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Holanda MT, Mediano MF, Hasslocher-Moreno AM, Gonzaga BM, Carvalho ACC, Ferreira RR, Garzoni LR, Pereira-Silva FS, Pimentel LO, Mendes MO, Azevedo MJ, Britto C, Moreira OC, Fernandes AG, Santos CM, Constermani J, Paravidino VB, Maciel ER, Carneiro FM, Xavier SS, Sperandio da Silva GM, Santos PF, Veloso HH, Brasil PE, de Sousa AS, Bonecini-de-Almeida MG, da Silva PS, Sangenis LHC, Saraiva RM, Araujo-Jorge TC. Effects of Selenium treatment on cardiac function in Chagas heart disease: Results from the STCC randomized Trial. EClinicalMedicine 2021; 40:101105. [PMID: 34485877 PMCID: PMC8406152 DOI: 10.1016/j.eclinm.2021.101105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chagas disease (caused by Trypanosoma cruzi infection) evolves to chronic chagasic cardiomyopathy (CCC) affecting 1.8 million people worldwide. This is the first randomized, placebo-controlled, double-blinded, clinical trial designed to estimate efficacy and safety of selenium (Se) treatment in CCC. METHODS 66 patients with CCC stages B1 (left ventricular ejection fraction [LVEF] > 45% and no heart failure; n = 54) or B2 (LVEF < 45% and no heart failure; n = 12) were randomly assigned to receive 100 mcg/day sodium selenite (Se, n = 32) or placebo (Pla, n = 34) for one year (study period: May 2014-September 2018). LVEF changes over time and adverse effects were investigated. Trial registration number: NCT00875173 (clinicaltrials.gov). FINDINGS No significant differences between the two groups were observed for the primary outcome: mean LVEF after 6 (β= +1.1 p = 0.51 for Se vs Pla) and 12 months (β= +2.1; p = 0.23). In a subgroup analysis, statistically significant longitudinal changes were observed for mean LVEF in the stage B2 subgroup (β= +10.1; p = 0.02 for Se [n = 4] vs Pla [n = 8]). Se treatment was safe for CCC patients, and the few adverse effects observed were similarly distributed across the two groups. INTERPRETATION Se treatment did not improve cardiac function (evaluated from LVEF) in CCC. However, in the subgroup of patients at B2 stage, a potential beneficial influence of Se was observed. Complementary studies are necessary to explore diverse Se dose and/or associations in different CCC stages (B2 and C), as well as in A and B1 stages with longer follow-up. FUNDING Brazilian Ministry of Health, Fiocruz, CNPq, FAPERJ.
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Affiliation(s)
- Marcelo T. Holanda
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Mauro F.F. Mediano
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Alejandro M. Hasslocher-Moreno
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Beatriz M.S. Gonzaga
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Anna Cristina C. Carvalho
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Roberto R. Ferreira
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Luciana R. Garzoni
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Fernanda S. Pereira-Silva
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Luis O. Pimentel
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Marcelo O. Mendes
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Marcos J. Azevedo
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
| | - Constança Britto
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute (LABIMDOE-IOC/Fiocruz), Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Leonidas Deane, Rio de Janeiro 21040-360, Brazil
| | - Otacilio C. Moreira
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute (LABIMDOE-IOC/Fiocruz), Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Leonidas Deane, Rio de Janeiro 21040-360, Brazil
| | - Alice G. Fernandes
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute (LABIMDOE-IOC/Fiocruz), Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Leonidas Deane, Rio de Janeiro 21040-360, Brazil
| | - Carolina M. Santos
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute (LABIMDOE-IOC/Fiocruz), Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Leonidas Deane, Rio de Janeiro 21040-360, Brazil
| | - Jéssica Constermani
- Laboratory of Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute (LABIMDOE-IOC/Fiocruz), Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Pavilhão Leonidas Deane, Rio de Janeiro 21040-360, Brazil
| | - Vitor B. Paravidino
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Pavilhão João Lyra Filho, 7° andar / blocos D e E, Maracanã, Rio de Janeiro 20550-013, Brazil
- Department of Physical Education and Sports, Naval Academy, Avenida Almirante Silvio de Noronha, s/n, Castelo, Rio de Janeiro 20021-010, Brazil
| | - Erica R. Maciel
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Fernanda M. Carneiro
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Sérgio S. Xavier
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Gilberto M. Sperandio da Silva
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Priscila F. Santos
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Henrique H. Veloso
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Pedro E.A.A. Brasil
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Andrea S. de Sousa
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Maria G. Bonecini-de-Almeida
- Laboratory of Immunology and Immunogenetics, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Paula S. da Silva
- Nutrition Service, Evandro Chagas Hospital, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Luiz Henrique C. Sangenis
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Roberto M. Saraiva
- Laboratory of Clinical Research in Chagas Disease, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-360, Brazil
| | - Tania C. Araujo-Jorge
- Laboratory of Innovations in Therapies, Education and Bioproducts, Oswaldo Cruz Institute (LITEB-IOC/Fiocruz), Oswaldo Cruz Foundation (Fiocruz), Avenida Brasil 4365, Manguinhos, Pavilhão Cardoso Fontes, Sala 64, Rio de Janeiro 21040-360, Brazil
- Corresponding author at: Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Instituto Oswaldo Cruz, Fiocruz, Av. Brasil 4365, Pav. Cardoso Fontes, Manguinhos, Rio de Janeiro RJ 21040-900, Brasil.
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Fracasso M, Dutra da Silva A, Bottari NB, Monteiro SG, Garzon LR, Farias de Souza LA, Schetinger MRC, Da Silva AS. Resveratrol impacts in oxidative stress in liver during Trypanosoma cruzi infection. Microb Pathog 2021; 153:104800. [PMID: 33609651 DOI: 10.1016/j.micpath.2021.104800] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/02/2021] [Accepted: 02/07/2021] [Indexed: 12/25/2022]
Abstract
Trypanosoma cruzi is the causative agent of Chagas disease, infecting the heart, intestines and liver tissues. There is growing evidence that oxidative stress, defined as a persistent imbalance between highly oxidative compounds and antioxidant defenses, is a marker of tissue inflammation; it is related to immune responses such as damage, as well as to strand breaks in DNA contributing to disease progression. Antioxidant agents help mitigate the damage caused by inflammation, preventing or slowing damage to cells caused by free radicals. In this sense, resveratrol (RSV) is an important polyphenol that demonstrates antioxidant effects. It reverses damage caused by several infectious diseases. The aim of the present study was to determine whether treatment with RSV would prevent or minimize oxidative damage caused by T. cruzi. The animals were divided into four groups (n = 5): A) control; B) control + RSV; C) infected and D) infected + RSV. The infected groups received 1 x 104 Y strain trypomastigotes via intraperitoneal injection; after confirmation of infection, the mice received RSV 100 mg/kg for seven days orally. On the 8th day post-infection, we collected liver tissue for analysis of oxidant/antioxidant status: superoxide dismutase (SOD), catalase (CAT), and glutathione s-transferase (GST) activities, as well as reactive oxygen species (ROS), non-protein thiols (NPSH), thiols, carbonyl protein, thiobarbituric acid reactive substance (TBARS), and finally, the nitrite/nitrate ratio (NOx) levels were determined. The administration of RSV did not exert direct effect on parasitemia. The infection produced high levels of TBARS, NOx, and ROS levels in liver tissue, suggesting cellular injury with production of free radicals in animals infected by T. cruzi. RSV positively modulated SOD and aumenting GST activities enzymes in infected animals. Protein thiols levels in infected animals were lower than those of control. Taken together, the data suggest T. cruzi causes hepatic oxidative stress, and RSV 100 mg/kg for seven days it's dosen't seem minimized these negative effects in the acute phase of disease.
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Affiliation(s)
- Mateus Fracasso
- Department of Biochemistry and Molecular Biology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Aniélen Dutra da Silva
- Department of Biochemistry and Molecular Biology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Nathieli Bianchin Bottari
- Department of Biochemistry and Molecular Biology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Silvia Gonzalez Monteiro
- Department of Parasitology, Microbiology and Immunology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Litiérri Razia Garzon
- Department of Parasitology, Microbiology and Immunology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Lucas Alexandre Farias de Souza
- Department of Parasitology, Microbiology and Immunology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Maria Rosa C Schetinger
- Department of Biochemistry and Molecular Biology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Aleksandro Schafer Da Silva
- Department of Biochemistry and Molecular Biology, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil; Department in Animal Science, Universidade do Estado de Santa Catarina (UDESC), Chapecó, SC, Brazil.
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Hernández M, Wicz S, Pérez Caballero E, Santamaría MH, Corral RS. Dual chemotherapy with benznidazole at suboptimal dose plus curcumin nanoparticles mitigates Trypanosoma cruzi-elicited chronic cardiomyopathy. Parasitol Int 2020; 81:102248. [PMID: 33238215 DOI: 10.1016/j.parint.2020.102248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/29/2020] [Accepted: 11/17/2020] [Indexed: 01/04/2023]
Abstract
Curcumin (Cur) is a natural polyphenolic flavonoid isolated from the rhizomes of Curcuma longa. Its anti-inflammatory and cardioprotective properties are increasingly considered to have beneficial effects on the progression of cardiomyopathy associated with Chagas disease, caused by Trypanosoma cruzi. However, the Cur therapeutic limitation is its bioavailability and new Cur nanomedicine formulations are developed to overcome this obstacle. In this research, we provide evidence showing that oral therapy with a suboptimal dose of the standard parasiticidal drug benznidazole (BZ) in combination with Cur-loaded nanoparticles is capable of reducing myocardial parasite load, cardiac hypertrophy, inflammation and fibrosis in mice with long-term infection by T. cruzi. Treatment with BZ plus Cur was highly effective in downregulating myocardial expression of proinflammatory cytokines/chemokines (IL-1β, TNF-α, IL-6, CCL5), and the level/activity of matrix metalloproteinases (MMP-2, MMP-9) and inducible enzymes (cyclooxygenase, nitric oxide synthase) implicated in leukocyte recruitment and cardiac remodeling. Oral administration of a Cur-based nanoformulation displays potential as a complementary strategy to the conventional BZ chemotherapy in the treatment of chronic Chagas heart disease.
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Affiliation(s)
- Matías Hernández
- Laboratorio de Biomedicina Molecular, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, San Luis, Argentina
| | - Susana Wicz
- Laboratorio de Biomedicina Molecular, Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, San Luis, Argentina
| | | | - Miguel H Santamaría
- Laboratorio de Biología Experimental, Centro de Estudios Metabólicos, Santander, Spain
| | - Ricardo S Corral
- Servicio de Parasitología-Chagas, Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas (IMIPP, GCBA-CONICET), Hospital de Niños "Dr. Ricardo Gutiérrez", Buenos Aires, Argentina.
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Gupta S, Smith C, Auclair S, Delgadillo ADJ, Garg NJ. Therapeutic Efficacy of a Subunit Vaccine in Controlling Chronic Trypanosoma cruzi Infection and Chagas Disease Is Enhanced by Glutathione Peroxidase Over-Expression. PLoS One 2015; 10:e0130562. [PMID: 26075398 PMCID: PMC4468200 DOI: 10.1371/journal.pone.0130562] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 05/22/2015] [Indexed: 12/15/2022] Open
Abstract
Trypanosoma cruzi-induced oxidative and inflammatory responses are implicated in chagasic cardiomyopathy. In this study, we examined the therapeutic utility of a subunit vaccine against T. cruzi and determined if glutathione peroxidase (GPx1, antioxidant) protects the heart from chagasic pathogenesis. C57BL/6 mice (wild-type (WT) and GPx1 transgenic (GPxtg) were infected with T. cruzi and at 45 days post-infection (dpi), immunized with TcG2/TcG4 vaccine delivered by a DNA-prime/Protein-boost (D/P) approach. The plasma and tissue-sections were analyzed on 150 dpi for parasite burden, inflammatory and oxidative stress markers, inflammatory infiltrate and fibrosis. WT mice infected with T. cruzi had significantly more blood and tissue parasite burden compared with infected/GPxtg mice (n = 5-8, p<0.01). Therapeutic vaccination provided >15-fold reduction in blood and tissue parasites in both WT and GPxtg mice. The increase in plasma levels of myeloperoxidase (MPO, 24.7%) and nitrite (iNOS activity, 45%) was associated with myocardial increase in oxidant levels (3-4-fold) and non-responsive antioxidant status in chagasic/WT mice; and these responses were not controlled after vaccination (n = 5-7). The GPxtg mice were better equipped than the WT mice in controlling T. cruzi-induced inflammatory and oxidative stress markers. Extensive myocardial and skeletal tissue inflammation noted in chagasic/WT mice, was significantly more compared with chagasic/GPxtg mice (n = 4-6, p<0.05). Vaccination was equally effective in reducing the chronic inflammatory infiltrate in the heart and skeletal tissue of infected WT and GPxtg mice (n = 6, p<0.05). Hypertrophy (increased BNP and ANP mRNA) and fibrosis (increased collagen) of the heart were extensively present in chronically-infected WT and GPxtg mice and notably decreased after therapeutic vaccination. We conclude the therapeutic delivery of D/P vaccine was effective in arresting the chronic parasite persistence and chagasic pathology; and GPx1 over-expression provided additive benefits in reducing the parasite burden, inflammatory/oxidative stress and cardiac remodeling in Chagas disease.
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Affiliation(s)
- Shivali Gupta
- Department of Microbiology and Immunology, School of Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- * E-mail: (SG); (NG)
| | - Charity Smith
- Department of Microbiology and Immunology, School of Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Sarah Auclair
- Department of Microbiology and Immunology, School of Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Anahi De Jesus Delgadillo
- Department of Microbiology and Immunology, School of Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Nisha Jain Garg
- Department of Microbiology and Immunology, School of Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity and the Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, Galveston, Texas, United States of America
- * E-mail: (SG); (NG)
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