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Ashbaugh AG, Ekelem C, Landaverde Y, Mesinkovska NA. Psoriatic Disease in the US Latino Population: A Comprehensive Review. Am J Clin Dermatol 2020; 21:265-274. [PMID: 31845122 DOI: 10.1007/s40257-019-00498-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Current evidence suggests that there are notable differences in the severity of psoriasis between racial and ethnic groups. While the US Latino population is growing rapidly, there is little research on the various factors impacting disease severity in this minority population. This review evaluates the current evidence on psoriasis in Latinos within the US. Psoriasis affects the US Latino population at a lower prevalence, with more severe disease and a greater quality-of-life impact than their White counterparts. In addition, Latinos with psoriasis experience higher rates of comorbidities, such as depression, obesity, and diabetes compared with Whites. There is evidence showing non-inferior or better response to systemic treatments, such as etanercept, secukinumab, and brodalumab, in this population. The combination of barriers to care and lack of involvement in research limit the current understanding of the mechanisms responsible for the pathologic outcomes and the environmental and social disparities observed. Future studies that reflect the growing proportion of minorities in the US may help close these knowledge gaps and improve care.
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Affiliation(s)
- Alyssa Gwen Ashbaugh
- Department of Dermatology, Dermatology Clinical Research Center, University of California, Irvine, 843 Health Sciences Road, Hewitt Hall 1001, Irvine, CA, 92697, USA
| | - Chloe Ekelem
- Department of Dermatology, Dermatology Clinical Research Center, University of California, Irvine, 843 Health Sciences Road, Hewitt Hall 1001, Irvine, CA, 92697, USA.
| | - Yessica Landaverde
- Department of Dermatology, Dermatology Clinical Research Center, University of California, Irvine, 843 Health Sciences Road, Hewitt Hall 1001, Irvine, CA, 92697, USA
| | - Natasha Atanaskova Mesinkovska
- Department of Dermatology, Dermatology Clinical Research Center, University of California, Irvine, 843 Health Sciences Road, Hewitt Hall 1001, Irvine, CA, 92697, USA
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Meienberger N, Anzengruber F, Amruthalingam L, Christen R, Koller T, Maul J, Pouly M, Djamei V, Navarini A. Observer‐independent assessment of psoriasis‐affected area using machine learning. J Eur Acad Dermatol Venereol 2020; 34:1362-1368. [DOI: 10.1111/jdv.16002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 09/20/2019] [Indexed: 12/17/2022]
Affiliation(s)
- N. Meienberger
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - F. Anzengruber
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - L. Amruthalingam
- Department of Dermatology University Hospital of Basel Basel Switzerland
| | - R. Christen
- Lucerne University for Applied Sciences and Arts Lucerne Switzerland
| | - T. Koller
- Lucerne University for Applied Sciences and Arts Lucerne Switzerland
| | - J.T. Maul
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - M Pouly
- Lucerne University for Applied Sciences and Arts Lucerne Switzerland
| | - V. Djamei
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - A.A. Navarini
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Department of Dermatology University Hospital of Basel Basel Switzerland
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Abstract
Phototherapy in skin of color requires special consideration. Pigmented skin is an efficient ultraviolet filter. Hence, higher doses of ultraviolet radiation are generally more effective and well tolerated in skin of color. An objective and practical system has not yet been established to determine optimal phototherapy dosing in skin of color. The authors recommend obtaining a detailed history of each individual patient's response to sun exposure before prescribing a phototherapy dosing regimen. In addition, providers should consider the role of socioeconomic factors and their impact on phototherapy-related outcomes, including barriers to access and compliance.
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Affiliation(s)
- Olivia R Ware
- Howard University College of Medicine, 2041 Georgia Avenue Northwest, Towers Building, Suite 4300, Washington, DC 20060, USA.
| | - Jonathan Guiyab
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Ginette A Okoye
- Department of Dermatology, Howard University Hospital, 2041 Georgia Avenue Northwest, Towers Building, Suite 4300, Washington, DC 20060, USA
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Li Y, Song Y, Zhu L, Wang X, Yang B, Lu P, Chen Q, Bin L, Deng L. Interferon Kappa Is Up-Regulated in Psoriasis and It Up-Regulates Psoriasis-Associated Cytokines in vivo. Clin Cosmet Investig Dermatol 2019; 12:865-873. [PMID: 31819584 PMCID: PMC6890215 DOI: 10.2147/ccid.s218243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/06/2019] [Indexed: 12/27/2022]
Abstract
Purpose There is increased type I interferon signature in psoriasis patients. Interferon-kappa (IFN-κ) is a member of type I interferon family that is constitutively expressed by keratinocytes. In this study, we investigate whether IFN-κ is involved in psoriasis etiology. Patients and methods Twenty healthy individuals, 20 psoriasis vulgaris patients and 10 atopic dermatitis (AD) were included for this study. Immunohistochemistry staining, normal human epidermal keratinocytes (NHEK) culture, Ca2Cl-induced differentiation, quantitative reverse transcription (qRT-PCR), ELISA and murine experiments were performed. Results We found IFN-κ protein expression was extremely low in the epidermis of normal skin, but it was significantly increased in the suprabasal layers of epidermal keratinocytes in psoriatic skin lesions. However, its expression in the skin lesions of AD was similar to normal skin. Additionally, IFN-κ protein was detected in sera from psoriasis patients, but not in sera from normal subjects and AD. We further investigated the regulation of IFNk gene expression in NHEK. We found that IFNk was significantly induced by types of nucleic acid pathogen recognition receptor (PRR) agonists in NHEK. While its expression was significantly induced by itself and IFN-γ, it was inhibited by type 2 immunity cytokines IL4 and IL13; other inflammatory cytokines including IL1 super-family members and IL17A did not alter its expression. Addition of recombinant IFN-κ did not affect keratinocytes differentiation. Using the murine experimental model, we demonstrated that subcutaneous administration of recombinant IFN-κ did not increase skin thickness, but significantly increased the transcription of TNFA and IL17A in mice skin. Conclusion Increased IFN-κ in psoriasis may be caused by injured cells-released nucleic acids, increased IFN-γ and self-activation. Its enhancement may contribute to the etiology of the disease by enhancing TNFA and IL17A gene expression.
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Affiliation(s)
- Yuanyuan Li
- Biomedical Translational Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong Province, People's Republic of China
| | - Yueqi Song
- Biomedical Translational Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong Province, People's Republic of China
| | - Leqing Zhu
- Biomedical Translational Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong Province, People's Republic of China
| | - Xiao Wang
- Biomedical Translational Research Institute, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong Province, People's Republic of China
| | - Bin Yang
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Ping Lu
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Quan Chen
- Division of Research Informatics Services, Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Lianghua Bin
- Department of Pediatrics, National Jewish Health, Denver, CO, USA
| | - Liehua Deng
- Department of Dermatology, The First Affiliated Hospital, Jinan University, Guangzhou, Guangdong Province, People's Republic of China
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Puig L, Wu JJ, Gooderham MJ, You Y, Shen YK, Randazzo B, Kerdel F. Consistent response to guselkumab treatment between Hispanic and non-Hispanic patients with psoriasis: an analysis from VOYAGE 1 and VOYAGE 2. J DERMATOL TREAT 2019; 32:484-491. [DOI: 10.1080/09546634.2019.1679336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jashin J. Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA
| | - Melinda J. Gooderham
- SKiN Centre for Dermatology and Department of Medicine, Queen’s University, Peterborough, Ontario, Canada
| | - Yin You
- Biostatistics, Immunology, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Yaung-Kaung Shen
- Biostatistics, Immunology, Janssen Research & Development, LLC, Spring House, PA, USA
| | - Bruce Randazzo
- Clinical Research, Janssen Research & Development, LLC, Spring House, PA, USA
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Chularojanamontri L, Nimanong S, Wongpraparut C, Silpa-Archa N, Chaiyabutr C, Charoenpipatsin N. How do we treat psoriasis patients with hepatitis C infections in real-world situations? A retrospective analysis of 34 patients. J DERMATOL TREAT 2019; 32:321-327. [PMID: 31418622 DOI: 10.1080/09546634.2019.1657225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND There is still relatively limited data on psoriasis and hepatitis C virus (HCV) infections. OBJECTIVE This study investigated the clinical characteristics and treatment of psoriasis patients with HCV infections in real-world practice. METHODS Medical records of all psoriasis patients with HCV infections who attended the outpatient clinic at Siriraj Hospital over a 10-year period were retrospectively reviewed. RESULTS Of 34 patients, 26 and 8 patients were men and women, respectively with a mean age of 57.0 ± 8.7 (range, 42.2-77.2) years. The median age of psoriasis onset was 42.7 ± 12.7 (range, 8-67.25) years. With a median follow-up period of 13.6 years, cirrhosis and hepatocellular carcinoma were found in 67.6% and 29.4% of the patients, respectively. The interferon used for HCV treatment exacerbated the psoriasis in 20% of those patients. Conventional treatments and anti-tumor necrosis factors (anti-TNFs) were used in strict collaboration with hepatologists. No patients experienced a worsening of their HCV infection. CONCLUSION Despite a limited number of patients, a male predominance and late-onset psoriasis were frequently observed. Although, interferon therapy for HCV can exacerbate psoriasis, it is not contraindicated. All conventional treatments and anti-TNFs can be used, provided that there is strict collaboration with hepatologists.
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Affiliation(s)
- Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supot Nimanong
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chanisada Wongpraparut
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Narumol Silpa-Archa
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Norramon Charoenpipatsin
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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McMichael A, Desai SR, Qureshi A, Rastogi S, Alexis AF. Efficacy and Safety of Brodalumab in Patients with Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results from the Pooled AMAGINE-2/-3 Randomized Trials. Am J Clin Dermatol 2019; 20:267-276. [PMID: 30471012 DOI: 10.1007/s40257-018-0408-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Data on treatment outcomes in patients with psoriasis who have skin of color are limited. Brodalumab has shown efficacy in patients with moderate-to-severe plaque psoriasis. OBJECTIVE Our objective was to evaluate the efficacy, safety, and health-related quality of life associated with brodalumab in patients with skin of color participating in two phase III, multicenter, randomized, double-blind, placebo- and active comparator-controlled studies (AMAGINE-2/-3). METHODS Patients were self-categorized into racial subgroups (black, Asian, or white) or the non-mutually exclusive ethnic subgroup Hispanic/Latino. Patients were randomized to receive brodalumab 210 mg every 2 weeks (Q2W) or ustekinumab (45 mg in patients weighing ≤ 100 kg and 90 mg in patients weighing > 100 kg) for 52 weeks. Skin clearance was monitored using the Psoriasis Area and Severity Index (PASI) and Static Physician's Global Assessment (sPGA). Treatment-emergent adverse events (TEAEs) were summarized by treatment and racial and ethnic subgroup. Health-related quality of life was assessed using the Dermatology Life Quality Index (DLQI). RESULTS During the 12-week induction phase, 613 patients received ustekinumab (black, n = 20; Asian, n = 24; white, n = 551; Hispanic/Latino, n = 68) and 1236 patients received brodalumab 210 mg Q2W (black, n = 36; Asian, n = 39; white, n = 1116; Hispanic/Latino, n = 132). At week 52, a total of 590 patients received continuous ustekinumab (black, n = 19; Asian, n = 23; white, n = 532; Hispanic/Latino, n = 64) and 339 patients were re-randomized to continue receiving brodalumab 210 mg Q2W (black, n = 10; Asian, n = 7; white, n = 308; Hispanic/Latino, n = 40). Among patients who received brodalumab 210 mg Q2W, skin clearance response rates were similar across racial and ethnic subgroups at week 12 and week 52; rates of 75%, 90%, and 100% improvement in PASI from baseline were also higher, as was sPGA score ≤ 1, than in patients who received ustekinumab across all racial and ethnic subgroups. Rates of TEAEs and ≥ 5-point improvement in DLQI score were similar across racial and ethnic subgroups. CONCLUSIONS Brodalumab 210 mg Q2W is well tolerated and efficacious across diverse racial and ethnic subgroups in patients with psoriasis, including black, Asian, white, and Hispanic/Latino patients. TRIAL REGISTRY ClinicalTrials.gov identifier NCT01708603 (AMAGINE-2); NCT01708629 (AMAGINE-3).
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Affiliation(s)
- Amy McMichael
- Department of Dermatology, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27104, USA.
| | - Seemal R Desai
- Innovative Dermatology, Plano, TX, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | - Andrew F Alexis
- Mount Sinai St. Luke's and Mount Sinai West, New York, NY, USA
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Huang X, Yu P, Liu M, Deng Y, Dong Y, Liu Q, Zhang J, Wu T. ERK inhibitor JSI287 alleviates imiquimod-induced mice skin lesions by ERK/IL-17 signaling pathway. Int Immunopharmacol 2019; 66:236-241. [DOI: 10.1016/j.intimp.2018.11.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/08/2018] [Accepted: 11/19/2018] [Indexed: 12/29/2022]
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Tang L, Yang X, Liang Y, Xie H, Dai Z, Zheng G. Transcription Factor Retinoid-Related Orphan Receptor γt: A Promising Target for the Treatment of Psoriasis. Front Immunol 2018; 9:1210. [PMID: 29899748 PMCID: PMC5988853 DOI: 10.3389/fimmu.2018.01210] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 05/15/2018] [Indexed: 12/13/2022] Open
Abstract
Psoriasis, which is a common chronic inflammatory skin disease, endangers human health and brings about a major economic burden worldwide. To date, treatments for psoriasis remain unsatisfied because of their clinical limitations and various side effects. Thus, developing a safer and more effective therapy for psoriasis is compelling. Previous studies have explicitly shown that psoriasis is an autoimmune disease that is predominantly mediated by T helper 17 (Th17) cells, which express high levels of interleukin-17 (IL-17) in response to interleukin-23 (IL-23). The discovery of the IL-23–Th17–IL-17 axis in the development of psoriasis has led to the paradigm shift of understanding pathogenesis of psoriasis. Although anti-IL-17 antibodies show marked clinical efficacy in treating psoriasis, compared with antibodies targeting IL-17A or IL-17R alone, targeting Th17 cells themselves may have a maximal benefit by affecting multiple proinflammatory cytokines, including IL-17A, IL-17F, IL-22, and granulocyte-macrophage colony-stimulating factor, which likely act synergistically to drive skin inflammation in psoriasis. In this review, we mainly focus on the critical role of Th17 cells in the pathogenesis of psoriasis. Especially, we explore the small molecules that target retinoid-related orphan receptor γt (RORγt), a vital transcription factor for Th17 cells. Given that RORγt is the lineage-defining transcription factor for Th17 cell differentiation, targeting RORγt via small molecular inverse agonists may be a promising strategy for the treatment of Th17-mediated psoriasis.
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Affiliation(s)
- Lipeng Tang
- Department of Pharmacology of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiaozhi Yang
- School of Bioscience and Bio-Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Yongxin Liang
- School of Bioscience and Bio-Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Hesong Xie
- School of Bioscience and Bio-Pharmaceutics, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Zhenhua Dai
- Section of Immunology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Guangjuan Zheng
- Department of Pharmacology of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Department of Pathology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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60
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Ghasemi Basir HR, Alirezaei P, Hamian Z, Khanlarzadeh E. Are quantitative histopathologic criteria capable of differentiating psoriasis from chronic dermatitis? Clin Cosmet Investig Dermatol 2018; 11:239-244. [PMID: 29785133 PMCID: PMC5955025 DOI: 10.2147/ccid.s160697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background There are overlapping features in histopathologic characteristics of psoriasis and chronic dermatitis, which sometimes make the correct diagnosis difficult. Objective The aim of this study was to compare the histopathologic diagnostic features of psoriasis with chronic dermatitis quantitatively. Patients and methods In this study, 30 patients with psoriasis and 30 patients with chronic dermatitis were included. Diagnosis of psoriasis or chronic dermatitis was based on clinicopathologic correlation. Photos of histopathologic slides were provided by LABOMED Digital Camera and LABOMED Microscope. Width and length of rete ridges, minimal thickness of suprapapillary plates, thickness of epidermis, thickness of hyperkeratotic layer, and minimal thickness of granular layer were determined using Pixel Pro software on micrometer scale. Results Suprapapillary plates and granular layer were significantly thicker in patients with chronic dermatitis compared with patients with psoriasis. The rete ridges were longer and wider, the epidermis was thicker, and the parakeratotic layer was also thicker in patients with psoriasis compared with patients with chronic dermatitis, and the difference between these corresponding parameters in the two groups was statistically significant except for thickness of parakeratotic layer. Moreover, the mean ratio of minimal suprapapillary plate’s thickness to epidermal thickness and the mean ratio of minimal granular layer’s thickness to parakeratotic layer’s thickness were significantly higher in patients with chronic dermatitis compared with those with psoriasis. Conclusion Despite overlapping histopathologic features in psoriasis and chronic dermatitis, quantitative histopathologic criteria might be valuable for differentiation of these two conditions. Ratios of minimal suprapapillary plate’s thickness to epidermal thickness and minimal granular layer’s thickness to parakeratotic layer’s thickness can be particularly helpful in this regard.
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Affiliation(s)
- Hamid Reza Ghasemi Basir
- Department of Pathology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Pedram Alirezaei
- Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Hamian
- School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Elham Khanlarzadeh
- Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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