Oncolytic virotherapy reverses chemoresistance in osteosarcoma by suppressing MDR1 expression.


Journal

Cancer chemotherapy and pharmacology
ISSN: 1432-0843
Titre abrégé: Cancer Chemother Pharmacol
Pays: Germany
ID NLM: 7806519

Informations de publication

Date de publication:
09 2021
Historique:
received: 17 12 2020
accepted: 31 05 2021
pubmed: 12 6 2021
medline: 18 11 2021
entrez: 11 6 2021
Statut: ppublish

Résumé

Osteosarcoma (OS) is a malignant bone tumor primarily affecting children and adolescents. The prognosis of chemotherapy-refractory OS patients is poor. We developed a tumor suppressor p53-expressing oncolytic adenovirus (OBP-702) that exhibits antitumor effects against human OS cells. Here, we demonstrate the chemosensitizing effect of OBP-702 in human OS cells. The in vitro and in vivo antitumor activities of doxorubicin (DOX) and OBP-702 were assessed using parental and DOX-resistant OS cells (U2OS, MNNG/HOS) and a DOX-resistant MNNG/HOS xenograft tumor model. DOX-resistant OS cells exhibited high multidrug resistant 1 (MDR1) expression, which was suppressed by OBP-702 or MDR1 siRNA, resulting in enhanced DOX-induced apoptosis. Compared to monotherapy, OBP-702 and DOX combination therapy significantly suppressed tumor growth in the DOX-resistant MNNG/HOS xenograft tumor model. Our results suggest that MDR1 is an attractive therapeutic target for chemoresistant OS. Tumor-specific virotherapy is thus a promising strategy for reversing chemoresistance in OS patients via suppression of MDR1 expression.

Sections du résumé

BACKGROUND
Osteosarcoma (OS) is a malignant bone tumor primarily affecting children and adolescents. The prognosis of chemotherapy-refractory OS patients is poor. We developed a tumor suppressor p53-expressing oncolytic adenovirus (OBP-702) that exhibits antitumor effects against human OS cells. Here, we demonstrate the chemosensitizing effect of OBP-702 in human OS cells.
MATERIALS AND METHODS
The in vitro and in vivo antitumor activities of doxorubicin (DOX) and OBP-702 were assessed using parental and DOX-resistant OS cells (U2OS, MNNG/HOS) and a DOX-resistant MNNG/HOS xenograft tumor model.
RESULTS
DOX-resistant OS cells exhibited high multidrug resistant 1 (MDR1) expression, which was suppressed by OBP-702 or MDR1 siRNA, resulting in enhanced DOX-induced apoptosis. Compared to monotherapy, OBP-702 and DOX combination therapy significantly suppressed tumor growth in the DOX-resistant MNNG/HOS xenograft tumor model.
CONCLUSION
Our results suggest that MDR1 is an attractive therapeutic target for chemoresistant OS. Tumor-specific virotherapy is thus a promising strategy for reversing chemoresistance in OS patients via suppression of MDR1 expression.

Identifiants

pubmed: 34114067
doi: 10.1007/s00280-021-04310-5
pii: 10.1007/s00280-021-04310-5
doi:

Substances chimiques

ABCB1 protein, human 0
ATP Binding Cassette Transporter, Subfamily B 0
Antibiotics, Antineoplastic 0
TP53 protein, human 0
Tumor Suppressor Protein p53 0
Doxorubicin 80168379AG

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

513-524

Subventions

Organisme : The Japan Agency for Medical Research and Development
ID : 17ck0106285h001
Organisme : The Ministry of Education, Culture, Sports, Science, and Technology, Japan
ID : 25293238
Organisme : The Ministry of Education, Culture, Sports, Science, and Technology, Japan
ID : 16H05416
Organisme : The Ministry of Education, Culture, Sports, Science, and Technology, Japan
ID : 25293323
Organisme : The Ministry of Education, Culture, Sports, Science, and Technology, Japan
ID : 25462333
Organisme : The Ministry of Education, Culture, Sports, Science, and Technology, Japan
ID : 16K10862
Organisme : The Ministry of Education, Culture, Sports, Science, and Technology, Japan
ID : 15K10446
Organisme : The Ministry of Education, Culture, Sports, Science, and Technology, Japan
ID : 16K10596

Informations de copyright

© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

Siegel RL, Miller KD, Jemal A (2018) Cancer statistics. CA Cancer J Clin 68(1):7–30. https://doi.org/10.3322/caac.21442
doi: 10.3322/caac.21442 pubmed: 29313949 pmcid: 29313949
Lamplot JD, Denduluri S, Qin J, Li R, Liu X, Zhang H, Chen X, Wang N, Pratt A, Shui W, Luo X, Nan G, Deng ZL, Luo J, Haydon RC, He TC, Luu HH (2013) The current and future therapies for human osteosarcoma. Curr Cancer Ther Rev 9(1):55–77. https://doi.org/10.2174/1573394711309010006
doi: 10.2174/1573394711309010006 pubmed: 26834515 pmcid: 4730918
Isakoff MS, Bielack SS, Meltzer P, Gorlick R (2015) Osteosarcoma: current treatment and a collaborative pathway to success. J Clin Oncol 33(27):3029–3035. https://doi.org/10.1200/JCO.2014.59.4895
doi: 10.1200/JCO.2014.59.4895 pubmed: 26304877 pmcid: 4979196
Gorlick R, Janeway K, Lessnick S, Randall RL, Marina N (2013) Children’s Oncology Group’s 2013 blueprint for research: bone tumors. Pediatr Blood Cancer 60(6):1009–1015. https://doi.org/10.1002/pbc.24429
doi: 10.1002/pbc.24429 pubmed: 23255238
Meyers PA, Schwartz CL, Krailo MD, Healey JH, Bernstein ML, Betcher D, Ferguson WS, Gebhardt MC, Goorin AM, Harris M, Kleinerman E, Link MP, Nadel H, Nieder M, Siegal GP, Weiner MA, Wells RJ, Womer RB, Grier HE (2008) Osteosarcoma: the addition of muramyl tripeptide to chemotherapy improves overall survival—a report from the Children’s Oncology Group. J Clin Oncol 26(4):633–638. https://doi.org/10.1200/JCO.2008.14.0095
doi: 10.1200/JCO.2008.14.0095 pubmed: 18235123
Bishop MW, Janeway KA, Gorlick R (2016) Future directions in the treatment of osteosarcoma. Curr Opin Pediatr 28(1):26–33. https://doi.org/10.1097/MOP.0000000000000298
doi: 10.1097/MOP.0000000000000298 pubmed: 26626558 pmcid: 4761449
Dean M, Rzhetsky A, Allikmets R (2001) The human ATP-binding cassette (ABC) transporter superfamily. Genome Res 11(7):1156–1166. https://doi.org/10.1101/gr.184901
doi: 10.1101/gr.184901 pubmed: 11435397
Gottesman MM, Fojo T, Bates SE (2002) Multidrug resistance in cancer: role of ATP-dependent transporters. Nat Rev Cancer 2(1):48–58. https://doi.org/10.1038/nrc706
doi: 10.1038/nrc706 pubmed: 11902585
Wu H, Hait WN, Yang JM (2003) Small interfering RNA-induced suppression of MDR1 (P-glycoprotein) restores sensitivity to multidrug-resistant cancer cells. Cancer Res 63(7):1515–1519
pubmed: 12670898
Nieth C, Priebsch A, Stege A, Lage H (2003) Modulation of the classical multidrug resistance (MDR) phenotype by RNA interference (RNAi). FEBS Lett 545(2–3):144–150
doi: 10.1016/S0014-5793(03)00523-4
Yague E, Higgins CF, Raguz S (2004) Complete reversal of multidrug resistance by stable expression of small interfering RNAs targeting MDR1. Gene Ther 11(14):1170–1174. https://doi.org/10.1038/sj.gt.3302269
doi: 10.1038/sj.gt.3302269 pubmed: 15164094
Pichler A, Zelcer N, Prior JL, Kuil AJ, Piwnica-Worms D (2005) In vivo RNA interference-mediated ablation of MDR1 P-glycoprotein. Clin Cancer Res 11(12):4487–4494. https://doi.org/10.1158/1078-0432.CCR-05-0038
doi: 10.1158/1078-0432.CCR-05-0038 pubmed: 15958634
Serra M, Pasello M, Manara MC, Scotlandi K, Ferrari S, Bertoni F, Mercuri M, Alvegard TA, Picci P, Bacci G, Smeland S (2006) May P-glycoprotein status be used to stratify high-grade osteosarcoma patients? Results from the Italian/Scandinavian Sarcoma Group 1 treatment protocol. Int J Oncol 29(6):1459–1468
pubmed: 17088985
Russell SJ, Peng KW, Bell JC (2012) Oncolytic virotherapy. Nat Biotechnol 30(7):658–670. https://doi.org/10.1038/nbt.2287
doi: 10.1038/nbt.2287 pubmed: 22781695 pmcid: 3888062
Fujiwara T, Shirakawa Y, Kagawa S (2011) Telomerase-specific oncolytic virotherapy for human gastrointestinal cancer. Expert Rev Anticancer Ther 11(4):525–532. https://doi.org/10.1586/era.10.200
doi: 10.1586/era.10.200 pubmed: 21504319
Kawashima T, Kagawa S, Kobayashi N, Shirakiya Y, Umeoka T, Teraishi F, Taki M, Kyo S, Tanaka N, Fujiwara T (2004) Telomerase-specific replication-selective virotherapy for human cancer. Clin Cancer Res 10(1 Pt 1):285–292
doi: 10.1158/1078-0432.CCR-1075-3
Hashimoto Y, Watanabe Y, Shirakiya Y, Uno F, Kagawa S, Kawamura H, Nagai K, Tanaka N, Kumon H, Urata Y, Fujiwara T (2008) Establishment of biological and pharmacokinetic assays of telomerase-specific replication-selective adenovirus. Cancer Sci 99(2):385–390. https://doi.org/10.1111/j.1349-7006.2007.00665.x
doi: 10.1111/j.1349-7006.2007.00665.x pubmed: 18201270
Nemunaitis J, Tong AW, Nemunaitis M, Senzer N, Phadke AP, Bedell C, Adams N, Zhang YA, Maples PB, Chen S, Pappen B, Burke J, Ichimaru D, Urata Y, Fujiwara T (2010) A phase I study of telomerase-specific replication competent oncolytic adenovirus (telomelysin) for various solid tumors. Mol Ther 18(2):429–434. https://doi.org/10.1038/mt.2009.262
doi: 10.1038/mt.2009.262 pubmed: 19935775
Sasaki T, Tazawa H, Hasei J, Kunisada T, Yoshida A, Hashimoto Y, Yano S, Yoshida R, Uno F, Kagawa S, Morimoto Y, Urata Y, Ozaki T, Fujiwara T (2011) Preclinical evaluation of telomerase-specific oncolytic virotherapy for human bone and soft tissue sarcomas. Clin Cancer Res 17(7):1828–1838. https://doi.org/10.1158/1078-0432.CCR-10-2066
doi: 10.1158/1078-0432.CCR-10-2066 pubmed: 21325287
Osaki S, Tazawa H, Hasei J, Yamakawa Y, Omori T, Sugiu K, Komatsubara T, Fujiwara T, Sasaki T, Kunisada T, Yoshida A, Urata Y, Kagawa S, Ozaki T, Fujiwara T (2016) Ablation of MCL1 expression by virally induced microRNA-29 reverses chemoresistance in human osteosarcomas. Sci Rep 6:28953. https://doi.org/10.1038/srep28953
doi: 10.1038/srep28953 pubmed: 27356624 pmcid: 4928055
Yamasaki Y, Tazawa H, Hashimoto Y, Kojima T, Kuroda S, Yano S, Yoshida R, Uno F, Mizuguchi H, Ohtsuru A, Urata Y, Kagawa S, Fujiwara T (2012) A novel apoptotic mechanism of genetically engineered adenovirus-mediated tumour-specific p53 overexpression through E1A-dependent p21 and MDM2 suppression. Eur J Cancer 48(14):2282–2291. https://doi.org/10.1016/j.ejca.2011.12.020
doi: 10.1016/j.ejca.2011.12.020 pubmed: 22244827
Hasei J, Sasaki T, Tazawa H, Osaki S, Yamakawa Y, Kunisada T, Yoshida A, Hashimoto Y, Onishi T, Uno F, Kagawa S, Urata Y, Ozaki T, Fujiwara T (2013) Dual programmed cell death pathways induced by p53 transactivation overcome resistance to oncolytic adenovirus in human osteosarcoma cells. Mol Cancer Ther 12(3):314–325. https://doi.org/10.1158/1535-7163.MCT-12-0869
doi: 10.1158/1535-7163.MCT-12-0869 pubmed: 23315976
Serra M, Scotlandi K, Manara MC, Maurici D, Lollini PL, De Giovanni C, Toffoli G, Baldini N (1993) Establishment and characterization of multidrug-resistant human osteosarcoma cell lines. Anticancer Res 13(2):323–329
pubmed: 8100126
Cox J, Mann M (2008) MaxQuant enables high peptide identification rates, individualized ppb-range mass accuracies and proteome-wide protein quantification. Nat Biotechnol 26(12):1367–1372. https://doi.org/10.1038/nbt.1511
doi: 10.1038/nbt.1511 pubmed: 19029910 pmcid: 19029910
Fujiwara T, Kagawa S, Tazawa H (2012) Synergistic interaction of telomerase-specific oncolytic virotherapy and chemotherapeutic agents for human cancer. Curr Pharm Biotechnol 13(9):1809–1816
doi: 10.2174/138920112800958887
Serra M, Scotlandi K, Manara MC, Maurici D, Benini S, Sarti M, Campanacci M, Baldini N (1995) Analysis of P-glycoprotein expression in osteosarcoma. Eur J Cancer 31A(12):1998–2002
doi: 10.1016/0959-8049(95)00335-5
Baldini N, Scotlandi K, Barbanti-Brodano G, Manara MC, Maurici D, Bacci G, Bertoni F, Picci P, Sottili S, Campanacci M et al (1995) Expression of P-glycoprotein in high-grade osteosarcomas in relation to clinical outcome. N Engl J Med 333(21):1380–1385. https://doi.org/10.1056/NEJM199511233332103
doi: 10.1056/NEJM199511233332103 pubmed: 7477118
Chen KG, Wang YC, Schaner ME, Francisco B, Duran GE, Juric D, Huff LM, Padilla-Nash H, Ried T, Fojo T, Sikic BI (2005) Genetic and epigenetic modeling of the origins of multidrug-resistant cells in a human sarcoma cell line. Cancer Res 65(20):9388–9397. https://doi.org/10.1158/0008-5472.CAN-04-4133
doi: 10.1158/0008-5472.CAN-04-4133 pubmed: 16230402
Liu T, Li Z, Zhang Q, De Amorim BK, Lozano-Calderon S, Choy E, Hornicek FJ, Duan Z (2016) Targeting ABCB1 (MDR1) in multi-drug resistant osteosarcoma cells using the CRISPR-Cas9 system to reverse drug resistance. Oncotarget 7(50):83502–83513. https://doi.org/10.18632/oncotarget.13148
doi: 10.18632/oncotarget.13148 pubmed: 27835872 pmcid: 5347784
Robey RW, Pluchino KM, Hall MD, Fojo AT, Bates SE, Gottesman MM (2018) Revisiting the role of ABC transporters in multidrug-resistant cancer. Nat Rev Cancer 18(7):452–464. https://doi.org/10.1038/s41568-018-0005-8
doi: 10.1038/s41568-018-0005-8 pubmed: 29643473 pmcid: 29643473
Chang YW, Hung MC, Su JL (2014) The anti-tumor activity of E1A and its implications in cancer therapy. Arch Immunol Ther Exp 62(3):195–204. https://doi.org/10.1007/s00005-014-0273-2
doi: 10.1007/s00005-014-0273-2
Mantwill K, Kohler-Vargas N, Bernshausen A, Bieler A, Lage H, Kaszubiak A, Surowiak P, Dravits T, Treiber U, Hartung R, Gansbacher B, Holm PS (2006) Inhibition of the multidrug-resistant phenotype by targeting YB-1 with a conditionally oncolytic adenovirus: implications for combinatorial treatment regimen with chemotherapeutic agents. Can Res 66(14):7195–7202. https://doi.org/10.1158/0008-5472.can-05-2339
doi: 10.1158/0008-5472.can-05-2339
Klein SR, Piya S, Lu Z, Xia Y, Alonso MM, White EJ, Wei J, Gomez-Manzano C, Jiang H, Fueyo J (2015) C-Jun N-terminal kinases are required for oncolytic adenovirus-mediated autophagy. Oncogene 34(41):5295–5301. https://doi.org/10.1038/onc.2014.452
doi: 10.1038/onc.2014.452 pubmed: 25619840 pmcid: 4515398
Zhou J, Liu M, Aneja R, Chandra R, Lage H, Joshi HC (2006) Reversal of P-glycoprotein-mediated multidrug resistance in cancer cells by the c-Jun NH2-terminal kinase. Cancer Res 66(1):445–452. https://doi.org/10.1158/0008-5472.CAN-05-1779
doi: 10.1158/0008-5472.CAN-05-1779 pubmed: 16397260
Chaudhary PM, Roninson IB (1991) Expression and activity of P-glycoprotein, a multidrug efflux pump, in human hematopoietic stem cells. Cell 66(1):85–94
doi: 10.1016/0092-8674(91)90141-K
Bossennec M, Di Roio A, Caux C, Menetrier-Caux C (2018) MDR1 in immunity: friend or foe? Oncoimmunology 7(12):e1499388. https://doi.org/10.1080/2162402X.2018.1499388
doi: 10.1080/2162402X.2018.1499388 pubmed: 30524890 pmcid: 6279327
Pendse SS, Behjati S, Schatton T, Izawa A, Sayegh MH, Frank MH (2006) P-glycoprotein functions as a differentiation switch in antigen presenting cell maturation. Am J Transpl Off J Am Soc Transpl Am Soc Transpl Surg 6(12):2884–2893. https://doi.org/10.1111/j.1600-6143.2006.01561.x
doi: 10.1111/j.1600-6143.2006.01561.x
Ludescher C, Pall G, Irschick EU, Gastl G (1998) Differential activity of P-glycoprotein in normal blood lymphocyte subsets. Br J Haematol 101(4):722–727
doi: 10.1046/j.1365-2141.1998.00751.x
Gupta S, Kim CH, Tsuruo T, Gollapudi S (1992) Preferential expression and activity of multidrug resistance gene 1 product (P-glycoprotein), a functionally active efflux pump, in human CD8+ T cells: a role in cytotoxic effector function. J Clin Immunol 12(6):451–458
doi: 10.1007/BF00918857
Chiocca EA, Rabkin SD (2014) Oncolytic viruses and their application to cancer immunotherapy. Cancer Immunol Res 2(4):295–300. https://doi.org/10.1158/2326-6066.CIR-14-0015
doi: 10.1158/2326-6066.CIR-14-0015 pubmed: 24764576 pmcid: 4303349
Tazawa H, Kuroda S, Hasei J, Kagawa S, Fujiwara T (2017) Impact of autophagy in oncolytic adenoviral therapy for cancer. Int J Mol Sci. https://doi.org/10.3390/ijms18071479
doi: 10.3390/ijms18071479 pubmed: 28698504 pmcid: 5535969
Yang F, Teves SS, Kemp CJ, Henikoff S (2014) Doxorubicin, DNA torsion, and chromatin dynamics. Biochim Biophys Acta 1845 1:84–89. https://doi.org/10.1016/j.bbcan.2013.12.002
doi: 10.1016/j.bbcan.2013.12.002
Seidman MA, Hogan SM, Wendland RL, Worgall S, Crystal RG, Leopold PL (2001) Variation in adenovirus receptor expression and adenovirus vector-mediated transgene expression at defined stages of the cell cycle. Mol Ther 4(1):13–21. https://doi.org/10.1006/mthe.2001.0414
doi: 10.1006/mthe.2001.0414 pubmed: 11472101
Martins-Neves SR, Paiva-Oliveira DI, Wijers-Koster PM, Abrunhosa AJ, Fontes-Ribeiro C, Bovee JV, Cleton-Jansen AM, Gomes CM (2016) Chemotherapy induces stemness in osteosarcoma cells through activation of Wnt/beta-catenin signaling. Cancer Lett 370(2):286–295. https://doi.org/10.1016/j.canlet.2015.11.013
doi: 10.1016/j.canlet.2015.11.013 pubmed: 26577806
Yano S, Tazawa H, Hashimoto Y, Shirakawa Y, Kuroda S, Nishizaki M, Kishimoto H, Uno F, Nagasaka T, Urata Y, Kagawa S, Hoffman RM, Fujiwara T (2013) A genetically engineered oncolytic adenovirus decoys and lethally traps quiescent cancer stem-like cells in S/G2/M phases. Clin Cancer Res 19(23):6495–6505. https://doi.org/10.1158/1078-0432.CCR-13-0742
doi: 10.1158/1078-0432.CCR-13-0742 pubmed: 24081978

Auteurs

Kazuhisa Sugiu (K)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Hiroshi Tazawa (H)

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan. htazawa@md.okayama-u.ac.jp.
Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan. htazawa@md.okayama-u.ac.jp.

Joe Hasei (J)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Yasuaki Yamakawa (Y)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Toshinori Omori (T)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Tadashi Komatsubara (T)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Yusuke Mochizuki (Y)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Hiroya Kondo (H)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Shuhei Osaki (S)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Tomohiro Fujiwara (T)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Aki Yoshida (A)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Toshiyuki Kunisada (T)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.
Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Koji Ueda (K)

Project for Personalized Cancer Medicine, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan.

Yasuo Urata (Y)

Oncolys BioPharma, Inc., Tokyo, 105-0001, Japan.

Shunsuke Kagawa (S)

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.
Minimally Invasive Therapy Center, Okayama University Hospital, Okayama, 700-8558, Japan.

Toshifumi Ozaki (T)

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Toshiyoshi Fujiwara (T)

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

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