Autoimmunity reviews最新文献

{"title":"Clinical features, pathogenesis, and treatment of inflammatory bowel disease-associated spondyloarthritis","authors":"Mitsuhiro Akiyama,&nbsp;Waleed Alshehri,&nbsp;Koji Suzuki,&nbsp;Kanako Shimanuki,&nbsp;Koichi Saito,&nbsp;Yuko Kaneko","doi":"10.1016/j.autrev.2025.103853","DOIUrl":"10.1016/j.autrev.2025.103853","url":null,"abstract":"<div><div>Inflammatory bowel disease-associated spondyloarthritis (IBD-SpA) is a unique subtype of SpA that affects approximately 10–20 % of patients with IBD. It encompasses both peripheral arthritis and axial involvement, with enthesitis being increasingly recognized. Despite its clinical significance, there are currently no established screening tools, classification criteria, or standardized treatment guidelines specific to IBD-SpA. Management is typically guided by recommendations for IBD and SpA, requiring close collaboration between gastroenterologists and rheumatologists. Emerging evidence suggests that subclinical gut inflammation and IL-23–IL-17–TNFα signaling pathway play central roles in the pathogenesis of IBD-SpA. Among the available therapeutic options, TNF inhibitors and JAK inhibitors have demonstrated efficacy in both IBD and SpA, whereas IL-17 inhibitors may exacerbate intestinal inflammation. Additionally, vedolizumab, an α4β7 integrin inhibitor, while effective for IBD, has been implicated in triggering de novo SpA. These complexities highlight the need for a tailored treatment approach that balances efficacy for both gut and joint inflammation. This review provides an updated overview of the clinical features, diagnosis, pathogenesis, and treatment strategies for IBD-SpA, emphasizing recent advancements and future directions in the field.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 9","pages":"Article 103853"},"PeriodicalIF":9.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313377","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":"Autoreactive B cells in autoimmune diseases: Mechanisms, functions and clinical implications","authors":"Aurore Collet ,&nbsp;Thomas Guerrier ,&nbsp;Sébastien Sanges ,&nbsp;Aurélien Chépy ,&nbsp;Vincent Sobanski ,&nbsp;David Launay ,&nbsp;Sylvain Dubucquoi","doi":"10.1016/j.autrev.2025.103851","DOIUrl":"10.1016/j.autrev.2025.103851","url":null,"abstract":"<div><div>Autoreactive B cells play a key role in the pathophysiology of autoimmune diseases (AIDs). Still, due to their low frequency in the circulating blood, they are less well characterized than the global B cell pool. This review aims at describing the tools that allow the study of autoreactive B cells, deciphering their features and functions, and discussing the therapeutic implications that arise from these findings.</div><div>The capacity to detect and analyze autoreactive B cells has been significantly improved by diverse techniques such as ELISpot and flow cytometry, shedding light on their roles in immune dysregulation. It reveals the multifaceted features of autoreactive B cells in terms of phenotypic and functional characteristics, that vary between different AIDs, and from one autoantigen to another. This heterogeneity may be influenced by factors such as the nature of the targeted autoantigen, or the costimulatory signals involved. These observations highlight that autoreactive B cells contribute not only to autoantibody production, but also to the perpetuation of autoimmunity through additional mechanisms, including antigen presentation and cytokine secretion. Recent therapeutic approaches have been developed to target autoreactive B cells, allowing an antigen-specific depletion of B cells, without causing widespread immunosuppression. Challenges remain, such as understanding the precise mechanisms by which the B cell tolerance breakdown occur, and the pathways by which autoreactive B cells activate (i.e. germinal centre or extrafollicular pathway). Ongoing research into the mechanisms regulating autoreactive B cells will be crucial for designing more targeted and effective therapies, leading to better outcomes for AID patients.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103851"},"PeriodicalIF":9.2,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262645","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":"The role of B cells in Sjögren's syndrome and their impact on the nervous system","authors":"Chuanxin Su ,&nbsp;Wang Wang ,&nbsp;Fang Cheng ,&nbsp;Futao Zhao ,&nbsp;Song Guo Zheng","doi":"10.1016/j.autrev.2025.103852","DOIUrl":"10.1016/j.autrev.2025.103852","url":null,"abstract":"<div><div>Primary Sjögren's syndrome is an autoimmune disease characterized by the dryness of exocrine glands. Recent studies emphasizes the significant role of B cells in its pathogenesis. This review provides an overview of the functions of B cells in Sjögren's syndrome and their impact on the nervous system. Current studies on the association between B cell-mediated immune responses and neurological symptoms are reviewed, aiming to offer new insights for diagnosing and treating. Understanding these connections is crucial for addressing the complex interplay between the immune system and neurological manifestations in affected individuals. A critical gap remains in determining whether B cell dysregulation initiates neuropathology or amplifies pre-existing neural inflammation, highlighting the need for mechanistic studies to guide targeted therapies.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103852"},"PeriodicalIF":9.2,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262646","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":"Corrigendum to “Safety of biologics in patients with autoimmune rheumatic diseases during pregnancy: Systematic review and meta-analysis” [Autoimmunity Reviews, Volume 24 (2025), Issue 8, /103827]","authors":"Shiran Li ,&nbsp;Hongxi Liu ,&nbsp;Siyu Zeng ,&nbsp;Jingxian Xie ,&nbsp;Zhimin Li ,&nbsp;Yong Yang ,&nbsp;Junlan Chuan","doi":"10.1016/j.autrev.2025.103840","DOIUrl":"10.1016/j.autrev.2025.103840","url":null,"abstract":"","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103840"},"PeriodicalIF":9.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144229740","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":"Clostridioides difficile-related reactive arthritis: A scoping review of the literature","authors":"Dimitrios Deligeorgakis ,&nbsp;Evangelia S. Makri ,&nbsp;Konstantinos Tsafis ,&nbsp;Elpida Skouvaklidou ,&nbsp;Ioanna Katsigianni ,&nbsp;Christina Adamichou ,&nbsp;Nikolaos Kougkas ,&nbsp;Theodoros Dimitroulas","doi":"10.1016/j.autrev.2025.103842","DOIUrl":"10.1016/j.autrev.2025.103842","url":null,"abstract":"<div><div>Reactive arthritis (ReA) is an inflammatory arthritis triggered by preceding infection. While various bacterial pathogens are well-established as causative agents, the role of <em>Clostridioides difficile</em> remains less elucidated. Α scoping review was conducted to evaluate the existing literature on CDI-induced ReA to determine clinical features, management, and disease trajectory. Sixty-one CDI-related ReA cases were identified (61 % male, mean age 38.8 years). HLA-B27 positivity was 64 % (30/47 tested). Prior antibiotic use was reported in 89 % of cases, with arthritis onset 8.5 days post-CDI. Oligoarthritis predominated (41 %), involving a median of 3 joints (knee 67 %, ankle 44 %, hand 26 %). Extra-articular manifestations were present in 20 %. Only 10 % required treatment escalation to disease-modifying anti-rheumatic drugs (DMARDs). Remission was achieved in 87 % within 21 days, with 9 % relapse rate. HLA-B27 positive patients had fewer affected joints (2 <em>vs</em> 5, <em>p</em> = 0.03) and older age at onset (43.1 <em>vs</em> 29.1, <em>p</em> = 0.02). Pediatric patients were more likely to experience hip arthritis than adults (54 % <em>vs</em> 10 %, <em>p</em> = 0.003). This study confirms CDI as a cause of ReA, highlighting its typically benign course with high remission rates. Further research is warranted, particularly regarding refractory cases.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103842"},"PeriodicalIF":9.2,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240040","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":"Genetic and immune dysregulation in vitiligo: Insights into autoimmune mechanisms and disease pathogenesis","authors":"Sathvik Upadhya ,&nbsp;Melisa J Andrade ,&nbsp;Vaibhav Shukla ,&nbsp;Raghavendra Rao ,&nbsp;Kapaettu Satyamoorthy","doi":"10.1016/j.autrev.2025.103841","DOIUrl":"10.1016/j.autrev.2025.103841","url":null,"abstract":"<div><div>Vitiligo is a hypopigmentary skin disease condition affecting local melanocytes leading to the white patched/macules of depigmented skin due to their progressive loss of melanocytes in the epidermis. Vitiligo pathogenesis involves complex interaction of several trigger factors including genetic predispositions, environmental stimuli, oxidative stress, immunological dysregulation, and impaired melanocyte function. Genetic studies have provided insight into the essential aspects related to immunological modulation, melanocyte biology and the oxidative stress response, aiding in understanding the possible mechanisms underlying vitiligo susceptibility. Epigenetic modifications further contribute to the regulatory landscape controlling the pathophysiology of this disease. While genetic studies identified key susceptibility loci, it is the functional studies that have driven the development of novel targeted therapies. Although vitiligo exhibits complex heterogenous clinical manifestations and multiple contributing factors, significant advancements have been achieved in understanding the underlying mechanism of the disease. Particularly, cytotoxic T-cell activity and interferon-gamma (IFN-ϒ) mediated immune response have been studied extensively in disease pathogenesis. This has led to the development of novel targeted therapies including cytokine targeted therapies, Janus-activated kinase (JAK) signaling inhibitors, and Wnt signaling agonists which have shown potential clinical success.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103841"},"PeriodicalIF":9.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224174","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":"Advances in precision medicine in imaging and therapeutic strategies for psoriatic disease","authors":"Thorben Witte ,&nbsp;Ioanna Minopoulou ,&nbsp;Norman Michael Drzeniek ,&nbsp;Murat Torgutalp ,&nbsp;Robert Sabat ,&nbsp;Vincent Casteleyn ,&nbsp;Fredrik Albach ,&nbsp;Filippo Fagni ,&nbsp;Georg Schett ,&nbsp;Alen Zabotti ,&nbsp;Gerhard Krönke ,&nbsp;Dennis McGonagle ,&nbsp;Michaela Köhm ,&nbsp;Frank Behrens ,&nbsp;Arnd Kleyer ,&nbsp;David Simon","doi":"10.1016/j.autrev.2025.103839","DOIUrl":"10.1016/j.autrev.2025.103839","url":null,"abstract":"<div><div>Psoriatic disease, encompassing psoriasis (PsO) and psoriatic arthritis (PsA), affects approximately 2 % of the global population. In the majority of cases, skin alterations occur first, followed by musculoskeletal disorders. The transition from cutaneous to synovio-entheseal disease reflects a gradual immune-driven progression from localized to systemic manifestations in most cases. Subclinical or non-specific symptoms often precede demonstrable synovitis or enthesitis, which further delays diagnosis and increases the risk of irreversible structural damage. Despite the critical importance of early detection, established risk factors for PsA are largely nonspecific, presenting challenges for precision medicine. Key amongst these is the presence of arthralgia, which usually precedes PsA development but is also common in degenerative and biomechanical problems. Recent advancements, encompassing cutting-edge imaging modalities, hold the potential to facilitate earlier and more precise detection of PsA, while groundbreaking therapeutic innovations are redefining treatment paradigms and may further integrate advanced imaging into personalized therapeutic strategies. This review explores the molecular and clinical complexity of psoriatic disease, highlights the latest developments in imaging and treatment, and considers their potential to revolutionize patient outcomes. Novel strategies promise advances in precision medicine and may pave the way for customized interventions that not only enhance the diagnosis and prognosis of psoriatic disease but also refine therapeutic decision-making. Innovative imaging techniques are essential to distinguishing psoriatic disease-related pain from alternative causes such as osteoarthritis, thereby guiding treatment continuation and optimization.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103839"},"PeriodicalIF":9.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207489","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":"Dual B-cell targeting in systemic lupus erythematosus: The role of combined and sequential therapy with rituximab and belimumab","authors":"Beatriz Frade-Sosa ,&nbsp;Juan C. Sarmiento-Monroy ,&nbsp;Ian N. Bruce ,&nbsp;Laurent Arnaud ,&nbsp;José A. Gómez-Puerta","doi":"10.1016/j.autrev.2025.103837","DOIUrl":"10.1016/j.autrev.2025.103837","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by immune dysregulation and autoantibody production. Despite advances in treatment, achieving sustained disease control remains challenging. Rituximab (RTX) and belimumab (BELI) are two B-cell-targeting biologics with complementary mechanisms of action, leading to increasing interest in their combination as a therapeutic strategy for refractory SLE. RTX depletes CD20+ B cells, whereas BELI inhibits B-lymphocyte stimulator (BLyS), reducing the survival of autoreactive B cells. Sequential therapy with these agents may mitigate B-cell repopulation and improve disease control.</div><div>Recent studies, including SynBioSe and BEAT-LUPUS, suggest that RTX-BELI therapy can reduce autoantibody levels, neutrophil extracellular trap formation, and disease activity, with many patients achieving a lupus low disease activity state (LLDAS). However, the BLISS-BELIEVE and CALIBRATE trials did not demonstrate superiority over monotherapy, highlighting the need to refine patient selection. Combination therapy may be particularly beneficial in lupus nephritis, where BELI delays autoreactive B-cell reconstitution following RTX, potentially prolonging remission.</div><div>While RTX-BELI therapy is generally well-tolerated, some studies report increased infections, necessitating careful patient monitoring. Lessons from other immune-mediated diseases, including inflammatory bowel disease and rheumatoid arthritis, underscore the potential benefits and risks of dual biologic therapy. Further research, including the ongoing SynBioSe-2 trial, is needed to clarify the optimal use, sequencing, and safety profile of RTX-BELI in SLE. Identifying biomarkers predictive of response may enable personalized treatment approaches, ultimately improving long-term outcomes for patients with refractory SLE.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103837"},"PeriodicalIF":9.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141325","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":"Experiences and unmet needs of persons living with systemic lupus erythematosus in Europe: Lupus Europe's 2024 Swiss knife survey","authors":"Alain Cornet ,&nbsp;Zoe Karakikla Mitsakou ,&nbsp;Jeanette Andersen ,&nbsp;Sarah Dyball ,&nbsp;Ricky Chotai ,&nbsp;Annemarie Sluijmers ,&nbsp;Cristiana Sieiro Santos ,&nbsp;Aldevina Sturiene ,&nbsp;Lucy Scarle ,&nbsp;Daniel Guimarães de Oliveira ,&nbsp;Nuria Zuniga ,&nbsp;Elfriede Wijsma ,&nbsp;Elisabetta Chessa ,&nbsp;Laurent Arnaud","doi":"10.1016/j.autrev.2025.103838","DOIUrl":"10.1016/j.autrev.2025.103838","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) is a complex autoimmune disease with important variations in disease burden across patients and European countries. In response to previous surveys revealing the burden of SLE on patients, Lupus Europe conducted the 2024 ‘Swiss Knife’ survey to further investigate disease burden, treatment goals, and patient-physician interactions in European patients living with lupus. Between April and May 2024, 4525 patients with self-reported physician-confirmed SLE across 36 European countries participated in an anonymous online study. Descriptive statistics were utilized to analyze responses related to SLE symptoms, treatment satisfaction, and unmet needs. Results indicated that fatigue (84.9 %), joint pain (72.8 %), and muscle pain (62.6 %) were the most prevalent symptoms, with fatigue notably under-addressed in treatment plans. The mean lupus burden score was high at 6.94 (SD: 1.95) on the 0–10 scale, highlighting a significant impact on quality of life, particularly in terms of fatigue and physical consequences. Notably, only 7.9 % of participants reported no disease flares in the past five years, contrasting with previous literature on remission rates. In terms of treatment goals, patients favored achieving low disease activity or remission without treatment, while satisfaction with current therapies was moderate, with 67.5 % expressing contentment but many indicating unmet needs, particularly regarding fatigue management and access to non-pharmacological therapies. The findings of Lupus Europe's 2024 Swiss Knife study underscore the necessity for improved communication between patients and healthcare professionals and the integration of patient-centered strategies to optimize SLE management and enhance quality of life across Europe.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103838"},"PeriodicalIF":9.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126454","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":"Integrating network pharmacology and experimental validation to advance psoriasis treatment: Multi-target mechanistic elucidation of medicinal herbs and natural compounds","authors":"Hee-Geun Jo ,&nbsp;Jihye Seo ,&nbsp;Boyun Jang ,&nbsp;Youngsoo Kim ,&nbsp;Hyehwa Kim ,&nbsp;Eunhye Baek ,&nbsp;Soo-Yeon Park ,&nbsp;Donghun Lee","doi":"10.1016/j.autrev.2025.103836","DOIUrl":"10.1016/j.autrev.2025.103836","url":null,"abstract":"<div><h3>Background</h3><div>Psoriasis, a chronic immune-mediated inflammatory disease (IMID), presents significant therapeutic challenges, necessitating exploration of alternative treatments like medicinal herbs (MH) and natural compounds (NC). Network pharmacology offers predictive insights, yet a systematic evaluation connecting these predictions with experimental validation outcomes specifically for MH/NC in psoriasis is lacking. This review specifically fills this gap by comprehensively integrating and analyzing studies that combine network pharmacology predictions with subsequent experimental validation.</div></div><div><h3>Methods</h3><div>A systematic literature search identified 44 studies employing both network pharmacology and in vitro or in vivo experimental methods for MH/NC targeting psoriasis. This review provides a systematic analysis of the specific network pharmacology platforms, predicted targets/pathways, in vivo and in vitro experimental validation models, and key biomarker changes reported across these integrated studies. Methodological approaches and the consistency between predictions and empirical findings were critically evaluated.</div></div><div><h3>Results</h3><div>This first comprehensive analysis reveals that network pharmacology predictions regarding MH/NC mechanisms in psoriasis are frequently corroborated by experimental data. Key signaling pathways, including the IL-17/IL-23 axis, MAPK, and NF-κB, emerge as consistently predicted and experimentally validated targets across diverse natural products. The review maps the specific network pharmacology tools and experimental designs utilized, establishing a methodological benchmark for the field and highlighting the successful synergy between computational prediction and empirical verification.</div></div><div><h3>Conclusion</h3><div>By systematically integrating and critically assessing the linkage between network pharmacology predictions and experimental validation for MH/NC in psoriasis, this review offers a unique clarification of the current, validated state-of-the-art, differentiating it from previous literature. It confirms network pharmacology's predictive power for natural products, identifies robustly validated therapeutic pathways, and provides a crucial benchmark, offering data-driven insights for future research into artificial intelligence-enhanced natural product-based therapies for psoriasis and other IMIDs.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"24 8","pages":"Article 103836"},"PeriodicalIF":9.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092032","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}