Jinping Chen, Zongda Cai, Shurong Huang, Yangqiang Wang, Shiyang Zhan, Wei Zheng, Pan Chi
{"title":"AQP9 weakens the cytotoxicity of CD8<sup>+</sup> T cells in colon adenocarcinoma by boosting M2 polarization of macrophages under hypoxia conditions.","authors":"Jinping Chen, Zongda Cai, Shurong Huang, Yangqiang Wang, Shiyang Zhan, Wei Zheng, Pan Chi","doi":"10.1080/1744666X.2025.2501718","DOIUrl":"10.1080/1744666X.2025.2501718","url":null,"abstract":"<p><strong>Background: </strong>Colon adenocarcinoma (COAD) is a leading cause of cancer mortality, with Aquaporin 9 (AQP9) implicated in its progression. M2 macrophages in the tumor microenvironment (TME) promote cancer metastasis, but the role of AQP9 on M2 macrophages remains unelucidated.</p><p><strong>Research design and methods: </strong>Using COAD cell lines, AQP9 expression was analyzed via RT-qPCR and Western blot (WB). Hypoxic conditions were simulated to assess HIF-1α and AQP9 interactions through ChIP and dual-luciferase assays. AQP9 knockdown effects on proliferation/migration were tested via colony formation and wound healing. M2 macrophage polarization and CD8+ T cell cytotoxicity were evaluated using flow cytometry, ELISA, and IHC in co-culture systems.</p><p><strong>Results: </strong>AQP9 was upregulated in COAD and correlated with poor prognosis. After AQP9 in COAD cells was knocked down, the abilities of tumor cells to migrate and proliferate were dampened. Hypoxia upregulated HIF-1α, which transcriptionally activated AQP9. Knocking down AQP9 repressed the M2 polarization of macrophages, thereby reinforcing the cytotoxicity of CD8<sup>+</sup> T cells. No adverse events were reported <i>in vitro</i>.</p><p><strong>Conclusion: </strong>AQP9 promotes COAD progression by driving HIF-1α-mediated M2 polarization, impairing CD8+ T cell function. Key limitations include the lack of <i>in vivo</i> validation and clinical cohort analysis.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"803-814"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Glucocorticoid in systemic lupus erythematosus: the art beyond science.","authors":"Tsz Ching Mok, Chi Chiu Mok","doi":"10.1080/1744666X.2025.2494654","DOIUrl":"10.1080/1744666X.2025.2494654","url":null,"abstract":"<p><strong>Introduction: </strong>Glucocorticoid (GC) remains the main stay of treatment for systemic lupus erythematosus (SLE) but is associated with a myriad of untoward effects. On the other hand, withdrawal of maintenance immunosuppression, including low-dose GCs, carries a risk of SLE flare.</p><p><strong>Areas covered: </strong>The molecular mechanisms of GCs and their implications for dosing strategies in clinical practice are discussed. Evidence regarding withdrawal of maintenance immunosuppression in SLE is reviewed.</p><p><strong>Expert opinions: </strong>The initial GC regimens for different manifestations of SLE are heterogeneous, with no major randomized controlled trials (RCTs) on their efficacy and toxicities available. RCTs on withdrawal of immunosuppressive drugs in quiescent SLE are inconsistent but appear to show an increase in disease flares, with risk factors being younger age, renal disease, cessation of hydroxychloroquine, shorter duration of remission, serological activity, and an abrupt tapering regime. The lowest effective doses of GC and immunosuppressive drugs should be adopted, and the decision to withdraw immunosuppression should be individualized. Newer strategies for GC sparing, including combination therapy of immunosuppressive and biological/targeted agents, and the use of methylprednisolone pulses for initial therapy of less serious manifestations of SLE, could ameliorate the toxicities of immunosuppression and help advance to the ultimate target of drug-free remission.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"543-553"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MennaAllah Mohamed Ali Elmalla, Hanaa Ahmad Samy Elbanna, Manal Shawky Hussein Sayed Ahmed, Amira Mohamed El Sharkawy
{"title":"Prevalence of peripheral neuropathy in Egyptian psoriatic arthritis patients and its correlation with disease activity.","authors":"MennaAllah Mohamed Ali Elmalla, Hanaa Ahmad Samy Elbanna, Manal Shawky Hussein Sayed Ahmed, Amira Mohamed El Sharkawy","doi":"10.1080/1744666X.2025.2495170","DOIUrl":"10.1080/1744666X.2025.2495170","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral neuropathy (PN) may arise from various etiologies, including immune-mediated diseases. This study aimed to detect the prevalence and clinical determinants of PN in psoriatic arthritis (PsA) patients, with or without skin lesions, and to evaluate its correlation with disease activity.</p><p><strong>Research design and methods: </strong>This cross-sectional study included 60 PsA patients and 60 apparently healthy controls. Neuropathic pain was evaluated using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) score, while PN was assessed through the Michigan Neuropathy Screening Instrument (MNSI), in conjunction with electrophysiological assessment.</p><p><strong>Results: </strong>The LANSS score demonstrated the capability to predict neuropathic pain in PsA patients with a sensitivity of 93.89% and specificity of 83.33%. Furthermore, the MNSI Questionnaire score revealed a sensitivity of 91.67% and specificity of 77.78% in predicting PN among PsA patients. Carpal tunnel syndrome represented the most prevalent neuropathy identified in 36% of PsA patients, followed by peripheral polyneuropathy in 6% and ulnar neuropathy in 4%.</p><p><strong>Conclusions: </strong>Patients with PsA have higher prevalence of neuropathy, particularly carpal tunnel syndrome, which negatively impacts pain perception, functional capability, and quality of life, particularly in those with higher disease activity suggesting potential association between inflammation and neurological dysfunction.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"659-665"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dandan Fang, Jiajia Wang, Jingyun Li, Luo Zhang, Yuan Zhang
{"title":"Individual differences in response to dust-mite-allergen specific immunotherapy in allergic rhinitis: a meta-analysis of randomized controlled trials.","authors":"Dandan Fang, Jiajia Wang, Jingyun Li, Luo Zhang, Yuan Zhang","doi":"10.1080/1744666X.2025.2499596","DOIUrl":"10.1080/1744666X.2025.2499596","url":null,"abstract":"<p><strong>Introduction: </strong>The variability in the efficacy of allergen-specific immunotherapy (AIT) for nasal symptom control can be attributed to individual differences, to explore the hypothesis of systematic variability in AR symptom alleviation with AIT and to determine whether this variability correlates with AR severity, route of administration, treatment duration, age, or study publication year.</p><p><strong>Methods: </strong>We reviewed randomized controlled trials (RCTs) of AIT for dust mite (DM)-induced AR, extracting data on baseline mean, endpoint mean, standard deviation (SD), and participant numbers. A random-slope mixed-effects model (RSMM) was employed to evaluate the differences in variability between the AIT and control groups, as well as to identify potential influencing factors.</p><p><strong>Results: </strong>There was no significant difference in response variability between the AIT and control groups. The response variability to AIT was not associated with AR severity, route of administration, age, or year of publication. The cohort that underwent 36 months of AIT exhibited a higher degree of response variability compared to the group treated for 6 months.</p><p><strong>Conclusion: </strong>The present study did not identify systematic variability in individual response to AIT when measured by TNSS alone. More refined outcome measures and more associated factors are needed to explore personalized AIT in the future.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"617-626"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Targeting the ubiquitin-proteasome pathway in systemic lupus erythematosus.","authors":"Chi Chiu Mok","doi":"10.1080/1744666X.2025.2497845","DOIUrl":"10.1080/1744666X.2025.2497845","url":null,"abstract":"<p><strong>Introduction: </strong>The ubiquitin-proteasome system (UPS) is the major non-lysosomal mechanism for selective degradation of intracellular proteins that is essential for the regulation of cellular functions and survival. Modulation of the proteasomes and cereblon E3 ligase promotes degradation of polyubiquitin-tagged transcription factors and oncoproteins, leading to depletion of long-lived plasma cells, diminished autoantibody and interferon-α production, reduced T-cell polarization to the proinflammatory phenotypes and increased regulatory T-cell activity that are relevant to the therapy of systemic lupus erythematosus (SLE).</p><p><strong>Areas covered: </strong>Selective immunoproteasome inhibitors and newer generation cereblon modulators have improved safety profiles compared to conventional compounds. This article summarizes the literature regarding the modulation of the UPS in murine and human SLE.</p><p><strong>Expert opinion: </strong>Bortezomib and the selective immunoproteasome inhibitors, ONX-0914 and zetomipzomib, ameliorate renal disease in murine lupus models. While clinically effective in refractory SLE, bortezomib is limited by its toxicities. Zetomipzomib shows promising data in phase Ib/II studies of SLE and lupus nephritis. Thalidomide and lenalidomide are effective in refractory cutaneous lupus but again limited by their off-target effects. A phase II RCT of iberdomide shows favorable results in SLE, especially chronic and subacute cutaneous lesions. These molecules should be further explored in larger clinical trials of renal and cutaneous SLE.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"531-542"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Induction of aquaporins by plasma of patients with systemic lupus erythematosus.","authors":"Hussein Baharlooi, Samaneh Enayati, Nooshin Ahmadzadeh, Elham Madreseh, Seyedeh Tahereh Faezi, Majid Alikhani, Ahmadreza Jamshidi, Mahdi Mahmoudi, Elham Farhadi","doi":"10.1080/1744666X.2025.2497841","DOIUrl":"10.1080/1744666X.2025.2497841","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus is a chronic, multisystemic, inflammatory disease. Aquaporins, a group of transmembrane channels, are known to help prime immune cells and their migration. In this study, a qRT-PCR analysis was performed to identify aquaporins whose expression in SLE patients was associated with the inflammatory profile of B cells.</p><p><strong>Methods: </strong>A stable and healthy line of B cells was cultured and subjected to plasma obtained from SLE patients or healthy individuals for 1 week. Subsequently, gene expression was assessed using real-time PCR.</p><p><strong>Results: </strong>The findings showed that B cells treated with SLE plasma had different expression profiles of inflammatory genes, including TNF-α, IFN-γ, CD40, TNFSF13B, and TNFRSF13C. The study also revealed abnormal expression patterns of aquaporins (AQP3, AQP6, AQP8, and AQP9) in the SLE-treated group. Among the genes, AQP3, AQP6, AQP8, AQP9, and AQP11 were differently correlated with the inflammatory phenotype of B cells. These genes may play a role in the pathogenesis of SLE by affecting B cell proliferation, regulation, inflammation, and cytokine processing.</p><p><strong>Conclusions: </strong>The findings suggest that plasma of SLE patients can induce the inflammatory phenotype of B lymphocytes and the expression of key aquaporin genes, which could impact the development of SLE.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"651-658"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth R Volkmann, Donald P Tashkin, Vanessa Smith
{"title":"Re-envisioning clinical trial design in systemic sclerosis.","authors":"Elizabeth R Volkmann, Donald P Tashkin, Vanessa Smith","doi":"10.1080/1744666X.2025.2500612","DOIUrl":"10.1080/1744666X.2025.2500612","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic sclerosis (SSc) is a progressive autoimmune rheumatic disease with high morbidity and mortality and few effective treatment options. Increased biopharmaceutical investment in therapeutic development for rare diseases has created new opportunities for drug discovery in SSc. However, despite the increased pipeline activity in SSc, success rates remain dismally low.</p><p><strong>Areas covered: </strong>This review describes the current state of therapeutic development in SSc with an in-depth coverage of cohort enrichment strategies, as well as a discussion of relevant ethical and feasibility concerns. This review also highlights lessons learned from phase 3 trials in SSc published within the last 5 years in PubMed, underscoring the impact of background therapy on SSc disease course during the trial period. Emerging clinical trial formats and endpoints are also explored.</p><p><strong>Expert opinion: </strong>The authors present recommendations to innovate clinical trial design in SSc, which integrate evidence from recent clinical trial and observational cohort studies in SSc. With a focus on the use of external control arms, the application of adaptive trial design and the development of global disease activity measures, the authors outline practical and ethical solutions to design precise and efficient trials in SSc with a higher probability of success.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"555-565"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"NF-κB pathway variants in Iranian patients with inborn errors of immunity.","authors":"Nazanin Fathi, Hassan Abolhassani, Fereshte Salami, Tannaz Moeini Shad, Samaneh Delavari, Reza Yazdani, Arash Kalantari, Sareh Sadat Ebrahimi, Nasrin Beniafard, Seyed Alireza Mahdaviani, Nima Rezaei","doi":"10.1080/1744666X.2025.2500608","DOIUrl":"10.1080/1744666X.2025.2500608","url":null,"abstract":"<p><strong>Background: </strong>Clinical and immunological manifestations associated with genetic alterations are crucial for understanding inborn errors of immunity (IEI). This study aims to characterize the clinical and immunological profiles and provide the molecular features of IEI patients from the Iranian population with IEI who harbor rare variants in the nuclear factor kappa B (NF-κB) pathway.</p><p><strong>Research design and methods: </strong>Peripheral blood mononuclear cells (PBMCs) were used for immunophenotyping of B and T lymphocyte subsets via flow cytometry and for assessing T cell proliferation. Immunoblotting was performed to evaluate the expression levels of NF-κB proteins.</p><p><strong>Results: </strong>This multi-center study enrolled 16 patients with mutations in the NFKB1, NFKB2, IKBKB, and IKBKG genes. NFKB1 and NFKB2 mutations were heterozygous, while IKBKB mutations were homozygous, and the IKBKG mutation was hemizygous. Patients exhibited hypogammaglobulinemia and switched memory B cell abnormalities. Immunoblotting revealed decreased NF-κB1 protein expression in most cases. Similarly, NFKB2 mutations led to lower protein expression in unstimulated PBMCs, with mild to strong reductions after stimulation, though some cases showed no significant changes.</p><p><strong>Conclusions: </strong>This study identifies novel IEI cases associated with NF-κB pathway defects. Further comprehensive evaluation and functional analysis of these mutations are warranted to confirm their impact on disease manifestation.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"667-681"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly G Gwathmey, Catherine M Broome, Matthias Goebeler, Hiroyuki Murai, Zsuzsanna Bata-Csörgo, Adrian C Newland, Jeffrey A Allen, Yoshitaka Miyakawa, Peter Ulrichts, Luc Truyen, Jana Podhorna, Rene Kerstens, Sophie Steeland, Jon Beauchamp, Jeffrey T Guptill, James F Howard
{"title":"Safety profile of efgartigimod from global clinical trials across multiple immunoglobulin G-mediated autoimmune diseases.","authors":"Kelly G Gwathmey, Catherine M Broome, Matthias Goebeler, Hiroyuki Murai, Zsuzsanna Bata-Csörgo, Adrian C Newland, Jeffrey A Allen, Yoshitaka Miyakawa, Peter Ulrichts, Luc Truyen, Jana Podhorna, Rene Kerstens, Sophie Steeland, Jon Beauchamp, Jeffrey T Guptill, James F Howard","doi":"10.1080/1744666X.2025.2497840","DOIUrl":"10.1080/1744666X.2025.2497840","url":null,"abstract":"<p><strong>Background: </strong>Efgartigimod is approved in multiple regions for the treatment of gMG, ITP, and CIDP, and is being evaluated in multiple IgG-mediated autoimmune diseases. Here, we report the long-term safety profiles of efgartigimod IV and PH20 SC across different dosing regimens and diseases where efgartigimod has received regulatory approval.</p><p><strong>Research design and methods: </strong>Efgartigimod safety was assessed across dosing regimens and administration routes in Phase 2, placebo-controlled Phase 3, and OLE studies in participants with gMG, ITP, and CIDP. Analyses were performed on all participants who received ≥ 1 dose or partial dose of efgartigimod or placebo. Data from efgartigimod-treated participants were pooled per disease. Event rates were calculated as events per PYFU.</p><p><strong>Results: </strong>Pooled data included 715 participants representing > 850 PYFU. In efgartigimod-treated participants, most TEAEs were mild-to-moderate in severity, with consistently low event rates for TEAE-related treatment discontinuation (range: 0.05-0.47). Severe and serious infection rates were comparable between placebo- and efgartigimod-treated participants. Rates of TEAEs, severe and serious infections, and treatment discontinuation did not increase with prolonged efgartigimod exposure. Efgartigimod did not reduce albumin or increase LDL cholesterol levels.</p><p><strong>Conclusions: </strong>Across clinical trials in IgG-mediated autoimmune diseases, efgartigimod was well tolerated with similar safety profiles regardless of dosing regimen.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"627-638"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The therapeutic effect of mRNA vaccines in glioma: a comprehensive review.","authors":"Fatemeh Afrashteh, Simin Seyedpour, Nima Rezaei","doi":"10.1080/1744666X.2025.2494656","DOIUrl":"10.1080/1744666X.2025.2494656","url":null,"abstract":"<p><strong>Introduction: </strong>Glioma is the most common primary brain tumor, with glioblastoma being the most lethal type due to its heterogeneous and invasive nature of the cancer. Current therapies have low curative success and are limited to surgery, radiotherapy, and chemotherapy. More than 50% of patients become resistant to chemotherapy, and tumor recurrence occurs in most patients following an initial course of therapy. Therefore, developing novel, effective strategies for glioma treatment is essential. Cancer vaccines are novel therapies that demonstrate advantages over conventional methods and, therefore, may be promising options for treating glioma.</p><p><strong>Areas covered: </strong>This article provided a critical review of pre-clinical and clinical studies that explored appropriate tumor antigen candidates for developing mRNA vaccines and discussed their clinical application in glioma patients. Medline database, PubMed, and ClinicalTrials.gov were searched for glioma vaccine studies published before 2025 using related keywords.</p><p><strong>Expert opinion: </strong>mRNA vaccines are promising strategies for treating glioma because they are efficient, cost-beneficial, and have lower side effects than other types such as peptide or DNA-based vaccines.</p>","PeriodicalId":12175,"journal":{"name":"Expert Review of Clinical Immunology","volume":" ","pages":"603-615"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}