Immunology letters最新文献

{"title":"Establishing a system to identify correlations among immune system components for exploring alternative pathways for immune information transfer.","authors":"Yaron Ilan","doi":"10.1016/j.imlet.2025.107085","DOIUrl":"https://doi.org/10.1016/j.imlet.2025.107085","url":null,"abstract":"<p><strong>Introduction: </strong>The classic immune system information transfer occurs through direct cell-to-cell contact and the secretion of mediators. However, certain immune phenomena suggest alternative pathways exist between immune components that operate independently of these conventional mechanisms.</p><p><strong>Methods: </strong>We used 24 male C57Bl/6J mice, divided into six groups, to establish a system for testing alternative immune information transfer pathways. Two triggers-splenectomy and 24-hour fasting-were applied in various combinations. Splenocytes were prepared from operated mice and placed in sterile tubes within cages of different treatment groups. Ex vivo lymphocyte responses were measured using fluorescence-activated cell sorting (FACS) for cell epitope expression (CD4, CD8, CD25, Foxp3) and enzyme-linked immunosorbent assay (ELISA) for cytokine secretion (IFN-γ, TNF-α, IL-10, TGF-β).</p><p><strong>Results: </strong>Significant changes were observed in CD25 and CD8+CD25 expression, as well as in IL-10 secretion, following the application of the triggers. The system exhibited inherent variability with trends toward altered immune responses in isolated splenocytes that had no direct contact with the trigger-exposed animals. Non-parametric analysis indicates a trend for these markers, even though there is significant variability within the groups..</p><p><strong>Conclusions: </strong>The data suggest a system where correlations between immune components may occur through alternative pathways, indicating the possibility of non-conventional information transfer mechanisms in the immune system that require further investigation.</p>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":" ","pages":"107085"},"PeriodicalIF":2.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B cell dysregulation during acute COVID-19 is transient.","authors":"Jokiranta Suvi T, Nguyen Ngoc Anh, Huang Xiaobo, Nowlan Kirsten, Hannolainen Leo, Pyöriä Lari, Pekkarinen Pirkka T, Dürnsteiner Pia, Lääveri Tinja, Heikkilä Nelli, Heinonen Santtu, Laakso Sini M, Kantele Anu, Vapalahti Olli, Strandin Tomas, Hepojoki Jussi, Perdomo Maria F, Kekäläinen Eliisa","doi":"10.1016/j.imlet.2025.107086","DOIUrl":"https://doi.org/10.1016/j.imlet.2025.107086","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is still a significant health concern worldwide. B cell responses to COVID-19 have been extensively studied in acute severe disease, but less so during extended follow-up or mild disease. Persisting immunological changes together with herpesvirus reactivations during acute COVID-19 have been suggested as contributing factors for post-acute sequelae of COVID-19 (PASC). Here, we evaluated the natural kinetics of B cell subpopulations together with serological markers of increased B cell activity during acute COVID-19 and long-term follow-up. We also measured human herpesvirus reactivations during acute COVID-19.</p><p><strong>Methods: </strong>We collected plasma and peripheral blood mononuclear cell samples from 120 SARS-CoV-2 positive patients (outpatients = 56, inpatients = 64) at up to five timepoints during acute disease and recovery (up to 460 days since symptom onset, dsso). We determined circulating B cell and Th cell subpopulations using flow cytometry, and measured free light chains, in addition to Epstein-Barr virus (EBV) serology, and herpesvirus qPCR from the plasma samples. The presence of anosmia as a proxy for PASC was self-reported at 3-12 months post-COVID.</p><p><strong>Results: </strong>All changes in B cell subpopulation proportions normalized within 200 dsso. Likewise, the acute alterations observed in circulating T follicular helper and T follicular regulatory cell proportions stabilized soon after. Free light chains were high in acute COVID-19, especially in inpatients, but normalized during follow-up. EBV and human herpesvirus 6B (HHV-6B) reactivations were significantly more common in inpatients than outpatients, with reactivation in 47 and 19% of inpatients and 4.3 and 0% of outpatients respectively. Anosmia was not significantly associated with any herpesvirus reactivation.</p><p><strong>Conclusions: </strong>The circulating B cell and Th cell subpopulations experience transitional changes during SARS-CoV-2 infection, but these changes recover in follow-up. EBV and HHV-6B reactivations are common in inpatients, but they are not associated with persisting anosmia.</p>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":" ","pages":"107086"},"PeriodicalIF":2.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of BCG Vaccination at Birth in Pediatric Patients with Chronic Granulomatous Disease after Hematopoietic Stem Cell Transplantation in Developing Countries.","authors":"Amir Ali Hamidieh, Maryam Behfar, Negar Nejati, Sadaf Setareh Azar, Mohammad Taha Salmanifard, Romana Malik, Homa Kashani, Rashin Mohseni, Leila Jafari","doi":"10.1016/j.imlet.2025.107083","DOIUrl":"https://doi.org/10.1016/j.imlet.2025.107083","url":null,"abstract":"<p><strong>Introduction: </strong>Recent advances in hematopoietic stem cell transplantation (HSCT) have improved clinical outcomes; however, various factors continue to influence HSCT success, especially vaccination in immunocompromised patients who receive vaccination at birth. While several studies have investigated the efficacy of vaccines in Chronic Granulomatous Disease (CGD) patients, the specific impact of vaccination on HSCT outcomes in these patients has not yet been studied. This study aimed to address an important gap in the current literature by investigating the effects of BCG vaccination on HSCT outcomes in patients with CGD.</p><p><strong>Participants and methods: </strong>In this prospective study, 24 pediatric patients with CGD were enrolled from 2016 to 2022, all of whom received the same reduced-intensity conditioning (RIC) regimen before HSCT. Of these, 12 patients received the Bacillus Calmette-Guérin (BCG) vaccine, while 14 patients were not vaccinated.</p><p><strong>Results: </strong>Contrary to other studies, our results showed that CGD patients who received the BCG vaccine before HSCT experienced varying degrees of BCGosis and BCGitis. Specifically, 8 patients showed symptoms of BCGosis, while 4 patients showed symptoms of BCGitis. In addition, our findings revealed no significant differences in graft-versus-host disease (GvHD) and other complications of HSCT between BCG-vaccinated and non-BCG-vaccinated CGD patients, although the overall survival (OS) rate was lower in the vaccinated group. This may be attributed to the reduced-intensity conditioning regimen applied to all patients which can balance HSCT outcome in CGD patients.</p><p><strong>Discussion and conclusion: </strong>Our study emphasizes the importance of screening and diagnosing immunodeficient patients at birth, especially in developing countries where BCG vaccine is administered at birth, as post- vaccination complications can significantly affect HSCT outcomes and subsequent treatments. BCG vaccination can significantly affect HSCT outcomes and subsequent treatments.</p>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":" ","pages":"107083"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B cells in inflammatory bowel disease","authors":"Francisca A. Castillo ,&nbsp;Bianca C. Kern ,&nbsp;Eduardo J. Villablanca","doi":"10.1016/j.imlet.2025.107071","DOIUrl":"10.1016/j.imlet.2025.107071","url":null,"abstract":"<div><div>Inflammatory bowel diseases (IBD) have traditionally been considered T cell-driven disorders; however, accumulating evidence challenges this view and underscores a critical, multifaceted role for B cells in the pathogenesis of chronic intestinal inflammation. In the healthy gut, B cells contribute to immune tolerance and mucosal protection primarily through the production of secretory IgA and the regulation of the microbiota. During IBD, the B cell compartment is markedly altered, characterized by increased infiltration of IgA and IgG-secreting PCs, altered humoral responses against gut microbiota and self-antigens, the formation of tertiary lymphoid structures and the emergence of pro-inflammatory subsets such as interferon-induced Sca1⁺PD-L1⁺ B cells. Experimental models have demonstrated both pathogenic and regulatory roles for B cells, which may explain the limited efficacy of pan-B cell depleting therapies, such as rituximab, in clinical settings. This review highlights the evolving landscape of B cell biology in IBD, emphasizing the need for selective therapeutic approaches that distinguish between protective and pathogenic B cells. A deeper understanding of the spatial, phenotypic, and temporal dynamics of intestinal B cell subsets may facilitate the development of precise immunotherapies in IBD.</div></div>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":"277 ","pages":"Article 107071"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sepsis as a complex syndrome: Are combined biomarkers the future of diagnosis and prognosis? Clinical perspective","authors":"R. Gaderparnah ,&nbsp;F. van Beuningen ,&nbsp;Y. Lin ,&nbsp;S.H. Sadrian ,&nbsp;H.M. Reijneveld ,&nbsp;H. Krabbe ,&nbsp;P. Jonkheijm ,&nbsp;H.R. Bouma ,&nbsp;R.T. Mankowski","doi":"10.1016/j.imlet.2025.107072","DOIUrl":"10.1016/j.imlet.2025.107072","url":null,"abstract":"<div><div>Sepsis remains a major cause of mortality worldwide, driven by a dysregulated host response to infection that leads to life-threatening organ dysfunction. Despite advances in evidence-based medicine, early diagnosis and risk stratification remain significant challenges due to the complex, multifaceted nature of sepsis and substantial interindividual variability in clinical presentation. Current approaches relying on single biomarkers cannot provide comprehensive insights into disease progression, limiting their clinical utility in guiding timely and effective interventions. Given the limitations of current single biomarkers in capturing the complexity of sepsis, there is an urgent need for improved diagnostic approaches. While the discovery of novel biomarkers remains important, combining existing biomarkers may offer a pragmatic and effective strategy to improve diagnostic accuracy by leveraging the strengths of each to compensate for the limitations of other. In this clinical perspective, we highlight the potential of such combined biomarker strategies to enhance diagnostic accuracy, support identification of the infection source, and improve prognostic assessment across the clinical course and into long-term outcomes. We provide examples of key biomarkers and their synergistic potential, emphasizing the need for advanced analytical methods such as machine learning and multi-omics integration to enhance predictive accuracy. Shifting toward multi-component biomarker panels represents a critical step toward a more precise, personalized approach to sepsis management to reduce sepsis-related morbidity and mortality. We advocate for further research and validation efforts to facilitate the clinical implementation of combined biomarker models, ultimately transforming sepsis care.</div></div>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":"277 ","pages":"Article 107072"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Antibodies to expanded virus antigen panels show elevated diagnostic sensitivities in multiple sclerosis and optic neuritis” [Immunol. Lett. 254 (2023) 54–64]","authors":"Helena Gåsland ,&nbsp;Nicole H Trier ,&nbsp;Cecilie Kyllesbech ,&nbsp;Anette H Draborg ,&nbsp;Rimantas Slibinskas ,&nbsp;Evaldas Ciplys ,&nbsp;Danguolė Žiogienė ,&nbsp;Alma Gedvilaitė ,&nbsp;Rasa Petraitytė-Burneikienė ,&nbsp;Jette L Frederiksen ,&nbsp;Gunnar Houen","doi":"10.1016/j.imlet.2025.107067","DOIUrl":"10.1016/j.imlet.2025.107067","url":null,"abstract":"","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":"276 ","pages":"Article 107067"},"PeriodicalIF":2.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ELF3 promotes the development of psoriasis through transcriptional up-regulation of ADAM8 expression","authors":"Yu Zhang ,&nbsp;Nannan Tong ,&nbsp;Siyu Hao ,&nbsp;He Ma ,&nbsp;Yuzhen Li","doi":"10.1016/j.imlet.2025.107069","DOIUrl":"10.1016/j.imlet.2025.107069","url":null,"abstract":"<div><div>Psoriasis is a systemic inflammatory disorder that has a significant impact on the quality of life of patients. E74-like factor 3 (ELF3) is a common transcriptional mediator of inflammation, but the effect of ELF3 on psoriasis development and severity is poorly understood. In this study, we first collected clinical normal skin tissues and skin tissues of psoriasis patients to detect the mRNA and protein levels of ELF3 and found that ELF3 was highly expressed in psoriasis skin tissues. We further used the imiquimod (IMQ)-induced mice model to mimic the phenotypic changes of human psoriasis <em>in vivo</em>, which are manifested as scaling, epidermal hyperplasia, and erythema formation, but knockdown of ELF3 resulted in suppression of these phenomena. In addition, downregulation of ELF3 expression inhibited neoangiogenesis and inflammatory cell infiltration. On this basis, we further found that ELF3 promotes the proliferation, angiogenesis, and inflammatory response of human keratinocyte HaCaT <em>in vitro</em>. Mechanistically, we found that ELF3 transcriptionally activated the activity of the downstream factor ADAM metallopeptidase domain 8 (ADAM8) by dual luciferase assays, thereby exacerbating the severity of psoriasis. We concluded that ELF3 is a key target for exacerbating psoriasis pathologic manifestations and promoting disease progression.</div></div>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":"277 ","pages":"Article 107069"},"PeriodicalIF":2.8,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic syndrome and inborn errors of immunity: A plausible connection","authors":"Mohit,&nbsp;Sheetal Verma,&nbsp;Vijay Laxmi,&nbsp;Jayhind Maury","doi":"10.1016/j.imlet.2025.107068","DOIUrl":"10.1016/j.imlet.2025.107068","url":null,"abstract":"<div><div>Inborn errors of immunity (IEI), traditionally known as primary immunodeficiencies, are genetically driven disorders that impair immune function. Emerging evidence suggests a strong connection between IEI and metabolic syndrome, including obesity, insulin resistance, and cardiovascular diseases, highlighting the complex interplay between immune and metabolic pathways. This review focuses on how changes in key immune regulatory genes can lead to both immune dysfunction and metabolic problems. Genome Wide Association Studies (GWAS) and Next Generation Sequencing (NGS) have identified numerous genetic variants that link immune and metabolic dysregulation. Both immune system dysfunction and metabolic imbalances are associated with mutations in several key genes such as STAT3, NLRP3, and FOXP3. Pharmacological interventions targeting inflammatory pathways, such as cytokine inhibitors and inflammasome modulators, offer promising therapeutic strategies to address both aspects of these intertwined conditions. Moreover, lifestyle modifications, including anti-inflammatory diets and physical activity, are essential components of a comprehensive approach to mitigate inflammation and improve metabolic outcomes. Advances in genomic profiling drive precision medicine, enabling the tailoring of treatments based on individual genetic variants, optimizing therapy for both immune and metabolic dysfunction. Personalized risk assessments incorporating genetic data further refine preventive strategies for metabolic syndrome. This cited approach underscores the importance of a holistic, integrated approach to unraveling the shared mechanisms of immune and metabolic dysregulation, offering insights into novel diagnostic and therapeutic strategies for these multifactorial disorders.</div></div>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":"276 ","pages":"Article 107068"},"PeriodicalIF":2.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schizophrenia-associated complement component C4 induces maturation and reactivity in human astrocytes","authors":"Isabella de Sousa Nóbrega,&nbsp;Melissa Bernardini Bachir Moysés,&nbsp;Bruno Yukio Yokota-Moreno,&nbsp;Guilherme Grecco Ferreira,&nbsp;Guilherme Martelossi Cebinelli,&nbsp;Andréa Laurato Sertié","doi":"10.1016/j.imlet.2025.107065","DOIUrl":"10.1016/j.imlet.2025.107065","url":null,"abstract":"<div><div>Beyond its canonical role in innate immunity, the complement system (CS) has been increasingly implicated in brain development and disease. Elevated expression of complement component C4, in particular, is strongly associated with an increased risk of schizophrenia (SCZ), potentially by promoting excessive synaptic pruning. Astrocytes, the primary producers of CS components in the brain and expressers of multiple CS receptors, play crucial roles in synaptic formation and refinement. Dysregulated C4 levels may therefore impair astrocyte function, disrupt synaptic development, and contribute to SCZ pathogenesis. In this study, we investigated the direct effects of exogenous C4 on astrocyte differentiation, maturation, and reactivity using human induced pluripotent stem cell (hiPSC)-derived astrocytes. Astrocytes were treated with recombinant human C4 protein either chronically during differentiation or acutely after maturation. While chronic C4 exposure did not significantly affect astrocyte differentiation, both treatment regimens induced phenotypic features of astrocyte maturation and reactivity. These included upregulation of reactive astrocyte markers (CD44 and GFAP), morphological changes consistent with mature and reactive states, and nuclear translocation of NF-κB. Mechanistically, these effects may be mediated, at least in part, by activation of the MAPK/ERK pathway and suppression of mTORC1 signaling. Together, our findings suggest that elevated C4 levels promote astrocyte maturation and reactivity, providing new insights into the mechanisms by which complement dysregulation may contribute to SCZ pathogenesis.</div></div>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":"276 ","pages":"Article 107065"},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B cells are major players in cancer immunity","authors":"Théo Bouloudani ,&nbsp;Guilhem Pupier ,&nbsp;Catherine Sautès-Fridman ,&nbsp;Wolf Herman Fridman","doi":"10.1016/j.imlet.2025.107064","DOIUrl":"10.1016/j.imlet.2025.107064","url":null,"abstract":"<div><div>The discovery of Tertiary Lymphoid Structures (TLS) within tumors has reshaped our understanding of cancer immunity. Unlike the classical view that immune responses are solely initiated in lymph nodes, TLS, ectopic lymphoid aggregates resembling secondary lymphoid organs, can form in the tumor microenvironment (TME). These structures contain T cells, B cells, dendritic cells (DC) presenting antigenic peptides to T cells in the T cell zone of TLS, and follicular dendritic cells (FDC) which are stromal cells involved in the formation of germinal centers (GCs) and presenting antigens, under the form of immune complexes, to B cells. Mature TLS with GCs support B cell differentiation into antibody-producing plasma cells (PCs). Clinical studies reveal that TLS presence correlates with improved survival and response to immunotherapy across multiple cancers, including melanoma, NSCLC, and renal cell carcinoma. Notably, B cells within TLS undergo clonal expansion, somatic hypermutation, and isotype switching, generating tumor-reactive antibodies (IgG, IgA). IgG-opsonized tumor cells can be eliminated by macrophages or NK cells via antibody-dependent cell mediated cytotoxicity or apoptosis by macrophages via antibody-dependent phagocytosis whereas IgA may have dual roles, sometimes promoting immunosuppression. Additionally, B cells enhance antigen presentation to T cells, amplifying anti-tumor responses. Emerging strategies aim to induce TLS formation (e.g., via CXCL13, lymphotoxins…) or harness B cells for adoptive therapies. Future research should clarify tumor-specific antibody targets and optimize TLS induction to enhance immunotherapy.</div><div>In summary, TLS and B cells are pivotal in shaping anti-tumor immunity, offering novel biomarkers and therapeutic avenues for cancer treatment.</div></div>","PeriodicalId":13413,"journal":{"name":"Immunology letters","volume":"276 ","pages":"Article 107064"},"PeriodicalIF":2.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}