Viral immunologyPub Date : 2023-06-01Epub Date: 2023-06-06DOI: 10.1089/vim.2022.0200
Yanqing Yao, Weijing Kong, Lijun Yang, Yingxue Ding, Hong Cui
{"title":"Immunity and Immune Evasion Mechanisms of Epstein-Barr Virus.","authors":"Yanqing Yao, Weijing Kong, Lijun Yang, Yingxue Ding, Hong Cui","doi":"10.1089/vim.2022.0200","DOIUrl":"10.1089/vim.2022.0200","url":null,"abstract":"<p><p>Epstein-Barr virus (EBV) is the first human oncogenic virus to be identified, which evades the body's immune surveillance through multiple mechanisms that allow long-term latent infection. Under certain pathological conditions, EBVs undergo a transition from the latent phase to the lytic phase and cause targeted dysregulation of the host immune system, leading to the development of EBV-related diseases. Therefore, an in-depth understanding of the mechanism of developing an immune response to EBV and the evasion of immune recognition by EBV is important for the understanding of the pathogenesis of EBV, which is of great significance for finding strategies to prevent EBV infection, and developing a therapy to treat EBV-associated diseases. In this review, we will discuss the molecular mechanisms of host immunological responses to EBV infection and the mechanisms of EBV-mediated immune evasion during chronic active infection.</p>","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 5","pages":"303-317"},"PeriodicalIF":2.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10009420","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":"The Imbalance Between Intestinal Th17 and Treg Cells Is Associated with an Incomplete Immune Reconstitution During Long-Term Antiretroviral Therapy in Patients with HIV.","authors":"Yun-Tian Guo, Xiao-Yan Guo, Li-Na Fan, Ze-Rui Wang, Meng-Meng Qu, Chao Zhang, Xing Fan, Jin-Wen Song, Bao-Peng Yang, Ji-Yuan Zhang, Ruonan Xu, Yan-Mei Jiao, Ping Ma, Yao-Kai Chen, Fu-Sheng Wang","doi":"10.1089/vim.2023.0017","DOIUrl":"10.1089/vim.2023.0017","url":null,"abstract":"<p><p>Studies assessing the gut mucosal immune balance in HIV-infected patients using intestinal samples are scarce. In this study, we used intestinal mucosal specimens from the ileocecal region of seven immunological nonresponders (INRs), nine immunological responders (IRs), and six HIV-negative controls. We investigated T helper 17 (Th17) and T regulatory (Treg) cell counts and their ratio, zonula occludens-1 (ZO-1), intestinal fatty acid-binding protein (I-FABP), tumor necrosis factor-α, CD4<sup>+</sup> T cell counts, HIV DNA, and cell-associated HIV RNA. The results showed that INRs had lower Th17 and higher Treg cell counts than IR, resulting in a significant difference in the Th17/Treg ratio between IRs and INRs. In addition, INRs had lower ZO-1 and higher I-FABP levels than IRs. The Th17/Treg ratio was positively associated with ZO-1 and negatively associated with I-FABP levels. There was a positive correlation between Th17/Treg ratio and CD4<sup>+</sup> T cell counts and a negative correlation between the Th17/Treg ratio and HIV DNA in the intestine. Our study suggests that the imbalance of Th17/Treg in the intestine is a characteristic of incomplete immune reconstitution to antiretroviral therapy and is associated with intestinal damage.</p>","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 5","pages":"331-342"},"PeriodicalIF":2.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9654575","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}
Viral immunologyPub Date : 2023-05-01DOI: 10.1089/vim.2022.0133.correx
{"title":"<i>Correction to:</i> A Seroprevalence Study on Residents in a Senior Care Facility with Breakthrough SARS-CoV-2 Omicron Infection, by Kim, et al. Viral Immunology 2023;36(3):203-208; doi: 10.1089/vim.2022.0133.","authors":"","doi":"10.1089/vim.2022.0133.correx","DOIUrl":"10.1089/vim.2022.0133.correx","url":null,"abstract":"","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"299"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hala Gabr, Asmaa A Abdel Aal, Samah Bastawy, Mohamed Fateen, Omnia Y Abd El Dayem, Eman A Youssef, Rania Afifi, Mostafa Kamal
{"title":"Comparison of T Lymphocyte Subsets and Natural Killer Lymphocytes in Moderate Versus Severe COVID-19 Patients.","authors":"Hala Gabr, Asmaa A Abdel Aal, Samah Bastawy, Mohamed Fateen, Omnia Y Abd El Dayem, Eman A Youssef, Rania Afifi, Mostafa Kamal","doi":"10.1089/vim.2022.0125","DOIUrl":"https://doi.org/10.1089/vim.2022.0125","url":null,"abstract":"<p><p>Severe respiratory involvement that follows a process of immune dysregulation and intense cytokine production remains to be the most dreaded complication of Coronavirus Disease-2019 (COVID-19) infection. The aim of this study was to analyze T lymphocyte subsets and natural killer (NK) lymphocytes in moderate and severe cases of COVID-19 infection and assess their significance in disease severity and prognosis. Twenty moderate cases and 20 severe cases of COVID-19 were studied and compared regarding blood picture, biochemical markers, T lymphocyte population subsets, and NK lymphocytes, which were determined by flow cytometric analysis. On analyzing the flow cytometric data of T lymphocyte cells and their subsets and NK cells in two groups of COVID-19 infection (one group moderate and the other severe cases), some immature NK lymphocyte relative and absolute counts were higher in the severe patients with worse outcome and death, while some mature NK lymphocyte relative and absolute counts were depressed in both groups. Also, interleukin (IL)-6 was significantly higher in severe cases when compared to moderate cases, and there was a positive significant correlation between immature NK lymphocyte relative and absolute counts and IL-6. There was no statistically significant difference between T lymphocyte subsets (T helper and T cytotoxic) with disease severity or outcome. Some immature NK lymphocyte subsets contribute to the widespread inflammatory response that complicates severe cases of COVID-19; therapeutic approaches directed to enhancing NK maturation or drugs that block NK cell inhibitory receptors have a potential role in controlling COVID-19 induced cytokine storm.</p>","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"250-258"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9556771","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}
Abdulkarim F Alhetheel, Ahmed M Albarrag, Zahid A Shakoor, Ali M Somily, Mazin A Barry, Haifa Altalhi, Muhammed A Bakhrebah, Majed S Nassar, Mohamed B Alfageeh, Ayed Assiri, Sarah H Alfaraj, Ziad A Memish
{"title":"Assessment of Proinflammatory Cytokines Among Patients with Middle East Respiratory Syndrome Coronavirus Infection.","authors":"Abdulkarim F Alhetheel, Ahmed M Albarrag, Zahid A Shakoor, Ali M Somily, Mazin A Barry, Haifa Altalhi, Muhammed A Bakhrebah, Majed S Nassar, Mohamed B Alfageeh, Ayed Assiri, Sarah H Alfaraj, Ziad A Memish","doi":"10.1089/vim.2022.0154","DOIUrl":"https://doi.org/10.1089/vim.2022.0154","url":null,"abstract":"<p><p>Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with significant morbidity and mortality. This study was performed to assess the proinflammatory cytokines profile among MERS-CoV patients. A total of 46 MERS-CoV-infected patients (27 symptomatic and 19 asymptomatic) were assessed and compared with 52 normal healthy controls for plasma levels of interleukin (IL)-1<i>β</i>, tumor necrosis factor (TNF)-<i>α</i>, IL-17, IL-7, IL-6, interferon (IFN)-<i>α</i>, and IL-15 using a customized luminex kit. Whereas asymptomatic MERS-CoV patients and controls were no different; the mean plasma levels among MERS-CoV symptomatic patients were significantly higher than the normal controls: IL-1<i>β</i> (16.89 ± 1.23 vs. 12.80 ± 0.59 pg/mL; <i>p</i> < 0.001), TNF-<i>α</i> (14.04 ± 0.93 vs. 10.35 ± 0.29 pg/mL; <i>p</i> < 0.0001), IL-17 (14.3 ± 0.89 vs. 11.47 ± 0.61 pg/mL; <i>p</i> < 0.001), IL-7 (21.56 ± 1.00 vs. 16.31 ± 0.30 pg/mL; <i>p</i> < 0.0001), IL-6 (156.5 ± 37.90 vs. 18.60 ± 1.59 pg/mL; <i>p</i> < 0.0001), and IFN-<i>α</i> (68.73 ± 13.06 vs. 23.57 ± 1.05 pg/mL; <i>p</i> < 0.0001). The mean plasma levels of IL-7 (24.81 ± 1.63 vs. 19.79 ± 0.94 pg/mL; <i>p</i> < 0.01), IL-6 (312.7 ± 94.67 vs. 101.2 ± 25.67 pg/mL; <i>p</i> < 0.01), and IFN-<i>α</i> (89.00 ± 18.97 vs. 51.05 ± 8.68 pg/mL; <i>p</i> < 0.05) were significantly elevated among MERS-CoV symptomatic patients with fatal outcome compared with MERS-CoV symptomatic patients who survived. Only IL-7 was found to have a higher risk ratio of mortality (4.76, 95% confidence interval: 1.5-14.94; <i>p</i> < 0.01). No differences were observed in IL-15 levels among the groups. Significantly elevated proinflammatory cytokines among symptomatic MERS-CoV-infected patients may contribute to manifestations of cytokine storm frequently observed among critically ill MERS-CoV patients and IL-7 may serve as a marker for disease activity.</p>","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"282-289"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914390","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}
Xin Zhang, Xuefu Wu, Haili Wang, Yiyun Xu, Yi Li, Tao Chen, Tiejun Zhang
{"title":"Association of Toll-Like Receptor 3 Polymorphisms with Kaposi's Sarcoma-Associated Herpesvirus Infection Among Human Immunodeficiency Virus-Infected Individuals in Xinjiang, China.","authors":"Xin Zhang, Xuefu Wu, Haili Wang, Yiyun Xu, Yi Li, Tao Chen, Tiejun Zhang","doi":"10.1089/vim.2022.0177","DOIUrl":"https://doi.org/10.1089/vim.2022.0177","url":null,"abstract":"<p><p>Toll-like receptors (TLRs) play a crucial role in the innate immune response to pathogens, and TLR3 could recognize and control the herpesvirus. We studied the effect of <i>TLR3</i> polymorphisms on the risk of Kaposi's sarcoma-associated herpesvirus (KSHV) infection. A cross-sectional study was performed among human immunodeficiency virus (HIV)-infected individuals in Xinjiang, a KSHV-endemic region of China. The frequencies of nine single-nucleotide polymorphisms (SNPs) in <i>TLR3</i> in 370 KSHV-infected patients and 558 controls, and their impact on plasma IFN-γ levels, were compared. The effect of <i>TLR3</i> SNPs on the KSHV viral load in KSHV-infected subjects was also assessed. The minor allelic variant at rs13126816 was more common among KSHV-seronegative than KSHV-infected individuals. Two <i>TLR3</i> SNPs (rs13126816 and rs3775291) showed a protective effect against KSHV infection (rs13126816: odds ratio [OR]<sub>dominant</sub> = 0.66, 95% confidence interval [CI]: 0.50-0.87; OR<sub>overdominant</sub> = 0.65, 95% CI: 0.49-0.87; rs3775291: OR<sub>dominant</sub> = 0.76, 95% CI: 0.58-0.99; OR<sub>overdominant</sub> = 0.75, 95% CI: 0.57-0.98). These associations were stronger in the Uyghur compared with the Han population. The haplotype, CGAC, significantly correlated with the risk of KSHV infection (OR = 0.72, <i>p</i> = 0.029). KSHV-infected individuals with homozygous rs13126816 AA genotypes had a lower KSHV viral load (aOR = 0.14; <i>p</i> = 0.038). However, no association was observed between <i>TLR3</i> SNPs and plasma levels of IFN-γ. Genetic variants in <i>TLR3</i> reduce the risk of KSHV infection and affect KSHV reactivation among HIV-infected individuals, especially in the Uyghur population.</p>","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"290-297"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9559364","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}
Viral immunologyPub Date : 2023-05-01DOI: 10.1089/vim.2023.0059.editorial
Rodney S Russell
{"title":"How Can We Predict Disease Severity in Viral Infections?","authors":"Rodney S Russell","doi":"10.1089/vim.2023.0059.editorial","DOIUrl":"https://doi.org/10.1089/vim.2023.0059.editorial","url":null,"abstract":"","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"239-240"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9563903","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":"Differential Expression Patterns of Indoleamine 2,3-Dioxygenase 1 and Other Tryptophan and Arginine Catabolic Pathway Genes in Dengue Correlate with Clinical Severity-Pilot Study Results.","authors":"Soumya Jose, Roshni Jerome, Ajai Krishnan, Ozhiparambhil AnilKumar Jagan, Dongmei Li, Veena Menon","doi":"10.1089/vim.2022.0160","DOIUrl":"https://doi.org/10.1089/vim.2022.0160","url":null,"abstract":"The kynurenine pathway of tryptophan catabolism can modulate inflammatory responses inducing immunotolerance or immunosuppressive effects. Indoleamine 2,3-dioxygenase (IDO) is the rate-limiting enzyme in this pathway. Early aberrant inflammation is implicated in severe dengue, and herein we investigate and characterize the expression of IDO pathway genes in severe dengue patients. We use a SyBR green-based qPCR to evaluate the leukocyte expression levels of IDO1, IDO2, AhR, TGF-β, ARG1, IFNγ, and IFNα in a dengue patient cohort (n = 51). Twenty-two cases were identified as severe dengue using the WHO case classification (2009) criteria. Principal component analysis (PCA) was employed to examine the relationships of gene expression profiles with disease severity and laboratory markers of clinical severity. We find that two principal components describe most of the variance (65.3%) in the expression patterns of the cohort. Reduced expression of IDO1, TGF-β, and AhR, represented by low Component 2 scores, was significantly associated with disease severity, thrombocytopenia, and leukopenia. Higher expression levels of IDO2, IFNγ, and IFNα positively correlated with Component 1 scores, and were significantly associated with elevated ALT (p = 0.018) and AST (p = 0.017) enzymes. Our results suggest that profiling the baseline expression patterns of the IDO pathway genes may aid in the identification of dengue patients most at risk of severe disease.","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"268-281"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914366","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}
Kame Alberto Galán-Huerta, Myriam Aseret Zamora-Márquez, Rómulo Omar Flores-Pérez, Paola Bocanegra-Ibarias, Daniel Salas-Treviño, Ana María Guadalupe Rivas-Estilla, Samantha Flores-Treviño, Sonia Amelia Lozano-Sepúlveda, Natalia Martínez-Acuña, Adrián Camacho-Ortiz, Eduardo Pérez Alba, Daniel Arellanos-Soto, Laura Nuzzolo-Shihadeh, Elvira Garza-González
{"title":"Association of the <i>Interleukin 1B</i>-31*C Proinflammatory Allele with the Severity of COVID-19 Patients: A Preliminary Report.","authors":"Kame Alberto Galán-Huerta, Myriam Aseret Zamora-Márquez, Rómulo Omar Flores-Pérez, Paola Bocanegra-Ibarias, Daniel Salas-Treviño, Ana María Guadalupe Rivas-Estilla, Samantha Flores-Treviño, Sonia Amelia Lozano-Sepúlveda, Natalia Martínez-Acuña, Adrián Camacho-Ortiz, Eduardo Pérez Alba, Daniel Arellanos-Soto, Laura Nuzzolo-Shihadeh, Elvira Garza-González","doi":"10.1089/vim.2022.0143","DOIUrl":"https://doi.org/10.1089/vim.2022.0143","url":null,"abstract":"<p><p>Individuals with no known comorbidities or risk factors may develop severe coronavirus disease 2019 (COVID-19). The present study assessed the effect of certain host polymorphisms and viral lineage on the severity of COVID-19 among hospitalized patients with no known comorbidities in Mexico. The analysis included 117 unrelated hospitalized patients with COVID-19. Patients were stratified by whether they required intensive care unit (ICU) admission: the ICU group (<i>n</i> = 40) and non-ICU group (<i>n</i> = 77). COVID-19 was diagnosed on the basis of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) assay and clinical and radiographic criteria. The presence of the <i>IL1B-31</i> (T/C) polymorphism was determined for all patients using PCR and nucleotide sequencing. Genotyping of the <i>IL-4</i> (-590, T/C) and <i>IL-8</i> (-251, T/A) polymorphisms was performed by the amplification refractory mutation system-PCR method. Genotyping of <i>IL1-RN</i> was performed using PCR. Viral genome sequencing was performed using the ARTIC Network amplicon sequencing protocol using a MinION. Logistic regression analysis identified the carriage of <i>IL-1 B*-31</i> *C as an independent potential risk factor (odds ratio [OR] = 3.1736, 95% confidence interval [CI] = 1.0748-9.3705, <i>p</i> = 0.0366) for ICU admission and the presence of <i>IL-RN</i>*2 as a protective factor (OR = 0.4371, 95% CI = 0.1935-0.9871, <i>p</i> = 0.0465) against ICU admission. Under the codominant model, the CC genotype of <i>IL1B</i>-31 significantly increased the risk of ICU admission (OR: 6.38, 95% CI: 11.57-25.86, <i>p</i> < 0.024). The <i>IL1B</i>-31 *C-<i>IL-4</i>-590 *T haplotype increased the risk of ICU admission (OR = 2.53, 95% CI = 1.02-6.25, <i>p</i> = 0.047). The 42 SARS-CoV-2 genomes sequenced belonged to four clades, 20A-20D. No association was detected between SARS-CoV-2 clades and ICU admission or death. Thus, in patients with no known comorbidities or risk factors, the <i>IL1B</i>-31*C proinflammatory allele was observed to be associated with the risk of ICU admission owing to COVID-19.</p>","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"241-249"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9558779","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":"Re: \"Association of the Interleukin 1B-31*C Proinflammatory Allele with the Severity of COVID-19 Patients: A Preliminary Report\" by Galán-Huerta <i>et al.</i>","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1089/vim.2023.0022","DOIUrl":"https://doi.org/10.1089/vim.2023.0022","url":null,"abstract":"","PeriodicalId":23665,"journal":{"name":"Viral immunology","volume":"36 4","pages":"298"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550873","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}