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Ledesma-Colunga MG, Passin V, Vujic Spasic M, Hofbauer LC, Baschant U, Rauner M. Comparison of the effects of high dietary iron levels on bone microarchitecture responses in the mouse strains 129/Sv and C57BL/6J. Sci Rep 2024; 14:4887. [PMID: 38418857 PMCID: PMC10902348 DOI: 10.1038/s41598-024-55303-2] [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: 10/11/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
Iron is an essential nutrient for all living organisms. Both iron deficiency and excess can be harmful. Bone, a highly metabolic active organ, is particularly sensitive to fluctuations in iron levels. In this study, we investigated the effects of dietary iron overload on bone homeostasis with a specific focus on two frequently utilized mouse strains: 129/Sv and C57BL/6J. Our findings revealed that after 6 weeks on an iron-rich diet, 129/Sv mice exhibited a decrease in trabecular and cortical bone density in both vertebral and femoral bones, which was linked to reduced bone turnover. In contrast, there was no evidence of bone changes associated with iron overload in age-matched C57BL/6J mice. Interestingly, 129/Sv mice exposed to an iron-rich diet during their prenatal development were protected from iron-induced bone loss, suggesting the presence of potential adaptive mechanisms. Overall, our study underscores the critical role of genetic background in modulating the effects of iron overload on bone health. This should be considered when studying effects of iron on bone.
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Affiliation(s)
- Maria G Ledesma-Colunga
- Department of Medicine III & Center for Healthy Aging, Medical Faculty and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Vanessa Passin
- Department of Medicine III & Center for Healthy Aging, Medical Faculty and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Maja Vujic Spasic
- Institute of Comparative Molecular Endocrinology, Ulm University, Ulm, Germany
| | - Lorenz C Hofbauer
- Department of Medicine III & Center for Healthy Aging, Medical Faculty and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Ulrike Baschant
- Department of Medicine III & Center for Healthy Aging, Medical Faculty and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Martina Rauner
- Department of Medicine III & Center for Healthy Aging, Medical Faculty and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.
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2
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Thepsuwan P, Bhattacharya A, Song Z, Hippleheuser S, Feng S, Wei X, Das NK, Sierra M, Wei J, Fang D, Huang YMM, Zhang K, Shah YM, Sun S. Hepatic SEL1L-HRD1 ER-associated degradation regulates systemic iron homeostasis via ceruloplasmin. Proc Natl Acad Sci U S A 2023; 120:e2212644120. [PMID: 36595688 PMCID: PMC9926173 DOI: 10.1073/pnas.2212644120] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/18/2022] [Indexed: 01/05/2023] Open
Abstract
Iron homeostasis is critical for cellular and organismal function and is tightly regulated to prevent toxicity or anemia due to iron excess or deficiency, respectively. However, subcellular regulatory mechanisms of iron remain largely unexplored. Here, we report that SEL1L-HRD1 protein complex of endoplasmic reticulum (ER)-associated degradation (ERAD) in hepatocytes controls systemic iron homeostasis in a ceruloplasmin (CP)-dependent, and ER stress-independent, manner. Mice with hepatocyte-specific Sel1L deficiency exhibit altered basal iron homeostasis and are sensitized to iron deficiency while resistant to iron overload. Proteomics screening for a factor linking ERAD deficiency to altered iron homeostasis identifies CP, a key ferroxidase involved in systemic iron distribution by catalyzing iron oxidation and efflux from tissues. Indeed, CP is highly unstable and a bona fide substrate of SEL1L-HRD1 ERAD. In the absence of ERAD, CP protein accumulates in the ER and is shunted to refolding, leading to elevated secretion. Providing clinical relevance of these findings, SEL1L-HRD1 ERAD is responsible for the degradation of a subset of disease-causing CP mutants, thereby attenuating their pathogenicity. Together, this study uncovers the role of SEL1L-HRD1 ERAD in systemic iron homeostasis and provides insights into protein misfolding-associated proteotoxicity.
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Affiliation(s)
- Pattaraporn Thepsuwan
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI48201
| | - Asmita Bhattacharya
- Department of Molecular & Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI48105
| | - Zhenfeng Song
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI48201
| | - Stephen Hippleheuser
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI48201
| | - Shaobin Feng
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI48201
| | - Xiaoqiong Wei
- Department of Molecular & Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI48105
| | - Nupur K. Das
- Department of Molecular & Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI48105
| | - Mariana Sierra
- Department of Physics and Astronomy, Wayne State University, Detroit, MI48201
| | - Juncheng Wei
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL60611
| | - Deyu Fang
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL60611
| | - Yu-ming M. Huang
- Department of Physics and Astronomy, Wayne State University, Detroit, MI48201
| | - Kezhong Zhang
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI48201
- Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, MI48201
| | - Yatrik M. Shah
- Department of Molecular & Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI48105
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI48109
| | - Shengyi Sun
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI48201
- Department of Biochemistry, Microbiology and Immunology, Wayne State University School of Medicine, Detroit, MI48201
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3
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Leal LB, Nogueira MS, Mageski JGA, Martini TP, Barauna VG, Dos Santos L, de Carvalho LFDCES. Diagnosis of Systemic Diseases Using Infrared Spectroscopy: Detection of Iron Overload in Plasma-Preliminary Study. Biol Trace Elem Res 2021; 199:3737-3751. [PMID: 33415581 DOI: 10.1007/s12011-020-02510-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023]
Abstract
Despite the important role of iron in cellular homeostasis, iron overload (IO) is associated with systemic and tissue deposits which damage several organs. In order to reduce the impact caused by IO, invasive diagnosis exams (e.g., biopsies) and minimally invasive methods were developed including computed tomography and magnetic resonance imaging. However, current diagnostic methods are still time-consuming and expensive. A cost-effective solution is using Fourier-transform infrared spectroscopy (FTIR) for real-time and molecular-sensitive biofluid analysis during conventional laboratory exams. In this study, we performed the first evaluation of the accuracy of FTIR for IO diagnosis. The study was performed by collecting FTIR spectra of plasma samples of five rats intravenously injected with iron-dextran and five control rats. We developed a classification model based on principal component analysis and supervised methods including J48, random forest, multilayer perceptron, and radial basis function network. We achieved 100% accuracy for the classification of the IO status and provided a list of possible biomolecules related to the vibrational modes detected. In this preliminary study, we give a first step towards real-time diagnosis for acute IO or intoxication. Furthermore, we have expanded the literature knowledge regarding the pathophysiological changes induced by iron overload.
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Affiliation(s)
- Leonardo Barbosa Leal
- Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Marechal Campos Ave, 1468, Maruípe, Vitória, Espírito Santo, 29040-090, Brazil.
| | - Marcelo Saito Nogueira
- Tyndall National Institute/University College Cork - Lee Maltings Complex, Dyke Parade, Cork, T12R5CP, Ireland
| | - Jandinay Gonzaga Alexandre Mageski
- Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Marechal Campos Ave, 1468, Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Thiago Pereira Martini
- Institute of Science and Technology, Federal University of Sao Paulo, São José dos Campos, Brazil
| | - Valério Garrone Barauna
- Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Marechal Campos Ave, 1468, Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Leonardo Dos Santos
- Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Marechal Campos Ave, 1468, Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Luis Felipe das Chagas E Silva de Carvalho
- Universidade de Taubaté. R. dos Operários, 09 - Centro, Taubaté, São Paulo, 12020-340, Brazil
- Centro Universitário Braz Cubas, Av. Francisco Rodrigues Filho, 1233 - Vila Mogilar, Mogi das Cruzes, São Paulo, Brazil
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4
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Liu Z, Simchick GA, Qiao J, Ashcraft MM, Cui S, Nagy T, Zhao Q, Xiong MP. Reactive Oxygen Species-Triggered Dissociation of a Polyrotaxane-Based Nanochelator for Enhanced Clearance of Systemic and Hepatic Iron. ACS NANO 2021; 15:419-433. [PMID: 33378155 PMCID: PMC8596504 DOI: 10.1021/acsnano.0c01083] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Chronic blood transfusions are used to alleviate anemic symptoms in thalassemia and sickle cell anemia patients but can eventually result in iron overload (IO) and subsequently lead to severe oxidative stress in cells and tissues. Deferoxamine (DFO) is clinically approved to treat transfusional IO, but the use of the iron chelator is hindered by nonspecific toxicity and poor pharmacokinetic (PK) properties in humans, resulting in the need to administer the drug via long-term infusion regimens that can often lead to poor patient compliance. Herein, a nanochelator system that uses the characteristic IO physiological environment to dissociate was prepared through the incorporation of DFO and reactive oxygen species (ROS)-sensitive thioketal groups into an α-cyclodextrin-based polyrotaxane platform (rPR-DFO). ROS-induced dissociation of this nanochelator (ca. 10 nm) into constructs averaging 2 nm in diameter significantly increased urine and fecal elimination of excess iron in vivo. In addition to significantly improved PK properties, rPR-DFO was well-tolerated in mice and no adverse side effects were noted in single high dose or multiple dose acute toxicity studies. The overall features of rPR-DFO as a promising system for iron chelation therapy can be attributed to a combination of the nanochelator's improved PK, favorable distribution to the liver, and ROS-induced dissociation properties into constructs <6 nm for faster renal elimination. This ROS-responsive nanochelator design may serve as a promising alternative for safely prolonging the circulation of DFO and more rapidly eliminating iron chelates from the body in iron chelation therapy regimens requiring repeated dosing of nanochelators.
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Affiliation(s)
- Zhi Liu
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Gregory A Simchick
- Bioimaging Research Center, University of Georgia, Athens, Georgia 30602, United States
- Department of Physics and Astronomy, University of Georgia, Athens, Georgia 30602, United States
| | - Jing Qiao
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Morgan M Ashcraft
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Shuolin Cui
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
| | - Tamas Nagy
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30602, United States
| | - Qun Zhao
- Bioimaging Research Center, University of Georgia, Athens, Georgia 30602, United States
- Department of Physics and Astronomy, University of Georgia, Athens, Georgia 30602, United States
| | - May P Xiong
- Department of Pharmaceutical & Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia 30602, United States
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5
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La Carpia F, Wojczyk BS, Annavajhala MK, Rebbaa A, Culp-Hill R, D’Alessandro A, Freedberg DE, Uhlemann AC, Hod EA. Transfusional iron overload and intravenous iron infusions modify the mouse gut microbiota similarly to dietary iron. NPJ Biofilms Microbiomes 2019; 5:26. [PMID: 31583109 PMCID: PMC6760189 DOI: 10.1038/s41522-019-0097-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/12/2019] [Indexed: 01/19/2023] Open
Abstract
Iron is essential for both microorganisms and their hosts. Although effects of dietary iron on gut microbiota have been described, the effect of systemic iron administration has yet to be explored. Here, we show that dietary iron, intravenous iron administration, and chronic transfusion in mice increase the availability of iron in the gut. These iron interventions have consistent and reproducible effects on the murine gut microbiota; specifically, relative abundance of the Parabacteroides and Lactobacillus genera negatively correlate with increased iron stores, whereas members of the Clostridia class positively correlate with iron stores regardless of the route of iron administration. Iron levels also affected microbial metabolites, in general, and indoles, in particular, circulating in host plasma and in stool pellets. Taken together, these results suggest that by shifting the balance of the microbiota, clinical interventions that affect iron status have the potential to alter biologically relevant microbial metabolites in the host.
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Affiliation(s)
- Francesca La Carpia
- Department of Pathology and Cell biology, Columbia University Irving Medical Center, New York, NY USA
| | - Boguslaw S. Wojczyk
- Department of Pathology and Cell biology, Columbia University Irving Medical Center, New York, NY USA
| | - Medini K. Annavajhala
- Department of Medicine, Columbia University, Irving Medical Center-New York Presbyterian Hospital, New York, NY USA
- Columbia Medicine Microbiome and Pathogen Genomic core, Columbia University Irving Medical Center, New York, NY USA
| | - Abdelhadi Rebbaa
- Department of Pathology and Cell biology, Columbia University Irving Medical Center, New York, NY USA
| | - Rachel Culp-Hill
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado USA
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado USA
| | - Daniel E. Freedberg
- Department of Medicine, Columbia University, Irving Medical Center-New York Presbyterian Hospital, New York, NY USA
| | - Anne-Catrin Uhlemann
- Department of Medicine, Columbia University, Irving Medical Center-New York Presbyterian Hospital, New York, NY USA
| | - Eldad A. Hod
- Department of Pathology and Cell biology, Columbia University Irving Medical Center, New York, NY USA
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6
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Yoshiyama M, Okamoto Y, Izumi S, Iizuka D. Graphite Furnace Atomic Absorption Spectrometric Evaluation of Iron Excretion in Mouse Urine Caused by Whole-Body Gamma Irradiation. Biol Trace Elem Res 2019; 191:149-158. [PMID: 30506323 DOI: 10.1007/s12011-018-1589-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/21/2018] [Indexed: 12/20/2022]
Abstract
A procedure for the determination of iron in mice urine using graphite furnace atomic absorption spectrometry was developed. The mice urinary samples contain many organic compounds in the matrix, whose concentrations are approximately 20%, and the value is 30-fold higher compared to those found in human urine. Moreover, only 0.2 mL or less of urine was obtained as a sample volume per urination event. It was difficult to decompose the organic materials in the samples by wet digestion using mineral acids and oxidising agents, because of the tiny volumes. In this experiment, raw urinary samples were placed directly into the graphite tube furnace for analysis. The organic contents were simply ashed during the preheating stages. To facilitate ashing in the furnace, air was invaded from the surroundings by interrupting the stream of argon gas. Atomic absorption was measured at 248.3270 nm (wavelength for atomic absorption), with the background monitored at 247.0658 nm (wavelength for background correction). The optimised instrument operating conditions precluded the use of chemical modification technique. The analytical procedures used are quite simple, i.e. an aliquot of raw urine sample was injected directly into the graphite tube furnace and was followed by a suitable heating programme with no chemical modifier. Therefore, this method is useful for scientists who are not familiar with delicate chemical experiments. The proposed analytical method was applied as a kind of biomarker by determining iron concentrations in urinary samples of mice, which were irradiated with 4 Gy of gamma irradiation to their whole body. The time dependence of the iron concentration was determined, and the iron concentrations increased within 1 day of irradiation exposure, then decreased to ordinal values after several days.
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Affiliation(s)
- Makoto Yoshiyama
- Graduate School of Science, Hiroshima University, Kagamiyama, Higashihiroshima, 739-8526, Japan
| | - Yasuaki Okamoto
- Graduate School of Science, Hiroshima University, Kagamiyama, Higashihiroshima, 739-8526, Japan.
| | - Shunsuke Izumi
- Graduate School of Science, Hiroshima University, Kagamiyama, Higashihiroshima, 739-8526, Japan
| | - Daisuke Iizuka
- Department of Radiation Effects Research, National Institute for Quantum and Radiological Science and Technology, Chiba, 263-8555, Japan
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7
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Simchick G, Liu Z, Nagy T, Xiong M, Zhao Q. Assessment of MR-based R2* and quantitative susceptibility mapping for the quantification of liver iron concentration in a mouse model at 7T. Magn Reson Med 2018; 80:2081-2093. [PMID: 29575047 PMCID: PMC6107404 DOI: 10.1002/mrm.27173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE To assess the feasibility of quantifying liver iron concentration (LIC) using R2* and quantitative susceptibility mapping (QSM) at a high field strength of 7 Tesla (T). METHODS Five different concentrations of Fe-dextran were injected into 12 mice to produce various degrees of liver iron overload. After mice were sacrificed, blood and liver samples were harvested. Ferritin enzyme-linked immunosorbent assay (ELISA) and inductively coupled plasma mass spectrometry were performed to quantify serum ferritin concentration and LIC. Multiecho gradient echo MRI was conducted to estimate R2* and the magnetic susceptibility of each liver sample through complex nonlinear least squares fitting and a morphology enabled dipole inversion method, respectively. RESULTS Average estimates of serum ferritin concentration, LIC, R2*, and susceptibility all show good linear correlations with injected Fe-dextran concentration; however, the standard deviations in the estimates of R2* and susceptibility increase with injected Fe-dextran concentration. Both R2* and susceptibility measurements also show good linear correlations with LIC (R2 = 0.78 and R2 = 0.91, respectively), and a susceptibility-to-LIC conversion factor of 0.829 ppm/(mg/g wet) is derived. CONCLUSION The feasibility of quantifying LIC using MR-based R2* and QSM at a high field strength of 7T is demonstrated. Susceptibility quantification, which is an intrinsic property of tissues and benefits from being field-strength independent, is more robust than R2* quantification in this ex vivo study. A susceptibility-to-LIC conversion factor is presented that agrees relatively well with previously published QSM derived results obtained at 1.5T and 3T.
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Affiliation(s)
- Gregory Simchick
- Physics and Astronomy, University of Georgia, Athens, GA, United States
- Bio-Imaging Research Center, University of Georgia, Athens, GA, United States
| | - Zhi Liu
- Pharmaceutical & Biomedical Sciences, University of Georgia, Athens, GA United States
| | - Tamas Nagy
- Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA United States
| | - May Xiong
- Pharmaceutical & Biomedical Sciences, University of Georgia, Athens, GA United States
| | - Qun Zhao
- Physics and Astronomy, University of Georgia, Athens, GA, United States
- Bio-Imaging Research Center, University of Georgia, Athens, GA, United States
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Hubler MJ, Erikson KM, Kennedy AJ, Hasty AH. MFe hi adipose tissue macrophages compensate for tissue iron perturbations in mice. Am J Physiol Cell Physiol 2018; 315:C319-C329. [PMID: 29768045 DOI: 10.1152/ajpcell.00103.2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Resident adipose tissue macrophages (ATMs) play multiple roles to maintain tissue homeostasis, such as removing excess free fatty acids and regulation of the extracellular matrix. The phagocytic nature and oxidative resiliency of macrophages not only allows them to function as innate immune cells but also to respond to specific tissue needs, such as iron homeostasis. MFehi ATMs are a subtype of resident ATMs that we recently identified to have twice the intracellular iron content as other ATMs and elevated expression of iron-handling genes. Although studies have demonstrated that iron homeostasis is important for adipocyte health, little is known about how MFehi ATMs may respond to and influence adipose tissue iron availability. Two methodologies were used to address this question: dietary iron supplementation and intraperitoneal iron injection. Upon exposure to high dietary iron, MFehi ATMs accumulated excess iron, whereas the iron content of MFelo ATMs and adipocytes remained unchanged. In this model of chronic iron excess, MFehi ATMs exhibited increased expression of genes involved in iron storage. In the injection model, MFehi ATMs incorporated high levels of iron, and adipocytes were spared iron overload. This acute model of iron overload was associated with increased numbers of MFehi ATMs; 17% could be attributed to monocyte recruitment and 83% to MFelo ATM incorporation into the MFehi pool. The MFehi ATM population maintained its low inflammatory profile and iron-cycling expression profile. These studies expand the field's understanding of ATMs and confirm that they can respond as a tissue iron sink in models of iron overload.
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Affiliation(s)
- Merla J Hubler
- Department of Molecular Physiology and Biophysics, School of Medicine, Vanderbilt University , Nashville, Tennessee
| | - Keith M Erikson
- Department of Nutrition, University of North Carolina at Greensboro , Greensboro, North Carolina
| | - Arion J Kennedy
- Department of Molecular Physiology and Biophysics, School of Medicine, Vanderbilt University , Nashville, Tennessee
| | - Alyssa H Hasty
- Department of Molecular Physiology and Biophysics, School of Medicine, Vanderbilt University , Nashville, Tennessee.,VA Tennessee Valley Healthcare System, Nashville, Tennessee
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