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Nam SH, Kim JA, Lim S, Lee SJ, Kim CH, Bae JS, Boo YC, Kim YJ, Park EK. Glycinamide Facilitates Nanocomplex Formation and Functions Synergistically with Bone Morphogenetic Protein 2 to Promote Osteoblast Differentiation In Vitro and Bone Regeneration in a Mouse Calvarial Defect Model. Tissue Eng Regen Med 2024; 21:1093-1107. [PMID: 38955905 PMCID: PMC11416447 DOI: 10.1007/s13770-024-00657-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/06/2024] [Accepted: 06/09/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND This study aimed to identify glycine analogs conducive to the formation of cell-absorbable nanocomplexes, enhancing collagen synthesis and subsequent osteogenesis in combination with BMP2 for improved bone regeneration. METHODS Glycine and its derivatives were assessed for their effects on osteogenic differentiation in MC3T3-E1 cells and human bone marrow mesenchymal stem cells (BMSCs) under osteogenic conditions or with BMP2. Osteogenic differentiation was assessed through alkaline phosphatase staining and real-time quantitative polymerase chain reaction (RT-qPCR). Nanocomplex formation was examined via scanning electron microscopy, circular dichroism, and ultraviolet-visible spectroscopy. In vivo osteogenic effects were validated using a mouse calvarial defect model, and bone regeneration was evaluated through micro-computed tomography and histomorphometric analysis. RESULTS Glycine, glycine methyl ester, and glycinamide significantly enhanced collagen synthesis and ALP activity in conjunction with an osteogenic medium (OSM). GA emerged as the most effective inducer of osteoblast differentiation marker genes. Combining GA with BMP2 synergistically stimulated ALP activity and the expression of osteoblast markers in both cell lines. GA readily formed nanocomplexes, facilitating cellular uptake through strong electrostatic interactions. In an in vivo calvarial defect mouse model, the GA and BMP2 combination demonstrated enhanced bone volume, bone volume/tissue volume ratio, trabecular numbers, and mature bone formation compared to other combinations. CONCLUSION GA and BMP2 synergistically promoted in vitro osteoblast differentiation and in vivo bone regeneration through nanocomplex formation. This combination holds therapeutic promise for individuals with bone defects, showcasing its potential for clinical intervention.
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Affiliation(s)
- Sang-Hyeon Nam
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Institute for Hard Tissue and Bio-Tooth Regeneration, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Ju Ang Kim
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Institute for Hard Tissue and Bio-Tooth Regeneration, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Soomin Lim
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Institute for Hard Tissue and Bio-Tooth Regeneration, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Su Jeong Lee
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Institute for Hard Tissue and Bio-Tooth Regeneration, Kyungpook National University, Daegu, 41940, Republic of Korea
| | - Chun-Ho Kim
- Laboratory of Tissue Engineering, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, Republic of Korea
| | - Jong-Sup Bae
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Yong Chool Boo
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea
| | - Young-Jin Kim
- Department of Biomedical Engineering, Daegu Catholic University, Gyeongsan, 38430, Republic of Korea.
| | - Eui Kyun Park
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Institute for Hard Tissue and Bio-Tooth Regeneration, Kyungpook National University, Daegu, 41940, Republic of Korea.
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Li Y, Si Y, Ma Y, Yin H. Application and prospect of metabolomics in the early diagnosis of osteoporosis: a narrative review. Bioanalysis 2023; 15:1369-1379. [PMID: 37695026 DOI: 10.4155/bio-2023-0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
This paper reviews the application of metabolomics in the early diagnosis of osteoporosis in recent years. The authors searched electronic databases for the keywords "metabolomics", "osteoporosis" and "biomarkers", then analyzed the relationship between functional markers and osteoporosis using categorical summarization. Lipid metabolism, amino acid metabolism and energy metabolism are closely related to osteoporosis development and can become early diagnostic markers of the condition. However, the existing studies in metabolomics suffer from varying application methods, difficulty in identifying isomers, small study cohorts and insufficient research on metabolic mechanisms. Consequently, it is important for future research to focus on broadening and standardizing the scope of the application of metabolomics. High-quality studies on a large scale should also be conducted while promoting the early diagnosis of osteoporosis in a more precise, comprehensive and sensitive manner.
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Affiliation(s)
- Yan Li
- School of Medicine, Southeast University, Nanjing, Jiangsu Province, 210009, China
| | - Yuhao Si
- School of Acupuncture-Moxibustion & Tuina, School of Regimen & Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, 210023, China
- Laboratory for New Techniques of Restoration & Reconstruction of Orthopedics & Traumatology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, 210023, China
| | - Yong Ma
- Laboratory for New Techniques of Restoration & Reconstruction of Orthopedics & Traumatology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, 210023, China
- College of Basic Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, 210023, China
| | - Heng Yin
- Department of Traumatology & Orthopedics, Wuxi TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, Jiangsu Province, 214071, China
- Jiangsu CM Clinical Innovation Center of Degenerative Bone & Joint Disease, Wuxi TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi, Jiangsu Province, 214071, China
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Lau KT, Krishnamoorthy S, Sing CW, Cheung CL. Metabolomics of Osteoporosis in Humans: A Systematic Review. Curr Osteoporos Rep 2023; 21:278-288. [PMID: 37060383 DOI: 10.1007/s11914-023-00785-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE OF REVIEW To systematically review recent studies investigating the association between metabolites and bone mineral density (BMD) in humans. METHODS Using predefined keywords, we searched literature published from Jan 1, 2019 to Feb 20, 2022 in PubMed, Web of Science, Embase, and Scopus. Studies that met the predefined exclusion criteria were excluded. Among the included studies, we identified metabolites that were reported to be associated with BMD by at least three independent studies. RECENT FINDINGS A total of 170 studies were retrieved from the databases. After excluding studies that did not meet our predefined inclusion criteria, 16 articles were used in this review. More than 400 unique metabolites in blood were shown to be significantly associated with BMD. Of these, three metabolites were reported by ≥ 3 studies, namely valine, leucine and glycine. Glycine was consistently shown to be inversely associated with BMD, while valine was consistently observed to be positively associated with BMD. Inconsistent associations with BMD was observed for leucine. With advances in metabolomics technology, an increasing number of metabolites associated with BMD have been identified. Two of these metabolites, namely valine and glycine, were consistently associated with BMD, highlighting their potential for clinical application in osteoporosis. International collaboration with a larger population to conduct clinical studies on these metabolites is warranted. On the other hand, given that metabolomics could be affected by genetics and environmental factors, whether the inconsistent association of the metabolites with BMD is due to the interaction between metabolites and genes and/or lifestyle warrants further study.
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Affiliation(s)
- Kat-Tik Lau
- Department of Pharmacology and Pharmacy, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Suhas Krishnamoorthy
- Department of Pharmacology and Pharmacy, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Chor-Wing Sing
- Department of Pharmacology and Pharmacy, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Ching Lung Cheung
- Department of Pharmacology and Pharmacy, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong.
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Johnson AA, Cuellar TL. Glycine and aging: Evidence and mechanisms. Ageing Res Rev 2023; 87:101922. [PMID: 37004845 DOI: 10.1016/j.arr.2023.101922] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
The restriction of calories, branched-chain amino acids, and methionine have all been shown to extend lifespan in model organisms. Recently, glycine was shown to significantly boost longevity in genetically heterogenous mice. This simple amino acid similarly extends lifespan in rats and improves health in mammalian models of age-related disease. While compelling data indicate that glycine is a pro-longevity molecule, divergent mechanisms may underlie its effects on aging. Glycine is abundant in collagen, a building block for glutathione, a precursor to creatine, and an acceptor for the enzyme Glycine N-methyltransferase (GNMT). A review of the literature strongly implicates GNMT, which clears methionine from the body by taking a methyl group from S-adenosyl-L-methionine and methylating glycine to form sarcosine. In flies, Gnmt is required for reduced insulin/insulin-like growth factor 1 signaling and caloric restriction to fully extend lifespan. The geroprotector spermidine requires Gnmt to upregulate autophagy genes and boost longevity. Moreover, the overexpression of Gnmt is sufficient to extend lifespan and reduce methionine levels. Sarcosine, or methylglycine, declines with age in multiple species and is capable of inducing autophagy both in vitro and in vivo. Taken all together, existing evidence suggests that glycine prolongs life by mimicking methionine restriction and activating autophagy.
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Wang T, Luo E, Zhou Z, Yang J, Wang J, Zhong J, Zhang J, Yao B, Li X, Dong H. Lyophilized powder of velvet antler blood improves osteoporosis in OVX-induced mouse model and regulates proliferation and differentiation of primary osteoblasts via Wnt/β-catenin pathway. J Funct Foods 2023. [DOI: 10.1016/j.jff.2023.105439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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Akter R, Chan Ahn J, Nahar J, Awais M, Ramadhania ZM, Oh SW, Oh JH, Kong BM, Rupa EJ, Lee DW, Yang DC, Chan kang S. Pomegranate juice fermented by tannin acyl hydrolase and Lactobacillus vespulae DCY75 enhance estrogen receptor expression and anti-inflammatory effect. Front Pharmacol 2022; 13:1010103. [PMID: 36249796 PMCID: PMC9558905 DOI: 10.3389/fphar.2022.1010103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Phenolics are phytochemicals in plants, fruits, and vegetables have potential health-promoting efficacies. However, mostly available as a complex form. So, to increase the contents and nutritional value of the phenolic compounds, fermentation is most readily used in the food industry. Especially, the hydrolyzable tannins present in the pomegranate that can be liberated into monomolecular substances, which enhances biological activity. Thus, this study aims to convert hydrolyzable tannins to ellagic acid by fermentation using Tannin acyl hydrolase (TAH) and a novel bacteria strain Lactobacillus vespulae DCY75, respectively to investigate its effect on Estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ) mRNA expression along with inflammation inhibition. As a result, the fermentation enhanced the ellagic acid content up to 70% by the synergetic effect of TAH and DCY75. Furthermore, fermented pomegranate (PG-F) increased cellular proliferation as well as upregulated the gene expression of estrogen regulators such as ERα, ERβ, and pS2 in breast cancer cell line (MCF-7), which commonly used to evaluate estrogenic activity. Moreover, to study the inflammation associated with low estrogen in menopause, we have analyzed the inhibition of nitric oxide (NO)/inducible nitric oxide synthase (iNOS) in RAW 264.7 cells. The PG-F juice did not exert any cytotoxicity in RAW 264.7 cells and inhibited NO production along with the downregulation of a major pro-inflammatory cytokine iNOS which indicates the anti-inflammatory potential of it. To sum it up, the fermented commercial pomegranate juice using a novel bacteria strain increased the amount of ellagic acid that the value added bioactive of pomegranate and it has significantly increased the estrogenic activity via upregulating estrogen related biomarkers expression and reduced the risk of related inflammation via NO/iNOS inhibition. This study could be a preliminary study to use fermented pomegranate as a potential health functional food after further evaluation.
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Affiliation(s)
- Reshmi Akter
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
| | - Jong Chan Ahn
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
| | - Jinnatun Nahar
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
| | - Muhammad Awais
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
| | - Zelika Mega Ramadhania
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
| | - Se-Woung Oh
- SMART FRUIT CO., LTD., Guri, Gyeonggi-do, South Korea
| | - Ji-Hyung Oh
- Fruitycompany Co., Ltd., Guri, Gyeonggi-do, South Korea
| | - Byoung Man Kong
- Department of Oriental Medicinal Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
| | - Esrat Jahan Rupa
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
| | | | - Deok Chun Yang
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
- *Correspondence: Deok Chun Yang, ; Se Chan kang,
| | - Se Chan kang
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Seoul, Gyeonggi-do, South Korea
- *Correspondence: Deok Chun Yang, ; Se Chan kang,
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The Effect of Rutin on Progesterone and Estrogen Receptor Expression in Uterine Endometrial Tissue in the Heterotopic Transplantation of Newborn Mouse Ovary. IRANIAN RED CRESCENT MEDICAL JOURNAL 2019. [DOI: 10.5812/ircmj.86289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Kim G, Park YS, Lee Y, Jin YM, Choi DH, Ryu KH, Park YJ, Park KD, Jo I. Tonsil-derived mesenchymal stem cell-embedded in situ crosslinkable gelatin hydrogel therapy recovers postmenopausal osteoporosis through bone regeneration. PLoS One 2018; 13:e0200111. [PMID: 29975738 PMCID: PMC6033433 DOI: 10.1371/journal.pone.0200111] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/19/2018] [Indexed: 12/23/2022] Open
Abstract
We investigated therapeutic potential of human tonsil-derived mesenchymal stem cells (TMSC) subcutaneously delivered to ovariectomized (OVX) mice for developing more safe and effective therapy for osteoporosis. TMSC were isolated from tonsil tissues of children undergoing tonsillectomy, and TMSC-embedded in situ crosslinkable gelatin-hydroxyphenyl propionic acid hydrogel (TMSC-GHH) or TMSC alone were delivered subcutaneously to the dorsa of OVX mice. After 3 months, three-dimensionally reconstructed micro-computed tomographic images revealed better recovery of the femoral heads in OVX mice treated with TMSC-GHH. Serum osteocalcin and alkaline phosphatase were also recovered, indicating bone formation only in TMSC-GHH-treated mice, and absence in hypercalcemia or other severe macroscopic deformities showed biocompatibility of TMSC-GHH. Additionally, visceral fat reduction effects by TMSC-GHH further supported their therapeutic potential. TMSC provided therapeutic benefits toward osteoporosis only when embedded in GHH, and showed potential as a supplement or alternative to current therapies.
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Affiliation(s)
- Gyungah Kim
- Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Ewha Tonsil-derived mesenchymal Stem cells Research Center (ETSRC), College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yoon Shin Park
- Major in Microbiology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, Republic of Korea
| | - Yunki Lee
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Yoon Mi Jin
- Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Ewha Tonsil-derived mesenchymal Stem cells Research Center (ETSRC), College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Da Hyeon Choi
- Major in Microbiology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, Republic of Korea
| | - Kyung-Ha Ryu
- Ewha Tonsil-derived mesenchymal Stem cells Research Center (ETSRC), College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yoon Jeong Park
- Department of Dental Regenerative Biotechnology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
- Central Research Institute, Nano Intelligent Biomedical Engineering Corporation (NIBEC), Seoul, Republic of Korea
| | - Ki Dong Park
- Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Inho Jo
- Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
- Ewha Tonsil-derived mesenchymal Stem cells Research Center (ETSRC), College of Medicine, Ewha Womans University, Seoul, Republic of Korea
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McCarty MF, O'Keefe JH, DiNicolantonio JJ. Dietary Glycine Is Rate-Limiting for Glutathione Synthesis and May Have Broad Potential for Health Protection. Ochsner J 2018; 18:81-87. [PMID: 29559876 PMCID: PMC5855430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Glutathione is a key scavenging antioxidant that opposes the proinflammatory signaling of hydrogen peroxide. Boosting cellular glutathione levels may have broad utility in the prevention and treatment of disorders driven by oxidative stress. Supplemental N-acetylcysteine has been employed for this purpose. Could supplemental glycine likewise promote glutathione synthesis? METHODS We conducted a review of the pertinent literature using PubMed. RESULTS Tissue glycine levels are lower than the glutathione synthase Michaelis constant (Km) for glycine. When glycine availability is too low to sustain a normal rate of glutathione synthesis, the consequent rise in tissue levels of gamma-glutamylcysteine leads to an increase in urinary excretion of its alternative metabolite 5-L-oxoproline. The fact that urinary excretion of this metabolite is elevated in vegetarians and others consuming relatively low-protein diets strongly suggests that dietary glycine can be rate-limiting for glutathione synthesis in normally fed humans. Moreover, supplemental glycine has been reported to increase tissue glutathione levels in several animal studies. Glycine is a biosynthetic precursor for porphyrins, purines, creatine, sarcosine, and bile salts; is an agonist for glycine-gated chloride channels and a coagonist for N-methyl-D-aspartate receptors; inhibits protein glycation; and increases hepatic production of pyruvate, an effective scavenger of hydrogen peroxide. Supplemental glycine may have the potential for improving endothelial function, preventing cardiac hypertrophy, aiding control of metabolic syndrome, preventing the complications of diabetes, dampening inflammation, protecting the liver, and promoting effective sleep. CONCLUSION Clinical research is warranted to evaluate the impact of supplemental glycine on glutathione levels and on various health disorders.
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Affiliation(s)
| | - James H. O'Keefe
- Department of Cardiology, Mid America Heart Institute, Saint Luke's Health System, Kansas City, MO
| | - James J. DiNicolantonio
- Department of Cardiology, Mid America Heart Institute, Saint Luke's Health System, Kansas City, MO
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Yao S, Guo Y, Dong SS, Hao RH, Chen XF, Chen YX, Chen JB, Tian Q, Deng HW, Yang TL. Regulatory element-based prediction identifies new susceptibility regulatory variants for osteoporosis. Hum Genet 2017. [PMID: 28634715 DOI: 10.1007/s00439-017-1825-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite genome-wide association studies (GWASs) have identified many susceptibility genes for osteoporosis, it still leaves a large part of missing heritability to be discovered. Integrating regulatory information and GWASs could offer new insights into the biological link between the susceptibility SNPs and osteoporosis. We generated five machine learning classifiers with osteoporosis-associated variants and regulatory features data. We gained the optimal classifier and predicted genome-wide SNPs to discover susceptibility regulatory variants. We further utilized Genetic Factors for Osteoporosis Consortium (GEFOS) and three in-house GWASs samples to validate the associations for predicted positive SNPs. The random forest classifier performed best among all machine learning methods with the F1 score of 0.8871. Using the optimized model, we predicted 37,584 candidate SNPs for osteoporosis. According to the meta-analysis results, a list of regulatory variants was significantly associated with osteoporosis after multiple testing corrections and contributed to the expression of known osteoporosis-associated protein-coding genes. In summary, combining GWASs and regulatory elements through machine learning could provide additional information for understanding the mechanism of osteoporosis. The regulatory variants we predicted will provide novel targets for etiology research and treatment of osteoporosis.
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Affiliation(s)
- Shi Yao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China
| | - Yan Guo
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China
| | - Shan-Shan Dong
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China
| | - Ruo-Han Hao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China
| | - Xiao-Feng Chen
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China
| | - Yi-Xiao Chen
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China
| | - Jia-Bin Chen
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China
| | - Qing Tian
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Hong-Wen Deng
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Tie-Lin Yang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, People's Republic of China.
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