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Published in: Diabetologia 1/2012

01-01-2012 | Article

cJUN N-terminal kinase (JNK) activation mediates islet amyloid-induced beta cell apoptosis in cultured human islet amyloid polypeptide transgenic mouse islets

Authors: S. L. Subramanian, R. L. Hull, S. Zraika, K. Aston-Mourney, J. Udayasankar, S. E. Kahn

Published in: Diabetologia | Issue 1/2012

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Abstract

Aims/hypothesis

Aggregation of human islet amyloid polypeptide (hIAPP) as islet amyloid is associated with increased beta cell apoptosis and reduced beta cell mass in type 2 diabetes. Islet amyloid formation induces oxidative stress, which contributes to beta cell apoptosis. The cJUN N-terminal kinase (JNK) pathway is a critical mediator of beta cell apoptosis in response to stress stimuli including oxidative stress and exogenous application of hIAPP. We determined whether amyloid formation by endogenous hIAPP mediates beta cell apoptosis through JNK activation and downstream signalling pathways.

Methods

hIAPP transgenic and non-transgenic mouse islets were cultured for up to 144 h in 16.7 mmol/l glucose to induce islet amyloid in the presence or absence of the amyloid inhibitor Congo Red or a cell-permeable JNK inhibitor. Amyloid, beta cell apoptosis, JNK signalling and activation of downstream targets in the intrinsic and extrinsic apoptotic pathways were measured.

Results

JNK activation occurred with islet amyloid formation in hIAPP transgenic islets after 48 and 144 h in culture. Neither high glucose nor the hIAPP transgene alone was sufficient to activate JNK independent of islet amyloid. Inhibition of islet amyloid formation with Congo Red reduced beta cell apoptosis and partially decreased JNK activation. JNK inhibitor treatment reduced beta cell apoptosis without affecting islet amyloid. Islet amyloid increased mRNA levels of markers of the extrinsic (Fas, Fadd) and intrinsic (Bim [also known as Bcl2l11]) apoptotic pathways, caspase 3 and the anti-apoptotic molecule Bclxl (also known as Bcl2l1) in a JNK-dependent manner.

Conclusions/interpretation

Islet amyloid formation induces JNK activation, which upregulates predominantly pro-apoptotic signals in both extrinsic and intrinsic pathways, resulting in beta cell apoptosis.
Literature
1.
go back to reference Westermark P, Wilander E (1978) The influence of amyloid deposits on the islet volume in maturity onset diabetes mellitus. Diabetologia 15:417–421PubMedCrossRef Westermark P, Wilander E (1978) The influence of amyloid deposits on the islet volume in maturity onset diabetes mellitus. Diabetologia 15:417–421PubMedCrossRef
2.
go back to reference Hull RL, Westermark GT, Westermark P, Kahn SE (2004) Islet amyloid: a critical entity in the pathogenesis of type 2 diabetes. J Clin Endocrinol Metab 89:3629–3643PubMedCrossRef Hull RL, Westermark GT, Westermark P, Kahn SE (2004) Islet amyloid: a critical entity in the pathogenesis of type 2 diabetes. J Clin Endocrinol Metab 89:3629–3643PubMedCrossRef
3.
go back to reference Jurgens CA, Toukatly MN, Fligner CL et al (2011) ß-cell loss and ß-cell apoptosis in human type 2 diabetes are related to islet amyloid deposition. Am J Pathol 178:2632–2640PubMedCrossRef Jurgens CA, Toukatly MN, Fligner CL et al (2011) ß-cell loss and ß-cell apoptosis in human type 2 diabetes are related to islet amyloid deposition. Am J Pathol 178:2632–2640PubMedCrossRef
4.
go back to reference Westermark P, Wernstedt C, Wilander E, Hayden DW, O’Brien TD, Johnson KH (1987) Amyloid fibrils in human insulinoma and islets of Langerhans of the diabetic cat are derived from a neuropeptide-like protein also present in normal islets. Proc Natl Acad Sci USA 84:3881–3885PubMedCrossRef Westermark P, Wernstedt C, Wilander E, Hayden DW, O’Brien TD, Johnson KH (1987) Amyloid fibrils in human insulinoma and islets of Langerhans of the diabetic cat are derived from a neuropeptide-like protein also present in normal islets. Proc Natl Acad Sci USA 84:3881–3885PubMedCrossRef
5.
go back to reference Cooper GJS, Willis AC, Clark A, Turner RC, Sim RB, Reid KBM (1987) Purification and characterization of a peptide from amyloid-rich pancreases of type 2 diabetic patients. Proc Natl Acad Sci USA 84:8628–8632PubMedCrossRef Cooper GJS, Willis AC, Clark A, Turner RC, Sim RB, Reid KBM (1987) Purification and characterization of a peptide from amyloid-rich pancreases of type 2 diabetic patients. Proc Natl Acad Sci USA 84:8628–8632PubMedCrossRef
6.
go back to reference Kahn SE, D’Alessio DA, Schwartz MW et al (1990) Evidence of cosecretion of islet amyloid polypeptide and insulin by ß-cells. Diabetes 39:634–638PubMedCrossRef Kahn SE, D’Alessio DA, Schwartz MW et al (1990) Evidence of cosecretion of islet amyloid polypeptide and insulin by ß-cells. Diabetes 39:634–638PubMedCrossRef
7.
go back to reference Westermark P, Engstrom U, Johnson KH, Westermark GT, Betsholtz C (1990) Islet amyloid polypeptide: pinpointing amino acid residues linked to amyloid fibril formation. Proc Natl Acad Sci USA 87:5036–5040PubMedCrossRef Westermark P, Engstrom U, Johnson KH, Westermark GT, Betsholtz C (1990) Islet amyloid polypeptide: pinpointing amino acid residues linked to amyloid fibril formation. Proc Natl Acad Sci USA 87:5036–5040PubMedCrossRef
8.
go back to reference Lorenzo A, Razzaboni B, Weir GC, Yankner BA (1994) Pancreatic islet cell toxicity of amylin associated with type-2 diabetes mellitus. Nature 368:756–760PubMedCrossRef Lorenzo A, Razzaboni B, Weir GC, Yankner BA (1994) Pancreatic islet cell toxicity of amylin associated with type-2 diabetes mellitus. Nature 368:756–760PubMedCrossRef
9.
go back to reference Mirzabekov TA, Lin MC, Kagan BL (1996) Pore formation by the cytotoxic islet amyloid peptide amylin. J Biol Chem 271:1988–1992PubMedCrossRef Mirzabekov TA, Lin MC, Kagan BL (1996) Pore formation by the cytotoxic islet amyloid peptide amylin. J Biol Chem 271:1988–1992PubMedCrossRef
10.
go back to reference Janciauskiene S, Ahren B (1998) Different sensitivity to the cytotoxic action of IAPP fibrils in two insulin-producing cell lines, HIT-T15 and RINm5F cells. Biochem Biophys Res Commun 251:888–893PubMedCrossRef Janciauskiene S, Ahren B (1998) Different sensitivity to the cytotoxic action of IAPP fibrils in two insulin-producing cell lines, HIT-T15 and RINm5F cells. Biochem Biophys Res Commun 251:888–893PubMedCrossRef
11.
go back to reference Janson J, Ashley RH, Harrison D, McIntyre S, Butler PC (1999) The mechanism of islet amyloid polypeptide toxicity is membrane disruption by intermediate-sized toxic amyloid particles. Diabetes 48:491–498PubMedCrossRef Janson J, Ashley RH, Harrison D, McIntyre S, Butler PC (1999) The mechanism of islet amyloid polypeptide toxicity is membrane disruption by intermediate-sized toxic amyloid particles. Diabetes 48:491–498PubMedCrossRef
12.
go back to reference Zhang S, Liu J, Saafi EL, Cooper GJ (1999) Induction of apoptosis by human amylin in RINm5F islet beta cells is associated with enhanced expression of p53 and p21WAF1/CIP1. FEBS Lett 455:315–320PubMedCrossRef Zhang S, Liu J, Saafi EL, Cooper GJ (1999) Induction of apoptosis by human amylin in RINm5F islet beta cells is associated with enhanced expression of p53 and p21WAF1/CIP1. FEBS Lett 455:315–320PubMedCrossRef
13.
go back to reference Harroun TA, Bradshaw JP, Ashley RH (2001) Inhibitors can arrest the membrane activity of human islet amyloid polypeptide independently of amyloid formation. FEBS Lett 507:200–204PubMedCrossRef Harroun TA, Bradshaw JP, Ashley RH (2001) Inhibitors can arrest the membrane activity of human islet amyloid polypeptide independently of amyloid formation. FEBS Lett 507:200–204PubMedCrossRef
14.
go back to reference Sakuraba H, Mizukami H, Yagihashi N, Wada R, Hanyu C, Yagihashi S (2002) Reduced beta cell mass and expression of oxidative stress-related DNA damage in the islet of Japanese type II diabetic patients. Diabetologia 45:85–96PubMedCrossRef Sakuraba H, Mizukami H, Yagihashi N, Wada R, Hanyu C, Yagihashi S (2002) Reduced beta cell mass and expression of oxidative stress-related DNA damage in the islet of Japanese type II diabetic patients. Diabetologia 45:85–96PubMedCrossRef
15.
go back to reference Zraika S, Hull RL, Udayasankar J et al (2009) Oxidative stress is induced by islet amyloid formation and time-dependently mediates amyloid-induced beta cell apoptosis. Diabetologia 52:626–635PubMedCrossRef Zraika S, Hull RL, Udayasankar J et al (2009) Oxidative stress is induced by islet amyloid formation and time-dependently mediates amyloid-induced beta cell apoptosis. Diabetologia 52:626–635PubMedCrossRef
16.
go back to reference Laybutt DR, Preston AM, Akerfeldt MC et al (2007) Endoplasmic reticulum stress contributes to beta cell apoptosis in type 2 diabetes. Diabetologia 50:752–763PubMedCrossRef Laybutt DR, Preston AM, Akerfeldt MC et al (2007) Endoplasmic reticulum stress contributes to beta cell apoptosis in type 2 diabetes. Diabetologia 50:752–763PubMedCrossRef
17.
go back to reference Hull RL, Zraika S, Udayasankar J, Aston-Mourney K, Subramanian SL, Kahn SE (2009) Amyloid formation in human IAPP transgenic mouse islets and pancreas, and human pancreas, is not associated with endoplasmic reticulum stress. Diabetologia 52:1102–1111PubMedCrossRef Hull RL, Zraika S, Udayasankar J, Aston-Mourney K, Subramanian SL, Kahn SE (2009) Amyloid formation in human IAPP transgenic mouse islets and pancreas, and human pancreas, is not associated with endoplasmic reticulum stress. Diabetologia 52:1102–1111PubMedCrossRef
18.
go back to reference Huang CJ, Haataja L, Gurlo T et al (2007) Induction of endoplasmic reticulum stress-induced beta cell apoptosis and accumulation of polyubiquitinated proteins by human islet amyloid polypeptide. Am J Physiol Endocrinol Metab 293:E1656–E1662PubMedCrossRef Huang CJ, Haataja L, Gurlo T et al (2007) Induction of endoplasmic reticulum stress-induced beta cell apoptosis and accumulation of polyubiquitinated proteins by human islet amyloid polypeptide. Am J Physiol Endocrinol Metab 293:E1656–E1662PubMedCrossRef
19.
go back to reference Huang CJ, Lin CY, Haataja L et al (2007) High expression rates of human islet amyloid polypeptide induce endoplasmic reticulum stress mediated beta cell apoptosis, a characteristic of humans with type 2 but not type 1 diabetes. Diabetes 56:2016–2027PubMedCrossRef Huang CJ, Lin CY, Haataja L et al (2007) High expression rates of human islet amyloid polypeptide induce endoplasmic reticulum stress mediated beta cell apoptosis, a characteristic of humans with type 2 but not type 1 diabetes. Diabetes 56:2016–2027PubMedCrossRef
20.
go back to reference Maedler K, Schulthess FT, Bielman C et al (2008) Glucose and leptin induce apoptosis in human beta cells and impair glucose-stimulated insulin secretion through activation of c-Jun N-terminal kinases. FASEB J 22:1905–1913PubMedCrossRef Maedler K, Schulthess FT, Bielman C et al (2008) Glucose and leptin induce apoptosis in human beta cells and impair glucose-stimulated insulin secretion through activation of c-Jun N-terminal kinases. FASEB J 22:1905–1913PubMedCrossRef
21.
go back to reference Cunha DA, Hekerman P, Ladriere L et al (2008) Initiation and execution of lipotoxic ER stress in pancreatic beta cells. J Cell Sci 121:2308–2318PubMedCrossRef Cunha DA, Hekerman P, Ladriere L et al (2008) Initiation and execution of lipotoxic ER stress in pancreatic beta cells. J Cell Sci 121:2308–2318PubMedCrossRef
22.
go back to reference Ammendrup A, Maillard A, Nielsen K et al (2000) The c-Jun amino-terminal kinase pathway is preferentially activated by interleukin-1 and controls apoptosis in differentiating pancreatic beta cells. Diabetes 49:1468–1476PubMedCrossRef Ammendrup A, Maillard A, Nielsen K et al (2000) The c-Jun amino-terminal kinase pathway is preferentially activated by interleukin-1 and controls apoptosis in differentiating pancreatic beta cells. Diabetes 49:1468–1476PubMedCrossRef
23.
go back to reference Major CD, Wolf BA (2001) Interleukin-1beta stimulation of c-Jun NH(2)-terminal kinase activity in insulin-secreting cells: evidence for cytoplasmic restriction. Diabetes 50:2721–2728PubMedCrossRef Major CD, Wolf BA (2001) Interleukin-1beta stimulation of c-Jun NH(2)-terminal kinase activity in insulin-secreting cells: evidence for cytoplasmic restriction. Diabetes 50:2721–2728PubMedCrossRef
24.
go back to reference Kaneto H, Matsuoka TA, Nakatani Y et al (2005) Oxidative stress, ER stress, and the JNK pathway in type 2 diabetes. J Mol Med (Berl) 83:429–439 Kaneto H, Matsuoka TA, Nakatani Y et al (2005) Oxidative stress, ER stress, and the JNK pathway in type 2 diabetes. J Mol Med (Berl) 83:429–439
25.
go back to reference Zhang S, Liu J, MacGibbon G, Dragunow M, Cooper GJ (2002) Increased expression and activation of c-Jun contributes to human amylin-induced apoptosis in pancreatic islet beta cells. J Mol Biol 324:271–285PubMedCrossRef Zhang S, Liu J, MacGibbon G, Dragunow M, Cooper GJ (2002) Increased expression and activation of c-Jun contributes to human amylin-induced apoptosis in pancreatic islet beta cells. J Mol Biol 324:271–285PubMedCrossRef
26.
go back to reference Zhang S, Liu J, Dragunow M, Cooper GJ (2003) Fibrillogenic amylin evokes islet ß-cell apoptosis through linked activation of a caspase cascade and JNK1. J Biol Chem 278:52810–52819PubMedCrossRef Zhang S, Liu J, Dragunow M, Cooper GJ (2003) Fibrillogenic amylin evokes islet ß-cell apoptosis through linked activation of a caspase cascade and JNK1. J Biol Chem 278:52810–52819PubMedCrossRef
27.
go back to reference Li XL, Xu G, Chen T et al (2009) Phycocyanin protects INS-1E pancreatic beta cells against human islet amyloid polypeptide-induced apoptosis through attenuating oxidative stress and modulating JNK and p38 mitogen-activated protein kinase pathways. Int J Biochem Cell Biol 41:1526–1535PubMedCrossRef Li XL, Xu G, Chen T et al (2009) Phycocyanin protects INS-1E pancreatic beta cells against human islet amyloid polypeptide-induced apoptosis through attenuating oxidative stress and modulating JNK and p38 mitogen-activated protein kinase pathways. Int J Biochem Cell Biol 41:1526–1535PubMedCrossRef
28.
go back to reference Zhang S, Liu H, Yu H, Cooper GJ (2008) Fas-associated death receptor signaling evoked by human amylin in islet beta cells. Diabetes 57:348–356PubMedCrossRef Zhang S, Liu H, Yu H, Cooper GJ (2008) Fas-associated death receptor signaling evoked by human amylin in islet beta cells. Diabetes 57:348–356PubMedCrossRef
30.
go back to reference Abdelli S, Puyal J, Bielmann C et al (2009) JNK3 is abundant in insulin-secreting cells and protects against cytokine-induced apoptosis. Diabetologia 52:1871–1880PubMedCrossRef Abdelli S, Puyal J, Bielmann C et al (2009) JNK3 is abundant in insulin-secreting cells and protects against cytokine-induced apoptosis. Diabetologia 52:1871–1880PubMedCrossRef
31.
go back to reference D’Alessio DA, Verchere CB, Kahn SE et al (1994) Pancreatic expression and secretion of human islet amyloid polypeptide in a transgenic mouse. Diabetes 43:1457–1461PubMedCrossRef D’Alessio DA, Verchere CB, Kahn SE et al (1994) Pancreatic expression and secretion of human islet amyloid polypeptide in a transgenic mouse. Diabetes 43:1457–1461PubMedCrossRef
32.
go back to reference Andrikopoulos S, Verchere CB, Terauchi K, Kadowaki T, Kahn SE (2000) ß-cell glucokinase deficiency and hyperglycemia are associated with reduced islet amyloid deposition in a mouse model of type 2 diabetes. Diabetes 49:2056–2062PubMedCrossRef Andrikopoulos S, Verchere CB, Terauchi K, Kadowaki T, Kahn SE (2000) ß-cell glucokinase deficiency and hyperglycemia are associated with reduced islet amyloid deposition in a mouse model of type 2 diabetes. Diabetes 49:2056–2062PubMedCrossRef
33.
go back to reference Zraika S, Hull RL, Udayasankar J et al (2007) Glucose- and time-dependence of islet amyloid formation in vitro. Biochem Biophys Res Commun 354:234–239PubMedCrossRef Zraika S, Hull RL, Udayasankar J et al (2007) Glucose- and time-dependence of islet amyloid formation in vitro. Biochem Biophys Res Commun 354:234–239PubMedCrossRef
34.
go back to reference Bonny C, Oberson A, Negri S, Sauser C, Schorderet DF (2001) Cell-permeable peptide inhibitors of JNK: novel blockers of beta cell death. Diabetes 50:77–82PubMedCrossRef Bonny C, Oberson A, Negri S, Sauser C, Schorderet DF (2001) Cell-permeable peptide inhibitors of JNK: novel blockers of beta cell death. Diabetes 50:77–82PubMedCrossRef
35.
go back to reference Maedler K, Sergeev P, Ris F et al (2002) Glucose-induced ß cell production of IL-1ß contributes to glucotoxicity in human pancreatic islets. J Clin Invest 110:851–860PubMed Maedler K, Sergeev P, Ris F et al (2002) Glucose-induced ß cell production of IL-1ß contributes to glucotoxicity in human pancreatic islets. J Clin Invest 110:851–860PubMed
36.
go back to reference Masters SL, Dunne A, Subramanian SL et al (2010) Activation of the NLRP3 inflammasome by islet amyloid polypeptide provides a mechanism for enhanced IL-1beta in type 2 diabetes. Nat Immunol 11:897–904PubMedCrossRef Masters SL, Dunne A, Subramanian SL et al (2010) Activation of the NLRP3 inflammasome by islet amyloid polypeptide provides a mechanism for enhanced IL-1beta in type 2 diabetes. Nat Immunol 11:897–904PubMedCrossRef
37.
go back to reference Abdelli S, Ansite J, Roduit R et al (2004) Intracellular stress signaling pathways activated during human islet preparation and following acute cytokine exposure. Diabetes 53:2815–2823PubMedCrossRef Abdelli S, Ansite J, Roduit R et al (2004) Intracellular stress signaling pathways activated during human islet preparation and following acute cytokine exposure. Diabetes 53:2815–2823PubMedCrossRef
38.
go back to reference Law E, Lu S, Kieffer TJ et al (2010) Differences between amyloid toxicity in alpha and beta cells in human and mouse islets and the role of caspase-3. Diabetologia 53:1415–1427PubMedCrossRef Law E, Lu S, Kieffer TJ et al (2010) Differences between amyloid toxicity in alpha and beta cells in human and mouse islets and the role of caspase-3. Diabetologia 53:1415–1427PubMedCrossRef
39.
go back to reference Benn SC, Woolf CJ (2004) Adult neuron survival strategies—slamming on the brakes. Nat Rev Neurosci 5:686–700PubMedCrossRef Benn SC, Woolf CJ (2004) Adult neuron survival strategies—slamming on the brakes. Nat Rev Neurosci 5:686–700PubMedCrossRef
40.
go back to reference McKenzie MD, Jamieson E, Jansen ES et al (2010) Glucose induces pancreatic islet cell apoptosis that requires the BH3-only proteins Bim and Puma and multi-BH domain protein Bax. Diabetes 59:644–652PubMedCrossRef McKenzie MD, Jamieson E, Jansen ES et al (2010) Glucose induces pancreatic islet cell apoptosis that requires the BH3-only proteins Bim and Puma and multi-BH domain protein Bax. Diabetes 59:644–652PubMedCrossRef
41.
go back to reference Thomas HE, McKenzie MD, Angstetra E, Campbell PD, Kay TW (2009) Beta cell apoptosis in diabetes. Apoptosis 14:1389–1404PubMedCrossRef Thomas HE, McKenzie MD, Angstetra E, Campbell PD, Kay TW (2009) Beta cell apoptosis in diabetes. Apoptosis 14:1389–1404PubMedCrossRef
42.
go back to reference Mehmeti I, Lenzen S, Lortz S (2010) Modulation of Bcl-2-related protein expression in pancreatic beta cells by pro-inflammatory cytokines and its dependence on the antioxidative defense status. Mol Cell Endocrinol 332:88–96PubMedCrossRef Mehmeti I, Lenzen S, Lortz S (2010) Modulation of Bcl-2-related protein expression in pancreatic beta cells by pro-inflammatory cytokines and its dependence on the antioxidative defense status. Mol Cell Endocrinol 332:88–96PubMedCrossRef
43.
go back to reference Li XL, Chen T, Wong YS et al (2011) Involvement of mitochondrial dysfunction in human islet amyloid polypeptide-induced apoptosis in INS-1E pancreatic beta cells: an effect attenuated by phycocyanin. Int J Biochem Cell Biol 43:525–534PubMedCrossRef Li XL, Chen T, Wong YS et al (2011) Involvement of mitochondrial dysfunction in human islet amyloid polypeptide-induced apoptosis in INS-1E pancreatic beta cells: an effect attenuated by phycocyanin. Int J Biochem Cell Biol 43:525–534PubMedCrossRef
44.
go back to reference Sarkar SA, Kutlu B, Velmurugan K et al (2009) Cytokine-mediated induction of anti-apoptotic genes that are linked to nuclear factor kappa-B (NF-kappaB) signalling in human islets and in a mouse beta cell line. Diabetologia 52:1092–1101PubMedCrossRef Sarkar SA, Kutlu B, Velmurugan K et al (2009) Cytokine-mediated induction of anti-apoptotic genes that are linked to nuclear factor kappa-B (NF-kappaB) signalling in human islets and in a mouse beta cell line. Diabetologia 52:1092–1101PubMedCrossRef
45.
go back to reference Rodriguez-Mulero S, Montanya E (2008) Islet graft response to transplantation injury includes upregulation of protective as well as apoptotic genes. Cell Transplant 17:1025–1034PubMedCrossRef Rodriguez-Mulero S, Montanya E (2008) Islet graft response to transplantation injury includes upregulation of protective as well as apoptotic genes. Cell Transplant 17:1025–1034PubMedCrossRef
46.
47.
go back to reference Alavez S, Vantipalli MC, Zucker DJ, Klang IM, Lithgow GJ (2011) Amyloid-binding compounds maintain protein homeostasis during ageing and extend lifespan. Nature 472:226–229PubMedCrossRef Alavez S, Vantipalli MC, Zucker DJ, Klang IM, Lithgow GJ (2011) Amyloid-binding compounds maintain protein homeostasis during ageing and extend lifespan. Nature 472:226–229PubMedCrossRef
Metadata
Title
cJUN N-terminal kinase (JNK) activation mediates islet amyloid-induced beta cell apoptosis in cultured human islet amyloid polypeptide transgenic mouse islets
Authors
S. L. Subramanian
R. L. Hull
S. Zraika
K. Aston-Mourney
J. Udayasankar
S. E. Kahn
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 1/2012
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2338-7

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