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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">pmedpharm</journal-id><journal-title-group><journal-title xml:lang="ru">Фармация и фармакология</journal-title><trans-title-group xml:lang="en"><trans-title>Pharmacy &amp; Pharmacology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2307-9266</issn><issn pub-type="epub">2413-2241</issn><publisher><publisher-name>Pyatigorsk Medical and Pharmaceutical Institute - branch of Volgograd State Medical Univer</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.19163/2307-9266-2024-12-1-32-48</article-id><article-id custom-type="elpub" pub-id-type="custom">pmedpharm-1449</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНАЯ СТАТЬЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>RESEARCH ARTICLE</subject></subj-group></article-categories><title-group><article-title>Ассоциация носительства полиморфизмов CYP3A4*1B, CYP3A4*22 и CYP3A5*3 с эффективностью и безопасностью тамсулозина у пациентов с доброкачественной гиперплазией предстательной железы</article-title><trans-title-group xml:lang="en"><trans-title>Association of CYP3A4*1B, CYP3A4*22 and CYP3A5*3 polymorphisms carriage with efficacy and safety of tamsulosin in patients with benign prostatic hyperplasia</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7737-1534</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдуллаев</surname><given-names>Ш. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdullaev</surname><given-names>Sh. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>аспирант кафедры эндоскопической урологии, ФГБОУ ДПО РМАНПО Минздрава России; врач-уролог НИЦ «Курчатовский институт».</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p><p>123182, Россия, г. Москва, пл. Академика Курчатова, д. 1.</p></bio><bio xml:lang="en"><p>postgraduate student of the Department of Endoscopic Urology of Russian Medical Academy of Continuous Professional Education; urologist of Kurchatov Institute.</p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993.</p><p>1, Akademika Kurchatova Sq., Moscow, Russia, 123182.</p></bio><email xlink:type="simple">luon@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1285-7357</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шатохин</surname><given-names>М. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Shatokhin</surname><given-names>M. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, профессор кафедры эндоскопической урологии, ФГБОУ ДПО РМАНПО Минздрава России; врач уролог-андролог, ЧУЗ «Центральная клиническая больница “РЖД-медицина”».</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p><p>125310, Россия, г. Москва, ул. Волоколамское шоссе, д. 84.</p></bio><bio xml:lang="en"><p>Doctor of Sciences (Medicine), professor, professor of the Department of Endoscopic Urology of Russian Medical Academy of Continuous Professional Education; urologist andrologist of Central Hospital «Russian Railways-Medicine».</p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993.</p><p>84, Volokolamskoye Hwy, Moscow, Russia, 125310.</p></bio><email xlink:type="simple">sh.77@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-9294-6504</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Cигайло</surname><given-names>О. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Sigailo</surname><given-names>O. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>ординатор кафедры эндоскопической урологии, ФГБОУ ДПО РМАНПО Минздрава России. </p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>resident of the Department of Endoscopic Urology of the Russian Medical Academy of Continuous Professional Education.</p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993</p></bio><email xlink:type="simple">sigailooleg@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9001-1499</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдуллаев</surname><given-names>Ш. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdullaev</surname><given-names>Sh. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук, заведующий отделом предиктивных и прогностических биомаркеров научно-исследовательского института молекулярной и персонализированной медицины, ФГБОУ ДПО РМАНПО Минздрава России.</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Candidate of Sciences (Biology), Head of the Department of Predictive and Prognostic Biomarkers, Research Institute of Molecular and Personalized Medicine of Russian Medical Academy of Continuous Professional Education. </p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993.</p></bio><email xlink:type="simple">abdullaevsp@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8555-5969</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бочков</surname><given-names>П. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Bochkov</surname><given-names>P. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук, старший научный сотрудник отдела предиктивных и прогностических биомаркеров научно-исследовательского института молекулярной и персонализированной медицины, ФГБОУ ДПО РМАНПО Минздрава России.</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Candidate of Sciences (Biology), Senior Researcher, Department of Predictive and Prognostic Biomarkers, Research Institute of Molecular and Personalized Medicine of Russian Medical Academy of Continuous Professional Education.</p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993</p></bio><email xlink:type="simple">bok-of@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-2744-2752</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тучкова</surname><given-names>С. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Tuchkova</surname><given-names>S. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>младший научный сотрудник отдела предиктивных и прогностических биомаркеров научно-исследовательского института молекулярной и персонализированной медицины, ФГБОУ ДПО РМАНПО Минздрава России. </p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>junior researcher of the Department of Predictive and Prognostic Biomarkers of the Research Institute of Molecular and Personalized Medicine of Russian Medical Academy of Continuous Professional Education. </p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993</p></bio><email xlink:type="simple">svetlanatuch1998@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5145-0445</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Теодорович</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Teodorovich</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заведующий кафедрой эндоскопической урологии, ФГБОУ ДПО РМАНПО Минздрава России; руководитель урологического центра, врач уролог-андролог, ЧУЗ «Центральная клиническая больница “РЖД-медицина”».</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p><p>125310, Россия, г. Москва, ул. Волоколамское шоссе, д. 84.</p></bio><bio xml:lang="en"><p>Doctor of Sciences (Medicine), Professor, Head of the Department of Endoscopic Urology of Russian Medical Academy of Continuous Professional Education; Head of the Urology Center, urologist andrologist of Central Hospital «Russian Railways-Medicine». </p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993.</p><p>84, Volokolamskoye Hwy, Moscow, Russia, 125310.</p></bio><email xlink:type="simple">teoclinic1@gmail.com</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7531-1511</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лоран</surname><given-names>О. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Loran</surname><given-names>O. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заведующий кафедрой урологии и хирургической андрологии, ФГБОУ ДПО РМАНПО Минздрава России; академик РАН.</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Doctor of Sciences (Medicine), Professor, Head of the Department of Urology and Surgical Andrology of Russian Medical Academy of Continuous Professional Education; Academician of the Russian Academy of Sciences. </p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993</p></bio><email xlink:type="simple">olegloran@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4496-3680</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сычев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sychev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, ректор, заведующий кафедрой клинической фармакологии и терапии имени Б.Е. Вотчала, ФГБОУ ДПО РМАНПО Минздрава России; академик РАН.</p><p>125993, Россия, г. Москва, ул. Баррикадная, д. 2/1, стр. 1.</p></bio><bio xml:lang="en"><p>Doctor of Sciences (Medicine), Professor, Rector, Head of the Department of Clinical Pharmacology and Therapy n.a. B.E. Votchal of Russian Medical Academy of Continuous Professional Education; аcademician of the Russian Academy of Sciences. </p><p>Bld. 1, 2/1, Barrikadnaya Str., Moscow, Russia, 125993</p></bio><email xlink:type="simple">dimasychev@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>1. Федеральное государственное бюджетное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации (РМАНПО).&#13;
2.Национальный исследовательский центр «Курчатовский институт».</institution><country>Россия</country></aff><aff xml:lang="en"><institution>1. Russian Medical Academy of Continuous Professional Education (RMACPE). &#13;
2. Kurchatov Institute.</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>1. Федеральное государственное бюджетное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации (РМАНПО).&#13;
2. Частное учреждение здравоохранения «Центральная клиническая больница “РЖД-медицина”».</institution><country>Россия</country></aff><aff xml:lang="en"><institution>1. Russian Medical Academy of Continuous Professional Education (RMACPE).&#13;
2. Central Hospital «Russian Railways-Medicine».</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации (РМАНПО).</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuous Professional Education (RMACPE)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>1.Федеральное государственное бюджетное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации (РМАНПО).&#13;
2. Частное учреждение здравоохранения «Центральная клиническая больница “РЖД-медицина”».</institution><country>Россия</country></aff><aff xml:lang="en"><institution>1. Russian Medical Academy of Continuous Professional Education (RMACPE).&#13;
2. Central Hospital «Russian Railways-Medicine».</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации (РМАНПО).</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuous Professional Education (RMACPE).</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>08</day><month>05</month><year>2024</year></pub-date><volume>12</volume><issue>1</issue><fpage>32</fpage><lpage>48</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Абдуллаев Ш.П., Шатохин М.Н., Cигайло О.Л., Абдуллаев Ш.П., Бочков П.О., Тучкова С.Н., Теодорович О.В., Лоран О.Б., Сычев Д.А., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Абдуллаев Ш.П., Шатохин М.Н., Cигайло О.Л., Абдуллаев Ш.П., Бочков П.О., Тучкова С.Н., Теодорович О.В., Лоран О.Б., Сычев Д.А.</copyright-holder><copyright-holder xml:lang="en">Abdullaev S.P., Shatokhin M.N., Sigailo O.L., Abdullaev S.P., Bochkov P.O., Tuchkova S.N., Teodorovich O.V., Loran O.B., Sychev D.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.pharmpharm.ru/jour/article/view/1449">https://www.pharmpharm.ru/jour/article/view/1449</self-uri><abstract><p>Тамсулозин является препаратом первой линии в лечении симптомов нижних мочевых путей (СНМП) при доброкачественной гиперплазии предстательной железы (ДГПЖ). Несмотря на высокие оценки эффективности и безопасности, показатели могут варьироваться из-за генетических полиморфизмов генов ферментов, участвующих в метаболизме препарата.</p><sec><title>Цель</title><p>Цель. Оценка влияния носительства полиморфизмов генов ферментов группы CYP3A метаболизаторов тамсулозина на эффективность и безопасность терапии у пациентов с СНМП при ДГПЖ.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В исследование было включено и прошли все этапы 142 пациента с СНМП при установленном диагнозе ДГПЖ (N40 по МКБ-10). Все пациенты получали монотерапию тамсулозином 0,4 мг/сут на протяжении как минимум 8 недель. Для оценки результатов лечения использовали опросник IPSS с определением качества жизни, ультразвуковое исследование предстательной железы с определением объема простаты и остаточной мочи, а также урофлоуметрию. Контроль осуществляли в сроки 2, 4 и 8 недель от начала терапии. У пациентов определялось носительство полиморфных маркеров CYP3A4 (*1B, *22) и CYP3A5*3, с помощью ВЭЖХ определяли концентрации препарата в плазме крови и уровни кортизола и его метаболита 6-бета-гидроксикортизола в моче для оценки фенотипической активности CYP3A.</p></sec><sec><title>Результаты</title><p>Результаты. Статистически значимых ассоциаций между фенотипом CYP3A (определяемого по генотипам CYP3A4 и CYP3A5) и клиническими параметрами оценки эффективности и безопасности терапии тамсулозином в исследованной выборке пациентов установлено не было (p &gt;0,05). Аналогичные данные были получены для отдельных вариантов CYP3A4*1B, CYP3A4*22, CYP3A5*3 (p &gt;0,05). Сравнение значений остаточной равновесной концентрации тамсулозина у пациентов в исследуемой выборке относительно носительства вариантов генов CYP3A4 и CYP3A5 не выявил наличия значимых различий как между фенотипами по CYP3A, так и носителями и неносителями отдельных вариантов CYP3A4*1B (p=0,57), CYP3A4*22 (p=0,37) и CYP3A5*3 (p=0,76). Не было обнаружено связи между метаболическим отношением 6-бета-гидроксикортизол / кортизол в моче и фенотипом CYP3A, кодируемым по сочетанию генотипов вариантов генов CYP3A4 и CYP3A5 (p &gt;0,05).</p></sec><sec><title>Заключение</title><p>Заключение. Возможная связь между носительством вариантов CYP3A4*1B, CYP3A4*22, CYP3A5*3, активностью CYP3A, оцениваемой по содержанию в моче эндогенного субстрата данного изофермента и его метаболита, уровнем плазменной концентрации препарата, эффективностью и безопасностью тамсулозина не подтверждена. Вопрос о вкладе генетических полиморфизмов CYP3A4 и CYP3A5 на клинические параметры терапии тамсулозином требует дальнейшего изучения.</p></sec></abstract><trans-abstract xml:lang="en"><p>Tamsulosin is a first-line drug in the treatment of lower urinary tract symptoms (LUTS) in benign prostatic hyperplasia (BPH). Despite high estimates of its efficacy and safety, it rates may vary due to genetic polymorphisms of genes for the enzymes involved in the drugs metabolism.</p><p>The aim of the work was to evaluate the carriage influence of genes polymorphisms of the CYP3A enzymes group of tamsulosin metabolizers on the efficacy and safety of therapy in patients with LUTS in BPH.</p><sec><title>Materials and methods</title><p>Materials and methods. A total of 142 patients with LUTS, with an established BPH diagnosis (N40 according to ICD-10) were included in the study and underwent all stages. All patients received monotherapy with tamsulosin 0.4 mg/day for at least 8 weeks. An IPSS questionnaire with the definition of quality of life, a prostate ultrasound with the determination of the prostate volume and residual urine, as well as uroflowmetry, were used to evaluate the results of the treatment. Controls were performed at 2, 4 and 8 weeks from the start of the therapy. The carriage of polymorphic markers CYP3A4 (*1B, *22) and CYP3A5*3 was determined in patients; HPLC was used to determine drug concentrations in blood plasma and levels of cortisol and its metabolite 6-beta-hydroxycortisol in urine to assess the phenotypic activity of CYP3A.</p></sec><sec><title>Results</title><p>Results. No statistically significant associations between CYP3A phenotype (defined by CYP3A4 and CYP3A5 genotypes) and clinical parameters of the tamsulosin therapy efficacy and the safety assessment in the studied sample of patients were found (p &gt;0.05). Similar data were obtained for individual variants of CYP3A4*1B, CYP3A4*22, CYP3A5*3 (p &gt;0.05). The comparison of the tamsulosin residual equilibrium concentration values in patients in the study sample with respect to the carriers of CYP3A4 and CYP3A5 gene variants did not reveal the presence of significant differences in either CYP3A phenotypes  and carriers and non-carriers of individual CYP3A4*1B (p=0.57), CYP3A4*22 (p=0.37) and CYP3A5*3 (p=0.76) variants. No association was found between the metabolic ratio of 6-beta-hydroxycortisol / cortisol in urine and the CYP3A phenotype encoded by a combination of genotypes of CYP3A4 and CYP3A5 gene variants (p &gt;0.05).</p></sec><sec><title>Conclusion</title><p>Conclusion. A possible association between the carriage of CYP3A4*1B, CYP3A4*22, CYP3A5*3 variants, a CYP3A activity assessed by the content of an endogenous substrate of this isoenzyme and its metabolite in urine, the level of plasma concentration of the drug, and the efficacy and safety of tamsulosin, has not been confirmed. The contribution of CYP3A4 and CYP3A5 genetic polymorphisms to clinical parameters of the tamsulosin therapy requires a further study.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>тамсулозин</kwd><kwd>фармакогенетика</kwd><kwd>CYP3A4</kwd><kwd>CYP3A5</kwd><kwd>концентрация тамсулозина</kwd></kwd-group><kwd-group xml:lang="en"><kwd>tamsulosin</kwd><kwd>pharmacogenetics</kwd><kwd>CYP3A4</kwd><kwd>CYP3A5</kwd><kwd>tamsulosin concentration</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена при финансовой поддержке Российского научного фонда по гранту № 23-15-00310 «Персонализированная фармакотерапия пациентов с доброкачественной гиперплазией предстательной железы на основе использования молекулярных биомаркеров ADME-процессов».</funding-statement><funding-statement xml:lang="en">The work was financially supported by the Russian Science Foundation under grant No. 23-15-00310 “Personalized pharmacotherapy of patients with benign prostatic hyperplasia based on the use of molecular biomarkers of ADME-processes”.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Wei J.T., Calhoun E., Jacobsen S.J. 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