Allergology International最新文献

{"title":"3D-CT-derived lung volumes and mortality risk in patients with fibrotic hypersensitivity pneumonitis","authors":"Shusuke Yazawa ,&nbsp;Yuzo Suzuki ,&nbsp;Yuko Tanaka ,&nbsp;Koshi Yokomura ,&nbsp;Masato Kono ,&nbsp;Dai Hashimoto ,&nbsp;Atsuki Fukada ,&nbsp;Yusuke Inoue ,&nbsp;Hideki Yasui ,&nbsp;Hironao Hozumi ,&nbsp;Masato Karayama ,&nbsp;Kazuki Furuhashi ,&nbsp;Noriyuki Enomoto ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Naoki Inui ,&nbsp;Takafumi Suda","doi":"10.1016/j.alit.2024.07.002","DOIUrl":"10.1016/j.alit.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Hypersensitivity pneumonitis (HP) is a complex and heterogenous interstitial lung disease (ILD) that occurs in susceptible individuals due to certain inhaled antigens. Fibrotic-HP is a major underlying disease of progressive pulmonary fibrosis. Therefore, in addition to the radiological features of HP, quantitatively measuring fibrosis is important to evaluate disease severity and progression. The present study aimed to compare three-dimensional computed tomography (3D-CT)-derived lung volumes (LVs) of patients with HP and determine its association with mortality risk.</div></div><div><h3>Methods</h3><div>In this retrospective and multicenter cohort study, 126 patients diagnosed with HP (fibrotic, n = 72 and non-fibrotic, n = 54) with a confidence level higher than moderate were enrolled. Each lobe LV was measured using 3D-CT at the time of diagnosis and standardized using predicted forced vital capacity. The 3D-CT LV was compared with those of 42 controls and 140 patients with idiopathic pulmonary fibrosis (IPF).</div></div><div><h3>Results</h3><div>Compared to patients with fibrotic-HP, the standardized total LV was significantly higher in controls and patients with non-fibrotic-HP and was similar in patients with IPF. Longitudinal analyses demonstrated that approximately half of the patients with fibrotic-HP had an annual decrease in total LV. Decreased total and lower-lobe LVs were associated with shorter survival, and were independently associated with mortality together with ongoing exposure to inciting antigens. A composite model consisting of ongoing exposure to inciting antigens and total or lower-lobe LV successfully classified mortality risk into three groups.</div></div><div><h3>Conclusions</h3><div>Quantitatively measuring standardized LV can help determine disease severity, progression, and mortality risk in patients with fibrotic-HP.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 78-85"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches","authors":"Yukinori Kato,&nbsp;Taiyo Morikawa,&nbsp;Shigeharu Fujieda","doi":"10.1016/j.alit.2024.08.007","DOIUrl":"10.1016/j.alit.2024.08.007","url":null,"abstract":"<div><div>Pollen-food allergy syndrome (PFAS) is caused by cross-reaction of a specific pollen antigen with the corresponding food allergen in sensitized individuals. The manifestations are usually limited to oral symptoms; however, sometimes, rhinitis, respiratory and skin symptoms, and anaphylactic shock may occur. In PFAS pathogenesis, when food containing protein antigens (pan-allergens) with high homology to pollen antigens is ingested, mast cells bound to pollen antigen-specific IgE distributed in the oral mucosa cross-react with the food antigen, causing a local type I allergic reaction. The prevalence of PFAS depends on the geographic conditions, such as the type and amount of pollen in the area. PFAS is prevalent in all regions owing to the wide variety of pollen antigens implicated in the disease, such as alder and grass pollen, even outside of the birch habitat area. Basic research on PFAS is expected to significantly contribute to elucidating the pathogenesis and development of therapeutic strategies for PFAS. Currently, effective treatment for patients with PFAS that allows safe consumption of raw foods is lacking, and avoiding the intake of causative foods is the basis of prevention. Furthermore, allergen immunotherapy for PFAS has not yet been established, but various attempts are underway to develop it into a novel treatment strategy. This review highlights the current research landscape on the pathophysiology, epidemiology, and clinical aspects of PFAS. We outline the research gaps that should be addressed to improve the outcomes of patients with PFAS.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 42-50"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysbiosis of the human skin mycobiome in patients receiving systemic IL-23 inhibitors","authors":"Yuta Koike ,&nbsp;Sayaka Kuwatsuka ,&nbsp;Daisuke Motooka ,&nbsp;Hiroyuki Murota","doi":"10.1016/j.alit.2024.06.003","DOIUrl":"10.1016/j.alit.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Systemic inhibition of pro-inflammatory cytokines affects the skin microbiome; however, the impact of systemic anti-inflammatory therapy on the skin fungal microbiome is poorly understood. To examine the effects of cytokine inhibition on the fungal community on human skin and oral mucosa, we analyzed the composition of the skin mycobiome before and after IL-23 inhibition.</div></div><div><h3>Methods</h3><div>The study enrolled 15 psoriasis patients. Swab samples were collected from the psoriasis-free skin of antecubital fossa, post-auricular, and the tongue surface before and after 16 weeks of treatment with anti-IL-23 antibodies. Fungal DNA was sequenced by ITS1 metagenomic analysis, and taxonomic classification was performed.</div></div><div><h3>Results</h3><div>Data from samples collected from the antecubital fossa revealed that the α diversity of the skin mycobiome decreased significantly after treatment with anti-IL-23 antibodies (p = 0.0120). Fungal DNAs were not amplified in 6/15 swab samples after 16 weeks of IL-23 inhibition; by contrast, sufficiently detected in all 15 samples before treatment (p = 0.0554). A comparison of 9/15 paired samples containing well-detected reads revealed that the percentage of genus <em>Malassezia</em> in the mycobiome fell significantly after treatment with IL-23 inhibitors (before, 29.3% ± 9.9%; after; 8.5% ± 3.4%, p = 0.0137). The mycobiome on post-auricular skin and on the tongue surface showed no marked changes after IL-23 inhibition.</div></div><div><h3>Conclusions</h3><div>Taken together, the data suggest that inhibition of systemic IL-23 provokes dysbiosis of the mycobiome at the antecubital fossa skin, a finding characterized by reduced fungal diversity and a reduction in the percentage of the genus <em>Malassezia</em>.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 72-77"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of image-based morphometry of the bronchial tree","authors":"Hiroko Kitaoka ,&nbsp;Takashi Kijima","doi":"10.1016/j.alit.2024.07.009","DOIUrl":"10.1016/j.alit.2024.07.009","url":null,"abstract":"","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 172-174"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T follicular helper cells and IgE","authors":"Yusei Ohshima (Associate Editor, Allergology International)","doi":"10.1016/j.alit.2024.12.001","DOIUrl":"10.1016/j.alit.2024.12.001","url":null,"abstract":"","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 2-3"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical pathomechanisms of NSAID-exacerbated respiratory disease (N-ERD) clarified by treatment with omalizumab, an anti-IgE antibody","authors":"Hiroaki Hayashi ,&nbsp;Makoto Ishii ,&nbsp;Yoshinori Hasegawa ,&nbsp;Masami Taniguchi","doi":"10.1016/j.alit.2024.08.008","DOIUrl":"10.1016/j.alit.2024.08.008","url":null,"abstract":"<div><div>Characteristic symptoms of NSAID-exacerbated respiratory disease (N-ERD) include asthma, chronic eosinophilic rhinosinusitis with nasal polyposis, cysteinyl LT (CysLT) overproduction and NSAIDs hypersensitivity. Some N-ERD patients present with episodic treatment-resistant extra-respiratory symptoms (CysLT-associated coronary artery vasospasm, gastroenteritis, or skin rash). Even when using standard treatments for respiratory and extra-respiratory symptoms, including systemic corticosteroids and aspirin desensitization, it is difficult to control the clinical symptoms and severe type 2 inflammation involved with mast cells, eosinophils, ILC2s, and platelet activation. Few treatment options are applicable in a clinical setting. Therefore, identifying effective treatments is essential for managing N-ERD patients who suffer from these conditions. Our previous observational study demonstrated 12-month omalizumab treatment of N-ERD was clinically effective against respiratory symptoms. Despite the remaining eosinophilia, omalizumab significantly reduced urinary LTE₄ and PGD₂ metabolites to near normal levels at steady state. Based on the preliminary study, we demonstrated that omalizumab induced tolerance to aspirin in N-ERD patients 3 months after therapy initiation and suppressed activation of mast cells during 24 h of initiation in a randomized manner. Moreover, omalizumab had significant efficacy against extra-respiratory symptoms at baseline (lacking aspirin exposure) as well as throughout aspirin challenge. This review addresses the latest discoveries related to N-ERD pathogenesis and the significant effectiveness of omalizumab on N-ERD as a mast cell stabilizer. Our findings regarding omalizumab-associated mast cell inhibitory effects are indirect evidence that mast cell dysregulation and, possibly, IgE are pivotal components of N-ERD.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 51-65"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of explainable AI on slit-lamp images of anterior surface of eyes to diagnose allergic conjunctival diseases","authors":"Michiko Yonehara ,&nbsp;Yuji Nakagawa ,&nbsp;Yuji Ayatsuka ,&nbsp;Yuko Hara ,&nbsp;Jun Shoji ,&nbsp;Nobuyuki Ebihara ,&nbsp;Takenori Inomata ,&nbsp;Tianxiang Huang ,&nbsp;Ken Nagino ,&nbsp;Ken Fukuda ,&nbsp;Tatsuma Kishimoto ,&nbsp;Tamaki Sumi ,&nbsp;Atsuki Fukushima ,&nbsp;Hiroshi Fujishima ,&nbsp;Moeko Kawai ,&nbsp;Etsuko Takamura ,&nbsp;Eiichi Uchio ,&nbsp;Kenichi Namba ,&nbsp;Ayumi Koyama ,&nbsp;Tomoko Haruki ,&nbsp;Dai Miyazaki","doi":"10.1016/j.alit.2024.07.004","DOIUrl":"10.1016/j.alit.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) is a promising new technology that has the potential of diagnosing allergic conjunctival diseases (ACDs). However, its development is slowed by the absence of a tailored image database and explainable AI models. Thus, the purpose of this study was to develop an explainable AI model that can not only diagnose ACDs but also present the basis for the diagnosis.</div></div><div><h3>Methods</h3><div>A dataset of 4942 slit-lamp images from 10 ophthalmological institutions across Japan were used as the image database. A sequential pipeline of segmentation AI was constructed to identify 12 clinical findings in 1038 images of seasonal and perennial allergic conjunctivitis (AC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC), and normal subjects. The performance of the pipeline was evaluated by determining its ability to obtain explainable results through the extraction of the findings. Its diagnostic accuracy was determined for 4 severity-based diagnosis classification of AC, AKC/VKC, GPC, and normal.</div></div><div><h3>Results</h3><div>Segmentation AI pipeline efficiently extracted crucial ACD indicators including conjunctival hyperemia, giant papillae, and shield ulcer, and offered interpretable insights. The AI pipeline diagnosis had a high diagnostic accuracy of 86.2%, and that of the board-certified ophthalmologists was 60.0%. The pipeline had a high classification performance, and the area under the curve (AUC) was 0.959 for AC, 0.905 for normal subjects, 0.847 for GPC, 0.829 for VKC, and 0.790 for AKC.</div></div><div><h3>Conclusions</h3><div>An explainable AI model created by a comprehensive image database can be used for diagnosing ACDs with high degree of accuracy.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 86-96"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed drug hypersensitivity reactions: How p-i transforms pharmacology into immunology","authors":"Werner J. Pichler","doi":"10.1016/j.alit.2024.08.006","DOIUrl":"10.1016/j.alit.2024.08.006","url":null,"abstract":"<div><div>Delayed drug hypersensitivity reactions (dDHRs) are iatrogenic diseases, which are mostly due to non-covalent interactions of a drug with the immune receptors HLA and/or TCR causing T-cell activation. This is also known as pharmacological interaction with immune receptors or p-i. P-i activation differs from classical antigen-driven immune reactions: a) drug binding induces structural changes in TCR-HLA proteins which make them look like allo-like TCR-HLA-complexes, able to elicit allo-like stimulations of T cells with cytotoxicity and IFNγ production, notably without the involvement of innate immunity; b) drug binding to TCR and/or HLA can increase the affinity of TCR-HLA interactions, which may affect signaling and IL-5 production by CD4+ T cells, and thus contribute to eosinophilia commonly found in dDHRs or induce oligoclonal T cell expansions; c) Both, antigen and p-i stimulations can induce eosinophil- or neutrophil-rich inflammations; but these stimulations should be distinguished as their underlying mechanism and development differ; and d) p-i stimulation can – like graft versus host reactions – result in long-lasting T-cell activations, which can lead to viremia, occasional autoimmunity, or a new syndrome characterized by multiple drug hypersensitivity (MDH).</div><div>In summary, dDHRs are not allergic reactions but represent peculiar T-cell activations, similar to allo-like stimulations. Understanding and considering the p-i mechanism is needed for preventive measures and optimal treatments of dDHR. In addition, it may help to understand TCR signaling, alloreactivity, and may even open a new way of specific immune stimulations.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 33-41"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin reaction patterns in cholinergic urticaria","authors":"Ilona Shurmelova ,&nbsp;Agata Baldyga ,&nbsp;Eva Grekowitz ,&nbsp;Susanne Kimeswenger ,&nbsp;Wolfram Hoetzenecker ,&nbsp;Marcus Maurer ,&nbsp;Sabine Altrichter","doi":"10.1016/j.alit.2024.07.008","DOIUrl":"10.1016/j.alit.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Skin reaction patterns vary across patients with cholinergic urticaria (CholU), but their definition, prevalence, and clinical significance remain ill characterized.</div></div><div><h3>Methods</h3><div>Patients with CholU underwent pulse-controlled ergometry provocation testing to analyze skin reaction patterns and their correlation with location, onset, severity, sweating behaviour, clinical features, disease control, and quality of life (QoL) impairment.</div></div><div><h3>Results</h3><div>Based on the size, color, spacing, and shape of wheals as well as their surrounding skin responses, we identified six distinct types of CholU skin reactions, which differed in prevalence, from 83% (Type I) to 11% (Type VI) of patients affected. Almost all patients (94%) had ≥1 type of skin reaction pattern. Sweating was reduced in the majority of CholU patients and most prominently reduced in patients with Type VI skin signs (very small, round, red, widely spaced wheals with surrounding anemic halo), which emerged exclusively on the extremities. Type V skin signs (large, irregular, anemic, widely spaced wheals with moderate size erythema) were associated with the most severe clinical presentation and poorest QoL.</div></div><div><h3>Conclusions</h3><div>Our analysis showed that most patients have more than one type of skin reaction patterns and that different skin signs are linked to distinct features. Future studies should determine any links between treatment response and types of skin signs in CholU.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 115-125"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting dupilumab effectiveness with Type-2 biomarkers: A real-world study of severe asthma","authors":"Kenji Mizumura ,&nbsp;Yasuhiro Gon ,&nbsp;Norihiro Harada ,&nbsp;Shiho Yamada ,&nbsp;Asami Fukuda ,&nbsp;Ryosuke Ozoe ,&nbsp;Shuichiro Maruoka ,&nbsp;Sumiko Abe ,&nbsp;Kazuhisa Takahashi ,&nbsp;Akihiko Tanaka ,&nbsp;Hironori Sagara ,&nbsp;Taisuke Akamatsu ,&nbsp;Toshihiro Shirai ,&nbsp;Katsunori Masaki ,&nbsp;Koichi Fukunaga ,&nbsp;Konomi Kobayashi ,&nbsp;Hiroyuki Nagase ,&nbsp;Nobuaki Miyahara ,&nbsp;Arihiko Kanehiro ,&nbsp;Noboru Kitamura ,&nbsp;Etsuko Tagaya","doi":"10.1016/j.alit.2024.08.005","DOIUrl":"10.1016/j.alit.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>The therapeutic effectiveness of dupilumab for severe asthma in real-world settings is yet to be prospectively investigated across multiple institutions, and uncertainties persist regarding predictive factors for its effectiveness. We aimed to assess the effectiveness of dupilumab and identify predictors of its effectiveness in real-world settings using two type-2 biomarkers: FeNO concentration and blood eosinophil count.</div></div><div><h3>Methods</h3><div>This prospective multicenter study included 103 patients with severe asthma. Exacerbations and respiratory functions were monitored for 24 weeks. Asthma control was evaluated using the Asthma Control Questionnaire-5. Clinical symptoms and their impact on cough and sputum were assessed using the Cough and Sputum Assessment Questionnaire (CASA-Q). Subgroup analyses of type-2 biomarkers were conducted based on FeNO levels and blood eosinophil counts at baseline.</div></div><div><h3>Results</h3><div>Treatment with dupilumab led to a reduction in exacerbations and enhancement in asthma control, FEV₁, and CASA-Q scores. FEV₁ improvement was correlated with enhancement in the sputum domain of the CASA-Q. Patients exhibiting elevated FeNO levels and blood eosinophil counts demonstrated more significant enhancements in FEV₁. CASA-Q sputum domain scores were significantly higher in the group with elevated eosinophil counts. Regression analysis revealed that FeNO levels and blood eosinophil counts are significant predictors of FEV₁ improvement, with blood eosinophil counts also predicting sputum improvement in patients treated with dupilumab.</div></div><div><h3>Conclusions</h3><div>Type-2 biomarkers may act as indicators of improvement in FEV₁ and sputum outcomes among patients with severe asthma undergoing dupilumab treatment in real-world settings.</div></div>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":"74 1","pages":"Pages 144-155"},"PeriodicalIF":6.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}