NRF2 signaling pathway and telomere length in aging and age-related diseases.

Aging NRF2 Oxidative stress Telomere length

Journal

Molecular and cellular biochemistry
ISSN: 1573-4919
Titre abrégé: Mol Cell Biochem
Pays: Netherlands
ID NLM: 0364456

Informations de publication

Date de publication:
02 Nov 2023
Historique:
received: 19 08 2023
accepted: 07 10 2023
medline: 2 11 2023
pubmed: 2 11 2023
entrez: 2 11 2023
Statut: aheadofprint

Résumé

The transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) is well recognized as a critical regulator of redox, metabolic, and protein homeostasis, as well as the regulation of inflammation. An age-associated decline in NRF2 activity may allow oxidative stress to remain unmitigated and affect key features associated with the aging phenotype, including telomere shortening. Telomeres, the protective caps of eukaryotic chromosomes, are highly susceptible to oxidative DNA damage, which can accelerate telomere shortening and, consequently, lead to premature senescence and genomic instability. In this review, we explore how the dysregulation of NRF2, coupled with an increase in oxidative stress, might be a major determinant of telomere shortening and age-related diseases. We discuss the relevance of the connection between NRF2 deficiency in aging and telomere attrition, emphasizing the importance of studying this functional link to enhance our understanding of aging pathologies. Finally, we present a number of compounds that possess the ability to restore NRF2 function, maintain a proper redox balance, and preserve telomere length during aging.

Identifiants

pubmed: 37917279
doi: 10.1007/s11010-023-04878-x
pii: 10.1007/s11010-023-04878-x
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s).

Références

López-Otín C, Blasco MA, Partridge L et al (2023) Hallmarks of aging: an expanding universe. Cell 186:243–278. https://doi.org/10.1016/J.CELL.2022.11.001
doi: 10.1016/J.CELL.2022.11.001 pubmed: 36599349
Richardson AG, Schadt EE (2014) The role of macromolecular damage in aging and age-related disease. J Gerontol A 69(Suppl 1):S28–S32. https://doi.org/10.1093/GERONA/GLU056
doi: 10.1093/GERONA/GLU056
Ferrucci L, Gonzalez-Freire M, Fabbri E et al (2020) Measuring biological aging in humans: a quest. Aging Cell. https://doi.org/10.1111/ACEL.13080
doi: 10.1111/ACEL.13080 pubmed: 32930491 pmcid: 7576259
Guo J, Huang X, Dou L et al (2022) Aging and aging-related diseases: from molecular mechanisms to interventions and treatments. Signal Transduct Target Ther. https://doi.org/10.1038/S41392-022-01251-0
doi: 10.1038/S41392-022-01251-0 pubmed: 36581622 pmcid: 9755275
Anik MI, Mahmud N, Al MA et al (2022) Role of reactive oxygen species in aging and age-related diseases: a review. ACS Appl Bio Mater. https://doi.org/10.1021/ACSABM.2C00411
doi: 10.1021/ACSABM.2C00411 pubmed: 36043942
Stefanatos R, Sanz A (2018) The role of mitochondrial ROS in the aging brain. FEBS Lett 592:743–758. https://doi.org/10.1002/1873-3468.12902
doi: 10.1002/1873-3468.12902 pubmed: 29106705
Wang L, Lu Z, Zhao J et al (2021) Selective oxidative stress induces dual damage to telomeres and mitochondria in human T cells. Aging Cell. https://doi.org/10.1111/ACEL.13513
doi: 10.1111/ACEL.13513 pubmed: 34953016 pmcid: 8761019
Lee J, Li J, Johnson DA et al (2005) Nrf2, a multi-organ protector? FASEB J 19:1061–1066. https://doi.org/10.1096/FJ.04-2591HYP
doi: 10.1096/FJ.04-2591HYP pubmed: 15985529
Malhotra D, Portales-Casamar E, Singh A et al (2010) Global mapping of binding sites for Nrf2 identifies novel targets in cell survival response through chip-seq profiling and network analysis. Nucleic Acids Res 38:5718–5734. https://doi.org/10.1093/nar/gkq212
doi: 10.1093/nar/gkq212 pubmed: 20460467 pmcid: 2943601
Davinelli S, Willcox DC, Scapagnini G (2012) Extending healthy ageing: nutrient sensitive pathway and centenarian population. Immun Ageing. https://doi.org/10.1186/1742-4933-9-9
doi: 10.1186/1742-4933-9-9 pubmed: 22524452 pmcid: 3379947
Lewis KN, Wason E, Edrey YH et al (2015) Regulation of Nrf2 signaling and longevity in naturally long-lived rodents. Proc Natl Acad Sci USA 112:3722–3727. https://doi.org/10.1073/PNAS.1417566112
doi: 10.1073/PNAS.1417566112 pubmed: 25775529 pmcid: 4378420
Gureev AP, Shaforostova EA, Popov VN (2019) Regulation of mitochondrial biogenesis as a way for active longevity: interaction between the Nrf2 and PGC-1α signaling pathways. Front Genet. https://doi.org/10.3389/FGENE.2019.00435/PDF
doi: 10.3389/FGENE.2019.00435/PDF pubmed: 31139208 pmcid: 6527603
Schmidlin CJ, Dodson MB, Madhavan L, Zhang DD (2019) Redox regulation by NRF2 in aging and disease. Free Radic Biol Med 134:702–707. https://doi.org/10.1016/j.freeradbiomed.2019.01.016
doi: 10.1016/j.freeradbiomed.2019.01.016 pubmed: 30654017 pmcid: 6588470
Davinelli S, Medoro A, Intrieri M et al (2022) Targeting NRF2-KEAP1 axis by omega-3 fatty acids and their derivatives: emerging opportunities against aging and diseases. Free Radic Biol Med 193:736–750. https://doi.org/10.1016/J.FREERADBIOMED.2022.11.017
doi: 10.1016/J.FREERADBIOMED.2022.11.017 pubmed: 36402440
Fasching CL (2018) Telomere length measurement as a clinical biomarker of aging and disease. Crit Rev Clin Lab Sci 55:443–465. https://doi.org/10.1080/10408363.2018.1504274
doi: 10.1080/10408363.2018.1504274 pubmed: 30265166
Vaiserman A, Krasnienkov D (2021) Telomere length as a marker of biological age: state-of-the-art, open issues, and future perspectives. Front Genet. https://doi.org/10.3389/FGENE.2020.630186/PDF
doi: 10.3389/FGENE.2020.630186/PDF pubmed: 33552142 pmcid: 7859450
Allsopp RC, Vaziri H, Patterson C et al (1992) Telomere length predicts replicative capacity of human fibroblasts. Proc Natl Acad Sci USA 89:10114–10118. https://doi.org/10.1073/pnas.89.21.10114
doi: 10.1073/pnas.89.21.10114 pubmed: 1438199 pmcid: 50288
Jacome Burbano MS, Cherfils‐Vicini J, Gilson E (2021) Neutrophils: mediating TelOxidation and senescence. EMBO J. https://doi.org/10.15252/EMBJ.2021108164
Chakravarti D, LaBella KA, DePinho RA (2021) Telomeres: history, health, and hallmarks of aging. Cell 184:306–322
doi: 10.1016/j.cell.2020.12.028 pubmed: 33450206 pmcid: 8081271
Wang Z, Xiaoying WU (2021) Abnormal function of telomere protein TRF2 induces cell mutation and the effects of environmental tumor-promoting factors (review). Oncol Rep. https://doi.org/10.3892/OR.2021.8135/DOWNLOAD
doi: 10.3892/OR.2021.8135/DOWNLOAD pubmed: 34958110 pmcid: 8674705
Maher J, Yamamoto M (2010) The rise of antioxidant signaling—the evolution and hormetic actions of Nrf2. Toxicol Appl Pharmacol 244:4–15. https://doi.org/10.1016/J.TAAP.2010.01.011
doi: 10.1016/J.TAAP.2010.01.011 pubmed: 20122947
Francisqueti-Ferron FV, Ferron AJT, Garcia JL et al (2019) Basic concepts on the role of nuclear factor erythroid-derived 2-like 2 (Nrf2) in age-related diseases. Int J Mol Sci. https://doi.org/10.3390/IJMS20133208
doi: 10.3390/IJMS20133208 pubmed: 31261912 pmcid: 6651020
Plafker KS, Nguyen L, Barneche M et al (2010) The ubiquitin-conjugating enzyme UbcM2 can regulate the stability and activity of the antioxidant transcription factor Nrf2. J Biol Chem 285:23064–23074. https://doi.org/10.1074/JBC.M110.121913
doi: 10.1074/JBC.M110.121913 pubmed: 20484052 pmcid: 2906300
Tonelli C, Chio IIC, Tuveson DA (2018) Transcriptional regulation by Nrf2. Antioxid Redox Signal 29:1727–1745. https://doi.org/10.1089/ARS.2017.7342
doi: 10.1089/ARS.2017.7342 pubmed: 28899199 pmcid: 6208165
Silva-Islas CA, Maldonado PD (2018) Canonical and non-canonical mechanisms of Nrf2 activation. Pharmacol Res 134:92–99. https://doi.org/10.1016/J.PHRS.2018.06.013
doi: 10.1016/J.PHRS.2018.06.013 pubmed: 29913224
Mou Y, Wen S, Li YX et al (2020) Recent progress in Keap1-Nrf2 protein–protein interaction inhibitors. Eur J Med Chem. https://doi.org/10.1016/J.EJMECH.2020.112532
doi: 10.1016/J.EJMECH.2020.112532 pubmed: 33383257 pmcid: 8325387
Wu KC, Cui JY, Klaassen CD (2011) Beneficial role of Nrf2 in regulating NADPH generation and consumption. Toxicol Sci 123:590–600. https://doi.org/10.1093/TOXSCI/KFR183
doi: 10.1093/TOXSCI/KFR183 pubmed: 21775727 pmcid: 3179677
Kovac S, Angelova PR, Holmström KM et al (2015) Nrf2 regulates ROS production by mitochondria and NADPH oxidase. Biochim Biophys Acta 1850:794–801. https://doi.org/10.1016/J.BBAGEN.2014.11.021
doi: 10.1016/J.BBAGEN.2014.11.021 pubmed: 25484314 pmcid: 4471129
Harvey CJ, Thimmulappa RK, Singh A et al (2009) Nrf2-regulated glutathione recycling independent of biosynthesis is critical for cell survival during oxidative stress. Free Radic Biol Med 46:443–453. https://doi.org/10.1016/J.FREERADBIOMED.2008.10.040
doi: 10.1016/J.FREERADBIOMED.2008.10.040 pubmed: 19028565
Suh JH, Shenvi SV, Dixon BM et al (2004) Decline in transcriptional activity of Nrf2 causes age-related loss of glutathione synthesis, which is reversible with lipoic acid. Proc Natl Acad Sci USA 101:3381–3386. https://doi.org/10.1073/PNAS.0400282101
doi: 10.1073/PNAS.0400282101 pubmed: 14985508 pmcid: 373470
Chen K, Wang S, Sun QW et al (2021) Klotho deficiency causes heart aging via impairing the Nrf2-GR pathway. Circ Res 128:492–507. https://doi.org/10.1161/CIRCRESAHA.120.317348
doi: 10.1161/CIRCRESAHA.120.317348 pubmed: 33334122
Yu C, Xiao JH (2021) The Keap1-Nrf2 system: a mediator between oxidative stress and aging. Oxid Med Cell Longev. https://doi.org/10.1155/2021/6635460
doi: 10.1155/2021/6635460 pubmed: 36226158 pmcid: 8741352
Zhang H, Davies KJA, Forman HJ (2015) Oxidative stress response and Nrf2 signaling in aging. Free Radic Biol Med 88:314–336. https://doi.org/10.1016/J.FREERADBIOMED.2015.05.036
doi: 10.1016/J.FREERADBIOMED.2015.05.036 pubmed: 26066302 pmcid: 4628850
Liu T, Zhang L, Joo D, Sun SC (2017) NF-κB signaling in inflammation. Signal Transduct Target Ther 2:17023
doi: 10.1038/sigtrans.2017.23 pubmed: 29158945 pmcid: 5661633
Sivandzade F, Prasad S, Bhalerao A, Cucullo L (2019) NRF2 and NF-қB interplay in cerebrovascular and neurodegenerative disorders: molecular mechanisms and possible therapeutic approaches. Redox Biol. https://doi.org/10.1016/J.REDOX.2018.11.017
doi: 10.1016/J.REDOX.2018.11.017 pubmed: 30576920
Davinelli S, Saso L, D’angeli F et al (2022) Astaxanthin as a modulator of Nrf2, NF-κB, and their crosstalk: molecular mechanisms and possible clinical applications. Molecules. https://doi.org/10.3390/MOLECULES27020502
doi: 10.3390/MOLECULES27020502 pubmed: 35056816 pmcid: 8779084
Pan H, Wang H, Wang X et al (2012) The absence of Nrf2 enhances NF-κB-dependent inflammation following scratch injury in mouse primary cultured astrocytes. Mediat Inflamm. https://doi.org/10.1155/2012/217580
doi: 10.1155/2012/217580
Ahmed SMU, Luo L, Namani A et al (2017) Nrf2 signaling pathway: pivotal roles in inflammation. Biochim Biophys Acta 1863:585–597
doi: 10.1016/j.bbadis.2016.11.005
Kozakiewicz M, Kornatowski M, Krzywińska O, Kędziora-Kornatowska K (2019) Changes in the blood antioxidant defense of advanced age people. Clin Interv Aging 14:763–771. https://doi.org/10.2147/CIA.S201250
doi: 10.2147/CIA.S201250 pubmed: 31118597 pmcid: 6507109
Pajares M, Rojo AI, Arias E et al (2018) Transcription factor NFE2L2/NRF2 modulates chaperone-mediated autophagy through the regulation of LAMP2A. Autophagy 14:1310–1322. https://doi.org/10.1080/15548627.2018.1474992
doi: 10.1080/15548627.2018.1474992 pubmed: 29950142 pmcid: 6103698
Pajares M, Jiménez-Moreno N, García-Yagüe ÁJ et al (2016) Transcription factor NFE2L2/NRF2 is a regulator of macroautophagy genes. Autophagy 12:1902–1916. https://doi.org/10.1080/15548627.2016.1208889
doi: 10.1080/15548627.2016.1208889 pubmed: 27427974 pmcid: 5079676
Cullinan SB, Zhang D, Hannink M et al (2003) Nrf2 is a direct PERK substrate and effector of PERK-dependent cell survival. Mol Cell Biol 23:7198–7209. https://doi.org/10.1128/MCB.23.20.7198-7209.2003
doi: 10.1128/MCB.23.20.7198-7209.2003 pubmed: 14517290 pmcid: 230321
Jayakumar S, Pal D, Sandur SK (2015) Nrf2 facilitates repair of radiation induced DNA damage through homologous recombination repair pathway in a ROS independent manner in cancer cells. Mutat Res 779:33–45. https://doi.org/10.1016/J.MRFMMM.2015.06.007
doi: 10.1016/J.MRFMMM.2015.06.007 pubmed: 26133502
Kim SB, Pandita RK, Eskiocak U et al (2012) Targeting of Nrf2 induces DNA damage signaling and protects colonic epithelial cells from ionizing radiation. Proc Natl Acad Sci USA. https://doi.org/10.1073/PNAS.1207718109/-/DCSUPPLEMENTAL/PNAS.201207718SI.PDF
doi: 10.1073/PNAS.1207718109/-/DCSUPPLEMENTAL/PNAS.201207718SI.PDF pubmed: 23269841 pmcid: 3545821
Dinkova-Kostova AT, Abramov AY (2015) The emerging role of Nrf2 in mitochondrial function. Free Radic Biol Med 88:179–188. https://doi.org/10.1016/J.FREERADBIOMED.2015.04.036
doi: 10.1016/J.FREERADBIOMED.2015.04.036 pubmed: 25975984 pmcid: 4726722
Yuan H, Xu Y, Luo Y et al (2021) Role of Nrf2 in cell senescence regulation. Mol Cell Biochem 476:247–259. https://doi.org/10.1007/S11010-020-03901-9
doi: 10.1007/S11010-020-03901-9 pubmed: 32918185
Joo MS, Kim WD, Lee KY et al (2016) AMPK facilitates nuclear accumulation of Nrf2 by phosphorylating at serine 550. Mol Cell Biol 36:1931–1942. https://doi.org/10.1128/MCB.00118-16
doi: 10.1128/MCB.00118-16 pubmed: 27161318 pmcid: 4936058
Sultana R, Perluigi M, Butterfield DA (2006) Protein oxidation and lipid peroxidation in brain of subjects with Alzheimer’s disease: insights into mechanism of neurodegeneration from redox proteomics. Antioxid Redox Signal 8:2021–2037. https://doi.org/10.1089/ARS.2006.8.2021
doi: 10.1089/ARS.2006.8.2021 pubmed: 17034347
Ramsey CP, Glass CA, Montgomery MB et al (2007) Expression of Nrf2 in neurodegenerative diseases. J Neuropathol Exp Neurol 66:75–85. https://doi.org/10.1097/NEN.0B013E31802D6DA9
doi: 10.1097/NEN.0B013E31802D6DA9 pubmed: 17204939
Rojo AI, Pajares M, García-Yagüe AJ et al (2018) Deficiency in the transcription factor NRF2 worsens inflammatory parameters in a mouse model with combined tauopathy and amyloidopathy. Redox Biol 18:173–180. https://doi.org/10.1016/J.REDOX.2018.07.006
doi: 10.1016/J.REDOX.2018.07.006 pubmed: 30029164 pmcid: 6052199
Jo C, Gundemir S, Pritchard S et al (2014) Nrf2 reduces levels of phosphorylated tau protein by inducing autophagy adaptor protein NDP52. Nat Commun. https://doi.org/10.1038/NCOMMS4496
doi: 10.1038/NCOMMS4496 pubmed: 25406935
Gureev AP, Popov VN (2019) Nrf2/ARE pathway as a therapeutic target for the treatment of Parkinson diseases. Neurochem Res 44:2273–2279. https://doi.org/10.1007/S11064-018-02711-2
doi: 10.1007/S11064-018-02711-2 pubmed: 30617864
Lastres-Becker I, García-Yagüe AJ, Scannevin RH et al (2016) Repurposing the NRF2 activator dimethyl fumarate as therapy against synucleinopathy in Parkinson’s disease. Antioxid Redox Signal 25:61–77. https://doi.org/10.1089/ARS.2015.6549
doi: 10.1089/ARS.2015.6549 pubmed: 27009601 pmcid: 4943471
Wu S, Lu H, Bai Y (2019) Nrf2 in cancers: a double-edged sword. Cancer Med 8:2252–2267. https://doi.org/10.1002/CAM4.2101
doi: 10.1002/CAM4.2101 pubmed: 30929309 pmcid: 6536957
Rojo de la Vega M, Chapman E, Zhang DD (2018) NRF2 and the hallmarks of cancer. Cancer Cell 34:21–43. https://doi.org/10.1016/J.CCELL.2018.03.022
doi: 10.1016/J.CCELL.2018.03.022 pubmed: 29731393
Schmidlin CJ, Shakya A, Dodson M et al (2021) The intricacies of NRF2 regulation in cancer. Semin Cancer Biol 76:110–119. https://doi.org/10.1016/J.SEMCANCER.2021.05.016
doi: 10.1016/J.SEMCANCER.2021.05.016 pubmed: 34020028 pmcid: 8599504
Ali S, Corbi G, Medoro A et al (2023) Relationship between monounsaturated fatty acids and sarcopenia: a systematic review and meta-analysis of observational studies. Aging Clin Exp Res 35:1823–1834. https://doi.org/10.1007/S40520-023-02465-0
doi: 10.1007/S40520-023-02465-0 pubmed: 37340168 pmcid: 10460305
Wiedmer P, Jung T, Castro JP et al (2021) Sarcopenia—molecular mechanisms and open questions. Ageing Res Rev. https://doi.org/10.1016/J.ARR.2020.101200
doi: 10.1016/J.ARR.2020.101200 pubmed: 33130247
Huang DD, Fan SD, Chen XY et al (2019) Nrf2 deficiency exacerbates frailty and sarcopenia by impairing skeletal muscle mitochondrial biogenesis and dynamics in an age-dependent manner. Exp Gerontol 119:61–73. https://doi.org/10.1016/J.EXGER.2019.01.022
doi: 10.1016/J.EXGER.2019.01.022 pubmed: 30690066
Miller CJ, Gounder SS, Kannan S et al (2012) Disruption of Nrf2/ARE signaling impairs antioxidant mechanisms and promotes cell degradation pathways in aged skeletal muscle. Biochim Biophys Acta 1822:1038–1050. https://doi.org/10.1016/J.BBADIS.2012.02.007
doi: 10.1016/J.BBADIS.2012.02.007 pubmed: 22366763
Kloska D, Kopacz A, Piechota-Polanczyk A et al (2019) Nrf2 in aging—focus on the cardiovascular system. Vasc Pharmacol 112:42–53. https://doi.org/10.1016/J.VPH.2018.08.009
doi: 10.1016/J.VPH.2018.08.009
D’Adda Di Fagagna F, Teo SH, Jackson SP (2004) Functional links between telomeres and proteins of the DNA-damage response. Genes Dev 18:1781–1799. https://doi.org/10.1101/GAD.1214504
doi: 10.1101/GAD.1214504 pubmed: 15289453
De Lange T (2018) Shelterin-mediated telomere protection. Annu Rev Genet 52:223–247. https://doi.org/10.1146/ANNUREV-GENET-032918-021921
doi: 10.1146/ANNUREV-GENET-032918-021921 pubmed: 30208292
Maciejowski J, De Lange T (2017) Telomeres in cancer: tumour suppression and genome instability. Nat Rev Mol Cell Biol 18:175–186. https://doi.org/10.1038/NRM.2016.171
doi: 10.1038/NRM.2016.171 pubmed: 28096526 pmcid: 5589191
Gala K, Khattar E (2021) Long non-coding RNAs at work on telomeres: functions and implications in cancer therapy. Cancer Lett 502:120–132. https://doi.org/10.1016/J.CANLET.2020.12.036
doi: 10.1016/J.CANLET.2020.12.036 pubmed: 33450357
Shay JW, Wright WE (2019) Telomeres and telomerase: three decades of progress. Nat Rev Genet 20:299–309. https://doi.org/10.1038/S41576-019-0099-1
doi: 10.1038/S41576-019-0099-1 pubmed: 30760854
Muraki K, Nyhan K, Han L, Murnane JP (2012) Mechanisms of telomere loss and their consequences for chromosome instability. Front Oncol 2:1–13. https://doi.org/10.3389/fonc.2012.00135
doi: 10.3389/fonc.2012.00135
Correia-Melo C, Hewitt G, Passos JF (2014) Telomeres, oxidative stress and inflammatory factors: partners in cellular senescence? Longev Health. https://doi.org/10.1186/2046-2395-3-1
doi: 10.1186/2046-2395-3-1
Sfeir A, Kosiyatrakul ST, Hockemeyer D et al (2009) Mammalian telomeres resemble fragile sites and require TRF1 for efficient replication. Cell 138:90–103. https://doi.org/10.1016/J.CELL.2009.06.021
doi: 10.1016/J.CELL.2009.06.021 pubmed: 19596237 pmcid: 2723738
De Rosa M, Johnson SA, Opresko PL (2021) Roles for the 8-oxoguanine DNA repair system in protecting telomeres from oxidative stress. Front Cell Dev Biol. https://doi.org/10.3389/FCELL.2021.758402/PDF
doi: 10.3389/FCELL.2021.758402/PDF pubmed: 34869357 pmcid: 8640212
Fouquerel E, Barnes RP, Uttam S et al (2019) Targeted and persistent 8-oxoguanine base damage at telomeres promotes telomere loss and crisis. Mol Cell 75:117-130.e6. https://doi.org/10.1016/J.MOLCEL.2019.04.024
doi: 10.1016/J.MOLCEL.2019.04.024 pubmed: 31101499 pmcid: 6625854
Aeby E, Ahmed W, Redon S et al (2016) Peroxiredoxin 1 protects telomeres from oxidative damage and preserves telomeric DNA for extension by telomerase. Cell Rep 17:3107–3114. https://doi.org/10.1016/J.CELREP.2016.11.071
doi: 10.1016/J.CELREP.2016.11.071 pubmed: 28009281
Xu G, Herzig M, Rotrekl V, Walter CA (2008) Base excision repair, aging and health span. Mech Ageing Dev 129:366–382. https://doi.org/10.1016/J.MAD.2008.03.001
doi: 10.1016/J.MAD.2008.03.001 pubmed: 18423806 pmcid: 2526234
Oikawa S, Kawanishi S (1999) Site-specific DNA damage at GGG sequence by oxidative stress may accelerate telomere shortening. FEBS Lett 453:365–368. https://doi.org/10.1016/S0014-5793(99)00748-6
doi: 10.1016/S0014-5793(99)00748-6 pubmed: 10405177
Opresko PL, Fan J, Danzy S et al (2005) Oxidative damage in telomeric DNA disrupts recognition by TRF1 and TRF2. Nucleic Acids Res 33:1230–1239. https://doi.org/10.1093/NAR/GKI273
doi: 10.1093/NAR/GKI273 pubmed: 15731343 pmcid: 549571
Karlseder J, Hoke K, Mirzoeva OK et al (2004) The telomeric protein TRF2 binds the ATM kinase and can inhibit the ATM-dependent DNA damage response. PLoS Biol. https://doi.org/10.1371/JOURNAL.PBIO.0020240
doi: 10.1371/JOURNAL.PBIO.0020240 pubmed: 15314656 pmcid: 509302
Richter T, Saretzki G, Nelson G et al (2007) TRF2 overexpression diminishes repair of telomeric single-strand breaks and accelerates telomere shortening in human fibroblasts. Mech Ageing Dev 128:340–345. https://doi.org/10.1016/J.MAD.2007.02.003
doi: 10.1016/J.MAD.2007.02.003 pubmed: 17395247
Fouquerel E, Lormand J, Bose A et al (2016) Oxidative guanine base damage regulates human telomerase activity. Nat Struct Mol Biol 23:1092–1100. https://doi.org/10.1038/NSMB.3319
doi: 10.1038/NSMB.3319 pubmed: 27820808 pmcid: 5140714
Lee HT, Bose A, Lee CY et al (2017) Molecular mechanisms by which oxidative DNA damage promotes telomerase activity. Nucleic Acids Res 45:11752–11765. https://doi.org/10.1093/NAR/GKX789
doi: 10.1093/NAR/GKX789 pubmed: 28981887 pmcid: 5714237
Barnes RP, Fouquerel E, Opresko PL (2019) The impact of oxidative DNA damage and stress on telomere homeostasis. Mech Ageing Dev 177:37–45. https://doi.org/10.1016/J.MAD.2018.03.013
doi: 10.1016/J.MAD.2018.03.013 pubmed: 29604323
Ahmed W, Lingner J (2018) Impact of oxidative stress on telomere biology. Differentiation 99:21–27. https://doi.org/10.1016/J.DIFF.2017.12.002
doi: 10.1016/J.DIFF.2017.12.002 pubmed: 29274896
Jurk D, Wilson C, Passos JF et al (2014) Chronic inflammation induces telomere dysfunction and accelerates ageing in mice. Nat Commun. https://doi.org/10.1038/NCOMMS5172
doi: 10.1038/NCOMMS5172 pubmed: 25027852
Shivappa N, Wirth MD, Hurley TG, Hébert JR (2017) Association between the dietary inflammatory index (DII) and telomere length and C-reactive protein from the National Health and Nutrition Examination Survey-1999–2002. Mol Nutr Food Res. https://doi.org/10.1002/MNFR.201600630
doi: 10.1002/MNFR.201600630 pubmed: 27981781 pmcid: 5415414
O’Donovan A, Pantell MS, Puterman E et al (2011) Cumulative inflammatory load is associated with short leukocyte telomere length in the Health, Aging and Body Composition Study. PLoS ONE. https://doi.org/10.1371/JOURNAL.PONE.0019687
Amsellem V, Gary-Bobo G, Marcos E et al (2011) Telomere dysfunction causes sustained inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 184:1358–1366. https://doi.org/10.1164/RCCM.201105-0802OC
doi: 10.1164/RCCM.201105-0802OC pubmed: 21885626
Zhang J, Rane G, Dai X et al (2016) Ageing and the telomere connection: an intimate relationship with inflammation. Ageing Res Rev 25:55–69. https://doi.org/10.1016/J.ARR.2015.11.006
doi: 10.1016/J.ARR.2015.11.006 pubmed: 26616852
Cawthon RM, Smith KR, O’Brien E et al (2003) Association between telomere length in blood and mortality in people aged 60 years or older. The Lancet (London, England) 361:393–395. https://doi.org/10.1016/S0140-6736(03)12384-7
doi: 10.1016/S0140-6736(03)12384-7 pubmed: 12573379
Valdes AM, Richards JB, Gardner JP et al (2007) Telomere length in leukocytes correlates with bone mineral density and is shorter in women with osteoporosis. Osteoporos Int 18:1203–1210. https://doi.org/10.1007/S00198-007-0357-5
doi: 10.1007/S00198-007-0357-5 pubmed: 17347788
Xu C, Wang Z, Su X et al (2020) Association between leucocyte telomere length and cardiovascular disease in a large general population in the United States. Sci Rep. https://doi.org/10.1038/S41598-019-57050-1
doi: 10.1038/S41598-019-57050-1 pubmed: 33372185 pmcid: 7769973
Shen G, Huang JY, Huang YQ, Feng YQ (2020) the relationship between telomere length and cancer mortality: data from the 1999–2002 National Healthy and Nutrition Examination Survey (NHANES). J Nutr Health Aging 24:9–15. https://doi.org/10.1007/S12603-019-1265-Z
doi: 10.1007/S12603-019-1265-Z pubmed: 31886802
Forero DA, González-Giraldo Y, López-Quintero C et al (2016) Meta-analysis of telomere length in Alzheimer’s disease. J Gerontol A 71:1069–1073. https://doi.org/10.1093/GERONA/GLW053
doi: 10.1093/GERONA/GLW053
Demanelis K, Jasmine F, Chen LS et al (2020) Determinants of telomere length across human tissues. Science. https://doi.org/10.1126/SCIENCE.AAZ6876
doi: 10.1126/SCIENCE.AAZ6876 pubmed: 32913074 pmcid: 8108546
Yu X, Liu MM, Zheng CY et al (2023) Telomerase reverse transcriptase and neurodegenerative diseases. Front Immunol 14:1165632. https://doi.org/10.3389/FIMMU.2023.1165632/PDF
doi: 10.3389/FIMMU.2023.1165632/PDF pubmed: 37063844 pmcid: 10091515
Spilsbury A, Miwa S, Attems J, Saretzki G (2015) The role of telomerase protein TERT in Alzheimer’s disease and in tau-related pathology in vitro. J Neurosci 35:1659–1674. https://doi.org/10.1523/JNEUROSCI.2925-14.2015
doi: 10.1523/JNEUROSCI.2925-14.2015 pubmed: 25632141 pmcid: 4308607
Tedone E, Arosio B, Colombo F et al (2015) Leukocyte telomere length in Alzheimer’s disease patients with a different rate of progression. J Alzheimers Dis 46:761–769. https://doi.org/10.3233/JAD-142808
doi: 10.3233/JAD-142808 pubmed: 26402514
Panossian LA, Porter VR, Valenzuela HF et al (2003) Telomere shortening in T cells correlates with Alzheimer’s disease status. Neurobiol Aging 24:77–84. https://doi.org/10.1016/S0197-4580(02)00043-X
doi: 10.1016/S0197-4580(02)00043-X pubmed: 12493553
Fordyce CA, Heaphy CM, Bisoffi M et al (2006) Telomere content correlates with stage and prognosis in breast cancer. Breast Cancer Res Treat 99:193–202. https://doi.org/10.1007/S10549-006-9204-1
doi: 10.1007/S10549-006-9204-1 pubmed: 16752076
Heaphy CM, Gaonkar G, Peskoe SB et al (2015) Prostate stromal cell telomere shortening is associated with risk of prostate cancer in the placebo arm of the Prostate Cancer Prevention Trial. Prostate 75:1160–1166. https://doi.org/10.1002/PROS.22997
doi: 10.1002/PROS.22997 pubmed: 25893825 pmcid: 4475463
Jia H, Wang Z (2016) Telomere length as a prognostic factor for overall survival in colorectal cancer patients. Cell Physiol Biochem 38:122–128. https://doi.org/10.1159/000438614
doi: 10.1159/000438614 pubmed: 26741140
Hou L, Joyce BT, Gao T et al (2015) Blood telomere length attrition and cancer development in the normative aging study cohort. EBioMedicine 2:591–596. https://doi.org/10.1016/J.EBIOM.2015.04.008
doi: 10.1016/J.EBIOM.2015.04.008 pubmed: 26288820 pmcid: 4535161
Zhu X, Han W, Xue W et al (2016) The association between telomere length and cancer risk in population studies. Sci Rep. https://doi.org/10.1038/SREP22243
doi: 10.1038/SREP22243 pubmed: 28442790 pmcid: 5180247
Weischer M, Nordestgaard BG, Cawthon RM et al (2013) Short telomere length, cancer survival, and cancer risk in 47102 individuals. J Natl Cancer Inst 105:459–468. https://doi.org/10.1093/JNCI/DJT016
doi: 10.1093/JNCI/DJT016 pubmed: 23468462
Julin B, Shui I, Heaphy CM et al (2015) Circulating leukocyte telomere length and risk of overall and aggressive prostate cancer. Br J Cancer 112:769–776. https://doi.org/10.1038/BJC.2014.640
doi: 10.1038/BJC.2014.640 pubmed: 25562437 pmcid: 4333493
Haycock PC, Burgess S, Nounu A et al (2017) Association between telomere length and risk of cancer and non-neoplastic diseases: a Mendelian randomization study. JAMA Oncol 3:636–651. https://doi.org/10.1001/JAMAONCOL.2016.5945
doi: 10.1001/JAMAONCOL.2016.5945 pubmed: 28241208
DeBoy EA, Tassia MG, Schratz KE et al (2023) Familial clonal hematopoiesis in a long telomere syndrome. N Engl J Med 388:2422–2433. https://doi.org/10.1056/NEJMOA2300503
doi: 10.1056/NEJMOA2300503 pubmed: 37140166
Sawhney V, Campbell NG, Brouilette SW et al (2016) Telomere shortening and telomerase activity in ischaemic cardiomyopathy patients—potential markers of ventricular arrhythmia. Int J Cardiol 207:157–163. https://doi.org/10.1016/J.IJCARD.2016.01.066
doi: 10.1016/J.IJCARD.2016.01.066 pubmed: 26803233
Brouilette SW, Moore JS, McMahon AD et al (2007) Telomere length, risk of coronary heart disease, and statin treatment in the West of Scotland Primary Prevention Study: a nested case-control study. The Lancet (London, England) 369:107–114. https://doi.org/10.1016/S0140-6736(07)60071-3
doi: 10.1016/S0140-6736(07)60071-3 pubmed: 17223473
Ogami M, Ikura Y, Ohsawa M et al (2004) Telomere shortening in human coronary artery diseases. Arterioscler Thromb Vasc Biol 24:546–550. https://doi.org/10.1161/01.ATV.0000117200.46938.E7
doi: 10.1161/01.ATV.0000117200.46938.E7 pubmed: 14726417
Sharifi-Sanjani M, Oyster NM, Tichy ED et al (2017) Cardiomyocyte-specific telomere shortening is a distinct signature of heart failure in humans. J Am Heart Assoc. https://doi.org/10.1161/JAHA.116.005086
doi: 10.1161/JAHA.116.005086 pubmed: 28882819 pmcid: 5634248
Carty CL, Kooperberg C, Liu J et al (2015) Leukocyte telomere length and risks of incident coronary heart disease and mortality in a racially diverse population of postmenopausal women. Arterioscler Thromb Vasc Biol 35:2225–2231. https://doi.org/10.1161/ATVBAHA.115.305838
doi: 10.1161/ATVBAHA.115.305838 pubmed: 26249011 pmcid: 4713196
Calvert PA, Liew TV, Gorenne I et al (2011) Leukocyte telomere length is associated with high-risk plaques on virtual histology intravascular ultrasound and increased proinflammatory activity. Arterioscler Thromb Vasc Biol 31:2157–2164. https://doi.org/10.1161/ATVBAHA.111.229237
doi: 10.1161/ATVBAHA.111.229237 pubmed: 21680897
Gruber HJ, Semeraro MD, Renner W, Herrmann M (2021) Telomeres and age-related diseases. Biomedicines. https://doi.org/10.3390/BIOMEDICINES9101335
doi: 10.3390/BIOMEDICINES9101335 pubmed: 34680452 pmcid: 8533433
Wang J, Dong X, Cao L et al (2016) Association between telomere length and diabetes mellitus: a meta-analysis. J Int Med Res 44:1156–1173. https://doi.org/10.1177/0300060516667132
doi: 10.1177/0300060516667132 pubmed: 28322101 pmcid: 5536737
Sanders JL, Cauley JA, Boudreau RM et al (2009) Leukocyte telomere length is not associated with BMD, osteoporosis, or fracture in older adults: results from the health, aging and body composition study. J Bone Miner Res 24:1531–1536. https://doi.org/10.1359/JBMR.090318
doi: 10.1359/JBMR.090318 pubmed: 19338455 pmcid: 2730927
Davinelli S, Scapagnini G, Denaro F et al (2014) Altered expression pattern of Nrf2/HO-1 axis during accelerated-senescence in HIV-1 transgenic rat. Biogerontology. https://doi.org/10.1007/s10522-014-9511-6
doi: 10.1007/s10522-014-9511-6 pubmed: 25027760
Singh MV, Kotla S, Le NT et al (2019) Senescent phenotype induced by p90RSK-NRF2 signaling sensitizes monocytes and macrophages to oxidative stress in HIV-positive individuals. Circulation 139:1199–1216. https://doi.org/10.1161/CIRCULATIONAHA.118.036232
doi: 10.1161/CIRCULATIONAHA.118.036232 pubmed: 30586719 pmcid: 6957233
Hu J, Hwang SS, Liesa M et al (2012) Antitelomerase therapy provokes ALT and mitochondrial adaptive mechanisms in cancer. Cell 148:651–663. https://doi.org/10.1016/J.CELL.2011.12.028
doi: 10.1016/J.CELL.2011.12.028 pubmed: 22341440 pmcid: 3286017
Gong C, Yang H, Wang S et al (2021) hTERT promotes CRC proliferation and migration by recruiting YBX1 to increase NRF2 expression. Front Cell Dev Biol. https://doi.org/10.3389/FCELL.2021.658101/PDF
doi: 10.3389/FCELL.2021.658101/PDF pubmed: 35237614 pmcid: 8740071
Liu T, Long Q, Li L et al (2021) The NRF2-dependent transcriptional axis, XRCC5/hTERT drives tumor progression and 5-Fu insensitivity in hepatocellular carcinoma. Mol Ther Oncolytics 24:249–261. https://doi.org/10.1016/J.OMTO.2021.12.012
doi: 10.1016/J.OMTO.2021.12.012 pubmed: 35071747 pmcid: 8762376
Dong H, Xia Y, Jin S et al (2021) Nrf2 attenuates ferroptosis-mediated IIR-ALI by modulating TERT and SLC7A11. Cell Death Dis. https://doi.org/10.1038/S41419-021-04307-1
doi: 10.1038/S41419-021-04307-1 pubmed: 34921137 pmcid: 8683478
Wu W, Du Z, Wu L (2022) Dexmedetomidine attenuates hypoxia-induced cardiomyocyte injury by promoting telomere/telomerase activity: possible involvement of ERK1/2-Nrf2 signaling pathway. Cell Biol Int 46:1036–1046. https://doi.org/10.1002/CBIN.11799
doi: 10.1002/CBIN.11799 pubmed: 35312207
Ahmad F, Dixit D, Sharma V et al (2016) Nrf2-driven TERT regulates pentose phosphate pathway in glioblastoma. Cell Death Dis. https://doi.org/10.1038/CDDIS.2016.117
doi: 10.1038/CDDIS.2016.117 pubmed: 27148686 pmcid: 4917655
Lovatt M, Adnan K, Kocaba V et al (2020) Peroxiredoxin-1 regulates lipid peroxidation in corneal endothelial cells. Redox Biol. https://doi.org/10.1016/J.REDOX.2019.101417
doi: 10.1016/J.REDOX.2019.101417 pubmed: 33099215 pmcid: 7578533
Begus-Nahrmann Y, Lechel A, Obenauf AC et al (2009) p53 deletion impairs clearance of chromosomal-instable stem cells in aging telomere-dysfunctional mice. Nat Genet 41:1138–1143. https://doi.org/10.1038/NG.426
doi: 10.1038/NG.426 pubmed: 19718028
Kalo E, Kogan-Sakin I, Solomon H et al (2012) Mutant p53R273H attenuates the expression of phase 2 detoxifying enzymes and promotes the survival of cells with high levels of reactive oxygen species. J Cell Sci 125:5578–5586. https://doi.org/10.1242/JCS.106815
doi: 10.1242/JCS.106815 pubmed: 22899716
Chen D, Tavana O, Chu B et al (2017) NRF2 is a major target of ARF in p53-independent tumor suppression. Mol Cell 68:224-232.e4. https://doi.org/10.1016/J.MOLCEL.2017.09.009
doi: 10.1016/J.MOLCEL.2017.09.009 pubmed: 28985506 pmcid: 5683418
D’Adda Di Fagagna F, Reaper PM, Clay-Farrace L et al (2003) A DNA damage checkpoint response in telomere-initiated senescence. Nature 426:194–198. https://doi.org/10.1038/NATURE02118
doi: 10.1038/NATURE02118 pubmed: 14608368
Lee SC, Zhang J, Strom J et al (2016) G-Quadruplex in the NRF2 mRNA 5′ untranslated region regulates de novo NRF2 protein translation under oxidative stress. Mol Cell Biol. https://doi.org/10.1128/MCB.00122-16
doi: 10.1128/MCB.00122-16 pubmed: 27736771 pmcid: 5192087
Tian T, Chen YQ, Wang SR, Zhou X (2018) G-quadruplex: a regulator of gene expression and its chemical targeting. Chem 4:1314–1344. https://doi.org/10.1016/J.CHEMPR.2018.02.014
doi: 10.1016/J.CHEMPR.2018.02.014
Xiong S, Patrushev N, Forouzandeh F et al (2015) PGC-1α modulates telomere function and DNA damage in protecting against aging-related chronic diseases. Cell Rep 12:1391–1399. https://doi.org/10.1016/J.CELREP.2015.07.047
doi: 10.1016/J.CELREP.2015.07.047 pubmed: 26299964 pmcid: 4549794
Dinkova-Kostova AT, Copple IM (2023) Advances and challenges in therapeutic targeting of NRF2. Trends Pharmacol Sci 44:137–149. https://doi.org/10.1016/J.TIPS.2022.12.003
doi: 10.1016/J.TIPS.2022.12.003 pubmed: 36628798
Akino N, Wada-Hiraike O, Isono W et al (2019) Activation of Nrf2/Keap1 pathway by oral dimethylfumarate administration alleviates oxidative stress and age-associated infertility might be delayed in the mouse ovary. Reprod Biol Endocrinol. https://doi.org/10.1186/S12958-019-0466-Y
doi: 10.1186/S12958-019-0466-Y pubmed: 30760288 pmcid: 6375213
Abrescia P, Treppiccione L, Rossi M, Bergamo P (2020) Modulatory role of dietary polyunsaturated fatty acids in Nrf2-mediated redox homeostasis. Prog Lipid Res. https://doi.org/10.1016/J.PLIPRES.2020.101066
doi: 10.1016/J.PLIPRES.2020.101066 pubmed: 32979455
Ali S, Scapagnini G, Davinelli S (2022) Effect of omega-3 fatty acids on the telomere length: a mini meta-analysis of clinical trials. Biomol Concepts 13:25–33. https://doi.org/10.1515/BMC-2021-0024/PDF
doi: 10.1515/BMC-2021-0024/PDF pubmed: 35189049
Wu S, Wu Y, Chen J et al (2023) Lifelong docosahexaenoic acid intervention ameliorates aging in the telomere-DNA-mitochondria axis in telomerase-deficient mice. J Nutr Biochem. https://doi.org/10.1016/J.JNUTBIO.2022.109202
doi: 10.1016/J.JNUTBIO.2022.109202 pubmed: 37875229
Yagishita Y, Gatbonton-schwager TN, McCallum ML, Kensler TW (2020) Current landscape of NRF2 biomarkers in clinical trials. Antioxidants (Basel, Switzerland) 9:1–36. https://doi.org/10.3390/ANTIOX9080716
doi: 10.3390/ANTIOX9080716
Yagishita Y, Fahey JW, Dinkova-Kostova AT, Kensler TW (2019) Broccoli or sulforaphane: is it the source or dose that matters? Molecules. https://doi.org/10.3390/MOLECULES24193593
doi: 10.3390/MOLECULES24193593 pubmed: 31590459 pmcid: 6804255
Abbas A, Hall JA, Patterson WL et al (2016) Sulforaphane modulates telomerase activity via epigenetic regulation in prostate cancer cell lines. Biochem Cell Biol 94:71–81. https://doi.org/10.1139/BCB-2015-0038
doi: 10.1139/BCB-2015-0038 pubmed: 26458818
Meeran SM, Patel SN, Tollefsbol TO (2010) Sulforaphane causes epigenetic repression of hTERT expression in human breast cancer cell lines. PLoS ONE. https://doi.org/10.1371/JOURNAL.PONE.0011457
doi: 10.1371/JOURNAL.PONE.0011457 pubmed: 20625516 pmcid: 2897894
de Jesus BB, Schneeberger K, Vera E et al (2011) The telomerase activator TA-65 elongates short telomeres and increases health span of adult/old mice without increasing cancer incidence. Aging Cell 10:604–621. https://doi.org/10.1111/J.1474-9726.2011.00700.X
doi: 10.1111/J.1474-9726.2011.00700.X
Yilmaz S, Bedir E, Ballar Kirmizibayrak P (2022) The role of cycloastragenol at the intersection of NRF2/ARE, telomerase, and proteasome activity. Free Radic Biol Med 188:105–116. https://doi.org/10.1016/J.FREERADBIOMED.2022.06.230
doi: 10.1016/J.FREERADBIOMED.2022.06.230 pubmed: 35718303
Kunnumakkara AB, Bordoloi D, Padmavathi G et al (2017) Curcumin, the golden nutraceutical: multitargeting for multiple chronic diseases. Br J Pharmacol 174:1325–1348. https://doi.org/10.1111/BPH.13621
doi: 10.1111/BPH.13621 pubmed: 27638428
Liczbiński P, Michałowicz J, Bukowska B (2020) Molecular mechanism of curcumin action in signaling pathways: review of the latest research. Phytother Res 34:1992–2005. https://doi.org/10.1002/PTR.6663
doi: 10.1002/PTR.6663 pubmed: 32141677
Zia A, Farkhondeh T, Pourbagher-Shahri AM, Samarghandian S (2021) The role of curcumin in aging and senescence: molecular mechanisms. Biomed Pharmacother. https://doi.org/10.1016/J.BIOPHA.2020.111119
doi: 10.1016/J.BIOPHA.2020.111119 pubmed: 33360051
Sorrenti V, Buriani A, Fortinguerra S et al (2023) Cell survival, death, and proliferation in senescent and cancer cells: the role of (poly)phenols. Adv Nutr. https://doi.org/10.1016/J.ADVNUT.2023.05.014
doi: 10.1016/J.ADVNUT.2023.05.014 pubmed: 37271484 pmcid: 10509428
Forouzanfar F, Majeed M, Jamialahmadi T, Sahebkar A (2021) Telomerase: a target for therapeutic effects of curcumin in cancer. Adv Exp Med Biol 1286:135–143. https://doi.org/10.1007/978-3-030-55035-6_10
doi: 10.1007/978-3-030-55035-6_10 pubmed: 33725351
Sheng R, Gu ZL, Xie ML (2013) Epigallocatechin gallate, the major component of polyphenols in green tea, inhibits telomere attrition mediated cardiomyocyte apoptosis in cardiac hypertrophy. Int J Cardiol 162:199–209. https://doi.org/10.1016/J.IJCARD.2011.07.083
doi: 10.1016/J.IJCARD.2011.07.083 pubmed: 22000973
Moghadam D, Zarei R, Vakili S et al (2023) The effect of natural polyphenols resveratrol, gallic acid, and kuromanin chloride on human telomerase reverse transcriptase (hTERT) expression in HepG2 hepatocellular carcinoma: role of SIRT1/Nrf2 signaling pathway and oxidative stress. Mol Biol Rep 50:77–84. https://doi.org/10.1007/S11033-022-08031-7
doi: 10.1007/S11033-022-08031-7 pubmed: 36307623

Auteurs

Alessandro Medoro (A)

Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via F. De Sanctis, s.n.c., 86100, Campobasso, Italy.

Luciano Saso (L)

Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy.

Giovanni Scapagnini (G)

Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via F. De Sanctis, s.n.c., 86100, Campobasso, Italy.

Sergio Davinelli (S)

Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Via F. De Sanctis, s.n.c., 86100, Campobasso, Italy. sergio.davinelli@unimol.it.

Classifications MeSH