Phosphoproteomic profiling of early rheumatoid arthritis synovium reveals active signalling pathways and differentiates inflammatory pathotypes.


Journal

Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438

Informations de publication

Date de publication:
12 Jun 2024
Historique:
received: 10 01 2024
accepted: 06 06 2024
medline: 13 6 2024
pubmed: 13 6 2024
entrez: 12 6 2024
Statut: epublish

Résumé

Kinases are intracellular signalling mediators and key to sustaining the inflammatory process in rheumatoid arthritis (RA). Oral inhibitors of Janus Kinase family (JAKs) are widely used in RA, while inhibitors of other kinase families e.g. phosphoinositide 3-kinase (PI3K) are under development. Most current biomarker platforms quantify mRNA/protein levels, but give no direct information on whether proteins are active/inactive. Phosphoproteome analysis has the potential to measure specific enzyme activation status at tissue level. We validated the feasibility of phosphoproteome and total proteome analysis on 8 pre-treatment synovial biopsies from treatment-naive RA patients using label-free mass spectrometry, to identify active cell signalling pathways in synovial tissue which might explain failure to respond to RA therapeutics. Differential expression analysis and functional enrichment revealed clear separation of phosphoproteome and proteome profiles between lymphoid and myeloid RA pathotypes. Abundance of specific phosphosites was associated with the degree of inflammatory state. The lymphoid pathotype was enriched with lymphoproliferative signalling phosphosites, including Mammalian Target Of Rapamycin (MTOR) signalling, whereas the myeloid pathotype was associated with Mitogen-Activated Protein Kinase (MAPK) and CDK mediated signalling. This analysis also highlighted novel kinases not previously linked to RA, such as Protein Kinase, DNA-Activated, Catalytic Subunit (PRKDC) in the myeloid pathotype. Several phosphosites correlated with clinical features, such as Disease-Activity-Score (DAS)-28, suggesting that phosphosite analysis has potential for identifying novel biomarkers at tissue-level of disease severity and prognosis. Specific phosphoproteome/proteome signatures delineate RA pathotypes and may have clinical utility for stratifying patients for personalised medicine in RA.

Sections du résumé

BACKGROUND BACKGROUND
Kinases are intracellular signalling mediators and key to sustaining the inflammatory process in rheumatoid arthritis (RA). Oral inhibitors of Janus Kinase family (JAKs) are widely used in RA, while inhibitors of other kinase families e.g. phosphoinositide 3-kinase (PI3K) are under development. Most current biomarker platforms quantify mRNA/protein levels, but give no direct information on whether proteins are active/inactive. Phosphoproteome analysis has the potential to measure specific enzyme activation status at tissue level.
METHODS METHODS
We validated the feasibility of phosphoproteome and total proteome analysis on 8 pre-treatment synovial biopsies from treatment-naive RA patients using label-free mass spectrometry, to identify active cell signalling pathways in synovial tissue which might explain failure to respond to RA therapeutics.
RESULTS RESULTS
Differential expression analysis and functional enrichment revealed clear separation of phosphoproteome and proteome profiles between lymphoid and myeloid RA pathotypes. Abundance of specific phosphosites was associated with the degree of inflammatory state. The lymphoid pathotype was enriched with lymphoproliferative signalling phosphosites, including Mammalian Target Of Rapamycin (MTOR) signalling, whereas the myeloid pathotype was associated with Mitogen-Activated Protein Kinase (MAPK) and CDK mediated signalling. This analysis also highlighted novel kinases not previously linked to RA, such as Protein Kinase, DNA-Activated, Catalytic Subunit (PRKDC) in the myeloid pathotype. Several phosphosites correlated with clinical features, such as Disease-Activity-Score (DAS)-28, suggesting that phosphosite analysis has potential for identifying novel biomarkers at tissue-level of disease severity and prognosis.
CONCLUSIONS CONCLUSIONS
Specific phosphoproteome/proteome signatures delineate RA pathotypes and may have clinical utility for stratifying patients for personalised medicine in RA.

Identifiants

pubmed: 38867295
doi: 10.1186/s13075-024-03351-4
pii: 10.1186/s13075-024-03351-4
doi:

Substances chimiques

Phosphoproteins 0
Proteome 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

120

Subventions

Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Barts and The London School of Medicine and Dentistry
ID : 523/819
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0800648, MR/K015346/1 and MR/V012509/1
Pays : United Kingdom
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : National Institute for Health and Care Research
ID : 131575 and 203330
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Arthritis Research UK
ID : 20022 and 20670
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C15966/A24375 and C16420/A18066
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C15966/A24375 and C16420/A18066
Pays : United Kingdom

Informations de copyright

© 2024. The Author(s).

Références

McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365(23):2205–19.
pubmed: 22150039 doi: 10.1056/NEJMra1004965
Higgins L, Gerdes H, Cutillas PR. Principles of phosphoproteomics and applications in cancer research. Biochem J. 2023;480(6):403–20.
pubmed: 36961757 doi: 10.1042/BCJ20220220
Casado P, Rodriguez-Prados JC, Cosulich SC, et al. Kinase-substrate enrichment analysis provides insights into the heterogeneity of signaling pathway activation in leukemia cells. Sci Signal. 2013;6(268):rs6.
pubmed: 23532336 doi: 10.1126/scisignal.2003573
Alcolea MP, Casado P, Rodriguez-Prados JC, Vanhaesebroeck B, Cutillas PR. Phosphoproteomic analysis of leukemia cells under basal and drug-treated conditions identifies markers of kinase pathway activation and mechanisms of resistance. Mol Cell Proteomics. 2012;11(8):453–66.
pubmed: 22547687 pmcid: 3412974 doi: 10.1074/mcp.M112.017483
Chakravarty SD, Poulikakos PI, Ivashkiv LB, Salmon JE, Kalliolias GD. Kinase inhibitors: a new tool for the treatment of rheumatoid arthritis. Clin Immunol. 2013;148(1):66–78.
pubmed: 23651870 doi: 10.1016/j.clim.2013.04.007
Korb A, Tohidast-Akrad M, Cetin E, Axmann R, Smolen J, Schett G. Differential tissue expression and activation of p38 MAPK alpha, beta, gamma, and delta isoforms in rheumatoid arthritis. Arthritis Rheum. 2006;54(9):2745–56.
pubmed: 16947383 doi: 10.1002/art.22080
Boyle DL, Soma K, Hodge J, et al. The JAK inhibitor tofacitinib suppresses synovial JAK1-STAT signalling in rheumatoid arthritis. Ann Rheum Dis. 2015;74(6):1311–6.
pubmed: 25398374 doi: 10.1136/annrheumdis-2014-206028
Fleischmann R, Kremer J, Cush J, et al. Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis. N Engl J Med. 2012;367(6):495–507.
pubmed: 22873530 doi: 10.1056/NEJMoa1109071
Rommel C, Camps M, Ji H. PI3K delta and PI3K gamma: partners in crime in inflammation in rheumatoid arthritis and beyond? Nat Rev Immunol. 2007;7(3):191–201.
pubmed: 17290298 doi: 10.1038/nri2036
Camps M, Ruckle T, Ji H, et al. Blockade of PI3Kgamma suppresses joint inflammation and damage in mouse models of rheumatoid arthritis. Nat Med. 2005;11(9):936–43.
pubmed: 16127437 doi: 10.1038/nm1284
Sekine C, Sugihara T, Miyake S, et al. Successful treatment of animal models of rheumatoid arthritis with small-molecule cyclin-dependent kinase inhibitors. J Immunol. 2008;180(3):1954–61.
pubmed: 18209094 doi: 10.4049/jimmunol.180.3.1954
Pratt AG, Siebert S, Cole M, et al. Targeting synovial fibroblast proliferation in rheumatoid arthritis (TRAFIC): an open-label, dose-finding, phase 1b trial. Lancet Rheumatol. 2021;3(5):e337–46.
pubmed: 33928262 pmcid: 8062952 doi: 10.1016/S2665-9913(21)00061-8
Lewis MJ, Barnes MR, Blighe K, et al. Molecular Portraits of Early Rheumatoid Arthritis Identify Clinical and Treatment Response Phenotypes. Cell Rep. 2019;28(9):2455–70 e5.
pubmed: 31461658 pmcid: 6718830 doi: 10.1016/j.celrep.2019.07.091
Bombardieri M, Lewis M, Pitzalis C. Ectopic lymphoid neogenesis in rheumatic autoimmune diseases. Nat Rev Rheumatol. 2017;13(3):141–54.
pubmed: 28202919 doi: 10.1038/nrrheum.2016.217
Dennis G Jr, Holweg CT, Kummerfeld SK, et al. Synovial phenotypes in rheumatoid arthritis correlate with response to biologic therapeutics. Arthritis Res Ther. 2014;16(2):R90.
pubmed: 25167216 pmcid: 4060385 doi: 10.1186/ar4555
Humby F, Lewis M, Ramamoorthi N, et al. Synovial cellular and molecular signatures stratify clinical response to csDMARD therapy and predict radiographic progression in early rheumatoid arthritis patients. Ann Rheum Dis. 2019;78(6):761–72.
pubmed: 30878974 doi: 10.1136/annrheumdis-2018-214539
Zhang F, Jonsson AH, Nathan A, et al. Deconstruction of rheumatoid arthritis synovium defines inflammatory subtypes. Nature. 2023;623:616–24.
pubmed: 37938773 pmcid: 10651487 doi: 10.1038/s41586-023-06708-y
Hijazi M, Smith R, Rajeeve V, Bessant C, Cutillas PR. Reconstructing kinase network topologies from phosphoproteomics data reveals cancer-associated rewiring. Nat Biotechnol. 2020;38(4):493–502.
pubmed: 31959955 doi: 10.1038/s41587-019-0391-9
Deutsch EW, Csordas A, Sun Z, et al. The ProteomeXchange consortium in 2017: supporting the cultural change in proteomics public data deposition. Nucleic Acids Res. 2017;45(D1):D1100–6.
pubmed: 27924013 doi: 10.1093/nar/gkw936
Hornbeck PV, Kornhauser JM, Tkachev S, et al. PhosphoSitePlus: a comprehensive resource for investigating the structure and function of experimentally determined post-translational modifications in man and mouse. Nucleic Acids Res. 2012;40(Database issue):D261–70.
pubmed: 22135298 doi: 10.1093/nar/gkr1122
Hu J, Rho HS, Newman RH, Zhang J, Zhu H, Qian J. PhosphoNetworks: a database for human phosphorylation networks. Bioinformatics. 2014;30(1):141–2.
pubmed: 24227675 doi: 10.1093/bioinformatics/btt627
Lachmann A, Ma’ayan A. KEA: kinase enrichment analysis. Bioinformatics. 2009;25(5):684–6.
pubmed: 19176546 pmcid: 2647829 doi: 10.1093/bioinformatics/btp026
Holland CH, Tanevski J, Perales-Paton J, et al. Robustness and applicability of transcription factor and pathway analysis tools on single-cell RNA-seq data. Genome Biol. 2020;21(1):36.
pubmed: 32051003 pmcid: 7017576 doi: 10.1186/s13059-020-1949-z
Caetano-Anolles D. RNAseq short variant discovery (SNPs+Indels). Available from: https://gatk.broadinstitute.org/hc/en-us/articles/360035531192-RNAseq-short-variant-discovery-SNPs-Indels . Accessed April 2023.
Pulford K, Jones M, Banham AH, Haralambieva E, Mason DY. Lymphocyte-specific protein 1: a specific marker of human leucocytes. Immunology. 1999;96(2):262–71.
pubmed: 10233704 pmcid: 2326732 doi: 10.1046/j.1365-2567.1999.00677.x
Rahman MT, Muppala S, Wu J, et al. Effects of thrombospondin-4 on pro-inflammatory phenotype differentiation and apoptosis in macrophages. Cell Death Dis. 2020;11(1):53.
pubmed: 31974349 pmcid: 6978349 doi: 10.1038/s41419-020-2237-2
Kwon HS, Lee HS, Ji Y, Rubin JS, Tomarev SI. Myocilin is a modulator of Wnt signaling. Mol Cell Biol. 2009;29(8):2139–54.
pubmed: 19188438 pmcid: 2663295 doi: 10.1128/MCB.01274-08
Shen X, Koga T, Park BC, SundarRaj N, Yue B. Rho GTPase and cAMP/protein kinase A signaling mediates myocilin-induced alterations in cultured human trabecular meshwork cells. J Biol Chem. 2008;283(1):603–12.
pubmed: 17984096 doi: 10.1074/jbc.M708250200
Gubbiotti MA, Vallet SD, Ricard-Blum S, Iozzo RV. Decorin interacting network: a comprehensive analysis of decorin-binding partners and their versatile functions. Matrix Biol. 2016;55:7–21.
pubmed: 27693454 pmcid: 6938589 doi: 10.1016/j.matbio.2016.09.009
Iwata TN, Ramirez-Komo JA, Park H, Iritani BM. Control of B lymphocyte development and functions by the mTOR signaling pathways. Cytokine Growth Factor Rev. 2017;35:47–62.
pubmed: 28583723 pmcid: 5559228 doi: 10.1016/j.cytogfr.2017.04.005
Sears R, Nuckolls F, Haura E, Taya Y, Tamai K, Nevins JR. Multiple Ras-dependent phosphorylation pathways regulate Myc protein stability. Genes Dev. 2000;14(19):2501–14.
pubmed: 11018017 pmcid: 316970 doi: 10.1101/gad.836800
Szabo SJ, Kim ST, Costa GL, Zhang X, Fathman CG, Glimcher LH. A novel transcription factor, T-bet, directs Th1 lineage commitment. Cell. 2000;100(6):655–69.
pubmed: 10761931 doi: 10.1016/S0092-8674(00)80702-3
Davydov IV, Bohmann D, Krammer PH, Li-Weber M. Cloning of the cDNA encoding human C/EBP gamma, a protein binding to the PRE-I enhancer element of the human interleukin-4 promoter. Gene. 1995;161(2):271–5.
pubmed: 7665092 doi: 10.1016/0378-1119(95)00271-7
Zhong Z, Yeow WS, Zou C, et al. Cyclin D1/cyclin-dependent kinase 4 interacts with filamin A and affects the migration and invasion potential of breast cancer cells. Cancer Res. 2010;70(5):2105–14.
pubmed: 20179208 pmcid: 2917898 doi: 10.1158/0008-5472.CAN-08-1108
Tsai HJ, Chien KY, Liao HR, et al. Functional links between Disabled-2 Ser723 phosphorylation and thrombin signaling in human platelets. J Thromb Haemost. 2017;15(10):2029–44.
pubmed: 28876503 doi: 10.1111/jth.13785
Jin EH, Shim SC, Kim HG, Chae SC, Chung HT. Polymorphisms of COTL1 gene identified by proteomic approach and their association with autoimmune disorders. Exp Mol Med. 2009;41(5):354–61.
pubmed: 19307756 pmcid: 2701985 doi: 10.3858/emm.2009.41.5.040
Baran CP, Fischer SN, Nuovo GJ, et al. Transcription factor ets-2 plays an important role in the pathogenesis of pulmonary fibrosis. Am J Respir Cell Mol Biol. 2011;45(5):999–1006.
pubmed: 21562315 pmcid: 3262682 doi: 10.1165/rcmb.2010-0490OC
Singh AK, Haque M, Madarampalli B, et al. Ets-2 propagates IL-6 trans-signaling mediated osteoclast-like changes in human rheumatoid arthritis synovial fibroblast. Front Immunol. 2021;12:746503.
pubmed: 34795667 pmcid: 8593237 doi: 10.3389/fimmu.2021.746503
Rivellese F, Surace AEA, Goldmann K, et al. Rituximab versus tocilizumab in rheumatoid arthritis: synovial biopsy-based biomarker analysis of the phase 4 R4RA randomized trial. Nat Med. 2022;28(6):1256–68.
pubmed: 35589854 pmcid: 9205785 doi: 10.1038/s41591-022-01789-0
Zou Z, Tao T, Li H, Zhu X. mTOR signaling pathway and mTOR inhibitors in cancer: progress and challenges. Cell Biosci. 2020;10:31.
pubmed: 32175074 pmcid: 7063815 doi: 10.1186/s13578-020-00396-1
Bruyn GA, Tate G, Caeiro F, et al. Everolimus in patients with rheumatoid arthritis receiving concomitant methotrexate: a 3-month, double-blind, randomised, placebo-controlled, parallel-group, proof-of-concept study. Ann Rheum Dis. 2008;67(8):1090–5.
pubmed: 18037627 doi: 10.1136/ard.2007.078808
Spring LM, Wander SA, Andre F, Moy B, Turner NC, Bardia A. Cyclin-dependent kinase 4 and 6 inhibitors for hormone receptor-positive breast cancer: past, present, and future. Lancet. 2020;395(10226):817–27.
pubmed: 32145796 doi: 10.1016/S0140-6736(20)30165-3
Okada Y, Wu D, Trynka G, et al. Genetics of rheumatoid arthritis contributes to biology and drug discovery. Nature. 2014;506(7488):376–81.
pubmed: 24390342 doi: 10.1038/nature12873
Gotoh Y, Oishi K, Shibata H, et al. Protein kinase PKN1 associates with TRAF2 and is involved in TRAF2-NF-kappaB signaling pathway. Biochem Biophys Res Commun. 2004;314(3):688–94.
pubmed: 14741690 doi: 10.1016/j.bbrc.2003.12.148
Sun X, Liu T, Zhao J, et al. DNA-PK deficiency potentiates cGAS-mediated antiviral innate immunity. Nat Commun. 2020;11(1):6182.
pubmed: 33273464 pmcid: 7712783 doi: 10.1038/s41467-020-19941-0
Wang F, Zhao M, Chang B, et al. Cytoplasmic PARP1 links the genome instability to the inhibition of antiviral immunity through PARylating cGAS. Mol Cell. 2022;82(11):2032–49 e7.
pubmed: 35460603 doi: 10.1016/j.molcel.2022.03.034
Edilova MI, Law JC, Zangiabadi S, et al. The PKN1- TRAF1 signaling axis as a potential new target for chronic lymphocytic leukemia. Oncoimmunology. 2021;10(1):1943234.
pubmed: 34589290 pmcid: 8475556 doi: 10.1080/2162402X.2021.1943234
Simanshu DK, Nissley DV, McCormick F. RAS proteins and their regulators in human disease. Cell. 2017;170(1):17–33.
pubmed: 28666118 pmcid: 5555610 doi: 10.1016/j.cell.2017.06.009
Adamson SE, Griffiths R, Moravec R, et al. Disabled homolog 2 controls macrophage phenotypic polarization and adipose tissue inflammation. J Clin Invest. 2016;126(4):1311–22.
pubmed: 26927671 pmcid: 4811113 doi: 10.1172/JCI79590
Jain N, Nguyen H, Friedline RH, et al. Cutting edge: Dab2 is a FOXP3 target gene required for regulatory T cell function. J Immunol. 2009;183(7):4192–6.
pubmed: 19767570 doi: 10.4049/jimmunol.0902041

Auteurs

Cankut Çubuk (C)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK.

Rachel Lau (R)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK.

Pedro Cutillas (P)

Cell Signalling and Proteomics Group, Centre for Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK.

Vinothini Rajeeve (V)

Cell Signalling and Proteomics Group, Centre for Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, UK.

Christopher R John (CR)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK.

Anna E A Surace (AEA)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK.

Rebecca Hands (R)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK.

Liliane Fossati-Jimack (L)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK.

Myles J Lewis (MJ)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK. myles.lewis@qmul.ac.uk.

Costantino Pitzalis (C)

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC & NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK. c.pitzalis@qmul.ac.uk.
IRCCS Istituto Clinico Humanitas, Via Manzoni 56, Rozzao, Milan, Italy. c.pitzalis@qmul.ac.uk.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

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

Classifications MeSH