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Published in: Diabetologia 3/2006

01-03-2006 | Article

Evidence that oestrogen receptor-α plays an important role in the regulation of glucose homeostasis in mice: insulin sensitivity in the liver

Authors: G. Bryzgalova, H. Gao, B. Ahren, J.R. Zierath, D. Galuska, T.L. Steiler, K. Dahlman-Wright, S. Nilsson, J.-Å. Gustafsson, S. Efendic, A. Khan

Published in: Diabetologia | Issue 3/2006

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Abstract

Aims/hypothesis

We used oestrogen receptor-α (ERα) knockout (ERKO) and receptor-β (ERβ) knockout (BERKO) mice to investigate the mechanism(s) behind the effects of oestrogens on glucose homeostasis.

Methods

Endogenous glucose production (EGP) was measured in ERKO mice using a euglycaemic–hyperinsulinaemic clamp. Insulin secretion was determined from isolated islets. In isolated muscles, glucose uptake was assayed by using radiolabelled isotopes. Genome-wide expression profiles were analysed by high-density oligonucleotide microarray assay, and the expression of the genes encoding steroyl-CoA desaturase and the Leptin receptor (Scd1 and Lepr, respectively) was confirmed by RT-PCR.

Results

ERKO mice had higher fasting blood glucose, plasma insulin levels and IGT. The plasma leptin level was increased, while the adiponectin concentration was decreased in ERKO mice. Levels of both glucose- and arginine-induced insulin secretion from isolated islets were similar in ERKO and wild-type mice. The euglycaemic–hyperinsulinaemic clamp revealed that suppression of EGP by increased insulin levels was blunted in ERKO mice, which suggests a pronounced hepatic insulin resistance. Microarray analysis revealed that in ERKO mice, the genes involved in hepatic lipid biosynthesis were upregulated, while genes involved in lipid transport were downregulated. Notably, hepatic Lepr expression was decreased in ERKO mice. In vitro studies showed a modest decrease in insulin-mediated glucose uptake in soleus and extensor digitorum longus (EDL) muscles of ERKO mice. BERKO mice demonstrated normal glucose tolerance and insulin release.

Conclusions/interpretation

We conclude that oestrogens, acting via ERα, regulate glucose homeostasis mainly by modulating hepatic insulin sensitivity, which can be due to the upregulation of lipogenic genes via the suppression of Lepr expression.
Literature
1.
go back to reference Bailey CJ, Ahmed-Sorour H (1980) Role of ovarian hormones in the long-term control of glucose homeostasis: effects on insulin secretion. Diabetologia 19:475–481CrossRefPubMed Bailey CJ, Ahmed-Sorour H (1980) Role of ovarian hormones in the long-term control of glucose homeostasis: effects on insulin secretion. Diabetologia 19:475–481CrossRefPubMed
2.
go back to reference Ahmed-Sorour H, Bailey CJ (1980) Role of ovarian hormones in the long-term control of glucose homeostasis. Interactions with insulin, glucagon and epinephrine. Horm Res 13:396–403PubMed Ahmed-Sorour H, Bailey CJ (1980) Role of ovarian hormones in the long-term control of glucose homeostasis. Interactions with insulin, glucagon and epinephrine. Horm Res 13:396–403PubMed
3.
go back to reference Takeda K, Toda K, Saibara T et al (2003) Progressive development of insulin resistance phenotype in male mice with complete aromatase (CYP19) deficiency. J Endocrinol 176:237–246CrossRefPubMed Takeda K, Toda K, Saibara T et al (2003) Progressive development of insulin resistance phenotype in male mice with complete aromatase (CYP19) deficiency. J Endocrinol 176:237–246CrossRefPubMed
4.
go back to reference Ohlsson C, Hellberg N, Parini P et al (2000) Obesity and disturbed lipoprotein profile in estrogen receptor-α-deficient male mice. Biochem Biophys Res Commun 278:640–645CrossRefPubMed Ohlsson C, Hellberg N, Parini P et al (2000) Obesity and disturbed lipoprotein profile in estrogen receptor-α-deficient male mice. Biochem Biophys Res Commun 278:640–645CrossRefPubMed
5.
go back to reference Heine PA, Taylor JA, Iwamoto GA, Lubahn DB, Cooke PS (2000) Increased adipose tissue in male and female estrogen receptor-α knockout mice. Proc Natl Acad Sci U S A 97:12729–12734CrossRefPubMed Heine PA, Taylor JA, Iwamoto GA, Lubahn DB, Cooke PS (2000) Increased adipose tissue in male and female estrogen receptor-α knockout mice. Proc Natl Acad Sci U S A 97:12729–12734CrossRefPubMed
6.
go back to reference Firth R, Bell P, Rizza R (1987) Insulin action in non-insulin-dependent diabetes mellitus: the relationship between hepatic and extrahepatic insulin resistance and obesity. Metabolism 36:1091–1095CrossRefPubMed Firth R, Bell P, Rizza R (1987) Insulin action in non-insulin-dependent diabetes mellitus: the relationship between hepatic and extrahepatic insulin resistance and obesity. Metabolism 36:1091–1095CrossRefPubMed
7.
go back to reference DeFronzo RA, Bonadonna RC, Ferrannini E (1992) Pathogenesis of NIDDM. A balanced overview. Diabetes Care 15:318–368PubMedCrossRef DeFronzo RA, Bonadonna RC, Ferrannini E (1992) Pathogenesis of NIDDM. A balanced overview. Diabetes Care 15:318–368PubMedCrossRef
8.
go back to reference Efendic S, Luft R, Wajngot A (1984) Aspects of the pathogenesis of type 2 diabetes. Endocr Rev 5:395–410PubMed Efendic S, Luft R, Wajngot A (1984) Aspects of the pathogenesis of type 2 diabetes. Endocr Rev 5:395–410PubMed
9.
go back to reference Mauvais-Jarvis F, Virkamaki A, Michael MD et al (2000) A model to explore the interaction between muscle insulin resistance and β-cell dysfunction in the development of type 2 diabetes. Diabetes 49:2126–2134PubMedCrossRef Mauvais-Jarvis F, Virkamaki A, Michael MD et al (2000) A model to explore the interaction between muscle insulin resistance and β-cell dysfunction in the development of type 2 diabetes. Diabetes 49:2126–2134PubMedCrossRef
10.
go back to reference Lubahn DB, Moyer JS, Golding TS, Couse JF, Korach KS, Smithies O (1993) Alteration of reproductive function but not prenatal sexual development after insertional disruption of the mouse estrogen receptor gene. Proc Natl Acad Sci U S A 90:11162–11166PubMedCrossRef Lubahn DB, Moyer JS, Golding TS, Couse JF, Korach KS, Smithies O (1993) Alteration of reproductive function but not prenatal sexual development after insertional disruption of the mouse estrogen receptor gene. Proc Natl Acad Sci U S A 90:11162–11166PubMedCrossRef
11.
go back to reference Krege JH, Hodgin JB, Couse JF et al (1998) Generation and reproductive phenotypes of mice lacking estrogen receptor β. Proc Natl Acad Sci U S A 95:15677–15682CrossRefPubMed Krege JH, Hodgin JB, Couse JF et al (1998) Generation and reproductive phenotypes of mice lacking estrogen receptor β. Proc Natl Acad Sci U S A 95:15677–15682CrossRefPubMed
12.
go back to reference Couse JF, Curtis SW, Washburn TF et al (1995) Analysis of transcription and estrogen insensitivity in the female mouse after targeted disruption of the estrogen receptor gene. Mol Endocrinol 9:1441–1454CrossRefPubMed Couse JF, Curtis SW, Washburn TF et al (1995) Analysis of transcription and estrogen insensitivity in the female mouse after targeted disruption of the estrogen receptor gene. Mol Endocrinol 9:1441–1454CrossRefPubMed
13.
go back to reference Khan A, Hong-Lie C, Landau BR (1995) Glucose-6-phophatase activity in islets from ob/ob and lean mice and the effect of dexamethasone. Endocrinology 136:1934–1938CrossRefPubMed Khan A, Hong-Lie C, Landau BR (1995) Glucose-6-phophatase activity in islets from ob/ob and lean mice and the effect of dexamethasone. Endocrinology 136:1934–1938CrossRefPubMed
14.
go back to reference Herbert V, Lau KS, Gottlieb CW, Bleicher SJ (1965) Coated charcoal immunoassay of insulin. J Clin Endocrinol Metab 25:1375–1384PubMed Herbert V, Lau KS, Gottlieb CW, Bleicher SJ (1965) Coated charcoal immunoassay of insulin. J Clin Endocrinol Metab 25:1375–1384PubMed
15.
go back to reference Wallberg-Henriksson H, Zetan N, Henriksson J (1987) Reversibility of decreased insulin-stimulated glucose transport capacity in diabetic muscle with in vitro incubation: insulin is not required. J Biol Chem 262:7665–7671PubMed Wallberg-Henriksson H, Zetan N, Henriksson J (1987) Reversibility of decreased insulin-stimulated glucose transport capacity in diabetic muscle with in vitro incubation: insulin is not required. J Biol Chem 262:7665–7671PubMed
16.
go back to reference Hansen P, Gulve E, Gao J, Schluter J, Mueckler M, Holloszy J (1995) Kinetics of 2-deoxyglucose transport in skeletal muscle: effects of insulin and contractions. Am J Physiol 268:C30–C35PubMed Hansen P, Gulve E, Gao J, Schluter J, Mueckler M, Holloszy J (1995) Kinetics of 2-deoxyglucose transport in skeletal muscle: effects of insulin and contractions. Am J Physiol 268:C30–C35PubMed
17.
go back to reference Ahren B, Mansson S, Gingerich RL, Havel PJ (1997) Regulation of plasma leptin in mice: influence of age, high-fat diet, and fasting. Am J Physiol 273:R113–R120PubMed Ahren B, Mansson S, Gingerich RL, Havel PJ (1997) Regulation of plasma leptin in mice: influence of age, high-fat diet, and fasting. Am J Physiol 273:R113–R120PubMed
18.
go back to reference Winzell MS, Nogueiras R, Dieguez C, Ahren B (2004) Dual action of adiponectin on insulin secretion in insulin-resistant mice. Biochem Biophys Res Commun 321:154–160CrossRefPubMed Winzell MS, Nogueiras R, Dieguez C, Ahren B (2004) Dual action of adiponectin on insulin secretion in insulin-resistant mice. Biochem Biophys Res Commun 321:154–160CrossRefPubMed
19.
go back to reference Lee JH, Bullen JW, Stoyneva VL, Mantzoros CS (2005) Circulating resistin in lean, obese, and insulin-resistant mouse models: lack of association with insulinemia and glycemia. Am J Physiol Endocrinol Metab 288:E625–E632CrossRefPubMed Lee JH, Bullen JW, Stoyneva VL, Mantzoros CS (2005) Circulating resistin in lean, obese, and insulin-resistant mouse models: lack of association with insulinemia and glycemia. Am J Physiol Endocrinol Metab 288:E625–E632CrossRefPubMed
20.
go back to reference Pavlidis P, Qin J, Arango V, Mann JJ, Sibille E (2004) Using the gene ontology for microarray data mining: a comparison of methods and application to age effects in human prefrontal cortex. Neurochem Res 29:1213–1222CrossRefPubMed Pavlidis P, Qin J, Arango V, Mann JJ, Sibille E (2004) Using the gene ontology for microarray data mining: a comparison of methods and application to age effects in human prefrontal cortex. Neurochem Res 29:1213–1222CrossRefPubMed
21.
go back to reference Zeeberg BR, Feng W, Wang G et al (2003) GoMiner: a resource for biological interpretation of genomic and proteomic data. Genom Biol 4:R28CrossRef Zeeberg BR, Feng W, Wang G et al (2003) GoMiner: a resource for biological interpretation of genomic and proteomic data. Genom Biol 4:R28CrossRef
22.
go back to reference Pierroz DD, Ziotopoulou M, Ungsunan L, Moschos S, Flier JS, Mantzoros CS (2002) Effect of acute and chronic administration of the melanocortin agonist MTII in mice with diet-induced obesity. Diabetes 51:1337–1345PubMedCrossRef Pierroz DD, Ziotopoulou M, Ungsunan L, Moschos S, Flier JS, Mantzoros CS (2002) Effect of acute and chronic administration of the melanocortin agonist MTII in mice with diet-induced obesity. Diabetes 51:1337–1345PubMedCrossRef
23.
go back to reference Ahlborg G, Wahren J, Felig P (1986) Splanchnic and peripheral glucose and lactate metabolism during and after prolonged arm exercise. J Clin Invest 77:690–699PubMedCrossRef Ahlborg G, Wahren J, Felig P (1986) Splanchnic and peripheral glucose and lactate metabolism during and after prolonged arm exercise. J Clin Invest 77:690–699PubMedCrossRef
24.
go back to reference Gerich JE, Meyer C, Woerle HJ, Stumvoll M (2001) Renal gluconeogenesis. Its importance in human glucose homeostasis. Diabetes Care 24:382–391PubMedCrossRef Gerich JE, Meyer C, Woerle HJ, Stumvoll M (2001) Renal gluconeogenesis. Its importance in human glucose homeostasis. Diabetes Care 24:382–391PubMedCrossRef
25.
go back to reference Matute ML, Kalkhoff RK (1973) Sex steroid influence on hepatic gluconeogenesis and glycogen formation. Endocrinology 92:762–768PubMedCrossRef Matute ML, Kalkhoff RK (1973) Sex steroid influence on hepatic gluconeogenesis and glycogen formation. Endocrinology 92:762–768PubMedCrossRef
26.
go back to reference Ahmed-Sorour H, Bailey CJ (1981) Role of ovarian hormones in the long-term control of glucose homeostasis. Glycogen formation and gluconeogenesis. Ann Nutr Metab 25:208–212PubMed Ahmed-Sorour H, Bailey CJ (1981) Role of ovarian hormones in the long-term control of glucose homeostasis. Glycogen formation and gluconeogenesis. Ann Nutr Metab 25:208–212PubMed
27.
go back to reference Borthwick EB, Houston MP, Coughtrie MW, Burchell A (2001) The antihyperglycemic effect of estrone sulfate in genetically obese-diabetic (ob/ob) mice is associated with reduced hepatic glucose-6-phosphatase. Horm Metab Res 33:721–726CrossRefPubMed Borthwick EB, Houston MP, Coughtrie MW, Burchell A (2001) The antihyperglycemic effect of estrone sulfate in genetically obese-diabetic (ob/ob) mice is associated with reduced hepatic glucose-6-phosphatase. Horm Metab Res 33:721–726CrossRefPubMed
28.
go back to reference Jamieson PM, Nyirenda MJ, Walker BR, Chapman KE, Seckl JR (1999) Interections between oestradiol and glucocorticoid regulatory effects on liver-specific glucocorticoid-inducible genes: possible evidence for a role of hepatic 11β-hydroxysteroid dehydrogenase type 1. J Endocrinol 160:103–109CrossRefPubMed Jamieson PM, Nyirenda MJ, Walker BR, Chapman KE, Seckl JR (1999) Interections between oestradiol and glucocorticoid regulatory effects on liver-specific glucocorticoid-inducible genes: possible evidence for a role of hepatic 11β-hydroxysteroid dehydrogenase type 1. J Endocrinol 160:103–109CrossRefPubMed
29.
go back to reference Krook A, Kawano Y, Song XM et al (1997) Improved glucose tolerance restores insulin-stimulated Akt kinase activity and glucose transport in skeletal muscle from diabetic Goto–Kakizaki rats. Diabetes 46:2110–2114PubMedCrossRef Krook A, Kawano Y, Song XM et al (1997) Improved glucose tolerance restores insulin-stimulated Akt kinase activity and glucose transport in skeletal muscle from diabetic Goto–Kakizaki rats. Diabetes 46:2110–2114PubMedCrossRef
30.
go back to reference An J, Muoio DM, Shiota M et al (2004) Hepatic expression of malonyl-CoA decarboxylase reverses muscle, liver and whole-animal insulin resistance. Nat Med 10:268–274CrossRefPubMed An J, Muoio DM, Shiota M et al (2004) Hepatic expression of malonyl-CoA decarboxylase reverses muscle, liver and whole-animal insulin resistance. Nat Med 10:268–274CrossRefPubMed
31.
32.
33.
go back to reference Biddinger SB, Almind K, Miyazaki M, Kokkotou E, Ntambi JM, Khan CR (2005) Effects of diet and genetic background on sterol regulatory element-binding protein-1c, stearoyl-CoA desaturase 1, and the development of metabolic syndrome. Diabetes 54:1314–1323PubMedCrossRef Biddinger SB, Almind K, Miyazaki M, Kokkotou E, Ntambi JM, Khan CR (2005) Effects of diet and genetic background on sterol regulatory element-binding protein-1c, stearoyl-CoA desaturase 1, and the development of metabolic syndrome. Diabetes 54:1314–1323PubMedCrossRef
34.
go back to reference Ntambi JM, Miyazaki M, Stoehr JP et al (2002) Loss of stearoyl-CoA desaturase-1 function protects mice against adiposity. Proc Natl Acad Sci U S A 99:11482–11486CrossRefPubMed Ntambi JM, Miyazaki M, Stoehr JP et al (2002) Loss of stearoyl-CoA desaturase-1 function protects mice against adiposity. Proc Natl Acad Sci U S A 99:11482–11486CrossRefPubMed
35.
go back to reference Cohen P, Miyazaki M, Socci ND et al (2002) Role for stearoyl-CoA desaturase-1 in leptin-mediated weight loss. Science 297:240–243CrossRefPubMed Cohen P, Miyazaki M, Socci ND et al (2002) Role for stearoyl-CoA desaturase-1 in leptin-mediated weight loss. Science 297:240–243CrossRefPubMed
36.
go back to reference Kakuma T, Lee Y, Unger RH (2002) Effect of leptin, troglitazone, and dietary fat on stearoyl CoA desaturase. Biochem Biophys Res Commun 297:1259–1263CrossRefPubMed Kakuma T, Lee Y, Unger RH (2002) Effect of leptin, troglitazone, and dietary fat on stearoyl CoA desaturase. Biochem Biophys Res Commun 297:1259–1263CrossRefPubMed
37.
go back to reference Meli R, Pacilio M, Raso GM et al (2004) Estrogen and raloxifene modulate leptin and its receptor in hypothalamus and adipose tissue from ovariectomized rats. Endocrinology 145:3115–3121CrossRefPubMed Meli R, Pacilio M, Raso GM et al (2004) Estrogen and raloxifene modulate leptin and its receptor in hypothalamus and adipose tissue from ovariectomized rats. Endocrinology 145:3115–3121CrossRefPubMed
38.
go back to reference Tvrdik P, Westerberg R, Silve S et al (2000) Role of a new mammalian gene family in the biosynthesis of very long chain fatty acids and sphingolipids. J Cell Biol 149:707–718CrossRefPubMed Tvrdik P, Westerberg R, Silve S et al (2000) Role of a new mammalian gene family in the biosynthesis of very long chain fatty acids and sphingolipids. J Cell Biol 149:707–718CrossRefPubMed
39.
go back to reference Borthwick EB, Burchell A, Coughtrie MWH (1995) Differential expression of hepatic oestrogen, phenol and dehydroepiandrosterone sulphotransferases in genetically obese diabetic (ob/ob) male and female mice. J Endocrinol 144:31–37PubMed Borthwick EB, Burchell A, Coughtrie MWH (1995) Differential expression of hepatic oestrogen, phenol and dehydroepiandrosterone sulphotransferases in genetically obese diabetic (ob/ob) male and female mice. J Endocrinol 144:31–37PubMed
40.
go back to reference Park CH, Abbaszade IC, Payne AH (1996) Expression of multiple forms of 3β-hydroxysteroid dehydrogenase in the mouse liver during fetal and postnatal development. Mol Cell Endocrinol 116:157–164CrossRefPubMed Park CH, Abbaszade IC, Payne AH (1996) Expression of multiple forms of 3β-hydroxysteroid dehydrogenase in the mouse liver during fetal and postnatal development. Mol Cell Endocrinol 116:157–164CrossRefPubMed
41.
go back to reference Falls JG, Blake BL, Cao Y, Levi PE, Hodgson E (1995) Gender differences in hepatic expression of flavin-containing monooxygenase isoforms (FMO1, FMO3, and FMO5) in mice. J Biochem Toxicol 10:171–177PubMedCrossRef Falls JG, Blake BL, Cao Y, Levi PE, Hodgson E (1995) Gender differences in hepatic expression of flavin-containing monooxygenase isoforms (FMO1, FMO3, and FMO5) in mice. J Biochem Toxicol 10:171–177PubMedCrossRef
42.
go back to reference Yamada H, Gohyama N, Honda S, Hara T, Harada N, Oguri K (2002) Estrogen-dependent regulation of the expression of hepatic Cyp2b and 3a isoforms: assessment using aromatase-deficient mice. Toxicol Appl Pharmacol 180:1–10CrossRefPubMed Yamada H, Gohyama N, Honda S, Hara T, Harada N, Oguri K (2002) Estrogen-dependent regulation of the expression of hepatic Cyp2b and 3a isoforms: assessment using aromatase-deficient mice. Toxicol Appl Pharmacol 180:1–10CrossRefPubMed
43.
go back to reference Muse ED, Obici S, Bhanot S et al (2004) Role of resistin in diet-induced hepatic insulin resistance. J Clin Invest 114:232–239CrossRefPubMed Muse ED, Obici S, Bhanot S et al (2004) Role of resistin in diet-induced hepatic insulin resistance. J Clin Invest 114:232–239CrossRefPubMed
44.
go back to reference Couse JF, Yates MM, Walker VR, Korach KS (2003) Characterization of the hypothalamic–pituitary–gonadal axis in estrogen receptor (ER) Null mice reveals hypergonadism and endocrine sex reversal in females lacking ERalpha but not ERbeta. Mol Endocrinol 17:1039–1053CrossRefPubMed Couse JF, Yates MM, Walker VR, Korach KS (2003) Characterization of the hypothalamic–pituitary–gonadal axis in estrogen receptor (ER) Null mice reveals hypergonadism and endocrine sex reversal in females lacking ERalpha but not ERbeta. Mol Endocrinol 17:1039–1053CrossRefPubMed
45.
go back to reference Combs TP, Berg AH, Rajala MW et al (2003) Sexual differentiation, pregnancy, calorie restriction, and aging affect the adipocyte-specific secretory protein adiponectin. Diabetes 52(2):268–276 FebPubMedCrossRef Combs TP, Berg AH, Rajala MW et al (2003) Sexual differentiation, pregnancy, calorie restriction, and aging affect the adipocyte-specific secretory protein adiponectin. Diabetes 52(2):268–276 FebPubMedCrossRef
46.
go back to reference Haluzik M, Parizkova J, Haluzik MM (2004) Adiponectin and its role in the obesity-induced insulin resistance and related complications. Physiol Res 53:123–129PubMed Haluzik M, Parizkova J, Haluzik MM (2004) Adiponectin and its role in the obesity-induced insulin resistance and related complications. Physiol Res 53:123–129PubMed
47.
go back to reference Combs TP, Pajvani UB, Berg AH et al (2004) A transgenic mouse with a deletion in the collagenous domain of adiponectin displays elevated circulating adiponectin and improved insulin sensitivity. Endocrinology 145:367–383CrossRefPubMed Combs TP, Pajvani UB, Berg AH et al (2004) A transgenic mouse with a deletion in the collagenous domain of adiponectin displays elevated circulating adiponectin and improved insulin sensitivity. Endocrinology 145:367–383CrossRefPubMed
48.
go back to reference Yamauchi T, Kamon J, Minokoshi Y et al (2002) Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating AMP-activated protein kinase. Nat Med 8:1288–1295PubMedCrossRef Yamauchi T, Kamon J, Minokoshi Y et al (2002) Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating AMP-activated protein kinase. Nat Med 8:1288–1295PubMedCrossRef
Metadata
Title
Evidence that oestrogen receptor-α plays an important role in the regulation of glucose homeostasis in mice: insulin sensitivity in the liver
Authors
G. Bryzgalova
H. Gao
B. Ahren
J.R. Zierath
D. Galuska
T.L. Steiler
K. Dahlman-Wright
S. Nilsson
J.-Å. Gustafsson
S. Efendic
A. Khan
Publication date
01-03-2006
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 3/2006
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-005-0105-3

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