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Biomedical subjects

N L Stephens

Publications and source records attributed to N L Stephens.

At least 37 records · Page 2Linked to original sources

Markers of airway smooth muscle cell phenotype.

Airway smooth muscle plays a principal role in the pathogenesis of asthma. Primary cultures are being used to investigate airway myocyte proliferation and cellular pathways regulating contraction. Airway smooth muscle cells (SMC) modulate from a contractile to a noncontractile phenotype in culture, but no systematic study of the concomitant changes in expression of cytocontractile and cytoskeletal proteins has been reported. We measured temporal changes in protein marker expression of canine tracheal SMC in primary culture, using specific antibodies and cDNA probes. Immunoblot analysis revealed that when cells became proliferative after 5 days of culture, the content of smooth muscle myosin heavy chain (sm-MHC), calponin, sm-alpha-actin, and desmin diminished by > 75%; myosin light chain kinase, h-caldesmon, and beta-tropomyosin had also decreased significantly (P < 0.05). Northern blots revealed that mRNA levels for sm-MHC and sm-alpha-actin were also significantly reduced in proliferative SMC. Conversely, immunoblotting demonstrated the content of non-muscle myosin heavy chain, l-caldesmon, vimentin, alpha/beta-protein kinase C (PKC), and CD44 homing cellular adhesion molecule (HCAM) increased one- to sixfold as cells became proliferative. The content of sm-MHC and sm-alpha-actin protein increased after confluence, suggesting that cultured airway SMC are capable of phenotypic plasticity. Marker protein contents were also compared, by immunoblot assay, between SMC dissociated from trachealis or pulmonary arterial media. Cytocontractile protein content was higher in the trachea, which shortens faster than the pulmonary artery. The identification of these markers provides tools for assessing the phenotype of airway SMC in culture and the airways of asthmatic patients.

Animals↗

Increased myosin light chain kinase content in sensitized canine saphenous vein.

Our previous studies revealed that smooth muscle from sensitized canine saphenous vein (SCSV) demonstrated greater active shortening capacity, maximum shortening velocity, and prolonged relaxation vis-a-vis the control muscle. These changes could be responsible for the in vivo hyperreactivity of venous smooth muscle observed in anaphylactic shock. Because smooth muscle cross-bridge cycling is regulated by myosin light chain kinase (MLCK)-dependent phosphorylation of the 20-kDa myosin light chain (MLC20), we studied MLC20 and MLCK phosphorylation in homogenates of SCSV and veins from littermate control dogs. We found that phosphorylation of MLC20 in SCSV homogenate was higher (42.26 +/- 5.10%) compared with control homogenates (26.69 +/- 3.30%; P < 0.05); MLCK content was significantly higher in SCSV homogenates [0.169 +/- 0.019 (SE) mu g/mg protein] than in control homogenates (0.075 +/- 0.004 mu g/mg protein; P < 0.05). Total MLCK activity increased from 6.16 +/- 0.60 x 10(-5) nmol Pi x mg fresh weight of tissue-1 x min-1 in control homogenates to 12.50 +/- 2.50 x 10(-5) nmol Pi x mg fresh weight of tissue-1 x min-1 in sensitized homogenates (P < 0.05). Specific MLCK activity was, however, similar in sensitized and control homogenates. The results of our study suggest that elevation of MLCK content in the homogenate could account for the increased contractility of the SCSV in anaphylactic shock.

Animals↗

Detection of two clusters of mechanical properties of smooth muscle along the airway tree.

Heterogeneity of function of airway smooth muscle along the airways may be of great importance in regulating regional ventilation and in the pathogenesis of asthma. To investigate the distribution of mechanical properties of airway smooth muscle along the airway, muscle strips free of cartilage and epithelium from the trachea down to bronchial generation 6 were studied by employing electrical field stimulation. Results showed that smooth muscle mechanical performance decreased progressively down the airway tree. Cluster analysis further indicated that smooth muscle from these airways could be divided into two groups: 1) an extrapulmonary group, which contains muscle from the trachea and bronchial generations 1 and 2 and is characterized by higher maximum shortening capacity and zero-load velocity of shortening (V0) in early shortening, the expected decrease of V0 values (the so-called latch phase) in the later phase of shortening, and lower sensitivity to stimulation; and 2) an intrapulmonary group, which contains bronchi from generations 3-6 and has a lower maximum shortening capacity and V0 in early shortening but higher sensitivity to stimulation. The relatively lower mechanical performance of intrapulmonary bronchial smooth muscle may represent a safety device that prevents excessive smooth muscle shortening in vivo.

Animals↗

The Schultz-Dale response of sensitized canine bronchial smooth muscle.

We wished to determine why in vitro agonist dose-response curves show reduced leftward shift (1/2-1 log dose units) in sensitized canine airway smooth muscle compared to curves elicited in vivo (2-3 log dose unit). The Schultz-Dale response was studied in sensitized dog tracheal (TSM) and bronchial (BSM) smooth muscle. Sensitized TSM challenged with specific antigen showed greater mechanical response, but only on exposure to 300 micrograms/ml; BSM responded to concentrations of ragweed as low as 0.001 microgram/ml. This result resolved the problem cited at the outset. Control TSM and BSM showed no response. The response in BSM is mediated through histamine release, and to a smaller extent by acetylcholine. With challenge release of histamine and acetylcholine increased significantly in sensitized airway smooth muscle. Integrated contractile responses obtained with high and low concentrations of antigen showed a dose-response relationship. Increased sensitivity of BSM to antigen compared to TSM indicates the former is the preparation of choice for study of allergic bronchoconstriction.

Acetylcholine↗

Increased Ca2+ and myosin phosphorylation, but not calmodulin activity in sensitized airway smooth muscles.

The increased shortening velocity and capacity of airway smooth muscle (ASM) from ragweed pollen-sensitized dogs, which may be responsible for its in vivo airway hyperresponsiveness, have been shown to be associated with higher actomyosin adenosinetriphosphatase activity and greater level of phosphorylation of the 20-kDa myosin light-chain (MLC20) at rest and during contraction. Current studies show that the elevated level of phosphorylation may be the result of an increased myosin light-chain kinase (MLCK) activity due to excessive quantity of MLCK. There were no significant changes in total activity of calmodulin, a protein that binds and activates MLCK, in sensitized dog ASM (SASM) compared with control ASM (CASM). When normalized to the relative calmodulin content in the tissues, the specific calmodulin activities (means +/- SE) in sensitized tracheal smooth muscle (STSM) and sensitized bronchial smooth muscle (SBSM) and in their controls were not different (STSM 0.359 +/- 0.117, CTSM 0.339 +/- 0.136. SBSM 0.201 +/- 0.098, and control bronchial smooth muscle 0.213 +/- 0.056 nmol Pi.calmodulin content-1.min-1, respectively). Intracellular Ca2+ levels indicated by fura 2 fluorescent dye remained unaltered in SASM. We conclude that airway hyperresponsiveness may result from higher MLCK content in SASM rather than from changes in Ca(2+)-calmodulin activities, which is an example of alteration in Ca2- sensitivity of ASM.

Animals↗

Calcium and smooth muscle contraction.

The fact that smooth muscle exists in almost every hollow organ and is involved in a large number of disease states has led to a vast increase in smooth muscle research, covering areas from testing response to antagonists and agonists to measuring the molecular force generated by a single actin filament. Yet, the exact mechanisms regulating contractile response of smooth muscle remain unsolved. Calcium has been a central player in mediating smooth muscle contraction through binding with calmodulin, although there is evidence showing that under special circumstances smooth muscle can contract without change in intracellular Ca2+. In addition to the major regulatory pathway of Ca(2+)-calmodulin-myosin light chain kinase, there are other thin filament linked regulatory mechanisms in which Ca(2+)-calmodulin dependent phosphorylation of calponin and caldesmon may be involved. Ca2+ sensitivity of smooth muscle contraction may vary under different situations and this has recently been recognized as an important regulatory mechanism. Examples are protein kinase C (PKC) dependent phosphorylation of myosin light chain kinase which results in partial inhibition of contraction, and activation of myosin light chain phosphatase. There is new evidence showing that not only does Ca2+ regulate contraction by regulating the interaction of contractile proteins in smooth muscle, but also that shortening of smooth muscle itself reduces intracellular Ca2+ concentration, via a negative feedback.

Actins↗

Relaxation of smooth muscle.

We have demonstrated that in dogs antigen sensitization results in alterations of contractile properties. These changes could account for the hyperresponsiveness reported in asthma. The failure of the muscle to relax could be another important factor responsible for maintaining high airway resistance. We therefore developed an index of isotonic relaxation, t1/2, CE (half time for relaxation that is independent of muscle load and initial contractile element length), for evaluation of the relaxation process. Because the maximum shortening velocity at 2 s but not at 10 s was greater in sensitized bronchial smooth muscle than that in controls, studies of relaxation were also undertaken at these two times. The mean half-relaxation time indicated by t1/2,CE showed no difference between sensitized and control muscles after 10 s of stimulation (8.38 +/- 0.92 vs. 7.78 +/- 0.93 s, means +/- SE); however, it was prolonged significantly in the sensitized muscle only stimulated for 1 s (12.74 +/- 2.5 s, mean +/- SE) compared with the control (6.98 +/- 1.01 s). During the late phase of isotonic relaxation, both groups showed an unexpected spontaneous increase in zero-load shortening velocity, which is an index of cross-bridge cycling rate. We conclude that (i) both contraction and relaxation properties of early normally cycling cross bridges are altered after sensitization and these changes may account for the hyperresponsiveness observed in asthmatics and (ii) the cross-bridge cycling rate increases spontaneously during isotonic relaxation, probably as a result of reactivation of the contractile mechanism.

Allergens↗

Early changes in airway smooth muscle hyperresponsiveness.

To study asthmatic airway smooth muscle we developed a canine model of ragweed pollen sensitized, airway hyperresponsiveness because of the difficulties in obtaining human tissue. Tracheal and bronchial smooth muscles from sensitized dogs were shown to possess greater ability to shorten and higher maximum shortening velocity (Vo), both of which contribute to the excessive narrowing of airways typical of human asthma. However, maximum force production remained normal, demonstrating the dissociation between the behaviour of shortening and force. Because we found no evidence of inflammation, hypertrophy, or hyperplasia in the sensitized airway smooth muscles, we felt this is a model of early disease and should provide insight into early and perhaps primary pathogenetic mechanisms. Vo is known to be determined by actomyosin ATPase, which in smooth muscle is activated via phosphorylation of the 20-kDa myosin light chain (MLC20) by myosin light chain kinase (MLCK). Therefore, ATPase activity, MLC20 phosphorylation, and MLCK were investigated. Sensitized tracheal and bronchial smooth muscles showed significantly higher ATPase activity, and a higher level of MLC20 phosphorylation, resulting from increased MLCK activity, a consequence of the measured increase in total quantity of MLCK rather than in specific activity. Since MLCK is activated by binding with Ca(2+)-calmodulin complex, intracellular Ca2+ concentration and calmodulin activity were also assessed, but no difference was found between sensitized and control animals. Our study suggests that increased MLCK quantity may be the cause of airway hyperresponsiveness found in sensitized animals, and future investigation should be focused on depicting the reason for the elevated MLCK.

Animals↗

Potential role for phenotypic modulation of bronchial smooth muscle cells in chronic asthma.

Asthma is considered to be a chronic inflammatory disease of the airways and is highlighted by excessive airway narrowing in response to various stimuli. Subepithelial fibrosis and increased airway smooth muscle mass are characteristic pathological features of the disease. Airway remodelling in asthma involves cellular hyperplasia and hypertrophy of bronchial myocytes. Smooth muscle cells from a variety of tissues have been shown to be multifunctional mesenchymal cells capable of expressing considerable phenotypic plasticity in vivo in response to injury and pathological stimuli. The growth response of vascular smooth muscle cells following arterial injury has been fairly well characterized, and it appears many of the chemical mediators responsible are common to the inflamed bronchi seen in asthmatics. Specific studies regarding the effects of phenotypic modulation of airway smooth muscle and the potential contribution of this phenomenon to the pathogenesis of chronic asthma have not been carried out. Limited evidence, some indirect, suggests that contractile properties of smooth muscle from inflamed tissues are altered; if this is the case in asthma, then considerations of the effects of airway smooth muscle hypertrophy should be broadened beyond that of only contributing to bronchial hyperresponsiveness via an increase in bronchial wall thickness. Recruitment and modulation of smooth muscle cells to functionally different phenotypes, which contribute to fibrosis by secreting extracellular matrix materials and promote cellular hyperplasia by producing growth factors, are known to occur in atherogenic blood vessels; and evidence suggests that airway smooth muscle cells might play a similar role in asthma. We report the identification of markers of differentiation for airway smooth muscle cells. These markers should be useful tools in the elucidation of phenotypic heterogeneity of smooth muscle in asthmatic airways and, thereby, allow for the definition of a clearer role for bronchial smooth muscle cells in the pathogenesis of chronic asthma.

Animals↗

Auxotonic loading and airway smooth muscle shortening.

Isometric and isotonic contractions represent two extremes in loading regimens that can be imposed on a contracting smooth muscle preparation in vitro. Under physiological conditions, however, it is likely that smooth muscle in hollow organs contracts against auxotonic loads, the magnitude of which is a function of muscle shortening. Therefore, attempts to determine physiologically significant contractile properties of smooth muscle should be made under auxotonic loading conditions. An electronic loader was built to provide four auxotonic loading modes: linear, logarithmic, sigmoidal, and exponential. These shortening-dependent auxotonic loads were imposed on an actively shortening canine tracheal smooth muscle. Results confirmed that (i) active force generated by the muscle is load dependent but that (ii) at the same load borne by the muscle in its steady state, i.e., at the same maximum force generated by the muscle, the maximum shortenings under different loading modes were significantly altered. The shortening was maximal under the exponential loading mode, which provided the smallest load in the early phase of contraction, while it was the least under the logarithmic loading mode, which provided the greatest load in that phase. We concluded that the shortening achieved by an airway smooth muscle was a function not only of the magnitude of the final load imposed on the muscle but, more importantly, of the time course of loading.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

A modified force-velocity equation for smooth muscle contraction.

It has been suggested that in skeletal muscle the force-velocity relationship may not be a simple hyperbolic one, as defined by Hill's equation. To determine whether smooth muscle demonstrated the same properties, quick-release force-velocity curves were obtained from canine tracheal smooth muscle. The results showed that the observed data points for tracheal smooth muscle systematically deviated from a hyperbola. Such deviation occurred at values of force (P) approaching maximum isometric force (Po) for curves elicited by quick release at 2 and 10 s in the course of isometric contractions. Shortening velocities under a given afterload were overestimated at the high-force end (P > 75% Po) by Hill's equation; this implied that a relationship more complex than a simple hyperbola was involved at high loads. We next focused on finding an equation to also fit those directly measured data points that did not conform to a hyperbola. Our rationale in developing the equation was that a plot of the linearized transform of Hill's equation should yield a straight line over the entire range of loads at which velocities were measured. The plot demonstrated that, in the low-load high-velocity portion of the curve, a peak value was reached at 70-80% Po, which decreased as load increased in the high-load low-velocity portion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Myosin light chain phosphatase activity in ragweed pollen-sensitized canine tracheal smooth muscle.

We have reported that myosin light chain phosphorylation is increased in contracting airway smooth muscle from hyperresponsive, ragweed pollen-sensitized dogs. This alteration is manifest physiologically in smooth muscle tissue from sensitized animals as it demonstrates faster shortening velocity and increased shortening capacity. One of the mechanisms underlying the defect is increased myosin light chain kinase activity; it is not known whether modulation of myosin phosphatase activity contributes to enhanced myosin light chain phosphorylation in sensitized canine smooth muscle. We describe a myosin phosphatase assay that we have used to compare the enzyme's activity in crude tracheal smooth muscle tissue homogenates from control and sensitized airway smooth muscle. Twenty kilodalton myosin light chain phosphorylation was initiated with Mg(2+)-ATP, and maximum levels were reached within 40 s; peak phosphorylation levels were stable for at least 3 min. The relative stoichiometry of 20 kD myosin light chain phosphorylation was estimated by chemiluminescent immunoblot assay. Smooth muscle phosphatase activity was estimated by the rate of decline in peak light chain phosphorylation, while myosin light chain kinase was inhibited indirectly with trifluoperazine, with EGTA, or directly by a synthetic peptide inhibitor. Okadaic acid, an inhibitor of phosphatase activity, curbed the decline in light chain phosphorylation seen after myosin light chain kinase inhibition, indicating that the light chain dephosphorylation observed was the result of smooth muscle phosphatase activity. Addition of okadaic acid to the samples led to a 30 to 40% increase in the peak myosin light chain phosphorylation attained for all samples. This indicates that similar populations of phosphatases were present in the homogenates of both control and sensitized tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗

[Mechanisms of bronchial hyperreactivity. Role of smooth muscle].

The understanding of the cellular and molecular mechanisms involved in the contraction of airway smooth muscle has tremendously advanced in the recent years. Extracellular messengers that control the muscle contraction as well as both the membrane transduction processes and the activation of the contractile proteins are known in some details. Sensitization alters the contractility of airway smooth muscle. It increases shortening in the early phase of the contraction when rapidly cycling cross bridges are operative. At the molecular level, the responsible mechanism is an increment in the activity of the processes leading to phosphorylation of the myosin light chain. Such an alteration in the airway smooth muscle contractility may be observed in the early phase of the development of bronchial hyperresponsiveness.

Animals↗

Role of airway smooth muscle in asthma: possible relation to the neuroendocrine system.

Though not yet firmly established, it appears likely that the neuroendocrine system (NES) regulates airway smooth muscle function. As it is the latter which is altered in asthma, the importance of the role of the NES in this disease is clear. The fact that transmitters from the NE cells are released from their basal aspect, and are in close proximity to the subjacent airway smooth muscle, further indicates an interaction. The question then arises as to what are the experimental desiderata for conducting studies of the ASM. These should constitute what Sergei Sorokin has called the "Koch's postulates of airway smooth muscle research." As human tissues from asthmatics are difficult to obtain, animal models have been developed. The requirements are that, in these animals, the allergy be IgE based, that a congenital or familial factor be operative, that a noncholinergic nonadrenergic inhibitory system be a component of the neural regulatory system, and that the antigen for immunization be of a type commonly found in human asthmatics. Ideally, evidence of clinical asthma and exercise-induced asthma and nocturnal attacks should also be present. Unfortunately, no ideal animal models exist and one cannot talk about asthmatic animals, but only of animals with allergic bronchospasm. If in vitro research is to be conducted, there are additional requirements. The tissue should be from a relevant location. The tracheal smooth muscle which has been the favorite, purely because of its convenience, is not a good model. For the early asthmatic attack, central bronchi (3-5 mm diameter) should be used. Muscle strips obtained from them should be parallel-fibred and the cartilage plaques should be carefully dissected away, otherwise they contribute unwanted frictional forces when velocity is measured. Care should be taken to ensure that the epithelial cell layer is intact, as evidence indicates that it may regulate airway muscle function, though this has not been established for all the animal species used in asthma research. The isolated muscle strip should be in a steady state, particularly with respect to the functional variable under study, before definitive data are collected. Most importantly, it is shortening capacity that must be studied, as this is the in vitro analogue to in vivo narrowing of airways. Isometric force development provides information about wall stiffness and is of very little relevance to the elucidation of the mechanism of bronchospasm.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine Triphosphatases↗

Developmental differences in vascular smooth muscle mechanics in pulmonary and systemic circulations.

To evaluate the maturational changes in vascular muscle mechanics we studied and compared the isotonic half-time relaxation (t1/2P,CE) and maximal load-bearing capacity normalized to stress of pulmonary and systemic arterial muscle from perinatal and adult sheep. For the pulmonary and systemic vessels t1/2P,CE was significantly shorter in adult than in perinatal sheep (P < 0.01). In newborns t1/2P,CE of the pulmonary vessels was 185 +/- 31 (SE) s, longer than that of the systemic vessels (64 +/- 10 s; P < 0.01). In adults t1/2P,CE of the pulmonary vessels (101 +/- 14 s) was longer than that of the systemic vessels (37 +/- 5 s; P < 0.01). Maximal load-bearing capacities normalized to stress of pulmonary vessels of fetal and newborn sheep were twofold greater than those of adult sheep and of the systemic vessels of newborns and adults (P < 0.01). In conclusion, significant maturational changes in the isotonic and isometric mechanical properties of vascular pulmonary and systemic smooth muscle were observed in sheep.

Aging↗

Use of a new index to study relaxation in a vascular model of anaphylactic shock.

We have reported increased smooth muscle shortening ability in ragweed pollen-sensitized saphenous vein (SSV). This may account for the vascular hyperreactivity of anaphylactic shock. We have now investigated relaxation in SSV. Because isotonic relaxation is load and initial contractile element length dependent, we developed an adjusted half-relaxation time index, which was independent of these variables. Muscle activation state was monitored by measuring maximum unloaded velocity. The relaxation index showed no difference between SSV and control saphenous vein after 2.5, 10, and 15 s of electrical stimulation; however, after 1 s of stimulation it was prolonged significantly in SSV. We concluded that the cross bridges activating early in contraction demonstrated prolonged relaxation. Activation state during muscle relaxation spontaneously increased toward the end of relaxation, coincident with a slowing in isotonic re-elongation rate. This was seen only in muscles relaxing from 15 s of stimulation. Our results indicate that 1) the relaxation properties of early cycling (1 s) cross bridges are altered after sensitization; and 2) toward the end of isotonic relaxation, cross-bridge cycling rate increases spontaneously, a phenomenon not previously reported. We speculate that the rapid re-elongation in late relaxation may reactivate muscle.

Allergens↗

Relevance of classification by size to topographical differences in bronchial smooth muscle response.

To investigate heterogeneity of airway smooth muscle response, we studied strips of large and small branches from third- to sixth-generation bronchi obtained from ragweed antigen-sensitized and control dogs. The response to electrical field stimulation and carbamylcholine chloride was greater in strips from larger branches of the same generation when expressed as "tissue stress" (force per unit cross-sectional area of the whole tissue), whereas no difference emerged with use of the more appropriate "smooth muscle stress" (force per unit cross-sectional area of the muscle tissue). The response to histamine was significantly higher in small branches than in large ones, and histamine sensitivity [mean effective concentration (EC50)] was 7.79 x 10(-6) [geometric standard error of the mean (GSEM) 1.20] and 1.49 x 10(-5) M (GSEM 1.14), respectively (P < 0.01). Strips from control and sensitized animals at each site and strips from different generations did not show any significant difference. When we clustered our preparations according to dimensions, the response to histamine was significantly higher in small bronchi than in large ones and histamine EC50 was 8.95 x 10(-6) (GSEM 1.17) and 1.57 x 10(-5) M (GSEM 1.18), respectively (P < 0.05). We conclude that evaluation of muscle response in different tissues requires appropriate normalization. Furthermore, classification into generations is inadequate to study bronchial responsiveness, inasmuch as major differences originate from airway size.

Animals↗

Fetal ductus arteriosus ligation. Pulmonary vascular smooth muscle biochemical and mechanical changes.

To evaluate the smooth muscle mechanical and biochemical changes associated with persistent pulmonary hypertension syndrome of the newborn, we studied 31 fetal sheep in which the ductus arteriosus was ligated at 125 days of gestation. Sixty-one noninstrumented and six sham-operated fetuses served as controls. All animals were delivered by cesarean section at 137-140 days of gestation, and the experimental group had the ductus arteriosus ligated for 12 +/- 3 days. The ligated group demonstrated a higher mean (+/- SEM) pulmonary artery pressure (72.3 +/- 3.8 versus 54.1 +/- 2 mm Hg, p < 0.01) and right ventricular mean free wall weight (12.5 +/- 0.7 versus 6.8 +/- 0.3 g, p < 0.01) as compared with the sham-operated group. Significant changes in the pulmonary vascular smooth muscle of the ligated group were observed. The myosin content of vessels from the second through fifth generation demonstrated a significant increase in actin and myosin content (p < 0.01), but given their disproportional changes, the noninstrumented group demonstrated a lower actin/myosin ratio than the experimental group (p < 0.01). Changes in the myosin heavy chain isoform stoichiometry, characterized by an increase in both the mean high/low myosin heavy chain isoform ratio (1.8 +/- 0.3 versus 1.0 +/- 0.1, p < 0.05) and the nonmuscle isoform as a percentage of the total myosin heavy chain (12.4 +/- 0.7% versus 2.7 +/- 0.9%, p < 0.01), were also observed in the ligated as compared with the noninstrumented animals. In addition, the muscle Mg-ATPase activity was significantly (p < 0.05) reduced in the experimental group.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗