The mechanoreceptor Piezo is required for spermatogenesis in Bombyx mori.


Journal

BMC biology
ISSN: 1741-7007
Titre abrégé: BMC Biol
Pays: England
ID NLM: 101190720

Informations de publication

Date de publication:
20 May 2024
Historique:
received: 15 12 2023
accepted: 10 05 2024
medline: 21 5 2024
pubmed: 21 5 2024
entrez: 20 5 2024
Statut: epublish

Résumé

The animal sperm shows high diversity in morphology, components, and motility. In the lepidopteran model insect, the silkworm Bombyx mori, two types of sperm, including nucleate fertile eupyrene sperm and anucleate unfertile apyrene sperm, are generated. Apyrene sperm assists fertilization by facilitating the migration of eupyrene spermatozoa from the bursa copulatrix to the spermatheca. During spermatogenesis, eupyrene sperm bundles extrude the cytoplasm by peristaltic squeezing, while the nuclei of the apyrene sperm bundles are discarded with the same process, forming matured sperm. In this study, we describe that a mechanoreceptor BmPiezo, the sole Piezo ortholog in B. mori, plays key roles in larval feeding behavior and, more importantly, is essential for eupyrene spermatogenesis and male fertility. CRISPR/Cas9-mediated loss of BmPiezo function decreases larval appetite and subsequent body size and weight. Immunofluorescence analyses reveal that BmPiezo is intensely localized in the inflatable point of eupyrene sperm bundle induced by peristaltic squeezing. BmPiezo is also enriched in the middle region of apyrene sperm bundle before peristaltic squeezing. Cytological analyses of dimorphic sperm reveal developmental arrest of eupyrene sperm bundles in BmPiezo mutants, while the apyrene spermatogenesis is not affected. RNA-seq analysis and q-RT-PCR analyses demonstrate that eupyrene spermatogenic arrest is associated with the dysregulation of the actin cytoskeleton. Moreover, we show that the deformed eupyrene sperm bundles fail to migrate from the testes, resulting in male infertility due to the absence of eupyrene sperm in the bursa copulatrix and spermatheca. In conclusion, our studies thus uncover a new role for Piezo in regulating spermatogenesis and male fertility in insects.

Sections du résumé

BACKGROUND BACKGROUND
The animal sperm shows high diversity in morphology, components, and motility. In the lepidopteran model insect, the silkworm Bombyx mori, two types of sperm, including nucleate fertile eupyrene sperm and anucleate unfertile apyrene sperm, are generated. Apyrene sperm assists fertilization by facilitating the migration of eupyrene spermatozoa from the bursa copulatrix to the spermatheca. During spermatogenesis, eupyrene sperm bundles extrude the cytoplasm by peristaltic squeezing, while the nuclei of the apyrene sperm bundles are discarded with the same process, forming matured sperm.
RESULTS RESULTS
In this study, we describe that a mechanoreceptor BmPiezo, the sole Piezo ortholog in B. mori, plays key roles in larval feeding behavior and, more importantly, is essential for eupyrene spermatogenesis and male fertility. CRISPR/Cas9-mediated loss of BmPiezo function decreases larval appetite and subsequent body size and weight. Immunofluorescence analyses reveal that BmPiezo is intensely localized in the inflatable point of eupyrene sperm bundle induced by peristaltic squeezing. BmPiezo is also enriched in the middle region of apyrene sperm bundle before peristaltic squeezing. Cytological analyses of dimorphic sperm reveal developmental arrest of eupyrene sperm bundles in BmPiezo mutants, while the apyrene spermatogenesis is not affected. RNA-seq analysis and q-RT-PCR analyses demonstrate that eupyrene spermatogenic arrest is associated with the dysregulation of the actin cytoskeleton. Moreover, we show that the deformed eupyrene sperm bundles fail to migrate from the testes, resulting in male infertility due to the absence of eupyrene sperm in the bursa copulatrix and spermatheca.
CONCLUSIONS CONCLUSIONS
In conclusion, our studies thus uncover a new role for Piezo in regulating spermatogenesis and male fertility in insects.

Identifiants

pubmed: 38769528
doi: 10.1186/s12915-024-01916-y
pii: 10.1186/s12915-024-01916-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

118

Subventions

Organisme : National Science Foundation of China
ID : 31925007
Organisme : National Science Foundation of China
ID : 32000336
Organisme : National Science Foundation of China
ID : 32000339
Organisme : Natural Science Foundation of Jiangsu Province
ID : BK20231249
Organisme : Jiangsu Provincial Association for Science and Technology Young Scientific and Technological Talents Trusteeship Project
ID : T-2022-045

Informations de copyright

© 2024. The Author(s).

Références

Murthy SE, Dubin AE, Patapoutian A. Piezos thrive under pressure: mechanically activated ion channels in health and disease. Nat Rev Mol Cell Biol. 2017;18(12):771–83.
pubmed: 28974772 doi: 10.1038/nrm.2017.92
Wu J, Lewis AH, Grandl J. Touch, tension, and transduction - the function and regulation of Piezo ion channels. Trends Biochem Sci. 2017;42(1):57–71.
pubmed: 27743844 doi: 10.1016/j.tibs.2016.09.004
Coste B, Mathur J, Schmidt M, Earley TJ, Ranade S, Petrus MJ, et al. Piezo1 and Piezo2 are essential components of distinct mechanically activated cation channels. Science. 2010;330(6000):55–60.
pubmed: 20813920 pmcid: 3062430 doi: 10.1126/science.1193270
Ranade SS, Qiu Z, Woo SH, Hur SS, Murthy SE, Cahalan SM, et al. Piezo1, a mechanically activated ion channel, is required for vascular development in mice. Proc Natl Acad Sci U S A. 2014;111(28):10347–52.
pubmed: 24958852 pmcid: 4104881 doi: 10.1073/pnas.1409233111
Ranade SS, Woo SH, Dubin AE, Moshourab RA, Wetzel C, Petrus M, et al. Piezo2 is the major transducer of mechanical forces for touch sensation in mice. Nature. 2014;516(7529):121–5.
pubmed: 25471886 pmcid: 4380172 doi: 10.1038/nature13980
Mousavi SAR, Dubin AE, Zeng WZ, Coombs AM, Do K, Ghadiri DA, et al. PIEZO ion channel is required for root mechanotransduction in Arabidopsis thaliana. Proc Natl Acad Sci U S A. 2021;118(20):e2102188118.
pubmed: 33975957 pmcid: 8158017 doi: 10.1073/pnas.2102188118
Bai X, Bouffard J, Lord A, Brugman K, Sternberg PW, Cram EJ, et al. Caenorhabditis elegans PIEZO channel coordinates multiple reproductive tissues to govern ovulation. Elife. 2020;9:e53603.
pubmed: 32490809 pmcid: 7340503 doi: 10.7554/eLife.53603
Kim SE, Coste B, Chadha A, Cook B, Patapoutian A. The role of Drosophila Piezo in mechanical nociception. Nature. 2012;483(7388):209–12 pmid: 22343891.
pubmed: 22343891 pmcid: 3297676 doi: 10.1038/nature10801
Douguet D, Patel A, Xu A, Vanhoutte PM, Honoré E. Piezo iIon channels in cardiovascular mechanobiology. Trends Pharmacol Sci. 2019;40(12):956–70.
pubmed: 31704174 doi: 10.1016/j.tips.2019.10.002
Kefauver JM, Ward AB, Patapoutian A. Discoveries in structure and physiology of mechanically activated ion channels. Nature. 2020;587(7835):567–76.
pubmed: 33239794 pmcid: 8477435 doi: 10.1038/s41586-020-2933-1
Ikeda R, Cha M, Ling J, Jia Z, Coyle D, Gu JG. Merkel cells transduce and encode tactile stimuli to drive Aβ-afferent impulses. Cell. 2014;157(3):664–75.
pubmed: 24746027 pmcid: 4003503 doi: 10.1016/j.cell.2014.02.026
Marshall KL, Saade D, Ghitani N, Coombs AM, Szczot M, Keller J, et al. PIEZO2 in sensory neurons and urothelial cells coordinates urination. Nature. 2020;588(7837):290–5.
pubmed: 33057202 pmcid: 7725878 doi: 10.1038/s41586-020-2830-7
Wang F, Knutson K, Alcaino C, Linden DR, Gibbons SJ, Kashyap P, et al. Mechanosensitive ion channel Piezo2 is important for enterochromaffin cell response to mechanical forces. J Physiol. 2017;595(1):79–91.
pubmed: 27392819 doi: 10.1113/JP272718
Zarychanski R, Schulz VP, Houston BL, Maksimova Y, Houston DS, Smith B, et al. Mutations in the mechanotransduction protein PIEZO1 are associated with hereditary xerocytosis. Blood. 2012;120(9):1908–15.
pubmed: 22529292 pmcid: 3448561 doi: 10.1182/blood-2012-04-422253
Albuisson J, Murthy SE, Bandell M, Coste B, Louis-Dit-Picard H, Mathur J, et al. Dehydrated hereditary stomatocytosis linked to gain-of-function mutations in mechanically activated PIEZO1 ion channels. Nat Commun. 2013;4:1884.
pubmed: 23695678 doi: 10.1038/ncomms2899
Bae C, Gnanasambandam R, Nicolai C, Sachs F, Gottlieb PA. Xerocytosis is caused by mutations that alter the kinetics of the mechanosensitive channel PIEZO1. Proc Natl Acad Sci U S A. 2013;110(12):E1162–8.
pubmed: 23487776 pmcid: 3606986 doi: 10.1073/pnas.1219777110
Ma S, Cahalan S, LaMonte G, Grubaugh ND, Zeng W, Murthy SE, et al. Common PIEZO1 allele in African populations vauses RBC dehydration and attenuates plasmodium infection. Cell. 2018;173(2):443–455.e12.
pubmed: 29576450 pmcid: 5889333 doi: 10.1016/j.cell.2018.02.047
Ma S, Dubin AE, Zhang Y, Mousavi SAR, Wang Y, Coombs AM, et al. A role of PIEZO1 in iron metabolism in mice and humans. Cell. 2021;184(4):969–982.e13.
pubmed: 33571427 pmcid: 7927959 doi: 10.1016/j.cell.2021.01.024
Lukacs V, Mathur J, Mao R, Bayrak-Toydemir P, Procter M, Cahalan SM, et al. Impaired PIEZO1 function in patients with a novel autosomal recessive congenital lymphatic dysplasia. Nat Commun. 2015;6:8329.
pubmed: 26387913 doi: 10.1038/ncomms9329
Fotiou E, Martin-Almedina S, Simpson MA, Lin S, Gordon K, Brice G, et al. Novel mutations in PIEZO1 cause an autosomal recessive generalized lymphatic dysplasia with non-immune hydrops fetalis. Nat Commun. 2015;6:8085.
pubmed: 26333996 doi: 10.1038/ncomms9085
McMillin MJ, Beck AE, Chong JX, Shively KM, Buckingham KJ, Gildersleeve HI, et al. Mutations in PIEZO2 cause Gordon syndrome, Marden-Walker syndrome, and distal arthrogryposis type 5. Am J Hum Genet. 2014;94(5):734–44.
pubmed: 24726473 pmcid: 4067551 doi: 10.1016/j.ajhg.2014.03.015
Ma S, Dubin AE, Romero LO, Loud M, Salazar A, Chu S, et al. Excessive mechanotransduction in sensory neurons causes joint contractures. Science. 2023;379(6628):201–6.
pubmed: 36634173 pmcid: 10163824 doi: 10.1126/science.add3598
Chesler AT, Szczot M, Bharucha-Goebel D, Čeko M, Donkervoort S, Laubacher C, et al. The role of PIEZO2 in human mechanosensation. N Engl J Med. 2016;375(14):1355–64.
pubmed: 27653382 pmcid: 5911918 doi: 10.1056/NEJMoa1602812
Szczot M, Liljencrantz J, Ghitani N, Barik A, Lam R, Thompson JH, et al. PIEZO2 mediates injury-induced tactile pain in mice and humans. Sci Transl Med. 2018;10(462):eaat9892.
pubmed: 30305456 pmcid: 6875774 doi: 10.1126/scitranslmed.aat9892
Song Y, Li D, Farrelly O, Miles L, Li F, Kim SE, et al. The mechanosensitive ion channel piezo inhibits axon regeneration. Neuron. 2019;102(2):373–389.e6.
pubmed: 30819546 pmcid: 6487666 doi: 10.1016/j.neuron.2019.01.050
Wang P, Jia Y, Liu T, Jan YN, Zhang W. Visceral mechano-sensing neurons control Drosophila feeding by using Piezo as a sensor. Neuron. 2020;108(4):640–650.e4.
pubmed: 32910893 pmcid: 8386590 doi: 10.1016/j.neuron.2020.08.017
Min S, Oh Y, Verma P, Whitehead SC, Yapici N, Van Vactor D, et al. Control of feeding by Piezo-mediated gut mechanosensation in Drosophila. Elife. 2021;10:e63049.
pubmed: 33599608 pmcid: 7920550 doi: 10.7554/eLife.63049
Oh Y, Lai JS, Min S, Huang HW, Liberles SD, Ryoo HD, et al. Periphery signals generated by Piezo-mediated stomach stretch and nNeuromedin-mediated glucose load regulate the Drosophila brain nutrient sensor. Neuron. 2021;109(12):1979–1995.e6.
pubmed: 34015253 pmcid: 8611812 doi: 10.1016/j.neuron.2021.04.028
Yamanouchi HM, Tanaka R, Kamikouchi A. Piezo-mediated mechanosensation contributes to stabilizing copulation posture and reproductive success in Drosophila males. iScience. 2023;26(5):106617.
pubmed: 37250311 pmcid: 10214400 doi: 10.1016/j.isci.2023.106617
Zechini L, Amato C, Scopelliti A, Wood W. Piezo acts as a molecular brake on wound closure to ensure effective inflammation and maintenance of epithelial integrity. Curr Biol. 2022;32(16):3584–3592.e4.
pubmed: 35835122 pmcid: 9616804 doi: 10.1016/j.cub.2022.06.041
Kelley LA, Mezulis S, Yates CM, Wass MN, Sternberg MJ. The Phyre2 web portal for protein modeling, prediction and analysis. Nat Protoc. 2015;10(6):845–58.
pubmed: 25950237 pmcid: 5298202 doi: 10.1038/nprot.2015.053
Li Z, You L, Zeng B, Ling L, Xu J, Chen X, et al. Ectopic expression of ecdysone oxidase impairs tissue degeneration in Bombyx mori. Proc Biol Sci. 1809;2015(282):20150513.
Phillips DM. Morphogenesis of the lacinate appendages of lepidopteran spermatozoa. J Ultrastruct Res. 1971;34(5):567–85.
pubmed: 5555018 doi: 10.1016/S0022-5320(71)80064-3
Sahara K, Kawamura N. Roles of actin networks in peristaltic squeezing of sperm bundles in Bombyx mori. J Morphol. 2004;259(1):1–6.
pubmed: 14666520 doi: 10.1002/jmor.10168
Georgiadou M, Ivaska J. Tensins: bridging AMP-activated protein kinase with integrin activation. Trends Cell Biol. 2017;27(10):703–11.
pubmed: 28698049 doi: 10.1016/j.tcb.2017.06.004
Sallee JL, Wittchen ES, Burridge K. Regulation of cell adhesion by protein-tyrosine phosphatases: II. Cell-cell adhesion J Biol Chem. 2006;281(24):16189–92.
pubmed: 16497667
Bulgakova NA, Klapholz B, Brown NH. Cell adhesion in Drosophila: versatility of cadherin and integrin complexes during development. Curr Opin Cell Biol. 2012;24(5):702–12.
pubmed: 22938782 doi: 10.1016/j.ceb.2012.07.006
Hutter H, Vogel BE, Plenefisch JD, Norris CR, Proenca RB, Spieth J, et al. Conservation and novelty in the evolution of cell adhesion and extracellular matrix genes. Science. 2000;287(5455):989–94.
pubmed: 10669422 doi: 10.1126/science.287.5455.989
Katsuno S. Studies on eupyrene and apyrene spermatozoa in the silkworm, Bombyx mori L.(Lepidoptera: Bombycidae): I. The intratesticular behaviour of the spermatozoa at various stages from the 5th-instar to the adult. Appl Entomol Zool. 1977;12(2):142–53.
doi: 10.1303/aez.12.142
Chen S, Liu Y, Yang X, Liu Z, Luo X, Xu J, et al. Dysfunction of dimorphic sperm impairs male fertility in the silkworm. Cell Discov. 2020;6:60.
pubmed: 32963806 pmcid: 7477584 doi: 10.1038/s41421-020-00194-6
He L, Si G, Huang J, Samuel ADT, Perrimon N. Mechanical regulation of stem-cell differentiation by the stretch-activated Piezo channel. Nature. 2018;555(7694):103–6.
pubmed: 29414942 pmcid: 6101000 doi: 10.1038/nature25744
Servin-Vences MR, Lam RM, Koolen A, Wang Y, Saade DN, Loud M, et al. PIEZO2 in somatosensory neurons controls gastrointestinal transit. Cell. 2023;186(16):3386–3399.e15.
pubmed: 37541196 pmcid: 10501318 doi: 10.1016/j.cell.2023.07.006
Lam RM, von Buchholtz LJ, Falgairolle M, Osborne J, Frangos E, Servin-Vences MR, et al. PIEZO2 and perineal mechanosensation are essential for sexual function. Science. 2023;381(6660):906–10.
pubmed: 37616369 doi: 10.1126/science.adg0144
Hughes K, Shah A, Bai X, Adams J, Bauer R, Jackson J, et al. Distinct mechanoreceptor pezo-1 isoforms modulate food intake in the nematode Caenorhabditis elegans. G3 (Bethesda). 2022;12(3):jkab429.
pubmed: 35100363 doi: 10.1093/g3journal/jkab429
Lemaitre B, Miguel-Aliaga I. The digestive tract of Drosophila melanogaster. Annu Rev Genet. 2013;47:377–404.
pubmed: 24016187 doi: 10.1146/annurev-genet-111212-133343
Chen K, Chen S, Xu J, Yu Y, Liu Z, Tan A, et al. Maelstrom regulates spermatogenesis of the silkworm. Bombyx mori Insect Biochem Mol Biol. 2019;109:43–51.
pubmed: 30970276 doi: 10.1016/j.ibmb.2019.03.012
Yang X, Chen D, Zheng S, Yi M, Wang S, Liu Y, et al. The Prmt5-Vasa module is essential for spermatogenesis in Bombyx mori. PLoS Genet. 2023;19(1): e1010600.
pubmed: 36634107 pmcid: 9876381 doi: 10.1371/journal.pgen.1010600
Sakai H, Oshima H, Yuri K, Gotoh H, Daimon T, Yaginuma T, et al. Dimorphic sperm formation by Sex-lethal. Proc Natl Acad Sci U S A. 2019;116(21):10412–7.
pubmed: 31036645 pmcid: 6535010 doi: 10.1073/pnas.1820101116
Yang D, Xu J, Chen K, Liu Y, Yang X, Tang L, et al. BmPMFBP1 regulates the development of eupyrene sperm in the silkworm, Bombyx mori. PLoS Genet. 2022;18(3): e1010131.
pubmed: 35312700 pmcid: 8970482 doi: 10.1371/journal.pgen.1010131
Yang X, Chen D, Zheng S, Yi M, Liu Z, Liu Y, et al. BmHen1 is essential for eupyrene sperm development in Bombyx mori but PIWI proteins are not. Insect Biochem Mol Biol. 2022;151: 103874.
pubmed: 36375757 doi: 10.1016/j.ibmb.2022.103874
Kawamura N, Yamashiki N, Saitoh H, Sahara K. Peristaltic squeezing of sperm bundles at the late stage of spermatogenesis in the silkworm. Bombyx mori J Morphol. 2000;246(2):53–8.
pubmed: 11074574
Pontes B, Monzo P, Gauthier NC. Membrane tension: aA challenging but universal physical parameter in cell biology. Semin Cell Dev Biol. 2017;71:30–41.
pubmed: 28851599 doi: 10.1016/j.semcdb.2017.08.030
Xu J, Chen S, Zeng B, James AA, Tan A, Huang Y. Bombyx mori P-element somatic inhibitor (BmPSI) is a key auxiliary factor for silkworm male sex determination. PLoS Genet. 2017;13(1): e1006576.
pubmed: 28103247 pmcid: 5289617 doi: 10.1371/journal.pgen.1006576
Zhang Z, Liu X, Shiotsuki T, Wang Z, Xu X, Huang Y, et al. Depletion of juvenile hormone esterase extends larval growth in Bombyx mori. Insect Biochem Mol Biol. 2017;81:72–9.
pubmed: 28057597 doi: 10.1016/j.ibmb.2017.01.001

Auteurs

Zhongjie Zhang (Z)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China. zjzhang01@just.edu.cn.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China. zjzhang01@just.edu.cn.

Xiaojing Liu (X)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China.

Bo Hu (B)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China.

Kai Chen (K)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China.

Ye Yu (Y)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China.

Chenxin Sun (C)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China.

Dalin Zhu (D)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China.

Hua Bai (H)

Department of Genetics, Development, and Cell Biology, Iowa State University, Ames, IA, 50011, USA.

Subba Reddy Palli (SR)

Department of Entomology, University of Kentucky, Lexington, KY, 40546-0091, USA.

Anjiang Tan (A)

Jiangsu Key Laboratory of Sericultural and Animal Biotechnology, School of Biotechnology, Jiangsu University of Science and Technology, Zhenjiang, 212100, China. atan@just.edu.cn.
Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Scientific Research Center, Chinese Academy of Agricultural Sciences, Zhenjiang, 212100, China. atan@just.edu.cn.

Articles similaires

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male
Humans Meals Time Factors Female Adult

Classifications MeSH