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Oral and Maxillofacial Surgery

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01.03.2011 | Review Article

Areca nut in pathogenesis of oral submucous fibrosis: revisited

verfasst von: Punnya V. Angadi, Sanjay S. Rao

Erschienen in: Oral and Maxillofacial Surgery | Ausgabe 1/2011

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Abstract

Background

Oral submucous fibrosis is a disease due to a chronic, insidious change in fibro-elasticity, characterized by burning sensation in the oral cavity, blanching, and stiffening of the oral mucosa and oropharynx leading to trismus and inability to open the mouth. The symptoms and signs depend on the progression of the lesions and number of affected sites. It is predominantly seen in Indians and other Asians. Once the disease has developed, there is neither regression nor any effective treatment. It is considered as a pre-malignant stage of oral cancer, and the reported risk of malignant transformation varies from 2.3–7.6%.

Conclusions

The common etiological factor considered for this unremitting disease is use of areca nut; however, the precise mechanism still remains elusive and controversial. A wide range of treatment consisting of drugs, surgical therapy, and physiotherapy have been attempted till date, with varying degrees of benefit, but none of them have proved to be a cure for this disease. This field remains open for clinical trials and research. This paper aims to give an overview on the role of areca nut in the pathogenesis and malignant potential of oral submucous fibrosis.

Pindborg JJ, Sirasat SM (1966) Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol 22:746–779CrossRef

Canniff JP, Harvey W, Harris M (1986) Oral submucous fibrosis: its pathogenesis and management. Br Dent J 160:429–434PubMedCrossRef

Paissat DK (1981) Oral submucous fibrosis. Int J Oral Surg 10:307–312PubMedCrossRef

Sinor PN, Gupta PC, Murti PR (1990) A case control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med 19:94–98PubMedCrossRef

Joshi SG (1953) Sub mucous fibrosis of the palate and pillars. Indian J Otolaryngol 4:1–4

Sirasat SM, Pindborg JJ (1967) Sub epithelial changes in oral submucous fibrosis. Acta Pathol Microbiol Scand 70:161–173CrossRef

Canniff JP, Harvey W (1981) The etiology of oral submucous fibrosis: the stimulation of collagen synthesis by extracts of areca nut. Int J Oral Surg 10:163–167PubMed

Van Wyk CW, Seedat HA, Phillips VM (1990) Collagen in submucous fibrosis: an electron microscopic study. J Oral Pathol Med 19:182–187PubMedCrossRef

Murti PR, Bhonsle RB, Pindborg JJ, Daftary DK, Gupta PC, Mehta FS (1997) Malignant transformation rate in oral submucous fibrosis over a 17 year period. Community Dent Oral Epidemiol 25:377–383CrossRef

10.

Kwan HW (1976) A statistical study on oral carcinomas in Taiwan with emphasis on the relationship with betel nut chewing—a preliminary report. J Formos Med assoc 75:497–505

11.

Pindborg JJ, Murti PR, Bhonsle RB, Gupta PC, Daftary DK, Mehta FS (1984) Oral submucous fibrosis as a precancerous condition. Scand J Dent Res 89:270–274

12.

Mani NJ, Singh B (1976) Studies on oral submucous fibrosis—epithelial changes. Oral Surg 41:203–214PubMedCrossRef

13.

Jeng JH, Chang MC, Hahn LJ (2001) Role of areca nut in betel quid associated chemical carcinogenesis: current awareness and future perspectives. Oral Oncol 37:477–492PubMedCrossRef

14.

Pindborg JJ, Mehta FS, Gupta PC, Daftary DK (1968) Prevalence of oral submucous fibrosis among 50,915 Indian villagers. Br J Cancer 22:646–654PubMedCrossRef

15.

Rajalalitha P, Vali S (2005) Molecular pathogenesis of oral submucous fibrosis—a collagen metabolic disorder. J Oral Pathol Med 34:321–328PubMedCrossRef

16.

Cox SC, Walker DM (1996) Oral submucous fibrosis: a review. Aust Dent J 41:294–299PubMedCrossRef

17.

Gupta PC, Sinor PN, Bhonsle RB, Pawar VS, Mehta HC (1998) Oral submucous fibrosis in India: a new epidemic. Natl Med J 1:113–114

18.

Hayes PA (1985) Oral submucous fibrosis in a 4 year old girl. Oral Surg Oral Med Oral Pathol 59:475–478PubMedCrossRef

19.

Oliver AJ, Radden BG (1992) Oral submucous fibrosis. Case report and review of literature. Aust Dent J 37:31–34PubMedCrossRef

20.

Hamner JE, Looney PD, Chused TM (1974) Submucous fibrosis. Oral Surg 37:412–421PubMedCrossRef

21.

Bhonsle RB, Murti PR, Daftary DK, Gupta PC, Mehta FS, Sinor PN, Irani RR, Pindborg JJ (1987) Regional variations in oral submucous fibrosis in India. Comm Dent Oral Epidemiol 15:225–229CrossRef

22.

Schwartz J (1962) Atrophica idiopathioca (Tropica) Mucosae oris. In: Proceedings of the 11th International Dental Congress, London, 1992 (Cited by Sirasat and Khanolkar), Indian J Med 16:185–197

23.

Su I (1954) Idiopathic scleroderma of the mouth. Arch Otolaryngol 59:330–332

24.

Paymaster JC (1956) Cancer of the buccal mucosa: clinical study of 650 cases in Indian patients. Cancer 9:431–435PubMedCrossRef

25.

Pindborg JJ (1972) Is submucous fibrosis a precancerous condition in the oral cavity? Int Dent 22:474–480

26.

Laskaris G, Bovopoulou O, Nicolis G (1981) Oral submucous fibrosis in a Greek female. Br J Oral Surg 19:197–201PubMedCrossRef

27.

Pindborg JJ, Chawla TN, Srivastara AN, Gupta PD et al (1972) Clinical aspects of oral submucous fibrosis. Acta Odontol Scand 22:679–691CrossRef

28.

Shiau YY, Kwan HW (1979) Submucous fibrosis in Taiwan. Oral Surg 47:454–457CrossRef

29.

Morawetz G, Katsikeris N, Weinberg S, Listorm R (1987) Oral submucous fibrosis. Int J Oral Maxillofac Surg 16:609–714PubMedCrossRef

30.

Pillai R, Balaram P (1992) Pathogenesis of oral submucous fibrosis: relationship to risk factors associated with cancer. Cancer 69:2011–2020PubMedCrossRef

31.

Warnakulasuriya KAAS, Trivedy C, Maher R, Johnson NW (1997) Etiology of oral submucous fibrosis. Oral Dis 3:286–287

32.

Sinor PN, Gupta PC, Murti PR et al (1990) A case control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med 19:94–98PubMedCrossRef

33.

Seedat H, Van Wyk CW (1988) Submucous fibrosis in non-betel nut chewing subjects. J Biol Buccale 16:3–6PubMed

34.

Seedat HA, Van Wyk CW (1998) Betel nut chewing and submucous fibrosis in Durban. S Afr Med J 74:568–571

35.

Murti PR, Bhonsle RB, Gupta PC, Daftary DK, Pindborg JJ, Mehta FS (1995) Etiology of oral submucous fibrosis with special reference to the role of areca nut chewing. J Oral Pathol Med 24:145–152PubMedCrossRef

36.

Shah N, Sharma PP (1998) Role of chewing and smoking habits in the etiology of oral submucous fibrosis—a case control study. J Oral Pathol Med 27:475–479PubMedCrossRef

37.

Yang YH, Lien YC, Ho PS, Chen CH, Chang JSF, Cheng TC, Shieh TY (2005) The effects of chewing areca/betel quid with and without cigarette smoking on oral submucous fibrosis and oral mucosal lesions. Oral Dis 11:88–94PubMedCrossRef

38.

Yusuf H, Yong SL (2002) Oral submucous fibrosis in a 12 year old Bangladeshi boy: a case report and review of literature. Int J Pediatr Dent 12:271–276CrossRef

39.

Ranganathan K, Uma Devi M, Joshua E, Kiran KK, Saraswathi TR (2004) Oral submucous fibrosis: a case control study in Chennai, South India. J Oral Pathol Med 33:274–277PubMedCrossRef

40.

Merchant AT, Haider SM, Fikree FF (1997) Increased severity of oral submucous fibrosis in young Pakistani men. Br J Oral Maxillofac Surg 35:284–287PubMedCrossRef

41.

Tilakaratne WM, Klinikowski MF, Takashi S, Peters TJ, Warnakulasuriya S (2006) Oral submucous fibrosis: review on etiology and pathogenesis. Oral Oncol 42:561–568PubMedCrossRef

42.

Rajendran R (1994) Oral submucous fibrosis: etiology, pathogenesis, and future research. Bull World Health Org 72:985–996PubMed

43.

Murti PR, Gupta PC, Bhonsle RB, Daftary DK, Mehta FS, Pindborg JJ (1990) Effect on the incidence of oral submucous fibrosis on intervention in the areca nut chewing habit. J Oral Pathol Med 19:99–100PubMedCrossRef

44.

Maher R, Lee AJ, Warnakulasuriya KAAS, Lewis JA, Johnson NW (1994) Role of areca nut in the causation of oral submucous fibrosis: a case–control study in Pakistan. J Oral Pathol Med 23:65–69PubMedCrossRef

45.

Reichart PA, Van Wyk CW, Becker J, Schuppan D (1994) Distribution of procollagen type III, collagen type IV and tenascin in oral submucous fibrosis. J Oral Pathol Med 23:394–398PubMedCrossRef

46.

Harvey W, Scutt A, Meghji S, Canniff P (1986) Stimulation of human buccal mucosa fibroblast in vitro by betel nut alkaloids. Arch Oral Biol 31:45–49PubMedCrossRef

47.

Kuo MYP, Chen HM, Hahn LJ, Hsieh CC, Chain CP (1995) Collagen biosynthesis in human oral submucous fibrosis fibroblast cultures. J Dent Res 74:1783–1788PubMedCrossRef

48.

De Waal J, Olivier A, Van Wyk CW, Maritz JS (1997) The fibroblast population in oral submucous fibrosis. J Oral Pathol Med 26:69–74PubMedCrossRef

49.

Meghji S, Scutt A, Harvey W, Canniff JP (1987) An in vitro comparison of human fibroblasts from normal and oral submucous fibrosis tissue. Arch Oral Biol 32:213–215PubMedCrossRef

50.

Haque MF, Meghji S, Khitab U, Harris M (2000) Oral submucous fibrosis patients have altered levels of cytokine production. J Oral Pathol Med 29:123–128PubMedCrossRef

51.

Kundendu AB, Radhakrishnan R, Satyamoorthy K (2008) The role of basic fibroblast growth factor in oral submucous fibrosis pathogenesis. J Oral Pathol Med 37:402–411CrossRef

52.

Tsai CH, Yang SF, Chen YJ, Chou MY, Chang YC (2005) Raised keratinocyte growth factor-1 expression in oral submucous fibrosis in vivo is upregulated by arecoline in human buccal mucosal fibroblasts in vitro. J Oral Pathol Med 34:100–105PubMedCrossRef

53.

Haque MF, Harris M, Meghji S, Spieght PM (1997) An immunohistochemical study of oral submucous fibrosis. J Oral Pathol Med 26:75–82PubMedCrossRef

54.

Tsai CH, Yang SF, Chen YJ, My C, Chang YC (2005) The upregulation of insulin-like growth factor-1 in oral submucous fibrosis. Oral Oncol 41:940–946PubMedCrossRef

55.

Haque MF, Harris M, Meghji S, Barret AW (1998) Immuno-localisation of cytokines and growth factors in oral submucous fibrosis. Cytokine 10:713–719PubMedCrossRef

56.

Tsai CH, Chou MY, Chang YC (2003) The upregulation of cycloxygenase-2 expression in human buccal mucosal fibroblasts by arecoline: a possible role in the pathogenesis of oral submucous fibrosis. J Oral Pathol Med 32:146–153PubMedCrossRef

57.

Chui CJ, Chang ML, Chaing CP, Hahn LJ, Hsieh LL, Chan CJ (2002) Interaction of collagen-related genes and susceptibility to betel quid induced oral submucous fibrosis. Cancer Epidemiol, Biomark Prev 11:646–653

58.

Tsai CH, Yang SF, Chang YC (2007) The upregulation of cystatin C in oral submucous fibrosis. Oral Oncol 43:680–685CrossRef

59.

Chiu CJ, Chaing CP, Chang ML (2001) Association between genetic polymorphism of tumor necrosis factor alpha and risk of oral submucous fibrosis: a precancerous condition of oral cancer. J Dent Res 80:2055–2059PubMedCrossRef

60.

Lui CJ, Lee YJ, Chang KW, Sinh YN, Liu HF, Dang CW (2004) Polymorphism of the MICA gene and risk for oral submucous fibrosis. J Oral Pathol Med 33:1–6CrossRef

61.

Shin YN, Lui CJ, Chang KW, Lee YY, Lui HF (2004) Association of CTLA-4 gene polymorphism with oral submucous fibrosis in Taiwan. J Oral Pathol Med 33:1–6CrossRef

62.

Tu HF, Liu CJ, Chang CS, Lui MT, Kao SY, Chang CP, Liu TY (2006) The functional (-1171 5A→6A) polymorphisms of matrix metalloproteinase-3 gene as a risk factor for oral submucous fibrosis among male areca users. J Oral Pathol Med 35:99–103PubMedCrossRef

63.

Shieh TM, Tu FH, Ku TH, Chang SS, Chang KW, Liu CJ (2009) Association between lysyl oxidase polymorphisms and oral submucous fibrosis in older male areca chewers. J Oral Pathol Med 38:109–113PubMedCrossRef

64.

Scutt A, Meghji S, Canniff JP, Harvey W (1987) Stabilization of collagen by betel nut polyphenols as a mechanism in oral submucous fibrosis. Experimentia 43:391–393CrossRef

65.

Meghji S, Scutt A, Canniff JP, Harvey W, Phillipson JD (1982) Inhibition of collagenase activity by areca nut tannins: a mechanism of collagen accumulation in oral submucous fibrosis. J Dent Res 61:545

66.

Shieh TY, Yang JF (1992) Collagenase activity in oral submucous fibrosis. Pro Natl Sci Counc China B 16:106–110

67.

Shieh DH, Chiang LC, Shieh TY (2003) Augmented mRNA expression of tissue inhibitor of metalloproteinase-1 in buccal mucosal fibroblasts by arecoline and safrole as a possible pathogenesis for oral submucous fibrosis. Oral Oncol 39:728–735PubMedCrossRef

68.

Chang YC, Yang SF, Tai KW, Chou MY, Hsieh YS (2002) Increased tissue inhibitor of metalloproteinase-1 expression and inhibition of gelatinase A activity in buccal mucosal fibroblasts by arecoline as possible mechanisms for oral submucous fibrosis. Oral Oncol 38:195–200PubMedCrossRef

69.

Yang SF, Hsieh YS, Tsai CH, Chou MY, Chang YC (2003) The upregulation of type I plasminogen activator inhibitor in oral submucous fibrosis. Oral Oncol 39:367–372PubMedCrossRef

70.

Yang SF, Hsieh YS, Tsai CH, Chen YJ, Chang YC (2007) Increased plasminogen activator inhibitor-1/tissue type plasminogen activator ratio in oral submucous fibrosis. Oral Dis 13:234–238PubMedCrossRef

71.

Tsai CC, Ma RH, Shieh TY (1999) Deficiency in collagen and fibronectin phagocytosis by human buccal mucosa fibroblasts in vitro as a possible mechanism for oral submucous fibrosis. J Oral Pathol Med 28:59–63PubMedCrossRef

72.

Shieh DH, Chiang LC, Lee CH, Yang YH, Shieh TY (2004) Effects of arecoline, saffrole and nicotine on collagen phagocytosis by human buccal mucosal fibroblasts as a possible mechanism for oral submucous fibrosis. J Oral Pathol Med 33:581–587PubMedCrossRef

73.

Trivedy C, Warnakulasuriya KAAS, Hazarey VK, Tavassoli M, Sommer P, Johnson NW (1999) The upregulation of lysyl oxidase in oral submucous fibrosis and squamous cell carcinoma. J Oral Pathol Med 28:246–251PubMedCrossRef

74.

Trivedy CR, Warnakulasuriya KAAS, Peter TJ, Senkus R, Hazarey VK, Johnson NW (2000) Raised tissue copper levels in oral submucous fibrosis. J Oral Pathol Med 29:241–248PubMedCrossRef

75.

Trivedy CR, Meghji S, Warnakulasuriya KAAS, Johnson NW, Harris M (2001) Copper stimulates human oral fibroblasts in vitro: a role in the pathogenesis of oral submucous fibrosis. J Oral Pathol Med 30:465–470PubMedCrossRef

76.

Trivedy CR, Warnakulasuriya KA, Peters TJ, Senkus R, Hazarey VK, Johnson NW (2000) Raised tissue copper levels in oral submucous fibrosis. J Oral Pathol Med 29:241–248PubMedCrossRef

77.

Trivedy C, Baldwin D, Warnakulasuriya S, Johnson NW, Peters T (1997) Copper content in areca catechu (betel nut) products and oral submucous fibrosis. Lancet 349:1447PubMedCrossRef

78.

Ma RH, Tsai CC, Shieh TY (1995) Increased lysyl oxidase activity in fibroblasts cultured from oral submucous fibrosis associated with betel nut chewing in Taiwan. J Oral Pathol Med 24:407–412PubMedCrossRef

79.

Chiang CP, Hsieh RP, Chen TH (2002) High incidence of autoantibodies in Taiwanese patients with oral submucous fibrosis. J Oral Pathol Med 31:402–409PubMedCrossRef

80.

Khanna SS, Karjodkar FR (2006) Circulating immune complexes and trace elements (copper, iron and selenium) as markers in oral precancer and cancer: a randomized, controlled clinical trial. Head Face Med 2:33PubMedCrossRef

81.

Ghosh PK, Madhavi R, Guntur M, Ghosh R (1990) Sister chromatid exchanges in patients with oral submucous fibrosis. Cancer Genet Cytogenet 44:197–201PubMedCrossRef

82.

Chiang CP, Wu HY, Lui BY, Wang JT, Kuo MYP (2002) Quantitative analysis of immunocompetent cells in oral submucous fibrosis in Taiwan. Oral Oncol 38:56–63PubMedCrossRef

83.

Gupta DS, Gupta MK, Oswal RH (1985) Estimation of major immunoglobulin profile in oral submucous fibrosis by radial immuno-diffusion. Int J Oral Surg 14:533–537PubMedCrossRef

84.

Shah N, Kumar R, Shah MK (1994) Immunological studies in oral submucous fibrosis. Indian J Dent Res 5:81–87PubMed

85.

Canniff JP, Batchelor JR, Dodi IA, Harvey W (1982) HLA typing in oral submucous fibrosis. Tissue Antigens 26:138–142CrossRef

86.

Saeed B, Haue MF, Meghji S, Harris M (1997) HLA typing in oral submucous fibrosis. J Dent Res 76:1024

87.

Chen HM, Hsieh RP, Yang H, Kuo YS, Kuao MYP, Chaing CP (2004) HLA antigens in oral submucous fibrosis. J Oral Pathol Med 33:191–199PubMedCrossRef

88.

Van Wyk CW, Grobler Rabie AF, Martel RW, Hammond MG (1994) HLA antigens in oral submucous fibrosis. J Oral Pathol Med 23:23–27PubMedCrossRef

89.

Gupta PC (1980) Incidence rates of oral cancer and natural history of oral precancerous lesions in a 10 year follow up study of Indian villagers. Community Dent Oral Epidemiol 8:287–333CrossRef

90.

Pindborg JJ, Murti PR, Bhonsle B, Gupta PC, Daftary DK, Mehta FS (1984) Oral submucous fibrosis as a precancerous condition. Scand J Dent Res 92:224–229PubMed

91.

Murti PR, Bhaonsle RB, Pindborg JJ, Daftary DK, Gupta PC, Mehta FS (1985) Malignant transformation rate in oral submucous fibrosis over 17 year period. Community Dent Oral Epidemiol 13:340–341PubMedCrossRef

92.

Nair U, Bartsch H, Nair J (2004) Alert for an epidemic of oral cancer due to use of the betel quid substitutes gutkha and paan masala; a review of agents and causative mechanisms. Mutagenesis 19:251–262PubMedCrossRef

93.

International Agency for Research on Cancer (2004) Betel quid and areca nut chewing and some areca nut derived nitrosoamines, Vol 85. IARC, Lyon, pp 123–129

94.

Zhou S, Guo F, Li L, Zhou Y, Lei Y, Su H et al (2008) Multiple logistic regression analysis of risk factors for carcinogenesis of oral submucous fibrosis in mainland China. Int J Oral Maxillofac Surg 37:1094–1098PubMedCrossRef

95.

Ho PS, Yang YH, Shieh TY, Huang IY, Chen YK, Lin KN et al (2007) Consumption of areca quid, cigarettes and alcohol related to comorbidity of oral submucous fibrosis and oral cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:647–652PubMedCrossRef

96.

Ranganathan K, Kavitha R, Sawant SS, Vaidya MM (2006) Cytokeratin expression in oral submucous fibrosis—an immunohistochemical study. J Oral Pathol Med 35:25–32PubMedCrossRef

97.

Kaur J, Chakravarti N, Mathur M, Srivastava A, Ralhan R (2004) Alterations in expression of retinoid receptor β and p53 in oral submucous fibrosis. Oral Dis 10:201–206PubMedCrossRef

98.

Cox SC, Walker DM (1996) Epithelial growth fraction and expression of p53 tumor suppressor gene in oral submucous fibrosis. Aust Dent J 41:91–96PubMedCrossRef

99.

Trivedy C, Warnakulasuriya KAAS, Tavassoli M, Steingrimsdottir H, Penhallow J, Maher R et al (1998) p53 aberrations in oral submucous fibrosis and oral squamous cell carcinoma detected by immuno-cytochemistry and PCR-SSCP. J Oral Pathol Med 27:72–77PubMedCrossRef

100.

Liao PH, Lee TL, Yang LC, Yang SH, Chen SL, Chou MY (2001) Adenomatous polyposis coli gene mutation and decreased wild type p53 protein expression in oral submucous fibrosis—a prelimnary investigation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:202–207PubMedCrossRef

101.

Chaing CP, Lang MJ, Liu BY, Wang JT, Leu JS, Hahn LJ et al (2000) Expression of proliferating cell nuclear antigen (PCNA) in oral submucous fibrosis, oral epithelial hyperkeratosis and oral epithelial dysplasia in Taiwan. Oral Oncol 36:353–359CrossRef

102.

Srinivasan M, Jewell SD (2001) Quantitative estimation of PCNA, c-myc, EGFR and TGF-ά in oral submucous fibrosis—an immunohistochemical study. Oral Oncol 37:461–467PubMedCrossRef

103.

Tilakaratne WM, Iqbal Z, Teh TM, Ariyawardana A, Pitiyage G, Cruchley A et al (2008) Upregulation of HIF-1ά in malignant transformation of oral submucous fibrosis. J Oral Pathol Med 37:372–377PubMedCrossRef

104.

Rajendran R, Nair SM (1992) Silver binding nucleolar organizer regions proteins as a possible prognostic indicator in oral submucous fibrosis. Oral Surg Oral Med Oral Pathol 74:481–486PubMedCrossRef

105.

Teh TM, Tilakaratne WM, Chaplin T, Young BD, Ariyawardana A, Pitiyage G et al (2008) Fingerprinting genomic instability in oral submucous fibrosis. J Oral Pathol Med 37:430–436PubMedCrossRef

Titel: Areca nut in pathogenesis of oral submucous fibrosis: revisited
verfasst von: Punnya V. Angadi
Sanjay S. Rao
Publikationsdatum: 01.03.2011
Verlag: Springer-Verlag
Erschienen in: Oral and Maxillofacial Surgery / Ausgabe 1/2011
Print ISSN: 1865-1550
Elektronische ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-010-0219-8

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Areca nut in pathogenesis of oral submucous fibrosis: revisited

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