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Effects of Dietary Chromium on Immune System

Yıl 2017, Cilt: 10 Sayı: 2, 99 - 105, 01.03.2017

Öz

Many studies were conducted on chromium (Cr) nutrition. Since earlier, Cr was accepted as an essential nutrient/mineral. Also, close relationship between dietary Cr and carbohydrate metabolism was revealed in detail. Although some effects of dietary Cr on immune response were revealed by earlier in vitro studies, interests on farm-based effects have been recently focused. In this review, the effects of dietary Cr on immune system have been emphasized.

Kaynakça

  • Abraham AS, Sonnenblick M, Eini M. The effect of chromium on cholesterol-induced atherosclerosis in rabbits. Atherosclerosis. 1982a;41(2–3): 371–9.
  • Abraham AS, Sonnenblick M, Eini M. The action of chromium on serum lipids and on atherosclerosis in cholesterol-fed rabbits. Atherosclerosis. 1982b;42(2–3): 185–95.
  • Anderson RA, Bryden NA, Polansky MM, Deuster PA. Exercise effects on chromium excretion of trained and untrained men consuming a constant diet. J. Appl. Physiol. 1988;64(1): 249–52.
  • Anderson RA, Polansky MM, Bryden NA, Roginski EE, Patterson KY, Reamer DC. Effect of Exercise (Running) on Serum Glucose, Insulin, Glucagon, and Chromium Excretion. Diabetes. 1982;31(3): 212–6.
  • Arthington JD, Corah LR, Minton JE, Elsasser TH, Blecha F. Supplemental Dietary Chromium Does Not Influence ACTH, Cortisol, or Immune Responses in Young Calves Inoculated with Bovine Herpesvirus-1. J. Anim. Sci. 1997;75(1): 217–23.
  • Burton JL, Mallard BA, Mowat DN. Effects of supplemental chromium on immune responses of periparturient and early lactation dairy cows. J. Anim. Sci. 1993;71(6): 1532–9.
  • Burton JL, Mallard BA, Mowat DN. Effects of supplemental chromium on antibody responses of newly weaned feedlot calves to immunization with infectious bovine rhinotracheitis and parainfluenza 3 virus. Can. J. Vet. Res. 1994;58(2): 148–51.
  • Burton JL, Nonnecke BJ, Dubeski PL, Elsasser TH, Mallard BA. Effects of supplemental chromium on production of cytokines by mitogen-stimulated bovine peripheral blood mononuclear cells. J. Dairy Sci. 1996;79(12): 2237–46.
  • Burton JL, Nonnecke BJ, Elsasser TH, Mallard BA, Yang WZ, Mowat DN. Immunomodulatory activity of blood serum from chromium-supplemented periparturient dairy cows. Vet. Immunol. Immunopathol. 1995;49: 29–38.
  • Chang X, Mallard BA, Mowat DN. Proliferation of peripheral blood lymphocytes of feeder calves in response to chromium. Nutr. Res. 1994;14(6): 851–64.
  • Chang X, Mallard BA, Mowat DN. Effects of chromium on health status, blood neutrophil phagocytosis and in vitro lymphocyte blastogenesis of dairy cows. Vet. Immunol. Immunopathol. 1996;52(1–2): 37–52.
  • Chang X, Mowat DN. Supplemental chromium for stressed and growing feeder calves. J. Anim. Sci. 1992;70(2): 559–65.
  • Chang X, Mowat DN, Mallard BA. Supplemental Chromium and Niacin for Stressed Feeder Calves. Can. J. Anim. Sci. 1995;75(3): 351–8.
  • Faldyna M, Pechova A, Krejci J. Chromium supplementation enhances antibody response to vaccination with tetanus toxoid in cattle. J. Vet. Med. Ser. B Infect. Dis. Vet. Public Heal. 2003;50(7): 326–31.
  • Gatta PP, Thompson KD, Smullen R, Piva A, Testi S, Adams A. Dietary organic chromium supplementation and its effect on the immune response of rainbow trout (Oncorhynchus mykiss). Fish Shellfish Immunol. 2001;11(5): 371–82.
  • Guidry AJ, Paape MJ, Pearson RE. Effects of parturition and lactation on blood and milk cell concentrations, corticosteroids, and neutrophil phagocytosis in the cow. Am. J. Vet. Res. 1976;37(10): 1195–200.
  • Haq Z, Jain RK, Khan N, Dar MY, Ali S, Gupta M, Varun TK. Recent advances in role of chromium and its antioxidant combinations in poultry nutrition: A review. Vet. World. 2016;9(12): 1392–9.
  • Hayirli A, Bremmer DR, Bertics SJ, Socha MT, Grummer RR. Effect of Chromium Supplementation on Production and Metabolic Parameters in Periparturient Dairy Cows. J. Dairy Sci. 2001;84(5): 1218–30.
  • Jain SK, Kannan K. Chromium chloride inhibits oxidative stress and TNF-alpha secretion caused by exposure to high glucose in cultured U937 monocytes. Biochem. Biophys. Res. Commun. 2001;289(3): 687–91.
  • Jeejeebhoy KN, Chu RC, Marliss EB, Greenberg GR, Bruce-Robertson A. Chromium deficiency, glucose intolerance, and neuropathy reversed by chromium supplementation, in a patient receiving longterm total parenteral nutrition. Am. J. Clin. Nutr. 1977;30(4): 531–8.
  • Kafilzadeh F, shabankareh HK, Targhibi MR. Effect of Chromium Supplementation on Productive and Reproductive Performances and Some Metabolic Parameters in Late Gestation and Early Lactation of Dairy Cows. Biol. Trace Elem. Res. 2012;149(1): 42–9.
  • Kegley EB, Spears JW, Brown TT. Immune Response and Disease Resistance of Calves Fed Chromium Nicotinic Acid Complex or Chromium Chloride. J. Dairy Sci. 1996;79(7): 1278–83.
  • Kegley EB, Spears JW, Eisemann JH. Performance and glucose metabolism in calves fed a chromium-nicotinic acid complex or chromium chloride. J. Dairy Sci. 1997;80(8): 1744–50.
  • Kehrli ME, Nonnecke BJ, Roth JA. Alterations in bovine neutrophil function during the periparturient period. Am. J. Vet. Res. 1989a;50(2): 207–14.
  • Kehrli ME, Nonnecke BJ, Roth JA. Alterations in bovine lymphocyte function during the periparturient period. Am. J. Vet. Res. 1989b;50(2): 215–20.
  • Lee DN, Yen HT, Shen TF, Chen BJ. Chromium-induced glucose uptake, superoxide anion production, and phagocytosis in cultured pulmonary alveolar macrophages of weanling pigs. Biol. Trace Elem. Res. 2000;77(1): 53–64.
  • Lien TF, Yang KH, Lin KJ. Effects of chromium propionate supplementation on growth performance, serum traits and immune response in weaned pigs. Asian-Australasian J. Anim. Sci. 2005;18(3): 403–8.
  • Lindell SA, Brandt, Robert T. J, Minton JE, Blecha F, Stokka GL, Milton CT. Supplemental chromium and revaccination effects on performance and health of newly weaned calves. Cattlemen’s Day. Kansas: Kansas State University. Agricultural Experiment Station and Cooperative Extension Service; 1994. p. 32–5.
  • Mallard B, Mowat D, Leslie K, Chang X, Wright A. Immunomodulatory effects of chelated chromium on dairy health and production. Annu. Meet. Natl. Mastit. Counc. Virginia; 1994. p. 69–76.
  • Mathisonl GW, Engstrom DF. Chromium and protein supplements for growing-finishing beef steers fed barley-based diets. Can. J. Anim. 1995; 549–58.
  • McNamara JP, Valdez F. Adipose Tissue Metabolism and Production Responses to Calcium Propionate and Chromium Propionate. J. Dairy Sci. 2005;88(7): 2498– 507.
  • Mertz W. Chromium. History and nutritional importance. Biol. Trace Elem. Res. 1992;32(2): 3–8.
  • Moonsie-Shageer S, Mowat DN. Effect of level of supplemental chromium on performance, serum constituents, and immune status of stressed feeder calves. J. Anim. Sci. 1993;71(1): 232–8.
  • Mowat DN, Chang X, Yang WZ. Chelated chromium for stressed feeder calves. Can. J. Anim. Sci. 1993;73: 49–55.
  • Munck A, Guyre PM, Holbrook NJ. Physiological functions of glucocorticoids in stress and their relations to pharmacological actions. Endocr Rev. 1984;5(1): 25–44.
  • Myers MJ, Farrell DE, Evock-Clover CM, Cope C V, Henderson M, Steele NC. Effect of recombinant growth hormone and chromium picolinate on cytokine production and growth performance in swine. Pathobiology. 1995;63(5): 283–7.
  • Pechova A, Pavlata L. Chromium as an essential nutrient: a review. Vet. Med. (Praha). 2007;52(1): 1–18.
  • Rabinowitz MB, Gonick HC, Levin SR, Davidson MB. Clinical trial of chromium and yeast supplements on carbohydrate and lipid metabolism in diabetic men. Biol. Trace Elem. Res. 1983;5(6): 449–66.
  • Roth JA, Kaeberle ML. Effect of glucocorticoids on the bovine immune system. J. Am. Vet. Med. Assoc. 1982;180: 894–901.
  • Schrauzer GN, Shrestha KP, Molenaar TB, Mead S. Effects of chromium supplementation on food energy utilization and the trace-element composition in the liver and heart of glucose-exposed young mice. Biol. Trace Elem. Res. 1986;9(2): 79–87.
  • Schwarz K, Mertz W. Chromium(III) and the glucose tolerance factor. Arch. Biochem. Biophys. 1959;85: 292–5.
  • Shrivastava R, Upreti RK, Seth PK, Chaturvedi UC. Effects of chromium on the immune system. FEMS Immunol. Med. Microbiol. 2002. p. 1–7.
  • Spears JW. Micronutrients and immune function in cattle. Proc. Nutr. Soc. 2000. p. 587–94.
  • Spears JW, Whisnant CS, Huntington GB, Lloyd KE, Fry RS, Krafka K, Lamptey A, Hyda J. Chromium propionate enhances insulin sensitivity in growing cattle. J. Dairy Sci. 2012;95(4): 2037–45.
  • Subiyatno A, Mowat DN, Yang WZ. Metabolite and Hormonal Responses to Glucose or Propionate Infusions in Periparturient Dairy Cows Supplemented with Chromium. J. Dairy Sci. 1996;79(8): 1436–45.
  • van de Ligt JLG, Lindemann MD, Harmon RJ, Monegue HJ, Cromwell GL. Effect of chromium tripicolinate supplementation on porcine immune response during the postweaning period. J. Anim. Sci. 2002;80(2): 449–55.
  • Villalobos-F. JA, Romero-R. C, Tarragó-C. MR, Rosado A. Supplementation with chromium picolinate reduces the incidence of placental retention in dairy cows. Can. J. Anim. Sci. NRC Research Press Ottawa, Canada; 1997;77(2): 329–30.
  • Xu X, Liu L, Long S-F, Piao X-S, Ward TL, Ji F. Effects of Chromium Methionine Supplementation with Different Sources of Zinc on Growth Performance, Carcass Traits, Meat Quality, Serum Metabolites, Endocrine Parameters, and the Antioxidant Status in Growing-Finishing Pigs. Biol. Trace Elem. Res. 2017;162(1–3): 134–41.

Krom ile Beslemenin Bağışıklık Sistemi Üzerine Etkileri

Yıl 2017, Cilt: 10 Sayı: 2, 99 - 105, 01.03.2017

Öz

Krom (Cr) beslemesi üzerine birçok çalışma yapılmıştır. İlk dönemlerde araştırmacılar tarafından esansiyel bir besin maddesi/mineral olarak kabul edilmiş ve karbonhidrat metabolizması ile yakın ilişkisi detaylı biçimde ortaya konmuştur. Erken dönemde Cr mineralinin bağışıklık sistemi üzerine bazı etkileri olduğu in vitro çalışmalar ile keşfedilmiştir. Son yıllarda ise bu etkilerinin çiftlik bazındaki yansımaları ortaya konmaktadır. Bu çalışmada, Cr beslemesinin bağışıklık sistemi ve yanıtına etkileri incelenmiştir.

Kaynakça

  • Abraham AS, Sonnenblick M, Eini M. The effect of chromium on cholesterol-induced atherosclerosis in rabbits. Atherosclerosis. 1982a;41(2–3): 371–9.
  • Abraham AS, Sonnenblick M, Eini M. The action of chromium on serum lipids and on atherosclerosis in cholesterol-fed rabbits. Atherosclerosis. 1982b;42(2–3): 185–95.
  • Anderson RA, Bryden NA, Polansky MM, Deuster PA. Exercise effects on chromium excretion of trained and untrained men consuming a constant diet. J. Appl. Physiol. 1988;64(1): 249–52.
  • Anderson RA, Polansky MM, Bryden NA, Roginski EE, Patterson KY, Reamer DC. Effect of Exercise (Running) on Serum Glucose, Insulin, Glucagon, and Chromium Excretion. Diabetes. 1982;31(3): 212–6.
  • Arthington JD, Corah LR, Minton JE, Elsasser TH, Blecha F. Supplemental Dietary Chromium Does Not Influence ACTH, Cortisol, or Immune Responses in Young Calves Inoculated with Bovine Herpesvirus-1. J. Anim. Sci. 1997;75(1): 217–23.
  • Burton JL, Mallard BA, Mowat DN. Effects of supplemental chromium on immune responses of periparturient and early lactation dairy cows. J. Anim. Sci. 1993;71(6): 1532–9.
  • Burton JL, Mallard BA, Mowat DN. Effects of supplemental chromium on antibody responses of newly weaned feedlot calves to immunization with infectious bovine rhinotracheitis and parainfluenza 3 virus. Can. J. Vet. Res. 1994;58(2): 148–51.
  • Burton JL, Nonnecke BJ, Dubeski PL, Elsasser TH, Mallard BA. Effects of supplemental chromium on production of cytokines by mitogen-stimulated bovine peripheral blood mononuclear cells. J. Dairy Sci. 1996;79(12): 2237–46.
  • Burton JL, Nonnecke BJ, Elsasser TH, Mallard BA, Yang WZ, Mowat DN. Immunomodulatory activity of blood serum from chromium-supplemented periparturient dairy cows. Vet. Immunol. Immunopathol. 1995;49: 29–38.
  • Chang X, Mallard BA, Mowat DN. Proliferation of peripheral blood lymphocytes of feeder calves in response to chromium. Nutr. Res. 1994;14(6): 851–64.
  • Chang X, Mallard BA, Mowat DN. Effects of chromium on health status, blood neutrophil phagocytosis and in vitro lymphocyte blastogenesis of dairy cows. Vet. Immunol. Immunopathol. 1996;52(1–2): 37–52.
  • Chang X, Mowat DN. Supplemental chromium for stressed and growing feeder calves. J. Anim. Sci. 1992;70(2): 559–65.
  • Chang X, Mowat DN, Mallard BA. Supplemental Chromium and Niacin for Stressed Feeder Calves. Can. J. Anim. Sci. 1995;75(3): 351–8.
  • Faldyna M, Pechova A, Krejci J. Chromium supplementation enhances antibody response to vaccination with tetanus toxoid in cattle. J. Vet. Med. Ser. B Infect. Dis. Vet. Public Heal. 2003;50(7): 326–31.
  • Gatta PP, Thompson KD, Smullen R, Piva A, Testi S, Adams A. Dietary organic chromium supplementation and its effect on the immune response of rainbow trout (Oncorhynchus mykiss). Fish Shellfish Immunol. 2001;11(5): 371–82.
  • Guidry AJ, Paape MJ, Pearson RE. Effects of parturition and lactation on blood and milk cell concentrations, corticosteroids, and neutrophil phagocytosis in the cow. Am. J. Vet. Res. 1976;37(10): 1195–200.
  • Haq Z, Jain RK, Khan N, Dar MY, Ali S, Gupta M, Varun TK. Recent advances in role of chromium and its antioxidant combinations in poultry nutrition: A review. Vet. World. 2016;9(12): 1392–9.
  • Hayirli A, Bremmer DR, Bertics SJ, Socha MT, Grummer RR. Effect of Chromium Supplementation on Production and Metabolic Parameters in Periparturient Dairy Cows. J. Dairy Sci. 2001;84(5): 1218–30.
  • Jain SK, Kannan K. Chromium chloride inhibits oxidative stress and TNF-alpha secretion caused by exposure to high glucose in cultured U937 monocytes. Biochem. Biophys. Res. Commun. 2001;289(3): 687–91.
  • Jeejeebhoy KN, Chu RC, Marliss EB, Greenberg GR, Bruce-Robertson A. Chromium deficiency, glucose intolerance, and neuropathy reversed by chromium supplementation, in a patient receiving longterm total parenteral nutrition. Am. J. Clin. Nutr. 1977;30(4): 531–8.
  • Kafilzadeh F, shabankareh HK, Targhibi MR. Effect of Chromium Supplementation on Productive and Reproductive Performances and Some Metabolic Parameters in Late Gestation and Early Lactation of Dairy Cows. Biol. Trace Elem. Res. 2012;149(1): 42–9.
  • Kegley EB, Spears JW, Brown TT. Immune Response and Disease Resistance of Calves Fed Chromium Nicotinic Acid Complex or Chromium Chloride. J. Dairy Sci. 1996;79(7): 1278–83.
  • Kegley EB, Spears JW, Eisemann JH. Performance and glucose metabolism in calves fed a chromium-nicotinic acid complex or chromium chloride. J. Dairy Sci. 1997;80(8): 1744–50.
  • Kehrli ME, Nonnecke BJ, Roth JA. Alterations in bovine neutrophil function during the periparturient period. Am. J. Vet. Res. 1989a;50(2): 207–14.
  • Kehrli ME, Nonnecke BJ, Roth JA. Alterations in bovine lymphocyte function during the periparturient period. Am. J. Vet. Res. 1989b;50(2): 215–20.
  • Lee DN, Yen HT, Shen TF, Chen BJ. Chromium-induced glucose uptake, superoxide anion production, and phagocytosis in cultured pulmonary alveolar macrophages of weanling pigs. Biol. Trace Elem. Res. 2000;77(1): 53–64.
  • Lien TF, Yang KH, Lin KJ. Effects of chromium propionate supplementation on growth performance, serum traits and immune response in weaned pigs. Asian-Australasian J. Anim. Sci. 2005;18(3): 403–8.
  • Lindell SA, Brandt, Robert T. J, Minton JE, Blecha F, Stokka GL, Milton CT. Supplemental chromium and revaccination effects on performance and health of newly weaned calves. Cattlemen’s Day. Kansas: Kansas State University. Agricultural Experiment Station and Cooperative Extension Service; 1994. p. 32–5.
  • Mallard B, Mowat D, Leslie K, Chang X, Wright A. Immunomodulatory effects of chelated chromium on dairy health and production. Annu. Meet. Natl. Mastit. Counc. Virginia; 1994. p. 69–76.
  • Mathisonl GW, Engstrom DF. Chromium and protein supplements for growing-finishing beef steers fed barley-based diets. Can. J. Anim. 1995; 549–58.
  • McNamara JP, Valdez F. Adipose Tissue Metabolism and Production Responses to Calcium Propionate and Chromium Propionate. J. Dairy Sci. 2005;88(7): 2498– 507.
  • Mertz W. Chromium. History and nutritional importance. Biol. Trace Elem. Res. 1992;32(2): 3–8.
  • Moonsie-Shageer S, Mowat DN. Effect of level of supplemental chromium on performance, serum constituents, and immune status of stressed feeder calves. J. Anim. Sci. 1993;71(1): 232–8.
  • Mowat DN, Chang X, Yang WZ. Chelated chromium for stressed feeder calves. Can. J. Anim. Sci. 1993;73: 49–55.
  • Munck A, Guyre PM, Holbrook NJ. Physiological functions of glucocorticoids in stress and their relations to pharmacological actions. Endocr Rev. 1984;5(1): 25–44.
  • Myers MJ, Farrell DE, Evock-Clover CM, Cope C V, Henderson M, Steele NC. Effect of recombinant growth hormone and chromium picolinate on cytokine production and growth performance in swine. Pathobiology. 1995;63(5): 283–7.
  • Pechova A, Pavlata L. Chromium as an essential nutrient: a review. Vet. Med. (Praha). 2007;52(1): 1–18.
  • Rabinowitz MB, Gonick HC, Levin SR, Davidson MB. Clinical trial of chromium and yeast supplements on carbohydrate and lipid metabolism in diabetic men. Biol. Trace Elem. Res. 1983;5(6): 449–66.
  • Roth JA, Kaeberle ML. Effect of glucocorticoids on the bovine immune system. J. Am. Vet. Med. Assoc. 1982;180: 894–901.
  • Schrauzer GN, Shrestha KP, Molenaar TB, Mead S. Effects of chromium supplementation on food energy utilization and the trace-element composition in the liver and heart of glucose-exposed young mice. Biol. Trace Elem. Res. 1986;9(2): 79–87.
  • Schwarz K, Mertz W. Chromium(III) and the glucose tolerance factor. Arch. Biochem. Biophys. 1959;85: 292–5.
  • Shrivastava R, Upreti RK, Seth PK, Chaturvedi UC. Effects of chromium on the immune system. FEMS Immunol. Med. Microbiol. 2002. p. 1–7.
  • Spears JW. Micronutrients and immune function in cattle. Proc. Nutr. Soc. 2000. p. 587–94.
  • Spears JW, Whisnant CS, Huntington GB, Lloyd KE, Fry RS, Krafka K, Lamptey A, Hyda J. Chromium propionate enhances insulin sensitivity in growing cattle. J. Dairy Sci. 2012;95(4): 2037–45.
  • Subiyatno A, Mowat DN, Yang WZ. Metabolite and Hormonal Responses to Glucose or Propionate Infusions in Periparturient Dairy Cows Supplemented with Chromium. J. Dairy Sci. 1996;79(8): 1436–45.
  • van de Ligt JLG, Lindemann MD, Harmon RJ, Monegue HJ, Cromwell GL. Effect of chromium tripicolinate supplementation on porcine immune response during the postweaning period. J. Anim. Sci. 2002;80(2): 449–55.
  • Villalobos-F. JA, Romero-R. C, Tarragó-C. MR, Rosado A. Supplementation with chromium picolinate reduces the incidence of placental retention in dairy cows. Can. J. Anim. Sci. NRC Research Press Ottawa, Canada; 1997;77(2): 329–30.
  • Xu X, Liu L, Long S-F, Piao X-S, Ward TL, Ji F. Effects of Chromium Methionine Supplementation with Different Sources of Zinc on Growth Performance, Carcass Traits, Meat Quality, Serum Metabolites, Endocrine Parameters, and the Antioxidant Status in Growing-Finishing Pigs. Biol. Trace Elem. Res. 2017;162(1–3): 134–41.
Toplam 48 adet kaynakça vardır.

Ayrıntılar

Bölüm DERLEME
Yazarlar

Eyüp Eren Gültepe

Cangir Uyarlar Bu kişi benim

İsmail Bayram Bu kişi benim

Yayımlanma Tarihi 1 Mart 2017
Kabul Tarihi 20 Mart 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 10 Sayı: 2

Kaynak Göster

APA Gültepe, E. E., Uyarlar, C., & Bayram, İ. (2017). Effects of Dietary Chromium on Immune System. Kocatepe Veterinary Journal, 10(2), 99-105.
AMA Gültepe EE, Uyarlar C, Bayram İ. Effects of Dietary Chromium on Immune System. kvj. Haziran 2017;10(2):99-105.
Chicago Gültepe, Eyüp Eren, Cangir Uyarlar, ve İsmail Bayram. “Effects of Dietary Chromium on Immune System”. Kocatepe Veterinary Journal 10, sy. 2 (Haziran 2017): 99-105.
EndNote Gültepe EE, Uyarlar C, Bayram İ (01 Haziran 2017) Effects of Dietary Chromium on Immune System. Kocatepe Veterinary Journal 10 2 99–105.
IEEE E. E. Gültepe, C. Uyarlar, ve İ. Bayram, “Effects of Dietary Chromium on Immune System”, kvj, c. 10, sy. 2, ss. 99–105, 2017.
ISNAD Gültepe, Eyüp Eren vd. “Effects of Dietary Chromium on Immune System”. Kocatepe Veterinary Journal 10/2 (Haziran 2017), 99-105.
JAMA Gültepe EE, Uyarlar C, Bayram İ. Effects of Dietary Chromium on Immune System. kvj. 2017;10:99–105.
MLA Gültepe, Eyüp Eren vd. “Effects of Dietary Chromium on Immune System”. Kocatepe Veterinary Journal, c. 10, sy. 2, 2017, ss. 99-105.
Vancouver Gültepe EE, Uyarlar C, Bayram İ. Effects of Dietary Chromium on Immune System. kvj. 2017;10(2):99-105.

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