Loading…

Cannabidiol prevents lipopolysaccharide-induced sickness behavior and alters cytokine and neurotrophic factor levels in the brain

Background Major depressive disorder (MDD) affects millions of people worldwide. While the exact pathogenesis is yet to be elucidated, the role of neuro-immune signaling has recently emerged. Despite major advances in pharmacotherapy, antidepressant use is marred by limited efficacy and potential si...

Full description

Saved in:
Bibliographic Details
Published in:Pharmacological reports 2021-12, Vol.73 (6), p.1680-1693
Main Authors: Tito, Pedro Augusto Lopes, Bernardino, Túlio Cézar de Souza, Bellozi, Paula Maria Quaglio, da Silva, Maria Carolina Machado, de Miranda, Aline Silva, Vieira, Érica Leandro Marciano, Moreira, Fabrício A., Palotás, András, de Oliveira, Antônio Carlos Pinheiro, Reis, Helton José
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c446t-bb86e6a874f63c46dc8d3b3e09d742e05140fc50848bddd4586adcd22c9d3c563
cites cdi_FETCH-LOGICAL-c446t-bb86e6a874f63c46dc8d3b3e09d742e05140fc50848bddd4586adcd22c9d3c563
container_end_page 1693
container_issue 6
container_start_page 1680
container_title Pharmacological reports
container_volume 73
creator Tito, Pedro Augusto Lopes
Bernardino, Túlio Cézar de Souza
Bellozi, Paula Maria Quaglio
da Silva, Maria Carolina Machado
de Miranda, Aline Silva
Vieira, Érica Leandro Marciano
Moreira, Fabrício A.
Palotás, András
de Oliveira, Antônio Carlos Pinheiro
Reis, Helton José
description Background Major depressive disorder (MDD) affects millions of people worldwide. While the exact pathogenesis is yet to be elucidated, the role of neuro-immune signaling has recently emerged. Despite major advances in pharmacotherapy, antidepressant use is marred by limited efficacy and potential side effects. Cannabidiol (CBD), a phytocannabinoid, exerts antidepressant-like effects in experimental animals. This study investigated the impact of CBD on sickness behavior (SB), a measure of depressive-like response, and neuro-immune changes induced by lipopolysaccharides (LPS) in mice. Methods Socially isolated rodents were administered with LPS to trigger SB. and treated with CBD or its vehicle. Animals were submitted to forced swimming test, to evaluate depressive-like behavior, and to open field test, to evaluate locomotory activity. Immediately after behavioral analyses, animals were euthanized and had their hypothalamus, prefrontal cortex and hippocampus dissected, to proceed neurotrophins and cytokines analyses. ELISA was used to detect IL-1β, BDNF and NGF; and cytometric beads array to measure IL-2, IL-4, IL-6, IFN-γ, TNF-α and IL-10 levels. Results CBD effectively prevented SB-induced changes in the forced swim test without altering spontaneous locomotion. This phytocannabinoid also partially reversed LPS-evoked IL-6 increase in both the hypothalamus and hippocampus. In addition, CBD prevented endotoxin-induced increase in BDNF and NGF levels in the hippocampus of SB animals. Conclusions Apparently, CBD prevents both behavioral and neuro-immunological changes associated with LPS-induced SB, which reinforces its potential use as an antidepressant which modulates neuroinflammation. This opens up potentially new therapeutic avenues in MDD.
doi_str_mv 10.1007/s43440-021-00301-8
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8254454</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2548624543</sourcerecordid><originalsourceid>FETCH-LOGICAL-c446t-bb86e6a874f63c46dc8d3b3e09d742e05140fc50848bddd4586adcd22c9d3c563</originalsourceid><addsrcrecordid>eNp9kU1v3CAQhlHVqtkm_QM9VBx7IeXLNr5UqlbphxQpl-aMMIxjEhZcsFfaY_55STaN2ktOSMwz7zA8CH1g9JxR2n0uUkhJCeWMUCooI-oV2nDe96RplXyNNqwTkjAm6Ql6V8otpZJx0bxFJ0JypkTfbdD91sRoBu98CnjOsIe4FBz8nOYUDsVYO5nsHRAf3WrB4eLtXYRS8ACT2fuUsYkOm7BALtgelnTnIzzeRVhzWnKaJ2_xaOxS2VAHhIJ9xMsEeMjGxzP0ZjShwPun8xRdf7v4tf1BLq--_9x-vSRWynYhw6BaaI3q5NgKK1tnlRODANq7TnKgTV1ztA1VUg3OOdmo1jjrOLe9E7ZpxSn6csyd12EHztZFswl6zn5n8kEn4_X_legnfZP2WvFGykbWgE9PATn9XqEseueLhRBMhLQWXTHV8geyovyI2pxKyTA-j2FUP7jTR3e6utOP7rSqTR__feBzy19ZFRBHoNRSvIGsb9OaY_20l2L_APBRqbE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2548624543</pqid></control><display><type>article</type><title>Cannabidiol prevents lipopolysaccharide-induced sickness behavior and alters cytokine and neurotrophic factor levels in the brain</title><source>Springer Link</source><creator>Tito, Pedro Augusto Lopes ; Bernardino, Túlio Cézar de Souza ; Bellozi, Paula Maria Quaglio ; da Silva, Maria Carolina Machado ; de Miranda, Aline Silva ; Vieira, Érica Leandro Marciano ; Moreira, Fabrício A. ; Palotás, András ; de Oliveira, Antônio Carlos Pinheiro ; Reis, Helton José</creator><creatorcontrib>Tito, Pedro Augusto Lopes ; Bernardino, Túlio Cézar de Souza ; Bellozi, Paula Maria Quaglio ; da Silva, Maria Carolina Machado ; de Miranda, Aline Silva ; Vieira, Érica Leandro Marciano ; Moreira, Fabrício A. ; Palotás, András ; de Oliveira, Antônio Carlos Pinheiro ; Reis, Helton José</creatorcontrib><description>Background Major depressive disorder (MDD) affects millions of people worldwide. While the exact pathogenesis is yet to be elucidated, the role of neuro-immune signaling has recently emerged. Despite major advances in pharmacotherapy, antidepressant use is marred by limited efficacy and potential side effects. Cannabidiol (CBD), a phytocannabinoid, exerts antidepressant-like effects in experimental animals. This study investigated the impact of CBD on sickness behavior (SB), a measure of depressive-like response, and neuro-immune changes induced by lipopolysaccharides (LPS) in mice. Methods Socially isolated rodents were administered with LPS to trigger SB. and treated with CBD or its vehicle. Animals were submitted to forced swimming test, to evaluate depressive-like behavior, and to open field test, to evaluate locomotory activity. Immediately after behavioral analyses, animals were euthanized and had their hypothalamus, prefrontal cortex and hippocampus dissected, to proceed neurotrophins and cytokines analyses. ELISA was used to detect IL-1β, BDNF and NGF; and cytometric beads array to measure IL-2, IL-4, IL-6, IFN-γ, TNF-α and IL-10 levels. Results CBD effectively prevented SB-induced changes in the forced swim test without altering spontaneous locomotion. This phytocannabinoid also partially reversed LPS-evoked IL-6 increase in both the hypothalamus and hippocampus. In addition, CBD prevented endotoxin-induced increase in BDNF and NGF levels in the hippocampus of SB animals. Conclusions Apparently, CBD prevents both behavioral and neuro-immunological changes associated with LPS-induced SB, which reinforces its potential use as an antidepressant which modulates neuroinflammation. This opens up potentially new therapeutic avenues in MDD.</description><identifier>ISSN: 1734-1140</identifier><identifier>EISSN: 2299-5684</identifier><identifier>DOI: 10.1007/s43440-021-00301-8</identifier><identifier>PMID: 34218397</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Animals ; Antidepressive Agents - pharmacology ; Behavior, Animal - drug effects ; Brain - drug effects ; Brain - metabolism ; Brain-Derived Neurotrophic Factor - metabolism ; Cannabidiol - pharmacology ; Cytokines - metabolism ; Depressive Disorder, Major - drug therapy ; Depressive Disorder, Major - physiopathology ; Disease Models, Animal ; Drug Safety and Pharmacovigilance ; Illness Behavior - drug effects ; Lipopolysaccharides ; Male ; Medicine ; Mice ; Mice, Inbred C57BL ; Nerve Growth Factor - metabolism ; Neuroinflammatory Diseases - drug therapy ; Neuroinflammatory Diseases - physiopathology ; Pharmacotherapy ; Pharmacy</subject><ispartof>Pharmacological reports, 2021-12, Vol.73 (6), p.1680-1693</ispartof><rights>Maj Institute of Pharmacology Polish Academy of Sciences 2021</rights><rights>2021. Maj Institute of Pharmacology Polish Academy of Sciences.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-bb86e6a874f63c46dc8d3b3e09d742e05140fc50848bddd4586adcd22c9d3c563</citedby><cites>FETCH-LOGICAL-c446t-bb86e6a874f63c46dc8d3b3e09d742e05140fc50848bddd4586adcd22c9d3c563</cites><orcidid>0000-0002-4055-701X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34218397$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tito, Pedro Augusto Lopes</creatorcontrib><creatorcontrib>Bernardino, Túlio Cézar de Souza</creatorcontrib><creatorcontrib>Bellozi, Paula Maria Quaglio</creatorcontrib><creatorcontrib>da Silva, Maria Carolina Machado</creatorcontrib><creatorcontrib>de Miranda, Aline Silva</creatorcontrib><creatorcontrib>Vieira, Érica Leandro Marciano</creatorcontrib><creatorcontrib>Moreira, Fabrício A.</creatorcontrib><creatorcontrib>Palotás, András</creatorcontrib><creatorcontrib>de Oliveira, Antônio Carlos Pinheiro</creatorcontrib><creatorcontrib>Reis, Helton José</creatorcontrib><title>Cannabidiol prevents lipopolysaccharide-induced sickness behavior and alters cytokine and neurotrophic factor levels in the brain</title><title>Pharmacological reports</title><addtitle>Pharmacol. Rep</addtitle><addtitle>Pharmacol Rep</addtitle><description>Background Major depressive disorder (MDD) affects millions of people worldwide. While the exact pathogenesis is yet to be elucidated, the role of neuro-immune signaling has recently emerged. Despite major advances in pharmacotherapy, antidepressant use is marred by limited efficacy and potential side effects. Cannabidiol (CBD), a phytocannabinoid, exerts antidepressant-like effects in experimental animals. This study investigated the impact of CBD on sickness behavior (SB), a measure of depressive-like response, and neuro-immune changes induced by lipopolysaccharides (LPS) in mice. Methods Socially isolated rodents were administered with LPS to trigger SB. and treated with CBD or its vehicle. Animals were submitted to forced swimming test, to evaluate depressive-like behavior, and to open field test, to evaluate locomotory activity. Immediately after behavioral analyses, animals were euthanized and had their hypothalamus, prefrontal cortex and hippocampus dissected, to proceed neurotrophins and cytokines analyses. ELISA was used to detect IL-1β, BDNF and NGF; and cytometric beads array to measure IL-2, IL-4, IL-6, IFN-γ, TNF-α and IL-10 levels. Results CBD effectively prevented SB-induced changes in the forced swim test without altering spontaneous locomotion. This phytocannabinoid also partially reversed LPS-evoked IL-6 increase in both the hypothalamus and hippocampus. In addition, CBD prevented endotoxin-induced increase in BDNF and NGF levels in the hippocampus of SB animals. Conclusions Apparently, CBD prevents both behavioral and neuro-immunological changes associated with LPS-induced SB, which reinforces its potential use as an antidepressant which modulates neuroinflammation. This opens up potentially new therapeutic avenues in MDD.</description><subject>Animals</subject><subject>Antidepressive Agents - pharmacology</subject><subject>Behavior, Animal - drug effects</subject><subject>Brain - drug effects</subject><subject>Brain - metabolism</subject><subject>Brain-Derived Neurotrophic Factor - metabolism</subject><subject>Cannabidiol - pharmacology</subject><subject>Cytokines - metabolism</subject><subject>Depressive Disorder, Major - drug therapy</subject><subject>Depressive Disorder, Major - physiopathology</subject><subject>Disease Models, Animal</subject><subject>Drug Safety and Pharmacovigilance</subject><subject>Illness Behavior - drug effects</subject><subject>Lipopolysaccharides</subject><subject>Male</subject><subject>Medicine</subject><subject>Mice</subject><subject>Mice, Inbred C57BL</subject><subject>Nerve Growth Factor - metabolism</subject><subject>Neuroinflammatory Diseases - drug therapy</subject><subject>Neuroinflammatory Diseases - physiopathology</subject><subject>Pharmacotherapy</subject><subject>Pharmacy</subject><issn>1734-1140</issn><issn>2299-5684</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v3CAQhlHVqtkm_QM9VBx7IeXLNr5UqlbphxQpl-aMMIxjEhZcsFfaY_55STaN2ktOSMwz7zA8CH1g9JxR2n0uUkhJCeWMUCooI-oV2nDe96RplXyNNqwTkjAm6Ql6V8otpZJx0bxFJ0JypkTfbdD91sRoBu98CnjOsIe4FBz8nOYUDsVYO5nsHRAf3WrB4eLtXYRS8ACT2fuUsYkOm7BALtgelnTnIzzeRVhzWnKaJ2_xaOxS2VAHhIJ9xMsEeMjGxzP0ZjShwPun8xRdf7v4tf1BLq--_9x-vSRWynYhw6BaaI3q5NgKK1tnlRODANq7TnKgTV1ztA1VUg3OOdmo1jjrOLe9E7ZpxSn6csyd12EHztZFswl6zn5n8kEn4_X_legnfZP2WvFGykbWgE9PATn9XqEseueLhRBMhLQWXTHV8geyovyI2pxKyTA-j2FUP7jTR3e6utOP7rSqTR__feBzy19ZFRBHoNRSvIGsb9OaY_20l2L_APBRqbE</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Tito, Pedro Augusto Lopes</creator><creator>Bernardino, Túlio Cézar de Souza</creator><creator>Bellozi, Paula Maria Quaglio</creator><creator>da Silva, Maria Carolina Machado</creator><creator>de Miranda, Aline Silva</creator><creator>Vieira, Érica Leandro Marciano</creator><creator>Moreira, Fabrício A.</creator><creator>Palotás, András</creator><creator>de Oliveira, Antônio Carlos Pinheiro</creator><creator>Reis, Helton José</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4055-701X</orcidid></search><sort><creationdate>20211201</creationdate><title>Cannabidiol prevents lipopolysaccharide-induced sickness behavior and alters cytokine and neurotrophic factor levels in the brain</title><author>Tito, Pedro Augusto Lopes ; Bernardino, Túlio Cézar de Souza ; Bellozi, Paula Maria Quaglio ; da Silva, Maria Carolina Machado ; de Miranda, Aline Silva ; Vieira, Érica Leandro Marciano ; Moreira, Fabrício A. ; Palotás, András ; de Oliveira, Antônio Carlos Pinheiro ; Reis, Helton José</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-bb86e6a874f63c46dc8d3b3e09d742e05140fc50848bddd4586adcd22c9d3c563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Animals</topic><topic>Antidepressive Agents - pharmacology</topic><topic>Behavior, Animal - drug effects</topic><topic>Brain - drug effects</topic><topic>Brain - metabolism</topic><topic>Brain-Derived Neurotrophic Factor - metabolism</topic><topic>Cannabidiol - pharmacology</topic><topic>Cytokines - metabolism</topic><topic>Depressive Disorder, Major - drug therapy</topic><topic>Depressive Disorder, Major - physiopathology</topic><topic>Disease Models, Animal</topic><topic>Drug Safety and Pharmacovigilance</topic><topic>Illness Behavior - drug effects</topic><topic>Lipopolysaccharides</topic><topic>Male</topic><topic>Medicine</topic><topic>Mice</topic><topic>Mice, Inbred C57BL</topic><topic>Nerve Growth Factor - metabolism</topic><topic>Neuroinflammatory Diseases - drug therapy</topic><topic>Neuroinflammatory Diseases - physiopathology</topic><topic>Pharmacotherapy</topic><topic>Pharmacy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tito, Pedro Augusto Lopes</creatorcontrib><creatorcontrib>Bernardino, Túlio Cézar de Souza</creatorcontrib><creatorcontrib>Bellozi, Paula Maria Quaglio</creatorcontrib><creatorcontrib>da Silva, Maria Carolina Machado</creatorcontrib><creatorcontrib>de Miranda, Aline Silva</creatorcontrib><creatorcontrib>Vieira, Érica Leandro Marciano</creatorcontrib><creatorcontrib>Moreira, Fabrício A.</creatorcontrib><creatorcontrib>Palotás, András</creatorcontrib><creatorcontrib>de Oliveira, Antônio Carlos Pinheiro</creatorcontrib><creatorcontrib>Reis, Helton José</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pharmacological reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tito, Pedro Augusto Lopes</au><au>Bernardino, Túlio Cézar de Souza</au><au>Bellozi, Paula Maria Quaglio</au><au>da Silva, Maria Carolina Machado</au><au>de Miranda, Aline Silva</au><au>Vieira, Érica Leandro Marciano</au><au>Moreira, Fabrício A.</au><au>Palotás, András</au><au>de Oliveira, Antônio Carlos Pinheiro</au><au>Reis, Helton José</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cannabidiol prevents lipopolysaccharide-induced sickness behavior and alters cytokine and neurotrophic factor levels in the brain</atitle><jtitle>Pharmacological reports</jtitle><stitle>Pharmacol. Rep</stitle><addtitle>Pharmacol Rep</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>73</volume><issue>6</issue><spage>1680</spage><epage>1693</epage><pages>1680-1693</pages><issn>1734-1140</issn><eissn>2299-5684</eissn><abstract>Background Major depressive disorder (MDD) affects millions of people worldwide. While the exact pathogenesis is yet to be elucidated, the role of neuro-immune signaling has recently emerged. Despite major advances in pharmacotherapy, antidepressant use is marred by limited efficacy and potential side effects. Cannabidiol (CBD), a phytocannabinoid, exerts antidepressant-like effects in experimental animals. This study investigated the impact of CBD on sickness behavior (SB), a measure of depressive-like response, and neuro-immune changes induced by lipopolysaccharides (LPS) in mice. Methods Socially isolated rodents were administered with LPS to trigger SB. and treated with CBD or its vehicle. Animals were submitted to forced swimming test, to evaluate depressive-like behavior, and to open field test, to evaluate locomotory activity. Immediately after behavioral analyses, animals were euthanized and had their hypothalamus, prefrontal cortex and hippocampus dissected, to proceed neurotrophins and cytokines analyses. ELISA was used to detect IL-1β, BDNF and NGF; and cytometric beads array to measure IL-2, IL-4, IL-6, IFN-γ, TNF-α and IL-10 levels. Results CBD effectively prevented SB-induced changes in the forced swim test without altering spontaneous locomotion. This phytocannabinoid also partially reversed LPS-evoked IL-6 increase in both the hypothalamus and hippocampus. In addition, CBD prevented endotoxin-induced increase in BDNF and NGF levels in the hippocampus of SB animals. Conclusions Apparently, CBD prevents both behavioral and neuro-immunological changes associated with LPS-induced SB, which reinforces its potential use as an antidepressant which modulates neuroinflammation. This opens up potentially new therapeutic avenues in MDD.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34218397</pmid><doi>10.1007/s43440-021-00301-8</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-4055-701X</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1734-1140
ispartof Pharmacological reports, 2021-12, Vol.73 (6), p.1680-1693
issn 1734-1140
2299-5684
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8254454
source Springer Link
subjects Animals
Antidepressive Agents - pharmacology
Behavior, Animal - drug effects
Brain - drug effects
Brain - metabolism
Brain-Derived Neurotrophic Factor - metabolism
Cannabidiol - pharmacology
Cytokines - metabolism
Depressive Disorder, Major - drug therapy
Depressive Disorder, Major - physiopathology
Disease Models, Animal
Drug Safety and Pharmacovigilance
Illness Behavior - drug effects
Lipopolysaccharides
Male
Medicine
Mice
Mice, Inbred C57BL
Nerve Growth Factor - metabolism
Neuroinflammatory Diseases - drug therapy
Neuroinflammatory Diseases - physiopathology
Pharmacotherapy
Pharmacy
title Cannabidiol prevents lipopolysaccharide-induced sickness behavior and alters cytokine and neurotrophic factor levels in the brain
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T13%3A16%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cannabidiol%20prevents%20lipopolysaccharide-induced%20sickness%20behavior%20and%20alters%20cytokine%20and%20neurotrophic%20factor%20levels%20in%20the%20brain&rft.jtitle=Pharmacological%20reports&rft.au=Tito,%20Pedro%20Augusto%20Lopes&rft.date=2021-12-01&rft.volume=73&rft.issue=6&rft.spage=1680&rft.epage=1693&rft.pages=1680-1693&rft.issn=1734-1140&rft.eissn=2299-5684&rft_id=info:doi/10.1007/s43440-021-00301-8&rft_dat=%3Cproquest_pubme%3E2548624543%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c446t-bb86e6a874f63c46dc8d3b3e09d742e05140fc50848bddd4586adcd22c9d3c563%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2548624543&rft_id=info:pmid/34218397&rfr_iscdi=true