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Pan Y, Sun Y, Chen L, Cheng Y, Jin P, Zhang W, Zheng L, Liu J, Zhou T, Xu Z, Li C, Kostoulias X, Watson CJ, McGiffin D, Peleg AY, Qu Y. Candida causes recurrent vulvovaginal candidiasis by forming morphologically disparate biofilms on the human vaginal epithelium. Biofilm 2023; 6:100162. [PMID: 37941804 PMCID: PMC10630605 DOI: 10.1016/j.bioflm.2023.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/11/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023] Open
Abstract
Background Recurrent vulvovaginal candidiasis (RVVC) is a recalcitrant medical condition that affects many women of reproductive age. The importance of biofilm formation by Candida in RVVC has been recently questioned. This study aimed to elucidate the fundamental growth modes of Candida in the vagina of patients with RVVC or sporadic vulvovaginal candidiasis (VVC) and to assess their roles in the persistence of RVVC. Methods Vaginal tissues were sampled from twelve patients clinically and microbiologically diagnosed as RVVC or VVC at a post-antifungal-treatment and asymptomatic period. High-resolution scanning electron microscopy, fluorescence in situ hybridization in combination with Candida-specific 18S rRNA probes and viable fungal burden were used to qualitatively and quantitatively evaluate Candida growth in the human vagina. The presence of Candida biofilm extracellular polymeric substances was examined using confocal laser scanning microscopy and biopsy sections pre-stained with Concanavalin A. Histopathological analysis was carried out on infected vaginal tissues stained with hematoxylin and eosin. Lastly, the susceptibility of epithelium-associated Candida biofilms to fluconazole at the peak serum concentration was evaluated. Results Candida species grew on the vaginal epithelium of RVVC patients as morphologically disparate biofilms including monolayers, microcolonies, and macro-colonies, in addition to sporadic adherent cells. Candida biofilm growth on the vaginal epithelium was associated with mild lymphocytic infiltration of the vaginal mucosa. These epithelium-based Candida biofilms presented an important characteristic contributing to the persistence of RVVC that is the high tolerance to fluconazole. Conclusions In summary, our study provides direct evidence to support the presence of Candida biofilms in RVVC and an important role of biofilm formation in disease persistence.
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Affiliation(s)
- Yihong Pan
- Wenzhou Medical University-Monash BDI Alliance in Clinical and Experimental Biomedicine, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, 325000, China
- Department of Obstetrics and Gynaecology, Taizhou Hospital of Wenzhou Medical University, Zhejiang, 318050, China
| | - Yao Sun
- Wenzhou Medical University-Monash BDI Alliance in Clinical and Experimental Biomedicine, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, 325000, China
- Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Lanqian Chen
- Department of Pathology, Taizhou Hospital of Wenzhou Medical University, Zhejiang, 318050, China
| | - Yali Cheng
- Department of Obstetrics and Gynaecology, Taizhou Hospital of Wenzhou Medical University, Zhejiang, 318050, China
| | - Panpan Jin
- Department of Obstetrics and Gynaecology, Taizhou Hospital of Wenzhou Medical University, Zhejiang, 318050, China
| | - Weidan Zhang
- Department of Obstetrics and Gynaecology, Taizhou Hospital of Wenzhou Medical University, Zhejiang, 318050, China
| | - Lingzhi Zheng
- Department of Obstetrics and Gynaecology, Taizhou Hospital of Wenzhou Medical University, Zhejiang, 318050, China
| | - Junyan Liu
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Engineering Research Center of Starch and Vegetable Protein Processing, Ministry of Education, South China University of Technology, Guangzhou, 510640, China
- Department of Civil and Environmental Engineering, University of Maryland, College Park, MD, 20742, United States
| | - Tieli Zhou
- Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Zhenbo Xu
- School of Food Science and Engineering, Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Engineering Research Center of Starch and Vegetable Protein Processing, Ministry of Education, South China University of Technology, Guangzhou, 510640, China
- Department of Civil and Environmental Engineering, University of Maryland, College Park, MD, 20742, United States
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, 02139, United States
| | - Cheng Li
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, 02139, United States
| | - Xenia Kostoulias
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, 3004, Australia
- Department of Microbiology, Infection Program, Biomedical Discovery Institute, Monash University, Clayton, 3800, Australia
| | - Cathy J. Watson
- School of Population and Global Health, University of Melbourne, Carlton, 3053, Australia
| | - David McGiffin
- Department of Cardiothoracic Surgery, The Alfred and Monash University, Melbourne, Victoria, 3004, Australia
| | - Anton Y. Peleg
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, 3004, Australia
- Department of Microbiology, Infection Program, Biomedical Discovery Institute, Monash University, Clayton, 3800, Australia
| | - Yue Qu
- Wenzhou Medical University-Monash BDI Alliance in Clinical and Experimental Biomedicine, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, 325000, China
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, 3004, Australia
- Department of Microbiology, Infection Program, Biomedical Discovery Institute, Monash University, Clayton, 3800, Australia
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Miranda-Cadena K, Marcos-Arias C, Mateo E, Aguirre-Urizar JM, Quindós G, Eraso E. In vitro activities of carvacrol, cinnamaldehyde and thymol against Candida biofilms. Biomed Pharmacother 2021; 143:112218. [PMID: 34649348 DOI: 10.1016/j.biopha.2021.112218] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022] Open
Abstract
Oral candidiasis is frequently associated with Candida biofilms. Biofilms are microbial communities related to persistent, recalcitrant and difficult to-treat infections. Conventional treatments are not sufficient to overcome biofilm-associated candidiasis; thus, the search of new antifungal compounds is necessary. In the current study, we have evaluated the effect of three phytocompounds, carvacrol, cinnamaldehyde and thymol, against Candida planktonic and sessile cells. Reduction in biofilm biomass and metabolic activity was assessed during adhesion and mature biofilm phases. Candida albicans was the most biofilm-producing Candida species. All phytocompounds tested were fungicidal against Candida planktonic cells. Cinnamaldehyde was the most active in inhibiting biofilm adhesion, but carvacrol and thymol significantly reduced both mature biofilm biomass and metabolic activity. These results highlight the role of cinnamaldehyde, carvacrol and thymol as promising alternatives for the treatment of candidiasis due to their antibiofilm capacities, and stress the necessity to continue studies on their safety, toxicity and pharmacodynamics and pharmacokinetics.
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Affiliation(s)
- Katherine Miranda-Cadena
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, P.O. Box 699, 48080 Bilbao, Spain.
| | - Cristina Marcos-Arias
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, P.O. Box 699, 48080 Bilbao, Spain.
| | - Estibaliz Mateo
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, P.O. Box 699, 48080 Bilbao, Spain.
| | - José Manuel Aguirre-Urizar
- Department of Stomatology II, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, P.O. Box 699, 48080 Bilbao, Spain.
| | - Guillermo Quindós
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, P.O. Box 699, 48080 Bilbao, Spain.
| | - Elena Eraso
- Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, P.O. Box 699, 48080 Bilbao, Spain.
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Pinheiro MJF, Costa JP, Marques F, Mira NP, Carvalho MFNN, Alves MM. Bioactive Coatings with Ag-Camphorimine Complexes to Prevent Surface Colonization by the Pathogenic Yeast Candida albicans. Antibiotics (Basel) 2021; 10:antibiotics10060638. [PMID: 34073375 PMCID: PMC8227220 DOI: 10.3390/antibiotics10060638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 01/08/2023] Open
Abstract
Currently there is a gap between the rate of new antifungal development and the emergence of resistance among Candida clinical strains, particularly threatened by the extreme adhesiveness of C. albicans to indwelling medical devices. Two silver camphorimine complexes, [Ag(OH){OC10H14N(C6H4)2NC10H14O}] (compound P) and [{Ag(OC10H14NC6H4CH3-p)}2(μ-O)] (compound Q), are herein demonstrated as having high inhibiting activity towards the growth of Candida albicans and Candida glabrata clinical strains resistant to azoles, the frontline antifungals used in clinical practice. Compounds P and Q were also explored as bioactive coatings to prevent colonization by C. albicans and colonize the surface of indwelling medical devices, resulting in persistent infections. Functionalization of stainless steel with polycaprolactone (PCL) matrix embedded with compounds P or Q was reported for the first time to inhibit the colonization of C. albicans by 82% and 75%, respectively. The coating of PCL loaded with Q or P did not cause cytotoxic effects in mammalian cells, demonstrating the biocompatibility of the explored approach. The identification and further exploration of new approaches for surface engineering based on new molecules that can sensitize resistant strains, as herein demonstrated for complexes P and Q, is a significant step forward to improve the successful treatment of candidiasis.
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Affiliation(s)
- M. Joana F. Pinheiro
- Department of Bioengineering, Instituto de Bioengenharia e Biociências (iBB), Instituto Superior Técnico, Avenida Rovisco Pais, 1049-001 Lisboa, Portugal;
| | - Joana P. Costa
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal;
| | - Fernanda Marques
- Centro de Ciências e Tecnologias Nucleares (CTN), Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10 (km 139,7), 2695-066 Bobadela LRS, Portugal;
| | - Nuno P. Mira
- Department of Bioengineering, Instituto de Bioengenharia e Biociências (iBB), Instituto Superior Técnico, Avenida Rovisco Pais, 1049-001 Lisboa, Portugal;
- Correspondence: (N.P.M.); (M.F.N.N.C.); (M.M.A.)
| | - M. Fernanda N. N. Carvalho
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal;
- Correspondence: (N.P.M.); (M.F.N.N.C.); (M.M.A.)
| | - Marta M. Alves
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisboa, Portugal;
- Correspondence: (N.P.M.); (M.F.N.N.C.); (M.M.A.)
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Simitsopoulou M, Chlichlia K, Kyrpitzi D, Walsh TJ, Roilides E. Pharmacodynamic and Immunomodulatory Effects of Micafungin on Host Responses against Biofilms of Candida parapsilosis in Comparison to Those of Candida albicans. Antimicrob Agents Chemother 2018; 62:e00478-18. [PMID: 29866877 DOI: 10.1128/AAC.00478-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/29/2018] [Indexed: 12/13/2022] Open
Abstract
Micafungin (MFG) demonstrates potent activity against biofilms of Candida albicans and Candida parapsilosis, the most frequent opportunistic fungal pathogens. Little is known about its immunopharmacologic effect on antibiofilm activity of phagocytic cells following exposure to Candida biofilms. In this study, we investigated the effects of MFG on human neutrophil-mediated damage of C. albicans and C. parapsilosis biofilms by XTT [2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide] and the potential mechanisms underlying the immunomodulatory MFG activities on cultured monocyte-derived THP-1 cells in response to these biofilms by reverse transcription-PCR and sandwich and multiplex enzyme-linked immunosorbent assay. Preexposure of C. albicans to subinhibitory MFG concentrations significantly enhanced neutrophil-mediated biofilm damage, an effect that appears to be species specific since a comparable effect was not observed with drug-pretreated C. parapsilosis biofilms. Human THP-1 cells responded to both Candida biofilms through Toll-like receptor 2 (TLR2) and TLR4 upregulation, modest TLR6 involvement, and enhanced NLRP3 activation, whereas the signal was relayed to the nucleus via NF-κB p65 activation. MFG caused 2- to 3-fold lower TLR2 and TLR4 mRNA levels than those caused by either organism. C. albicans biofilms induced a robust proinflammatory response, whereas C. parapsilosis biofilms either alone or in the presence of MFG caused increased interleukin-1β (IL-1β) production, but small amounts of IL-8, IL-23, and tumor necrosis factor alpha. In conclusion, MFG may condition THP-1 cells toward an inflammatory response through TLR2/TLR4 recruitment. Inflammatory signals observed with C. albicans biofilms are considerably reduced upon exposure of THP-1 cells to C. parapsilosis biofilms, possibly enhancing fungal survival and increasing biofilm pathogenicity.
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Tan Y, Leonhard M, Moser D, Ma S, Schneider-Stickler B. Inhibitory effect of probiotic lactobacilli supernatants on single and mixed non-albicans Candida species biofilm. Arch Oral Biol 2018; 85:40-5. [PMID: 29031236 DOI: 10.1016/j.archoralbio.2017.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Oral candidiasis is one of the most common human fungal infections. While most cases of the Candida species isolated from the oral cavity are Candida albicans, a large number of candidiasis is attributed to non-albicans Candida species. In this study, we aim to evaluate the in vitro inhibition of supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus on the single and mixed species biofilm of non-albicans Candida species, including Candida tropicalis, Candida krusei and Candida parapsilosis. DESIGN Cell-free supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus were prepared. Single and mixed non-albicans Candida species biofilm were formed in the 96-well microplate and on the surfaces of medical grade silicone. Biomass and cell viability were tested with crystal violet and cell counting kit-8. In order to examine the ability of the supernatant to disrupt pre-formed biofilm, supernatant was added to 24h-old biofilms. Biofilm architecture on silicone was investigated by scanning electron microscopy and confocal laser scanning microscopy was used to examine live/dead organisms within biofilm. RESULTS Single and mixed species biofilms and cell viability of non-albicans Candida biofilms were inhibited by probiotic lactobacilli supernatants. Matrue biofilm formation was disrupted by lactobacilli supernatants added at 24h after biofilm initiation. Examination with confocal laser scanning microscopy and scanning electron microscopy confirmed that lactobacilli supernatants inhibited the mixed biofilms and damaged the cells. CONCLUSIONS Our data elucidate the inhibitory activity of probiotic lactobacilli on non-albicans Candida biofilm, so as to support their utility as an adjunctive therapeutic mode against oral candida infections.
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Marioni J, Arce JE, Cabrera JL, Paraje MG, Núñez Montoya SC. Reduction of Candida tropicalis biofilm by photoactivation of a Heterophyllaea pustulata extract. Pharm Biol 2016; 54:2791-2801. [PMID: 27256704 DOI: 10.1080/13880209.2016.1183683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/05/2016] [Accepted: 04/24/2016] [Indexed: 06/05/2023]
Abstract
CONTEXT Biofilm formation is an important problem, since this growth mode confers resistance to drugs usually used in therapeutics. OBJECTIVE In vitro antifungal activity of extracts obtained from Heterophyllaea pustulata Hook f. (Rubiaceae) were studied against Candida tropicalis biofilms, evaluating the effect of irradiation and the oxidative and nitrosative stresses as possible mechanisms of action. MATERIALS AND METHODS Hexane, benzene, ethyl acetate and ethanol extracts were evaluated at three concentrations (0.2, 0.1 and 0.05 mg/mL) over mature biofilm, under darkness and irradiation. After 48 h of incubation, biofilm quantitation was performed by the O'Toole and Kolter method. Reactive oxygen species (ROS) was measured by nitro-blue tetrazolium (NBT) reaction and reactive nitrogen intermediates (RNI) by the Griess reagent. Superoxide dismutase activation (SOD, NBT assay) and total antioxidant system (FRAP test) were studied. RESULTS Only the benzene extract at 0.2 mg/mL reduced the biofilms formation. The slight decrease achieved in darkness (17.06 ± 2.80% reduction) was increased by light action (39.31 ± 3.50% reduction), clearly observing a photostimulation. This great reduction was confirmed by confocal microscopy. In darkness, biofilm reduction was mediated by an increase in RNI, whereas under irradiation, the ROS action was most important. Although no SOD activation was observed, a strong stimulation of the total antioxidant system was detected. HPLC analysis established a high content of several anthraquinones in this extract. DISCUSSION AND CONCLUSION Biofilm reduction by benzene extract was mainly mediated by oxidative stress triggered under light action, confirming a photodynamic sensitization, which could be attributed to its high content of photosensitizing anthraquinones.
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Affiliation(s)
- Juliana Marioni
- a IMBIV-CONICET, Departamento De Farmacia, Facultad De Ciencias Químicas , Universidad Nacional De Córdoba , Córdoba , Argentina
- b IMBIV-CONICET , Cátedra De Microbiología, Facultad De Ciencias Exactas Físicas Y Naturales . Universidad Nacional De Córdoba , Córdoba , Argentina
| | - Julio E Arce
- b IMBIV-CONICET , Cátedra De Microbiología, Facultad De Ciencias Exactas Físicas Y Naturales . Universidad Nacional De Córdoba , Córdoba , Argentina
| | - José L Cabrera
- a IMBIV-CONICET, Departamento De Farmacia, Facultad De Ciencias Químicas , Universidad Nacional De Córdoba , Córdoba , Argentina
| | - María G Paraje
- b IMBIV-CONICET , Cátedra De Microbiología, Facultad De Ciencias Exactas Físicas Y Naturales . Universidad Nacional De Córdoba , Córdoba , Argentina
| | - Susana C Núñez Montoya
- a IMBIV-CONICET, Departamento De Farmacia, Facultad De Ciencias Químicas , Universidad Nacional De Córdoba , Córdoba , Argentina
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Monteiro DR, Silva S, Negri M, Gorup LF, de Camargo ER, Oliveira R, Barbosa DB, Henriques M. Antifungal activity of silver nanoparticles in combination with nystatin and chlorhexidine digluconate against Candida albicans and Candida glabrata biofilms. Mycoses 2013; 56:672-80. [PMID: 23773119 DOI: 10.1111/myc.12093] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 04/29/2013] [Accepted: 05/05/2013] [Indexed: 11/26/2022]
Abstract
Although silver nanoparticles (SN) have been investigated as an alternative to conventional antifungal drugs in the control of Candida-associated denture stomatitis, the antifungal activity of SN in combination with antifungal drugs against Candida biofilms remains unknown. Therefore, the aim of this study was to evaluate the antifungal efficacy of SN in combination with nystatin (NYT) or chlorhexidine digluconate (CHG) against Candida albicans and Candida glabrata biofilms. The drugs alone or combined with SN were applied on mature Candida biofilms (48 h), and after 24 h of treatment their antibiofilm activities were assessed by total biomass quantification (by crystal violet staining) and colony forming units enumeration. The structure of Candida biofilms was analysed by scanning electron microscopy (SEM) images. The data indicated that SN combined with either NYT or CHG demonstrated synergistic antibiofilm activity, and this activity was dependent on the species and on the drug concentrations used. SEM images showed that some drug combinations were able to disrupt Candida biofilms. The results of this study suggest that the combination of SN with NYT or CHG may have clinical implications in the treatment of denture stomatitis. However, further studies are needed before recommending the use of these drugs safely in clinical situations.
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Affiliation(s)
- Douglas R Monteiro
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, Univ Estadual Paulista (UNESP), Araçatuba, São Paulo, Brazil; Department of Biological Engineering, Institute for Biotechnology and Bioengineering, University of Minho, Braga, Portugal
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