhibited lipid peroxidation. Moreover, the combination of sesamol and N-acetylcysteine antagonistically inhibited sesamol’s protection against acetaminophen-induced liver injury. We conclude that the protective effect of sesamol against acetaminophen-induced liver damage is comparable to that of N-acetylcysteine by maintaining glutathione levels and inhibiting lipid peroxidation in mice.
Collapse
Affiliation(s)
| | - Se-Ping Chien
- Institute of Living Science, Tainan University of Technology, Tainan, Taiwan
| | - Dur-Zong Hsu
- Department of Environmental and Occupational Health, National Cheng Kung University Medical College, Tainan, Taiwan
| | - Ming-Yie Liu
- Department of Environmental and Occupational Health, National Cheng Kung University Medical College, Tainan, Taiwan
| |
Collapse
|
12
|
Periasamy S, Chen SY, Hsu DZ, Liu MY. Comments on Vennila and Pugalendi. Vennila L, Pugalendi KV. Protective effect of sesamol against myocardial infarction caused by isoproterenol in Wistar rats. Redox Rep 2010; 15: 36-42. Redox Rep 2010; 15:288-9. [PMID: 21208529 PMCID: PMC7067342 DOI: 10.1179/135100010x12826446921860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Srinivasan Periasamy
- Department of Environmental and Occupational Health National Cheng Kung University Medical CollegeTainan 70428, Taiwan
| | - Shin Yi Chen
- Department of Environmental and Occupational Health National Cheng Kung University Medical CollegeTainan 70428, Taiwan
| | - Dur-Zong Hsu
- Department of Environmental and Occupational Health National Cheng Kung University Medical CollegeTainan 70428, Taiwan
| | - Ming-Yie Liu
- Department of Environmental and Occupational Health National Cheng Kung University Medical CollegeTainan 70428, Taiwan;,
| |
Collapse
|