<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">JBM</journal-id><journal-title-group><journal-title>Journal of Biosciences and Medicines</journal-title></journal-title-group><issn pub-type="epub">2327-5081</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/jbm.2017.51001</article-id><article-id pub-id-type="publisher-id">JBM-73247</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject></subj-group></article-categories><title-group><article-title>
 
 
  Forskolin Modulates the Inhibitory Effect of C-Type Natriuretic Peptide on Hypoxia-Induced Atrial Dynamics and Hypoxia Inducible Factor 1 Alpha Activity
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Chengming</surname><given-names>Guan</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Yanan</surname><given-names>Jia</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Chaochao</surname><given-names>Bian</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bo</surname><given-names>Zhang</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Dazhi</surname><given-names>Ding</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Xun</surname><given-names>Cui</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib></contrib-group><aff id="aff3"><addr-line>Key Laboratory of Organism Functional Factors of the Changbai Mountain, Ministry of Education, Yanbian University, Yanji, China</addr-line></aff><aff id="aff4"><addr-line>Cellular Function Research Center, Yanbian University, Yanji, China</addr-line></aff><aff id="aff2"><addr-line>Department of Physiology, School of Medicine, Yanbian University, Yanji, China</addr-line></aff><aff id="aff1"><addr-line>Institue of Clinical Medicine, Yanbian University, Yanji, China</addr-line></aff><pub-date pub-type="epub"><day>03</day><month>01</month><year>2017</year></pub-date><volume>05</volume><issue>01</issue><fpage>1</fpage><lpage>10</lpage><history><date date-type="received"><day>December</day>	<month>1,</month>	<year>2016</year></date><date date-type="rev-recd"><day>Accepted:</day>	<month>December</month>	<year>31,</year>	</date><date date-type="accepted"><day>January</day>	<month>3,</month>	<year>2017</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  Our study investigated effects of C-type natriuretic peptide (CNP) on atrial dynamics and hypoxia inducible factor 1 alpha (HIF-1
  <em>α</em>) activity in perfused beating rat atria, under hypoxic conditions. Hypoxia significantly increased the levels of HIF-1
  <em>α</em>, concomitant with decreased trial dynamics. CNP (0.1 μmol/L) further decreased atrial dynamics under hypoxia and suppressed hypoxia-induced stimulation of HIF-1
  <em>α</em> expression. An adenylylcyclase (AC) activator, forskolin (0.1 μmol/L), significantly up-regulated atrial phosphodiesterase subtype 3A (PDE 3A) protein without affecting hypoxia-induced dynamics. In the presence of forskolin, the inhibitory effects of CNP on hypoxia-induced atrial dynamics and HIF-1
  <em>α</em> levels were significantly attenuated. Forskolin also prevented hypoxia-induced downregulation of PDE3A protein. These findings suggested that CNP inhibited atrial dynamics and HIF-1
  <em>α</em> activity in the isolated perfused beating rat atria under hypoxic conditions. Furthermore, both effects were modulated by the AC activator forskolin, through activation of CNP-PDE 3A signaling.
 
</p></abstract><kwd-group><kwd>C-Type Natriuretic Peptide</kwd><kwd> Hypoxia Inducible Factor-1α</kwd><kwd> Phosphodiesterase</kwd><kwd> Adenylyl Cyclase</kwd><kwd> Forskolin</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>Hypoxia is a common phenomenon in most cardiovascular diseases, including coronary artery disease, heart failure, myocardial hypertrophy and pulmonary hypertension [<xref ref-type="bibr" rid="scirp.73247-ref1">1</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref2">2</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref3">3</xref>] . Hypoxia-inducible factor-1 (HIF-1) is a heterodimeric transcription factor that plays a major role in cellular adaptation to hypoxia [<xref ref-type="bibr" rid="scirp.73247-ref4">4</xref>] . It is composed of HIF-1α and HIF-1β subunits, and its activity is dependent on stability of the α-subunit [<xref ref-type="bibr" rid="scirp.73247-ref5">5</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref6">6</xref>] . It was reported that cyclic adenosine monophosphate (cAMP)-dependent protein kinase (protein kinase A, PKA) phospho- rylated Thr<sup>63</sup> and Ser<sup>692</sup> on HIF-1α in vitro, enhancing its transcriptional activity and increasing target gene expression of rat cardiomyocytes. PKA also stimulated binding of the coactivator p300 to HIF-1α, enhancing its transcriptional activity while counteracting inhibition by asparaginyl hydroxylation of the association of p300 with HIF-1α [<xref ref-type="bibr" rid="scirp.73247-ref7">7</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref8">8</xref>] . Thus, cAMP promotes HIF-1 transcriptional activity and increases HIF-1α protein levels through PKA activation, exerting physiological and pathophysiological effects on the myocardium.</p><p>As an endocrine gland, the heart produces and secretes natriuretic peptides (NPs), such as atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP). Hypoxia potently stimulated cardiac ANP and BNP secretion [<xref ref-type="bibr" rid="scirp.73247-ref9">9</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref10">10</xref>] . ANP and BNP conferred resistance in the ischemic heart to hypoxia and myocardial cell damage, resulting in cellular adaptation to hypoxia and cardioprotection, through activation of cyclic guanosine monophosphate (cGMP)-protein kinase G (PKG) signaling [<xref ref-type="bibr" rid="scirp.73247-ref11">11</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref12">12</xref>] . Several studies demonstrated that ANP and BNP markedly down-regulated HIF-1α during renal ischemia/reperfusion (I/R) injury in mice [<xref ref-type="bibr" rid="scirp.73247-ref13">13</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref14">14</xref>] . However, effect of CNP on HIF-1α regulation in the atrium is unclear. Our study, therefore, investigated effects of CNP on hypoxia-induced HIF-1α levels in isolated beating rat atria. We also evaluated effects of the adenylyl cyclase (AC) activator, forskolin, on regulation of hypoxia-induced HIF-1α levels by CNP.</p></sec><sec id="s2"><title>2. Materials and Methods</title><sec id="s2_1"><title>2.1. Preparation of Perfused Beating Rat Atria</title><p>Sprague-Dawley (SD) rats of both sexes were used, with mean weights of 250 - 300 g. Isolated perfused beating left atria were prepared as previously described [<xref ref-type="bibr" rid="scirp.73247-ref15">15</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref16">16</xref>] . Soon after setting up each perfused atrium, transmural electrical field stimulation with a luminal electrode was started at 1.5 Hz (0.3 ms, 30 - 40 V), and the atrium was perfused with HEPES buffer solution using a peristaltic pump (1 mL/min), allowing atrial pacing for measurement of changes in atrial pulse pressure. The perfused atrium was supplied with sufficient oxygen during the entire process. The HEPES buffer contained (in mmol/L) 118 NaCl, 4.7 KCl, 2.5 CaCl<sub>2</sub>, 1.2 MgCl<sub>2</sub>, 25 NaHCO<sub>3</sub>, 10 glucose, and 10 HEPES (pH 7.4 with NaOH), as well as 0.1% bovine serum albumin.</p></sec><sec id="s2_2"><title>2.2. Hypoxic Atrial Model Preparation</title><p>The hypoxic atrial model was prepared as previously described [<xref ref-type="bibr" rid="scirp.73247-ref9">9</xref>] . Briefly, the atrial O<sub>2</sub> was replaced by N<sub>2</sub> gas and the normal HEPES buffer was replaced with N<sub>2</sub>-saturated HEPES buffer.</p><p>Intra-atrial pressure was recorded using a Physiograph (Power Lab 2/20) via a pressure transducer (Statham P23Db, Oxnard, CA, USA) and pulse pressure was calculated by the difference between systolic and diastolic pressures. Pulse pressures were expressed as cm H<sub>2</sub>O.</p><p>Changes in atrial pulse pressure (fold) = (value of pulse pressure − mean basal value of pulse pressure)/mean basal value of pulse pressure.</p></sec><sec id="s2_3"><title>2.3. Experimental Protocol</title><p>Each atrium was perfused for 60 min to stabilize atrial dynamics and then the control cycle (12 min as an experimental cycle) was followed by infusion of hypoxic buffer for four cycles, monitoring changes in atrial dynamics. For western blot analysis, immediately after perfusion, the atrial tissue was frozen and stored at −80˚C until analyzed.</p><p>To investigate effects of CNP and forskolin on hypoxia-induced atrial dynamics, one cycle of hypoxia after the control was followed by three cycles of infused treatment agent plus hypoxia. The treatment agents used were CNP (0.1 &#181;mol/L) and forskolin (0.1 &#181;mol/L). In the control group, vehicle was introduced instead of treatment agent. Values obtained during the periods corresponding to control and experimental observations were compared.</p></sec><sec id="s2_4"><title>2.4. Western Blot Analysis</title><p>Proteins derived from left atrial tissue were analyzed by western blotting. Atrial tissues were homogenized in radio-immunoprecipitation assay lysis buffer (Solarbio institute of Biotechnology, Shanghai, China), and protein concentrations were determined with a Bradford protein assay kit. Solubilized proteins were denatured in Lane Maker Loading buffer and proteins separated by 10% or 8% sodium dodecyl sulfate polyacrylamide gel electrophoresis. Protein bands were then transferred to polyvinylidene difluoride filter membranes (Beyotime Institute of Biotechnology, China). Each membrane was blocked with a 5% skim milk in phosphate buffer (PBST) solution at room temperature. After 2 h the membranes were incubated with the appropriate primary antibodies, overnight at 4˚C. The primary antibodies used were anti-phosphodiesterase subtype 3A (PDE3A, 1:1000, Abcam Shanghai, Shanghai, China) or anti-HIF-1α (1:1000, Abcam Shanghai), using, rabbit polyclonal β-actin (1:1000; Com Win Biotech, Beijing, China) as a loading control for all lanes. The membranes were then washed and incubated with secondary antibodies (1:2000) at room temperature for 2 h. After washing membranes thoroughly with PBST, stained bands were visualized by the ECL method (ECL Western Blot Kit, Com Win Biotech) and band densities quantified using Image J software (National Institutes of Health, Bethesda, MD, USA).</p></sec><sec id="s2_5"><title>2.5. Statistical Analysis</title><p>The significance of differences among values was determined by one-way ANO- VA followed by Dunnett’s multiple comparison test. An unpaired t-test was also applied. Statistical significance was defined as P &lt; 0.05. All data were presented as means &#177; SEM.</p></sec></sec><sec id="s3"><title>3. Results</title><sec id="s3_1"><title>3.1. Effect of CNP on Hypoxia-Induced Atrial Dynamics</title><p>As shown in <xref ref-type="fig" rid="fig1">Figure 1</xref>, hypoxia significantly decreased pulse pressure in isolated perfused beating rat atria (P &lt; 0.05 vs. control, (a)). CNP also substantially</p><fig-group id="fig1"><label><xref ref-type="fig" rid="fig1">Figure 1</xref></label><caption><title> Effect of CNP (0.1 &#181;mol/L) on hypoxia-induced pulse pre- ssure (PP) in isolated perfused rat atria. (a) hypoxia-induced PP; (b) and (c) CNP modulated PP (data in (c) were derived from (a) and (b) control as well as the last cycle of the experimental period). Data were expressed as mean &#177; SEM, n = 6. *P &lt; 0.05 vs. control; #P &lt; 0.05 vs. hypoxia.</title></caption><fig id ="fig1_1"><label> (b)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-2150323x2.png"/></fig><fig id ="fig1_2"><label> (c)</label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-2150323x3.png"/></fig><fig id ="fig1_3"><label></label><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-2150323x4.png"/></fig></fig-group><p>decreased pulse pressure in the hypoxic atria (P &lt; 0.05 vs. control, (b)), a net effect that was greater than that of hypoxia alone (P &lt; 0.05 vs. hypoxia alone, (c)). These data indicated that CNP had a negative inotropic effect in the hypoxic atrium.</p></sec><sec id="s3_2"><title>3.2. Effects of Forskolin on CNP-Induced Suppression of Hypoxic Atrial Pulse Pressure</title><p>To determined effects of an AC activator, forskolin, on regulation of hypoxia- induced atrial dynamics by CNP, a series of experiments were performed with this agent in the perfused beating rat atria. As shown in <xref ref-type="fig" rid="fig2">Figure 2</xref>, forskolin did not affect hypoxia-induced atrial pulse pressure (P &lt; 0.05 vs. control; P &gt; 0.05 vs. hypoxia). In contrast, the AC activator dramatically attenuated the inhibitory effects of CNP on hypoxia-induced pulse pressure (P &lt; 0.05 vs. hypoxia; P &lt; 0.05 vs. CNP; P &lt; 0.05 vs. forskolin). These results suggested that forskolin reversed the inhibitory effects of CNP on atrial dynamics in the beating hypoxic atrium.</p></sec><sec id="s3_3"><title>3.3. Effects of Forskolin and CNP on Atrial PDE3A Levels under Hypoxia</title><p>PDE 3A regulates intracellular cAMP levels, so we examined levels of this protein to investigate the mechanism of forskolin-mediated reversal of inhibition by CNP of hypoxia-induced atrial pulse pressure. Atrial PDE3A levels were determined by western blotting in hypoxic beating atria that had been treated with or without forskolin and/or CNP. Forskolin significantly up-regulated atrial PDE 3A protein levels under hypoxic conditions (P &lt; 0.05 vs. control group; P &lt; 0.05 vs. hypoxia group, <xref ref-type="fig" rid="fig3">Figure 3</xref>). There were no significant changes in PDE 3A levels with hypoxia alone or with hypoxia plus CNP. However, in the presence of forskolin, CNP dramatically suppressed levels of PDE 3A in hypoxic atria (P &lt; 0.05 compared with all other groups, <xref ref-type="fig" rid="fig3">Figure 3</xref>). This indicated that CNP inhibited forskolin-induced PDE3A activity activation in hypoxic atria.</p><fig id="fig2"  position="float"><label><xref ref-type="fig" rid="fig2">Figure 2</xref></label><caption><title> Effect of forskolin (0.1 &#181;mol/L), an activator of adenylyl cyclase, on the regulation of CNP-induced pulse pressure in perfused beating rat hypoxic atria. Data were expressed as mean &#177; SEM, n = 6. *P &lt; 0.05 vs. control group; #P &lt; 0.05 vs. hypoxia group; ♦P &lt; 0.05 vs. CNP group; &amp;P &lt; 0.05 vs. forskolin group</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-2150323x5.png"/></fig><fig id="fig3"  position="float"><label><xref ref-type="fig" rid="fig3">Figure 3</xref></label><caption><title> Effects of CNP (0.1 &#181;mol/L) and forskolin (0.1 &#181;mol/L) on hypoxia- induced atrial phosphodiesterase subtype 3A (PDE 3A) expression. Con, control; Hy, hypoxia; F, forskolin; C, CNP. Data were expressed as mean &#177; SEM, n = 5. *P &lt; 0.05 vs. control group; #P &lt; 0.05 vs. hypoxia group; ♦P &lt; 0.05 vs. CNP group; &amp;P &lt; 0.05 vs. forskolin group</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-2150323x6.png"/></fig></sec><sec id="s3_4"><title>3.4. Effects of CNP and Forskolin on HIF-1α Levels in Hypoxic Atria</title><p>We next investigated regulation by CNP of hypoxia-induced increases in atrial HIF-1α, as well as the impact of forskolin. As shown in <xref ref-type="fig" rid="fig4">Figure 4</xref>, hypoxia substantially increased atrial levels of HIF-1α (P &lt; 0.05 vs. control group) and this effect was completely abolished by CNP (P &lt; 0.05 vs. hypoxia group). In addition, forskolin clearly augmented the hypoxia-induced increase in HIF-1α levels in the atria (P &lt; 0.05 vs. control group; P &lt; 0.05 vs. hypoxia group). This effect was dramatically attenuated by CNP, though HIF-1α levels remained elevated, as compared with hypoxic atria with CNP alone (P &lt; 0.05 vs. control group; P &lt; 0.05 vs. hypoxia group; P &lt; 0.05 vs. CNP group). These results suggested that, in hypoxic atria, CNP suppressed upregulation of HIF-1α and that this effect could be modulated by the AC activator forskolin.</p></sec></sec><sec id="s4"><title>4. Discussion</title><p>In our study, in isolated perfused beating rat atria under hypoxic conditions, CNP inhibited atrial dynamics and suppressed HIF-1α levels. This effect of CNP was modulated by the AC activator forskolin, through activation of CNP-PDE 3A signaling.</p><p>It is well known that CNP can bind to B-type natriuretic peptide receptors (NPR-B) and negatively affect cardiac myocyte function through activation of the guanylyl cyclase (GC)-cGMP-PKG signaling pathway [<xref ref-type="bibr" rid="scirp.73247-ref17">17</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref18">18</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref19">19</xref>] . In addition, particulate GC (pGC) activation in atria by CNP led to increased pGC- cGMP-PDE 3 signaling and elevated cAMP levels [<xref ref-type="bibr" rid="scirp.73247-ref20">20</xref>] . In our study, hypoxia</p><fig id="fig4"  position="float"><label><xref ref-type="fig" rid="fig4">Figure 4</xref></label><caption><title> Effects of forskolin (0.1 &#181;mol/L) and CNP (0.1 &#181;mol/L) on hypoxia-induced atrial HIF-1α expression. Con, control; Hy, hypoxia; F, forskolin; C, CNP. Data were expressed as mean &#177; SEM, n = 5. *P &lt; 0.05 vs. control group; #P &lt; 0.05 vs. hypoxia group; ♦P &lt; 0.05 vs. CNP group; &amp;P &lt; 0.05 vs. forskolin group</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/1-2150323x7.png"/></fig><p>significantly inhibited atrial dynamics, an effect clearly augmented by CNP treatment. Furthermore, under hypoxia, the AC activator forskolin substantially increased atrial PDE 3A protein levels without affecting dynamics. Nevertheless, under hypoxia and in the presence of forskolin, the inhibitory effect of CNP on atrial dynamics was substantially attenuated, with concomitant suppression of the forskolin-induced increases in PDE 3A protein levels. These results indicated that CNP can have negative inotropic effects on atrial dynamics under hypoxia and that these actions can be modulated by forskolin, through activation of CNP- PDE 3A signaling. Our results agreed well with previous findings [<xref ref-type="bibr" rid="scirp.73247-ref17">17</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref18">18</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref19">19</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref20">20</xref>] .</p><p>Intracellular cAMP is levels are determined by the rate of cAMP generation, through activation of adenylyl cyclase, and its degradation by phosphodiesterases (PDEs) [<xref ref-type="bibr" rid="scirp.73247-ref21">21</xref>] . At least four families of PDEs, PDE 1, PDE 2, PDE 3 and PDE 4, were identified in the heart [<xref ref-type="bibr" rid="scirp.73247-ref22">22</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref23">23</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref24">24</xref>] . PDE 3, a cGMP-inhibited PDE subtype, represents one of the major cAMP-degrading PDEs in the human heart [<xref ref-type="bibr" rid="scirp.73247-ref25">25</xref>] . PKA enhances HIF-1α transcriptional activity [<xref ref-type="bibr" rid="scirp.73247-ref7">7</xref>] [<xref ref-type="bibr" rid="scirp.73247-ref8">8</xref>] and PDE 3 inhibition leading to an elevating of intracellular cAMP levels [<xref ref-type="bibr" rid="scirp.73247-ref20">20</xref>] , which subsequently, activates PKA. Thus, PDE 3 may be involved in regulation of HIF-1α activity. In our study, hypoxia significantly increased atrial HIF-1α protein levels and this effect was augmented by forskolin, which also increased PDE 3A levels. The effect was, in contrast, blocked by CNP, without affecting PDE 3A levels. Nevertheless, the inhibitory effect of CNP on hypoxia-induced atrial HIF-1α protein expression was dramatically attenuated by forskolin. Under these conditions, there was concomitant suppression, by CNP, of the forskolin-induced increases in PDE 3A levels. These results indicated that the suppression by CNP of hypoxia-induced HIF-1α elevation in the perfused beating rat atria was modulated by forskolin, through activation of CNP-PDE 3 signaling. Thus, PDE 3 is a potential regulatory target for modulating HIF-1α activity.</p></sec><sec id="s5"><title>5. Conclusion</title><p>In conclusion, CNP inhibited atrial dynamics and HIF-1α activity in the isolated perfused beating rat atria under hypoxic conditions. These effects of CNP were modulated by the AC activator, forskolin, through increased CNP-PDE 3A signaling.</p></sec><sec id="s6"><title>Acknowledgements</title><p>This work was supported by the National Natural Science Foundation of China (No. 81360061 and 81660089) and a of Jilin Province educational project (No. 2015-44).</p></sec><sec id="s7"><title>Cite this paper</title><p>Guan, C.M., Jia, Y.N., Bian, C.C., Zhang, B., Ding, D.Z. and Cui, X. 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