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Papadatou V, Tologkos S, Deftereou T, Alexiadis T, Pagonopoulou O, Alexiadi CA, Bakatselou P, Oglou STC, Tripsianis G, Mitrakas A, Lambropoulou M. Viral-induced inflammation can lead to adverse pregnancy outcomes. Folia Med (Plovdiv) 2023; 65:744-752. [PMID: 38351756 DOI: 10.3897/folmed.65.e90054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/07/2022] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Parvoviruses are DNA viruses of small size. There have been a number of reports indicating the possible effects of B19 infections during pregnancy. These effects include spontaneous abortions, stillbirth, fetal damage, and quite often, fetal anemia with hydrops fetalis.
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Fiorenza MF, Amaral CDS, da Anunciação ARDA, Portela VVM, Marey MA, Miyamoto A, Antoniazzi AQ. Possible impact of neutrophils on immune responses during early pregnancy in ruminants. Anim Reprod 2021; 18:e20210048. [PMID: 34745357 PMCID: PMC8562715 DOI: 10.1590/1984-3143-ar2021-0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/24/2021] [Indexed: 12/17/2022] Open
Abstract
The interaction between early embryo and maternal immune system for the establishment of pregnancy is the focus of several studies; however, it remains unclear. The maternal immune response needs to keep a balance between avoiding any damage to the conceptus and maintaining its function in combating microbes as well. When conceptus-maternal crosstalk cannot achieve this balance, pregnancy losses might occur. Intercommunication between mother and conceptus is fundamental during early pregnancy to dictate the outcome of pregnancy. In ruminants, the embryo reacts with the maternal system mainly via interferon tau (IFNT) release. IFNT can act locally on the embryo and endometrial cells and systemically in several tissues and cells to regulate their response via the expression of interferon-stimulated genes (ISGs). Also, IFNT can induce the expression of inflammatory-related genes in immune cells. Day 7 embryo induces a shift in the maternal immune response towards anti-inflammatory (Th2) immune responses. During maternal recognition of pregnancy, peripheral mononuclear cells (PBMCs) and polymorphonuclear cells (PMNs) express markers that configure an anti-inflammatory response. However, PMNs response is more sensitive to the effects of IFNT. PMNs are more likely to express interferon-stimulated genes (ISGs), transforming growth factor-beta (TGFB), interleukin 10 (IL10), and arginase-1 (ARG1), configuring one of the most rapid immune responses to early pregnancy. This review focus on the local and peripheral immune responses during early pregnancy in ruminants, mainly the PMNs function in the immune system.
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Affiliation(s)
- Mariani Farias Fiorenza
- Programa de Pós-graduação em Medicina Veterinária, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | - Carolina Dos Santos Amaral
- Programa de Pós-graduação em Medicina Veterinária, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
| | | | | | - Mohammed Ali Marey
- Global Agromedicine Research Center, Obihiro University of Agricultural and Veterinary Medicine, Obihiro, Japan.,Department of Theriogenology, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Akio Miyamoto
- Global Agromedicine Research Center, Obihiro University of Agricultural and Veterinary Medicine, Obihiro, Japan
| | - Alfredo Quites Antoniazzi
- Programa de Pós-graduação em Medicina Veterinária, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil
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Phoswa WN, Khaliq OP. Is pregnancy a risk factor of COVID-19? Eur J Obstet Gynecol Reprod Biol 2020; 252:605-609. [PMID: 32620513 PMCID: PMC7320674 DOI: 10.1016/j.ejogrb.2020.06.058] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 01/26/2023]
Abstract
This review evaluates whether pregnancy is a risk factor for COVID-19 by looking at the expression of immune markers such as immune cells and cytokines in order to have a better understanding on the pathophysiology of the disease, thus reducing maternal deaths. Pregnant women are more at risk of contracting COVID-19 due to their weakened immune system. Studies demonstrate that COVID-19 is an immune condition which is marked by reduced lymphocytes and elevated selected proinflammatory cytokines. Similar immune expression has been demonstrated in pregnancy by several studies. In addition, the placenta has been shown to possess ACE2 receptors on the villous cytotrophoblast and the syncytiotrophoblast and findings suggest that the coronavirus enters the host cells via these ACE2 receptors. The immune response in pregnancy increases the risk of contracting COVID-19. Both normal pregnancy and COVID-19 are marked by decreased lymphocytes, NKG2A inhibitory receptors, and increased ACE2, IL-8, IL-10, and IP-10 it therefore safer to conclude that pregnancy is a risk factor for COVID-19 development. Furthermore, the presence of the ACE2 receptors in the placenta may increase the risk of mother to baby transmission of the virus. Therefore, more studies investigating the link between pregnancy and COVID-19 are needed.
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Affiliation(s)
- Wendy N Phoswa
- Department of Life and Consumer Sciences, University of South Africa (UNISA), Science Campus, Private Bag X6, Florida, Roodepoort, 1710, South Africa.
| | - Olive P Khaliq
- Department of Obstetrics and Gynaecology and Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
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Rasmussen MA, Thorsen J, Dominguez-Bello MG, Blaser MJ, Mortensen MS, Brejnrod AD, Shah SA, Hjelmsø MH, Lehtimäki J, Trivedi U, Bisgaard H, Sørensen SJ, Stokholm J. Ecological succession in the vaginal microbiota during pregnancy and birth. ISME JOURNAL 2020; 14:2325-2335. [PMID: 32488167 PMCID: PMC7609337 DOI: 10.1038/s41396-020-0686-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 04/20/2020] [Accepted: 05/14/2020] [Indexed: 11/09/2022]
Abstract
The mother's vaginal microbiota represents the first microbes to which a child is exposed when delivered vaginally. However, little is known about the composition and development of the vaginal microbiota during pregnancy and birth. Here, we analyzed the vaginal microbiota of 57 women in pregnancy week 24, 36 and at birth after rupture of membranes but before delivery, and further compared the composition with that of the gut and airways of the 1-week-old child. The vaginal community structure had dramatic changes in bacterial diversity and taxonomic distribution, yet carried an individual-specific signature. The relative abundance of most bacterial taxa increased stepwise from week 24 of pregnancy until birth, with a gradual decline of Lactobacillus. Mother-to-child vertical transfer, as suggested by sharing, was modest, with the strongest transfer being for Clostridiales followed by Lactobacillales and Enterobacteriales. In conclusion, late gestation is associated with an increase in maternal vaginal microbiota diversity, and vaginal bacteria at birth only modestly predict the composition of the neonatal microbiota.
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Affiliation(s)
- M A Rasmussen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Section of Chemometrics and Analytical Technologies, Department of Food Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - J Thorsen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, 2100, Copenhagen, Denmark
| | - M G Dominguez-Bello
- Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, NJ, USA
| | - M J Blaser
- Departments of Medicine and Microbiology, and the Human Microbiome Program, New York University Langone Medical Center, New York, NY, USA.,Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, NJ, USA
| | - M S Mortensen
- Section of Microbiology, Department of Biology, University of Copenhagen, 2100, Copenhagen, Denmark
| | - A D Brejnrod
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, 2100, Copenhagen, Denmark.,Section of Microbiology, Department of Biology, University of Copenhagen, 2100, Copenhagen, Denmark
| | - S A Shah
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - M H Hjelmsø
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - J Lehtimäki
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - U Trivedi
- Section of Microbiology, Department of Biology, University of Copenhagen, 2100, Copenhagen, Denmark
| | - H Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - S J Sørensen
- Section of Microbiology, Department of Biology, University of Copenhagen, 2100, Copenhagen, Denmark
| | - J Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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Swieboda D, Johnson EL, Beaver J, Haddad L, Enninga EAL, Hathcock M, Cordes S, Jean V, Lane I, Skountzou I, Chakraborty R. Baby's First Macrophage: Temporal Regulation of Hofbauer Cell Phenotype Influences Ligand-Mediated Innate Immune Responses across Gestation. THE JOURNAL OF IMMUNOLOGY 2020; 204:2380-2391. [PMID: 32213562 DOI: 10.4049/jimmunol.1901185] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/21/2020] [Indexed: 12/20/2022]
Abstract
The importance of fetal placental macrophages (Hofbauer cell [HCs]) is underscored by their appearance 18 d postconception and maintenance through term; however, how human HCs evolve during healthy pregnancy and how microenvironment and ontogeny impact phenotype and function remain unknown. In this study, we comprehensively classify human HCs ex vivo, interrogate phenotypic plasticity, and characterize antiviral immune responses through gestation. Activated HCs were abundant in early pregnancy and decreased by term; molecular signatures emphasize inflammatory phenotypes early in gestation. Frequency of HCs with regulatory phenotypes remained high through term. Furthermore, term HCs exhibited blunted responses to stimulation, indicating reduced plasticity. IFN-λ1 is a key placental IFN that appeared less protective than IFN-α, suggesting a potential weakness in antiviral immunity. Ligand-specific responses were temporally regulated: we noted an absence of inflammatory mediators and reduced antiviral gene transcription following RIG-I activation at term despite all HCs producing inflammatory mediators following IFN-γ plus LPS stimulation. Collectively, we demonstrate sequential, evolving immunity as part of the natural history of HCs through gestation.
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Affiliation(s)
- Dominika Swieboda
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30322.,Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA 30322
| | - Erica L Johnson
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30322
| | - Jacob Beaver
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA 30322
| | - Lisa Haddad
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322
| | - Elizabeth Ann L Enninga
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic, Alix School of Medicine, Rochester, MN 55905
| | - Matthew Hathcock
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Alix School of Medicine, Rochester, MN 55905; and
| | - Sarah Cordes
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322
| | - Valerie Jean
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322
| | - Ivy Lane
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA 30322
| | - Ioanna Skountzou
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA 30322
| | - Rana Chakraborty
- Department of Pediatrics, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30322; .,Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic, Alix School of Medicine, Rochester, MN 55905.,Division of Infectious Diseases, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Alix School of Medicine, Rochester, MN 55905
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Pathophysiological changes associated with sleep disordered breathing and supine sleep position in pregnancy. Sleep Med Rev 2019; 46:1-8. [PMID: 31055144 DOI: 10.1016/j.smrv.2019.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 01/06/2023]
Abstract
Sleep is a complex and active physiological process that if disrupted, can result in adverse outcomes both within and outside of pregnancy. Sleep disordered breathing (SDB) occurs in 10-32% of pregnancies. Substantial physiological changes occur during pregnancy that impact on maternal sleep, which typically deteriorates with advancing gestation. Pregnancy challenges maternal homeostatic regulation of many systems which effect maternal sleep, including the respiratory, cardiovascular, endocrine, and immune systems. SDB can result from varying degrees of airway compromise and potentially cause systemic hypoxia. The hypoxia may be acute, intermittent or chronic in nature with complications dependant on the duration and the gestation at which the insult occurs. It is unlikely that this effect is mediated by a singular mechanistic pathway but results from a complex cascade of events across multiple maternal organ systems. Regardless of the etiology, both SDB and supine sleep position are associated with a variety of obstetric and perinatal complications including, pre-eclampsia/eclampsia, gestational diabetes mellitus, cardiomyopathy, heart failure, fetal growth restriction, poor neonatal condition at birth, stillbirth and neuro-psychiatric problems in offspring. Both maternal sleep position and sleep disordered breathing are potentially modifiable or treatable factors that if addressed have the potential to improve maternal and fetal outcomes. This narrative review summarizes the maternal and placental pathophysiological aberrations associated with sleep disordered breathing and supine sleep position in pregnancy.
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IL-36 Cytokines: Regulators of Inflammatory Responses and Their Emerging Role in Immunology of Reproduction. Int J Mol Sci 2019; 20:ijms20071649. [PMID: 30987081 PMCID: PMC6479377 DOI: 10.3390/ijms20071649] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 01/01/2023] Open
Abstract
The IL-36 subfamily of cytokines has been recently described as part of the IL-1 superfamily. It comprises three pro-inflammatory agonists (IL-36α, IL-36β, and IL-36γ), their receptor (IL-36R), and one antagonist (IL-36Ra). Although expressed in a variety of cells, the biological relevance of IL-36 cytokines is most evident in the communication between epithelial cells, dendritic cells, and neutrophils, which constitute the common triad responsible for the initiation, maintenance, and expansion of inflammation. The immunological role of IL-36 cytokines was initially described in studies of psoriasis, but novel evidence demonstrates their involvement in further immune and inflammatory processes in physiological and pathological situations. Preliminary studies have reported a dynamic expression of IL-36 cytokines in the female reproductive tract throughout the menstrual cycle, as well as their association with the production of immune mediators and cellular recruitment in the vaginal microenvironment contributing to host defense. In pregnancy, alteration of the placental IL-36 axis has been reported upon infection and pre-eclampsia suggesting its pivotal role in the regulation of maternal immune responses. In this review, we summarize current knowledge regarding the regulatory mechanisms and biological actions of IL-36 cytokines, their participation in different inflammatory conditions, and the emerging data on their potential role in normal and complicated pregnancies.
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McSorley EM, Yeates AJ, Mulhern MS, van Wijngaarden E, Grzesik K, Thurston SW, Spence T, Crowe W, Davidson PW, Zareba G, Myers GJ, Watson GE, Shamlaye CF, Strain JJ. Associations of maternal immune response with MeHg exposure at 28 weeks' gestation in the Seychelles Child Development Study. Am J Reprod Immunol 2018; 80:e13046. [PMID: 30295973 PMCID: PMC6202202 DOI: 10.1111/aji.13046] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 12/30/2022] Open
Abstract
PROBLEM Maternal methylmercury (MeHg) exposure may be associated with immune response during pregnancy. METHOD OF STUDY In the high fish-eating Seychelles Child Development Study Nutrition Cohort 2, we examined the association between maternal MeHg, polyunsaturated fatty acids (PUFA), and immune markers (Th1:Th2; TNF-α, IL-1β, IFN-γ, IL-2, IL-4, IL-5, IL-10, MCP-1, TARC, sFlt-1, VEGF-D, CRP and IL-6) at 28 weeks' gestation. Linear regression examined associations between MeHg exposure and immune markers with and without adjustment for PUFA. RESULTS In all models, as MeHg concentrations increased, the Th1:Th2 ratio, total Th1 and individual Th1 (IL-1β, IL-2, TNF-α) concentrations decreased. MeHg was not associated with total Th2 cytokines but was associated with a decrease in IL-4 and IL-10. MeHg was positively associated with TARC and VEGF-D and negatively associated with CRP. There was a significant interaction between MeHg and the n-6:n-3 ratio, with MeHg associated with a larger decrease in Th1:Th2 at higher n-6:n-3 PUFA ratios. The n-3 PUFA were associated with lower CRP, IL-4 and higher IFN-γ. The n-6 PUFA were associated with higher IL-1β, IL-2, TNF-α, IL-4, IL-10, CRP and IL-6. CONCLUSION Maternal MeHg was associated with markers of immune function at 28 weeks' gestation. A significant interaction between MeHg and the n-6:n-3 ratio on the Th1:Th2 ratio suggests that the n-3 PUFA may mitigate any immunosuppressive associations of MeHg. The n-3 and n-6 PUFA were associated with suppressive and stimulatory immune responses, respectively. Overall, the associations were of small magnitude, and further research is required to determine the clinical significance.
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Affiliation(s)
- Emeir M. McSorley
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - Alison J. Yeates
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - Maria S. Mulhern
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | | | - Katherine Grzesik
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Sally W. Thurston
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Toni Spence
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - William Crowe
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
| | - Philip W. Davidson
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Grazyna Zareba
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Gary J. Myers
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | - Gene E. Watson
- School of Medicine and DentistryUniversity of RochesterRochesterNew York
| | | | - J. J. Strain
- Nutrition Innovation Centre for Food and Health (NICHE)School of Biomedical SciencesUniversity of UlsterColeraineNorthern Ireland
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Abstract
The aim of this review is to discuss the role of Toll-like receptors at the maternal-fetal interface and the capacity of trophoblast cells to initiate innate immune responses towards infection. The maternal-fetal interface represents an immunologically unique site that must promote tolerance to the allogenic fetus, whilst maintaining host defense against a diverse array of possible pathogens. Clinical studies have shown a strong association between certain complications of pregnancy and intrauterine infections. Therefore, innate immune responses against microorganisms at the maternal-fetal interface may have a significant impact on the success of a pregnancy. There is growing evidence that trophoblast cells are able to recognize and respond to pathogens through the expression of Toll-like receptors, an important part of innate immunity. This review will discuss the role of Toll-like receptors at the maternal-fetal interface, the potential for trophoblast cells to function as components of the innate immune system and the impact TLR-mediated trophoblast responses may have on pregnancy outcome.
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Affiliation(s)
- V M Abrahams
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA.
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