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(1S,2S,4R,8S,9S,11S,13R)-11-hydroxy-8-(2-hydroxyacetyl)-9,13-dimethyl-6-propyl-5,7-dioxapentacyclo[10.8.0.02,9.04,8.013,18]icosa-14,17-dien-16-one | 51333-22-3

中文名称
——
中文别名
——
英文名称
(1S,2S,4R,8S,9S,11S,13R)-11-hydroxy-8-(2-hydroxyacetyl)-9,13-dimethyl-6-propyl-5,7-dioxapentacyclo[10.8.0.02,9.04,8.013,18]icosa-14,17-dien-16-one
英文别名
——
(1S,2S,4R,8S,9S,11S,13R)-11-hydroxy-8-(2-hydroxyacetyl)-9,13-dimethyl-6-propyl-5,7-dioxapentacyclo[10.8.0.02,9.04,8.013,18]icosa-14,17-dien-16-one化学式
CAS
51333-22-3
化学式
C25H34O6
mdl
——
分子量
430.5
InChiKey
VOVIALXJUBGFJZ-DZSVZFANSA-N
BEILSTEIN
——
EINECS
——
  • 物化性质
  • 计算性质
  • ADMET
  • 安全信息
  • SDS
  • 制备方法与用途
  • 上下游信息
  • 反应信息
  • 文献信息
  • 表征谱图
  • 同类化合物
  • 相关功能分类
  • 相关结构分类

物化性质

  • 熔点:
    221-232°C (dec.)
  • 比旋光度:
    D25 +98.9° (c = 0.28 in methylene chloride)
  • 沸点:
    464.79°C (rough estimate)
  • 密度:
    1.1046 (rough estimate)
  • 溶解度:
    几乎不溶于水,易溶于二氯甲烷,微溶于乙醇(96%)。
  • 颜色/状态:
    Crystals
  • 蒸汽压力:
    8.81X10-15 mm Hg at 25 °C (est)
  • 稳定性/保质期:

    Chemical stability: Stable under recommended storage conditions.

  • 旋光度:
    Specific optical rotation: +98.9 deg at 25 °C/D (c = 0.28 in methylene chloride)

计算性质

  • 辛醇/水分配系数(LogP):
    2.5
  • 重原子数:
    31
  • 可旋转键数:
    4
  • 环数:
    5.0
  • sp3杂化的碳原子比例:
    0.76
  • 拓扑面积:
    93.1
  • 氢给体数:
    2
  • 氢受体数:
    6

ADMET

代谢
布地奈德在肝脏中被细胞色素P-450(CYP)同工酶3A4代谢;主要代谢物的糖皮质激素受体亲和力不到母化合物的1%。布地奈德以代谢物的形式通过尿液和粪便排出体外。
Budesonide is metabolized in the liver by the cytochrome P-450 (CYP) isoenzyme 3A4; the 2 main metabolites have less than 1% of affinity for glucocorticoid receptors than the parent compound. Budesonide is excreted in urine and feces as metabolites.
来源:Hazardous Substances Data Bank (HSDB)
代谢
哮喘是世界上最常见的疾病之一,其主要治疗方法是吸入糖皮质激素(GCs)。尽管这些药物被广泛使用,但大约30%的哮喘患者表现出一定程度的激素不敏感或对吸入型GCs有抗药性。解释这种现象的一个假设是患者之间这些化合物清除率的差异。这项研究的目的是确定CYP3A家族酶对GCs的代谢如何影响哮喘患者的疗效。在这项工作中,研究了四种经常处方的吸入型GCs,即丙酸倍氯米松、氟尼缩松、布地奈德和丙酸氟替卡松,通过CYP3A家族酶的代谢,以确定它们清除率的差异并识别它们的代谢物。观察到了代谢率和代谢命运的跨酶和跨药物变异性。CYP3A4是所有化合物的最有效代谢催化剂,而CYP3A7的代谢速率最慢。CYP3A5,特别是在肺部GC代谢中特别相关,也被证明有效地代谢了丙酸倍氯米松、布地奈德和丙酸氟替卡松。相比之下,氟尼缩松仅通过CYP3A4代谢,CYP3A5或CYP3A7没有显著转化。常见的代谢物包括6位β-羟基化和Δ(6)-脱氢化,适用于丙酸倍氯米松、布地奈德和氟尼缩松。通过NMR分析明确确立了Δ(6)-氟尼缩松的结构。代谢也发生在D环的取代基上,包括丙酸倍氯米松和氟尼缩松的21-羧基代谢物。通过液相色谱-质谱和NMR分析还鉴定出了新的代谢物21-去甲丙酸倍氯米松。
Asthma is one of the most prevalent diseases in the world, for which the mainstay treatment has been inhaled glucocorticoids (GCs). Despite the widespread use of these drugs, approximately 30% of asthma sufferers exhibit some degree of steroid insensitivity or are refractory to inhaled GCs. One hypothesis to explain this phenomenon is interpatient variability in the clearance of these compounds. The objective of this research is to determine how metabolism of GCs by the CYP3A family of enzymes could affect their effectiveness in asthmatic patients. In this work, the metabolism of four frequently prescribed inhaled GCs, triamcinolone acetonide, flunisolide, budesonide, and fluticasone propionate, by the CYP3A family of enzymes was studied to identify differences in their rates of clearance and to identify their metabolites. Both interenzyme and interdrug variability in rates of metabolism and metabolic fate were observed. CYP3A4 was the most efficient metabolic catalyst for all the compounds, and CYP3A7 had the slowest rates. CYP3A5, which is particularly relevant to GC metabolism in the lungs, was also shown to efficiently metabolize triamcinolone acetonide, budesonide, and fluticasone propionate. In contrast, flunisolide was only metabolized via CYP3A4, with no significant turnover by CYP3A5 or CYP3A7. Common metabolites included 6 Beta-hydroxylation and Delta (6)-dehydrogenation for triamcinolone acetonide, budesonide, and flunisolide. The structure of Delta (6)-flunisolide was unambiguously established by NMR analysis. Metabolism also occurred on the D-ring substituents, including the 21-carboxy metabolites for triamcinolone acetonide and flunisolide. The novel metabolite 21-nortriamcinolone acetonide was also identified by liquid chromatography-mass spectrometry and NMR analysis.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 肝毒性
长期使用布地奈德治疗并未与血清酶水平升高有关联,在临床试验中,与安慰剂治疗相比,ALT升高的比率相似。在有对照的试验中,没有报告与使用布地奈德相关的临床上明显的肝损伤病例。与传统的系统性给予的皮质类固醇不同,布地奈德并未与乙型肝炎再激活的发作有关联。布地奈德已用于严重的自身免疫性肝病,没有证据表明它会加剧本已存在的肝脏损伤。由于它能够改善自身免疫性肝炎患者血清转氨酶的升高,因此停药后可能会出现反弹升高,这也发生在传统的皮质类固醇治疗中。此外,曾有个别病例报告在布地奈德治疗期间出现急性血清转氨酶升高,但在停药后这些升高得以解决,但相关记录有限,且患者同时使用了多种其他可能对肝脏有毒性的药物。
Long term therapy with budesonide has not been linked to elevations in serum enzyme levels, and in clinical trials rates of ALT elevations were similar with budesonide as with placebo treatment. In controlled trials, there were no reported cases of clinically apparent liver injury associated with its use. Unlike conventional systemically administered corticosteroids, budesonide has not been linked to episodes of reactivation of hepatitis B. Budesonide has been used in severe autoimmune liver diseases without evidence that it causes worsening of liver injury. Because it can improve serum aminotransferase elevations in patients with autoimmune hepatitis, its withdrawal may be followed by rebound elevations as also occurs with conventional corticosteroid therapy. In addition, there has been a single case report of acute serum aminotransferase elevations during budesonide therapy that resolved when the drug was stopped, but documentation was limited and the patient was on multiple other potentially hepatotoxic drugs.
来源:LiverTox
毒理性
  • 相互作用
口服糖皮质激素的类固醇精神症已经被很好地描述,然而,我们在文献搜索中并没有发现谵妄与吸入糖皮质激素和长效β2受体激动剂联合使用之间存在关联。我们描述了吸入糖皮质激素和支气管扩张剂联合使用时发生谵妄的情况。一位老年男性在使用布地奈德/福莫特罗治疗慢性阻塞性肺疾病一周后出现了混乱和幻觉。停用联合吸入剂后,症状得到缓解。几周后,患者再次入院并重新开始使用联合吸入剂。患者入院时神志清醒,定向正常,然而,在住院期间,混乱和幻觉症状逐渐加重。停用联合吸入剂后,他的混乱和幻觉在出院时得到了解决。这些事件的时间关系以及可能的Naranjo关联使得有合理的假设认为使用布地奈德/福莫特罗联合吸入剂导致了或促成了这位老年患者谵妄的发生。谵妄的发作可能是由于糖皮质激素从肺部沉积的系统性吸收,在一个具有几个谵妄易感风险因素的个人中复杂化。卫生保健提供者在对有谵妄风险的老年患者开具吸入药物时,应该意识到这种潜在的药物不良反应。
Steroid psychosis has been well described with oral glucocorticoids, however, our search of the literature did not identify an association between delirium and the combination of inhaled glucocorticoids and long-acting beta-agonists. We describe the occurrence of delirium with the combination of an inhaled glucocorticoid and bronchodilator. An elderly male described confusion and hallucinations within 1 week after initiation of budesonide/formoterol for chronic obstructive pulmonary disease. The combination inhaler was discontinued with resolution of symptoms. Several weeks later, the patient was hospitalized and restarted on the combination inhaler. The patient was alert and oriented on admission, however, confusion and hallucinations progressed throughout his hospital stay. The combination inhaler was discontinued and his confusion and hallucinations resolved by discharge. The temporal relationship of these events and a probable Naranjo association allows for reasonable assumption that the use of the budesonide/formoterol combination inhaler caused or contributed to the occurrences of delirium in this elderly patient. The onset of delirium was likely due to the systemic absorption of the glucocorticoid from lung deposition, complicated in an individual with several predisposing risk factors for delirium. Health care providers should be aware of this potential adverse drug reaction when prescribing inhaled medications to older patients at risk for delirium.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 相互作用
一位48岁的艾滋病毒感染女性在服用利托那韦增强的达芦那韦期间出现了库欣综合症特征。由于利托那韦和布地奈德之间的药物相互作用,确诊为库欣综合症。在服用利托那韦增强的蛋白酶抑制剂(PIs)的艾滋病毒阳性患者中,诊断医源性库欣综合症存在临床挑战,因为与利托那韦增强的PIs相关的脂肪增多的临床特征相似。尽管这种并发症在使用吸入性氟替卡松时已经被广泛描述,但与治疗剂量的吸入性布地奈德相互作用并没有被广泛认识。
A 48-year-old woman with HIV infection developed Cushingoid features while she was taking ritonavir-boosted darunavir. Cushing's syndrome was confirmed due to the drug interaction between ritonavir and budesonide. Diagnosis of iatrogenic Cushing's syndrome in HIV-positive patients who are on ritonavir-boosted protease inhibitors (PIs) presents a clinical challenge due to similar clinical features of lipohypertrophy related to ritonavir-boosted PIs. Although this complication has been widely described with the use of inhaled fluticasone, the interaction with inhaled budesonide at therapeutic dose is not widely recognized.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 相互作用
我们报告了两例因布地奈德这种吸入性糖皮质激素与利托那韦和伊曲康唑相互作用引起的医源性库欣综合征病例,并介绍了这两位患者的临床和生化数据。一位71岁的男性患者因慢性阻塞性肺病接受吸入布地奈德治疗,并因肺曲霉病接受伊曲康唑治疗。该患者迅速出现了典型的库欣综合征,并伴有双侧股骨头无菌性坏死。两次测量的早晨8点血清皮质醇浓度分别为0.76和0.83微克/分升,受到抑制。患者四天后因大面积心肌梗死去世。第二例是一位46岁的女性,她因哮喘接受吸入布地奈德治疗多年。她开始服用利托那韦这种反转录病毒蛋白酶抑制剂来治疗人类免疫缺陷病毒(HIV)。在接下来的几个月里,她出现了库欣综合征的典型症状。她的早晨血清皮质醇浓度为1.92微克/分升。进行了促肾上腺皮质激素刺激测试,结果显示在0、30和60分钟时血清皮质醇值分别为<1.10、2.65和5.36微克/分升,确认了肾上腺功能不足。由于患者无法停止使用布地奈德,她被建议减少用药频率,并最终逐渐减少剂量直至停药。临床医生应该意识到吸入性皮质类固醇与伊曲康唑或利托那韦联合使用可能导致医源性库欣综合征和继发性肾上腺功能不足的发生。
To present two cases of iatrogenic Cushing syndrome caused by the interaction of budesonide, an inhaled glucocorticoid, with ritonavir and itraconazole, we present the clinical and biochemical data of two patients in whom diagnosis of Cushing syndrome was caused by this interaction. A 71-year-old man was treated with inhaled budesonide for a chronic obstructive pulmonary disease and itraconazole for a pulmonary aspergillosis. The patient rapidly developed a typical Cushing syndrome complicated by bilateral avascular necrosis of the femoral heads. Serum 8:00 AM cortisol concentrations were suppressed at 0.76 and 0.83 ug/dL on two occasions. The patient died 4 days later of a massive myocardial infarction. The second case is a 46-year-old woman who was treated for several years with inhaled budesonide for asthma. She was put on ritonavir, a retroviral protease inhibitor, for the treatment of human immunodeficiency virus (HIV). In the following months, she developed typical signs of Cushing syndrome. Her morning serum cortisol concentration was 1.92 ug/dL. A cosyntropin stimulation test showed values of serum cortisol of <1.10, 2.65, and 5.36 ug/dL at 0, 30, and 60 minutes, respectively, confirming an adrenal insufficiency. Because the patient was unable to stop budesonide, she was advised to reduce the frequency of its administration and eventually taper the dose until cessation. Clinicians should be aware of the potential occurrence of iatrogenic Cushing syndrome and secondary adrenal insufficiency due to the association of inhaled corticosteroids with itraconazole or ritonavir.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
  • 相互作用
口服布地奈德通常用于克罗恩病的治疗,因为它对糖皮质激素受体的亲和力高,且由于通过肝脏细胞色素P450(CYP)3A4的广泛首过代谢,其系统性活动较低。伏立康唑是一种第二代三唑类抗真菌药物,既是CYP同工酶的底物,也是强效抑制剂,尤其是CYP2C19、CYP2C9和CYP3A4;因此,伏立康唑与其他药物发生药物相互作用的潜力很高。据我们所知,文献中尚未特别报告伏立康唑与皮质类固醇之间的药物相互作用。我们描述了一位48岁的女性,她因克罗恩病的治疗而接受口服布地奈德9毫克/天,并被诊断为耐氟康唑的白假丝酵母菌食管炎;为了治疗,开出了每12小时口服伏立康唑200毫克,持续3周。由于患者出现了吞咽困难复发的症状,她再次服用了3周的伏立康唑疗程。在最初开出伏立康唑7周后,她因血压升高、下肢水肿和体重增加来到初级护理诊所;她被开出利尿剂并评估肾功能。6周后,在她专科诊所的随访中,患者的血压升高,体格检查显著表现为满月脸、颈后脂肪垫突出和下肢凹陷性水肿。怀疑是由于伏立康唑与布地奈德之间的药物相互作用导致的医源性库欣综合征,因此停用了伏立康唑。布地奈德继续按以前的治疗方案用于她的克罗恩病。在2个月后的重新评估中,患者的库欣特征显著消退。据我们所知,这是第一份公开发表的关于伏立康唑与口服布地奈德可能相互作用导致的医源性库欣综合征的病例报告。在接受这些药物同时治疗并出现库欣特征的病人中,临床医生应考虑这些药物之间的潜在药物相互作用,并必须考虑继续治疗的 risk 和益处。
Oral budesonide is commonly used for the management of Crohn's disease given its high affinity for glucocorticoid receptors and low systemic activity due to extensive first-pass metabolism through hepatic cytochrome P450 (CYP) 3A4. Voriconazole, a second-generation triazole antifungal agent, is both a substrate and potent inhibitor of CYP isoenzymes, specifically CYP2C19, CYP2C9, and CYP3A4; thus, the potential for drug-drug interactions with voriconazole is high. To our knowledge, drug-drug interactions between voriconazole and corticosteroids have not been specifically reported in the literature. We describe a 48-year-old woman who was receiving oral budesonide 9 mg/day for the management of Crohn's disease and was diagnosed with fluconazole-resistant Candida albicans esophagitis; oral voriconazole 200 mg every 12 hours for 3 weeks was prescribed for treatment. Because the patient experienced recurrent symptoms of dysphagia, a second 3-week course of voriconazole therapy was taken. Seven weeks after originally being prescribed voriconazole, she came to her primary care clinic with elevated blood pressure, lower extremity edema, and weight gain; she was prescribed a diuretic and evaluated for renal dysfunction. At a follow-up visit 6 weeks later with her specialty clinic, the patient's blood pressure was elevated, and her physical examination was notable for moon facies, posterior cervical fat pad prominence, and lower extremity pitting edema. Iatrogenic Cushing syndrome due to a drug-drug interaction between voriconazole and budesonide was suspected, and voriconazole was discontinued. Budesonide was continued as previously prescribed for her Crohn's disease. On reevaluation 2 months later, the patient's Cushingoid features had markedly regressed. To our knowledge, this is the first published case report of iatrogenic Cushing syndrome due to a probable interaction between voriconazole and oral budesonide. In patients presenting with Cushingoid features who have received these drugs concomitantly, clinicians should consider the potential drug interaction between these agents, and the risks and benefits of continued therapy must be considered.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
/MILK/ 不清楚布地奈德是否分布到牛奶中。
/MILK/ Not known whether budesonide is distributed in milk.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
当布地奈德通过鼻腔给药时,大约34%的剂量会进入全身循环。布地奈德的平均血浆峰浓度在大约0.7小时后达到。
When budesonide is administered intranasally, approximately 34% of a dose reaches systemic circulation. Mean peak plasma budesonide concentrations are achieved in about 0.7 hours.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
吸入性皮质类固醇(ICS)是治疗哮喘和慢性阻塞性肺病的主要治疗方法。然而,高度亲脂性的ICS在系统性组织中积累,可能导致不良反应。一种新型的高度亲脂性ICS,环索奈德及其活性代谢物(去-CIC)的积累尚未见报道。在这里,我们比较了在雄性CD1白化病小鼠中,一次每日治疗14天后,去-CIC和中度亲脂性ICS,布地奈德(BUD)的组织积累情况。将[(3) H]-去-CIC或[(3) H]-BUD单次、三次或14次每日剂量皮下给药给小鼠,最后一次给药后4小时、24小时或5天处死。通过定量全身自动放射性显影研究放射性在组织中的分布。在单次给药和重复给药后,大多数组织中两种皮质类固醇的放射性分布模式相似。然而,去-CIC和BUD之间的组织放射性浓度不同。单次给药后,大多数组织的放射性浓度较低,但在每日给药14天后增加。在14次给药后24小时和5天,去-CIC的组织放射性是BUD的大多数组织的2-3倍。将组织放射性浓度在14次给药后5天与第3次给药后进行比较,去-CIC的平均比率为5.2,BUD的平均比率为2.7(p < 0.0001)。总之,去-CIC的积累显著高于BUD。系统性积累可能导致长期治疗中不良反应的风险增加。
Inhaled corticosteroids (ICS) are mainstay treatment of asthma and chronic obstructive pulmonary disease. However, highly lipophilic ICS accumulate in systemic tissues, which may lead to adverse systemic effects. The accumulation of a new, highly lipophilic ICS, ciclesonide and its active metabolite (des-CIC) has not yet been reported. Here, we have compared tissue accumulation of des-CIC and an ICS of a moderate lipophilicity, budesonide (BUD), after 14 days of once-daily treatment in mice. Single, three or 14 daily doses of [(3) H]-des-CIC or [(3) H]-BUD were administered subcutaneously to male CD1 albino mice, which were killed at 4 hrs, 24 hrs or 5 days after the last dose. Distribution of tissue concentration of radioactivity was studied by quantitative whole-body autoradiography. Pattern of radioactivity distribution across most tissues was similar for both corticosteroids after a single as well as after repeated dosing. However, tissue concentration of radioactivity differed between des-CIC and BUD. After a single dose, concentrations of radioactivity for both corticosteroids were low for most tissues but increased over 14 days of daily dosing. The tissue radioactivity of des-CIC at 24 hrs and 5 days after the 14th dose was 2-3 times higher than that of BUD in majority of tissues. Tissue accumulation, assessed as concentration of tissue radioactivity 5 days after the 14th versus 3rd dose, showed an average ratio of 5.2 for des-CIC and 2.7 for BUD (p < 0.0001). In conclusion, des-CIC accumulated significantly more than BUD. Systemic accumulation may lead to increased risk of adverse systemic side effects during long-term therapy.
来源:Hazardous Substances Data Bank (HSDB)

安全信息

  • 危险品标志:
    Xn
  • 安全说明:
    S22,S36
  • 危险类别码:
    R40
  • WGK Germany:
    3
  • 海关编码:
    29372900
  • 危险品运输编号:
    NONH for all modes of transport
  • RTECS号:
    TU3723000

SDS

SDS:93485fb9be0a4dc5c44b6d5abb3f27ac
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制备方法与用途

布地奈德是一种糖皮质激素类药物,用于治疗哮喘和非传染性鼻炎。它通过抑制炎症反应和免疫反应来减轻症状。

作用机制
  • 靶点: 主要是糖皮质激素受体。
  • 生物活性:
    • 在人支气管上皮细胞系BEAS-2B和原代人支气管上皮细胞中,布地奈德有效地抑制eotaxin和RANTES蛋白质的产生。
    • 减少趋化因子和MCP-4的mRNA的衰变。
    • 抑制VEGF的分泌和VEGF mRNA表达。
体内研究

在大鼠实验中,布地奈德可以完全抑制LPS诱导产生的TNF-α、白细胞介素(IL)1beta、IL-6和单核细胞趋化蛋白(MCP)-1。此外,在A/J小鼠中,它还发挥化学预防作用。

临床应用
  • 哮喘: 布地奈德气雾剂可用于轻症支气管哮喘。
  • 非传染性鼻炎:适用于治疗这类病症。
注意事项与禁忌
  • 慎用于肺结核、气道真菌感染或病毒感染患者。
  • 孕妇应避免使用。
  • 对依赖口服激素的病人,应在并用本品10天后逐渐减少口服激素剂量。
安全性

虽然布地奈德对大多数患者的副作用较小,但仍需注意其可能引起的咽痛、白色念珠菌感染等问题。此外,在严重应激状态或痰液变稠导致气道堵塞时,建议补充使用其他治疗方法如较大剂量水溶性皮质激素等。

急性毒性
  • 腹腔 - 大鼠:LD50 (半数致死剂量) 为138毫克/公斤。
  • 口服 - 小鼠:LD50 为4750毫克/公斤。
火灾危险与灭火方法

布地奈德在热分解过程中可能会排出有毒的辛辣刺激性烟雾。因此,在储存和运输时需要库房通风、低温干燥,并配备适当的消防设备如水、干粉、二氧化碳等灭火剂。

综上所述,布地奈德是一种有效的治疗哮喘和非传染性鼻炎的药物,但需注意其使用条件与潜在副作用。

文献信息

  • [EN] ANTI-MSR1 ANTIBODIES AND METHODS OF USE THEREOF<br/>[FR] ANTICORPS ANTI-MSR1 ET LEURS PROCÉDÉS D'UTILISATION
    申请人:REGENERON PHARMA
    公开号:WO2019217591A1
    公开(公告)日:2019-11-14
    Provided herein are antibodies and antigen-binding fragments that bind MSR1 and methods of use thereof. According to certain embodiments, the antibodies bind human MSR1 with high affinity. In certain embodiments, the antibodies bind MSR1 without blocking, or blocking less than 90%, of modified LDL binding to MSR1. In some embodiments, the antibodies bind cell surface expressed-MSR1 and are internalized. The antibodies of the invention may be fully human antibodies. The invention includes anti-MSR1 antibodies, or antigen-binding fragments thereof, conjugated to drugs or therapeutic compounds.
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