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  1. Article ; Online: MiR-23a-5p alleviates chronic obstructive pulmonary disease through targeted regulation of RAGE-ROS pathway.

    Chang, Chenli / Huang, Ke / Xu, Xia / Duan, Ruirui / Yu, Tao / Chu, Xu / Chen, Chen / Li, Baicun / Yang, Ting

    Respiratory research

    2024  Volume 25, Issue 1, Page(s) 93

    Abstract: Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease and represents the third leading cause of death worldwide. This study aimed to investigate miRNA regulation of Receptor for Advanced Glycation End-products (RAGE), ... ...

    Abstract Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease and represents the third leading cause of death worldwide. This study aimed to investigate miRNA regulation of Receptor for Advanced Glycation End-products (RAGE), a causal receptor in the pathogenesis of cigarette smoke (CS)-related COPD, to guide development of therapeutic strategies.
    Methods: RAGE expression was quantified in lung tissue of COPD patients and healthy controls, and in mice with CS-induced COPD. RNA-sequencing of peripheral blood from COPD patients with binding site prediction was used to screen differentially expressed miRNAs that may interact with RAGE. Investigation of miR-23a-5p as a potential regulator of COPD progression was conducted with miR-23a-5p agomir in COPD mice in vivo using histology and SCIREQ functional assays, while miR-23a-5p mimics or RAGE inhibitor were applied in 16-HBE human bronchial epithelial cells in vitro. RNA-sequencing, ELISA, and standard molecular techniques were used to characterize downstream signaling pathways in COPD mice and 16-HBE cells treated with cigarette smoke extract (CSE).
    Results: RAGE expression is significantly increased in lung tissue of COPD patients, COPD model mice, and CSE-treated 16-HBE cells, while inhibiting RAGE expression significantly reduces COPD severity in mice. RNA-seq analysis of peripheral blood from COPD patients identified miR-23a-5p as the most significant candidate miRNA interaction partner of RAGE, and miR-23a-5p is significantly downregulated in mice and cells treated with CS or CSE, respectively. Injection of miR-23a-5p agomir leads to significantly reduced airway inflammation and alleviation of symptoms in COPD mice, while overexpressing miR-23a-5p leads to improved lung function. RNA-seq with validation confirmed that reactive oxygen species (ROS) signaling is increased under CSE-induced aberrant upregulation of RAGE, and suppressed in CSE-stimulated cells treated with miR-23a-5p mimics or overexpression. ERK phosphorylation and subsequent cytokine production was also increased under RAGE activation, but inhibited by increasing miR-23a-5p levels, implying that the miR-23a-5p/RAGE/ROS axis mediates COPD pathogenesis via ERK activation.
    Conclusions: This study identifies a miR-23a-5p/RAGE/ROS signaling axis required for pathogenesis of COPD. MiR-23a-5p functions as a negative regulator of RAGE and downstream activation of ROS signaling, and can inhibit COPD progression in vitro and in vivo, suggesting therapeutic targets to improve COPD treatment.
    MeSH term(s) Animals ; Humans ; Mice ; Lung/metabolism ; MicroRNAs/metabolism ; Pulmonary Disease, Chronic Obstructive/metabolism ; Reactive Oxygen Species/metabolism ; Receptor for Advanced Glycation End Products/genetics ; Receptor for Advanced Glycation End Products/metabolism
    Chemical Substances MicroRNAs ; Reactive Oxygen Species ; Receptor for Advanced Glycation End Products ; MIRN23a microRNA, human ; Mirn23b microRNA, mouse
    Language English
    Publishing date 2024-02-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-024-02736-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Interleukin-2/anti-interleukin-2 complex attenuates inflammation in a mouse COPD model by expanding CD4

    Duan, Ruirui / Huang, Ke / Yu, Tao / Chang, Chenli / Chu, Xu / Huang, Yuhang / Zheng, Zhoude / Ma, Linxi / Li, Baicun / Yang, Ting

    International immunopharmacology

    2024  Volume 131, Page(s) 111849

    Abstract: Background and purpose: Chronic, nonspecific inflammation of the alveoli and airways is an important pathological feature of chronic obstructive pulmonary disease (COPD), while sustained inflammatory reactions can cause alveolar damage. Regulatory T ... ...

    Abstract Background and purpose: Chronic, nonspecific inflammation of the alveoli and airways is an important pathological feature of chronic obstructive pulmonary disease (COPD), while sustained inflammatory reactions can cause alveolar damage. Regulatory T cells (Tregs) inhibit inflammation, whereas the interleukin-2/anti-interleukin-2 complex (IL-2C) increases the number of Tregs; however, whether the IL-2C has a therapeutic role in COPD remains unknown. Therefore, this study investigated whether IL-2C alleviates lung inflammation in COPD by increasing the number of Tregs.
    Experimental approach: A mouse COPD model was created by exposing mice to lipopolysaccharides (LPS) and cigarette smoke (CS), and the effects of IL-2C treatment on COPD were evaluated. The number of Tregs in the spleen and lung, pulmonary pathological changes, and inflammatory damage were examined through flow cytometry, histopathology, and immunofluorescence, respectively.
    Key results: IL-2C increased the number of Treg cells in the spleen and lungs after exposure to CS and LPS, reduced the number of T helper 17 (Th17) cells in lung tissue, and improved the Th17/Treg balance. IL-2C decreased the number of inflammatory cells and reduced the levels of pro-inflammatory cytokines IL-6, TNF-α, IL-1β, CCL5, KC, and MCP-1 in bronchoalveolar lavage fluid and serum. IL-2C significantly reduced the pathological scores for lung inflammation, as well as decreased airway mucus secretion and infiltration of neutrophils and macrophages in the lungs. The depletion of Tregs using anti-CD25 antibodies eliminated the beneficial effects of IL-2C.
    Conclusions and implications: IL-2C is a potential therapeutic agent for alleviating excessive inflammation in the lungs of patients with COPD.
    MeSH term(s) Humans ; Mice ; Animals ; Interleukin-2 ; T-Lymphocytes, Regulatory ; Lipopolysaccharides/pharmacology ; Pulmonary Disease, Chronic Obstructive ; Lung/pathology ; Disease Models, Animal ; Inflammation/drug therapy ; Inflammation/pathology ; Transcription Factors ; Pneumonia/drug therapy ; Pneumonia/pathology ; Forkhead Transcription Factors
    Chemical Substances Interleukin-2 ; Lipopolysaccharides ; Transcription Factors ; Foxp3 protein, mouse ; Forkhead Transcription Factors
    Language English
    Publishing date 2024-03-18
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2043785-7
    ISSN 1878-1705 ; 1567-5769
    ISSN (online) 1878-1705
    ISSN 1567-5769
    DOI 10.1016/j.intimp.2024.111849
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Serum Proteomic Profiling in Patients with Chronic Obstructive Pulmonary Disease.

    Wu, Sinan / Huang, Ke / Chang, Chenli / Chu, Xu / Zhang, Kun / Li, Baicun / Yang, Ting

    International journal of chronic obstructive pulmonary disease

    2023  Volume 18, Page(s) 1623–1635

    Abstract: Purpose: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with high morbidity and mortality rates. This study used proteomic profiling of serum to identify the differentially expressed proteins in COPD patients compared with ... ...

    Abstract Purpose: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with high morbidity and mortality rates. This study used proteomic profiling of serum to identify the differentially expressed proteins in COPD patients compared with healthy controls, to expand the knowledge of COPD pathogenesis and to ascertain potential new targets for diagnosis and treatment of COPD.
    Methods: Serum samples were collected from 56 participants (COPD group n = 28; Healthy Control group n = 28). A data-independent acquisition quantitative proteomics approach was used to identify differentially expressed proteins (DEPs) between the two groups. Gene Ontology (GO) functional annotation, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway functional enrichment, and protein-protein interaction analyses of DEPs were conducted to identify their relevant biological processes, cellular components, and related pathways. We used a parallel reaction monitoring (PRM)-based targeted quantitative proteomics approach to validate those findings.
    Results: Of 8484 peptides identified by searching the UniProtKB/Swiss-Prot knowledgebase, 867 proteins were quantifiable, of which 20 were upregulated and 35 were downregulated in the COPD group. GO functional annotation indicated that the subcellular localization of most DEPs was extracellular. The top three molecular functions of the DEPs were signaling receptor binding, antigen binding, and immunoglobulin receptor binding. The most relevant biological process was immune response. The transforming growth factor-β signaling pathway,
    Conclusion: This study using data-independent acquisition analyses with PRM confirmation of findings identified 11 DEPs in the serum of patients with COPD. These DEPs are potential diagnostic or prognostic biomarkers or may be future targets for the treatment of COPD.
    MeSH term(s) Humans ; Proteomics ; Pulmonary Disease, Chronic Obstructive/diagnosis
    Language English
    Publishing date 2023-07-28
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2212419-6
    ISSN 1178-2005 ; 1176-9106
    ISSN (online) 1178-2005
    ISSN 1176-9106
    DOI 10.2147/COPD.S413924
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Exogenous IL-25 ameliorates airway neutrophilia via suppressing macrophage M1 polarization and the expression of IL-12 and IL-23 in asthma.

    Chang, Chenli / Chen, Gongqi / Wu, Wenliang / Chen, Dian / Chen, Shengchong / Gao, Jiali / Feng, Yuchen / Zhen, Guohua

    Respiratory research

    2023  Volume 24, Issue 1, Page(s) 260

    Abstract: Background: Severe asthma is associated with substantial mortality and has unmet therapeutic need. A subset of severe asthma is characterized by neutrophilic airway inflammation. Classically activated (or M1) macrophages which express IL-12 and IL-23 ... ...

    Abstract Background: Severe asthma is associated with substantial mortality and has unmet therapeutic need. A subset of severe asthma is characterized by neutrophilic airway inflammation. Classically activated (or M1) macrophages which express IL-12 and IL-23 are associated with airway neutrophilia in asthma. Exogenous IL-25 was reported to suppress intestinal inflammation in animal models of inflammatory bowel diseases via suppressing IL-12 and IL-23 production. We hypothesize that IL-25 ameliorates airway neutrophilia via inhibiting macrophage M1 polarization and the expression of IL-12 and IL-23 in asthma.
    Methods: In a mouse model of neutrophil-dominant allergic airway inflammation, the effect of mouse recombinant IL-25 on airway inflammation were assessed by H&E staining and bronchoalveolar lavage (BAL) cell counting. The percentage of M1 macrophages in lung tissue and BAL cells were analyzed by flow cytometry. Quantitative PCR and immunostaining were performed to measure the expression of Il12, Il23, and inflammatory cytokines. Mechanistic experiments were performed in primary culture of macrophages from mouse lungs. The expression of IL-12, IL-23 and IL-25 in sputum was analyzed in a cohort of severe asthma and subjects with eosinophilic or non-eosinophilic asthma.
    Results: Intranasal administration of IL-25 markedly decreased the number of neutrophils in BAL cells in a murine model of neutrophil-dominant allergic airway inflammation. Moreover, exogenous IL-25 decreased the number of M1 macrophages, and reduced the expression of IL-12, IL-23 in the lungs of the mouse model. Exogenous IL-25 also inhibited the expression of inflammatory cytokines IL-1β, IFN-γ, TNF-α and IL-17 A. In vitro, IL-25 suppressed IL-12 and IL-23 expression in lipopolysaccharide (LPS)-stimulated primary culture of mouse pulmonary macrophages. Mechanistically, IL-25 inhibited LPS-induced c-Rel translocation to nucleus via STAT3-dependent signaling. In a cohort of severe asthma, IL-25 protein levels in sputum were significantly lower than control subjects. The transcript levels of IL-12 and IL-23 were increased whereas IL-25 transcripts were decreased in sputum cells from subjects with non-eosinophilic asthma compared to eosinophilic asthma.
    Conclusions: IL-25 expression is downregulated in subjects with severe or non-eosinophilic asthma. Exogenous IL-25 ameliorates airway neutrophilia, at least in part, via inhibiting macrophage M1 polarization and the expression of IL-12 and IL-23.
    MeSH term(s) Humans ; Animals ; Mice ; Interleukin-12/therapeutic use ; Interleukin-17 ; Lipopolysaccharides ; Asthma/drug therapy ; Asthma/metabolism ; Cytokines/metabolism ; Inflammation ; Macrophages, Alveolar/metabolism ; Interleukin-23/therapeutic use
    Chemical Substances Interleukin-12 (187348-17-0) ; Interleukin-17 ; Lipopolysaccharides ; Cytokines ; Interleukin-23
    Language English
    Publishing date 2023-10-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-023-02557-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Inhibition of Nur77 expression and translocation by compound B6 reduces ER stress and alleviates cigarette smoke-induced inflammation and injury in bronchial epithelial cells.

    Chang, Chenli / He, Fengming / Ao, Mingtao / Chen, Jun / Yu, Tao / Li, Weiyu / Li, Baicun / Fang, Meijuan / Yang, Ting

    Frontiers in pharmacology

    2023  Volume 14, Page(s) 1200110

    Abstract: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide with inflammation and injury in airway epithelial cells. However, few treatment options effectively reduce severity. We previously found that Nur77 is involved in ... ...

    Abstract Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide with inflammation and injury in airway epithelial cells. However, few treatment options effectively reduce severity. We previously found that Nur77 is involved in lipopolysaccharide-induced inflammation and injury of lung tissue. Here, we established an
    Language English
    Publishing date 2023-06-19
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2587355-6
    ISSN 1663-9812
    ISSN 1663-9812
    DOI 10.3389/fphar.2023.1200110
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  6. Article ; Online: Decreased eosinophil counts and elevated lactate dehydrogenase predict severe COVID-19 in patients with underlying chronic airway diseases.

    Chen, Dian / Zhang, Shuchen / Feng, Yuchen / Wu, Wenliang / Chang, Chenli / Chen, Shengchong / Zhen, Guohua / Yi, Lingling

    Postgraduate medical journal

    2023  Volume 98, Issue 1166, Page(s) 906–913

    Abstract: Background: Several predictors of COVID-19 severity have been reported. However, chronic airway inflammation characterised by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19.: Methods: In this retrospective cohort study, ...

    Abstract Background: Several predictors of COVID-19 severity have been reported. However, chronic airway inflammation characterised by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19.
    Methods: In this retrospective cohort study, we reviewed the medical records of all patients with laboratory-confirmed COVID-19 with chronic bronchitis, chronic obstructive pulmonary disease (COPD) and asthma admitted to the Sino-French New City Branch of Tongji Hospital, a large regional hospital in Wuhan, China, from 26 January to 3 April. The Tongji Hospital Ethics Committee approved this study.
    Results: There were 59 patients with chronic bronchitis, COPD and asthma. When compared with non-severe patients, severe patients were more likely to have decreased lymphocyte counts (0.6×10⁹/L vs 1.1×10⁹/L, p<0.001), eosinopaenia (<0.02×10⁹/L; 73% vs 24%, p<0.001), increased lactate dehydrogenase (LDH) (471.0 U/L vs 230.0 U/L, p<0.001) and elevated interleukin 6 level (47.4 pg/mL vs 5.7 pg/mL, p=0.002) on admission. Eosinopaenia and elevated LDH were significantly associated with disease severity in both univariate and multivariate regression models including the above variables. Moreover, eosinophil count and LDH level tended to return to normal range over time in both groups after treatment and severe patients recovered slower than non-severe patients, especially in eosinophil count.
    Conclusions: Eosinopaenia and elevated LDH are potential predictors of disease severity in patients with COVID-19 with underlying chronic airway diseases. In addition, they could indicate disease progression and treatment effectiveness.
    MeSH term(s) Humans ; Asthma/complications ; Bronchitis, Chronic/pathology ; COVID-19/complications ; Eosinophils ; Inflammation/pathology ; Lactate Dehydrogenases ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies
    Chemical Substances Lactate Dehydrogenases (EC 1.1.-)
    Language English
    Publishing date 2023-03-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 80325-x
    ISSN 1469-0756 ; 0032-5473
    ISSN (online) 1469-0756
    ISSN 0032-5473
    DOI 10.1136/postgradmedj-2021-139704
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  7. Article: Identification of Key Signaling Pathways and Genes in Eosinophilic Asthma and Neutrophilic Asthma by Weighted Gene Co-Expression Network Analysis.

    Chen, Gongqi / Chen, Dian / Feng, Yuchen / Wu, Wenliang / Gao, Jiali / Chang, Chenli / Chen, Shengchong / Zhen, Guohua

    Frontiers in molecular biosciences

    2022  Volume 9, Page(s) 805570

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2022-02-02
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2814330-9
    ISSN 2296-889X
    ISSN 2296-889X
    DOI 10.3389/fmolb.2022.805570
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  8. Article ; Online: Epithelial microRNA-30a-3p targets RUNX2/HMGB1 axis to suppress airway eosinophilic inflammation in asthma.

    Wu, Wenliang / Gao, Jiali / Chen, Dian / Chen, Gongqi / Feng, Yuchen / Chang, Chenli / Chen, Shengchong / Yi, Lingling / Zhen, Guohua

    Respiratory research

    2022  Volume 23, Issue 1, Page(s) 17

    Abstract: Background: Type 2-high asthma is a prominent endotype of asthma which is characterized by airway eosinophilic inflammation. Airway epithelial cells play a critical role in the pathogenesis of asthma. Our previous miRNA profiling data showed that miR- ... ...

    Abstract Background: Type 2-high asthma is a prominent endotype of asthma which is characterized by airway eosinophilic inflammation. Airway epithelial cells play a critical role in the pathogenesis of asthma. Our previous miRNA profiling data showed that miR-30a-3p was downregulated in bronchial epithelial cells from asthma patients. We hypothesize that epithelial miR-30a-3p plays a role in asthma airway inflammation.
    Methods: We measured miR-30a-3p expression in bronchial brushings of asthma patients (n = 51) and healthy controls (n = 16), and analyzed the correlations between miR-30a-3p expression and airway eosinophilia. We examined whether Runt-related transcription factor 2 (RUNX2) was a target of miR-30a-3p and whether RUNX2 bound to the promoter of high mobility group box 1 (HMGB1) by using luciferase reporter assay and chromatin immunoprecipitation (ChIP)-PCR. The role of miR-30a-3p was also investigated in a murine model of allergic airway inflammation.
    Results: We found that miR-30a-3p expression were significantly decreased in bronchial brushings of asthma patients compared to control subjects. Epithelial miR-30a-3p expression was negatively correlated with parameters reflecting airway eosinophilia including eosinophils in induced sputum and bronchial biopsies, and fraction of exhaled nitric oxide in asthma patients. We verified that RUNX2 is a target of miR-30a-3p. Furthermore, RUNX2 bound to the promoter of HMGB1 and upregulated HMGB1 expression. RUNX2 and HMGB1 expression was both enhanced in airway epithelium and was correlated with each other in asthma patients. Inhibition of miR-30a-3p enhanced RUNX2 and HMGB1 expression, and RUNX2 overexpression upregulated HMGB1 in BEAS-2B cells. Intriguingly, airway overexpression of mmu-miR-30a-3p suppressed Runx2 and Hmgb1 expression, and alleviated airway eosinophilia in a mouse model of allergic airway inflammation.
    Conclusions: Epithelial miR-30a-3p could possibly target RUNX2/HMGB1 axis to suppress airway eosinophilia in asthma.
    MeSH term(s) Animals ; Asthma/complications ; Asthma/genetics ; Asthma/pathology ; Cells, Cultured ; Core Binding Factor Alpha 1 Subunit/biosynthesis ; Core Binding Factor Alpha 1 Subunit/genetics ; Disease Models, Animal ; Eosinophilia/complications ; Eosinophilia/genetics ; Eosinophilia/pathology ; Female ; Gene Expression Regulation ; HMGB1 Protein/biosynthesis ; HMGB1 Protein/genetics ; Humans ; Inflammation/genetics ; Inflammation/metabolism ; Inflammation/pathology ; Mice ; Mice, Inbred C57BL ; MicroRNAs/biosynthesis ; MicroRNAs/genetics ; Sputum/metabolism ; Up-Regulation
    Chemical Substances Core Binding Factor Alpha 1 Subunit ; HMGB1 Protein ; HMGB1 protein, human ; MIRN30a microRNA, mouse ; MicroRNAs ; RUNX2 protein, human
    Language English
    Publishing date 2022-01-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-022-01933-x
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  9. Article ; Online: Cadherin-26 Amplifies Airway Epithelial IL-4 Receptor Signaling in Asthma.

    Feng, Yuchen / Chen, Shengchong / Xiong, Luyang / Chang, Chenli / Wu, Wenliang / Chen, Dian / Gao, Jiali / Chen, Gongqi / Yi, Lingling / Zhen, Guohua

    American journal of respiratory cell and molecular biology

    2022  Volume 67, Issue 5, Page(s) 539–549

    Abstract: Activation of IL-4R (IL-4 receptor) signaling in airway epithelial cells leads to airway hyperresponsiveness and mucus overproduction in asthma. CDH26 (cadherin-26), a cadherin implicated in the polarization of airway epithelial cells, is upregulated in ... ...

    Abstract Activation of IL-4R (IL-4 receptor) signaling in airway epithelial cells leads to airway hyperresponsiveness and mucus overproduction in asthma. CDH26 (cadherin-26), a cadherin implicated in the polarization of airway epithelial cells, is upregulated in asthma. However, the role of CDH26 in asthma remains unknown. In this study, we demonstrated that
    MeSH term(s) Humans ; Mice ; Animals ; Interleukin-13 ; Receptors, Interleukin-4 ; Asthma/metabolism ; Hypersensitivity/metabolism ; Eosinophilia ; Cadherins
    Chemical Substances Interleukin-13 ; Receptors, Interleukin-4 ; Cadherins
    Language English
    Publishing date 2022-08-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1025960-0
    ISSN 1535-4989 ; 1044-1549
    ISSN (online) 1535-4989
    ISSN 1044-1549
    DOI 10.1165/rcmb.2021-0109OC
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  10. Article ; Online: Correction: Eosinophils promote pulmonary matrix destruction and emphysema via Cathepsin L.

    Xu, Xia / Yu, Tao / Dong, Lingling / Glauben, Rainer / Wu, Siyuan / Huang, Ronghua / Qumu, Shiwei / Chang, Chenli / Guo, Jing / Pan, Lin / Yang, Ting / Lin, Xin / Huang, Ke / Chen, Zhihua / Wang, Chen

    Signal transduction and targeted therapy

    2023  Volume 8, Issue 1, Page(s) 438

    Language English
    Publishing date 2023-11-27
    Publishing country England
    Document type Published Erratum
    ZDB-ID 2886872-9
    ISSN 2059-3635 ; 2095-9907
    ISSN (online) 2059-3635
    ISSN 2095-9907
    DOI 10.1038/s41392-023-01698-9
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