1
|
Ergenc I, Capar E, Erturk SB, Bahramzade G, Atalah F, Kocakaya D, Karakurt S, Haklar G, Odabasi Z. Diagnostic performance of lactate dehydrogenase (LDH) isoenzymes levels for the severity of COVID-19. J Med Biochem 2023; 42:16-26. [PMID: 36819140 PMCID: PMC9920992 DOI: 10.5937/jomb0-37234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/09/2022] [Indexed: 11/02/2022] Open
Abstract
Background Lactate dehydrogenase (LDH) levels predict coronavirus disease 2019 (COVID-19) severity. We investigated LDH isoenzyme levels to identify the tissue responsible for serum LDH elevation in patients with COVID-19. Methods Hospitalised COVID-19 patients with serum LDH levels exceeding the upper reference limit included. LDH isoenzymes were detected quantitatively on agarose gels. The radiological severity of lung involvement on computed tomography was scored as 0-5 for each lobe (total possible score, 0-25). Disease severity was determined using the World Health Organization (WHO) clinical progression scale. Results In total, 111 patients (mean age, 59.96 ± 16.14), including 43 females (38.7%), were enrolled. The serum levels of total LDH and all five LDH isoenzymes were significantly higher in the severe group. The levels of all LDH isoenzymes excluding LDH5 positively correlated with the WHO score. LDH3 levels correlated with chest computed tomography findings (r2 = 0.267, p = 0.005). On multivariate analysis, LDH3 was an independent risk factor for the deterioration of COVID-19. Conclusions LDH3 appears to be an independent risk factor for deterioration in patients with COVID-19. LDH elevation in patients with COVID-19 predominantly resulted from lung, liver and muscle damage.
Collapse
Affiliation(s)
- Ilkay Ergenc
- Marmara University, School of Medicine, Department of Gastroenterology, Istanbul, Turkey
| | - Emre Capar
- Marmara University, School of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - Sengel Buket Erturk
- Marmara University, School of Medicine, Department of Infectious Disease and Clinical Microbiology, Istanbul, Turkey
| | - Gunel Bahramzade
- Marmara University, School of Medicine, Department of Biochemistry, Istanbul, Turkey
| | - Fatih Atalah
- Marmara University, School of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - Derya Kocakaya
- Marmara University, School of Medicine, Department of Pulmonary Medicine, Istanbul, Turkey
| | - Sait Karakurt
- Marmara University, School of Medicine, Department of Pulmonary Medicine, Istanbul, Turkey
| | - Goncagul Haklar
- Marmara University, School of Medicine, Department of Biochemistry, Istanbul, Turkey
| | - Zekaver Odabasi
- Marmara University, School of Medicine, Department of Internal Medicine, Istanbul, Turkey
| |
Collapse
|
2
|
Salvioni L, Testa F, Sulejmani A, Pepe F, Giorgio Lovaglio P, Berta P, Dominici R, Leoni V, Prosperi D, Vittadini G, Colombo M, Fiandra L. Surfactant protein D (SP-D) as a biomarker of SARS-CoV-2 infection. Clin Chim Acta 2022; 537:140-145. [PMCID: PMC9617654 DOI: 10.1016/j.cca.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
Background Surfactant protein-D (SP-D) is a lung-resident protein that has emerged as a potential biomarker for COVID-19. Previous investigations on acute respiratory distress syndrome patients demonstrated a significant increment of SP-D serum levels in pathological conditions. Since SP-D is not physiologically permeable to alveoli-capillary membrane and poorly expressed by other tissues, this enhancement is likely due to an impairment of the pulmonary barrier caused by prolonged inflammation. Methods A retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio was conducted to assess differences of the hematic SP-D concentrations among COVID-19 patients and healthy donors and if SP-D levels resulted a risk factor for disease severity and mortality. Results The first analysis, using an ANOVA-model, showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors. Significant variations were also found between dead vs survived patients. Results confirm that SP-D concentrations were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. Further analysis conducted with Logistic Mixed models, highlighted that higher SP-D levels at admission and increasing differences among follow-up and admission values resulted the strongest significant risk factors of mortality (model predictive accuracy, AUC = 0.844). Conclusions The results indicate that SP-D can be a predictive marker of COVID-19 disease and its outcome. Considering its prognostic value in terms of mortality, the early detection of SP-D levels and its follow-up in hospitalized patients should be considered to direct the therapeutic intervention.
Collapse
Affiliation(s)
- Lucia Salvioni
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milan, Italy
| | - Filippo Testa
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milan, Italy
| | - Adela Sulejmani
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Francesca Pepe
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Pietro Giorgio Lovaglio
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy
| | - Paolo Berta
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy
| | - Roberto Dominici
- Laboratory of Clinical Biochemistry, Ospedale Pio XI of Desio, ASST-Brianza, via Mazzini 1, 20833 Desio, Italy
| | - Valerio Leoni
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, 20900 Monza, Italy,Laboratory of Clinical Biochemistry, Ospedale Pio XI of Desio, ASST-Brianza, via Mazzini 1, 20833 Desio, Italy
| | - Davide Prosperi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milan, Italy
| | - Giorgio Vittadini
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy
| | - Miriam Colombo
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milan, Italy,Corresponding authors
| | - Luisa Fiandra
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, P.zza della Scienza 2, 20126 Milan, Italy,Corresponding authors
| |
Collapse
|
3
|
Santos RS, Barros DS, Moraes TM, Hayashi CY, Ralio RB, Minenelli FF, van Zon K, Ripardo JP. Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a Brazilian hospital: a retrospective study of the first and second waves. IJID REGIONS 2022; 3:189-195. [PMID: 35720152 PMCID: PMC9007747 DOI: 10.1016/j.ijregi.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/06/2022] [Accepted: 04/10/2022] [Indexed: 12/15/2022]
Abstract
This study describes the characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) in a Brazilian hospital. Characteristics from the first and second waves were compared. The number of cases was higher in the second wave, but hospitalizations were lower, compared with the first wave. Admission and death rates were slightly lower in the study hospital compared with national rates. This study can help managers to plan resources needed for the treatment of patients with COVID-19.
Objectives To describe clinical characteristics, hospitalization flow and outcomes in a cohort of patients with coronavirus disease 2019 (COVID-19) in a Brazilian hospital in the first and second waves of the pandemic. Methods This retrospective, observational study included patients with confirmed COVID-19 who were evaluated in the emergency department (ED) between 1 March 2020 and 30 June 2021. Descriptive statistics have been used to report clinical characteristics, admissions and outcomes. Comparison between the two waves was inferred using hypothesis test techniques. Results During the study period, 7723 (86.54%) patients were evaluated in the ED, of which 1908 (24.70%) were admitted. Of these, 476 (24.95%) patients were initially allocated to the intensive care unit (ICU) and 1432 (75.05%) to the general ward. Of the patients initially allocated to the general ward, 349 (24.37%) were later transferred to the ICU. One hundred and fifty-eight patients were intubated (19.15% of ICU admissions) and 110 patients died (5.77% of all admissions). In the second wave, the admission rates decreased in both the ICU (from 13.84% to 9.56%; P<0.01) and the general ward (from 22.41% to 17.16%; P<0.01). The average age in the second wave decreased from 44.06 to 41.87 years (P<0.01). Patients with severe symptoms, such as dyspnoea, decreased from 25.51% to 13.13% (P<0.01) in the second wave. The death rate among admitted patients decreased by 17.84% (from 6.52% to 5.38%; P<0.01). Conclusion Despite the greater number of patients in the second wave, the admission and death rates were lower compared with the first wave. The mean age of patients was lower in the second wave, and patients arrived at the hospital with less severe symptoms compared with the first wave.
Collapse
|
4
|
Taha SI, Shata AK, El-Sehsah EM, Mohamed MF, Moustafa NM, Youssef MK. Comparison of COVID-19 characteristics in Egyptian patients according to their Toll-Like Receptor-4 (Asp299Gly) polymorphism. LE INFEZIONI IN MEDICINA 2022; 30:96-103. [PMID: 35350262 PMCID: PMC8929736 DOI: 10.53854/liim-3001-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/06/2022] [Indexed: 04/21/2023]
Abstract
BACKGROUND Toll-like receptor (TLR)-4 plays a vital role in recognizing viral particles, activating the innate immune system, and producing pro-inflammatory cytokines. OBJECTIVES This cross-sectional study aimed to compare COVID-19 severity, progression, and fate according to TLR-4 (Asp299Gly) polymorphism in Egyptian patients. METHODS A total of 145 COVID-19 patients were included in this study. TLR-4 (Asp299Gly) genotyping was done using the PCR restriction fragment length polymorphism (PCR-RFLP) approach. RESULTS The most commonly encountered TLR-4 genotype in relation to the amino acid at position 299 was the wild-type AA (73.1%); meanwhile, the homozygous mutant GG genotype (8.3%) was the least encountered. At hospital admission, 85.8% of the AA group had free (with no ground glass opacities) chest computed tomography (CT) examination, and 16.0% were asymptomatic. On the other hand, of the AG and GG groups, 81.5% and 83.3%, respectively showed bilateral ground-glass opacities in chest CT, as well as 25.9% and 75.0%, respectively were dyspneic. Values of the total leucocytic count, C-reactive protein (CRP), ferritin, and D dimer increased in the AA<AG<GG sequence. In contrast, hemoglobin values and the absolute lymphocyte counts decreased in the AA>AG>GG sequence. ICU admission (83.3%) and in-hospital death (33.3%) rates were significantly higher in the GG group. CONCLUSIONS In COVID-19 patients, the TLR-4 mutant G allele may be associated with a more aggressive disease course and in-hospital death. New therapeutic alternatives could be aimed at this area.
Collapse
Affiliation(s)
- Sara I Taha
- Department of Clinical Pathology/Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Aalaa K Shata
- Department of Pulmonary Medicine, Faculty of Medicine, Ain Shams university, Cairo, Egypt
| | - Eman M El-Sehsah
- Department of Medical Microbiology and Immunology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Manar F Mohamed
- Department of Internal Medicine, Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nouran M Moustafa
- Basic Medical Science Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
- Medical Microbiology and Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mariam K Youssef
- Department of Clinical Pathology/Hematology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
5
|
Wang L, Yang LM, Pei SF, Chong YZ, Guo Y, Gao XL, Tang QY, Li Y, Feng FM. CRP, SAA, LDH, and DD predict poor prognosis of coronavirus disease (COVID-19): a meta-analysis from 7739 patients. Scandinavian Journal of Clinical and Laboratory Investigation 2021; 81:679-686. [PMID: 34762008 DOI: 10.1080/00365513.2021.2000635] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Understanding factors associated with disease severity and mortality from coronavirus disease (COVID-19) was critical for effective risk stratification. We aimed to investigate the association between biomarkers of clinical laboratory tests, including serum C-reactive protein (CRP), serum amyloid protein (SAA), lactate dehydrogenase (LDH), and D-dimer (DD) and poor prognosis of COVID-19. We have searched many studies on COVID-19 on PubMed (Medline), Web of Science and Cochrane until 1 March 2021. The interest of this study was original articles reporting on laboratory testing projects and outcome of patients with COVID-19 that comprises mortality, acute respiratory distress syndrome (ARDS), need for care in an intensive care unit (ICU), and severe COVID-19. After synthesizing all data, we performed meta-analysis of random effects, and determined mean difference (MD) and standard mean difference at the biomarker level for different disease severity. A total of 7,739 patients with COVID-19 were pooled from 32 studies. CRP was significantly associated with poor prognosis of COVID-19 (SMD = 0.98, 95% CI = (0.85, 1.11), p < .001). Elevated SAA was associated with an increased composite poor outcome in COVID-19 (SMD = 1.06, 95% CI = (0.39, 1.72), p = .002). An elevated LDH was associated with a composite poor outcome (SMD = 1.18, 95% CI = (1.00, 1.36), p < .001). Patients with a composite poor outcome had a higher DD level (SMD = 0.91, 95% CI = (0.79, 1.02), p < .001). This meta-analysis showed that elevated serum CRP, SAA, LDH, and DD were associated with a poor outcome in COVID-19.
Collapse
Affiliation(s)
- Lin Wang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Lu Ming Yang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Sheng Fei Pei
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Ying Zhi Chong
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Yu Guo
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Xue Lei Gao
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Qin Yan Tang
- School of Life Science, North China University of Science and Technology, Tangshan, China
| | - Yue Li
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Fu Min Feng
- School of Public Health, North China University of Science and Technology, Tangshan, China.,School of Life Science, North China University of Science and Technology, Tangshan, China
| |
Collapse
|
6
|
Puri A, He L, Giri M, Wu C, Zhao Q. Comparison of comorbidities among severe and non-severe COVID-19 patients in Asian versus non-Asian populations: A systematic review and meta-analysis. Nurs Open 2021; 9:733-751. [PMID: 34761532 PMCID: PMC8661719 DOI: 10.1002/nop2.1126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/25/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the comorbidities among severe and non-severe COVID-19 patients in Asian versus non-Asian populations. DESIGN Systemic review and Meta-analysis. METHODS A systematic literature search was conducted using PubMed, Embase, Scopus and the web of science Database up to 24 March 2021. Odds ratios were calculated using a random-effects model. RESULTS We identified 66 studies including 39 Asian and 27 non-Asian studies. This study demonstrated that the proportion of hypertension was significantly higher in severe group than in non-severe group for Asian (OR = 2.46) and non-Asian (OR = 1.60, 95% CI: 1.37-1.86, I2 = 84%; p < .00001) patients. Similarly, the proportion of diabetes, cardiovascular disease and chronic kidney disease was significantly higher in severe group than in non-severe group for both Asian and non-Asian studies. We found no statistically significant difference between the severe versus non-severe group for cancer (OR = 1.26) and chronic obstructive pulmonary disease (OR = 1.32) among non-Asian patients.
Collapse
Affiliation(s)
- Anju Puri
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin He
- Department of Respiratory and Critical Care Medicine, Fuling Central Hospital of Chongqing City, Chongqing, China
| | - Mohan Giri
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chengfei Wu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
7
|
Ghzaiel I, Sassi K, Zarrouk A, Nury T, Ksila M, Leoni V, Bouhaouala-Zahar B, Hammami S, Hammami M, Mackrill JJ, Samadi M, Ghrairi T, Vejux A, Lizard G. 7-Ketocholesterol: Effects on viral infections and hypothetical contribution in COVID-19. J Steroid Biochem Mol Biol 2021; 212:105939. [PMID: 34118414 PMCID: PMC8188774 DOI: 10.1016/j.jsbmb.2021.105939] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023]
Abstract
7-Ketocholesterol, which is one of the earliest cholesterol oxidization products identified, is essentially formed by the auto-oxidation of cholesterol. In the body, 7-ketocholesterol is both provided by food and produced endogenously. This pro-oxidant and pro-inflammatory molecule, which can activate apoptosis and autophagy at high concentrations, is an abundant component of oxidized Low Density Lipoproteins. 7-Ketocholesterol appears to significantly contribute to the development of age-related diseases (cardiovascular diseases, age-related macular degeneration, and Alzheimer's disease), chronic inflammatory bowel diseases and to certain cancers. Recent studies have also shown that 7-ketocholesterol has anti-viral activities, including on SARS-CoV-2, which are, however, lower than those of oxysterols resulting from the oxidation of cholesterol on the side chain. Furthermore, 7-ketocholesterol is increased in the serum of moderately and severely affected COVID-19 patients. In the case of COVID-19, it can be assumed that the antiviral activity of 7-ketocholesterol could be counterbalanced by its toxic effects, including pro-oxidant, pro-inflammatory and pro-coagulant activities that might promote the induction of cell death in alveolar cells. It is therefore suggested that this oxysterol might be involved in the pathophysiology of COVID-19 by contributing to the acute respiratory distress syndrome and promoting a deleterious, even fatal outcome. Thus, 7-ketocholesterol could possibly constitute a lipid biomarker of COVID-19 outcome and counteracting its toxic effects with adjuvant therapies might have beneficial effects in COVID-19 patients.
Collapse
Affiliation(s)
- Imen Ghzaiel
- University Bourgogne Franche-Comté, Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA 7270 / Inserm, 21000 Dijon, France; University of Monastir, Faculty of Medicine, LR12ES05, Lab-NAFS 'Nutrition - Functional Food & Vascular Health', 5000 Monastir, Tunisia; University Tunis-El Manar, Faculty of Sciences of Tunis, 2092 Tunis, Tunisia.
| | - Khouloud Sassi
- University Bourgogne Franche-Comté, Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA 7270 / Inserm, 21000 Dijon, France; University Tunis El Manar, Laboratory of Onco-Hematology (LR05ES05), Faculty of Medicine, 1007 Tunis, Tunisia.
| | - Amira Zarrouk
- University of Monastir, Faculty of Medicine, LR12ES05, Lab-NAFS 'Nutrition - Functional Food & Vascular Health', 5000 Monastir, Tunisia; University of Sousse, Faculty of Medicine, Sousse, Tunisia.
| | - Thomas Nury
- University Bourgogne Franche-Comté, Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA 7270 / Inserm, 21000 Dijon, France.
| | - Mohamed Ksila
- University Bourgogne Franche-Comté, Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA 7270 / Inserm, 21000 Dijon, France; University Tunis-El Manar, Loboratory of Neurophysiology, Cellular Physiopathology and Valorisation of BioMoleecules, LR18ES03, Department of Biologie, Faculty of Sciences, 2092 Tunis, Tunisia.
| | - Valerio Leoni
- Laboratory of Clinical Chemistry, Hospitals of Desio, ASST-Brianza and Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy.
| | - Balkiss Bouhaouala-Zahar
- Laboratory of Venoms and Therapeutic Molecules, Pasteur Institute of Tunis & University of Tunis El Manar, 1002 Tunis, Tunisia.
| | - Sonia Hammami
- University of Monastir, Faculty of Medicine, LR12ES05, Lab-NAFS 'Nutrition - Functional Food & Vascular Health', 5000 Monastir, Tunisia.
| | - Mohamed Hammami
- University of Monastir, Faculty of Medicine, LR12ES05, Lab-NAFS 'Nutrition - Functional Food & Vascular Health', 5000 Monastir, Tunisia.
| | - John J Mackrill
- Department of Physiology, School of Medicine, University College Cork, Cork, Ireland.
| | - Mohammad Samadi
- LCPMC-A2, ICPM, Dept of Chemistry, Univ. Lorraine, Metz Technopôle, Metz, France.
| | - Taoufik Ghrairi
- University Tunis-El Manar, Loboratory of Neurophysiology, Cellular Physiopathology and Valorisation of BioMoleecules, LR18ES03, Department of Biologie, Faculty of Sciences, 2092 Tunis, Tunisia.
| | - Anne Vejux
- University Bourgogne Franche-Comté, Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA 7270 / Inserm, 21000 Dijon, France.
| | - Gérard Lizard
- University Bourgogne Franche-Comté, Team 'Biochemistry of the Peroxisome, Inflammation and Lipid Metabolism' EA 7270 / Inserm, 21000 Dijon, France.
| |
Collapse
|