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Sebastiani M, Manfredi A, Croci S, Faverio P, Cassone G, Vacchi C, Salvarani C, Luppi F. Rheumatoid arthritis extra-articular lung disease: new insights on pathogenesis and experimental drugs. Expert Opin Investig Drugs 2024:1-13. [PMID: 38967534 DOI: 10.1080/13543784.2024.2376567] [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: 12/31/2023] [Accepted: 07/02/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION Pulmonary involvement is one of the most common extra-articular manifestations of rheumatoid arthritis (RA), a systemic inflammatory disease characterized by joint swelling and tenderness. All lung compartments can be interested in the course of RA, including parenchyma, airways, and, more rarely, pleura and vasculature. AREAS COVERED The aim of this paper is to review the main RA lung manifestations, focusing on pathogenesis, clinical and therapeutic issues of RA-related interstitial lung disease (ILD). Despite an increasing number of studies in the last years, pathogenesis of RA-ILD remains largely debated and the treatment of RA patients with lung involvement is still challenging in these patients. EXPERT OPINION Management of RA-ILD is largely based on expert-opinion. Due to the broad clinical manifestations, including both joints and pulmonary involvement, multidisciplinary discussion, including rheumatologist and pulmonologist, is essential, not only for diagnosis, but also to evaluate the best therapeutic approach and follow-up. In fact, the coexistence of different lung manifestations may influence the treatment response and safety. The identification of biomarkers and risk-factors for an early identification of RA patients at risk of developing ILD remains a need that still needs to be fulfilled, and that will require further investigation in the next years.
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Affiliation(s)
- Marco Sebastiani
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Rheumatology Unit, AUSL Piacenza, Piacenza, Italy
| | - Andreina Manfredi
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paola Faverio
- Respiratory Disease Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giulia Cassone
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Vacchi
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Reggio Emilia, Italy
- Faculty of Medicine and Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabrizio Luppi
- Respiratory Disease Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Luo Y, Luo J, An P, Zhao Y, Zhao W, Fang Z, Xia Y, Zhu L, Xu T, Zhang X, Zhou S, Yang M, Li J, Zhu J, Liu Y, Li H, Gong M, Liu Y, Han J, Guo H, Zhang H, Jiang W, Ren F. The activator protein-1 complex governs a vascular degenerative transcriptional programme in smooth muscle cells to trigger aortic dissection and rupture. Eur Heart J 2024; 45:287-305. [PMID: 37992083 DOI: 10.1093/eurheartj/ehad534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/11/2023] [Accepted: 08/09/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND AND AIMS Stanford type A aortic dissection (AD) is a degenerative aortic remodelling disease marked by an exceedingly high mortality without effective pharmacologic therapies. Smooth muscle cells (SMCs) lining tunica media adopt a range of states, and their transformation from contractile to synthetic phenotypes fundamentally triggers AD. However, the underlying pathomechanisms governing this population shift and subsequent AD, particularly at distinct disease temporal stages, remain elusive. METHODS Ascending aortas from nine patients undergoing ascending aorta replacement and five individuals undergoing heart transplantation were subjected to single-cell RNA sequencing. The pathogenic targets governing the phenotypic switch of SMCs were identified by trajectory inference, functional scoring, single-cell regulatory network inference and clustering, regulon, and interactome analyses and confirmed using human ascending aortas, primary SMCs, and a β-aminopropionitrile monofumarate-induced AD model. RESULTS The transcriptional profiles of 93 397 cells revealed a dynamic temporal-specific phenotypic transition and marked elevation of the activator protein-1 (AP-1) complex, actively enabling synthetic SMC expansion. Mechanistically, tumour necrosis factor signalling enhanced AP-1 transcriptional activity by dampening mitochondrial oxidative phosphorylation (OXPHOS). Targeting this axis with the OXPHOS enhancer coenzyme Q10 or AP-1-specific inhibitor T-5224 impedes phenotypic transition and aortic degeneration while improving survival by 42.88% (58.3%-83.3% for coenzyme Q10 treatment), 150.15% (33.3%-83.3% for 2-week T-5224), and 175.38% (33.3%-91.7% for 3-week T-5224) in the β-aminopropionitrile monofumarate-induced AD model. CONCLUSIONS This cross-sectional compendium of cellular atlas of human ascending aortas during AD progression provides previously unappreciated insights into a transcriptional programme permitting aortic degeneration, highlighting a translational proof of concept for an anti-remodelling intervention as an attractive strategy to manage temporal-specific AD by modulating the tumour necrosis factor-OXPHOS-AP-1 axis.
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Affiliation(s)
- Yongting Luo
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Junjie Luo
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Peng An
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Yuanfei Zhao
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Wenting Zhao
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Zhou Fang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Yi Xia
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Lin Zhu
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Teng Xu
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Xu Zhang
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Shuaishuai Zhou
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Mingyan Yang
- Analytical Biosciences Limited, Beijing 100084, China
| | - Jiayao Li
- Analytical Biosciences Limited, Beijing 100084, China
| | - Junming Zhu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Yongmin Liu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Haiyang Li
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Ming Gong
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Yuyong Liu
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Jie Han
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Huiyuan Guo
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
| | - Hongjia Zhang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Wenjian Jiang
- Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
- Beijing Lab for Cardiovascular Precision Medicine, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100069, China
| | - Fazheng Ren
- Department of Nutrition and Health, Beijing Advanced Innovation Center for Food Nutrition and Human Health, No. 10 Tianxiu Road, Haidian District, China Agricultural University, Beijing 100193, China
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Gao AY, Diaz Espinosa AM, Gianì F, Pham TX, Carver CM, Aravamudhan A, Bartman CM, Ligresti G, Caporarello N, Schafer MJ, Haak AJ. Pim-1 kinase is a positive feedback regulator of the senescent lung fibroblast inflammatory secretome. Am J Physiol Lung Cell Mol Physiol 2022; 323:L685-L697. [PMID: 36223640 PMCID: PMC9744654 DOI: 10.1152/ajplung.00023.2022] [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: 01/19/2022] [Revised: 09/01/2022] [Accepted: 09/26/2022] [Indexed: 12/15/2022] Open
Abstract
Cellular senescence is emerging as a driver of idiopathic pulmonary fibrosis (IPF), a progressive and fatal disease with limited effective therapies. The senescence-associated secretory phenotype (SASP), involving the release of inflammatory cytokines and profibrotic growth factors by senescent cells, is thought to be a product of multiple cell types in IPF, including lung fibroblasts. NF-κB is a master regulator of the SASP, and its activity depends on the phosphorylation of p65/RelA. The purpose of this study was to assess the role of Pim-1 kinase as a driver of NF-κB-induced production of inflammatory cytokines from low-passage IPF fibroblast cultures displaying markers of senescence. Our results demonstrate that Pim-1 kinase phosphorylates p65/RelA, activating NF-κB activity and enhancing IL-6 production, which in turn amplifies the expression of PIM1, generating a positive feedback loop. In addition, targeting Pim-1 kinase with a small molecule inhibitor dramatically inhibited the expression of a broad array of cytokines and chemokines in IPF-derived fibroblasts. Furthermore, we provide evidence that Pim-1 overexpression in low-passage human lung fibroblasts is sufficient to drive premature senescence, in vitro. These findings highlight the therapeutic potential of targeting Pim-1 kinase to reprogram the secretome of senescent fibroblasts and halt IPF progression.
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Affiliation(s)
- Ashley Y Gao
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Ana M Diaz Espinosa
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Fiorenza Gianì
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Centel, Catania, Italy
| | - Tho X Pham
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Chase M Carver
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Aja Aravamudhan
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Colleen M Bartman
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Giovanni Ligresti
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Nunzia Caporarello
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
| | - Marissa J Schafer
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Andrew J Haak
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota
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Sivakumar P, Ammar R, Thompson JR, Luo Y, Streltsov D, Porteous M, McCoubrey C, Cantu E, Beers MF, Jarai G, Christie JD. Integrated plasma proteomics and lung transcriptomics reveal novel biomarkers in idiopathic pulmonary fibrosis. Respir Res 2021; 22:273. [PMID: 34689792 PMCID: PMC8543878 DOI: 10.1186/s12931-021-01860-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/09/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with a significant unmet medical need. Development of transformational therapies for IPF is challenging in part to due to lack of robust predictive biomarkers of prognosis and treatment response. Importantly, circulating biomarkers of IPF are limited and none are in clinical use. METHODS We previously reported dysregulated pathways and new disease biomarkers in advanced IPF through RNA sequencing of lung tissues from a cohort of transplant-stage IPF patients (n = 36) in comparison to normal healthy donors (n = 19) and patients with acute lung injury (n = 11). Here we performed proteomic profiling of matching plasma samples from these cohorts through the Somascan-1300 SomaLogics platform. RESULTS Comparative analyses of lung transcriptomic and plasma proteomic signatures identified a set of 34 differentially expressed analytes (fold change (FC) ≥ ± 1.5, false discovery ratio (FDR) ≤ 0.1) in IPF samples compared to healthy controls. IPF samples showed strong enrichment of chemotaxis, tumor infiltration and mast cell migration pathways and downregulated extracellular matrix (ECM) degradation. Mucosal (CCL25 and CCL28) and Th2 (CCL17 and CCL22) chemokines were markedly upregulated in IPF and highly correlated within the subjects. The mast cell maturation chemokine, CXCL12, was also upregulated in IPF plasma (fold change 1.92, FDR 0.006) and significantly correlated (Pearson r = - 0.38, p = 0.022) to lung function (%predicted FVC), with a concomitant increase in the mast cell Tryptase, TPSB2. Markers of collagen III and VI degradation (C3M and C6M) were significantly downregulated (C3M p < 0.001 and C6M p < 0.0001 IPF vs control) and correlated, Pearson r = 0.77) in advanced IPF consistent with altered ECM homeostasis. CONCLUSIONS Our study identifies a panel of tissue and circulating biomarkers with clinical utility in IPF that can be validated in future studies across larger cohorts.
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Affiliation(s)
- Pitchumani Sivakumar
- grid.419971.30000 0004 0374 8313Translational Early Development, Bristol-Myers Squibb Research and Development, 3551 Lawrenceville Road, Princeton, NJ 08540 USA
| | - Ron Ammar
- grid.419971.30000 0004 0374 8313Informatics and Predictive Sciences, Bristol-Myers Squibb Research and Development, Princeton, NJ USA
| | - John Ryan Thompson
- grid.419971.30000 0004 0374 8313Informatics and Predictive Sciences, Bristol-Myers Squibb Research and Development, Princeton, NJ USA
| | - Yi Luo
- grid.419971.30000 0004 0374 8313Translational Medicine, Bristol-Myers Squibb Research and Development, Princeton, NJ USA
| | - Denis Streltsov
- grid.419971.30000 0004 0374 8313Fibrosis Discovery Biology, Bristol-Myers Squibb Research and Development, Princeton, NJ USA
| | - Mary Porteous
- grid.25879.310000 0004 1936 8972Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Carly McCoubrey
- grid.25879.310000 0004 1936 8972Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Edward Cantu
- grid.25879.310000 0004 1936 8972Department of Surgery, Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, PA USA
| | - Michael F. Beers
- grid.25879.310000 0004 1936 8972Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972PENN Lung Biology Institute, University of Pennsylvania, Philadelphia, PA USA
| | - Gabor Jarai
- grid.419971.30000 0004 0374 8313Fibrosis Discovery Biology, Bristol-Myers Squibb Research and Development, Princeton, NJ USA
| | - Jason D. Christie
- grid.25879.310000 0004 1936 8972Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972PENN Lung Biology Institute, University of Pennsylvania, Philadelphia, PA USA
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