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Journal of Cachexia, Sarcopenia and Muscle

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Open Access 01-12-2010 | Review

Ghrelin for cachexia

Authors: Takashi Akamizu, Kenji Kangawa

Published in: Journal of Cachexia, Sarcopenia and Muscle | Issue 2/2010

Abstract

Ghrelin, a natural ligand for the growth hormone (GH)-secretagogue receptor, is primarily produced in the stomach. Administration of ghrelin stimulates food intake and GH secretion in both animals and humans. Ghrelin is the only circulating hormone known to stimulate appetite in humans. As GH is an anabolic hormone, protein stores are spared at the expense of fat during conditions of caloric restriction. Ghrelin also inhibits the production of anorectic proinflammatory cytokines. Thus, ghrelin exhibits anti-cachectic actions via both GH-dependent and -independent mechanisms. Several studies are evaluating the efficacy of ghrelin in the treatment of cachexia caused by a variety of diseases, including congestive heart failure, chronic obstructive pulmonary disease, cancer, and end-stage renal disease. These studies will hopefully lead to the development of novel clinical applications for ghrelin in the future. These studies have also facilitated a better understanding of the molecular basis of the anti-catabolic effects of ghrelin. This review summarizes the recent advances in this area of research.

Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999;402:656–60.CrossRefPubMed

van der Lely AJ, Tschop M, Heiman ML, Ghigo E. Biological, physiological, pathophysiological, and pharmacological aspects of ghrelin. Endocr Rev. 2004;25:426–57.CrossRefPubMed

Korbonits M, Goldstone AP, Gueorguiev M, Grossman AB. Ghrelin—a hormone with multiple functions. Front Neuroendocrinol. 2004;25:27–68.CrossRefPubMed

Kojima M, Kangawa K. Ghrelin: structure and function. Physiol Rev. 2005;85:495–522.CrossRefPubMed

Dixit VD, Schaffer EM, Pyle RS, Collins GD, Sakthivel SK, Palaniappan R, et al. Ghrelin inhibits leptin- and activation-induced proinflammatory cytokine expression by human monocytes and T cells. J Clin Invest. 2004;114:57–66.PubMed

Dembinski A, Warzecha Z, Ceranowicz P, Tomaszewska R, Stachura J, Konturek SJ, et al. Ghrelin attenuates the development of acute pancreatitis in rat. J Physiol Pharmacol. 2003;54:561–73.PubMed

Evans WJ, Morley JE, Argiles J, Bales C, Baracos V, Guttridge D, et al. Cachexia: a new definition. Clin Nutr. 2008;27:793–9.CrossRefPubMed

Cummings DE. Ghrelin and the short- and long-term regulation of appetite and body weight. Physiol Behav. 2006;89:71–84.CrossRefPubMed

Wren AM, Bloom SR. Gut hormones and appetite control. Gastroenterology. 2007;132:2116–30.CrossRefPubMed

10.

Wren AM, Small CJ, Ward HL, Murphy KG, Dakin CL, Taheri S, et al. The novel hypothalamic peptide ghrelin stimulates food intake and growth hormone secretion. Endocrinology. 2000;141:4325–8.CrossRefPubMed

11.

Wren AM, Seal LJ, Cohen MA, Brynes AE, Frost GS, Murphy KG, et al. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab. 2001;86:5992.CrossRefPubMed

12.

Kamegai J, Tamura H, Shimizu T, Ishii S, Sugihara H, Wakabayashi I. Chronic central infusion of ghrelin increases hypothalamic neuropeptide Y and Agouti-related protein mRNA levels and body weight in rats. Diabetes. 2001;50:2438–43.CrossRefPubMed

13.

Shintani M, Ogawa Y, Ebihara K, Aizawa-Abe M, Miyanaga F, Takaya K, et al. Ghrelin, an endogenous growth hormone secretagogue, is a novel orexigenic peptide that antagonizes leptin action through the activation of hypothalamic neuropeptide Y/Y1 receptor pathway. Diabetes. 2001;50:227–32.CrossRefPubMed

14.

Chen HY, Trumbauer ME, Chen AS, Weingarth DT, Adams JR, Frazier EG, et al. Orexigenic action of peripheral ghrelin is mediated by neuropeptide Y and agouti-related protein. Endocrinology. 2004;145:2607–12.CrossRefPubMed

15.

Toshinai K, Date Y, Murakami N, Shimada M, Mondal MS, Shimbara T, et al. Ghrelin-induced food intake is mediated via the orexin pathway. Endocrinology. 2003;144:1506–12.CrossRefPubMed

16.

Date Y, Murakami N, Toshinai K, Matsukura S, Niijima A, Matsuo H, et al. The role of the gastric afferent vagal nerve in ghrelin-induced feeding and growth hormone secretion in rats. Gastroenterology. 2002;123:1120–8.CrossRefPubMed

17.

Wren AM, Small CJ, Abbott CR, Dhillo WS, Seal LJ, Cohen MA, et al. Ghrelin causes hyperphagia and obesity in rats. Diabetes. 2001;50:2540–7.CrossRefPubMed

18.

Nagaya N, Itoh T, Murakami S, Oya H, Uematsu M, Miyatake K, et al. Treatment of cachexia with ghrelin in patients with COPD. Chest. 2005;128:1187–93.CrossRefPubMed

19.

Tschop M, Smiley DL, Heiman ML. Ghrelin induces adiposity in rodents. Nature. 2000;407:908–13.CrossRefPubMed

20.

Dornonville de la Cour C, Lindqvist A, Egecioglu E, Tung YC, Surve V, Ohlsson C, et al. Ghrelin treatment reverses the reduction in weight gain and body fat in gastrectomised mice. Gut. 2005;54:907–13.CrossRefPubMed

21.

Akamizu T, Iwakura H, Ariyasu H, Murayama T, Sumi E, Teramukai S, et al. Effects of ghrelin treatment on patients undergoing total hip replacement for osteoarthritis: different outcomes from studies in patients with cardiac and pulmonary cachexia. J Am Geriatr Soc. 2008;56:2363–5.CrossRefPubMed

22.

Adachi S, Takiguchi S, Okada K, Yamamoto K, Yamasaki M, Miyata H, et al. Effects of ghrelin administration after total gastrectomy: a prospective, randomized, placebo-controlled phase II study. Gastroenterology. 2010;138:1312–20.CrossRefPubMed

23.

Yamamoto K, Takiguchi S, Miyata H, Adachi S, Hiura Y, Yamasaki M, et al. Randomized phase II study of clinical effects of ghrelin after esophagectomy with gastric tube reconstruction. Surgery. 2010;148:31–8.CrossRefPubMed

24.

Ariyasu H, Iwakura H, Yamada G, Nakao K, Kangawa K, Akamizu T. Efficacy of ghrelin as a therapeutic approach for age-related physiological changes. Endocrinology. 2008;149:3722–8.CrossRefPubMed

25.

Deboer MD, Zhu X, Levasseur PR, Inui A, Hu Z, Han G, et al. Ghrelin treatment of chronic kidney disease: improvements in lean body mass and cytokine profile. Endocrinology. 2008;149:827–35.CrossRefPubMed

26.

Svensson J, Lonn L, Jansson JO, Murphy G, Wyss D, Krupa D, et al. Two-month treatment of obese subjects with the oral growth hormone (GH) secretagogue MK-677 increases GH secretion, fat-free mass, and energy expenditure. J Clin Endocrinol Metab. 1998;83:362–9.CrossRefPubMed

27.

Nass R, Pezzoli SS, Oliveri MC, Patrie JT, Harrell Jr FE, Clasey JL, et al. Effects of an oral ghrelin mimetic on body composition and clinical outcomes in healthy older adults: a randomized trial. Ann Intern Med. 2008;149:601–11.PubMed

28.

Takaya K, Ariyasu H, Kanamoto N, Iwakura H, Yoshimoto A, Harada M, et al. Ghrelin strongly stimulates growth hormone release in humans. J Clin Endocrinol Metab. 2000;85:4908–11.CrossRefPubMed

29.

Arvat E, Maccario M, Di Vito L, Broglio F, Benso A, Gottero C, et al. Endocrine activities of ghrelin, a natural growth hormone secretagogue (GHS), in humans: comparison and interactions with hexarelin, a nonnatural peptidyl GHS, and GH-releasing hormone. J Clin Endocrinol Metab. 2001;86:1169–74.CrossRefPubMed

30.

Hataya Y, Akamizu T, Takaya K, Kanamoto N, Ariyasu H, Saijo M, et al. A low dose of ghrelin stimulates growth hormone (GH) release synergistically with GH-releasing hormone in humans. J Clin Endocrinol Metab. 2001;86:4552.CrossRefPubMed

31.

Akamizu T, Takaya K, Irako T, Hosoda H, Teramukai S, Matsuyama A, et al. Pharmacokinetics, safety, and endocrine and appetite effects of ghrelin administration in young healthy subjects. Eur J Endocrinol. 2004;150:447–55.CrossRefPubMed

32.

Nass R, Farhy LS, Liu J, Prudom CE, Johnson ML, Veldhuis P, et al. Evidence for acyl-ghrelin modulation of growth hormone release in the fed state. J Clin Endocrinol Metab. 2008;93:1988–94.CrossRefPubMed

33.

Gibney J, Healy ML, Sonksen PH. The growth hormone/insulin-like growth factor-I axis in exercise and sport. Endocr Rev. 2007;28:603–24.CrossRefPubMed

34.

Velloso CP. Regulation of muscle mass by growth hormone and IGF-I. Br J Pharmacol. 2008;154:557–68.CrossRefPubMed

35.

Gullett NP, Hebbar G, Ziegler TR. Update on clinical trials of growth factors and anabolic steroids in cachexia and wasting. Am J Clin Nutr. 2010;91:1143 S–7.CrossRef

36.

Nagaya N, Moriya J, Yasumura Y, Uematsu M, Ono F, Shimizu W, et al. Effects of ghrelin administration on left ventricular function, exercise capacity, and muscle wasting in patients with chronic heart failure. Circulation. 2004;110:3674–9.CrossRefPubMed

37.

Bach MA, Rockwood K, Zetterberg C, Thamsborg G, Hebert R, Devogelaer JP, et al. The effects of MK-0677, an oral growth hormone secretagogue, in patients with hip fracture. J Am Geriatr Soc. 2004;52:516–23.CrossRefPubMed

38.

Garcia JM, Graham C, Kumor KWP. A Phase II, randomized, placebo-controlled, double blind study of the efficacy and safety of RC-1291 for the treatment of cancer-cachexia [abstract]. J Clin Oncol. 2007;25:S25.CrossRef

39.

Garcia JM, Polvino WJ. Pharmacodynamic hormonal effects of anamorelin, a novel oral ghrelin mimetic and growth hormone secretagogue in healthy volunteers. Growth Horm IGF Res. 2009;19:267–73.CrossRefPubMed

40.

LeRoith D. Clinical relevance of systemic and local IGF-I: lessons from animal models. Pediatr Endocrinol Rev. 2008;5 Suppl 2:739–43.PubMed

41.

Pelosi L, Giacinti C, Nardis C, Borsellino G, Rizzuto E, Nicoletti C, et al. Local expression of IGF-1 accelerates muscle regeneration by rapidly modulating inflammatory cytokines and chemokines. FASEB J. 2007;21:1393–402.CrossRefPubMed

42.

Li WG, Gavrila D, Liu X, Wang L, Gunnlaugsson S, Stoll LL, et al. Ghrelin inhibits proinflammatory responses and nuclear factor-kappaB activation in human endothelial cells. Circulation. 2004;109:2221–6.CrossRefPubMed

43.

Gonzalez-Rey E, Chorny A, Delgado M. Therapeutic action of ghrelin in a mouse model of colitis. Gastroenterology. 2006;130:1707–20.CrossRefPubMed

44.

Wu R, Dong W, Zhou M, Zhang F, Marini CP, Ravikumar TS, et al. Ghrelin attenuates sepsis-induced acute lung injury and mortality in rats. Am J Respir Crit Care Med. 2007;176:805–13.CrossRefPubMed

45.

Theil MM, Miyake S, Mizuno M, Tomi C, Croxford JL, Hosoda H, et al. Suppression of experimental autoimmune encephalomyelitis by ghrelin. J Immunol. 2009;183:2859–66.CrossRefPubMed

46.

Kodama T, Ashitani J, Matsumoto N, Kangawa K, Nakazato M. Ghrelin treatment suppresses neutrophil-dominant inflammation in airways of patients with chronic respiratory infection. Pulm Pharmacol Ther. 2008;21:774–9.CrossRefPubMed

47.

Waseem T, Duxbury M, Ito H, Ashley SW, Robinson MK. Exogenous ghrelin modulates release of pro-inflammatory and anti-inflammatory cytokines in LPS-stimulated macrophages through distinct signaling pathways. Surgery. 2008;143:334–42.CrossRefPubMed

48.

Tracey KJ. Physiology and immunology of the cholinergic antiinflammatory pathway. J Clin Invest. 2007;117:289–96.CrossRefPubMed

49.

Jackman RW, Kandarian SC. The molecular basis of skeletal muscle atrophy. Am J Physiol Cell Physiol. 2004;287:C834–43.CrossRefPubMed

50.

Balasubramaniam A, Joshi R, Su C, Friend LA, Sheriff S, Kagan RJ, et al. Ghrelin inhibits skeletal muscle protein breakdown in rats with thermal injury through normalizing elevated expression of E3 ubiquitin ligases MuRF1 and MAFbx. Am J Physiol Regul Integr Comp Physiol. 2009;296:R893–901.PubMed

51.

Sheriff S, Joshi R, Friend LA, James JH, Balasubramaniam A. Ghrelin receptor agonist, GHRP-2, attenuates burn injury-induced MuRF-1 and MAFbx expression and muscle proteolysis in rats. Peptides. 2009;30:1909–13.CrossRefPubMed

52.

Yamamoto D, Ikeshita N, Matsubara T, Tasaki H, Herningtyas EH, Toda K, et al. GHRP-2, a GHS-R agonist, directly acts on myocytes to attenuate the dexamethasone-induced expressions of muscle-specific ubiquitin ligases, Atrogin-1 and MuRF1. Life Sci. 2008;82:460–6.CrossRefPubMed

53.

Stitt TN, Drujan D, Clarke BA, Panaro F, Timofeyva Y, Kline WO, et al. The IGF-1/PI3K/Akt pathway prevents expression of muscle atrophy-induced ubiquitin ligases by inhibiting FOXO transcription factors. Mol Cell. 2004;14:395–403.CrossRefPubMed

54.

Peeters TL. Central and peripheral mechanisms by which ghrelin regulates gut motility. J Physiol Pharmacol. 2003;54 Suppl 4:95–103.PubMed

55.

Sibilia V, Rindi G, Pagani F, Rapetti D, Locatelli V, Torsello A, et al. Ghrelin protects against ethanol-induced gastric ulcers in rats: studies on the mechanisms of action. Endocrinology. 2003;144:353–9.CrossRefPubMed

56.

Xu X, Jhun BS, Ha CH, Jin ZG. Molecular mechanisms of ghrelin-mediated endothelial nitric oxide synthase activation. Endocrinology. 2008;149:4183–92.CrossRefPubMed

57.

Morley JE, Farr SA. Cachexia and neuropeptide Y. Nutrition. 2008;24:815–9.CrossRefPubMed

58.

Konturek PC, Brzozowski T, Engel M, Burnat G, Gaca P, Kwiecien S, et al. Ghrelin ameliorates colonic inflammation. Role of nitric oxide and sensory nerves. J Physiol Pharmacol. 2009;60:41–7.

59.

Nagaya N, Uematsu M, Kojima M, Date Y, Nakazato M, Okumura H, et al. Elevated circulating level of ghrelin in cachexia associated with chronic heart failure: relationships between ghrelin and anabolic/catabolic factors. Circulation. 2001;104:2034–8.CrossRefPubMed

60.

Itoh T, Nagaya N, Yoshikawa M, Fukuoka A, Takenaka H, Shimizu Y, et al. Elevated plasma ghrelin level in underweight patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004;170:879–82.CrossRefPubMed

61.

Garcia JM, Garcia-Touza M, Hijazi RA, Taffet G, Epner D, Mann D, et al. Active ghrelin levels and active to total ghrelin ratio in cancer-induced cachexia. J Clin Endocrinol Metab. 2005;90:2920–6.CrossRefPubMed

62.

Shimizu Y, Nagaya N, Isobe T, Imazu M, Okumura H, Hosoda H, et al. Increased plasma ghrelin level in lung cancer cachexia. Clin Cancer Res. 2003;9:774–8.PubMed

63.

Kerem M, Ferahkose Z, Yilmaz UT, Pasaoglu H, Ofluoglu E, Bedirli A, et al. Adipokines and ghrelin in gastric cancer cachexia. World J Gastroenterol. 2008;14:3633–41.CrossRefPubMed

64.

Perez-Fontan M, Cordido F, Rodriguez-Carmona A, Peteiro J, Garcia-Naveiro R, Garcia-Buela J. Plasma ghrelin levels in patients undergoing haemodialysis and peritoneal dialysis. Nephrol Dial Transplant. 2004;19:2095–100.CrossRefPubMed

65.

Aygen B, Dogukan A, Dursun FE, Aydin S, Kilic N, Sahpaz F, et al. Ghrelin and obestatin levels in end-stage renal disease. J Int Med Res. 2009;37:757–65.PubMed

66.

Rodriguez Ayala E, Pecoits-Filho R, Heimburger O, Lindholm B, Nordfors L, Stenvinkel P. Associations between plasma ghrelin levels and body composition in end-stage renal disease: a longitudinal study. Nephrol Dial Transplant. 2004;19:421–6.CrossRefPubMed

67.

Iglesias P, Diez JJ, Fernandez-Reyes MJ, Codoceo R, Alvarez-Fidalgo P, Bajo MA, et al. Serum ghrelin concentrations in patients with chronic renal failure undergoing dialysis. Clin Endocrinol (Oxf). 2006;64:68–73.CrossRef

68.

Szczepanska M, Szprynger K, Mazur B, Zwolinska D, Kilis-Pstrusinska K, Makulska I. Plasma ghrelin levels in children with chronic renal failure on peritoneal dialysis. Perit Dial Int. 2007;27:61–6.PubMed

69.

Mak RH, Cheung W, Purnell J. Ghrelin in chronic kidney disease: too much or too little? Perit Dial Int. 2007;27:51–5.PubMed

70.

Jarkovska Z, Hodkova M, Sazamova M, Rosicka M, Dusilova-Sulkova S, Marek J, et al. Plasma levels of active and total ghrelin in renal failure: a relationship with GH/IGF-I axis. Growth Horm IGF Res. 2005;15:369–76.CrossRefPubMed

71.

Morley J, Thomas D, MG W. Cachexia: pathophysiology and clinical relevance. Am J Clin Nutr. 2006;83:735–43.PubMed

72.

Cummings DE, Foster-Schubert KE, Overduin J. Ghrelin and energy balance: focus on current controversies. Curr Drug Targets. 2005;6:153–69.PubMed

73.

Nagaya N, Kangawa K. Therapeutic potential of ghrelin in the treatment of heart failure. Drugs. 2006;66:439–48.CrossRefPubMed

74.

Akashi YJ, Springer J, Anker SD. Cachexia in chronic heart failure: prognostic implications and novel therapeutic approaches. Curr Heart Fail Rep. 2005;2:198–203.CrossRefPubMed

75.

Nagaya N, Kojima M, Kangawa K. Ghrelin, a novel growth hormone-releasing peptide, in the treatment of cardiopulmonary-associated cachexia. Intern Med. 2006;45:127–34.CrossRefPubMed

76.

Lainscak M, Andreas S, Scanlon PD, Somers VK, Anker SD. Ghrelin and neurohumoral antagonists in the treatment of cachexia associated with cardiopulmonary disease. Intern Med. 2006;45:837.CrossRefPubMed

77.

Ashitani J, Matsumoto N, Nakazato M. Ghrelin and its therapeutic potential for cachectic patients. Peptides. 2009;30:1951–6.CrossRefPubMed

78.

Gertner JM, Oo C (2009) Performance improvement in COPD cachexia with SUN11031 (a synthetic human ghrelin) in a placebo controlled trial [abstract]. The 5th cachexia conference, Barcelona, 2009, p 143

79.

Hanada T, Toshinai K, Kajimura N, Nara-Ashizawa N, Tsukada T, Hayashi Y, et al. Anti-cachectic effect of ghrelin in nude mice bearing human melanoma cells. Biochem Biophys Res Commun. 2003;301:275–9.CrossRefPubMed

80.

Wang W, Andersson M, Iresjo BM, Lonnroth C, Lundholm K. Effects of ghrelin on anorexia in tumor-bearing mice with eicosanoid-related cachexia. Int J Oncol. 2006;28:1393–400.PubMed

81.

DeBoer MD, Zhu XX, Levasseur P, Meguid MM, Suzuki S, Inui A, et al. Ghrelin treatment causes increased food intake and retention of lean body mass in a rat model of cancer cachexia. Endocrinology. 2007;148:3004–12.CrossRefPubMed

82.

Neary NM, Small CJ, Wren AM, Lee JL, Druce MR, Palmieri C, et al. Ghrelin increases energy intake in cancer patients with impaired appetite: acute, randomized, placebo-controlled trial. J Clin Endocrinol Metab. 2004;89:2832–6.CrossRefPubMed

83.

Strasser F, Lutz TA, Maeder MT, Thuerlimann B, Bueche D, Tschop M, et al. Safety, tolerability and pharmacokinetics of intravenous ghrelin for cancer-related anorexia/cachexia: a randomised, placebo-controlled, double-blind, double-crossover study. Br J Cancer. 2008;98:300–8.CrossRefPubMed

84.

Bossola M, Tazza L, Giungi S, Luciani G. Anorexia in hemodialysis patients: an update. Kidney Int. 2006;70:417–22.PubMed

85.

Wynne K, Giannitsopoulou K, Small CJ, Patterson M, Frost G, Ghatei MA, et al. Subcutaneous ghrelin enhances acute food intake in malnourished patients who receive maintenance peritoneal dialysis: a randomized, placebo-controlled trial. J Am Soc Nephrol. 2005;16:2111–8.CrossRefPubMed

86.

Ashby DR, Ford HE, Wynne KJ, Wren AM, Murphy KG, Busbridge M, et al. Sustained appetite improvement in malnourished dialysis patients by daily ghrelin treatment. Kidney Int. 2009;76:199–206.CrossRefPubMed

87.

Hotta M, Ohwada R, Akamizu T, Shibasaki T, Takano K, Kangawa K. Ghrelin increases hunger and food intake in patients with restricting-type anorexia nervosa: a pilot study. Endocr J. 2009;56:1119–28.CrossRefPubMed

88.

Akamizu T, Iwakura H, Ariyasu H, Hosoda H, Murayama T, Yokode M, et al. Repeated administration of ghrelin to patients with functional dyspepsia: its effects on food intake and appetite. Eur J Endocrinol. 2008;158:491–8.CrossRefPubMed

89.

Liu YL, Malik NM, Sanger GJ, Andrews PL. Ghrelin alleviates cancer chemotherapy-associated dyspepsia in rodents. Cancer Chemother Pharmacol. 2006;58:326–33.CrossRefPubMed

90.

Garcia JM, Cata JP, Dougherty PM, Smith RG. Ghrelin prevents cisplatin-induced mechanical hyperalgesia and cachexia. Endocrinology. 2008;149:455–60.CrossRefPubMed

91.

Balasubramaniam A, Wood S, Joshi R, Su C, Friend LA, Sheriff S, et al. Ghrelin stimulates food intake and growth hormone release in rats with thermal injury: synthesis of ghrelin. Peptides. 2006;27:1624–31.CrossRefPubMed

92.

von Haehling S, Morley JE, Coats AJS, Anker SD. Ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle. J Cachexia Sarcopenia Muscle 2010;1:7–8.

Title: Ghrelin for cachexia
Authors: Takashi Akamizu
Kenji Kangawa
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: Journal of Cachexia, Sarcopenia and Muscle / Issue 2/2010
Print ISSN: 2190-5991
Electronic ISSN: 2190-6009
DOI: https://doi.org/10.1007/s13539-010-0011-5

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