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Akilov OE. What Does the Future Hold for Biomarkers of Response to Extracorporeal Photopheresis for Mycosis Fungoides and Sézary Syndrome? Cells 2023; 12:2321. [PMID: 37759543 PMCID: PMC10527589 DOI: 10.3390/cells12182321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Extracorporeal photopheresis (ECP) is an FDA-approved immunotherapy for cutaneous T-cell lymphoma, which can provide a complete response in some patients. However, it is still being determined who will respond well, and predictive biomarkers are urgently needed to target patients for timely treatment and to monitor their response over time. The aim of this review is to analyze the current state of the diagnostic, prognostic, and disease state-monitoring biomarkers of ECP, and outline the future direction of the ECP biomarker discovery. Specifically, we focus on biomarkers of response to ECP in mycosis fungoides and Sézary syndrome. The review summarizes the current knowledge of ECP biomarkers, including their limitations and potential applications, and identifies key challenges in ECP biomarker discovery. In addition, we discuss emerging technologies that could revolutionize ECP biomarker discovery and accelerate the translation of biomarker research into clinical practice. This review will interest researchers and clinicians seeking to optimize ECP therapy for cutaneous T-cell lymphoma.
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Affiliation(s)
- Oleg E Akilov
- Cutaneous Lymphoma Program, University of Pittsburgh, Pittsburgh, PA 15213, USA
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2
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Hanaoka Y, Kiyohara E, Tani M, Kusakabe S, Maeda T, Tanemura A, Fujimoto M. A rare case of folliculotropic mycosis fungoides with eosinophilic pneumonia. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2022. [DOI: 10.1002/cia2.12229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yuma Hanaoka
- Department of Dermatology Graduate School of Medicine Osaka University Suita Japan
| | - Eiji Kiyohara
- Department of Dermatology Graduate School of Medicine Osaka University Suita Japan
| | - Mamori Tani
- Department of Dermatology Graduate School of Medicine Osaka University Suita Japan
| | - Shinsuke Kusakabe
- Department of Hematology and Oncology Graduate School of Medicine Osaka University Suita Japan
| | - Tetsuo Maeda
- Department of Hematology and Oncology Graduate School of Medicine Osaka University Suita Japan
| | - Atsushi Tanemura
- Department of Dermatology Graduate School of Medicine Osaka University Suita Japan
| | - Manabu Fujimoto
- Department of Dermatology Graduate School of Medicine Osaka University Suita Japan
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Sekiguchi N, Komatsu M, Ichiyama T, Kobayashi A, Gomi D, Fukushima T, Kobayashi T, Noguchi T, Nakazawa H, Asano N, Ishida F, Koizumi T. CCR4-positive peripheral T-cell lymphoma presenting as eosinophilic pneumonia and developing from prolonged pustular psoriasis. J Int Med Res 2021; 49:300060521996165. [PMID: 33641488 PMCID: PMC7917889 DOI: 10.1177/0300060521996165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A 29-year-old woman with chronic, prolonged pustular psoriasis was admitted to our hospital because of high-grade fever and a systemic skin rash. General examination revealed a whole-body skin rash and superficial lymphadenopathy. Peripheral blood examination showed unclassified cells positive for CD3, CD4, and T-cell receptor αβ, and negative for CD20 and CD56. Soon after administration, she developed acute respiratory failure and required artificial ventilation. Bronchoalveolar lavage fluid showed increased numbers of eosinophils and abnormal lymphocytes of the same phenotype in peripheral blood and skin. She was diagnosed with eosinophilic pneumonia, and her respiratory failure was improved by corticosteroid therapy. Based on the histological findings of skin, lymph node, and bone marrow biopsies, a diagnosis of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), with positivity for CC chemokine receptor 4 was made. She received chemotherapy followed by allogeneic stem cell transplantation, which resulted in complete remission of her PTCL-NOS. She remained alive and disease-free 6 years later. This is the first reported case of PTCL-NOS developing during the clinical course of pustular psoriasis. The clinical manifestations of PTCL-NOS are complex, but an accurate diagnosis and appropriate therapy may produce a good clinical outcome in patients with PTCL-NOS.
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Affiliation(s)
- Nodoka Sekiguchi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan.,Second Department of Internal Medicine, Division of Hematology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masamichi Komatsu
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Ichiyama
- First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Aya Kobayashi
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Daisuke Gomi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toshirou Fukushima
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Kobayashi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takuro Noguchi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hideyuki Nakazawa
- Second Department of Internal Medicine, Division of Hematology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoko Asano
- Department of Molecular Diagnostics, Nagano Prefectural Shinshu Medical Center, Japan
| | - Fumihiro Ishida
- Second Department of Internal Medicine, Division of Hematology, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Clinical Laboratory Sciences, Shinshu University School of Health Sciences, Matsumoto, Japan
| | - Tomonobu Koizumi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
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4
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Aladle DA, Salem MA, Mahmoud LA. The Relevance of Circulating Interleukin-5 (IL-5) in Lymphoproliferative Disorders. Hematology 2016; 6:47-51. [DOI: 10.1080/10245332.2001.11746552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Doaa A. Aladle
- Hematology Unit, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt
| | - Mohammad A. Salem
- Hematology Unit, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt
| | - Lotfy A. Mahmoud
- Hematology Unit, Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt
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5
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Stacey R, Green JT. Nonendoscopic therapies for the management of radiation-induced rectal bleeding. Curr Opin Support Palliat Care 2013; 7:175-82. [DOI: 10.1097/spc.0b013e32835f3e00] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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6
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Kural YB, Su O, Onsun N, Uras AR. Atopy, IgE and eosinophilic cationic protein concentration, specific IgE positivity, eosinophil count in cutaneous T Cell lymphoma. Int J Dermatol 2010; 49:390-5. [DOI: 10.1111/j.1365-4632.2010.04228.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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7
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Ishiguro T, Kimura H, Araya T, Minato H, Katayama N, Yasui M, Kasahara K, Fujimura M. Eosinophilic pneumonia and thoracic metastases as an initial manifestation of prostatic carcinoma. Intern Med 2008; 47:1419-23. [PMID: 18670149 DOI: 10.2169/internalmedicine.47.1124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report an 80-year-old man with prostatic carcinoma who developed eosinophilic pneumonia and intrathoracic metastases. He presented with shortness of breath, cough, and fever as a chief complaint. Chest X-ray and computed tomography showed bilateral pulmonary nodules, intrathoracic lymphadenopathy, and right-sided consolidation. Positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) showed poor uptake in these nodules and lymph nodes. The patient subsequently received a pelvic computed tomography scan, which revealed a massively enlarged prostate. The serum prostate specific antigen level was elevated to 4,181.2 ng/mL, and a transrectal biopsy revealed prostatic adenocarcinoma. Based on the morphological and immunohistochemical findings, the nodules in the lung and the lymph nodes were diagnosed as secondary neoplasm from the prostate. As for right-sided consolidation, remarkable bronchoalvelar lavage fluid eosinophilia was detected, that was compatible with eosinophilic pneumonia. Eosinophilic pneumonia in this case disappeared and has not recurred by treatment of prostatic carcinoma and steroid therapy for a week, and was regarded to be tumor-associated. Although prostatic carcinoma with an initial manifestation of intrathoracic metastases and eosinophilic pneumonia is uncommon, physicians should suspect the condition. In addition, we should also keep in mind that prostatic carcinoma sometimes shows poor uptake in FDG-PET. PET: Positron emission tomography, FDG: (18)F-flouorodeoxyglucose.
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Affiliation(s)
- Takashi Ishiguro
- Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science.
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8
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Abstract
Chronic eosinophilic pneumonia (CEP) is a disease of unknown cause. The hallmark of CEP is eosinophil accumulation in the lungs. While the triggering factor is unknown, eosinophil accumulation in the lungs is now believed to be secondary to the actions of eosinophil-specific chemoattractants, including eotaxin and regulated upon activation, normal T-cell expressed and secreted (RANTES), and IL-5 released from Th2 lymphocytes in the lungs. There is a female preponderance in CEP, with a peak incidence in the 5th decade; the onset is insidious with weight loss, cough, and dyspnea. An atopic history is common, but asthma is not a prerequisite for the development of CEP. Airways obstruction may develop during the course of CEP, but may also result from CEP. The chest x-ray usually shows bilateral peripheral shadows, which may be migratory. Peripheral eosinophilia is usual. Standard treatment of CEP is with oral steroids, usually with dramatic resolution of symptoms and radiographic changes; however, relapses are common when the daily steroid dose is reduced below 15 mg. Current data suggest that when treatment is stopped, relapse is common in the majority of patients (>80%) followed for a sufficiently long period of time. Some recent reports suggest that treatment with inhaled steroids may be of some value in this condition.
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Affiliation(s)
- Mahmood Alam
- Division of Pulmonary Medicine, MC 1225, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1321, USA
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9
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Abstract
Background Despite great advances in clinical oncology, the molecular mechanisms underlying the failure of chemotherapeutic intervention in treating lymphoproliferative and related disorders are not well understood. Hypothesis A hypothetical scheme to explain the damage induced by chemotherapy and associated chronic oxidative stress is proposed on the basis of published literature, experimental data and anecdotal observations. Brief accounts of multidrug resistance, lymphoid malignancy, the cellular and molecular basis of autoimmunity and chronic oxidative stress are assembled to form a basis for the hypothesis and to indicate the likelihood that it is valid in vivo. Conclusion The argument set forward in this article suggests a possible mechanism for the development of autoimmunity. According to this view, the various sorts of damage induced by chemotherapy have a role in the pattern of drug resistance, which is associated with the initiation of autoimmunity.
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Affiliation(s)
- Subburaj Kannan
- DNA Repair & Drug Resistance Group, Department of Microbiology, School of Medicine, University of Texas Medical Branch, Galveston, Texas 77555-0609, USA.
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10
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P212 - Pneumopathie à éosinophiles au cours d’un mycosis fongoïde érythrodermique traité par béxarotène et fénofibrate. Ann Dermatol Venereol 2005. [DOI: 10.1016/s0151-9638(05)79941-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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11
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Ionescu MA, Rivet J, Daneshpouy M, Briere J, Morel P, Janin A. In situ eosinophil activation in 26 primary cutaneous T-cell lymphomas with blood eosinophilia. J Am Acad Dermatol 2005; 52:32-9. [PMID: 15627078 DOI: 10.1016/j.jaad.2004.03.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Blood and tissue eosinophils can be associated with Hodgkin and non-Hodgkin lymphomas in that they have prognostic value. Tissue eosinophils in T-cell lymphoma patients with blood eosinophilia have not been systematically assessed. The objective of this research was to study the presence, density, and activation of tissue eosinophils in patients with primary cutaneous T-cell lymphomas (CTCLs) with blood eosinophilia and a possible relationship between features of the disease and prognosis. With skin biopsy specimens from 26 CTCL patients with blood eosinophilia, tissue eosinophils were studied with electron microscopy, extracellular eosinophil peroxidase deposits, and interleukin-5 expression. Tissue eosinophils, found in 22 of 26 cases, were constantly activated. Both density and activation of tissue eosinophils were significantly related to disease progression. The state of activation of tissue eosinophils in CTCL might reflect inflammatory flare-ups associated with aggressive lymphomas. Further studies are needed to confirm the value of eosinophil density as a simple and reliable marker of CTCL progression.
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Affiliation(s)
- Marius A Ionescu
- Department of Dermatology, ERM 0220 INSERM/Hematology Institute IFR 105, Saint-Louis Hospital University Paris VII, France
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12
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Abstract
This review summarizes the recent advances regarding pathogenesis, diagnosis, and treatment of immunological diseases of the lung. Rather than attempt a comprehensive analysis, we have focused on selected diseases that are of particular relevance to the practicing physician, and the material has been organized according to the dominant immunologic mechanisms underlying the disease. Because of the redundancy that characterizes the mammalian immune repertoire, this system of classification inevitably produces overlap but facilitates acquisition of what is otherwise a disparate collection of facts. The principal lung immunologic mechanisms are most broadly classified as innate or adaptive immune processes. Innate immunity includes neutrophils and complement that are important in diseases, such as pneumonia and the acute respiratory distress syndrome. Adaptive immunity involves T and B cells capable of recognizing discrete antigens. T(H)1- and T(H)2-dependent adaptive immune responses underlie some of the most common and important of lung diseases, including tuberculosis and asthma, respectively. Other important immunopathologic processes include granulomatous inflammation that characterizes sarcoidosis and Churg-Strauss vasculitis, and autoimmunity, which is characteristic of antiglomerular basement membrane disease and others.
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Affiliation(s)
- Joseph E Prince
- Biology of Inflammation Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
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13
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Saita N, Yamanaka T, Kohrogi H, Ando M, Hirashima M. Apoptotic response of eosinophils in chronic eosinophilic pneumonia. Eur Respir J 2001; 17:190-4. [PMID: 11334118 DOI: 10.1183/09031936.01.17201900] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To clarify the pathogenesis of chronic eosinophilic pneumonia (CEP), the apoptosis of eosinophils from bronchoalveolar lavage (BAL-Eos) was compared with that of eosinophils from peripheral blood (PB-Eos) in six cases of CEP. The survival rate of eosinophils and the percentage of apoptotic cells of both types of eosinophils were examined, and the effects of interleukin 5 (IL-5) were evaluated. The role of Fas expression in apoptosis of these eosinophils was also studied. The survival rate of BAL-Eos on the third day of culture was significantly higher than that of PB-Eos (p < 0.01). This was associated with a lower proportion of apoptotic cells in BAL-Eos than in PB-Eos; the percentages of apoptotic cells in PB-Eos and BAL-Eos after 24 h of incubation were 21.7 +/- 3.4% and 10.6 +/- 1.7% respectively. IL-5 suppressed apoptosis and increased the survival rate of both PB-Eos and BAL-Eos. It was found that the apoptotic character of BAL-Eos differed from that of PB-Eos in at least three ways. Firstly, the positive rate of Fas expression on PB-Eos was increased after 24 h of incubation, whereas that on BAL-Eos did not change. Secondly, the expression of Fas on PB-Eos was suppressed by IL-5 (18.5 +/- 4.2% - 8.3 +/- 3.2%, p < 0.05), whereas IL-5 failed to suppress Fas expression on BAL-Eos (3.3 +/- 1.6% - 3.6 +/- 1.0%). Lastly, binding of antibody to Fas antigen induced apoptosis of PB-Eos, but not of BAL-Eos. These data suggested that Fas seemed to be involved in the apoptosis of PB-Eos, whereas BAL-Eos were Fas-resistant in chronic eosinophilic pneumonia. In conclusion, apoptosis of eosinophils might be suppressed by proinflammatory cytokines such as IL-5 leading to their accumulation in the lung. Chronic stimulation of eosinophils in the alveolar space with IL-5 may play a crucial role chronic eosinophilic disorders.
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Affiliation(s)
- N Saita
- First Dept of Internal Medicine, Kumamoto University, School of Medicine, Japan
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14
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Lappin MB, Campbell JD. The Th1-Th2 classification of cellular immune responses: concepts, current thinking and applications in haematological malignancy. Blood Rev 2000; 14:228-39. [PMID: 11124110 DOI: 10.1054/blre.2000.0136] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The finding that T cell immune responses could be divided into those promoting cell mediated immunity (Th1) and humoral responses (Th2) has had a profound effect on the understanding of immune response generation over the last 15 years. With ever increasing knowledge of the immune system, the model has come under criticism, as not all responses easily fit the classification. Nonetheless, the model still provides a valuable framework on which to base immunological research. In this review we update the model with current thinking regarding the generation and maintenance of immune responses. We then examine how the Th1-Th2 paradigm may be applied in developing new understanding of several topical issues in haematological malignancy-control of graft-versus-host disease; cytokine control of proliferating clones in B and T cell diseases; and suppression of T cell responses in multiple myeloma.
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Affiliation(s)
- M B Lappin
- Academic Transfusion Medicine Unit, Department of Medicine, University of Glasgow, Royal Infirmary, 10 Alexandra Parade, Glasgow, UK
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15
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Shurin MR, Lu L, Kalinski P, Stewart-Akers AM, Lotze MT. Th1/Th2 balance in cancer, transplantation and pregnancy. SPRINGER SEMINARS IN IMMUNOPATHOLOGY 2000; 21:339-59. [PMID: 10666777 DOI: 10.1007/bf00812261] [Citation(s) in RCA: 139] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M R Shurin
- Biologic Therapy and Surgical Oncology Program, University of Pittsburgh Cancer Institute, PA 15261, USA
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