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Published in: Irish Journal of Medical Science (1971 -) 4/2017

01-11-2017 | Original Article

Lymphocyte integrin expression differences between SIRS and sepsis patients

Authors: D. S. Heffernan, S. F. Monaghan, Alfred Ayala

Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2017

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Abstract

Background

Systemic Inflammatory Response Syndrome (SIRS) and sepsis remain leading causes of death. Despite many similarities, the two entities are very distinct clinically and immunologically. T-Lymphocytes play a key pivotal role in the pathogenesis and ultimately outcome following both SIRS and sepsis. Integrins are essential in the trafficking and migration of lymphocytes. They also serve vital roles in efficient wound healing and clearance of infections. Here, we investigate whether integrin expression, specifically β1 (CD29) and β2 (CD18), are disrupted in SIRS and sepsis, and assess differences in integrin expression between these two critically ill clinical categories.

Methods

T-Lymphocytes were isolated from whole blood collected from ICU patients exhibiting SIRS or sepsis. Samples were analyzed for CD18 (β2) and CD29 (β1) on CD3+ T cells through flow cytometry. Septic patients were stratified into either exclusively abdominal or non-abdominal sources of sepsis.

Results

CD18 was almost ubiquitously expressed on CD3+ T cells irrespective of clinical condition. However, CD29 (β1 integrin) was lowest in SIRS patients (20.4% of CD3+ T cells) when compared with either septic patients (35.5%) or healthy volunteers (54.1%). Furthermore, there was evidence of compartmentalization in septic patients, where abdominal sources had a greater percentage of CD3+CD29+ T cells (41.7%) when compared with those with non-abdominal sources (29.5%).

Conclusion

Distinct differences in T-cell integrin expression exists between patients in SIRS versus sepsis, as well as relative to the source of sepsis. Further work is needed to understand cause and effect relative to the progression from SIRS into sepsis.
Literature
1.
go back to reference Singer M, Deutschman C, Seymour C, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard G, Chiche J, Coopersmith C, Hotchkiss R, Levy M, Marshall J, Martin G, Opal S, Rubenfeld G, Van der Poll T, Vincent J, Angus D (2016) The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8):801–810CrossRefPubMedPubMedCentral Singer M, Deutschman C, Seymour C, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard G, Chiche J, Coopersmith C, Hotchkiss R, Levy M, Marshall J, Martin G, Opal S, Rubenfeld G, Van der Poll T, Vincent J, Angus D (2016) The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8):801–810CrossRefPubMedPubMedCentral
2.
go back to reference Rhodes A, Phillips G, Beale R, Cecconi M, Chiche J, De Backer D, Divatia J, Du B, Evans L, Ferrer R, Girardis M, Koulenti D, Machado F, Simpson S, Tan C, Wittebole X, Levy M (2015) The surviving sepsis campaign bundles and outcomes: results from the international multicentre prevalence study on sepsis (the IMPreSS) study. Intensive Care Med 41(9):1620–1628CrossRefPubMed Rhodes A, Phillips G, Beale R, Cecconi M, Chiche J, De Backer D, Divatia J, Du B, Evans L, Ferrer R, Girardis M, Koulenti D, Machado F, Simpson S, Tan C, Wittebole X, Levy M (2015) The surviving sepsis campaign bundles and outcomes: results from the international multicentre prevalence study on sepsis (the IMPreSS) study. Intensive Care Med 41(9):1620–1628CrossRefPubMed
3.
go back to reference Heffernan D, Monaghan S, Chung C, Cioffi W, Gravenstein S, Ayala A (2014) A divergent response of innate regulatory T-cells to sepsis in humans: circulating invariant natural killer T-cells are preserved. Hum Immunol 75(3):277–282CrossRefPubMed Heffernan D, Monaghan S, Chung C, Cioffi W, Gravenstein S, Ayala A (2014) A divergent response of innate regulatory T-cells to sepsis in humans: circulating invariant natural killer T-cells are preserved. Hum Immunol 75(3):277–282CrossRefPubMed
4.
go back to reference Thakkar R, Huang X, Lomas-Neira J, Heffernan D, Ayala A (2011) Sepsis and the immune response. In: Eremin O, Sewell H (eds) Essential immunology for surgeons. Oxford University Press, Oxford, pp 303–342CrossRef Thakkar R, Huang X, Lomas-Neira J, Heffernan D, Ayala A (2011) Sepsis and the immune response. In: Eremin O, Sewell H (eds) Essential immunology for surgeons. Oxford University Press, Oxford, pp 303–342CrossRef
5.
go back to reference Binkowska A, Michalak G, Slotwinski R (2015) Current views on the mechanisms of immune responses to trauma and infection. Cent Eur J Immunol 40(2):206–216CrossRefPubMedPubMedCentral Binkowska A, Michalak G, Slotwinski R (2015) Current views on the mechanisms of immune responses to trauma and infection. Cent Eur J Immunol 40(2):206–216CrossRefPubMedPubMedCentral
6.
go back to reference Hotchkiss R, Monneret G, Payen D (2013) Sepsis induced immunosuppression: from cellular dysfunctions to immunotherapy. Nat Rev Immunol 13(12):862–874CrossRefPubMedPubMedCentral Hotchkiss R, Monneret G, Payen D (2013) Sepsis induced immunosuppression: from cellular dysfunctions to immunotherapy. Nat Rev Immunol 13(12):862–874CrossRefPubMedPubMedCentral
7.
go back to reference Venet F, Chung C, Monneret G, Huang X, Horner B, Garber M, Ayala A (2008) Regulatory T cell populations in sepsis and trauma. J Leukoc Biol 83(3):523–535CrossRefPubMed Venet F, Chung C, Monneret G, Huang X, Horner B, Garber M, Ayala A (2008) Regulatory T cell populations in sepsis and trauma. J Leukoc Biol 83(3):523–535CrossRefPubMed
8.
go back to reference Shubin N, Monaghan S, Heffernan D, Chung C, Ayala A (2013) B and T lymphocyte attenuator expression on CD4 + T-cells associates with sepsis and subsequent infections. Crit Care 17(6):R276CrossRefPubMedPubMedCentral Shubin N, Monaghan S, Heffernan D, Chung C, Ayala A (2013) B and T lymphocyte attenuator expression on CD4 + T-cells associates with sepsis and subsequent infections. Crit Care 17(6):R276CrossRefPubMedPubMedCentral
9.
go back to reference Young J, Monaghan S, Chung C, Cioffi W, Ayala A, Heffernan D (2015) Divergent invariant natural killer T-cell response to sepsis of abdominal versus non-adominal origin in human beings. Surg Infect 16(1):29–35CrossRef Young J, Monaghan S, Chung C, Cioffi W, Ayala A, Heffernan D (2015) Divergent invariant natural killer T-cell response to sepsis of abdominal versus non-adominal origin in human beings. Surg Infect 16(1):29–35CrossRef
10.
go back to reference Drewry A, Samra N, Skrupky L, Fuller B, Compton S, Hotchkiss R (2014) Persistent lymphopenia after diagnosis of sepsis predicts mortality. Shock 42(5):383–391CrossRefPubMedPubMedCentral Drewry A, Samra N, Skrupky L, Fuller B, Compton S, Hotchkiss R (2014) Persistent lymphopenia after diagnosis of sepsis predicts mortality. Shock 42(5):383–391CrossRefPubMedPubMedCentral
11.
go back to reference Heffernan D, Monaghan S, Thakkar R, Machan J, Cioffi W, Ayala A (2012) Failure to normalize lymphopenia following trauma is associated with increased mortality, independent of the leukocytosis pattern. Crit Care 16(1):R12CrossRefPubMedPubMedCentral Heffernan D, Monaghan S, Thakkar R, Machan J, Cioffi W, Ayala A (2012) Failure to normalize lymphopenia following trauma is associated with increased mortality, independent of the leukocytosis pattern. Crit Care 16(1):R12CrossRefPubMedPubMedCentral
12.
go back to reference Benechet A, Menon M, Khanna K (2014) Visualizing T cell migration in situ. Front Immunol 5(363):1–12 Benechet A, Menon M, Khanna K (2014) Visualizing T cell migration in situ. Front Immunol 5(363):1–12
13.
go back to reference Heffernan D, Monaghan S, Thakkar R, Tran M, Chung C, Gregory S, Cioffi W, Ayala A (2013) Inflammatory mechanisms in sepsis: elevated invariant natural killer T-cell numbers in mouse and their modulatory effect on macrophage function. Shock 40(2):122–128CrossRefPubMedPubMedCentral Heffernan D, Monaghan S, Thakkar R, Tran M, Chung C, Gregory S, Cioffi W, Ayala A (2013) Inflammatory mechanisms in sepsis: elevated invariant natural killer T-cell numbers in mouse and their modulatory effect on macrophage function. Shock 40(2):122–128CrossRefPubMedPubMedCentral
14.
go back to reference Mitroulis I, Alexaki V, Kourtzelis I, Ziogas A, Hajishengallis G, Chavakis T (2015) Leukocyte integrins: role in leukocyte recruitment and as therapeutic targets in inflammatory disease. Pharmacol Ther 147:123–135CrossRefPubMed Mitroulis I, Alexaki V, Kourtzelis I, Ziogas A, Hajishengallis G, Chavakis T (2015) Leukocyte integrins: role in leukocyte recruitment and as therapeutic targets in inflammatory disease. Pharmacol Ther 147:123–135CrossRefPubMed
15.
go back to reference Zhang Y, Wang H (2013) Integrin signaling and function in immune cells. Immunology 135(4):268–275CrossRef Zhang Y, Wang H (2013) Integrin signaling and function in immune cells. Immunology 135(4):268–275CrossRef
16.
17.
go back to reference Koivisto L, Heino J, Hakkinen L, Larjava H (2014) Integrins in wound healing. Adv Wound Care 3(12):762–783CrossRef Koivisto L, Heino J, Hakkinen L, Larjava H (2014) Integrins in wound healing. Adv Wound Care 3(12):762–783CrossRef
18.
go back to reference Baaten B, Cooper A, Swain S, Bradley L (2013) Location, location, location: the impact of migratory heterogeneity on T cell function. Front Immunol 4:311CrossRefPubMedPubMedCentral Baaten B, Cooper A, Swain S, Bradley L (2013) Location, location, location: the impact of migratory heterogeneity on T cell function. Front Immunol 4:311CrossRefPubMedPubMedCentral
19.
go back to reference Valignat M, Theodoly O, Gucciardi A, Hogg N, Lellouch A (2013) T lymphocytes orient against the direction of fluid flow during LFA-1 mediated migration. Biophys J 104(2):322–331CrossRefPubMedPubMedCentral Valignat M, Theodoly O, Gucciardi A, Hogg N, Lellouch A (2013) T lymphocytes orient against the direction of fluid flow during LFA-1 mediated migration. Biophys J 104(2):322–331CrossRefPubMedPubMedCentral
20.
go back to reference Reichardt P, Patzak I, Jones K, Etemire E, Gunzer M, Hogg N (2013) A role for LFA-1 in delaying T-lymphocyte egress from lymph nodes. EMBO J 32(6):829–843CrossRefPubMedPubMedCentral Reichardt P, Patzak I, Jones K, Etemire E, Gunzer M, Hogg N (2013) A role for LFA-1 in delaying T-lymphocyte egress from lymph nodes. EMBO J 32(6):829–843CrossRefPubMedPubMedCentral
21.
go back to reference Tan S (2012) The Leukocyte beta2 (CD18) integrins: the structure, functional regulation and signalling. Biosci Rep 32(3):241–269CrossRefPubMed Tan S (2012) The Leukocyte beta2 (CD18) integrins: the structure, functional regulation and signalling. Biosci Rep 32(3):241–269CrossRefPubMed
22.
go back to reference Cantor J, Rose D, Slepak M, Ginsberg M (2015) Fine tuning tumor immunity with integrin trans-regulation. Cancer Immunol Res 3(6):661–667CrossRefPubMed Cantor J, Rose D, Slepak M, Ginsberg M (2015) Fine tuning tumor immunity with integrin trans-regulation. Cancer Immunol Res 3(6):661–667CrossRefPubMed
23.
go back to reference Uotila L, Jahan F, Soto Hinojosa L, Melandri E, Gronholm M, Gahmberg C (2014) Specific phosphorylations transmit signals from leukocyte beta2 to beta1 integrins and regulate adhesion. J Biol Chem 289(46):32230–32242CrossRefPubMedPubMedCentral Uotila L, Jahan F, Soto Hinojosa L, Melandri E, Gronholm M, Gahmberg C (2014) Specific phosphorylations transmit signals from leukocyte beta2 to beta1 integrins and regulate adhesion. J Biol Chem 289(46):32230–32242CrossRefPubMedPubMedCentral
24.
go back to reference Verma N, Kelleher D (2014) Adaptor regulation of LFA-1 signaling in T lymphocyte migration: Potential druggable targets for immunotherapies? Eur J Immunol 44(12):3484–3499CrossRefPubMed Verma N, Kelleher D (2014) Adaptor regulation of LFA-1 signaling in T lymphocyte migration: Potential druggable targets for immunotherapies? Eur J Immunol 44(12):3484–3499CrossRefPubMed
25.
26.
go back to reference Gerner R, Moschen A, Tilg H (2013) Targeting T and B lymphocytes in inflammatory bowel diseases: lessons from clinical trials. Dig Dis 31(3–4):328–335CrossRefPubMed Gerner R, Moschen A, Tilg H (2013) Targeting T and B lymphocytes in inflammatory bowel diseases: lessons from clinical trials. Dig Dis 31(3–4):328–335CrossRefPubMed
27.
go back to reference Weaver L, Bao F, Dekaban G, Hryciw T, Schultz S, Cain D, Brown A (2015) CD11b integrin blockade reduces the systemic inflammatory respose syndrome after traumatic brain injury in rats. Exp Neurol 271:409–422CrossRefPubMedPubMedCentral Weaver L, Bao F, Dekaban G, Hryciw T, Schultz S, Cain D, Brown A (2015) CD11b integrin blockade reduces the systemic inflammatory respose syndrome after traumatic brain injury in rats. Exp Neurol 271:409–422CrossRefPubMedPubMedCentral
28.
go back to reference Gorlino C, Ranocchia R, Harman M, Garcia M, Crespo M, Moron G, Maletto B, Pistoresi-Palencia M (2014) Neutrophils exhibit differential requirements for homing molecules in their lymphatic and blood trafficking into draining lymph nodes. J Immunol 193(4):1966–1974CrossRefPubMed Gorlino C, Ranocchia R, Harman M, Garcia M, Crespo M, Moron G, Maletto B, Pistoresi-Palencia M (2014) Neutrophils exhibit differential requirements for homing molecules in their lymphatic and blood trafficking into draining lymph nodes. J Immunol 193(4):1966–1974CrossRefPubMed
29.
go back to reference Wostradowski T, Gudi V, Pul R, Gingele S, Lindquist J, Stangel M, Lindquist S (2015) Effect of interferon-beta1b on CXCR4-dependent chemotaxis in T cells from multiple sclerosis patients. Clin Exp Immunol 182(2):162–172CrossRefPubMedPubMedCentral Wostradowski T, Gudi V, Pul R, Gingele S, Lindquist J, Stangel M, Lindquist S (2015) Effect of interferon-beta1b on CXCR4-dependent chemotaxis in T cells from multiple sclerosis patients. Clin Exp Immunol 182(2):162–172CrossRefPubMedPubMedCentral
30.
31.
go back to reference Ding Z, Jia S, Marshall J, Downey G, Waddell T (2006) Up-regulation of functional CXCR4 expression on human lymphocytes in sepsis. Crit Care Med 34(12):3011–3017CrossRefPubMed Ding Z, Jia S, Marshall J, Downey G, Waddell T (2006) Up-regulation of functional CXCR4 expression on human lymphocytes in sepsis. Crit Care Med 34(12):3011–3017CrossRefPubMed
32.
go back to reference Manetti M, Guiducci S, Romano E, Rosa I, Ceccarelli C, Mello T, Milia A, Conforti M, Ibba-Manneschi L, Matucci-Cerinic M (2013) Differential expression of junctional adhesion molecules in different stages of systemic sclerosis. Arthritis Rheum 65(1):247–257CrossRefPubMed Manetti M, Guiducci S, Romano E, Rosa I, Ceccarelli C, Mello T, Milia A, Conforti M, Ibba-Manneschi L, Matucci-Cerinic M (2013) Differential expression of junctional adhesion molecules in different stages of systemic sclerosis. Arthritis Rheum 65(1):247–257CrossRefPubMed
33.
go back to reference Sladojevic N, Stamatovic S, Keep R, Grailer J, Sarma J, Ward P, Andjelkovic A (2014) Inhibition of junctional adhesion molecule-A/LFA interaction attenuates leukocyte trafficking and inflammation in brain ischemia/reperfusion injury. Neurobiol Dis 67:57–70CrossRefPubMedPubMedCentral Sladojevic N, Stamatovic S, Keep R, Grailer J, Sarma J, Ward P, Andjelkovic A (2014) Inhibition of junctional adhesion molecule-A/LFA interaction attenuates leukocyte trafficking and inflammation in brain ischemia/reperfusion injury. Neurobiol Dis 67:57–70CrossRefPubMedPubMedCentral
34.
go back to reference Huang Y, Clarke F, Karimi M, Roy N, Williamson E, Okumura M, Mochizuki K, Chen E, Park T, Debes G, Zhang Y, Curran T, Kambayasgi T, Burkhardt J (2015) CRK proteins selectively regulate T cell migration into inflammed tissues. J Clin Investig 125(3):1019–1032CrossRefPubMedPubMedCentral Huang Y, Clarke F, Karimi M, Roy N, Williamson E, Okumura M, Mochizuki K, Chen E, Park T, Debes G, Zhang Y, Curran T, Kambayasgi T, Burkhardt J (2015) CRK proteins selectively regulate T cell migration into inflammed tissues. J Clin Investig 125(3):1019–1032CrossRefPubMedPubMedCentral
35.
go back to reference Morrison V, MacPherson M, Savinko T, Lek H, Prescott A, Fagerholm S (2013) The beta2 integrin-kindlin-3 interaction is essential for T-cell homing but dispensable for T-cell activation in vivo. Blood 122(8):1428–1436CrossRefPubMedPubMedCentral Morrison V, MacPherson M, Savinko T, Lek H, Prescott A, Fagerholm S (2013) The beta2 integrin-kindlin-3 interaction is essential for T-cell homing but dispensable for T-cell activation in vivo. Blood 122(8):1428–1436CrossRefPubMedPubMedCentral
36.
go back to reference Gonzalez-Alvaro I, Munoz C, Garcia-Vicuna R, Sabando P, Cabanas C, Sanchez-Madrid F, Diaz-Gonzalez F (1998) Interference of nonsteroidal antiinflammatory drugs with very late activation antgen 4/vascular cells adhesion molecule 1-mediated lymphocyte-endothelial cell adhesion. Arthritis Rheum 41(9):1677–1688CrossRefPubMed Gonzalez-Alvaro I, Munoz C, Garcia-Vicuna R, Sabando P, Cabanas C, Sanchez-Madrid F, Diaz-Gonzalez F (1998) Interference of nonsteroidal antiinflammatory drugs with very late activation antgen 4/vascular cells adhesion molecule 1-mediated lymphocyte-endothelial cell adhesion. Arthritis Rheum 41(9):1677–1688CrossRefPubMed
37.
go back to reference Rosenthal-Allieri M, Ticchioni M, Breittmayer J, Breittmayer J, Shimizu Y, Bernard A (2005) Influence of beta 1 integrin intracytoplasmic domains in the regulation of VLA-4 mediated adhesion of human T cells to VCAM-1 under flow conditions. J Immunol 17(2):1214–1223CrossRef Rosenthal-Allieri M, Ticchioni M, Breittmayer J, Breittmayer J, Shimizu Y, Bernard A (2005) Influence of beta 1 integrin intracytoplasmic domains in the regulation of VLA-4 mediated adhesion of human T cells to VCAM-1 under flow conditions. J Immunol 17(2):1214–1223CrossRef
38.
go back to reference Parkash J, Cimino I, Ferraris N, Casoni F, Wray S, Cappy H, Prevot V, Giacobini P (2012) Suppression of b1- integrin in gonadotropin-releasing hormone cells disrupts migration and axonal extension resulting in severe reproductive alterations. J Neurosci 32(47):16992–17002CrossRefPubMedPubMedCentral Parkash J, Cimino I, Ferraris N, Casoni F, Wray S, Cappy H, Prevot V, Giacobini P (2012) Suppression of b1- integrin in gonadotropin-releasing hormone cells disrupts migration and axonal extension resulting in severe reproductive alterations. J Neurosci 32(47):16992–17002CrossRefPubMedPubMedCentral
39.
go back to reference Howe G, Addison C (2012) Beta-1 integrin: an emerging player in the modulation of tumorigenesis and response to therapy. Cell Adhes Migr 6(2):71–77CrossRef Howe G, Addison C (2012) Beta-1 integrin: an emerging player in the modulation of tumorigenesis and response to therapy. Cell Adhes Migr 6(2):71–77CrossRef
40.
go back to reference Kadioglu A, De Filippo K, Bangert M, Fernandes V, Richards L, Jones K, Andrew P, Hogg N (2011) The integrins Mac-1 and alpha4beta 1 perform cruical roles in neutrophil and T cell recruitment to lungs during Streptoccus pneumoniae infection. J Immunol 186(10):5907–5915CrossRefPubMed Kadioglu A, De Filippo K, Bangert M, Fernandes V, Richards L, Jones K, Andrew P, Hogg N (2011) The integrins Mac-1 and alpha4beta 1 perform cruical roles in neutrophil and T cell recruitment to lungs during Streptoccus pneumoniae infection. J Immunol 186(10):5907–5915CrossRefPubMed
41.
go back to reference Luque A, Gomez M, Puzon W, Takada Y, Sanchez-Madrid F, Cabanas C (1996) Activated conformations of very late activation integrins detected by a group of antibodies (HUTS) specific for a novel regulatory region (355–425) of the common beta-1 chain. J Biol Chem 271(19):11067–11075CrossRefPubMed Luque A, Gomez M, Puzon W, Takada Y, Sanchez-Madrid F, Cabanas C (1996) Activated conformations of very late activation integrins detected by a group of antibodies (HUTS) specific for a novel regulatory region (355–425) of the common beta-1 chain. J Biol Chem 271(19):11067–11075CrossRefPubMed
43.
go back to reference Nachtsheim R, Dudley B, McNeil P (2006) The peritoneal cavity is a distinct compartment of angiogenic molecular mediators. J Surg Res 134(1):28–35CrossRefPubMed Nachtsheim R, Dudley B, McNeil P (2006) The peritoneal cavity is a distinct compartment of angiogenic molecular mediators. J Surg Res 134(1):28–35CrossRefPubMed
44.
go back to reference Cavaillon J, Annane D (2006) Compartmentalization of the inflammatory response in sepsis and SIRS. J Endotoxin Res 12(3):151–170PubMed Cavaillon J, Annane D (2006) Compartmentalization of the inflammatory response in sepsis and SIRS. J Endotoxin Res 12(3):151–170PubMed
45.
go back to reference Stromberg P, Woolsey C, Clark A, Clark J, Turnbull I, McConnell K, Chang K, Chung C, Ayala A, Buchman T, Hotchkiss R, Coopersmith C (2009) CD4 + lymphocytes control gut epithelial apoptosis and mediate survival in sepsis. FASEB J 23(6):1817–1825CrossRefPubMedPubMedCentral Stromberg P, Woolsey C, Clark A, Clark J, Turnbull I, McConnell K, Chang K, Chung C, Ayala A, Buchman T, Hotchkiss R, Coopersmith C (2009) CD4 + lymphocytes control gut epithelial apoptosis and mediate survival in sepsis. FASEB J 23(6):1817–1825CrossRefPubMedPubMedCentral
Metadata
Title
Lymphocyte integrin expression differences between SIRS and sepsis patients
Authors
D. S. Heffernan
S. F. Monaghan
Alfred Ayala
Publication date
01-11-2017
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 4/2017
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-016-1525-4

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