技术文章

Receptor Signaling Regulation of Actin Dynamics and Its Role in Cell Behavior and Disease

GPCRs, integrins, and receptor tyrosine kinases regulate actin polymerization, contraction, and adhesion turnover through Rho family small GTPases, thereby controlling cell migration, morphology, and tissue function.

 

Keywords: actin dynamics; cytoskeleton; GPCR; integrin; receptor tyrosine kinase; RhoA; Rac1; Cdc42; ROCK; PAK; Arp2/3; cell migration

 

1 Dynamic Remodeling Basis of the Actin Cytoskeleton

1.1 Dynamic Conversion Between G-actin and F-actin

Actin exists mainly in two states: globular actin (G-actin) and filamentous actin (F-actin). ATP-bound G-actin can be incorporated into actin filaments, and ATP is gradually hydrolyzed after polymerization, making older filament segments more susceptible to severing and depolymerization. Actin filaments are polarized. The barbed end usually has a faster monomer addition rate, while the pointed end has relatively weaker polymerization capacity. Barbed-end extension, filament severing, pointed-end depolymerization, and monomer recycling together maintain rapid turnover of the actin network. Increased F-actin content does not necessarily indicate faster polymerization; it may also result from impaired depolymerization, enhanced filament stability, or redistribution of actin structures. Therefore, actin dynamics cannot be judged only by static fluorescence intensity.

 

1.2 Formation and Turnover of Actin Networks

Dynamic remodeling of actin networks mainly includes three connected processes: nucleation, elongation, and severing/recycling.

(1) Nucleation and branch formation

The Arp2/3 complex can form new branches on the side of existing actin filaments, building dense networks in lamellipodia, phagocytic cups, and immune synapses. Formin proteins mainly promote the formation of longer linear actin filaments and participate in the construction of stress fibers, filopodia, and cytokinetic rings.

(2) Actin filament elongation

Profilin binds G-actin and promotes its delivery to the barbed end of actin filaments. Ena/VASP can maintain filament-end elongation, while capping proteins terminate continued polymerization at some filament ends, thereby regulating network density and filament length.

(3) Severing and monomer recycling

Cofilin preferentially binds older ADP-containing actin filaments, promoting filament twisting, severing, and depolymerization, while also generating new polymerizable filament ends. LIM kinase-mediated Ser3 phosphorylation inhibits cofilin activity, and slingshot phosphatase can restore its severing function by removing this phosphate group.

 

1.3 Major Actin Structures and Their Functions

 

Actin Structure

Structural Features

Key Regulatory Molecules

Main Functions

Lamellipodia

Dense branched network

Rac1, WAVE, Arp2/3, cofilin

Leading-edge protrusion and two-dimensional migration

Filopodia

Parallel bundles of actin filaments

Cdc42, formin, Ena/VASP, fascin

Environmental sensing and directional perception

Stress fibers

Contractile bundles composed of actin and non-muscle myosin II

RhoA, ROCK, mDia, myosin II

Traction force generation and focal adhesion maturation

Cortical actin

Mesh-like structure beneath the plasma membrane

ERM proteins, Arp2/3, myosin

Maintenance of membrane stability and cell morphology

Contractile ring

Ring-shaped actin-myosin structure in the equatorial region

RhoA, formin, ROCK, myosin II

Cytokinesis

 

2 Upstream Signal Inputs Mediated by GPCRs, Integrins, and RTKs

2.1 GPCR-Mediated Chemotactic and Contractile Signaling

G protein-coupled receptors (GPCRs) can sense chemokines, lipid mediators, hormones, and neurotransmitters, and regulate actin structures through different G protein subtypes. Gα12/13 can activate RhoGEFs and promote RhoA-ROCK-mediated contraction. Some Gαi-coupled receptors promote Rac1 activation through Gβγ, PI3Kγ, and Rac-related GEFs, forming PIP3 enrichment and branched actin networks at the cell leading edge. Gαq can regulate adhesion and myosin contraction through PLCβ, Ca²⁺, and protein kinase C. The specific effect depends on receptor type, cellular background, and stimulation duration. A single G protein subtype should not be fixed to one specific cytoskeletal phenotype.

 

2.2 Integrin-Mediated Adhesion and Mechanical Signaling

Integrins connect the extracellular matrix with the intracellular actin cytoskeleton. Chemokine or growth factor signaling can promote talin and kindlin binding to integrin cytoplasmic tails, shifting integrins into a high-affinity state. After integrins bind the matrix, FAK, Src, paxillin, and vinculin are further recruited to form focal adhesions, transmitting traction force generated by actin-myosin to the extracellular matrix. The FAK-Src complex can also control Rac1 and RhoA through p130Cas, Crk, DOCK, and other Rho regulatory proteins. Therefore, integrins are both mechanical connection points and signaling receptors that sense matrix composition, stiffness, and tension.

 

2.3 RTK-Mediated Growth Factor Signaling

After activation of receptor tyrosine kinases (RTKs), such as epidermal growth factor receptor, platelet-derived growth factor receptor, and vascular endothelial growth factor receptor, PI3K, PLCγ, Grb2, and other adaptor proteins can be recruited. PIP3 generated by PI3K locally recruits Rac1- and Cdc42-related GEFs at the plasma membrane, promoting leading-edge actin polymerization. PLCγ-mediated phospholipid hydrolysis and Ca²⁺ signaling can regulate myosin contraction, adhesion turnover, and membrane trafficking. The RAS-RAF-MEK-ERK pathway connects immediate cytoskeletal remodeling with longer-term protein expression, cell migration, and proliferation responses.

 

2.4 Coordinated Integration of Different Receptor Signals

Effective migration usually requires the joint participation of chemotactic receptors, integrins, and growth factor receptors. GPCRs and RTKs provide directional and leading-edge polymerization signals. Integrins establish matrix binding and transmit traction force. FAK, Src, PI3K, and Rho family small GTPases integrate inputs from different receptors. Leading-edge extension, adhesion formation, cell body contraction, and rear detachment can be converted into sustained displacement only when coordinated in time and space.

 

3 Activation and Signal Regulation of Rho Family Small GTPases

3.1 Molecular Switch Cycle of Rho Family Small GTPases

Rho family small GTPases switch between a GDP-bound inactive state and a GTP-bound active state. Guanine nucleotide exchange factors (GEFs) promote GDP release and GTP binding, GTPase-activating proteins (GAPs) accelerate GTP hydrolysis, and guanine nucleotide dissociation inhibitors (GDIs) restrict membrane localization of some Rho proteins. Receptor signals mainly determine the activation intensity and duration of Rho proteins in specific membrane regions by controlling the localization and activity of GEFs, GAPs, and GDIs.

 

3.2 Functional Division Among RhoA, Rac1, and Cdc42

(1) RhoA

RhoA promotes myosin II contraction, stress fiber formation, focal adhesion maturation, and rear retraction through ROCK and mDia, and also participates in cortical tension and cytokinesis regulation.

(2) Rac1

Rac1 promotes lamellipodia formation through the WAVE regulatory complex and Arp2/3, controlling cell spreading, leading-edge adhesion, and directional migration.

(3) Cdc42

Cdc42 promotes filopodia formation through WASP, N-WASP, and formins, and participates in cell polarity, centrosome positioning, and directed vesicle trafficking.

 

 

Figure 1. Schematic of GPCR-, RTK-, and Integrin-Mediated Regulation of Actin Structures through Rho Family GTPases

 

3.3 Spatiotemporal Coordination of Rho GTPases

Migrating cells usually show local Rac1 and Cdc42 activation at the leading edge to maintain membrane protrusion and directional sensing. RhoA promotes contraction in the cell body and rear, and can also be transiently activated at the leading edge to participate in new adhesion formation. These three GTPases show both cooperation and mutual inhibition. Their spatial distribution changes with matrix stiffness, adhesion strength, and migration mode. Therefore, Rac1 and Cdc42 should not be absolutely restricted to the leading edge, and RhoA should not be interpreted only as a rear contraction signal.

 

4 Effector Mechanisms of ROCK, PAK, and Actin Regulatory Proteins

4.1 RhoA-ROCK-Mediated Contraction and Tension Regulation

After activated RhoA binds ROCK1 or ROCK2, it can directly promote myosin light chain phosphorylation and inhibit myosin light chain phosphatase, thereby enhancing non-muscle myosin II activity, stress fiber contraction, and focal adhesion maturation. ROCK can also activate LIM kinase and inhibit cofilin-mediated actin filament severing. Moderate activation helps maintain contractile structures, while persistently excessive activation may reduce actin turnover and restrict cell migration.

 

4.2 Rac1/Cdc42-PAK-Mediated Cytoskeletal Rearrangement

The PAK family is an important effector of Rac1 and Cdc42. It can regulate LIM kinase, myosin light chain kinase, focal adhesion proteins, and microtubule-related molecules, coordinating leading-edge polymerization, adhesion disassembly, and cell polarity. PAK can stabilize local actin networks through the LIMK-cofilin axis and can also regulate cellular tension by altering myosin light chain phosphorylation. Its specific role depends on PAK subtype, cell type, and subcellular localization.

 

4.3 WASP/WAVE-Arp2/3-Mediated Branched Polymerization

WASP and N-WASP are mainly regulated by Cdc42, membrane phospholipids, and binding proteins, while the WAVE regulatory complex is mainly located downstream of Rac1. Activated WASP or WAVE can relieve self-inhibition or complex inhibition and recruit Arp2/3 to form new branches on the side of existing actin filaments. This is an important basis for the formation of lamellipodia, phagocytic cups, immune synapses, and some endocytic structures.

 

4.4 Filament Turnover Mediated by Formin, Profilin, and Cofilin

Formin can continuously promote linear filament elongation at the barbed end of actin filaments and cooperate with profilin to improve delivery efficiency of ATP-actin. Cofilin generates new filament ends and recyclable monomers after severing aged filament segments. These two mechanisms are not simply an opposition between polymerization and depolymerization, but jointly maintain actin structure renewal, enabling cells to rapidly change migration direction while maintaining tension and morphology.

 

5 Regulation of Cell Adhesion, Migration, and Morphology by Actin Dynamics

5.1 Formation and Turnover of Cell Adhesion

After cells contact the matrix, integrins cluster and form initial adhesion complexes. Rac1-driven leading-edge polymerization facilitates new adhesion formation, while traction force generated by RhoA-ROCK-myosin II promotes expansion and maturation of some adhesion structures. Under force, talin can expose new vinculin-binding sites, strengthening the connection between focal adhesions and actin bundles. Adhesion that is too weak causes insufficient traction force, while adhesion that is too strong restricts rear detachment; both can reduce migration efficiency.

 

5.2 Cell Migration Process

Cell migration consists of a continuous sequence of leading-edge protrusion, new adhesion formation, forward movement of the cell body, and rear retraction. Rac1, Cdc42, and Arp2/3 drive membrane extension toward the migration direction. Integrins establish new matrix binding at the leading edge. Actin-myosin contraction pulls the cell body forward, and rear adhesion disassembly plus RhoA-ROCK-related contraction completes tail detachment. Impairment of any step may appear as reduced migration speed, but the underlying molecular causes are not the same.

 

5.3 Cell Polarity and Morphology Maintenance

Asymmetric distribution of the actin cytoskeleton determines the front-rear axis, apical-basal axis, and local membrane tension. Cdc42 participates in localization of polarity complexes, Rac1 promotes leading-edge expansion, and RhoA regulates cortical tension and contractile structures. These three GTPases cooperate to control epithelial cell polarity, neurite formation, immune cell deformation, and endothelial barrier stability.

 

5.4 Phagocytosis, Endocytosis, and Secretion

During phagocytosis, local actin polymerization drives the plasma membrane to wrap particles and form phagocytic cups. Endocytosis and vesicle trafficking require transient cortical actin rearrangement. Secretory granule exocytosis depends on opening pathways in the actin network and regulating granule movement toward the plasma membrane. Excessive actin stabilization or broad depolymerization can both interfere with membrane deformation, vesicle positioning, and secretion efficiency.

 

6 Abnormal Actin Signaling in Immune Diseases, Developmental Defects, and Tumors

6.1 Immune Dysfunction and Immune Diseases

Immune cell chemotaxis, immune synapses, phagocytosis, and degranulation all depend on actin dynamics. WAS deficiency can weaken Arp2/3-mediated branched polymerization, affecting lymphocyte migration, antigen recognition, and immune synapse formation. Abnormalities in DOCK8, RAC2, and other cytoskeletal regulatory genes can also impair chemotaxis, cell survival, and killing function. In chronic inflammation, sustained enhancement of chemokine receptor, integrin, or Rho-ROCK signaling can promote immune cell entry into tissues. Therefore, related pathways may cause immunodeficiency when function is insufficient and may drive inflammatory injury when overactivated.

 

6.2 Developmental Defects and Abnormal Tissue Morphogenesis

Cell migration, tissue folding, neurite extension, and cytokinesis during embryonic development all require precise actin regulation. Variants in ACTB, ACTG1, FLNA, DIAPH, and other cytoskeleton-related genes can alter cell morphology, mechanical stability, and migration capacity, and are associated with neurodevelopmental abnormalities, craniofacial defects, hearing impairment, and tissue developmental abnormalities. Disease severity depends not only on actin content, but also on mutation site, protein interactions, and tissue-specific expression.

 

6.3 Tumor Invasion and Metastasis

Tumor cells can promote membrane protrusion, invadopodia formation, cell contraction, and matrix traversal by enhancing RhoA, Rac1, Cdc42, and their downstream ROCK, PAK, Arp2/3, and formin signaling. Rac1-Arp2/3-related networks favor mesenchymal-like migration, while the high-contractility state mediated by RhoA-ROCK can support rounded or amoeboid migration. These two modes can switch according to matrix pore size, adhesion strength, and therapeutic pressure. Actin remodeling also affects receptor trafficking, cytokinesis, and cell survival. However, detection of Rho proteins or cytoskeletal protein expression alone is insufficient to prove that they drive metastasis; activation status, spatial localization, and functional intervention results should also be combined.

 

7 Experimental Research and Result Evaluation of Actin Dynamics

7.1 Detection of Actin Structure and Turnover

(1) Fluorescent phalloidin staining

This method is suitable for observing F-actin, stress fibers, cortical actin, and cell protrusions, but fixation, permeabilization, cell thickness, and imaging parameters can affect signal intensity.

(2) F-actin/G-actin separation

This method can evaluate the overall actin polymerization status of cells, but cannot display structural changes in different subcellular regions.

(3) Live-cell imaging

Fluorescent fusion actin, LifeAct, and other live-cell probes can be used to observe real-time actin turnover, but excessive probe expression may interfere with normal dynamics.

 

7.2 Detection of Rho Family Small GTPase Activity

RhoA activity can be detected by enriching GTP-bound RhoA using Rhotekin-RBD. Rac1 and Cdc42 activity can be detected by enriching the corresponding activated proteins using PAK-PBD. Pull-down assays are suitable for comparing overall activity among samples, but cannot show intracellular activation locations. FRET biosensors can observe local dynamic changes, but probe expression needs to be controlled, and photobleaching and cell morphology changes need to be corrected. Total protein levels of RhoA, Rac1, and Cdc42 cannot replace detection of the GTP-bound state.

 

7.3 Downstream Signal Detection

After receptor stimulation, phosphorylation changes in FAK, Src, PAK, LIMK, cofilin, and myosin light chain can be detected, and pathway dependence can be verified using ROCK, PAK, Arp2/3, or myosin II inhibitors. Phosphorylated proteins should be detected together with total proteins. Increased cofilin Ser3 phosphorylation usually indicates that actin filament severing activity is inhibited, and should not be interpreted as enhanced cofilin function.

 

7.4 Cell Behavior and Result Interpretation

Scratch assays are suitable for observing collective migration, but are affected by cell proliferation and death. Transwell assays can evaluate directional migration or invasion, but cannot distinguish abnormalities in leading-edge polymerization, adhesion, or contraction. Single-cell tracking, focal adhesion imaging, traction force microscopy, and three-dimensional matrix migration can further analyze speed, directionality, adhesion lifetime, and mechanical output.

 

8 Products Related to Actin Dynamics Research

 

Cat. No.

Product Name

Grade & Purity

Research Stage

Main Application

P378332

488-Phalloidin

 

F-actin fluorescent staining

Observes stress fibers, cortical actin, lamellipodia, and cell morphology

O1524683

One-Step LumiDye™ 555 Phalloidin/Nucleiblue Double Staining Kit

Ready-to-use, sterile, for microscopy, biological stain, BioReagent

F-actin and nuclear co-staining

Simultaneously displays the actin cytoskeleton and nuclei, suitable for cell morphology and migration experiment imaging

P478506

Phalloidin-Atto 488

BioReagent, suitable for fluorescence analysis, ≥90%(HPLC)

F-actin fluorescent staining

Detects F-actin structures and subcellular distribution in fixed cells

P755434

Phalloidin–Atto 565

Suitable for fluorescence analysis, ≥80%(HPLC)

Multicolor fluorescence staining

Used together with nuclear dyes, focal adhesion markers, or signaling protein antibodies for imaging

P755454

Phalloidin–Atto 647N

BioReagent, suitable for fluorescence analysis, ≥80%(HPLC)

Far-red F-actin staining

Used for multichannel imaging and reducing short-wavelength background interference

A743602

Actin-Tracker Red-555

 

Microfilament structure detection

Labels intracellular actin microfilaments and observes cytoskeletal distribution

Ab327504

Actin Beta Mouse mAb

KO Validation

Actin expression detection

Detects β-actin expression

Ab104668

gamma Actin Antibody

Carrier-free, ExactAb™, validated, 2.0 mg/mL

γ-actin expression detection

Analyzes expression and distribution of different actin isoforms

Ab087281

Actin Regulatory Protein CAPG/MCP Mouse mAb

Carrier-free, ExactAb™, validated, 1.0 mg/mL

Actin regulatory protein detection

Studies CAPG-mediated actin filament capping and cell migration

Ab097390

Recombinant Cortactin Antibody

Recombinant, ExactAb™, validated, 0.1 mg/mL

Branched actin network detection

Analyzes cortactin and Arp2/3-related branched polymerization, lamellipodia, and invadopodia

L275457

Latrunculin B

Moligand™, ≥96%

Actin polymerization intervention

Binds G-actin and inhibits F-actin formation, studying cellular phenotypes after cytoskeletal depolymerization

L275019

Latrunculin A (LAT-A)

≥93%

Actin polymerization intervention

Inhibits actin filament formation and analyzes dependence of cell adhesion, morphology, and migration

C477743

Cytochalasin D

Ready-made solution prepared from Zygosporium mansonii, 5 mg/mL in DMSO

Actin filament-end intervention

Interferes with actin filament elongation as well as cell migration, phagocytosis, and cytokinesis

C1499977

Cytochalasin D

Moligand™, 10 mM in DMSO

Actin dynamics intervention

Used for cytoskeletal disruption, adhesion turnover, and migration mechanism validation

R749940

Rhotekin-RBD Agarose

 

RhoA activity detection

Enriches GTP-bound RhoA and evaluates RhoA activation after receptor stimulation

R1477411

RHOA Human Pre-designed siRNA Set A

 

RhoA gene intervention

Knocks down RHOA to validate RhoA dependence of cell contraction, stress fibers, and rear retraction

Ab125269

Recombinant RhoA Antibody

Recombinant, ExactAb™, validated, see COA

RhoA expression detection

Detects total RhoA protein and should be used together with RhoA-GTP activity detection

R1416874

RhoA-ROCK-IN-1

 

RhoA-ROCK pathway inhibition

Studies regulation of myosin contraction and cell migration by the RhoA-ROCK axis

R1464222

RAC1 Human Pre-designed siRNA Set A

 

Rac1 gene intervention

Validates the role of Rac1 in lamellipodia, cell spreading, and leading-edge migration

R929460

Rac1 Inhibitor II

≥99%

Rac1 pharmacological inhibition

Inhibits Rac1-related cytoskeletal rearrangement and evaluates lamellipodia and migration changes

C286570

CPYPP

≥98%(HPLC)

Rac1 upstream signal intervention

Studies DOCK2-mediated Rac1 activation and immune cell chemotaxis

Ab124312

Rac1/2/3 Antibody

ExactAb™, validated, 1.2 mg/mL

Rac protein expression detection

Detects total Rac family proteins and assists in analyzing receptor downstream signaling

C1469745

CDC42 Human Pre-designed siRNA Set A

 

Cdc42 gene intervention

Validates the role of Cdc42 in filopodia, cell polarity, and directional migration

M275404

ML 141

≥98%

Cdc42 pharmacological inhibition

Inhibits Cdc42 activity and analyzes cell polarity, protrusion formation, and migration

Z288200

ZCL 278

≥95%(HPLC)

Cdc42 signal intervention

Studies Cdc42-related GEF signaling and filopodia formation

Ab095633

Recombinant CDC42 Antibody

Recombinant, ExactAb™, validated, 1.5 mg/mL

Cdc42 expression detection

Detects total Cdc42 protein and should be interpreted together with activation status or functional intervention

G127028

GSK429286A

Moligand™, ≥98%

ROCK1/2 functional inhibition

Studies ROCK-mediated stress fibers, cell contraction, and focal adhesion maturation

R126531

RKI-1447

Moligand™, ≥98%

ROCK1/2 functional inhibition

Validates the role of RhoA-ROCK signaling in migration, invasion, and cell tension

R1465339

ROCK1 Human Pre-designed siRNA Set A

 

ROCK1 gene intervention

Distinguishes the function of ROCK1 in cell contraction and cytoskeletal remodeling

R1487458

ROCK2 Human Pre-designed siRNA Set A

 

ROCK2 gene intervention

Evaluates the regulation of cell morphology, adhesion, and migration by ROCK2

Ab125629

Recombinant ROCK1 Antibody

Recombinant, ExactAb™, validated, 1.5 mg/mL

ROCK1 expression detection

Detects ROCK1 protein expression and assists in evaluating RhoA downstream signaling

Ab125639

Recombinant ROCK2 Antibody

Recombinant, ExactAb™, KD Validation, validated, see COA

ROCK2 expression detection

Detects ROCK2 expression and validates gene knockdown efficiency

Ab097098

Cofilin 1 Mouse mAb

Carrier-free, ExactAb™, validated, high performance, see COA

Cofilin expression detection

Detects total cofilin 1 protein and evaluates the basis of actin filament severing and turnover

Ab116903

Recombinant Myosin light chain kinase/MLCK Antibody

Recombinant, ExactAb™, validated, see COA

Myosin contraction signal detection

Detects MLCK protein expression

M287814

MLCK inhibitor peptide 18 TFA

Moligand™, ≥98%

MLCK functional inhibition

Studies the effects of MLCK on myosin contraction, adhesion, and barrier function

D650233

Defactinib hydrochloride

Moligand™, ≥98%

FAK signaling inhibition

Inhibits FAK-related focal adhesion signaling and studies integrin-mediated adhesion and migration

Ab110853

Integrin beta 1/CD29 Rat mAb

Carrier-free, azide-free, validated, PBS Only, ≥95%(SDS-PAGE), see COA

Integrin β1 detection

Analyzes cell adhesion, matrix recognition, and integrin-mediated cytoskeletal signaling

Ab110802

Recombinant Integrin alpha 5 Antibody

Recombinant, ExactAb™, validated, high performance, see COA

Integrin α5 detection

Studies α5β1 integrin-fibronectin adhesion and migration signaling

Ab175701

Volociximab (anti-Integrin α5β1)

Animal-free, carrier-free, recombinant, ExactAb™, low endotoxin, azide-free, validated, ≥95%(SDS-PAGE&SEC-HPLC), see COA

α5β1 integrin blockade

Validates α5β1-mediated adhesion, traction force, and cell migration

G1428357

G4RGDSP, integrin-binding peptide

≥99%

Integrin binding intervention

Competitively blocks integrin binding to RGD-containing matrix ligands and analyzes adhesion dependence

T1506001

Transwell Staining Kit

BioReagent, for microscopy, for cell culture

Cell migration and invasion evaluation

Stains and counts transmembrane cells in Transwell migration or invasion experiments

 

Actin dynamics convert GPCR, integrin, and RTK inputs into cell protrusion, adhesion, contraction, and morphological changes. Related research should jointly evaluate Rho GTPase activity, actin structure, adhesion signaling, and cell behavior, and should avoid judging specific regulatory mechanisms only based on F-actin fluorescence intensity, total Rho protein level, or a single migration assay.

 

For more related articles, please see below:

[1] G Protein–Coupled Receptors (GPCRs): Structure, Signaling, and Drug Targets

[2] Ras-Raf-MEK-ERK Signaling

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阿拉丁科学.《Receptor Signaling Regulation of Actin Dynamics and Its Role in Cell Behavior and Disease》. 阿拉丁知识库,更新于 2026年8月18日。 https://www.aladdin-e.com/zh_cn/faqs/receptor-signaling-regulation-of-actin-dynamics-and-its-role-in-cell-behavior-and-disease-en.html
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