Provocation with adenosine 5′-monophosphate, but not methacholine, induces sputum eosinophilia

Summary Introduction Bronchial hyper‐responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5′‐monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper‐responsiveness. Aim To i...

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Published inClinical and experimental allergy Vol. 34; no. 1; pp. 71 - 76
Main Authors Van den berge, M., Kerstjens, H. A. M., De reus, D. M., Koëter, G. H., Kauffman, H. F., Postma, D. S.
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Science Ltd 01.01.2004
Blackwell
Wiley Subscription Services, Inc
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Online AccessGet full text
ISSN0954-7894
1365-2222
DOI10.1111/j.1365-2222.2004.01832.x

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Abstract Summary Introduction Bronchial hyper‐responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5′‐monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper‐responsiveness. Aim To investigate whether provocation with inhaled AMP itself initiates an inflammatory response resulting in an influx of eosinophils into the airway lumen. Methods We have included 21 non‐smoking atopic asthmatic subjects (mean FEV1 101% predicted, mean age 34 years). Each subject performed three sputum inductions on different days, at least seven days apart: one without previous provocation, one hour after PC20 methacholine, and one hour after PC20 AMP. Results After provocation with AMP, but not methacholine, the percentage of sputum eosinophils increased significantly (from 1.9±0.5% to 4.5±1% (P<0.01) and 1.9±0.5% (P=0.89)). No changes in the percentages of neutrophils, lymphocytes, macrophages, or bronchial epithelial cells were found. Conclusion A provocation test with AMP leads to an increased percentage of sputum eosinophils. This observation cannot be explained by a non‐specific response of the airways to a vigorous bronchoconstriction, since methacholine had no effect on inflammatory cells.
AbstractList Summary Introduction Bronchial hyper‐responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5′‐monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper‐responsiveness. Aim To investigate whether provocation with inhaled AMP itself initiates an inflammatory response resulting in an influx of eosinophils into the airway lumen. Methods We have included 21 non‐smoking atopic asthmatic subjects (mean FEV1 101% predicted, mean age 34 years). Each subject performed three sputum inductions on different days, at least seven days apart: one without previous provocation, one hour after PC20 methacholine, and one hour after PC20 AMP. Results After provocation with AMP, but not methacholine, the percentage of sputum eosinophils increased significantly (from 1.9±0.5% to 4.5±1% (P<0.01) and 1.9±0.5% (P=0.89)). No changes in the percentages of neutrophils, lymphocytes, macrophages, or bronchial epithelial cells were found. Conclusion A provocation test with AMP leads to an increased percentage of sputum eosinophils. This observation cannot be explained by a non‐specific response of the airways to a vigorous bronchoconstriction, since methacholine had no effect on inflammatory cells.
Bronchial hyper-responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5'-monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper-responsiveness.INTRODUCTIONBronchial hyper-responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5'-monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper-responsiveness.To investigate whether provocation with inhaled AMP itself initiates an inflammatory response resulting in an influx of eosinophils into the airway lumen.AIMTo investigate whether provocation with inhaled AMP itself initiates an inflammatory response resulting in an influx of eosinophils into the airway lumen.We have included 21 non-smoking atopic asthmatic subjects (mean FEV1 101% predicted, mean age 34 years). Each subject performed three sputum inductions on different days, at least seven days apart: one without previous provocation, one hour after PC20 methacholine, and one hour after PC20 AMP.METHODSWe have included 21 non-smoking atopic asthmatic subjects (mean FEV1 101% predicted, mean age 34 years). Each subject performed three sputum inductions on different days, at least seven days apart: one without previous provocation, one hour after PC20 methacholine, and one hour after PC20 AMP.After provocation with AMP, but not methacholine, the percentage of sputum eosinophils increased significantly (from 1.9+/-0.5% to 4.5+/-1% (P<0.01) and 1.9+/-0.5% (P=0.89)). No changes in the percentages of neutrophils, lymphocytes, macrophages, or bronchial epithelial cells were found.RESULTSAfter provocation with AMP, but not methacholine, the percentage of sputum eosinophils increased significantly (from 1.9+/-0.5% to 4.5+/-1% (P<0.01) and 1.9+/-0.5% (P=0.89)). No changes in the percentages of neutrophils, lymphocytes, macrophages, or bronchial epithelial cells were found.A provocation test with AMP leads to an increased percentage of sputum eosinophils. This observation cannot be explained by a non-specific response of the airways to a vigorous bronchoconstriction, since methacholine had no effect on inflammatory cells.CONCLUSIONA provocation test with AMP leads to an increased percentage of sputum eosinophils. This observation cannot be explained by a non-specific response of the airways to a vigorous bronchoconstriction, since methacholine had no effect on inflammatory cells.
Bronchial hyper-responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5'-monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper-responsiveness. To investigate whether provocation with inhaled AMP itself initiates an inflammatory response resulting in an influx of eosinophils into the airway lumen. We have included 21 non-smoking atopic asthmatic subjects (mean FEV1 101% predicted, mean age 34 years). Each subject performed three sputum inductions on different days, at least seven days apart: one without previous provocation, one hour after PC20 methacholine, and one hour after PC20 AMP. After provocation with AMP, but not methacholine, the percentage of sputum eosinophils increased significantly (from 1.9+/-0.5% to 4.5+/-1% (P<0.01) and 1.9+/-0.5% (P=0.89)). No changes in the percentages of neutrophils, lymphocytes, macrophages, or bronchial epithelial cells were found. A provocation test with AMP leads to an increased percentage of sputum eosinophils. This observation cannot be explained by a non-specific response of the airways to a vigorous bronchoconstriction, since methacholine had no effect on inflammatory cells.
Introduction Bronchial hyper-responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5'-monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper-responsiveness. Aim To investigate whether provocation with inhaled AMP itself initiates an inflammatory response resulting in an influx of eosinophils into the airway lumen. Methods We have included 21 non-smoking atopic asthmatic subjects (mean FEV sub(1) 101% predicted, mean age 34 years). Each subject performed three sputum inductions on different days, at least seven days apart: one without previous provocation, one hour after PC sub(20) methacholine, and one hour after PC sub(20) AMP. Results After provocation with AMP, but not methacholine, the percentage of sputum eosinophils increased significantly (from 1.9 plus or minus 0.5% to 4.5 plus or minus 1% (P<0.01) and 1.9 plus or minus 0.5% (P=0.89)). No changes in the percentages of neutrophils, lymphocytes, macrophages, or bronchial epithelial cells were found. Conclusion A provocation test with AMP leads to an increased percentage of sputum eosinophils. This observation cannot be explained by a non-specific response of the airways to a vigorous bronchoconstriction, since methacholine had no effect on inflammatory cells.
Introduction Bronchial hyper‐responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5′‐monophosphate (AMP), which acts indirectly via the secondary release of mediators, is another stimulus to measure bronchial hyper‐responsiveness. Aim To investigate whether provocation with inhaled AMP itself initiates an inflammatory response resulting in an influx of eosinophils into the airway lumen. Methods We have included 21 non‐smoking atopic asthmatic subjects (mean FEV 1 101% predicted, mean age 34 years). Each subject performed three sputum inductions on different days, at least seven days apart: one without previous provocation, one hour after PC 20 methacholine, and one hour after PC 20 AMP. Results After provocation with AMP, but not methacholine, the percentage of sputum eosinophils increased significantly (from 1.9±0.5% to 4.5±1% ( P <0.01) and 1.9±0.5% ( P =0.89)). No changes in the percentages of neutrophils, lymphocytes, macrophages, or bronchial epithelial cells were found. Conclusion A provocation test with AMP leads to an increased percentage of sputum eosinophils. This observation cannot be explained by a non‐specific response of the airways to a vigorous bronchoconstriction, since methacholine had no effect on inflammatory cells.
Author Koëter, G. H.
Kerstjens, H. A. M.
Kauffman, H. F.
Postma, D. S.
De reus, D. M.
Van den berge, M.
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Issue 1
Keywords Allergy
Immunopathology
Purine nucleoside
Adenosine
Immunology
hyper-responsiveness
inflammation
Sputum
adenosine 5'-monophosphate
Hemopathy
Antiarrhythmic agent
Eosinophilia
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Blease K, Seybold J, Adcock IM, Hellewell PG, Burke-Gaffney A. Interleukin-4 and lipopolysaccharide synergize to induce vascular cell adhesion molecule-1 expression in human lung microvascular endothelial cells. Am J Respir Cell Mol Biol 1998; 18: 620-30.
Kraft M, Bettinger CM, Wenzel SE, Irvin CG, Ackerman SJ, Martin RJ. Methacholine challenge does not affect bronchoalveolar fluid cell number and many indices of cell function in asthma. Eur Respir J 1995; 8: 1966-71.
Purokivi M, Randell J, Hirvonen MR, Tukiainen H. Reproducibility of measurements of exhaled NO, and cell count and cytokine concentrations in induced sputum. Eur Respir J 2000; 16: 242-6.
Compton SJ, Cairns JA, Holgate ST, Walls AF. Interaction of human mast cell tryptase with endothelial cells to stimulate inflammatory cell recruitment. Int Arch Allergy Immunol 1999; 118: 204-5.
Van Den Berge M, Kerstjens HAM, Meijer RJ et al. Corticosteroid-induced improvement in the PC(20) of adenosine monophosphate is more closely associated with reduction in airway inflammation than improvement in the PC(20) of methacholine. Am J Respir Crit Care Med 2001; 164: 1127-32.
Fahy JV, Liu JT, Wong H, Boushey HA. Cellular and biochemical analysis of induced sputum from asthmatic and from healthy subjects. Am Rev Respir Dis 1993; 147: 1126-31.
Hirata N, Kohrogi H, Iwagoe H et al. Allergen exposure induces the expression of endothelial adhesion molecules in passively sensitized human bronchus: time course and the role of cytokines. Am J Respir Cell Mol Biol 1998; 18: 12-20.
Bradding P, Roberts JA, Britten KM et al. Interleukin-4, -5, and -6 and tumor necrosis factor-alpha in normal and asthmatic airways: evidence for the human mast cell as a source of these cytokines. Am J Respir Cell Mol Biol 1994; 10: 471-80.
Cockcroft DW, Killian DN, Mellon JJ, Hargreave FE. Bronchial reactivity to inhaled histamine: a method and clinical survey. Clin Allergy 1977; 7: 235-43.
Spanevello A, Migliori GB, Sharara A et al. Induced sputum to assess airway inflammation: a study of reproducibility. Clin Exp Allergy 1997; 27: 1138-44.
Church MK, Holgate ST, Hughes PJ. Adenosine inhibits and potentiates IgE-dependent histamine release from human basophils by an A2-receptor mediated mechanism. Br J Pharmacol 1983; 80: 719-26.
Pizzichini E, Pizzichini MM, Kidney JC et al. Induced sputum, bronchoalveolar lavage and blood from mild asthmatics: inflammatory cells, lymphocyte subsets and soluble markers compared. Eur Respir J 1998; 11: 828-34.
Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993; 16: 5-40.
Nowak D, Grimminger F, Jorres RA et al. Increased LTB4 metabolites and PGD2 in BAL fluid after methacholine challenge in asthmatic subjects. Eur Respir J 1993; 6: 405-12.
Bradding P, Feather IH, Wilson SJ et al. Immunolocalization of cytokines in the nasal mucosa of normal and perennial rhinitic subjects. The mast cell as a source of IL-4, IL-5, and IL-6 in human allergic mucosal inflammation. J Immunol 1993; 151: 3853-65.
Selroos O, Halme M. Effect of a volumatic spacer and mouth rinsing on systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler. Thorax 1991; 46: 891-4.
Cronstein BN, Daguma L, Nichols D, Hutchison AJ, Williams KM. The adenosine/neutrophil paradox resolved: human neutrophils possess both A1 and A2 receptors that promote chemotaxis and inhibit O2 generation, respectively. J Clin Invest 1990; 85: 1150-7.
Felsch A, Stocker K, Borchard U. Phorbol ester-stimulated adherence of neutrophils to endothelial cells is reduced by adenosine A2 receptor agonists. J Immunol 1995; 155: 333-8.
Polosa R, Ng WH, Crimi N et al. Release of mast-cell-derived mediators after endobronchial adenosine challenge in asthma. Am J Respir Crit Care Med 1995; 151: 624-9.
Barnes PJ. Scientific rationale for inhaled combination therapy with long-acting beta2-agonists and corticosteroids. Eur Respir J 2002; 19: 182-91.
Hughes PJ, Holgate ST, Church MK. Adenosine inhibits and potentiates IgE-dependent histamine release from human lung mast cells by an A2-purinoceptor mediated mechanism. Biochem Pharmacol 1984; 33: 3847-52.
Diamant Z, Hiltermann TJ, Van Rensen EL et al. The effect of inhaled leukotriene D4 and methacholine on sputum cell differentials in asthma. Am J Respir Crit Care Med 1997; 155: 1247-53.
Miyamasu M, Misaki Y, Izumi S et al. Glucocorticoids inhibit chemokine generation by human eosinophils. J Allergy Clin Immunol 1998; 101: 75-83.
Mulder A, Gauvreau GM, Watson RM, O'Byrne PM. Effect of inhaled leukotriene D4 on airway eosinophilia and airway hyperresponsiveness in asthmatic subjects. Am J Respir Crit Care Med 1999; 159: 1562-7.
Oosterhoff Y, Jansen MA, Postma DS, Koeter GH. Airway responsiveness to adenosine 5′-monophosphate in smokers and nonsmokers with atopic asthma. J Allergy Clin Immunol 1993; 92: 773-6.
Van Den Berge M, Meijer RJ, Kerstjens HAM et al. PC20 adenosine 5′-monophosphate is more closely associated with airway inflammation in asthma than PC20 methacholine. Am J Respir Crit Care Med 2001; 163: 1546-50.
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Hirata N (e_1_2_6_28_2) 1998; 18
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Okada S (e_1_2_6_21_2) 1997; 17
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References_xml – reference: Hughes PJ, Holgate ST, Church MK. Adenosine inhibits and potentiates IgE-dependent histamine release from human lung mast cells by an A2-purinoceptor mediated mechanism. Biochem Pharmacol 1984; 33: 3847-52.
– reference: Spanevello A, Migliori GB, Sharara A et al. Induced sputum to assess airway inflammation: a study of reproducibility. Clin Exp Allergy 1997; 27: 1138-44.
– reference: Walls AF, He S, Teran LM et al. Granulocyte recruitment by human mast cell tryptase. Int Arch Allergy Immunol 1995; 107: 372-3.
– reference: Suzuki H, Takei M, Nakahata T, Fukamachi H. Inhibitory effect of adenosine on degranulation of human cultured mast cells upon cross-linking of Fc epsilon RI. Biochem Biophys Res Commun 1998; 242: 697-702.
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– reference: Cronstein BN, Daguma L, Nichols D, Hutchison AJ, Williams KM. The adenosine/neutrophil paradox resolved: human neutrophils possess both A1 and A2 receptors that promote chemotaxis and inhibit O2 generation, respectively. J Clin Invest 1990; 85: 1150-7.
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– reference: He S, Walls AF. Human mast cell chymase induces the accumulation of neutrophils, eosinophils and other inflammatory cells in vivo. Br J Pharmacol 1998; 125: 1491-500.
– reference: Mulder A, Gauvreau GM, Watson RM, O'Byrne PM. Effect of inhaled leukotriene D4 on airway eosinophilia and airway hyperresponsiveness in asthmatic subjects. Am J Respir Crit Care Med 1999; 159: 1562-7.
– reference: Selroos O, Halme M. Effect of a volumatic spacer and mouth rinsing on systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler. Thorax 1991; 46: 891-4.
– reference: Miyamasu M, Misaki Y, Izumi S et al. Glucocorticoids inhibit chemokine generation by human eosinophils. J Allergy Clin Immunol 1998; 101: 75-83.
– reference: Felsch A, Stocker K, Borchard U. Phorbol ester-stimulated adherence of neutrophils to endothelial cells is reduced by adenosine A2 receptor agonists. J Immunol 1995; 155: 333-8.
– reference: Kraft M, Bettinger CM, Wenzel SE, Irvin CG, Ackerman SJ, Martin RJ. Methacholine challenge does not affect bronchoalveolar fluid cell number and many indices of cell function in asthma. Eur Respir J 1995; 8: 1966-71.
– reference: Barnes PJ. Scientific rationale for inhaled combination therapy with long-acting beta2-agonists and corticosteroids. Eur Respir J 2002; 19: 182-91.
– reference: Van Den Berge M, Meijer RJ, Kerstjens HAM et al. PC20 adenosine 5′-monophosphate is more closely associated with airway inflammation in asthma than PC20 methacholine. Am J Respir Crit Care Med 2001; 163: 1546-50.
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– reference: Pizzichini E, Pizzichini MM, Kidney JC et al. Induced sputum, bronchoalveolar lavage and blood from mild asthmatics: inflammatory cells, lymphocyte subsets and soluble markers compared. Eur Respir J 1998; 11: 828-34.
– reference: Church MK, Holgate ST, Hughes PJ. Adenosine inhibits and potentiates IgE-dependent histamine release from human basophils by an A2-receptor mediated mechanism. Br J Pharmacol 1983; 80: 719-26.
– reference: Cockcroft DW, Killian DN, Mellon JJ, Hargreave FE. Bronchial reactivity to inhaled histamine: a method and clinical survey. Clin Allergy 1977; 7: 235-43.
– reference: Okada S, Kita H, George TJ, Gleich GJ, Leiferman KM. Migration of eosinophils through basement membrane components in vitro: role of matrix metalloproteinase-9. Am J Respir Cell Mol Biol 1997; 17: 519-28.
– reference: Hirata N, Kohrogi H, Iwagoe H et al. Allergen exposure induces the expression of endothelial adhesion molecules in passively sensitized human bronchus: time course and the role of cytokines. Am J Respir Cell Mol Biol 1998; 18: 12-20.
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– reference: Fahy JV, Liu JT, Wong H, Boushey HA. Cellular and biochemical analysis of induced sputum from asthmatic and from healthy subjects. Am Rev Respir Dis 1993; 147: 1126-31.
– reference: Walker BA, Jacobson MA, Knight DA et al. Adenosine A3 receptor expression and function in eosinophils. Am J Respir Cell Mol Biol 1997; 16: 531-7.
– reference: Diamant Z, Hiltermann TJ, Van Rensen EL et al. The effect of inhaled leukotriene D4 and methacholine on sputum cell differentials in asthma. Am J Respir Crit Care Med 1997; 155: 1247-53.
– reference: Meijer RJ, Kerstjens HAM, Arends LR, Kauffman HF, Koeter GH, Postma DS. Effects of inhaled fluticasone and oral prednisolone on clinical and inflammatory parameters in patients with asthma. Thorax 1999; 54: 894-9.
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– reference: Nowak D, Grimminger F, Jorres RA et al. Increased LTB4 metabolites and PGD2 in BAL fluid after methacholine challenge in asthmatic subjects. Eur Respir J 1993; 6: 405-12.
– reference: Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 1993; 16: 5-40.
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– reference: Purokivi M, Randell J, Hirvonen MR, Tukiainen H. Reproducibility of measurements of exhaled NO, and cell count and cytokine concentrations in induced sputum. Eur Respir J 2000; 16: 242-6.
– reference: Bradding P, Holgate ST. The mast cell as a source of cytokines in asthma. Ann N Y Acad Sci 1996; 796: 272-81.
– reference: Polosa R, Ng WH, Crimi N et al. Release of mast-cell-derived mediators after endobronchial adenosine challenge in asthma. Am J Respir Crit Care Med 1995; 151: 624-9.
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  year: 1994
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Snippet Summary Introduction Bronchial hyper‐responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5′‐monophosphate...
Introduction Bronchial hyper‐responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5′‐monophosphate (AMP),...
Bronchial hyper-responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5'-monophosphate (AMP), which acts...
Introduction Bronchial hyper-responsiveness is usually measured with direct stimuli such as methacholine (MCh) or histamine. Adenosine 5'-monophosphate (AMP),...
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SubjectTerms adenosine
adenosine 5′-monophosphate
Adenosine Monophosphate
Administration, Inhalation
Adult
Allergic diseases
Asthma - drug therapy
Asthma - immunology
Biological and medical sciences
Bronchial Hyperreactivity - diagnosis
Bronchial Provocation Tests
Bronchoconstrictor Agents
Cross-Over Studies
Eosinophilia - chemically induced
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Glucocorticoids - therapeutic use
Humans
hyper-responsiveness
Immunopathology
inflammation
Male
Medical sciences
Methacholine Chloride
sputum
Sputum - immunology
Statistics, Nonparametric
Title Provocation with adenosine 5′-monophosphate, but not methacholine, induces sputum eosinophilia
URI https://api.istex.fr/ark:/67375/WNG-C1F67M6N-W/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1365-2222.2004.01832.x
https://www.ncbi.nlm.nih.gov/pubmed/14720265
https://www.proquest.com/docview/199918348
https://www.proquest.com/docview/19258512
https://www.proquest.com/docview/80095801
Volume 34
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