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Paolino G, Di Nicola MR, Avella I, Mercuri SR. Venomous Bites, Stings and Poisoning by European Vertebrates as an Overlooked and Emerging Medical Problem: Recognition, Clinical Aspects and Therapeutic Management. Life (Basel) 2023; 13:1228. [PMID: 37374011 DOI: 10.3390/life13061228] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 06/29/2023] Open
Abstract
Europe presents a high number of venomous and poisonous animals able to elicit medically relevant symptoms in humans. However, since most of the accidents involving venomous or poisonous animals in Europe are unreported, their incidence and morbidity are severely overlooked. Here we provide an overview of the European vertebrate species of greatest toxicological interest, the clinical manifestations their toxins can cause, and their treatment. We report the clinical symptoms induced by envenomations and poisoning caused by reptiles, fishes, amphibians and mammals in Europe, ranging from mild, local symptoms (e.g., erythema, edema) to systemic and potentially deadly. The present work constitutes a tool for physicians to recognize envenomation/poisoning symptoms caused by the most medically relevant European vertebrates and to decide which approach is the most appropriate to treat them.
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Affiliation(s)
- Giovanni Paolino
- Unit of Dermatology and Cosmetology, I.R.C.C.S. San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy
- Unit of Clinical Dermatology, Università Vita-Salute San Raffaele, Via Olgettina 60, 20132 Milan, Italy
| | - Matteo Riccardo Di Nicola
- Unit of Dermatology and Cosmetology, I.R.C.C.S. San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy
- Asociación Herpetológica Española, Apartado de Correos 191, 28911 Leganés, Spain
| | - Ignazio Avella
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, Campus de Vairão, Universidade do Porto, 4485-661 Vairão, Portugal
- Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, 4099-002 Porto, Portugal
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, 4485-661 Vairão, Portugal
| | - Santo Raffaele Mercuri
- Unit of Dermatology and Cosmetology, I.R.C.C.S. San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy
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Comparative Venom Proteomics of Iranian, Macrovipera lebetina cernovi, and Cypriot, Macrovipera lebetina lebetina, Giant Vipers. Toxins (Basel) 2022; 14:toxins14100716. [PMID: 36287984 PMCID: PMC9609362 DOI: 10.3390/toxins14100716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/05/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
Envenoming by Macrovipera lebetina subspecies causes severe life-threatening difficulties for people living in North Africa and the Middle East. To better understand the pathophysiology of envenoming and improve patient management, knowledge about the venom components of the subspecies is essential. Here, the venom proteomes of Macrovipera lebetina lebetina from Cyprus and Macrovipera lebetina cernovi from Iran were characterized using RP-HPLC separation of the crude venom proteins, SDS-PAGE of fractionated proteins, and LC-MS/MS of peptides obtained from in-gel tryptic digestion of protein bands. Moreover, we also used high-resolution shot-gun proteomics to gain more reliable identification, where the whole venom proteomes were subjected directly to in-solution digestion before LC-HR-MS/MS. The data revealed that both venoms consisted of at least 18 protein families, of which snake venom Zn2+-dependent metalloprotease (SVMP), serine protease, disintegrin, phospholipase A2, C-type lectin-like, and L-amino acid oxidase, together accounted for more than 80% of the venoms’ protein contents. Although the two viper venoms shared mostly similar protein classes, the relative occurrences of these toxins were different in each snake subspecies. For instance, P-I class of SVMP toxins were found to be more abundant than P-III class in the venoms of M. l. cernovi compared to M. l. lebetina, which gives hints at a more potent myonecrotic effect and minor systemic hemorrhage following envenoming by M. l. cernovi than M. l. lebetina. Moreover, single-shot proteomics also revealed many proteins with low abundance (<1%) within the venoms, such as aminopeptidase, hyaluronidase, glutaminyl-peptide cyclotransferase, cystatin, phospholipase B, and vascular endothelial growth factor. Our study extends the in-depth understanding of the venom complexity of M. lebetina subspecies, particularly regarding toxin families associated with envenoming pathogenesis and those hard-detected protein classes expressed in trace amounts.
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Nourreddine FZ, Oussedik-Oumehdi H, Laraba-Djebari F. Myotoxicity induced by Cerastes cerastes venom: Beneficial effect of heparin in skeletal muscle tissue regeneration. Acta Trop 2020; 202:105274. [PMID: 31738878 DOI: 10.1016/j.actatropica.2019.105274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 01/03/2023]
Abstract
Myonecrosis is a relevant tissue damage induced by snakes of Viperidae family often leading to permanent tissue and function loss and even amputation. The aim of this study was to evaluate the effect of heparin on skeletal muscle tissue regeneration after Cerastes cerastes envenomation. Mice received either the venom (1 LD50) by i.m. route, or the venom followed, by heparin administration by i.v. route at 15 min and 4 h. Obtained results showed that Cerastes cerastes venom induced deep tissue structure alterations, characterized mainly by edema, hemorrhage, myonecrosis and inflammation. Myotoxicity was correlated with increased CK levels in sera, concomitant with their decrease in muscle tissue homogenates. Muscle wet weight was restored within 2 weeks after heparin treatment and 28 days in the envenomed group. Heparin treatment significantly decreased MPO activity, suggesting an anti-inflammatory effect. NO, HGF, VEGF and G-CSF levels were increased after heparin administration. These mitogenic factors constitute potent stimuli for satellite and endothelial cells improving, thus, muscle regeneration. This study showed that muscle tissue recovery was significantly enhanced after heparin treatment. Heparin use seems to be a promising therapeutic approach after viper envenomation.
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Affiliation(s)
- Fatima Zohra Nourreddine
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, BP 32, El-Alia, Bab Ezzouar,16111, Algiers, Algeria
| | - Habiba Oussedik-Oumehdi
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, BP 32, El-Alia, Bab Ezzouar,16111, Algiers, Algeria
| | - Fatima Laraba-Djebari
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, BP 32, El-Alia, Bab Ezzouar,16111, Algiers, Algeria.
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Siigur J, Aaspõllu A, Siigur E. Biochemistry and pharmacology of proteins and peptides purified from the venoms of the snakes Macrovipera lebetina subspecies. Toxicon 2019; 158:16-32. [DOI: 10.1016/j.toxicon.2018.11.294] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 12/20/2022]
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Makran B, Fahmi L, Boussada L, Oukkache N, Chgoury F, Benomar H, Ghalim N, Lkhider M. Comparative toxicological characterization of venoms of Cerastes cerastes and Macrovipera mauritanica from Morocco and neutralization by monospecific antivenoms. TOXIN REV 2018. [DOI: 10.1080/15569543.2018.1540012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Bouchra Makran
- Venoms and Toxins Laboratory, Pasteur Institute of Morocco 1, Casablanca, Morocco
- Biotechnology, Biochemistry and Nutrition Laboratory, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco
| | - Laila Fahmi
- Venoms and Toxins Laboratory, Pasteur Institute of Morocco 1, Casablanca, Morocco
- Biotechnology, Biochemistry and Nutrition Laboratory, Faculty of Sciences, Chouaib Doukkali University, El Jadida, Morocco
| | - Lotfi Boussada
- Animal Unity of The Pasteur Institute of Morocco, Casablanca, Morocco
| | - Naoual Oukkache
- Venoms and Toxins Laboratory, Pasteur Institute of Morocco 1, Casablanca, Morocco
| | - Fatima Chgoury
- Venoms and Toxins Laboratory, Pasteur Institute of Morocco 1, Casablanca, Morocco
| | - Hakima Benomar
- Anathomopathology Laboratory, Institut Pasteur of Morocco 1, Casablanca, Morocco
| | - Noreddine Ghalim
- Venoms and Toxins Laboratory, Pasteur Institute of Morocco 1, Casablanca, Morocco
| | - Mustapha Lkhider
- LNPISN, Faculty of Science and Technology, Mohammedia-Hassan II University, Mohammedia, Morocco
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Ombati R, Luo L, Yang S, Lai R. Centipede envenomation: Clinical importance and the underlying molecular mechanisms. Toxicon 2018; 154:60-68. [DOI: 10.1016/j.toxicon.2018.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/21/2018] [Accepted: 09/25/2018] [Indexed: 12/11/2022]
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Rima M, Alavi Naini SM, Karam M, Sadek R, Sabatier JM, Fajloun Z. Vipers of the Middle East: A Rich Source of Bioactive Molecules. Molecules 2018; 23:molecules23102721. [PMID: 30360399 PMCID: PMC6222703 DOI: 10.3390/molecules23102721] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 10/14/2018] [Accepted: 10/19/2018] [Indexed: 11/30/2022] Open
Abstract
Snake venom serves as a tool of defense against threat and helps in prey digestion. It consists of a mixture of enzymes, such as phospholipase A2, metalloproteases, and l-amino acid oxidase, and toxins, including neurotoxins and cytotoxins. Beside their toxicity, venom components possess many pharmacological effects and have been used to design drugs and as biomarkers of diseases. Viperidae is one family of venomous snakes that is found nearly worldwide. However, three main vipers exist in the Middle Eastern region: Montivipera bornmuelleri, Macrovipera lebetina, and Vipera (Daboia) palaestinae. The venoms of these vipers have been the subject of many studies and are considered as a promising source of bioactive molecules. In this review, we present an overview of these three vipers, with a special focus on their venom composition as well as their biological activities, and we discuss further frameworks for the exploration of each venom.
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Affiliation(s)
- Mohamad Rima
- Department of Neuroscience, Institut de Biologie Paris Seine (IBPS), INSERM, CNRS, Sorbonne Université, F-75005 Paris, France.
| | - Seyedeh Maryam Alavi Naini
- Department of Neuroscience, Institut de Biologie Paris Seine (IBPS), INSERM, CNRS, Sorbonne Université, F-75005 Paris, France.
| | - Marc Karam
- Department of Biology, Faculty of Sciences, University of Balamand, Kourah3843, Lebanon.
| | - Riyad Sadek
- Department of Biology, American University of Beirut, Beirut 1107-2020, Lebanon.
| | - Jean-Marc Sabatier
- Laboratory INSERM UMR 1097, Aix-Marseille University, 163, Parc Scientifique et Technologique de Luminy, Avenue de Luminy, Bâtiment TPR2, Case 939, 13288 Marseille, France.
| | - Ziad Fajloun
- Department of Biology, Faculty of Sciences III, Lebanese University, Tripoli 1300, Lebanon.
- Laboratory of Applied Biotechnology, Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon.
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Bennacef-Heffar N, Laraba-Djebari F. Beneficial effects of Heparin and l Arginine on dermonecrosis effect induced by Vipera lebetina venom: Involvement of NO in skin regeneration. Acta Trop 2017; 171:226-232. [PMID: 28427959 DOI: 10.1016/j.actatropica.2017.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/03/2017] [Accepted: 04/14/2017] [Indexed: 11/17/2022]
Abstract
It is well known that snake venoms such as Viperidae caused severe local effects such as hemorrhage, myonecrosis and dermonecrosis which can lead to permanent tissue loss or the disability. The aim of this study is to evaluate the skin regeneration using heparin and l-arginine as well as the dermonecrotic effects induced by Vipera lebetina venom (VLV). To better understand the toxic effects induced by VLV and to prevent or treat these effects, we evaluate the local effects and the skin regeneration with or without drugs. The evaluation of NO as a marker of angiogenesis was also undertaken to understand its involvement in tissue wound healing and skin regeneration after envenomation. Obtained results showed that this venom is able to induce severe necrosis characterized by hemorrhage, hair follicles' destruction, glandular structure and increased of the thickness (acanthosis) in the epidermo-dermic junction. Inflammatory cells were also observed in the dermis. Pretreatment with heparin or L arginine seemed to decrease the induced dermonecrotic after one and two weeks improving the skin regeneration. The high level of NO could be involved in this regeneration, since it participates in the skin homeostatic functions' regulation and the maintenance of the skin protective barrier integrity against microorgansims. Nitric oxide plays also a key role in wound healing; it acts as a potent mitogenic stimulus to keratinocytes during skin repair and enhances the hair follicles and sebaceous gland structure that appeared after two weeks of treatment. Thus, these drugs could be used in therapeutic approach for dermonecrotic skin repair.
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Affiliation(s)
- Nouara Bennacef-Heffar
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, BP 32 El-Alia, Bab Ezzouar, Algiers, Algeria
| | - Fatima Laraba-Djebari
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, BP 32 El-Alia, Bab Ezzouar, Algiers, Algeria.
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Isolation, Functional Characterization and Proteomic Identification of CC2-PLA2 from Cerastes cerastes Venom: A Basic Platelet-Aggregation-Inhibiting Factor. Protein J 2014; 33:61-74. [DOI: 10.1007/s10930-013-9534-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Chérifi F, Laraba-Djebari F. Isolated biomolecules of pharmacological interest in hemostasis from Cerastes cerastes venom. J Venom Anim Toxins Incl Trop Dis 2013; 19:11. [PMID: 23849477 PMCID: PMC3710202 DOI: 10.1186/1678-9199-19-11] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 11/19/2012] [Indexed: 11/10/2022] Open
Abstract
Biomolecules from Cerastes cerastes venom have been purified and characterized. Two phospholipases isolated from Cerastes cerastes venom share 51% of homology. CC2-PLA2 exhibits antiplatelet activity that blocks coagulation. CCSV-MPase, a non-hemorrhagic Zn2+-metalloproteinase, significantly reduced the plasmatic fibrinogen level and hydrolyzes only its Bβ chain. Serine proteinases such as RP34, afaâcytin and CC3-SPase hydrolyze the fibrinogen and are respectively α, αβ and αβ fibrinogenases. In deficient human plasma, afaâcytin replaces the missing factors VIII and IX, and activates purified human factor X into factor Xa. It releases serotonin from platelets and directly aggregates human (but not rabbit) blood platelets. RP34 proteinase also had no effect on both human and rabbit blood platelet aggregation. CC3-SPase revealed a pro-coagulant activity. However, the insolubility of the obtained clot indicates that CC3-SPase does not activate factor XIII. In addition, CC3-SPase clotting activity was carried out with human plasmas from volunteer patients deficient in clotting factors. Results showed that CC3-SPase shortens clotting time of plasma deficient in factors II and VII but with weaker clotting than normal plasma. The clotting time of plasma deficient in factor II is similar to that obtained with normal plasma; suggesting that CC3-SPase is able to replace both factors IIa and VII in the coagulation cascade and thus could be involved in the blood clotting process via an extrinsic pathway. These results imply that CC3-SPase and afaâcytin could repair hemostatic abnormalities and may replace some factors missing in pathological deficiency. Afaâcytin also exhibits α fibrinase property similar to a plasmin-like proteinase. Despite its thrombin-like characteristics, afaâcytin is not inhibited by plasmatic thrombin inhibitors. The procoagulant properties of afaâcytin might have potential clinical applications.
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Affiliation(s)
- Fatah Chérifi
- USTHB, Faculty of Biological Sciences, University of Sciences and Technology Houari Boumedienne, BP 32 El Alia, Bab Ezzouar, Algiers, Algeria.
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Key events in microvascular damage induced by snake venom hemorrhagic metalloproteinases. J Proteomics 2011; 74:1781-94. [DOI: 10.1016/j.jprot.2011.03.026] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Revised: 03/21/2011] [Accepted: 03/22/2011] [Indexed: 01/28/2023]
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Poor regenerative outcome after skeletal muscle necrosis induced by Bothrops asper venom: alterations in microvasculature and nerves. PLoS One 2011; 6:e19834. [PMID: 21629691 PMCID: PMC3101212 DOI: 10.1371/journal.pone.0019834] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 04/17/2011] [Indexed: 11/19/2022] Open
Abstract
Background Viperid snakebite envenoming is characterized by prominent local tissue damage, including muscle necrosis. A frequent outcome of such local pathology is deficient skeletal muscle regeneration, which causes muscle dysfunction, muscle loss and fibrosis, thus provoking permanent sequelae that greatly affect the quality of life of patients. The causes of such poor regenerative outcome of skeletal muscle after viperid snakebites are not fully understood. Methodology/Principal Findings A murine model of muscle necrosis and regeneration was adapted to study the effects of the venom and isolated toxins of Bothrops asper, the medically most important snake in Central America. Gastrocnemius muscle was injected with either B. asper venom, a myotoxic phospholipase A2 (Mtx), a hemorrhagic metalloproteinase (SVMP), or saline solution. At various time intervals, during one month, tissue samples were collected and analyzed by histology, and by immunocytochemical and immunohistochemical techniques aimed at detecting muscle fibers, collagen, endothelial cells, myoblasts, myotubes, macrophages, TUNEL-positive nuclei, and axons. A successful regenerative response was observed in muscle injected with Mtx, which induces myonecrosis but does not affect the microvasculature. In contrast, poor regeneration, with fibrosis and atrophic fibers, occurred when muscle was injected with venom or SVMP, both of which provoke necrosis, microvascular damage leading to hemorrhage, and poor axonal regeneration. Conclusions/Significance The deficient skeletal muscle regeneration after injection of B. asper venom is likely to depend on the widespread damage to the microvasculature, which affects the removal of necrotic debris by phagocytes, and the provision of nutrients and oxygen required for regeneration. In addition, deficient axonal regeneration is likely to contribute to the poor regenerative outcome in this model.
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Undheim EAB, King GF. On the venom system of centipedes (Chilopoda), a neglected group of venomous animals. Toxicon 2011; 57:512-24. [PMID: 21255597 DOI: 10.1016/j.toxicon.2011.01.004] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 12/08/2010] [Accepted: 01/11/2011] [Indexed: 12/16/2022]
Abstract
Centipedes are among the oldest extant terrestrial arthropods and are an ecologically important group of soil and leaf litter predators. Despite their abundance and frequent, often painful, encounters with humans, little is known about the venom and venom apparatus of centipedes, although it is apparent that these are both quite different from other venomous lineages. The venom gland can be regarded as an invaginated cuticle and epidermis, consisting of numerous epithelial secretory units each with its own unique valve-like excretory system. The venom contains several different enzymes, but is strikingly different to most other arthropods in that metalloproteases appear to be important. Myotoxic, cardiotoxic, and neurotoxic activities have been described, most of which have been attributed to high molecular weight proteins. Neurotoxic activities are also unusual in that G-protein coupled receptors often seem to be involved, either directly as targets of neurotoxins or indirectly by activating endogenous agonists. These relatively slow responses may be complemented by the rapid effects caused by histamines present in the venom and from endogenous release of histamines induced by venom cytotoxins. The differences probably reflect the ancient and independent evolutionary history of the centipede venom system, although they may also be somewhat exaggerated by the paucity of information available on this largely neglected group.
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Affiliation(s)
- Eivind A B Undheim
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia.
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