Molecular Oral Microbiology最新文献

{"title":"The Oral Microbiota, Its Evolution, and Aspects of Support for Oral Health.","authors":"Svetlana Pleskova, Nikolay Bezrukov","doi":"10.1111/omi.70011","DOIUrl":"https://doi.org/10.1111/omi.70011","url":null,"abstract":"<p><p>Over the years, humanity has accumulated knowledge about the pathogens of infectious diseases and the ability of the human body to resist external aggression. In the last century, it became clear that the normal microflora of the human body can be used as an ally to resist a whole range of diseases. However, the intestinal microflora is the main object of modern complex studies. This review focuses on the microflora of the oral cavity. It describes the main microbiological composition of the microflora, including the most important bacterial species, fungi, and viruses. The main factors influencing the emergence of balance in the system \"human oral cavity-microorganisms\" are considered as well as environmental features that affect the formation of the species composition. The main functions performed by the oral microflora are described. Possible mechanisms for correcting initial dysbiotic disorders are also considered, including probiotics, bacteriophages, gases and thermotherapy, photobiomodulation, and diet correction.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"e70011"},"PeriodicalIF":2.9,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345763","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":"Apelin-12 Attenuates LPS-Induced Cellular Senescence in Human Dental Pulp Cells via SIRT6-Mediated Pathways: Implications for Gingivitis Management.","authors":"Lin Zhang, Dan Luo, Li Bai","doi":"10.1111/omi.70012","DOIUrl":"https://doi.org/10.1111/omi.70012","url":null,"abstract":"<p><p>Microbial infections and lipopolysaccharide (LPS)-induced senescence in human dental pulp cells (hDPCs) play a significant role in gingivitis etiology. However, the role of Apelin-12 in oral diseases, particularly its modulation of cellular senescence, remains poorly understood. This study investigated the protective effects of Apelin-12 against LPS-induced cellular senescence in hDPCs and its underlying mechanisms using cell isolation, culture, treatment, and transduction techniques, combined with reverse transcription-polymerase chain reaction (RT-PCR), Western blotting, telomerase activity assays, senescence-associated β-galactosidase (SA-β-Gal) staining, and gene silencing. We first confirmed apelin receptor (APJ) expression in hDPCs and found that LPS significantly downregulated APJ at both mRNA and protein levels. Apelin-12 treatment restored telomerase activity and upregulated human telomerase reverse transcriptase (hTERT), while reducing senescence markers, including γH2AX and SA-β-Gal. Additionally, Apelin-12 suppressed the expression of senescence regulators p21 and acetylated p53 (ac-p53). Mechanistically, Apelin-12 restored SIRT6 (but not SIRT1) expression, and silencing SIRT6 abolished its anti-senescence effects, as evidenced by elevated p21, ac-p53, and SA-β-Gal, along with reduced hTERT and telomerase activity. These findings demonstrate that Apelin-12 attenuates LPS-induced cellular senescence in hDPCs via SIRT6-mediated pathways, suggesting its therapeutic potential for gingivitis management.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"e70012"},"PeriodicalIF":2.9,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318459","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":"Long Noncoding RNA Malat1 and Neat1 Associated With Dysbiotic Microbiome and Epithelial-Mesenchymal Transition in Periodontitis.","authors":"Saif M Al-Mufti, Ali A Abdulkareem, Nibras H Chasib, Mike Milward, Paul R Cooper","doi":"10.1111/omi.70010","DOIUrl":"https://doi.org/10.1111/omi.70010","url":null,"abstract":"<p><strong>Introduction: </strong>The regulatory mechanisms of epithelial-mesenchymal transition (EMT) involved in periodontitis pathogenesis are poorly understood. Consequently, this study aimed to investigate the association of the long noncoding (lnc) RNAs, NEAT1 and MALAT1, with EMT in periodontitis.</p><p><strong>Methods: </strong>Gingival tissue samples (n = 57) were obtained from periodontitis patients indicated for surgical treatment and healthy control individuals. Full mouth periodontal charting was recorded for all patients together with collection of subgingival biofilm samples to determine bacterial load for key-periodontal pathogens. Histopathological analysis was used to assess inflammatory cell infiltration, and RT-qPCR analysis was performed to quantify the expression of the key EMT biomarkers of E-cadherin, β-catenin, Snail1 and vimentin, and the lncRNAs of Neat1 and Malat1.</p><p><strong>Results: </strong>The clinical parameters and percentage of inflammatory cell infiltration were significantly higher in the periodontitis group compared with healthy controls. In periodontitis, expressions of Malat1 and E-cadherin were significantly downregulated, whereas Neat1, Snail1 and vimentin were significantly upregulated in comparison to controls. Receiver-operating characteristic (ROC) analyses demonstrated moderate-to-good diagnostic accuracy of Neat1, Malat1, Snail1, E-cadherin and vimentin (area under the curve [AUC]: 70.3%, 67.5%, 78.7%, 89.9% and 74.3%, respectively) to discriminate periodontal health from disease.</p><p><strong>Conclusion: </strong>Probing pocket depth, bleeding scores, expression of Neat1, red complex bacteria (Porphyromonas gingivalis and Treponema denticola) and downregulation of Malat1 and E-cadherin were strongly associated with EMT. Data also highlighted an association between Neat1 and Malat1 with the induction of the EMT phenotype in periodontitis, and these lncRNAs may therefore provide novel diagnostic biomarkers.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"e70010"},"PeriodicalIF":2.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275396","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":"Tolerance Induced by Porphyromonas gingivalis Altered Inflammatory Responses in Mice.","authors":"Miao Yu, Wen-Bo Qian, Yuan-Chun Fang, Yang Chen, Qiao Zhou, Ying Sun","doi":"10.1111/omi.70002","DOIUrl":"10.1111/omi.70002","url":null,"abstract":"<p><p>Tolerance refers to a hyporesponsiveness toward repeated stimulations with bacteria and their virulence factors, which might exist in the development of periodontitis. To identify the roles of tolerance induced by Porphyromonas gingivalis (P. gingivalis) in periodontitis, an original tolerized mice model was established by high-dose of oral P. gingivalis inoculation following a primary infection. The alveolar bone loss of maxillae was detected by Micro-CT. The infiltration of neutrophils and macrophages, and macrophage polarization were detected by IHC and flow cytometry, respectively. Residual P. gingivalis in subgingival plaque with and without macrophage/neutrophil depletion was measured by real-time PCR. Moreover, a real-time PCR chip and bioinformatic analysis were then employed to explore the cytokine expression profiles in gingivae. The abundance of TNF-α, Toll-like receptor 2 (TLR2), and TLR4 were further verified by western blot. In comparison with the non-tolerance group, TNF-α protein levels, alveolar bone loss, and the infiltration of neutrophils and macrophages in the tolerance group were significantly suppressed (p < 0.05), while the quantities of residual P. gingivalis in subgingival plaque were increased (p < 0.05). Moreover, the depletion of macrophages by liposomal clodronate weakened the inhibitory effect of tolerance, as evidenced by the lack of differences in the quantities of residual bacteria between the tolerance and non-tolerance groups (p > 0.05). Macrophages in gingivae of tolerized mice were more likely to polarize into M2 type. In addition, the expressions of cytokines related to neutrophil and macrophage infiltration and recruitment and the protein levels of TLR2 and TLR4 were decreased in tolerized mice (p < 0.05). Tolerance induced by repeated P. gingivalis stimulations suppressed inflammatory responses in periodontal tissues, and the established periodontal tolerance model provided a reliable tool for the further study on periodontal tolerance in vivo.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"223-233"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691009","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":"Role of Oral Microbes in Epithelial-Mesenchymal Transition in Cancer Progression.","authors":"Divya Gopinath, Zhengrui Li, Marwan Mansoor Mohammed, Swagatika Panda","doi":"10.1111/omi.70001","DOIUrl":"10.1111/omi.70001","url":null,"abstract":"<p><p>Epithelial-mesenchymal transition (EMT) is a fundamental biological process where epithelial cells lose their polarity and adhesion properties, acquiring mesenchymal characteristics such as enhanced migratory ability and invasiveness. Cells undergoing EMT exhibit enhanced motility, aggressiveness, and stemness, contributing to a pro-tumor environment that facilitates malignant metastasis in cancer. Numerous studies have suggested that oral microbes facilitate carcinogenesis through EMT. Oral microbes can directly initiate EMT by adhering to mucosal layers and provoking the disintegration of intercellular adhesion among epithelial cells, thereby modifying cell polarity and downstream signaling pathways. Indirectly, the microbial metabolites and associated compounds can affect the dynamics of EMT. This review summarizes the mechanisms by which oral microbes regulate EMT and thus contribute significantly to cancer. Elucidating the mechanisms underlying the increased plasticity of cancer cells induced by the oral microbiota will facilitate the development of novel targeted therapeutic strategies.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"191-201"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637582","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":"Marine-Derived Cyclo(l-Leucyl-l-Prolyl) Targets d-Alanylation of Lipoteichoic Acid to Combat Streptococcus mutans UA159 Mediated Dental Cariogenesis.","authors":"Ravichellam Sangavi, Nambiraman Malligarjunan, Shunmugiah Karutha Pandian, Shanmugaraj Gowrishankar","doi":"10.1111/omi.70000","DOIUrl":"10.1111/omi.70000","url":null,"abstract":"<p><p>With the growing threat of antimicrobial resistance (AMR), antivirulence strategies present a promising alternative to traditional antibiotics, particularly in dentistry. Dental caries, a chronic biofilm-associated disease primarily driven by the AMR pathogen Streptococcus mutans, results in enamel demineralization and significant oral health challenges. This study explores the anticariogenic mechanism of marine-derived cyclo(l-leucyl-l-prolyl) (CLP), a biomolecule known to inhibit key virulence factors of S. mutans UA159. LC-MS/MS proteomic analysis revealed 30 and 71 significantly regulated proteins following 12 and 24 h of CLP treatment, respectively. Protein-protein interaction and gene ontology analyses demonstrated that CLP downregulates critical virulence proteins related to d-alanylation of lipoteichoic acid (LTA), glucan synthesis, acid production and acid tolerance, while upregulating proteins associated with translation, DNA repair and protein metabolism. KEGG pathway analysis highlighted the involvement of downregulated proteins in key metabolic pathways, including d-alanine metabolism, starch and sucrose metabolism, glycolysis and branched-chain amino acid metabolism. Given the pivotal role of d-alanine metabolism in modulating interconnected virulence pathways, a comparative analysis of in vitro virulence assays-including cell adherence, biofilm formation, acid production and cell surface charge-alongside proteomic data signify that CLP specifically targets the d-alanylation of LTA. This hypothesis was further validated by LTA and d-alanine quantification assays, which confirmed a significant reduction in d-alanine content within LTA after CLP treatment, leading to a marked attenuation of S. mutans cariogenic virulence. Additionally, qPCR and molecular docking analyses corroborated that CLP disrupts S. mutans virulence by interfering with the d-alanylation of LTA. These findings highlight CLP's potential as a novel therapeutic agent for combating dental cariogenesis by targeting S. mutans virulence, offering a promising avenue for the development of advanced anticariogenic therapies.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"202-222"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326312","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 Secretion and Maturation Journey of Gingipains.","authors":"Zixue Lei, Qizhao Ma, Xuedong Zhou, Yuqing Li","doi":"10.1111/omi.12497","DOIUrl":"10.1111/omi.12497","url":null,"abstract":"<p><p>Multifunctional gingipains are trypsin-like enzymes secreted extracellularly by Porphyromonas gingivalis, which require delicate transit and processing to be activated in different mature forms. This review manages to reconstruct each processing step including the specific cleavage sites and relative proteins or helpers. Errors in any steps can lead to the accumulation of immature gingipains and weaken the virulence of P. gingivalis. Of special note, we emphasize the contribution of new studies to the refinement of the gingipain maturation process and factors that influence their pathogenicity. For example, it is proposed that glutamine cyclase, which is responsible for cyclizing exposed glutamine to pyroglutamic acid after the N-terminal signal peptide is removed, may be able to serve as a potential target for periodontitis treatment, as normal cyclization is key to maintaining the stability of gingipains. Further structural and functional unraveling of the type IX secretion system components, such as the identification of the structure of the PorV-associated shuttle complex, the determination of PorZ's role as the A-LPS deliverer, and the confirmation of the specific mechanism by which PorU promotes CTD removal and catalyzes the transpeptide reaction, has also contributed to a better understanding of gingipain processing. Meanwhile, as the successful activation of gingipains serves to fulfill their functions, this work also concentrates on gingipain pathogenicity, with a particular focus on how gingipains can induce or stimulate the development of systemic diseases, such as causing cardiovascular disorder through vascular damage or exacerbating inflammation in the brain in Alzheimer's disease after crossing the blood-brain barrier.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"177-190"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258591","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":"Porphyromonas gingivalis: Multiple Tools of an Inflammatory Damage.","authors":"Hlafira Polishchuk, Aleksandra Synowiec, Natalia Zubrzycka, Tomasz Kantyka","doi":"10.1111/omi.12496","DOIUrl":"10.1111/omi.12496","url":null,"abstract":"<p><p>Periodontitis (periodontal disease [PD]) is a complex inflammatory disease caused by a polymicrobial infection that facilitates the destruction of the connective tissue and bone that support the teeth. PD is highly correlated with cardiovascular disease, low birth weight, preterm osteoporosis, Alzheimer's disease, and rheumatoid arthritis. Porphyromonas gingivalis, a main causative agent of PD, is a non-motile, asaccharolytic, Gram-negative bacterium identified in subgingival, supragingival, and tongue sites in patients. P. gingivalis produces an arsenal of virulence factors, which include fimbriae, lipopolysaccharide (LPS), gingipains and other proteases, P. gingivalis peptidyl arginine deiminase (PPAD), and others. Recently, a number of reports highlighted novel aspects of P. gingivalis virulence. LPS signaling via Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) was elucidated; outer membrane vesicles (OMVs) were implicated as the shuttle for inflammatory induction and neurotoxicity, and gingipains were found to disrupt the integrity of blood-brain barrier (BBB). Further, Tpr protease substrate specificity was described in detail, a novel variant of PPAD was identified and correlated with the aggressive disease, and the role of C-terminal domain as the substrate for the Type IX secretion system (T9SS) transport has been unveiled, together with the identification of the first T9SS inhibitors. The impact of the COVID-19 pandemic prompted the novel research, expanding our understanding of the P. gingivalis correlation with viral infections. These recent findings implicate the need to update the current knowledge of the P. gingivalis virulence factors and provide a comprehensive review of the current trends in P. gingivalis research.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"159-176"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216381","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":"Genomic Insights Into the Treponema Genus: Taxonomic Resolution of Treponema vincentii and Description of Two Novel Species, Treponema plautii sp. nov. and Treponema sinense sp. nov.","authors":"Jordan Y H Fong, Man Lung Yeung, Tsz Tuen Li, Wing Ho Li, Yuanchao Ma, Yan Zhao, Wai Keung Leung, Jade L L Teng","doi":"10.1111/omi.70009","DOIUrl":"https://doi.org/10.1111/omi.70009","url":null,"abstract":"<p><strong>Objectives: </strong>Periodontal disease, a global health concern, is strongly associated with oral treponemes. However, the taxonomy of some species remains unresolved, hindering our understanding of their roles in disease. This study aims to clarify the taxonomy of three strains isolated from patients with periodontal disease using phylogenomic and comparative genomic analyses.</p><p><strong>Materials and methods: </strong>We performed genome sequencing for OMZ 800 and conducted phylogenomic and comparative genomic analyses of multiple strains to clarify their taxonomy.</p><p><strong>Results: </strong>Phylogenomic and in-silico genome comparisons confirmed OMZ 800 as \"T. vincentii\" (Average Nucleotide Identity [ANI]>95%). We designated OMZ 800^T as the type strain for T. vincentii to establish its official standing in bacterial taxonomy. OMZ 806 (2.7 Mb, 44.9% GC) clustered with phylogroup IB strain (ANI>95% vs. OMZ 305), whereas OMZ 838 (2.7 Mb, 44.6% GC) clustered with phylogroup IA strains (ANI>95% vs. OMZ 855 and OMZ 857). Both OMZ 806 and OMZ 838 strains showed ANI<95% compared to T. medium ATCC700293^T, supporting their classification as novel species. We propose Treponema plautii sp. nov. OMZ 806^T (with OMZ305 as additional strain) and Treponema sinense sp. nov. OMZ 838^T (with OMZ 855 and OMZ 857 as additional strains).</p><p><strong>Conclusion: </strong>This study clarifies Treponema taxonomy by designating OMZ 800^T as the type strain of T. vincentii and proposing two novel species, providing a refined taxonomical framework for this important genus.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"e70009"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054519","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":"A Defined Artificial Saliva Medium Allows Characterization of the Hypothiocyanite Response of Streptococcus sanguinis and Streptococcus mutans.","authors":"Avery D Lieber, Drashti Vaghasia, Christopher W Hamm, Michael J Gray","doi":"10.1111/omi.70008","DOIUrl":"https://doi.org/10.1111/omi.70008","url":null,"abstract":"<p><p>Hypothiocyanite (OSCN^-/HOSCN) is an antimicrobial molecule found at high concentrations in saliva. HOSCN is thought to differentially affect oral streptococci, since noncariogenic streptococci (e.g. Streptococcus sanguinis) possess HOSCN reductase activity that cariogenic streptococci (e.g. Streptococcus mutans) lack. However, the enzyme responsible for this activity and the effects of HOSCN and HOSCN reductase activity on biofilm formation by oral streptococci have not been previously established. In this work, we developed an artificial saliva medium for growth of oral streptococci with minimal redox-active components, called Defined Recipe Optimized Oral Liquid (DROOL), and used it to characterize the HOSCN responses of S. sanguinis and S. mutans. We identified a homolog of the Streptococcus pneumoniae Har protein in S. sanguinis as HOSCN reductase. S. mutans wild-type and S. sanguinis ∆har mutants were more sensitive to inhibition by physiological concentrations of HOSCN in DROOL than wild-type S. sanguinis when grown planktonically. S. mutans biofilm formation and glucan production were strongly decreased by HOSCN treatment, suggesting HOSCN inhibits S. mutans exopolysaccharide production. Collectively, our data demonstrate the specific ability of HOSCN to inhibit functions of cariogenic but not noncariogenic oral streptococci and show that Har is responsible for mediating this difference.</p>","PeriodicalId":18815,"journal":{"name":"Molecular Oral Microbiology","volume":" ","pages":"e70008"},"PeriodicalIF":2.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993107","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}