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Fallahi P, Elia G, Ragusa F, Paparo SR, Patrizio A, Balestri E, Mazzi V, Benvenga S, Varricchi G, Gragnani L, Botrini C, Baldini E, Centanni M, Ferri C, Antonelli A, Ferrari SM. Thyroid Autoimmunity and SARS-CoV-2 Infection. J Clin Med 2023; 12:6365. [PMID: 37835009 PMCID: PMC10573843 DOI: 10.3390/jcm12196365] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological culprit of COronaVIrus Disease 19 (COVID-19), can enter the cells via the angiotensin-converting enzyme 2 (ACE2) receptor, which has been found in several tissues including in endocrine organs, such as the ovaries, testes, pancreas, and thyroid. Several thyroid disorders have been associated with SARS-CoV-2 infection [subacute thyroiditis (SAT), thyrotoxicosis, and non-thyroidal illness syndrome (NTIS)] and, in part, they are believed to be secondary to the local virus replication within the gland cells. However, as documented for other viruses, SARS-CoV-2 seems to interfere with several aspects of the immune system, inducing the synthesis of autoantibodies and triggering latent or new onset autoimmune disease (AID), including autoimmune thyroid disease (AITD), such as Hashimoto Thyroiditis (HT) and Graves' disease (GD). Several mechanisms have been hypothesized to explain this induction of autoimmunity by SARS-CoV-2 infection: the immune system hyper-stimulation, the molecular mimicry between the self-antigens of the host and the virus, neutrophils extracellular traps, and finally, the virus induced transcriptional changes in the immune genes; nonetheless, more evidence is needed especially from large, long-term cohort studies involving COVID-19 patients, to establish or reject this pathogenetic relationship.
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Affiliation(s)
- Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.F.); (S.R.P.); (L.G.)
| | - Giusy Elia
- Department of Surgery, Medical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy; (G.E.); (F.R.); (E.B.); (V.M.); (C.B.)
| | - Francesca Ragusa
- Department of Surgery, Medical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy; (G.E.); (F.R.); (E.B.); (V.M.); (C.B.)
| | - Sabrina Rosaria Paparo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.F.); (S.R.P.); (L.G.)
| | - Armando Patrizio
- Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy;
| | - Eugenia Balestri
- Department of Surgery, Medical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy; (G.E.); (F.R.); (E.B.); (V.M.); (C.B.)
| | - Valeria Mazzi
- Department of Surgery, Medical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy; (G.E.); (F.R.); (E.B.); (V.M.); (C.B.)
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine—Endocrinology, University of Messina, 98122 Messina, Italy;
- Master Program on Childhood, Adolescent and Women’s Endocrine Health, University of Messina, 98122 Messina, Italy
- Interdepartmental Program of Molecular & Clinical Endocrinology and Women’s Endocrine Health, University Hospital Policlinico “G. Martino”, 98124 Messina, Italy
| | - Gilda Varricchi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy;
- Center for Basic and Clinical Immunology Research, University of Naples Federico II, 80131 Naples, Italy
- World Allergy Organization Center of Excellence, University of Naples Federico II, 80131 Naples, Italy
- Institute of Experimental Endocrinology and Oncology “Gaetano Salvatore”, National Research Council, 80131 Naples, Italy
| | - Laura Gragnani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.F.); (S.R.P.); (L.G.)
| | - Chiara Botrini
- Department of Surgery, Medical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy; (G.E.); (F.R.); (E.B.); (V.M.); (C.B.)
| | - Enke Baldini
- Department of Experimental Medicine, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Marco Centanni
- Department of Medico-Surgical Sciences and Biotechnologies, Endocrinology Section, ‘‘Sapienza’’ University of Rome, 00185 Rome, Italy;
- Endocrine Unit, Azienda Unità Sanitaria Locale (AUSL) Latina, 04100 Latina, Italy
| | - Clodoveo Ferri
- Rheumatology Unit, School of Medicine, University of Modena and Reggio Emilia, 41100 Modena, Italy;
- Rheumatology Clinic ‘Madonna Dello Scoglio’ Cotronei, 88836 Crotone, Italy
| | - Alessandro Antonelli
- Department of Surgery, Medical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy; (G.E.); (F.R.); (E.B.); (V.M.); (C.B.)
| | - Silvia Martina Ferrari
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
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Ferri C, Giuggioli D, Raimondo V, Fallahi P, Antonelli A. COVID-19 in Italian patients with rheumatic autoimmune systemic diseases. Ann Rheum Dis 2023; 82:e211. [PMID: 33055077 DOI: 10.1136/annrheumdis-2020-219113] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Clodoveo Ferri
- Rheumatology Unit, University of Modena & RE, School of Medicine, Modena, Italy
- Rheumatology Clinic 'Madonna dello Scoglio', Cotronei, Italy
| | - Dilia Giuggioli
- Rheumatology Unit, University of Modena & RE, School of Medicine, Modena, Italy
| | | | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, School of Medicine, Pisa, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Rezaei B, Shahedi A, Keshtkaran Z, Eidi A, Delam H, Safari K, Shadmehr R, Abdollahpour-Alitappeh M. Changes in incidence and mortality trend due to COVID-19 in southern Iran, from 2020 to 2021: based on Cochran-Armitage trend test. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-7. [PMID: 37361263 PMCID: PMC10076376 DOI: 10.1007/s10389-023-01902-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
Background In 2020, COVID-19 spread rapidly in Iran and other parts of the world. Some of the epidemiological aspects of this disease remain unknown; therefore, the present study was designed with the aim of determining the trend of incidence and mortality of COVID-19 from February 2020 to July 2021 in southern Iran. Methods The present study was a cross-sectional analytical study that included all people who had COVID-19 in the period from February 2020 to July 2021 and whose information had been registered in the Infectious Diseases Center of Larestan city and MCMC unit. The study area included the cities of Larestan, Evaz, and Khonj, located in the south of Fars province in southern Iran. Results Since the emergence of COVID-19 until July 2021, a total of 23,246 new cases of infection were reported in the southern region of Fars province. The average age of patients was 39.90±18.30 years and the range of ages varied from 1 to 103 years. The results of the Cochran-Armitage trend test showed that the trend of the disease in 2020 was completely upward. The first positive case of COVID-19 was recorded on February 27, 2020. The incidence curve in 2021 is sinusoidal, but in general, the results of the Cochran-Armitage trend test showed that the incidence of the disease increased significantly (P-trend < 0.001). Most cases were reported in July, April, and the end of March. Conclusion In general, the incidence rate of COVID-19 has varied sinusoidally from 2020 to mid-2021. Although the incidence of the disease increased, the number of deaths has fallen. It seems that the increase in the number of diagnostic tests and the implementation of the national COVID-19 immunization program have been effective in changing the trend of the disease.
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Affiliation(s)
- Behzad Rezaei
- Department of Surgery, Larestan University of Medical Sciences, Larestan, Iran
| | - Alireza Shahedi
- Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
| | - Zahra Keshtkaran
- Department of Nursing, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of medical sciences, Shiraz, Iran
| | - Ahmadreza Eidi
- Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
| | - Hamed Delam
- Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
- Imam Reza Teaching Hospital, Larestan University of Medical Sciences, Larestan, Iran
| | - Khalil Safari
- Larestan University of Medical Sciences, Larestan, Iran
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Potential for Stem Cell-Based Therapy in the Road of Treatment for Neurological Disorders Secondary to COVID-19. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2021; 8:355-369. [PMID: 34746370 PMCID: PMC8555723 DOI: 10.1007/s40883-021-00234-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 09/19/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
Abstract
The severe acute respiratory syndrome coronavirus 2 has led to the worldwide pandemic named coronavirus disease 2019 (COVID-19). It has caused a significant increase in the number of cases and mortalities since its first diagnosis in December 2019. Although COVID-19 primarily affects the respiratory system, neurological involvement of the central and peripheral nervous system has been also reported. Herein, the higher risk of neurodegenerative diseases in COVID-19 patients in future is also imaginable. Neurological complications of COVID-19 infection are more commonly seen in severely ill individuals; but, earlier diagnosis and treatment can lead to better long-lasting results. In this respect, stem cell biotechnologies with considerable self-renewal and differentiation capacities have experienced great progress in the field of neurological disorders whether in finding out their underlying processes or proving them promising therapeutic approaches. Herein, many neurological disorders have been found to benefit from stem cell medicine strategies. Accordingly, in the present review, the authors are trying to discuss stem cell-based biotechnologies as promising therapeutic options for neurological disorders secondary to COVID-19 infection through reviewing neurological manifestations of COVID-19 and current stem cell-based biotechnologies for neurological disorders. Lay Summary Due to the substantial burden of neurological disorders in the health, economic, and social system of society, the emergence of neurological manifestations following COVID-19 (as a life-threatening pandemic) creates the need to use efficient and modern methods of treatment. Since stem cell-based methods have been efficient for a large number of neurological diseases, it seems that the use of mentioned methods is also effective in the process of improving neurological disorders caused by COVID-19. Hereupon, the current review aims to address stem cell-based approaches as treatments showing promise to neurological disorders related to COVID-19.
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Motamedi H, Ari MM, Dashtbin S, Fathollahi M, Hossainpour H, Alvandi A, Moradi J, Abiri R. An update review of globally reported SARS-CoV-2 vaccines in preclinical and clinical stages. Int Immunopharmacol 2021; 96:107763. [PMID: 34162141 PMCID: PMC8101866 DOI: 10.1016/j.intimp.2021.107763] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/21/2021] [Accepted: 05/04/2021] [Indexed: 02/07/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the rapidly spreading pandemic COVID-19 in the world. As an effective therapeutic strategy is not introduced yet and the rapid genetic variations in the virus, there is an emerging necessity to design, evaluate and apply effective new vaccines. An acceptable vaccine must elicit both humoral and cellular immune responses, must have the least side effects and the storage and transport systems should be available and affordable for all countries. These vaccines can be classified into different types: inactivated vaccines, live-attenuated virus vaccines, subunit vaccines, virus-like particles (VLPs), nucleic acid-based vaccines (DNA and RNA) and recombinant vector-based vaccines (replicating and non-replicating viral vector). According to the latest update of the WHO report on April 2nd, 2021, at least 85 vaccine candidates were being studied in clinical trial phases and 184 candidate vaccines were being evaluated in pre-clinical stages. In addition, studies have shown that other vaccines, including the Bacillus Calmette-Guérin (BCG) vaccine and the Plant-derived vaccine, may play a role in controlling pandemic COVID-19. Herein, we reviewed the different types of COVID-19 candidate vaccines that are currently being evaluated in preclinical and clinical trial phases along with advantages, disadvantages or adverse reactions, if any.
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Affiliation(s)
- Hamid Motamedi
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Marzie Mahdizade Ari
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Dashtbin
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Matin Fathollahi
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hadi Hossainpour
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amirhoushang Alvandi
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran; Medical Technology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jale Moradi
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ramin Abiri
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran; Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Ferri C, Giuggioli D, Raimondo V, L'Andolina M, Tavoni A, Cecchetti R, Guiducci S, Ursini F, Caminiti M, Varcasia G, Gigliotti P, Pellegrini R, Olivo D, Colaci M, Murdaca G, Brittelli R, Mariano GP, Spinella A, Bellando-Randone S, Aiello V, Bilia S, Giannini D, Ferrari T, Caminiti R, Brusi V, Meliconi R, Fallahi P, Antonelli A. COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series. Clin Rheumatol 2020; 39:3195-3204. [PMID: 32852623 PMCID: PMC7450255 DOI: 10.1007/s10067-020-05334-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune systemic diseases. We investigated the clinical-epidemiological findings of 1641 autoimmune systemic disease Italian patients during the Covid-19 pandemic. METHOD This observational multicenter study included 1641 unselected patients with autoimmune systemic diseases from three Italian geographical areas with different prevalence of Covid-19 [high in north (Emilia Romagna), medium in central (Tuscany), and low in south (Calabria)] by means of telephone 6-week survey. Covid-19 was classified as (1) definite diagnosis of Covid-19 disease: presence of symptomatic Covid-19 infection, confirmed by positive oral/nasopharyngeal swabs; (2) highly suspected Covid-19 disease: presence of highly suggestive symptoms, in absence of a swab test. RESULTS A significantly higher prevalence of patients with definite diagnosis of Covid-19 disease, or with highly suspected Covid-19 disease, or both the conditions together, was observed in the whole autoimmune systemic disease series, compared to "Italian general population" (p = .030, p = .001, p = .000, respectively); and for definite + highly suspected diagnosis of Covid-19 disease, in patients with autoimmune systemic diseases of the three regions (p = .000, for all comparisons with the respective regional general population). Moreover, significantly higher prevalence of definite + highly suspected diagnosis of Covid-19 disease was found either in patients with various "connective tissue diseases" compared to "inflammatory arthritis group" (p < .000), or in patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs treatments (p = .011). CONCLUSIONS The finding of a higher prevalence of Covid-19 in patients with autoimmune systemic diseases is particularly important, suggesting the need to develop valuable prevention/management strategies, and stimulates in-depth investigations to verify the possible interactions between Covid-19 infection and impaired immune-system of autoimmune systemic diseases. Key Points • Significantly higher prevalence of Covid-19 is observed in a large series of patients with autoimmune systemic diseases compared to the Italian general population, mainly due to patients' increased susceptibility to infections and favored by the high exposure to the virus at medical facilities before the restriction measures on individual movement. • The actual prevalence of Covid-19 in autoimmune systemic diseases may be underestimated, possibly due to the wide clinical overlapping between the two conditions, the generally mild Covid-19 disease manifestations, and the limited availability of virological testing. • Patients with "connective tissue diseases" show a significantly higher prevalence of Covid-19, possibly due to deeper immune-system impairment, with respect to "inflammatory arthritis group". • Covid-19 is more frequent in the subgroup of autoimmune systemic diseases patients without ongoing conventional synthetic disease-modifying anti-rheumatic drugs, mainly hydroxyl-chloroquine and methotrexate, which might play some protective role against the most harmful manifestations of Covid-19.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antirheumatic Agents/therapeutic use
- Arthritis, Psoriatic/drug therapy
- Arthritis, Psoriatic/epidemiology
- Arthritis, Psoriatic/physiopathology
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/epidemiology
- Arthritis, Rheumatoid/physiopathology
- Autoimmune Diseases/drug therapy
- Autoimmune Diseases/epidemiology
- Autoimmune Diseases/physiopathology
- Betacoronavirus
- COVID-19
- Coronavirus Infections/epidemiology
- Coronavirus Infections/physiopathology
- Dermatomyositis/drug therapy
- Dermatomyositis/epidemiology
- Dermatomyositis/physiopathology
- Female
- Glucocorticoids/therapeutic use
- Humans
- Italy/epidemiology
- Lupus Erythematosus, Systemic/drug therapy
- Lupus Erythematosus, Systemic/epidemiology
- Lupus Erythematosus, Systemic/physiopathology
- Male
- Middle Aged
- Pandemics
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/physiopathology
- Rheumatic Diseases/drug therapy
- Rheumatic Diseases/epidemiology
- Rheumatic Diseases/physiopathology
- SARS-CoV-2
- Scleroderma, Systemic/drug therapy
- Scleroderma, Systemic/epidemiology
- Scleroderma, Systemic/physiopathology
- Sjogren's Syndrome/drug therapy
- Sjogren's Syndrome/epidemiology
- Sjogren's Syndrome/physiopathology
- Spondylitis, Ankylosing/drug therapy
- Spondylitis, Ankylosing/epidemiology
- Spondylitis, Ankylosing/physiopathology
- Undifferentiated Connective Tissue Diseases/drug therapy
- Undifferentiated Connective Tissue Diseases/epidemiology
- Undifferentiated Connective Tissue Diseases/physiopathology
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Affiliation(s)
- Clodoveo Ferri
- Rheumatology Unit, School of Medicine, University of Modena & RE, Modena, Italy.
- Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy.
| | - Dilia Giuggioli
- Rheumatology Unit, School of Medicine, University of Modena & RE, Modena, Italy
| | - Vincenzo Raimondo
- Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy
| | - Massimo L'Andolina
- Rheumatology Outpatient Clinic, ASP-Vibo Valentia-Tropea Hospital, Tropea, Italy
| | - Antonio Tavoni
- Clinical Immunology Unit, University of Pisa, Pisa, Italy
| | | | | | - Francesco Ursini
- Rizzoli Orthopaedic Institute Bologna, University of Bologna, Bologna, Italy
| | - Maurizio Caminiti
- UOD Reumatologia, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | | | | | | | - Domenico Olivo
- Rheumatology Outpatient Clinic, San Giovanni di Dio Hospital, Crotone, Italy
| | - Michele Colaci
- Rheumatology Unit, University of Catania, Catania, Italy
| | - Giuseppe Murdaca
- Department of Internal Medicine, San Martino Policlinic Hospital, University of Genoa, Genoa, Italy
| | | | | | - Amelia Spinella
- Rheumatology Unit, School of Medicine, University of Modena & RE, Modena, Italy
| | | | - Vincenzo Aiello
- Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy
| | - Silvia Bilia
- Clinical Immunology Unit, University of Pisa, Pisa, Italy
| | | | | | - Rodolfo Caminiti
- Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy
| | - Veronica Brusi
- Rizzoli Orthopaedic Institute Bologna, University of Bologna, Bologna, Italy
| | - Riccardo Meliconi
- Rizzoli Orthopaedic Institute Bologna, University of Bologna, Bologna, Italy
| | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, School of Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Antonelli
- Department of Clinical and Experimental Medicine, Immuno-Endocrine Section of Internal Medicine, Laboratory of Primary Human Cells, School of Medicine, University of Pisa, Via Savi, 10, I-56126, Pisa, Italy.
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