Treatment of periodontitis reduces systemic inflammation in type 2 diabetes
Aims To assess the impact of periodontal treatment on systemic inflammation in type 2 diabetes. Materials and Methods Adults with type 2 diabetes (n = 83) and without diabetes (controls, n = 75) were recruited, and participants with periodontitis received periodontal treatment and 12 months’ follow‐...
Gespeichert in:
| Veröffentlicht in: | Journal of clinical periodontology 2020-06, Vol.47 (6), p.737-746 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 746 |
|---|---|
| container_issue | 6 |
| container_start_page | 737 |
| container_title | Journal of clinical periodontology |
| container_volume | 47 |
| creator | Preshaw, Philip M. Taylor, John J. Jaedicke, Katrin M. De Jager, Marko Bikker, Jan Willem Selten, Wieke Bissett, Susan M. Whall, Kerry M. Merwe, Rachel Areibi, Aisha Jitprasertwong, Paiboon Al‐Shahwani, Rana Weaver, Jolanta Taylor, Roy Wassall, Rebecca R. |
| description | Aims
To assess the impact of periodontal treatment on systemic inflammation in type 2 diabetes.
Materials and Methods
Adults with type 2 diabetes (n = 83) and without diabetes (controls, n = 75) were recruited, and participants with periodontitis received periodontal treatment and 12 months’ follow‐up. Biomarkers for periodontal inflammation (gingival crevicular fluid interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, matrix metalloproteinase‐8, matrix metalloproteinase‐9, adiponectin) and serum markers of inflammation and diabetes control (glycated haemoglobin, high sensitivity C‐reactive protein, interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, leptin, adiponectin) were measured. Structural equation modelling was used to evaluate periodontal treatment effects on oral and systemic inflammation.
Results
Periodontal treatment resulted in significant improvements in clinical status and reductions in gingival crevicular fluid biomarkers from baseline to month 12. Structural equation modelling identified that, at baseline, individuals with diabetes and periodontitis had significantly higher systemic inflammation than non‐diabetic controls with periodontitis (Δ = 0.20, p = .002), with no significant differences between groups for oral inflammation. There was a greater reduction in systemic inflammation following periodontal treatment in individuals with diabetes and periodontitis compared to those with periodontitis but not diabetes (Δ = −0.25, p = .01).
Conclusions
Diabetes and periodontitis together appear to increase systemic inflammation, with evidence of reductions following periodontal treatment. |
| doi_str_mv | 10.1111/jcpe.13274 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2369426484</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2369426484</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3934-1c08e77bd1a68300438ad080f64d5c4883374e881ce5bfd6341bbbe50cde9e013</originalsourceid><addsrcrecordid>eNp9kEtLxDAQgIMouj4u_gApeBGhOulk2_Qoi29BDwreQppMIUtfJimy_97qqgcP5jIZ-PgYPsYOOZzx6Z0vzUBnHLNCbLAZzwFSmPPXTTYDBEzzsih32G4ISwBeIOI228GMQz59Z-z-2ZOOLXUx6etkIO9623fRRRcST3Y0FJKwCpFaZxLX1Y1uWx1d301LElcDJVlina4oUthnW7VuAh18zz32cnX5vLhJHx6vbxcXD6nBEkXKDUgqispynUsEECi1BQl1LuzcCCkRC0FSckPzqrY5Cl5VFc3BWCoJOO6xk7V38P3bSCGq1gVDTaM76segMsxLkeVCigk9_oMu-9F303UqE1Ag51lZTNTpmjK-D8FTrQbvWu1XioP6TKw-E6uvxBN89K0cq5bsL_rTdAL4Gnh3Da3-Uam7xdPlWvoBZmWFjw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2407311297</pqid></control><display><type>article</type><title>Treatment of periodontitis reduces systemic inflammation in type 2 diabetes</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Preshaw, Philip M. ; Taylor, John J. ; Jaedicke, Katrin M. ; De Jager, Marko ; Bikker, Jan Willem ; Selten, Wieke ; Bissett, Susan M. ; Whall, Kerry M. ; Merwe, Rachel ; Areibi, Aisha ; Jitprasertwong, Paiboon ; Al‐Shahwani, Rana ; Weaver, Jolanta ; Taylor, Roy ; Wassall, Rebecca R.</creator><creatorcontrib>Preshaw, Philip M. ; Taylor, John J. ; Jaedicke, Katrin M. ; De Jager, Marko ; Bikker, Jan Willem ; Selten, Wieke ; Bissett, Susan M. ; Whall, Kerry M. ; Merwe, Rachel ; Areibi, Aisha ; Jitprasertwong, Paiboon ; Al‐Shahwani, Rana ; Weaver, Jolanta ; Taylor, Roy ; Wassall, Rebecca R.</creatorcontrib><description>Aims
To assess the impact of periodontal treatment on systemic inflammation in type 2 diabetes.
Materials and Methods
Adults with type 2 diabetes (n = 83) and without diabetes (controls, n = 75) were recruited, and participants with periodontitis received periodontal treatment and 12 months’ follow‐up. Biomarkers for periodontal inflammation (gingival crevicular fluid interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, matrix metalloproteinase‐8, matrix metalloproteinase‐9, adiponectin) and serum markers of inflammation and diabetes control (glycated haemoglobin, high sensitivity C‐reactive protein, interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, leptin, adiponectin) were measured. Structural equation modelling was used to evaluate periodontal treatment effects on oral and systemic inflammation.
Results
Periodontal treatment resulted in significant improvements in clinical status and reductions in gingival crevicular fluid biomarkers from baseline to month 12. Structural equation modelling identified that, at baseline, individuals with diabetes and periodontitis had significantly higher systemic inflammation than non‐diabetic controls with periodontitis (Δ = 0.20, p = .002), with no significant differences between groups for oral inflammation. There was a greater reduction in systemic inflammation following periodontal treatment in individuals with diabetes and periodontitis compared to those with periodontitis but not diabetes (Δ = −0.25, p = .01).
Conclusions
Diabetes and periodontitis together appear to increase systemic inflammation, with evidence of reductions following periodontal treatment.</description><identifier>ISSN: 0303-6979</identifier><identifier>EISSN: 1600-051X</identifier><identifier>DOI: 10.1111/jcpe.13274</identifier><identifier>PMID: 32106333</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adiponectin ; Adult ; Biomarkers ; Chronic Periodontitis ; Cytokines ; Dentistry ; Diabetes ; diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - therapy ; Gingival Crevicular Fluid - chemistry ; Glycated Hemoglobin A - analysis ; Gum disease ; Hemoglobin ; Humans ; Inflammation ; Interferon ; Leptin ; Matrix metalloproteinase ; Metalloproteinase ; Periodontitis ; Periodontitis - complications ; Periodontitis - therapy ; Tumor necrosis factor ; Tumor necrosis factor-TNF ; Tumors ; type 2</subject><ispartof>Journal of clinical periodontology, 2020-06, Vol.47 (6), p.737-746</ispartof><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3934-1c08e77bd1a68300438ad080f64d5c4883374e881ce5bfd6341bbbe50cde9e013</citedby><cites>FETCH-LOGICAL-c3934-1c08e77bd1a68300438ad080f64d5c4883374e881ce5bfd6341bbbe50cde9e013</cites><orcidid>0000-0002-7153-4865 ; 0000-0002-2767-5361</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpe.13274$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpe.13274$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32106333$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Preshaw, Philip M.</creatorcontrib><creatorcontrib>Taylor, John J.</creatorcontrib><creatorcontrib>Jaedicke, Katrin M.</creatorcontrib><creatorcontrib>De Jager, Marko</creatorcontrib><creatorcontrib>Bikker, Jan Willem</creatorcontrib><creatorcontrib>Selten, Wieke</creatorcontrib><creatorcontrib>Bissett, Susan M.</creatorcontrib><creatorcontrib>Whall, Kerry M.</creatorcontrib><creatorcontrib>Merwe, Rachel</creatorcontrib><creatorcontrib>Areibi, Aisha</creatorcontrib><creatorcontrib>Jitprasertwong, Paiboon</creatorcontrib><creatorcontrib>Al‐Shahwani, Rana</creatorcontrib><creatorcontrib>Weaver, Jolanta</creatorcontrib><creatorcontrib>Taylor, Roy</creatorcontrib><creatorcontrib>Wassall, Rebecca R.</creatorcontrib><title>Treatment of periodontitis reduces systemic inflammation in type 2 diabetes</title><title>Journal of clinical periodontology</title><addtitle>J Clin Periodontol</addtitle><description>Aims
To assess the impact of periodontal treatment on systemic inflammation in type 2 diabetes.
Materials and Methods
Adults with type 2 diabetes (n = 83) and without diabetes (controls, n = 75) were recruited, and participants with periodontitis received periodontal treatment and 12 months’ follow‐up. Biomarkers for periodontal inflammation (gingival crevicular fluid interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, matrix metalloproteinase‐8, matrix metalloproteinase‐9, adiponectin) and serum markers of inflammation and diabetes control (glycated haemoglobin, high sensitivity C‐reactive protein, interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, leptin, adiponectin) were measured. Structural equation modelling was used to evaluate periodontal treatment effects on oral and systemic inflammation.
Results
Periodontal treatment resulted in significant improvements in clinical status and reductions in gingival crevicular fluid biomarkers from baseline to month 12. Structural equation modelling identified that, at baseline, individuals with diabetes and periodontitis had significantly higher systemic inflammation than non‐diabetic controls with periodontitis (Δ = 0.20, p = .002), with no significant differences between groups for oral inflammation. There was a greater reduction in systemic inflammation following periodontal treatment in individuals with diabetes and periodontitis compared to those with periodontitis but not diabetes (Δ = −0.25, p = .01).
Conclusions
Diabetes and periodontitis together appear to increase systemic inflammation, with evidence of reductions following periodontal treatment.</description><subject>Adiponectin</subject><subject>Adult</subject><subject>Biomarkers</subject><subject>Chronic Periodontitis</subject><subject>Cytokines</subject><subject>Dentistry</subject><subject>Diabetes</subject><subject>diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Gingival Crevicular Fluid - chemistry</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Gum disease</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Interferon</subject><subject>Leptin</subject><subject>Matrix metalloproteinase</subject><subject>Metalloproteinase</subject><subject>Periodontitis</subject><subject>Periodontitis - complications</subject><subject>Periodontitis - therapy</subject><subject>Tumor necrosis factor</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumors</subject><subject>type 2</subject><issn>0303-6979</issn><issn>1600-051X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLxDAQgIMouj4u_gApeBGhOulk2_Qoi29BDwreQppMIUtfJimy_97qqgcP5jIZ-PgYPsYOOZzx6Z0vzUBnHLNCbLAZzwFSmPPXTTYDBEzzsih32G4ISwBeIOI228GMQz59Z-z-2ZOOLXUx6etkIO9623fRRRcST3Y0FJKwCpFaZxLX1Y1uWx1d301LElcDJVlina4oUthnW7VuAh18zz32cnX5vLhJHx6vbxcXD6nBEkXKDUgqispynUsEECi1BQl1LuzcCCkRC0FSckPzqrY5Cl5VFc3BWCoJOO6xk7V38P3bSCGq1gVDTaM76segMsxLkeVCigk9_oMu-9F303UqE1Ag51lZTNTpmjK-D8FTrQbvWu1XioP6TKw-E6uvxBN89K0cq5bsL_rTdAL4Gnh3Da3-Uam7xdPlWvoBZmWFjw</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Preshaw, Philip M.</creator><creator>Taylor, John J.</creator><creator>Jaedicke, Katrin M.</creator><creator>De Jager, Marko</creator><creator>Bikker, Jan Willem</creator><creator>Selten, Wieke</creator><creator>Bissett, Susan M.</creator><creator>Whall, Kerry M.</creator><creator>Merwe, Rachel</creator><creator>Areibi, Aisha</creator><creator>Jitprasertwong, Paiboon</creator><creator>Al‐Shahwani, Rana</creator><creator>Weaver, Jolanta</creator><creator>Taylor, Roy</creator><creator>Wassall, Rebecca R.</creator><general>Blackwell Publishing Ltd</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>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7153-4865</orcidid><orcidid>https://orcid.org/0000-0002-2767-5361</orcidid></search><sort><creationdate>202006</creationdate><title>Treatment of periodontitis reduces systemic inflammation in type 2 diabetes</title><author>Preshaw, Philip M. ; Taylor, John J. ; Jaedicke, Katrin M. ; De Jager, Marko ; Bikker, Jan Willem ; Selten, Wieke ; Bissett, Susan M. ; Whall, Kerry M. ; Merwe, Rachel ; Areibi, Aisha ; Jitprasertwong, Paiboon ; Al‐Shahwani, Rana ; Weaver, Jolanta ; Taylor, Roy ; Wassall, Rebecca R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3934-1c08e77bd1a68300438ad080f64d5c4883374e881ce5bfd6341bbbe50cde9e013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adiponectin</topic><topic>Adult</topic><topic>Biomarkers</topic><topic>Chronic Periodontitis</topic><topic>Cytokines</topic><topic>Dentistry</topic><topic>Diabetes</topic><topic>diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Gingival Crevicular Fluid - chemistry</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Gum disease</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Interferon</topic><topic>Leptin</topic><topic>Matrix metalloproteinase</topic><topic>Metalloproteinase</topic><topic>Periodontitis</topic><topic>Periodontitis - complications</topic><topic>Periodontitis - therapy</topic><topic>Tumor necrosis factor</topic><topic>Tumor necrosis factor-TNF</topic><topic>Tumors</topic><topic>type 2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Preshaw, Philip M.</creatorcontrib><creatorcontrib>Taylor, John J.</creatorcontrib><creatorcontrib>Jaedicke, Katrin M.</creatorcontrib><creatorcontrib>De Jager, Marko</creatorcontrib><creatorcontrib>Bikker, Jan Willem</creatorcontrib><creatorcontrib>Selten, Wieke</creatorcontrib><creatorcontrib>Bissett, Susan M.</creatorcontrib><creatorcontrib>Whall, Kerry M.</creatorcontrib><creatorcontrib>Merwe, Rachel</creatorcontrib><creatorcontrib>Areibi, Aisha</creatorcontrib><creatorcontrib>Jitprasertwong, Paiboon</creatorcontrib><creatorcontrib>Al‐Shahwani, Rana</creatorcontrib><creatorcontrib>Weaver, Jolanta</creatorcontrib><creatorcontrib>Taylor, Roy</creatorcontrib><creatorcontrib>Wassall, Rebecca R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical periodontology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Preshaw, Philip M.</au><au>Taylor, John J.</au><au>Jaedicke, Katrin M.</au><au>De Jager, Marko</au><au>Bikker, Jan Willem</au><au>Selten, Wieke</au><au>Bissett, Susan M.</au><au>Whall, Kerry M.</au><au>Merwe, Rachel</au><au>Areibi, Aisha</au><au>Jitprasertwong, Paiboon</au><au>Al‐Shahwani, Rana</au><au>Weaver, Jolanta</au><au>Taylor, Roy</au><au>Wassall, Rebecca R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of periodontitis reduces systemic inflammation in type 2 diabetes</atitle><jtitle>Journal of clinical periodontology</jtitle><addtitle>J Clin Periodontol</addtitle><date>2020-06</date><risdate>2020</risdate><volume>47</volume><issue>6</issue><spage>737</spage><epage>746</epage><pages>737-746</pages><issn>0303-6979</issn><eissn>1600-051X</eissn><abstract>Aims
To assess the impact of periodontal treatment on systemic inflammation in type 2 diabetes.
Materials and Methods
Adults with type 2 diabetes (n = 83) and without diabetes (controls, n = 75) were recruited, and participants with periodontitis received periodontal treatment and 12 months’ follow‐up. Biomarkers for periodontal inflammation (gingival crevicular fluid interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, matrix metalloproteinase‐8, matrix metalloproteinase‐9, adiponectin) and serum markers of inflammation and diabetes control (glycated haemoglobin, high sensitivity C‐reactive protein, interleukin‐6, tumour necrosis factor‐α, interleukin‐1β, interferon‐γ, leptin, adiponectin) were measured. Structural equation modelling was used to evaluate periodontal treatment effects on oral and systemic inflammation.
Results
Periodontal treatment resulted in significant improvements in clinical status and reductions in gingival crevicular fluid biomarkers from baseline to month 12. Structural equation modelling identified that, at baseline, individuals with diabetes and periodontitis had significantly higher systemic inflammation than non‐diabetic controls with periodontitis (Δ = 0.20, p = .002), with no significant differences between groups for oral inflammation. There was a greater reduction in systemic inflammation following periodontal treatment in individuals with diabetes and periodontitis compared to those with periodontitis but not diabetes (Δ = −0.25, p = .01).
Conclusions
Diabetes and periodontitis together appear to increase systemic inflammation, with evidence of reductions following periodontal treatment.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>32106333</pmid><doi>10.1111/jcpe.13274</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7153-4865</orcidid><orcidid>https://orcid.org/0000-0002-2767-5361</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0303-6979 |
| ispartof | Journal of clinical periodontology, 2020-06, Vol.47 (6), p.737-746 |
| issn | 0303-6979 1600-051X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2369426484 |
| source | Wiley-Blackwell Journals; MEDLINE |
| subjects | Adiponectin Adult Biomarkers Chronic Periodontitis Cytokines Dentistry Diabetes diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - therapy Gingival Crevicular Fluid - chemistry Glycated Hemoglobin A - analysis Gum disease Hemoglobin Humans Inflammation Interferon Leptin Matrix metalloproteinase Metalloproteinase Periodontitis Periodontitis - complications Periodontitis - therapy Tumor necrosis factor Tumor necrosis factor-TNF Tumors type 2 |
| title | Treatment of periodontitis reduces systemic inflammation in type 2 diabetes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T20%3A13%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Treatment%20of%20periodontitis%20reduces%20systemic%20inflammation%20in%20type%202%20diabetes&rft.jtitle=Journal%20of%20clinical%20periodontology&rft.au=Preshaw,%20Philip%20M.&rft.date=2020-06&rft.volume=47&rft.issue=6&rft.spage=737&rft.epage=746&rft.pages=737-746&rft.issn=0303-6979&rft.eissn=1600-051X&rft_id=info:doi/10.1111/jcpe.13274&rft_dat=%3Cproquest_cross%3E2369426484%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2407311297&rft_id=info:pmid/32106333&rfr_iscdi=true |