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Antimitochondrial antibody serocoversion post-liver transplant during hepatitis C treatment with peginterferon α, ribavirin and telaprevir
Vladimir Marquez-Azalgara*, Trana Hussaini**, Siegfried R. Erb*, Eric M. Yoshida**,
Corresponding author
eric.yoshida@vch.ca

Correspondence and reprint request:
* Division of Gastroenterology. University of British Columbia. Canada
** Faculty of Pharmaceutical Science. University of British Columbia. Canada
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Introduction</span><p id="p0005" class="elsevierStylePara elsevierViewall">Pegylated interferon alpha &#40;PEG-IFN &#945;&#41; remains a key component of effective therapy for the treatment of hepatitis C infection&#46; There are several reports of the immunomodulatory effects of interferon alpha and it is known that it can exacerbate autoimmune diseases&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> There is also a single report of antimitochondrial antibody &#40;AMA&#41; seroconversion during treatment with interferon-&#945;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> We report the first case of AMA seroconverion during PEG-IFN a-based treatment for chronic hepatitis C &#40;HCV&#41; in a patient on immunosuppressants after liver transplantation&#46;</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Case Report</span><p id="p0010" class="elsevierStylePara elsevierViewall">We report a 57 year old man who was transplanted for end-stage liver disease secondary to chronic hepatitis C&#44; with a 4&#46;5 cm hepatocellular carcinoma&#46; His HCV genotype was 1b and attempted treatment with peginterferon and ribavirin 12 years prior to transplantation&#44; but discontinued due to an esophageal variceal bleeding&#46; During his pre-transplant assessment&#44; his antinuclear antibodies and AMA were negative&#46; The anti-smooth muscle antibodies were weakly positive at a titer of 1&#58;80&#46; He underwent an orthotopic liver transplant from a deceased donor who was HBs antigen negative and HBc antibody positive with no significant post-operative complications and was discharged home on his post-operative day 11&#46; He received standard immunosuppression with mycophenolate mofetil&#44; tacrolimus and intravenous methylprednisolone followed by oral prednisone&#46; Prophylactic lamivudine&#44; valgancyclovir and cotrimoxazole were also started for hepatitis B&#44; cytomegalovirus and <span class="elsevierStyleItalic">Pneumocystis jirovecii</span> prophylaxis respectively&#46; Two months after transplantation&#44; a liver biopsy was obtained to assess an increase in his liver enzymes revealingvmild rejection with a rejection activity index &#40;RAI&#41; score of 3 and no appreciable fibrosis&#46; Five months aftertransplant&#44; his liver enzymes were&#58; AST 659 IU &#40;normal &#60; 40 IU&#47; L&#41;&#44; ALT 643 IU &#40;normal &#60; 60 IU&#47;L&#41;&#44; GGT 151 IU &#40;normal &#60; 55 IU&#47;L&#41;&#44; alkaline phosphatase 490 &#40;normal &#60; 110 IU&#47;L&#41;&#44; total bilirubin of 9 <span class="elsevierStyleItalic">&#956;</span> mol&#47;L &#40;normal &#60; 22 <span class="elsevierStyleItalic">&#956;</span> mol&#47;L&#41;&#46; A FibroScan showed a score of 12&#46;4 Kpa&#44; consistent with an F2-F3 stage fibrosis&#46; The patient was switched from tacrolimus to oral cyclosporine in preparation of starting treatment for his hepatitis C recurrence with combination of telapravir&#44; peginterferon and ribavirin&#46; Serum HCV RNA levels were 24 534 447 IU&#47;mL prior to treatment initiation and less than 15 IU&#47;mL after four weeks of therapy&#46; The serum HCV RNA levels became undetectable at week 8 and remained so at week 12&#46; All the liver enzymes normalized at week 6 of therapy&#46; After 22 weeks of treatment&#44; a new elevation in liver enzymes was observed with alkaline phosphatase 3-4 times the upper limit of normal&#46; A repeated measurement of immunological markers at week 31 of therapy revealed a positive AMA with a titer of 1&#58;160&#46; Antinuclear antibodies&#44; extractable nuclear antibodies and double-stranded DNA antibodies remained negative&#46; A liver biopsy performed at week 36 of therapy&#44; while the HCV RNA remained undetectable&#44; showed changes consistent with recurrent hepatitis C&#44; no allograft rejection&#44; but no histological evidence of primary biliary cirrhosis&#46; He started therapy with urseodeoxycholic acid at 15mg&#47; kg&#47;day with subsequent improvement of his liver enzymes&#46;</p></span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0025">Discussion</span><p id="p0015" class="elsevierStylePara elsevierViewall">Chronic HCV is associated with a high prevalence of auto-antibodies&#46; One study compared the prevalence of autoantibodies in chronic HCV to autoimmune hepatitis &#40;AIH&#41;&#46; The prevalence of antinuclear&#44; anti-smooth muscle and antimitochondrial antibodies was 63&#37;&#44; 65&#37; and 4&#37; in patients with HCV compared to 63&#44; 65 and 50&#37; in AIH respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Another study in 58 patients with chronic HCV receiving interferon-&#945; therapy found at baseline a prevalence of 11&#46;3&#44; 37&#46;9 and 1&#46;7&#37; for antinuclear&#44; anti-smooth muscle and antimitochondrial antibodies&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In one study the sera of 460 patients with untreated HCV were tested for AMA using indirect immunofluorescence and 7 &#40;1&#46;5&#37;&#41; were found to be positive&#59; none had PBC&#46; All patients were treated with IFN-alpha for six months&#46; Only one of the seven patients achieved SVR and AMA became undetectable&#46; The others remained HCV RNA and AMA positive&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="p0020" class="elsevierStylePara elsevierViewall">We report a patient without any evidence of autoimmune liver disease prior to the posttransplant initiation of treatment for hepatitis C&#46; During the course of treatment&#44; the initial normalization of the liver enzymes was followed by an increase in the ALT and alkaline phosphatase levels&#44; associated with a seroconversion of AMA&#44; that partially responded to therapy with ursodeoxycholic acid&#46; However&#44; the liver biopsy failed to show histological evidence of primary biliary cirrhosis&#46; This&#44; however&#44; may be because the disease was at a very early stage or because of sampling error&#46; Therefore&#44; with a positive AMA and a liver biochemical pattern that can be consistent&#44; we cannot absolutely exclude a diagnosis of PBC&#46; D&#8217;Amico&#44; <span class="elsevierStyleItalic">et al&#46;</span> published the case of a woman who developed overlap syndrome of AIH and PBC shortly after completing treatment with interferon-&#945;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This was the first case report of interferon treatment inducing PBC with biochemical&#44; immunological and histological evidence&#46; Other studies have shown AMA seroconversion during treatment with interferon&#46; Imagawa reported in a cohort of 58 patients one case &#40;1&#46;7&#37;&#41; of <span class="elsevierStyleItalic">de novo</span> AMA appearance during treatment with interferon-a and one case with worsening of liver enzymes during treatment in a patient with pre-existent AMA&#46;</p><p id="p0025" class="elsevierStylePara elsevierViewall">Interferon-&#945; has cytokine activity and stimulates the production of T-helper &#40;Th&#41; cells&#44; more specifically Th-1 cells that produces interferon&#947; and interleukin-2 &#40;IL-2&#41; over Th-2 cells that produce IL-4 and IL-5&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> On the other hand&#44; calcineurin inhibitors &#40;CNI&#41; are inhibitors of IL-2 and interferon-&#947; transcription&#44; thus interfering with T-cell co-stimulation and clonal expansion&#46; In the case of our patient&#44; it would be expected that the stimulatory effects of interferon-&#945; on T-cells would be directly counterbalanced by the inhibitory effect of CNI&#46; One study in 15 renal transplant patients with hepatitis C receiving interferon-&#945; treatment evaluated the impact of therapy on several autoantibodies&#46; Five patients developed autoantibodies &#40;Antinuclear 1&#44; smooth-muscle 1&#44; antithyroid microsomes 3&#41;&#46; None of the 15 patients had pre-existing or developed antimitochondrial an-tibodies&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> It is interesting that this patient&#8217;s AMA did not seroconvert during his initial pegIFN treatment 12 years pre-transplant and only occurred post-transplant&#46; It is possible that the antigenic stimulation from the donor allograft&#44; in combination with the immunostimulatory properties of pegIFN&#44; may have been a factor in the seroconversion&#46; If this is the case&#44; the seroconversion could be considered an unusual serologic variant of allograft versus host interaction that has not affected graft function or histology&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">In summary&#44; this is the first reported case of AMA seroconversion in a patient undergoing PEG-IFN&#945; based treatment for HCV after liver transplantation&#46; This occurred despite immunosuppressive treatment with a CNI and mycophenolate and demonstrates that AMA-seroconversion may occur after transplant during interferon-based therapy&#46; Although routine screening of autoantibodies may not be warranted&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> one should entertain the possibility of a de novo primary biliary cirrhosis-like process in a patient with an unexplained increase in alkaline phosphatase levels during PEG-IFN&#945; therapy as an AMA seroconversion may alter the clinical management&#46;</p></span></span>"
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        "resumen" => "<span id="abs0010" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Pegylated interferon alpha &#40;PEG-IFN &#945;&#41;&#44; a key component of chronic hepatitis C therapy&#44; has been linked to the development of auto-antibodies and autoimmune disease&#46; We report the first case of antimitochondrial antibody &#40;AMA&#41; seroconversion during PEG-INF &#945; based therapy after liver&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#8211;</span><a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> transplantation&#46; A fiftyseven year-old man five months after liver transplantation was initiated on hepatitis C triple therapy with PEG-INF &#945;&#44; ribavirin and telaprevir&#46; He had failed previous PEG-IFN &#945; and ribavirin 12 years pre-transplant and his AMA remained negative pre-transplant&#46; After twelve weeks of antiviral therapy&#44; he developed elevated liver enzyme tests associated with an AMA seroconversion to seropositivity&#46; A liver biopsy failed to show histological evidence of primary biliary cirrhosis or graft rejection&#46; He was initiated on urseodeoxy-cholic acid with subsequent improvement of his liver enzymes&#46; This case demonstrates that despite adequate immunosuppression&#44; AMA seroconversion may occur post-transplant during interferon-based therapy&#46; As AMA seroconversion did not occur during the pre-transplant PEG-IFN therapy&#44; we speculate that donor allograft antigens in combination with PEG-IFN may have been a factor in the post-transplant seroconversion&#46;</p></span>"
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                      "titulo" => "Primary biliary cirrhosis induced by interferon-alpha therapy for hepatitis C virus infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "D&#8217;Amico E&#46;"
                            1 => "Paroli M&#46;"
                            2 => "Fratelli V&#46;"
                            3 => "Palazzi C&#46;"
                            4 => "Barnaba V&#46;"
                            5 => "Callea F&#46;"
                            6 => "Consoli G&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Dig Dis Sci"
                        "fecha" => "1995"
                        "volumen" => "40"
                        "paginaInicial" => "2113"
                        "paginaFinal" => "2116"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7587775"
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            1 => array:3 [
              "identificador" => "bib0010"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Latent autoimmune hepatitis triggered during interferon therapy in patients with chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Garc&#237;a-Buey L&#46;"
                            1 => "Garc&#237;a-Monz&#243;n C&#46;"
                            2 => "Rodriguez S&#46;"
                            3 => "Borque M&#46;J&#46;"
                            4 => "Garc&#237;a-S&#225;nchez A&#46;"
                            5 => "Iglesias R&#46;"
                            6 => "DeCastro M&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterology"
                        "fecha" => "1995"
                        "volumen" => "108"
                        "paginaInicial" => "1770"
                        "paginaFinal" => "1777"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7768382"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autoimmune endocrine disease induced by recombinant interferon-alpha therapy for chronic active type C hepatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Imagawa A&#46;"
                            1 => "Itoh N&#46;"
                            2 => "Hanafusa T&#46;"
                            3 => "Oda Y&#46;"
                            4 => "Waguri M&#46;"
                            5 => "Miyagawa J&#46;"
                            6 => "Kono N&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.80.3.7883851"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1995"
                        "volumen" => "80"
                        "paginaInicial" => "922"
                        "paginaFinal" => "926"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7883851"
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                          ]
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                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Induction of autoimmune hepatitis by pegylated interferon alfa-2b in chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Lorke J&#46;"
                            1 => "Erhardt A&#46;"
                            2 => "Haussinger D&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Gastroenterol Hepatol"
                        "fecha" => "2004"
                        "volumen" => "2"
                        "paginaInicial" => "xx"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15625645"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0025"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of the prevalence of autoantibodies in individuals with chronic hepatitis C and those with autoimmune hepatitis&#58; the role of interferon in the development of autoimmune diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Bayraktar Y&#46;"
                            1 => "Bayraktar M&#46;"
                            2 => "Gurakar A&#46;"
                            3 => "Hassanein T&#46;I&#46;"
                            4 => "Van Thiel D&#46;H&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatogastroenterology"
                        "fecha" => "1997"
                        "volumen" => "44"
                        "paginaInicial" => "417"
                        "paginaFinal" => "425"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9164512"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antimitochondrial antibodies in patients with chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Grimbert S&#46;"
                            1 => "Johanet C&#46;"
                            2 => "Bendjaballah F&#46;"
                            3 => "Homberg J&#46;C&#46;"
                            4 => "Poupon R&#46;"
                            5 => "Beaugrand M&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Liver"
                        "fecha" => "1996"
                        "volumen" => "16"
                        "paginaInicial" => "161"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8873002"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0035"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New insights into the mechanisms of interferon alfa&#58; an immunoregulatory and anti-inflammatory cytokine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Tilg H&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gastroenterology"
                        "fecha" => "1997"
                        "volumen" => "112"
                        "paginaInicial" => "1017"
                        "paginaFinal" => "1021"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9041265"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serological markers of autoimmunity in renal transplant patients before and after alpha-interferon therapy for chronic hepatitis C"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Rostaing L&#46;"
                            1 => "Oksman F&#46;"
                            2 => "Izopet J&#46;"
                            3 => "Baron E&#46;"
                            4 => "Cisterne J&#46;M&#46;"
                            5 => "Hoff M&#46;"
                            6 => "Abbal M&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000169047"
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                        "tituloSerie" => "Am J Nephrol"
                        "fecha" => "1996"
                        "volumen" => "16"
                        "paginaInicial" => "478"
                        "paginaFinal" => "483"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8955758"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening for autoantibodies in chronic hepatitis C patients has no effect on treatment initiation or outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:7 [
                            0 => "Mauss S&#46;"
                            1 => "Berger F&#46;"
                            2 => "Schober A&#46;"
                            3 => "Moog G&#46;"
                            4 => "Heyne R&#46;"
                            5 => "John C&#46;"
                            6 => "Pape S&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jvh.12011"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Viral Hepat"
                        "fecha" => "2013"
                        "volumen" => "20"
                        "paginaInicial" => "e72"
                        "paginaFinal" => "e77"
                        "link" => array:1 [
                          0 => array:2 [
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                ]
              ]
            ]
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ISSN: 16652681
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