Sena A. Gocuk , Jasleen K. Jolly , Thomas L. Edwards , Lauren N. Ayton
{"title":"Female carriers of X-linked inherited retinal diseases – Genetics, diagnosis, and potential therapies","authors":"Sena A. Gocuk , Jasleen K. Jolly , Thomas L. Edwards , Lauren N. Ayton","doi":"10.1016/j.preteyeres.2023.101190","DOIUrl":"10.1016/j.preteyeres.2023.101190","url":null,"abstract":"<div><p>Inherited retinal diseases (IRDs) are a group of heterogeneous conditions that cause progressive vision loss, typically due to monogenic mutations. Female carriers of X-linked IRDs have a single copy of the disease-causing gene, and therefore, may exhibit variable clinical signs that vary from near normal retina to severe disease and vision loss. The relationships between individual genetic mutations and disease severity in X-linked carriers requires further study.</p><p>This review summarises the current literature surrounding the spectrum of disease seen in female carriers of choroideremia and X-linked retinitis pigmentosa. Various classification systems are contrasted to accurately grade retinal disease. Furthermore, genetic mechanisms at the early embryonic stage are explored to potentially explain the variability of disease seen in female carriers.</p><p>Future research in this area will provide insight into the association between genotype and retinal phenotypes of female carriers, which will guide in the management of these patients. This review acknowledges the importance of identifying which patients may be at high risk of developing severe symptoms, and therefore should be considered for emerging treatments, such as retinal gene therapy.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"96 ","pages":"Article 101190"},"PeriodicalIF":17.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10645919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edward H. Wood , Alexander Kreymerman , Tia Kowal , David Buickians , Yang Sun , Stephanie Muscat , Mark Mercola , Darius M. Moshfeghi , Jeffrey L. Goldberg
{"title":"Cellular and subcellular optogenetic approaches towards neuroprotection and vision restoration","authors":"Edward H. Wood , Alexander Kreymerman , Tia Kowal , David Buickians , Yang Sun , Stephanie Muscat , Mark Mercola , Darius M. Moshfeghi , Jeffrey L. Goldberg","doi":"10.1016/j.preteyeres.2022.101153","DOIUrl":"10.1016/j.preteyeres.2022.101153","url":null,"abstract":"<div><p><span><span><span>Optogenetics<span> is defined as the combination of genetic and optical methods to induce or inhibit well-defined events in isolated cells, tissues, or animals. While optogenetics within ophthalmology has been primarily applied towards treating inherited </span></span>retinal disease<span>, there are a myriad of other applications that hold great promise for a variety of eye diseases including cellular regeneration, modulation of mitochondria and metabolism, regulation of </span></span>intraocular pressure<span><span>, and pain control. Supported by primary data from the authors’ work with in vitro and in vivo applications, we introduce a novel approach to metabolic regulation, Opsins to Restore Cellular ATP (ORCA). We review the fundamental constructs for </span>ophthalmic optogenetics, present current therapeutic approaches and </span></span>clinical trials<span><span>, and discuss the future of subcellular and signaling pathway applications for </span>neuroprotection and vision restoration.</span></p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"96 ","pages":"Article 101153"},"PeriodicalIF":17.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10276271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gary Hin-Fai Yam , Shaohua Pi , Yiqin Du , Jodhbir S. Mehta
{"title":"Posterior corneoscleral limbus: Architecture, stem cells, and clinical implications","authors":"Gary Hin-Fai Yam , Shaohua Pi , Yiqin Du , Jodhbir S. Mehta","doi":"10.1016/j.preteyeres.2023.101192","DOIUrl":"10.1016/j.preteyeres.2023.101192","url":null,"abstract":"<div><p>The limbus is a transition from the cornea to conjunctiva and sclera. In human eyes, this thin strip has a rich variation of tissue structures and composition, typifying a change from scleral irregularity and opacity to corneal regularity and transparency; a variation from richly vascularized conjunctiva and sclera to avascular cornea; the neural passage and drainage of aqueous humor. The limbal stroma is enriched with circular fibres running parallel to the corneal circumference, giving its unique role in absorbing small pressure changes to maintain corneal curvature and refractivity. It contains specific niches housing different types of stem cells for the corneal epithelium, stromal keratocytes, corneal endothelium, and trabecular meshwork. This truly reflects the important roles of the limbus in ocular physiology, and the limbal functionality is crucial for corneal health and the entire visual system. Since the anterior limbus containing epithelial structures and limbal epithelial stem cells has been extensively reviewed, this article is focused on the posterior limbus. We have discussed the structural organization and cellular components of the region beneath the limbal epithelium, the characteristics of stem cell types: namely corneal stromal stem cells, endothelial progenitors and trabecular meshwork stem cells, and recent advances leading to the emergence of potential cell therapy options to replenish their respective mature cell types and to correct defects causing corneal abnormalities. We have reviewed different clinical disorders associated with defects of the posterior limbus and summarized the available preclinical and clinical evidence about the developing topic of cell-based therapy for corneal disorders.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"96 ","pages":"Article 101192"},"PeriodicalIF":17.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10280386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Familial normal tension glaucoma genetics","authors":"Austin R. Fox , John H. Fingert","doi":"10.1016/j.preteyeres.2023.101191","DOIUrl":"10.1016/j.preteyeres.2023.101191","url":null,"abstract":"<div><p><span><span>Glaucoma is defined by characteristic optic nerve damage<span><span> and corresponding visual field defects and is the leading cause of irreversible </span>blindness in the world. Elevated </span></span>intraocular pressure<span> (IOP) is a strong risk factor for developing glaucoma. However, glaucoma can occur at any IOP. Normal tension glaucoma<span> (NTG) arises with IOPs that are within what has been defined as a normal range, i.e., 21 mm Hg or less, which may present challenges in its diagnosis and management. Identifying inheritance patterns and genetic mutations in families with NTG has helped elucidate mechanisms of NTG, however the pathophysiology<span> is complex and not fully understood. Approximately 2% of NTG cases are caused primarily by mutations in single genes, optineurin (</span></span></span></span><em>OPTN</em><span>), TANK binding kinase 1 (</span><em>TKB1</em><span>), or myocilin (</span><em>MYOC</em><span>). Herein, we review pedigree studies of NTG and autosomal dominant NTG caused by </span><em>OPTN, TBK1,</em> and <em>MYOC</em> mutations. We review identified mutations and resulting clinical features of <em>OPTN</em>-associated and <em>TBK1-</em>associated NTG, including long-term follow up of these patients with NTG. In addition, we report a new four-generation pedigree of NTG caused by a Glu50Lys <em>OPTN</em> mutation, including six family members with a mean follow up of 17 years. Common features of <em>OPTN</em><span> -associated NTG due to Glu50Lys mutation included early onset of disease with an IOP <21 mm Hg, marked optic disc cupping, and progressive visual field loss which appeared to stabilize once an IOP of less than 10 mm Hg was achieved. Lastly, we review risk factor genes which have been identified to contribute to the complex inheritance of NTG.</span></p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"96 ","pages":"Article 101191"},"PeriodicalIF":17.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10282137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sandra Hoyek , Natasha F.S. da Cruz , Nimesh A. Patel , Hasenin Al-Khersan , Kenneth C. Fan , Audina M. Berrocal
{"title":"Identification of novel biomarkers for retinopathy of prematurity in preterm infants by use of innovative technologies and artificial intelligence","authors":"Sandra Hoyek , Natasha F.S. da Cruz , Nimesh A. Patel , Hasenin Al-Khersan , Kenneth C. Fan , Audina M. Berrocal","doi":"10.1016/j.preteyeres.2023.101208","DOIUrl":"10.1016/j.preteyeres.2023.101208","url":null,"abstract":"<div><p><span>Retinopathy of prematurity (ROP) is a leading cause of preventable </span>vision loss<span><span> in preterm infants. While appropriate screening is crucial for early identification and treatment of ROP, current screening guidelines remain limited by inter-examiner variability in screening modalities, absence of local protocol for ROP screening in some settings, a paucity of resources and an increased survival of younger and smaller infants. This review summarizes the advancements and challenges of current innovative technologies, artificial intelligence (AI), and predictive biomarkers for the diagnosis and management of ROP. We provide a contemporary overview of AI-based models for detection of ROP, its severity, progression, and response to treatment. To address the transition from experimental settings to real-world clinical practice, challenges to the clinical implementation of AI for ROP are reviewed and potential solutions are proposed. The use of </span>optical coherence tomography<span> (OCT) and OCT angiography (OCTA) technology is also explored, providing evaluation of subclinical ROP characteristics that are often imperceptible on fundus examination. Furthermore, we explore several potential biomarkers to reduce the need for invasive procedures, to enhance diagnostic accuracy and treatment efficacy. Finally, we emphasize the need of a symbiotic integration of biologic and imaging biomarkers and AI in ROP screening, where the robustness of biomarkers in early disease detection is complemented by the predictive precision of AI algorithms.</span></span></p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101208"},"PeriodicalIF":17.8,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10430055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Vittoria Cicinelli , Prithvi Ramtohul , Alessandro Marchese , Francesco Bandello , K. Bailey Freund , Elisabetta Miserocchi , Lee M. Jampol
{"title":"Latest advances in white spot syndromes: New findings and interpretations","authors":"Maria Vittoria Cicinelli , Prithvi Ramtohul , Alessandro Marchese , Francesco Bandello , K. Bailey Freund , Elisabetta Miserocchi , Lee M. Jampol","doi":"10.1016/j.preteyeres.2023.101207","DOIUrl":"10.1016/j.preteyeres.2023.101207","url":null,"abstract":"<div><p>White spot syndromes<span><span><span><span> (WSS) pose challenges in the field of ophthalmology, particularly in terms of accurate diagnosis and effective management. However, recent advancements in </span>multimodal imaging<span> (MMI) have significantly contributed to our understanding of WSS, allowing for improved characterization of these inflammatory chorioretinopathies. By employing various imaging modalities, including fundus fluorescein </span></span>angiography<span>, indocyanine green angiography, fundus autofluorescence, </span></span>optical coherence tomography<span> (OCT), ultra-widefield imaging, and OCT angiography, researchers and clinicians have gained valuable insights into the underlying pathophysiological changes and clinical progression of WSS.</span></span></p><p>Furthermore, MMI has unveiled novel and atypical variants within the spectrum of WSS, expanding our knowledge in this field. Notably, the identification of secondary forms of WSS occurring concurrently with unrelated chorioretinal disorders has suggested a potential autoimmune mechanism underlying these conditions. The introduction of MMI has also facilitated a more comprehensive evaluation of previously ill-defined entities, such as acute zonal occult outer retinopathy, leading to improved diagnostic criteria and enhanced recognition of distinct features. This review paper provides a comprehensive overview of the latest advances and interpretations in WSS. By integrating MMI into the diagnosis and management of these conditions, this review aims to enhance patient outcomes and provide valuable insights into the complexities surrounding WSS.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101207"},"PeriodicalIF":17.8,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nadia K. Waheed , Richard B. Rosen , Yali Jia , Marion R. Munk , David Huang , Amani Fawzi , Victor Chong , Quan Dong Nguyen , Yasir Sepah , Elizabeth Pearce
{"title":"Optical coherence tomography angiography in diabetic retinopathy","authors":"Nadia K. Waheed , Richard B. Rosen , Yali Jia , Marion R. Munk , David Huang , Amani Fawzi , Victor Chong , Quan Dong Nguyen , Yasir Sepah , Elizabeth Pearce","doi":"10.1016/j.preteyeres.2023.101206","DOIUrl":"10.1016/j.preteyeres.2023.101206","url":null,"abstract":"<div><p>There remain many unanswered questions on how to assess and treat the pathology and complications that arise from diabetic retinopathy (DR). Optical coherence tomography angiography (OCTA) is a novel and non-invasive three-dimensional imaging method that can visualize capillaries in all retinal layers. Numerous studies have confirmed that OCTA can identify early evidence of microvascular changes and provide quantitative assessment of the extent of diseases such as DR and its complications.</p><p>A number of informative OCTA metrics could be used to assess DR in clinical trials, including measurements of the foveal avascular zone (FAZ; area, acircularity, 3D para-FAZ vessel density), vessel density, extrafoveal avascular zones, and neovascularization. Assessing patients with DR using a full-retinal slab OCTA image can limit segmentation errors and confounding factors such as those related to center-involved diabetic macular edema. Given emerging data suggesting the importance of the peripheral retinal vasculature in assessing and predicting DR progression, wide-field OCTA imaging should also be used. Finally, the use of automated methods and algorithms for OCTA image analysis, such as those that can distinguish between areas of true and false signals, reconstruct images, and produce quantitative metrics, such as FAZ area, will greatly improve the efficiency and standardization of results between studies.</p><p>Most importantly, clinical trial protocols should account for the relatively high frequency of poor-quality data related to sub-optimal imaging conditions in DR and should incorporate time for assessing OCTA image quality and re-imaging patients where necessary.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"97 ","pages":"Article 101206"},"PeriodicalIF":17.8,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10083731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ikhwanuliman Putera , Benjamin Schrijver , Josianne C.E.M. ten Berge , Vishali Gupta , Rina La Distia Nora , Rupesh Agrawal , P. Martin van Hagen , Saskia M. Rombach , Willem A. Dik
{"title":"The immune response in tubercular uveitis and its implications for treatment: From anti-tubercular treatment to host-directed therapies","authors":"Ikhwanuliman Putera , Benjamin Schrijver , Josianne C.E.M. ten Berge , Vishali Gupta , Rina La Distia Nora , Rupesh Agrawal , P. Martin van Hagen , Saskia M. Rombach , Willem A. Dik","doi":"10.1016/j.preteyeres.2023.101189","DOIUrl":"10.1016/j.preteyeres.2023.101189","url":null,"abstract":"<div><p>Tubercular uveitis (TB-uveitis) remains a conundrum in the uveitis field, which is mainly related to the diverse clinical phenotypes of TB-uveitis. Moreover, it remains difficult to differentiate whether <em>Mycobacterium tuberculosis</em> (<em>Mtb</em>) is present in the ocular tissues, elicits a heightened immune response without <em>Mtb</em> invasion in ocular tissues, or even induces an anti-retinal autoimmune response. Gaps in the immuno-pathological knowledge of TB-uveitis likely delay timely diagnosis and appropriate management. In the last decade, the immunopathophysiology of TB-uveitis and its clinical management, including experts' consensus to treat or not to treat certain conditions with anti-tubercular treatment (ATT), have been extensively investigated. In the meantime, research on TB treatment, in general, is shifting more toward host-directed therapies (HDT). Given the complexities of the host-<em>Mtb</em> interaction, enhancement of the host immune response is expected to boost the effectiveness of ATT and help overcome the rising burden of drug-resistant <em>Mtb</em> strains in the population. This review will summarize the current knowledge on the immunopathophysiology of TB-uveitis and recent advances in treatment modalities and outcomes of TB-uveitis, capturing results gathered from high- and low-burden TB countries with ATT as the mainstay of treatment. Moreover, we outline the recent progress of HDT development in the pulmonary TB field and discuss the possibility of its applicability to TB-uveitis. The concept of HDT might help direct future development of efficacious therapy for TB-uveitis, although more in-depth research on the immunoregulation of this disease is still necessary.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"95 ","pages":"Article 101189"},"PeriodicalIF":17.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cell identity changes in ocular surface Epithelia","authors":"Nick Di Girolamo, Mijeong Park","doi":"10.1016/j.preteyeres.2022.101148","DOIUrl":"10.1016/j.preteyeres.2022.101148","url":null,"abstract":"<div><p>Corneal and conjunctival epithelia arise from a common ancestral ectoderm cell, then diverge into distinct lineages. The former develops into a multilayered stratified squamous epithelium, the latter into an expansive mucous membrane that stretches the eyelid margin to the cornea's outskirts. The limbus, which intersects these epithelia, is purported to harbor corneal stem cells. Intrinsic programs that prevent these neighbouring epithelia from mixing and changing identity have not been elucidated, however microenvironmental cues that emanate following tissue damage and ensuing disease, dictate cell fate choices including those that influence form and function. Plasticity of ocular surface epithelia is gauged by their ability to undergo epithelial-mesenchymal transition, transdifferentiation, dedifferentiation and metaplastic transformation. Elucidating the molecular mechanism by which these rare and unusual phenomena arise, and persuading cells to either revert to their original state or remain newly committed, could be exploited into game-changing therapeutics for patients with corneal blindness and other diseases.</p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"95 ","pages":"Article 101148"},"PeriodicalIF":17.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily G. Saccuzzo, Hannah A. Youngblood, Raquel L. Lieberman
{"title":"Myocilin misfolding and glaucoma: A 20-year update","authors":"Emily G. Saccuzzo, Hannah A. Youngblood, Raquel L. Lieberman","doi":"10.1016/j.preteyeres.2023.101188","DOIUrl":"10.1016/j.preteyeres.2023.101188","url":null,"abstract":"<div><p>Mutations in the gene <span><em>MYOC</em></span><span> account for approximately 5% of cases of primary open angle glaucoma (POAG). </span><em>MYOC</em><span><span><span> encodes for the protein myocilin, a multimeric secreted glycoprotein composed of N-terminal coiled-coil (CC) and </span>leucine zipper<span><span><span> (LZ) domains that are connected via a disordered linker to a 30 kDa olfactomedin (OLF) domain. More than 90% of glaucoma-causing mutations are localized to the OLF domain. While myocilin is expressed in numerous tissues, mutant myocilin is only associated with disease in the anterior segment of the eye, in the trabecular meshwork. The prevailing pathogenic mechanism involves a gain of toxic function whereby mutant myocilin aggregates intracellularly instead of being secreted, which causes cell stress and an early timeline for TM </span>cell death, elevated </span>intraocular pressure, and subsequent glaucoma-associated </span></span>retinal degeneration. In this review, we focus on the work our lab has conducted over the past ∼15 years to enhance our molecular understanding of myocilin-associated glaucoma, which includes details of the molecular structure and the nature of the aggregates formed by mutant myocilin. We conclude by discussing open questions, such as predicting phenotype from genotype alone, the elusive native function of myocilin, and translational directions enabled by our work.</span></p></div>","PeriodicalId":21159,"journal":{"name":"Progress in Retinal and Eye Research","volume":"95 ","pages":"Article 101188"},"PeriodicalIF":17.8,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10330797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9794571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}