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Liu P, Gao H, Wang Y, Li Y, Zhao L. LncRNA H19 Contributes to Smoke-Related Chronic Obstructive Pulmonary Disease by Targeting miR-181/PDCD4 Axis. COPD 2023; 20:119-125. [PMID: 36943093 DOI: 10.1080/15412555.2023.2165906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. Exercise plays a positive role in the prevention and treatment of diaphragm dysfunction in COPD, and the changes in diaphragm structure and function induced by exercise are closely related to the regulation of oxidative stress. But the mechanism remains unclear. So the aim of this study was to reveal the therapeutic mechanism of exercise to COPD using both in vivo and in vitro experiments. In this study, cigarette smoke (CS) induced COPD mice model, treadmill aerobic training for COPD mice were constructed and cigarette smoke extract (CSE) induced bronchial epithelial cells (BECs) model were used for COPD study. Bioinformatics analysis, luciferase reporting analysis, and RT-qPCR detection were used to clarify the interacted relationship among lncRNA, miRNA, and mRNA. ROS, inflammatory cytokines expression, and EMT relative protein α-SMA were detected using immunofluorescence and ELISA detection. The result shows that exercise ameliorates COPD induced lung injury by inhibit ROS, inflammation, and epithelial-mesenchymal transition (EMT) relative protein α-SMA expression. RT-qPCR detection shows that lnc-H19 expression was increased in lung tissues of COPD mice. Exercise decreased COPD induced lnc-H19 expression. Downregulation lnc-H19 inhibits COPD mediated lung injury. Bioinformatics analysis and luciferase reporting analysis confirmed that miR-181 and PDCD4 were downstream targets of lnc-H19. Upregulation of PDCD4 or downregulation of miR-181 reversed the protective effect of si-lnc-H19 to BECs after exposure to CSE. In conclusion, lncRNA H19 contributes to smoke-related chronic obstructive pulmonary disease by targeting miR-181/PDCD4 Axis.
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Affiliation(s)
- Panpan Liu
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, P.R. China
| | - Hongchang Gao
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, P.R. China
| | - Yumeng Wang
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, P.R. China
| | - Yujuan Li
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, P.R. China
| | - Lei Zhao
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, P.R. China
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Baltasar-Fernandez I, Losa-Reyna J, Carretero A, Rodriguez-Lopez C, Alfaro-Acha A, Guadalupe-Grau A, Ara I, Alegre LM, Gomez-Cabrera MC, García-García FJ, Alcazar J. Residual effects of 12 weeks of power-oriented resistance training plus high-intensity interval training on muscle dysfunction, systemic oxidative damage, and antioxidant capacity after 10 months of training cessation in older people with COPD. Scand J Med Sci Sports 2023; 33:1661-1676. [PMID: 37322570 DOI: 10.1111/sms.14428] [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: 04/19/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study aimed to assess the residual effects of a 12-week concurrent training program (power training + high-intensity interval training) in older adults with chronic obstructive pulmonary disease (COPD). METHODS A total of 21 older adults with COPD [intervention (INT), n = 8; control (CON), n = 13; 76.9 ± 6.8 years] were assessed at baseline and 10 months after the completion of the intervention by the short physical performance battery (SPPB), health-related quality of life (EQ-5D-5L), vastus lateralis muscle thickness (MT), peak pulmonary oxygen uptake (peak VO2 ) and peak work rate (Wpeak ), early and late isometric rate of force development (RFD), leg and chest press maximum muscle power (LPmax and CPmax ), and systemic oxidative damage and antioxidant capacity. RESULTS Compared to baseline, after 10 months of detraining, the INT group presented increased SPPB (∆ = 1.0 point), health-related quality of life (∆ = 0.07 points), early RFD (∆ = 834 N∙s-1 ), LPmax (∆ = 62.2 W), and CPmax (∆ = 16.0 W) (all p < 0.05). In addition, a positive effect was noted in INT compared to CON regarding MT and Wpeak (both p < 0.05). No between-group differences were reported in peak VO2 , late RFD, systemic oxidative damage, and antioxidant capacity from baseline to 10 months after the completion of the intervention (all p > 0.05). CONCLUSIONS Twelve weeks of concurrent training were enough to ensure improved physical function, health-related quality of life, early RFD and maximum muscle power and to preserve MT and Wpeak but not peak VO2 , late RFD, systemic oxidative damage and antioxidant capacity in the subsequent 10 months of detraining in older adults with COPD.
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Affiliation(s)
- Ivan Baltasar-Fernandez
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, Talavera de la Reina, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Jose Losa-Reyna
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Valoración del Rendimiento Deportivo, Actividad Física y Salud y Lesiones Deportivas (REDAFLED), Universidad de Valladolid, Soria, Spain
| | - Aitor Carretero
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Carlos Rodriguez-Lopez
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Geriatric Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ana Alfaro-Acha
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Amelia Guadalupe-Grau
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Luis M Alegre
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
| | - Mari Carmen Gomez-Cabrera
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Francisco J García-García
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario Universitario de Toledo, Toledo, Spain
| | - Julian Alcazar
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER on Frailty and Healthy Ageing (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Spain
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Miklós Z, Horváth I. The Role of Oxidative Stress and Antioxidants in Cardiovascular Comorbidities in COPD. Antioxidants (Basel) 2023; 12:1196. [PMID: 37371927 DOI: 10.3390/antiox12061196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Oxidative stress driven by several environmental and local airway factors associated with chronic obstructive bronchiolitis, a hallmark feature of COPD, plays a crucial role in disease pathomechanisms. Unbalance between oxidants and antioxidant defense mechanisms amplifies the local inflammatory processes, worsens cardiovascular health, and contributes to COPD-related cardiovascular dysfunctions and mortality. The current review summarizes recent developments in our understanding of different mechanisms contributing to oxidative stress and its countermeasures, with special attention to those that link local and systemic processes. Major regulatory mechanisms orchestrating these pathways are also introduced, with some suggestions for further research in the field.
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Affiliation(s)
- Zsuzsanna Miklós
- National Korányi Institute for Pulmonology, Korányi F. Street 1, H-1121 Budapest, Hungary
| | - Ildikó Horváth
- National Korányi Institute for Pulmonology, Korányi F. Street 1, H-1121 Budapest, Hungary
- Department of Pulmonology, University of Debrecen, Nagyerdei krt 98, H-4032 Debrecen, Hungary
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Xu Z, Xue Y, Wen H, Chen C. Association of oxidative balance score and lung health from the National Health and Nutrition Examination Survey 2007-2012. Front Nutr 2023; 9:961950. [PMID: 36698460 PMCID: PMC9869685 DOI: 10.3389/fnut.2022.961950] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Background Oxidative stress is associated with outcomes of chronic lung disease. The oxidative stress-related exposures of diet and lifestyle can be evaluated by the oxidative balance score (OBS), and higher OBS scores indicate more significant antioxidant exposures. But the relationship between OBS and lung health is unknown. Purpose The aim of this study was to explore the association between OBS and lung health (respiratory symptoms, chronic lung disease, and lung function). Methods A series of models, including weighted linear models, weighted logistic regression, and weighted multinomial logistic regression, were performed to assess the associations of OBS with respiratory symptoms, chronic lung disease, and lung function. The models adjusted by age, race/ethnicity, gender, educational background, poverty-to-income ratio, and dietary energy were also performed. Results Cross-sectional data of 5,214 participants from the National Health and Nutrition Examination Survey for the years 2007-2012 were analyzed. For every one-unit increase in OBS, the odds of wheezing/chronic bronchitis decreased by 6%. Increased OBS was associated with higher percent-predicted forced expiratory volume in one second (FEV1) (adjusted mean difference (MD), 0.21%; 95% CI: 0.10-0.32) and percent-predicted forced vital capacity (FVC) (adjusted MD, 0.15%; 95% CI: 0.07-0.24). A significantly lower risk of wheezing/chronic bronchitis was found in participants in the second/third/fourth OBS quartile compared to those in the first OBS quartile (all P for trend < 0.05). Moreover, higher percent-predicted FEV1 and FVC were also found in the third quartile and fourth quartile (all P for trend < 0.05). Furthermore, both dietary and lifestyle components were tightly related to pulmonary outcomes. Many associations were maintained after stratified by sex or after sensitivity analyses. Conclusion Oxidative balance score was negatively correlated with the diagnosis of chronic bronchitis/wheezing/restrictive spirometry pattern and positively correlated with percent-predicted FVC and FEV1. It seems that the higher the OBS score, the better the pulmonary outcomes. The findings highlight the importance of adherence to an antioxidant diet and lifestyle and that it contributes to lung health.
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Affiliation(s)
- Zhixiao Xu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yincong Xue
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Interventional Pulmonology of Zhejiang Province, Wenzhou, China
| | - Hezhi Wen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Interventional Pulmonology of Zhejiang Province, Wenzhou, China
| | - Chengshui Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Interventional Pulmonology of Zhejiang Province, Wenzhou, China.,The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
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5
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Watson A, Wilkinson TMA. Digital healthcare in COPD management: a narrative review on the advantages, pitfalls, and need for further research. Ther Adv Respir Dis 2022; 16:17534666221075493. [PMID: 35234090 PMCID: PMC8894614 DOI: 10.1177/17534666221075493] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality despite current treatment strategies which focus on smoking cessation, pulmonary rehabilitation, and symptomatic relief. A focus of COPD care is to encourage self-management, particularly during COVID-19, where much face-to-face care has been reduced or ceased. Digital health solutions may offer affordable and scalable solutions to support COPD patient education and self-management, such solutions could improve clinical outcomes and expand service reach for limited additional cost. However, optimal ways to deliver digital medicine are still in development, and there are a number of important considerations for clinicians, commissioners, and patients to ensure successful implementation of digitally augmented care. In this narrative review, we discuss advantages, pitfalls, and future prospects of digital healthcare, which offer a variety of tools including self-management plans, education videos, inhaler training videos, feedback to patients and healthcare professionals (HCPs), exacerbation monitoring, and pulmonary rehabilitation. We discuss the key issues with sustaining patient and HCP engagement and limiting attrition of use, interoperability with devices, integration into healthcare systems, and ensuring inclusivity and accessibility. We explore the essential areas of research beyond determining safety and efficacy to understand the acceptability of digital healthcare solutions to patients, clinicians, and healthcare systems, and hence ways to improve this and sustain engagement. Finally, we explore the regulatory challenges to ensure quality and engagement and effective integration into current healthcare systems and care pathways, while maintaining patients’ autonomy and privacy. Understanding and addressing these issues and successful incorporation of an acceptable, simple, scalable, affordable, and future-proof digital solution into healthcare systems could help remodel global chronic disease management and fractured healthcare systems to provide best patient care and optimisation of healthcare resources to meet the global burden and unmet clinical need of COPD.
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Affiliation(s)
- Alastair Watson
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UKNIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UKCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Tom M A Wilkinson
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK. NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
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6
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Freeman A, Cellura D, Minnion M, Fernandez BO, Spalluto CM, Levett D, Bates A, Wallis T, Watson A, Jack S, Staples KJ, Grocott MPW, Feelisch M, Wilkinson TMA. Exercise Training Induces a Shift in Extracellular Redox Status with Alterations in the Pulmonary and Systemic Redox Landscape in Asthma. Antioxidants (Basel) 2021; 10:antiox10121926. [PMID: 34943027 PMCID: PMC8750917 DOI: 10.3390/antiox10121926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 12/25/2022] Open
Abstract
Redox dysregulation and oxidative stress have been implicated in asthma pathogenesis. Exercise interventions improve symptoms and reduce inflammation in asthma patients, but the underlying mechanisms remain unclear. We hypothesized that a personalised exercise intervention would improve asthma control by reducing lung inflammation through modulation of local and systemic reactive species interactions, thereby increasing antioxidant capacity. We combined deep redox metabolomic profiling with clinical assessment in an exploratory cohort of six female patients with symptomatic asthma and studied their responses to a metabolically targeted exercise intervention over 12 weeks. Plasma antioxidant capacity and circulating nitrite levels increased following the intervention (p = 0.028) and lowered the ratio of reduced to oxidised glutathione (p = 0.029); this was accompanied by improvements in physical fitness (p = 0.046), symptoms scores (p = 0.020), quality of life (p = 0.046), lung function (p = 0.028), airway hyperreactivity (p = 0.043), and eosinophilic inflammation (p = 0.007). Increased physical fitness correlated with improved plasma antioxidant capacity (p = 0.019), peak oxygen uptake and nitrite changes (p = 0.005), the latter also associated with reductions in peripheral blood eosinophil counts (p = 0.038). Thus, increases in “redox resilience” may underpin the clinical benefits of exercise in asthma. An improved understanding of exercise-induced alterations in redox regulation offers opportunities for greater treatment personalisation and identification of new treatment targets.
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Affiliation(s)
- Anna Freeman
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
- Correspondence:
| | - Doriana Cellura
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
| | - Magdalena Minnion
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
| | - Bernadette O. Fernandez
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
| | - Cosma Mirella Spalluto
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
| | - Denny Levett
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Andrew Bates
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Timothy Wallis
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Alastair Watson
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
| | - Sandy Jack
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Karl J. Staples
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Michael P. W. Grocott
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Martin Feelisch
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
| | - Tom M. A. Wilkinson
- Clinical and Experimental Sciences and Southampton Centre for Biomedical Research, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; (D.C.); (M.M.); (B.O.F.); (C.M.S.); (D.L.); (A.B.); (T.W.); (A.W.); (S.J.); (K.J.S.); (M.P.W.G.); (M.F.); (T.M.A.W.)
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
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