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Grisolia JC, Santos LA, Dias NA, Malaquias LCC, Burger E. Low-level LASER therapy accelerates fungal lesions cicatrization by increasing the production of Th1 and Th2 cytokines. Photochem Photobiol Sci 2024; 23:1295-1307. [PMID: 38806861 DOI: 10.1007/s43630-024-00595-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/11/2024] [Indexed: 05/30/2024]
Abstract
Paracoccidioidomycosis (PCM) is a systemic mycosis with serious clinical consequences in which the use of antifungal drugs requires long-term treatment. Therefore, we studied the effect of low-level LASER therapy (LLLT) to evaluate its prospects as a complementary treatment for PCM and improve the clinical response to the disease. OBJECTIVES Our study focused on the resolution of lesions caused by fungal infection using a subcutaneous air pouch model of infection. METHODS We evaluated cell profile and cytokines, fungi viability, and the presence of fibroblasts and fibrocytes at the site of infection. Inoculation of P. brasiliensis (Pb) was performed using a subcutaneous air pouch model and the LLLT irradiation was performed on alternate days on the rear paws of mice for 10 days, after which the cells from the air pouch were collected and analyzed. RESULTS In animals irradiated with LLLT, the influx of cells to the air pouch was reduced, but they were more activated and produced pro-inflammatory (IL-12, IL-17 and TNF-α) and neutrophil (PMN) activating cytokines (IL-8, GM-CSF and γ-IFN). A better resolution of the infection, evidenced by the reduction in the number of viable fungi with preserved morphology in the air pouch, and an increase in the number of fibrocytes, indicating a healing profile were also observed. CONCLUSION LLLT decreased the influx of PMN, but those presents were highly activated, with increased fungicidal activity. LLLT irradiation also resulted in earlier cicatrization at the site of infection, leading to a better outcome of the infection. These data are favorable to the use of LLLT as a complementary therapy in PCM.
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Affiliation(s)
- Julianne Caravita Grisolia
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, Federal University of Alfenas UNIFAL-MG, Rua Gabriel Monteiro da Silva, 700, Centro, Alfenas, MG, 37130-001, Brazil.
| | - Lauana Aparecida Santos
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, Federal University of Alfenas UNIFAL-MG, Rua Gabriel Monteiro da Silva, 700, Centro, Alfenas, MG, 37130-001, Brazil
| | - Nayara Andrade Dias
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, Federal University of Alfenas UNIFAL-MG, Rua Gabriel Monteiro da Silva, 700, Centro, Alfenas, MG, 37130-001, Brazil
| | - Luiz Cosme Cotta Malaquias
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, Federal University of Alfenas UNIFAL-MG, Rua Gabriel Monteiro da Silva, 700, Centro, Alfenas, MG, 37130-001, Brazil
| | - Eva Burger
- Department of Microbiology and Immunology, Institute of Biomedical Sciences, Federal University of Alfenas UNIFAL-MG, Rua Gabriel Monteiro da Silva, 700, Centro, Alfenas, MG, 37130-001, Brazil
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Li Q, Liu Y, Zheng J, Chen Y, Liu Z, Xie Q, Li D, Xi L, Zheng J, Liu H. Potassium iodide enhances the killing effect of methylene blue mediated photodynamic therapy against F. monophora. Photodiagnosis Photodyn Ther 2024; 48:104255. [PMID: 38901715 DOI: 10.1016/j.pdpdt.2024.104255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/14/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Chromoblastomycosis (CMB) is a chronic granulomatous fungal infection that affect the skin and subcutaneous tissues. It is clinically problematic due to limited treatment options, low cure rates, and high rates of relapse. This underscores the necessity for innovative treatment approaches. In this study, potassium iodide (KI) combined with Methylene Blue (MB) mediated antimicrobial photodynamic therapy (PDT) were assessed in the treatment of Fonsecaea monophora (F. monophora) both in vitro and in vivo. And the underlying mechanism that contributes to the efficacy of this treatment approach was investigated. METHODS In vitro experiments were conducted using different combinations and concentrations of MB, KI, and 660 nm light (60 mW/cm2) to inhibit F. monophora. The study was carried out using colony-forming unit (CFU) counts and scanning electron microscopy (SEM). The production of singlet oxygen (1O2), free iodine (I2), hydrogen peroxide (H2O2), and superoxide anion during the KI combined MB-mediated antimicrobial PDT process was also detected. In vivo experiments were developed using a Balb/c mouse paw infection model with F. monophora and treated with PBS, 10 mM KI, 2 mM MB +100 J/cm² and 10 mM KI+2 mM MB +100 J/cm² respectively. Inflammatory swelling, fungal load and histopathological analyses of the mouse footpads were assessed. RESULTS KI enhanced the killing effect of MB-mediated antimicrobial PDT on the conidial spores of F. monophora at the cell and infected animal model level. During the process, the main antimicrobial agents in KI combined with MB- mediated antimicrobial PDT could produce stronger toxic active species including free I2 and H2O2. CONCLUSION: KI combined with MB-mediated antimicrobial PDT could be an effective adjunct therapy for treating CBM.
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Affiliation(s)
- Qian Li
- Guangdong Clinical College of Dermatology, Anhui Medical University, Hefei, China; Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Yinghui Liu
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Jinjin Zheng
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Yangxia Chen
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zeyu Liu
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Qiulin Xie
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Dongmei Li
- Department of Microbiology/Immunology, Georgetown University Medical Center, Washington, D.C., USA
| | - Liyan Xi
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China; Department of Dermatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Judun Zheng
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China.
| | - Hongfang Liu
- Guangdong Clinical College of Dermatology, Anhui Medical University, Hefei, China; Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China.
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Gil-Pallares P, Gracia-Cazaña T, Álvarez-Salafranca M, Gorgojo MA, García-García M, Beltrán-Rosel A, Almenara-Blasco M, Navarro-Bielsa A, Gilaberte Y. Cutaneous Alternariosis in Immunosuppressed Patients Treated with Photodynamic Therapy and Oral Antifungals, a Synergistic Strategy. Pharmaceuticals (Basel) 2024; 17:245. [PMID: 38399460 PMCID: PMC10893038 DOI: 10.3390/ph17020245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Cutaneous alternariosis is a rare condition, more frequently presented in immunocompromised patients, which usually requires long courses of systemic antifungals that may interact with other medications. The presented series shows three cases of cutaneous alternariosis in immunocompromised patients and organ transplant recipients that were successfully treated with photodynamic therapy and oral antifungals, allowing a reduction in the systemic treatment duration and therefore decreasing the risk of side effects and drug interactions.
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Affiliation(s)
- Pedro Gil-Pallares
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Department of Surgery and Medical-Surgical Specialities, Universidad de Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Tamara Gracia-Cazaña
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Marcial Álvarez-Salafranca
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
| | | | - Mar García-García
- Department of Pathology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain;
| | - Antonio Beltrán-Rosel
- Department of Microbiology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
| | - Manuel Almenara-Blasco
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Alba Navarro-Bielsa
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain (M.Á.-S.); (M.A.-B.); (Y.G.)
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Department of Dermatology, University of Zaragoza, 50009 Zaragoza, Spain
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Cavallone IN, Belda W, de Carvalho CHC, Laurenti MD, Passero LFD. New Immunological Markers in Chromoblastomycosis-The Importance of PD-1 and PD-L1 Molecules in Human Infection. J Fungi (Basel) 2023; 9:1172. [PMID: 38132773 PMCID: PMC10744586 DOI: 10.3390/jof9121172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
The pathogenesis of chromoblastomycosis (CBM) is associated with Th2 and/or T regulatory immune responses, while resistance is associated with a Th1 response. However, even in the presence of IFN-γ, fungi persist in the lesions, and the reason for this persistence is unknown. To clarify the factors associated with pathogenesis, this study aimed to determine the polarization of the cellular immune response and the densities of cells that express markers of exhaustion in the skin of CBM patients. In the skin of patients with CBM, a moderate inflammatory infiltrate was observed, characterized primarily by the occurrence of histiocytes. Analysis of fungal density allowed us to divide patients into groups that exhibited low and high fungal densities; however, the intensity of the inflammatory response was not related to mycotic loads. Furthermore, patients with CBM exhibited a significant increase in the number of CD4+ and CD8+ cells associated with a high density of IL-10-, IL-17-, and IFN-γ-producing cells, indicating the presence of a chronic and mixed cellular immune response, which was also independent of fungal load. A significant increase in the number of PD-1+ and PD-L1+ cells was observed, which may be associated with the maintenance of the fungus in the skin and the progression of the disease.
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Affiliation(s)
- Italo N. Cavallone
- Institute of Biosciences, São Paulo State University (UNESP), Praça Infante Dom Henrique, s/n, São Vicente 11330-900, Brazil;
- Laboratory of Pathology of Infectious Diseases (LIM50), Department of Pathology, Medical School, São Paulo University, São Paulo 01246-903, Brazil
| | - Walter Belda
- Dermatology Department, Medical School, São Paulo University, Clinics Hospital, São Paulo 05403-000, Brazil; (W.B.J.); (C.H.C.d.C.); (M.D.L.)
| | - Caroline Heleno C. de Carvalho
- Dermatology Department, Medical School, São Paulo University, Clinics Hospital, São Paulo 05403-000, Brazil; (W.B.J.); (C.H.C.d.C.); (M.D.L.)
| | - Marcia D. Laurenti
- Dermatology Department, Medical School, São Paulo University, Clinics Hospital, São Paulo 05403-000, Brazil; (W.B.J.); (C.H.C.d.C.); (M.D.L.)
| | - Luiz Felipe D. Passero
- Institute of Biosciences, São Paulo State University (UNESP), Praça Infante Dom Henrique, s/n, São Vicente 11330-900, Brazil;
- Institute for Advanced Studies of Ocean (IEAMAR), São Paulo State University (UNESP), Rua João Francisco Bensdorp, 1178, São Vicente 11350-011, Brazil
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Wu X, Hu Y. Photodynamic Therapy for the Treatment of Fungal Infections. Infect Drug Resist 2022; 15:3251-3266. [PMID: 35761978 PMCID: PMC9233483 DOI: 10.2147/idr.s369605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
Cutaneous fungal infections are common in humans and are associated with significant physical and psychological distress to patients. Although conventional topical and/or oral anti-fungal medications are commonly recommended treatments, drug resistance has emerged as a significant concern in this patient population, and safer, more efficacious, and cost-effective alternatives are warranted. Recent studies have reported effectiveness of photodynamic therapy (PDT) against fungal infections without severe adverse effects. In this review, we briefly discuss the mechanisms underlying PDT, current progress, adverse effects, and limitations of this treatment in the management of superficial and deep fungal infections.
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Affiliation(s)
- Xuelin Wu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
| | - Yongxuan Hu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People's Republic of China
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Rodríguez-Amigo B, Hally C, Roig-Yanovsky N, Delcanale P, Abbruzzetti S, Agut M, Viappiani C, Nonell S. A Double Payload Complex between Hypericin and All-Trans Retinoic Acid in the β-Lactoglobulin Protein. Antibiotics (Basel) 2022; 11:antibiotics11020282. [PMID: 35203884 PMCID: PMC8868348 DOI: 10.3390/antibiotics11020282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022] Open
Abstract
Combined therapies are usually used to treat acne vulgaris since this approach can tackle various foci simultaneously. Using a combination of spectroscopic, computational, and microbiological techniques and methods, herein we report on the use of β-lactoglobulin as a double payload carrier of hypericin (an antimicrobial photodynamic agent) and all-trans retinoic acid (an anti-inflammatory drug) for S. aureus in vitro photodynamic inactivation. The addition of all-trans retinoic acid to hypericin-β-lactoglobulin complex renders a photochemically safe vehicle due to the photophysical quenching of hypericin, which recovers its photodynamic activity when in contact with bacteria. The ability of hypericin to photoinactivate S. aureus was not affected by retinoic acid. β-Lactoglobulin is a novel biocompatible and photochemically safe nanovehicle with strong potential for the treatment of acne.
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Affiliation(s)
- Beatriz Rodríguez-Amigo
- Institut Quimic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain; (B.R.-A.); (C.H.); (N.R.-Y.); (M.A.)
| | - Cormac Hally
- Institut Quimic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain; (B.R.-A.); (C.H.); (N.R.-Y.); (M.A.)
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università di Parma, 43124 Parma, Italy; (P.D.); (S.A.)
| | - Núria Roig-Yanovsky
- Institut Quimic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain; (B.R.-A.); (C.H.); (N.R.-Y.); (M.A.)
| | - Pietro Delcanale
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università di Parma, 43124 Parma, Italy; (P.D.); (S.A.)
| | - Stefania Abbruzzetti
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università di Parma, 43124 Parma, Italy; (P.D.); (S.A.)
| | - Montserrat Agut
- Institut Quimic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain; (B.R.-A.); (C.H.); (N.R.-Y.); (M.A.)
| | - Cristiano Viappiani
- Dipartimento di Scienze Matematiche, Fisiche e Informatiche, Università di Parma, 43124 Parma, Italy; (P.D.); (S.A.)
- Correspondence: (C.V.); (S.N.)
| | - Santi Nonell
- Institut Quimic de Sarrià, Universitat Ramon Llull, 08017 Barcelona, Spain; (B.R.-A.); (C.H.); (N.R.-Y.); (M.A.)
- Correspondence: (C.V.); (S.N.)
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Reviewing the Etiologic Agents, Microbe-Host Relationship, Immune Response, Diagnosis, and Treatment in Chromoblastomycosis. J Immunol Res 2021; 2021:9742832. [PMID: 34761009 PMCID: PMC8575639 DOI: 10.1155/2021/9742832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/30/2021] [Indexed: 01/19/2023] Open
Abstract
Chromoblastomycosis (CBM) is a neglected human disease, caused by different species of pigmented dematiaceous fungi that cause subcutaneous infections. This disease has been considered an occupational disease, occurring among people working in the field of agriculture, particularly in low-income countries. In 1914, the first case of CBM was described in Brazil, and although efforts have been made, few scientific and technological advances have been made in this area. In the field of fungi and host cell relationship, a very reduced number of antigens were characterized, but available data suggest that ectoantigens bind to the cell membrane of host cells and modulate the phagocytic, immunological, and microbicidal responses of immune cells. Furthermore, antigens cleave extracellular proteins in tissues, allowing fungi to spread. On the contrary, if phagocytic cells are able to present antigens in MHC molecules to T lymphocytes in the presence of costimulation and IL-12, a Th1 immune response will develop and a relative control of the disease will be observed. Despite knowledge of the resistance and susceptibility in CBM, up to now, no effective vaccines have been developed. In the field of chemotherapy, most patients are treated with conventional antifungal drugs, such as itraconazole and terbinafine, but these drugs exhibit limitations, considering that not all patients heal cutaneous lesions. Few advances in treatment have been made so far, but one of the most promising ones is based on the use of immunomodulators, such as imiquimod. Data about a standard treatment are missing in the medical literature; part of it is caused by the existence of a diversity of etiologic agents and clinical forms. The present review summarizes the advances made in the field of CBM related to the diversity of pathogenic species, fungi and host cell relationship, antigens, innate and acquired immunity, clinical forms of CBM, chemotherapy, and diagnosis.
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Aroso RT, Schaberle FA, Arnaut LG, Pereira MM. Photodynamic disinfection and its role in controlling infectious diseases. Photochem Photobiol Sci 2021; 20:1497-1545. [PMID: 34705261 PMCID: PMC8548867 DOI: 10.1007/s43630-021-00102-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022]
Abstract
Photodynamic therapy is witnessing a revival of its origins as a response to the rise of multi-drug resistant infections and the shortage of new classes of antibiotics. Photodynamic disinfection (PDDI) of microorganisms is making progresses in preclinical models and in clinical cases, and the perception of its role in the clinical armamentarium for the management of infectious diseases is changing. We review the positioning of PDDI from the perspective of its ability to respond to clinical needs. Emphasis is placed on the pipeline of photosensitizers that proved effective to inactivate biofilms, showed efficacy in animal models of infectious diseases or reached clinical trials. Novel opportunities resulting from the COVID-19 pandemic are briefly discussed. The molecular features of promising photosensitizers are emphasized and contrasted with those of photosensitizers used in the treatment of solid tumors. The development of photosensitizers has been accompanied by the fabrication of a variety of affordable and customizable light sources. We critically discuss the combination between photosensitizer and light source properties that may leverage PDDI and expand its applications to wider markets. The success of PDDI in the management of infectious diseases will ultimately depend on the efficacy of photosensitizers, affordability of the light sources, simplicity of the procedures, and availability of fast and efficient treatments.
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Affiliation(s)
- Rafael T Aroso
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Fábio A Schaberle
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Luís G Arnaut
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal.
| | - Mariette M Pereira
- Chemistry Department, University of Coimbra, 3004-535, Coimbra, Portugal.
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