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Ohshima J, Abe S, Morita M, Tanaka N, Yamaguchi M, Hayashi M. Time-course study of genetic changes in periodontal ligament regeneration after tooth replantation in a mouse model. Sci Rep 2024; 14:15502. [PMID: 38969768 PMCID: PMC11226448 DOI: 10.1038/s41598-024-66542-8] [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: 03/20/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024] Open
Abstract
This research focused on analyzing gene expression changes in the periodontal ligament (PDL) after tooth re-plantation to identify key genes and pathways involved in healing and regeneration. Utilizing a mouse model, mRNA was extracted from the PDL at various intervals post-replantation for RNA sequencing analysis, spanning from 3 to 56 days. The results revealed significant shifts in gene expression, particularly notable on day 28, supported by hierarchical clustering and principal component analysis. Gene ontology (GO) enrichment analysis highlighted an upregulation in olfactory receptor and G protein-coupled receptor signaling pathways at this time point. These findings were validated through reverse transcription-quantitative PCR (RT-qPCR), with immunochemical staining localizing olfactory receptor gene expression to the PDL and surrounding tissues. Moreover, a scratch assay indicated that olfactory receptor genes might facilitate wound healing in human PDL fibroblasts. These results underscore the importance of the 28-day post-transplant phase as a potential "tipping point" in PDL healing and regeneration. In conclusion, this research sheds light on the potential role of olfactory receptor genes in PDL regeneration, providing a foundation for developing new therapeutic approaches in tooth replantation and transplantation, with broader implications for regenerative medicine in oral health.
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Affiliation(s)
- Jun Ohshima
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Shotaro Abe
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masayoshi Morita
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Nobutake Tanaka
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masaya Yamaguchi
- Bioinformatics Research Unit, Osaka University Graduate School of Dentistry, Osaka, Japan
- Bioinformatics Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Microbiology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Center for Infectious Diseases Education and Research, Osaka University, Osaka, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Meng M, Chen Y, Ren H, Zhang Q, Chen S, Zhou X, Zou J. Effect of tetracyclines on pulpal and periodontal healing after tooth replantation: a systematic review of human and animal studies. BMC Oral Health 2021; 21:289. [PMID: 34090399 PMCID: PMC8180113 DOI: 10.1186/s12903-021-01615-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/09/2021] [Indexed: 02/08/2023] Open
Abstract
Background Pulpal and periodontal healing are two main concerns of delayed replantation of avulsed teeth. The objective of this review was to evaluate the effectiveness of topical and systemic application of tetracyclines on pulpal and periodontal healing after tooth replantation. Methods A comprehensive electronic search was conducted in six databases. This systematic review was carried out according to Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results After exclusion of 246 irrelevant papers, 14 animal studies and one human study were included in this review. The human study showed that avulsed permanent teeth treated with doxycycline did not show a better clinical outcome for pulp and periodontal healing compared with treatment with normal saline. As for animal studies, significant more pulpal healing was observed in immature teeth treated with topical doxycycline in two researches, while another one study showed that there is no difference between teeth treated with normal saline and teeth treated with doxycycline. Systemic doxycycline exerted no significant effect on pulpal revascularization illustrated by one research. Only one out of four articles illustrated the positive effect of systemic tetracyclines on periodontal healing. One paper reported that intracanal application of demeclocycline promoted favorable periodontal healing. Two articles showed topical doxycycline contributed to favorable periodontal healing, while five studies showed no significant effect of topical tetracyclines on periodontal healing. Conclusions As a result of data heterogeneity and limitations of the studies, the effect of topical or systemic application of tetracyclines on pulpal and periodontal healing is inconclusive. More studies are required to get more clinically significant conclusions.
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Affiliation(s)
- Mingmei Meng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yandi Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Huidi Ren
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Qiong Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China. .,Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
| | - Jing Zou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China. .,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
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Roskamp L, Trevilatto PC, Souza CM, Ignácio SA, de Lima GD, Pereira TM, Westphalen VPD. The role of polymorphism of the IL6 gene in tooth replantation. AUST ENDOD J 2021; 47:314-319. [PMID: 33410579 DOI: 10.1111/aej.12483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 11/29/2022]
Abstract
The absence or presence of root resorption on the root surface of a replanted tooth indicates an immune-inflammatory reaction. Since interleukin-6 (IL-6) is considered an inflammatory marker in bone resorption, this study aimed to investigate the association between clinical variables and polymorphisms in IL6, with the outcome of replanted teeth at 1-year follow-up. Altogether, 127 avulsed teeth that were replanted and had their root canals treated were selected for this study. Periapical radiographs were taken after replantation and after 1 year. Real-time PCR was used to genotype IL6 polymorphisms. Chi-square and 'Z' tests were performed to verify the association between genetic variables and the prognosis of replanted teeth (P < 0.05). An association was observed between the rs2069843 polymorphism of IL6 and the outcome of replanted teeth (P < 0.05). The rs2069843 polymorphism of IL6 may influence the outcome of avulsed and replanted teeth in the first year post-trauma.
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Affiliation(s)
- Liliane Roskamp
- Curso de Odontologia, Universidade Tuiuti do Paraná, Curitiba-Paraná, Brazil.,School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Cleber Machado Souza
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Programa de pos Graduação BIOTEC - Faculdades Pequeno Principe, Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil
| | | | - Giomo Dieila de Lima
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.,Departamento de Biociências, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, São Paulo, Brazil
| | - Thaís Munhoz Pereira
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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Machado NEDS, Banci HA, da Silva LD, Santinoni CDS, de Oliveira DL, Ervolino E, Prado RLD, Mori GG. Influence of anti-allergic drugs used systemically on the process of root resorption during delayed tooth replantation: A study in rats. Dent Traumatol 2019; 36:264-271. [PMID: 31845526 DOI: 10.1111/edt.12535] [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: 09/19/2019] [Revised: 12/07/2019] [Accepted: 12/11/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND/AIM Anti-allergic drugs can inhibit the hard tissue resorption process, and due to similarities between root resorption and bone mechanisms, it can be inferred that these drugs may also control root resorption. The aim of this study was to analyze the effects of anti-allergic drugs used systemically on the process of root resorption following delayed tooth replantation. MATERIALS AND METHODS Thirty-two maxillary right incisors of rats were extracted and subsequently replanted. Rats were divided into four groups according to the anti-allergic drug administered: the rats in groups DEX, Q, and MO were treated systemically with dexamethasone phosphate, quercetin, and montelukast, respectively, and no systemic medication was administered to rats in group C. After 60 days, the animals were euthanized, and the specimens were processed for histomorphometric and immunohistochemical analyses. Statistical significance was set at P < .05. RESULTS There were no significant differences between the groups in terms of inflammatory resorption, replacement resorption, or presence of tartrate-resistant acid phosphatase. In terms of events occurring in the periodontal ligament space, there was a difference between groups Q and MO due to the presence of dental ankylosis and inflammatory connective tissue (P < .05). A difference in inflammatory cells was also observed through CD45 immunolabeling between the DEX and Q groups when compared to the C group (P < .05). CONCLUSION The systemic administration of anti-allergic drugs did not have an effect on the process of root resorption following delayed tooth replantation.
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Affiliation(s)
- Nathália Evelyn da Silva Machado
- Graduate Program in Dentistry, University of Western São Paulo, Presidente Prudente, Brazil.,Department of Endodontics, Araçatuba Dental School, UNESP - University Estadual Paulista, Araçatuba, Brazil
| | - Henrique Augusto Banci
- Department of Endodontics, Araçatuba Dental School, UNESP - University Estadual Paulista, Araçatuba, Brazil.,Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Brazil
| | - Lucas Deszo da Silva
- Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Brazil
| | - Carolina Dos Santos Santinoni
- Graduate Program in Dentistry, University of Western São Paulo, Presidente Prudente, Brazil.,Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Brazil
| | | | - Edilson Ervolino
- Department of Basic Science, Araçatuba Dental School, UNESP - University Estadual Paulista, Araçatuba, Brazil
| | - Rosana Leal do Prado
- Graduate Program in Dentistry, University of Western São Paulo, Presidente Prudente, Brazil.,Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Brazil
| | - Graziela Garrido Mori
- Graduate Program in Dentistry, University of Western São Paulo, Presidente Prudente, Brazil.,Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Brazil
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5
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Roskamp L, Trevilatto PC, Souza CM, Silva Neto UX, Carneiro E, Fariniuk LF, Westphalen VPD. Types of External Root Resorption of Replanted Teeth: Analysis of the Clinical Aspects and of Interleukin-4 Gene Polymorphisms Involvement. J Endod 2017; 43:1792-1796. [PMID: 28818443 DOI: 10.1016/j.joen.2017.06.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/12/2017] [Accepted: 06/16/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The absence or presence of root resorption on the surface of a replanted tooth indicates an immune-inflammatory reaction. Recent research even suggests the participation of host predominant immunologic profile on types of resorptions detected on the root surface. Because interleukin 4 (IL-4) is an important anti-inflammatory cytokine, this study aimed to investigate the association of clinical variables and polymorphisms in IL4 with types of resorption of replanted teeth after 1 year of follow-up. METHODS One hundred twenty-seven avulsed teeth that were replanted were selected. Periapical radiographs were taken after replantation and for 1 year to detect the types of root resorption. Real-time polymerase chain reaction was used to genotype IL4 polymorphisms. The χ2 and Z tests were performed to verify the association of clinical and genetic variables with the outcomes of replanted teeth (P < .05). RESULTS An association was observed of extra-alveolar time, storage medium, and development of the root (P < .05), but not of IL4 polymorphisms, with the outcomes of replanted teeth (P > .05). CONCLUSIONS Extraoral time, storage medium, and development of the root, but not IL4 polymorphisms, may influence the types of resorption of avulsed and replanted teeth in the first year after trauma.
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Affiliation(s)
- Liliane Roskamp
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
| | | | - Cleber Machado Souza
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Everdan Carneiro
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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Roskamp L, Trevilatto PC, Souza CM, Silva Neto UX, Carneiro E, Fariniuk LF, Westphalen VPD. Analysis of the association of clinical factors and IL4 gene polymorphisms with root resorption in avulsed teeth after 1 year of replantation. Int Endod J 2017; 51:12-19. [PMID: 28617966 DOI: 10.1111/iej.12797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 06/09/2017] [Indexed: 01/19/2023]
Abstract
AIM To investigate the association of clinical variables and polymorphisms (tag SNPs) in the interleukin 4 (IL4) gene, with the prognosis of avulsed and replanted teeth. METHODOLOGY Ninety-four patients who suffered avulsion and had their teeth replanted and endodontically treated were included. Periapical radiographs were obtained soon after tooth replantation and after 1 year. For genotypic IL4 gene analysis, the DNA from oral mucosa cells was collected, and polymorphisms were investigated by real-time PCR. Univariate and multivariate analyses were performed to verify the association of clinical and genetic variables and the outcome of the replanted teeth (P < 0.05). RESULTS After multivariate analysis, extra-alveolar time longer than 1 h was significantly associated with external root resorption. No significant association was observed between IL4 gene polymorphisms and root resorption. CONCLUSION No association between root resorption and IL4 gene polymorphisms was observed. An extra-alveolar time of more than 1 h was associated with a susceptibility for external root resorption. Replanting the tooth in its socket immediately is the most important factor to maintain a healthy root surface.
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Affiliation(s)
- L Roskamp
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - P C Trevilatto
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - C M Souza
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - U X Silva Neto
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - E Carneiro
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - L F Fariniuk
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - V P D Westphalen
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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Roskamp L, Silva Neto UXD, Carneiro E, Fariniuk LF, Westphalen VPD. Influence of Atopy in the Outcome of Avulsed and Replanted Teeth during 5 Years of Follow-up. J Endod 2017; 43:25-28. [DOI: 10.1016/j.joen.2016.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/05/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022]
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Age and Timing of Pulp Extirpation as Major Factors Associated with Inflammatory Root Resorption in Replanted Permanent Teeth. J Endod 2014; 40:366-71. [DOI: 10.1016/j.joen.2013.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/02/2013] [Accepted: 10/02/2013] [Indexed: 11/18/2022]
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Herrera BS, Bastos AS, Coimbra LS, Teixeira SA, Rossa C, Van Dyke TE, Muscara MN, Spolidorio LC. Peripheral blood mononuclear phagocytes from patients with chronic periodontitis are primed for osteoclast formation. J Periodontol 2013; 85:e72-81. [PMID: 24059638 DOI: 10.1902/jop.2013.130280] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND During inflammatory periodontal disease, peripheral blood mononuclear cells (PBMCs) are attracted to bone and differentiate into active bone-resorbing osteoclasts (OCs), thus providing evidence that the impact of chronic periodontitis (CP) on the activity of circulating mononuclear cells is of central importance. The authors test the hypothesis that peripheral blood mononuclear phagocytes (PBMPs) from patients with CP are activated and more susceptible to differentiation into OCs, which in turn would lead to more intense bone resorption. METHODS In vitro cytokine production by both unstimulated and lipopolysaccharide-stimulated PBMCs from individuals with (n = 10) or without (n = 12) periodontitis was determined by cytokine array. OC differentiation from CD14(+) PBMCs was induced by receptor activator of nuclear factor-kappa B ligand (RANKL), either alone or in the presence of macrophage colony-stimulating factor (M-CSF). PBMC differentiation to OCs was confirmed by tartrate-resistant acid phosphatase staining; bone resorbing activity was assessed by using an osteologic plate assay (bone resorption pit formation). RESULTS PBMCs from patients with CP produced tumor necrosis factor-α and higher amounts of interferon-γ, interleukin (IL)-1α, IL-1β, IL-1rα, CXC motif chemokine 10, macrophage migration inhibitory factor, macrophage inflammatory protein (MIP)-1α, and MIP-1β than the control cells. OC differentiation was induced by RANKL alone in PBMCs from patients with CP, but not in PBMCs from the healthy controls, which required the addition of M-CSF. In addition, PBMC-derived OCs from patients with CP showed significantly higher resorption activity than that observed in the healthy controls. Also, the circulating concentrations of M-CSF were significantly higher in patients with CP than in the control participants. CONCLUSIONS These data indicate that in patients with CP, circulating PBMCs are primed for increased proinflammatory activity and that M-CSF plays a central role in this process by increasing OC formation and the consequent bone resorption activity.
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Affiliation(s)
- Bruno S Herrera
- Departments of Physiology and Pathology, Araraquara Dental School, State University of São Paulo, Araraquara, Brazil
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Roskamp L, Westphalen VP, Carneiro E, Fariniuk LF, Silva Neto UX. The Positive Influence of Atopy on the Prognosis of Avulsed and Replanted Teeth Despite Differences in Post-trauma Management. J Endod 2011; 37:463-5. [DOI: 10.1016/j.joen.2010.12.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Revised: 12/15/2010] [Accepted: 12/20/2010] [Indexed: 01/01/2023]
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Fariniuk LF, Souza MHD, Westphalen VPD, Carneiro E, Silva Neto UX, Roskamp L, Cavali AE. Evaluation of care of dentoalveolar trauma. J Appl Oral Sci 2010; 18:343-5. [PMID: 20835567 PMCID: PMC5349070 DOI: 10.1590/s1678-77572010000400004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Accepted: 10/05/2009] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this study was to evaluate cases of dental trauma treated at the
specialized center of Pontifical Catholic University of Paraná, Curitiba,
Brazil, during a period of 2 years. Material and Methods A total of 647 patients were evaluated and treated between 2003 and 2005. Data
obtained from each patient were tabulated and analyzed as to gender, age,
etiology, time elapsed after the injury, diagnosis (type of trauma), and affected
teeth. Results The results revealed that male individuals aged 7 to 13 years presented the
highest prevalence of injury, and falling was the main causal factor. In most
cases, the time elapsed between the accident and the first care ranged from 4 to
24 h. A total of 1,747 teeth were affected, with higher incidence of
concussion/subluxation and coronal fracture, followed by lateral luxation and
avulsion. The permanent maxillary central incisors were the most commonly affected
teeth. Conclusion The frequency and causes of dentoalveolar trauma should be investigated for
identification of risk groups, treatment demands and costs in order to allow for
the establishment of effective preventive measures that can reduce the treatment
duration and costs for both patients and oral health services.
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Affiliation(s)
- Luiz Fernando Fariniuk
- Endodontics, Department of Dentistry, Pontifical Catholic University of Paraná, Curitiba, PR, Brazil.
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Relationship Between Extra-Alveolar Time and Atopy in the Prognosis of the Replantation of Avulsed Teeth. ACTA ACUST UNITED AC 2010; 69:E79-81. [DOI: 10.1097/ta.0b013e3181ec112b] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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