Hiroto Satake1, Toshiya Sakata1. 1. Department of Materials Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656, Japan.
Abstract
In this paper, we clarify the interfacial pH behavior induced by allergic responses at a mast cell/gate insulator nanogap detected by laser scanning confocal fluorescence microscopy. In a previous work, the change in interfacial pH detected on the basis of allergic responses was monitored at a mast cell/gate insulator nanogap interface using a cell-cultured gate ion-sensitive field-effect transistor (ISFET), but the interfacial pH behavior at a mast cell/gate insulator nanogap has not been clarified using other methods. Here, the phospholipid fluorescein is employed as the extracellular pH indicator, which is fixed to the external side of the plasma membrane of mast cells cultured on a substrate. As a result, the interfacial pH at the mast cell/substrate nanogap increases after mast cells with IgE on their membrane are activated by the interaction between IgE and an allergen. This is due to the basicity of histamine molecules released from mast cells. Moreover, the change in the interfacial pH at the mast cell/substrate nanogap is larger than that at the mast cell/bulk solution interface. That is, molecules of substances secreted as a result of allergic responses are assumed to accumulate around the cell/substrate nanogap. The data obtained in this study support the idea that potentiometric ion sensors such as ISFETs can detect a cellular-function-induced change in pH at a cell/electrode nanogap in real time.
In this paper, we clarify the interfacial pH behavior induced by allergic responses at a mast cell/gate insulator nanogap detected by laser scanning confocal fluorescence microscopy. In a previous work, the change in interfacial pH detected on the basis of allergic responses was monitored at a mast cell/gate insulator nanogap interface using a cell-cultured gate ion-sensitive field-effect transistor (ISFET), but the interfacial pH behavior at a mast cell/gate insulator nanogap has not been clarified using other methods. Here, the phospholipidfluorescein is employed as the extracellular pH indicator, which is fixed to the external side of the plasma membrane of mast cells cultured on a substrate. As a result, the interfacial pH at the mast cell/substrate nanogap increases after mast cells with IgE on their membrane are activated by the interaction between IgE and an allergen. This is due to the basicity of histamine molecules released from mast cells. Moreover, the change in the interfacial pH at the mast cell/substrate nanogap is larger than that at the mast cell/bulk solution interface. That is, molecules of substances secreted as a result of allergic responses are assumed to accumulate around the cell/substrate nanogap. The data obtained in this study support the idea that potentiometric ion sensors such as ISFETs can detect a cellular-function-induced change in pH at a cell/electrode nanogap in real time.
Allergy
is one of the most common diseases at present;[1] in particular, allergy in infants often causes
death. Therefore, simple and accurate tests for allergy are required
for early detection in infants. The specific binding of an allergen
to IgE may be detected by various immunological methods, such as enzyme-linked
immunosorbent assay, but such methods cannot be used to determine
whether the IgE binding to an antigen activates mast cells and basophils,
which play important roles in type I allergy or IgE-associated diseases,
in patients. That is, the potential of allergen-specific IgE to activate
mast cells and basophils from a patient should be evaluated rather
than the analysis of simple IgE–allergen binding in the diagnosis
of type I allergy.[2−4]Nonoptical monitoring of allergic responses
has been realized by
the detection of the increase in pH induced by basic histamine released
from mast cells using a cell-cultured gate ion-sensitive field-effect
transistor (cell-cultured gate ISFET).[5] Here, rat basophilic leukemia (RBL-2H3) mast cells were utilized
as a signal transduction interface to cause allergic reactions on
the gate insulator of the ISFET because IgE antibodies, which bind
to Fcε receptors on the mast cell membrane, are specifically
cross-linked by allergens, contributing to allergic responses of RBL-2H3
cells.[6−8] Ionic and molecular charges that are related to biological
functions are directly detected using an ISFET sensor at the gate
surface, which is covered by various functional groups and probe molecules
that interact with target substances. Basically, a solution-gate ISFET
was developed to detect ions in biological environments.[9] Particularly, an electrolyte solution induces
the potential at the interface between the solution and the gate insulator.
A gate insulator is mostly composed of oxide or nitride membranes
such as SiO2, Si3N4, Ta2O5, and Al2O3; that is, hydroxy
groups at the oxide or nitride surface in a solution take the equilibrium
reaction with hydrogen ions according to protonation (−OH +
H+ ⇄ −OH2+) and deprotonation (−OH ⇄ −O– + H+) so that a change in the surface charge
is measured as a change in pH on the basis of the principle of the
field effect.[10,11] Thus, the changes in pH based
on not only allergic responses[5] but also
cellular respiration[12−18] were measured as the change in the output potential at the cell/gate
insulator interface using cell-cultured gate ISFETs.However,
certain issues encountered in a previous work remain to
be clarified.[5] The release of basic histamine
molecules together with other molecules from mast cells is activated
following the allergen–IgE interaction at the cell membrane
and then causes an increase in pH at the mast cell/gate insulator
interface. That is, the pH at the mast cell/gate insulator nanoscale
interface, hereafter the interfacial pH, reflects cellular functions
in situ. Indeed, previous works showed a cleft of about 50–150
nm at the cell/substrate interface, where focal or nonfocal regions
of contact between substrates and membrane proteins were observed
by total internal reflection fluorescence microscopy.[19−21] This increase in interfacial pH at the mast cell/gate insulator
nanogap induced by histamine released from mast cells was demonstrated
using a cell-cultured gate ISFET but has not been confirmed using
other methods. On the other hand, cellular respiration was continuously
monitored as a decrease in interfacial pH induced by carbon dioxide
released from cells at the cell/gate insulator nanogap using a cell-cultured
gate ISFET.[12,14−18] Such interfacial pH behavior at the nanogap was also
clarified by fluorescence imaging.[13] Considering
the above, the interfacial pH behavior at the nanogap between the
mast cell and the substrate can be analyzed using a lipophilic pH
indicator[22−25] to ensure the data obtained using ISFETs. Here, the phospholipidfluorescein [N-(fluorescein-5-thio-carbamyl)-1,2-dihexadecanoyl-sn-glycero-3-phosphoethanolamine,
DHPE] can be fixed as an extracellular pH indicator to the external
side of the plasma membrane of a cell by inserting its lipophilic
alkyl chain into the membrane and utilized to detect the change in
interfacial pH.In this study, we investigated the interfacial
pH behavior based
on allergic responses at a mast cell/substrate nanogap by laser scanning
confocal fluorescence microscopy. Here, the phospholipidfluoresceinDHPE was utilized as the extracellular pH indicator. The results obtained
in this study support the detection principle of cell-cultured gate
ISFET sensors, which are expected to be widely applied as an analytical
tool in the fields of cell biology and medicine.
Results
and Discussion
Interfacial pH Behavior
at Cell/Substrate
Induced by Type I Allergic Response
RBL-2H3 cells with or
without IgE on their membrane were prepared on a glass substrate under
appropriate conditions (see Section ) and then labeled with fluorescein DHPE.
As shown in Figure , the obtained fluorescence images were examined focusing on the
following two regions: one was the interface between the mast cell
and the glass substrate and another was the interface between the
mast cell and the bulk solution. As shown in Figure S1 (Supporting Information), the interfacial pH in the former
region was estimated from the peak fluorescence intensity obtained
in an optical slice, which was set at z = 0–0.38
μm, and that in the latter region was estimated from the fluorescence
intensities within four optical slices (z = 0.38–1.90
μm), which were between the middle and bottom of a cell placed
on the substrate.
Figure 1
Schematic illustration of RBL-2H3 cell on the substrate.
DHPE was
utilized as the extracellular pH probe. The z-axis
was set in the normal direction to a glass substrate. Two regions
around a cell were focused on for fluorescence observation: the cell/substrate
interface and cell/bulk solution interface. Considering previous works,[19−21] a nanogap of approximately 50–150 nm is assumed to be at
the cell/substrate interface. Credit: From ref (13). Reprinted with permission
from The Royal Society of Chemistry.
Schematic illustration of RBL-2H3 cell on the substrate.
DHPE was
utilized as the extracellular pH probe. The z-axis
was set in the normal direction to a glass substrate. Two regions
around a cell were focused on for fluorescence observation: the cell/substrate
interface and cell/bulk solution interface. Considering previous works,[19−21] a nanogap of approximately 50–150 nm is assumed to be at
the cell/substrate interface. Credit: From ref (13). Reprinted with permission
from The Royal Society of Chemistry.Figure a shows
the x–y–z cross-sectional image of RBL-2H3 cells stained with fluoresceinDHPE (z > 0.38 μm). Fluorescein DHPE molecules
were observed at the surface of the cellular membrane. The optical
slice with the peak fluorescence intensity near the glass substrate
(z = 0–0.38 μm) provides the image including
the cell/glass substrate interface (Figure b). Moreover, the ratio of fluorescence intensity
(the emission intensity at 488 nm to that at 458 nm) at the interface
between the cell and the glass substrate showed a linear relationship
with the pH of the standard Mettler Toledo (MT) buffer solution (Figure c). That is, the
effect of photobleaching of fluorescein DHPE was taken into account
by a ratiometric measurement to decide the actual pH.[26−28] Therefore, the change in interfacial pH was estimated for cultured
mast cells from the calibration curve shown in Figure c.
Figure 2
(a) z-Stack image of IgE-bound RBL-2H3 cells
stained with fluorescein
DHPE in MT buffer medium (pH 8.0). The fluorescence image was observed
in a circular manner (along the cell membrane), that is, the x–y cross-sectional image was observed
at an optical slice for z > 0.38 μm. (b)
z-Stack
image of IgE-bound RBL-2H3 cells stained with fluorescein DHPE in
MT buffer. The fluorescence image was observed in plane (on the cell
membrane), that is, the x–y cross-sectional image was observed at an optical slice for z = 0–0.38 μm. The fluorescent backgrounds
found around the RBL-2H3 cells also seemed to be due to the debris
with a lipophilic double layer derived from these cells. (c) Calibration
curve of fluorescence peak intensity for interfacial pH measured by
ratiometric analysis (488/458 nm). The data shown are the average
of six cells in the MT buffer at different pH values.
(a) z-Stack image of IgE-bound RBL-2H3 cells
stained with fluoresceinDHPE in MT buffer medium (pH 8.0). The fluorescence image was observed
in a circular manner (along the cell membrane), that is, the x–y cross-sectional image was observed
at an optical slice for z > 0.38 μm. (b)
z-Stack
image of IgE-bound RBL-2H3 cells stained with fluorescein DHPE in
MT buffer. The fluorescence image was observed in plane (on the cell
membrane), that is, the x–y cross-sectional image was observed at an optical slice for z = 0–0.38 μm. The fluorescent backgrounds
found around the RBL-2H3 cells also seemed to be due to the debris
with a lipophilic double layer derived from these cells. (c) Calibration
curve of fluorescence peak intensity for interfacial pH measured by
ratiometric analysis (488/458 nm). The data shown are the average
of six cells in the MT buffer at different pH values.Figure shows
the
change in interfacial pH at the cell/substrate interface for RBL-2H3
cells with or without IgE stained with fluorescein DHPE. After these
cells were precultured for 10 min in the MT buffer solution, 50 ng/mL
dinitrophenyl-conjugated humanserum albumin (DNP-HSA) as an antigen
was injected into the cells, the effect of which was confirmed by
the activation of β-hexosaminidase released from mast cells
owing to allergic responses (Figure S2 in
the Supporting Information). For the RBL-2H3 cells with IgE, the significant increase in the interfacial
pH at the mast cell/substrate nanogap of about 0.3 was observed upon
adding DNP-HSA, whereas no change in interfacial pH was detected for
the RBL-2H3 cells without IgE. This finding shows that the type I
allergic reaction induced the extracellular alkalization at the mast
cell/substrate nanogap interface. Indeed, the surface potential at
the gate decreased upon adding DNP-HSA to the mast cell-cultured ISFET
sensor,[5] which indicates the increase in
the interfacial pH. As mentioned in a previous paper,[5] the increase in the interfacial pH at the mast cell/gate
insulator nanogap was likely to be caused by the release of basichistamine from intracellular granules; the increase was about 0.2
at 100 ng/mL DNP-HSA, depending on the antigen concentration. Thus,
the extracellular alkalization at the nanogap observed in this study
was consistent with the data from the mast cell-cultured gate ISFET.
Moreover, the RBL-2H3 cells with IgE showed a morphological change
from a spherical shape to a flat shape, which is consistent with the
type I allergic reaction, as shown in Figure . This morphological change is due to the
reorganization of the actin cytoskeleton of the RBL-2H3 cells as an
allergic response.[29] That is, the released
histamine should accumulate in more concentration at the mast cell/substrate
(or gate) nanogap interface than in other regions.
Figure 3
Change in interfacial
pH at the interface between the mast cell
and substrate for incubation time. IgE-bound (IgE(+)) or unmodified
(IgE(−)) RBL-2H3 cells were used for reaction with the antigen
(50 ng/mL). Interfacial pH was analyzed on the basis of the ratio
of fluorescence intensities (Figure S1 in
the Supporting Information) and the calibration curve (Figure c). The data presented are
the average of five cells with IgE and seven cells without IgE.
Figure 4
Change in morphology of IgE-bound RBL cell upon adding
antigen
(50 ng/mL). (a) Before addition of antigen. (b) After addition of
antigen.
Change in interfacial
pH at the interface between the mast cell
and substrate for incubation time. IgE-bound (IgE(+)) or unmodified
(IgE(−)) RBL-2H3 cells were used for reaction with the antigen
(50 ng/mL). Interfacial pH was analyzed on the basis of the ratio
of fluorescence intensities (Figure S1 in
the Supporting Information) and the calibration curve (Figure c). The data presented are
the average of five cells with IgE and seven cells without IgE.Change in morphology of IgE-bound RBL cell upon adding
antigen
(50 ng/mL). (a) Before addition of antigen. (b) After addition of
antigen.
Comparison
of Interfacial pH at the Cell/Substrate
Interface with Interfacial pH at the Cell/Bulk Solution Interface
Figure shows the
change in pH (ΔpH) along the z-stack position for the IgE-bound
RBL-2H3 cells upon adding DNP-HSA. The allergic reactions were allowed
to proceed for 2, 5, and 8 min. ΔpH at the cell/substrate interface
(z = 0–0.38 μm) was clearly different
from that at the cell/bulk solution interface (z >
0.38 μm). The interfacial pH at the mast cell/substrate interface
markedly increased after the addition of DNP-HSA and reached a peak
(ΔpH ≈ 0.5) after 5 min, followed by a decrease in ΔpH
to about 0.2 after 8 min. On the other hand, ΔpH at the mast
cell/bulk solution interface did not significantly change and remained
constant at about ±0.15 after the addition of DNP-HSA. This may
be due to the diffusion rate of histamine released from the IgE-bound
RBL-2H3 cells stimulated by the antigen. That is, the concentration
of histamine near each interface should depend on the balance of the
inflow of histamine from intracellular granules and the outflow of
histamine diffusing to the bulk solution. At the mast cell/substrate
interface, the diffusion of histamine molecules released from the
mast cells was restricted to the horizontal direction because this
interface was sandwiched by the cellular membrane and the substrate.
On the other hand, at the mast cell/bulk solution interface, the released
histamine easily diffused in every direction in the bulk solution.
Therefore, the outflow of histamine at the mast cell/substrate interface
would have been smaller than that at the mast cell/bulk solution interface,
resulting in the local accumulation of histamine at the mast cell/substrate
nanogap interface. Moreover, the morphological change of RBL-2H3 from
a spherical shape to a flat shape may have contributed to the accumulation
of histamine molecules at the mast cell/substrate nanogap interface.
The morphological change to the flat shape increased the area of adhesion
of RBL-2H3 cells to the substrate (Figure ) and may have prevented the released histamine
from diffusing to the bulk solution from the mast cell/substrate nanogap.
In a previous work, the cellular morphology was found to likely affect
the accumulation of ions at the cell/substrate nanogap.[13] The contribution of the cellular morphology
to the accumulation of histamine should be considered in the future
including the distance between the mast cell and the substrate, although
the nanogap distance before and after the allergic response has not
yet been correctly measured.
Figure 5
Change in interfacial pH (ΔpH) along the
z-stack position
upon adding antigen (50 ng/mL). The allergic reactions were allowed
to proceed for 2, 5, and 8 min. ΔpH at the cell/substrate interface
(slice number 0; z = 0–0.38 μm) and
ΔpH at the cell/bulk solution interface (slice number 1; z = 0.38–0.76 μm, slice number 2; z = 0.76–1.14 μm, slice number 3; z =
1.14–1.52 μm, and slice number 4; z =
1.52–1.90 μm) were evaluated. The data shown are the
average of five cells.
Change in interfacial pH (ΔpH) along the
z-stack position
upon adding antigen (50 ng/mL). The allergic reactions were allowed
to proceed for 2, 5, and 8 min. ΔpH at the cell/substrate interface
(slice number 0; z = 0–0.38 μm) and
ΔpH at the cell/bulk solution interface (slice number 1; z = 0.38–0.76 μm, slice number 2; z = 0.76–1.14 μm, slice number 3; z =
1.14–1.52 μm, and slice number 4; z =
1.52–1.90 μm) were evaluated. The data shown are the
average of five cells.Considering the local
increase in the interfacial pH detected on
the basis of the accumulation of basic histamine molecules at the
mast cell/substrate nanogap, our results suggest that a dish-type
sensor with cultured cells such as cell-cultured gate ISFETs has a
structural merit in terms of enhancing the detection sensitivity to
substances released from cells, compared with other measurement methods
(e.g., the use of microelectrodes to approach a cellular membrane
from the outside). Indeed, minute changes in pH were detected at the
cell/bulk solution interface in this fluorescence measurement; therefore,
it would be difficult to measure minute changes in the pH based on
allergic responses using microelectrodes. Thus, platforms based on
a cell-cultured gate ISFET sensor are suitable for a label-free and
in situ cell analysis system.
Conclusions
In this study, we have demonstrated the interfacial pH behavior
based on the allergic response at a RBL-2H3 cell/substrate nanogap
by the laser scanning confocal fluorescence microscopy. In particular,
the induction of the type I allergy reaction resulted in extracellular
alkalization at the mast cell/substrate nanogap interface, which was
induced by basic histamine released from the mast cells. Moreover,
such secreted molecules accumulated at the mast cell/substrate nanogap
interface, resulting in the increase in the interfacial pH, whereas
minute changes in pH were monitored at the mast cell/bulk solution
interface. Thus, the results of this study have proved the detection
principle for allergic responses using the mast cell-coupled gate
ISFET sensor and further support the idea that potentiometric ion
sensors such as ISFETs can detect a cellular-function-induced change
in pH at a cell/electrode nanogap in real time.
Experimental
Section
Chemicals
The chemicals used were
obtained from the following sources: dinitrophenyl-conjugated humanserum albumin (DNP-HSA; A6661), mouse monoclonal anti-DNPIgE (D8406),
fetal bovine serum (FBS), bovineserum albumin (BSA), and p-nitrophenyl-2-acetoamido-2-deoxy-β-d-glucopyranoside
(pNPG) from Sigma-Aldrich Japan (Tokyo, Japan). Ringer buffer was
composed of 126 mM NaCl, 4 mM KCl, 3 mM CaCl2, 1 mM MgCl2, 10 mM N-(2-hydroxyethyl)piperazine-N′-ethanesulfonic acid (HEPES), and 15 mM glucose.
MT buffer was composed of 137 mM NaCl, 2.7 mM KCl, 1.8 mM CaCl2, 1 mM MgCl2, 5.6 mM glucose, 20 mM HEPES, and
0.1% (v/v) BSA. The pH of each buffer was adjusted by adding 1 M NaOH
and measured using a conventional pH meter (HORIBA).
Cell Culture
RBL-2H3 cells were seeded
in Roswell Park Memorial Institute (RPMI) medium supplemented with
10% FBS, 50 U/mL penicillin, and 50 μg/mL streptomycin on a
cell culture dish (φ = 10 cm) at 37 °C in 5% CO2 in an incubator system at a density of 2.5 × 105 cells/dish. The cells were cultured for 5 days including the replacement
of medium on day 3. Cells were collected by trypsin treatment and
used for each experiment.
Confirmation of Release
of β-Hexosaminidase
β-Hexosaminidase released
from RBL-2H3 cells was used as
the index of type I allergy reaction. RBL-2H3 cells were transferred
to 24-well plates at a density of 2.5 × 105 cells/well.
RBL-2H3 cells were cultured in RPMI culture medium containing the
50 ng/mL IgE antibody, as described in Section . After cultivation overnight, cells were
washed twice with MT buffer solution. MT buffer solution (500 μL)
containing 50 ng/mL DNP-HSA as the antigen was added to each well,
and the plates were incubated for 30 min in an incubator (5% CO2, 37 °C). The sample plates were cooled with ice for
10 min to stop allergic reactions. The supernatant (50 μL) from
each well was transferred to 96-well plates. Then, 100 μL of
substrate solution containing 0.1, 1, 3.3, or 10 mM pNPG in 100 mM
citrate buffer (pH 4.5) was added to each sample and the sample was
incubated for 25 min in an incubator (5% CO2, 37 °C).
One hundred microliter of 2 M glycine buffer (pH 10.4) was added to
each well to stop the enzyme reaction, and the absorbance (405 nm)
of each well was obtained using a microplate reader (Corona Electric
Co., Ltd.; SH-9000). The velocity of the enzyme reaction was calculated
and fitted using the Michaelis–Menten equation (Figure S2 in the Supporting Information).
Preparation of RBL Cells Stained with Fluorescein
DHPE
RBL-2H3 cells were transferred to a glass bottom dish
(φ = 35 mm) at a cell density of 2 × 105 cells/dish.
The IgE antibody (50 ng/mL) was added to the culture medium for sample
measurement. Samples to which no IgE antibody was added were used
as the control. After cultivating overnight, the culture medium was
removed and washed with Ringer buffer (pH 7.4). RBL-2H3 cells were
stained by incubating them in Ringer buffer containing 30 μM
fluorescein DHPE for 30 min at room temperature. Stained cells were
washed twice in Ringer buffer.
Fluorescence
Imaging by Laser Scanning Confocal
Microscopy
An LSM510 laser scanning confocal microscope (Carl
Zeiss Co., Ltd.) was used for fluorescence imaging of stained RBL-2H3
cells. An Ar laser (458 and 488 nm) was used as the excitation laser.
A long-pass filter (∼505 nm) was used as the emission filter
for each excitation wavelength. The ratio of emission intensity at
488 nm to that at 458 nm was calculated for the ratiometric analysis
of fluorescence intensity. An oil immersion objective (×63, numerical
aperture = 1.4) was utilized, and the pinhole size was set at one
Airy disk unit. The image size was set to 256 × 256 pixels, and
the pixel size was 0.56 × 0.56 μm. An optical slice was
set at an interval of 0.38 μm in the normal direction to the
glass substrate, and z-stack images of stained RBL cells were taken.
The entire process of fluorescein imaging was conducted at 37 °C
in air.The pH behavior around RBL-2H3 cells caused by allergic
responses was evaluated using fluorescence images. The IgE-bound RBL-2H3
cells or unmodified RBL-2H3 cells cultured on the glass bottom dish
were stained with fluorescein DHPE, as described in Section . MT buffer solution (pH
7.3) was used as a fluorescence measurement buffer. z-Stack images
were obtained every 2 or 3 min for the RBL-2H3 cells with or without
IgE. At 10 min after the start of measurement, the antigen was added
to the cultured cells at the final concentration of 50 ng/mL. Fluorescence
images were evaluated using ZEN lite software (Carl Zeiss Co., Ltd.),
and the plugin “Ratio Plus” in Image J was utilized
to estimate the ratio of fluorescence intensities (488/458 nm).
Calibration of Fluorescence Intensity Ratio
for Interfacial pH
To construct the calibration curve between
the ratio of fluorescence intensity and the pH of measurement solution
(Figure c), the pH
of MT buffer solution was adjusted from 6.8 to 8.0 upon adding 1 M
NaOH and analyzed using a conventional pH meter (HORIBA). The z-stack
images of RBL-2H3 cells stained with fluorescein DHPE in MT buffer
were obtained using the same protocol as in the above-mentioned microscopy
measurement at different pH values. An optical slice was moved around
the substrate surface (under the cell/substrate interface) to the
top of adhering cells to find the region with the peak fluorescence
intensity, where the mast cell/substrate interface was found. From
the peak intensity, the fluorescence ratio at the cell/substrate interface
around the center of a cell was calculated. pH calibration was conducted
for the IgE-bound RBL cells or unmodified RBL-2H3 cells.
Authors: Eva M Sturm; Bettina Kranzelbinder; Akos Heinemann; Andrea Groselj-Strele; Werner Aberer; Gunter J Sturm Journal: Cytometry B Clin Cytom Date: 2010-04-14 Impact factor: 3.058
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