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Article ; Online: Improving the Diagnosis of Dermatitis Herpetiformis Using the Intraepithelial Lymphogram.

Fernández-Bañares, Fernando / Crespo, Laura / Planella, Montserrat / Farrais, Sergio / Izquierdo, Sandra / López-Palacios, Natalia / Roy, Garbiñe / Vidal, Judith / Núñez, Concepción

Nutrients

2024 Volume 16, Issue 2

Abstract: Dermatitis herpetiformis is a cutaneous manifestation of celiac disease. Phenotyping of intraepithelial lymphocytes in the small bowel mucosa can strengthen the diagnosis of celiac disease when it is not clear-cut. We aim to evaluate the usefulness of ... ...

Abstract	Dermatitis herpetiformis is a cutaneous manifestation of celiac disease. Phenotyping of intraepithelial lymphocytes in the small bowel mucosa can strengthen the diagnosis of celiac disease when it is not clear-cut. We aim to evaluate the usefulness of the intraepithelial lymphogram to confirm dermatitis herpetiformis in equivocal cases. We performed a retrospective multicenter study on patients diagnosed with dermatitis herpetiformis and collected data from the intraepithelial lymphogram assessed by flow cytometry. A total of 36 patients were analyzed in relation to the severity of intestinal damage (18 had non-atrophic mucosa) at baseline (N = 28) and/or after the adoption of a gluten-free diet (median follow-up of three years, N = 16). We observed that patients with atrophy more often had positive celiac serology (
MeSH term(s)	Humans ; Anemia, Iron-Deficiency ; Atrophy ; Celiac Disease/complications ; Celiac Disease/diagnosis ; Data Collection ; Dermatitis Herpetiformis/diagnosis ; Retrospective Studies
Language	English
Publishing date	2024-01-11
Publishing country	Switzerland
Document type	Multicenter Study ; Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu16020232
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Article: An autoimmune polyglandular syndrome complicated with celiac disease and autoimmune hepatitis.

Dieli-Crimi, Romina / Núñez, Concepción / Estrada, Lourdes / López-Palacios, Natalia

Annals of hepatology

2016 Volume 15, Issue 4, Page(s) 588–591

Abstract: Autoimmune polyglandular syndrome (APS) is a combination of different autoimmune diseases. The close relationship between immune-mediated disorders makes it mandatory to perform serological screening periodically in order to avoid delayed diagnosis of ... ...

Abstract	Autoimmune polyglandular syndrome (APS) is a combination of different autoimmune diseases. The close relationship between immune-mediated disorders makes it mandatory to perform serological screening periodically in order to avoid delayed diagnosis of additional autoimmune diseases. We studied a patient with type 1 diabetes (T1D) who later developed an autoimmune thyroid disease (ATD) and was referred to our hospital with a serious condition of his clinical status. The patient was suffering from an advance stage of celiac disease (CD), the delay in its diagnosis and in the establishment of a gluten-free dietled the patient to a severe proteincalorie malnutrition. Later, the patient developed an autoimmune hepatitis (AIH). We consider that clinical deterioration in patients with APS should alert physicians about the possible presence of other immune-mediated diseases. Periodic screening for autoantibodies would help to prevent delayed diagnosis and would improve patient's quality of life.
MeSH term(s)	Autoantibodies/immunology ; Celiac Disease/complications ; Celiac Disease/diagnosis ; Celiac Disease/diet therapy ; Celiac Disease/immunology ; Delayed Diagnosis ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/immunology ; Diet, Gluten-Free ; Hepatitis, Autoimmune/complications ; Hepatitis, Autoimmune/diagnosis ; Hepatitis, Autoimmune/immunology ; Humans ; Male ; Middle Aged ; Polyendocrinopathies, Autoimmune/complications ; Polyendocrinopathies, Autoimmune/diagnosis ; Polyendocrinopathies, Autoimmune/immunology ; Protein-Energy Malnutrition/diagnosis ; Protein-Energy Malnutrition/etiology ; Thyroiditis, Autoimmune/complications ; Thyroiditis, Autoimmune/diagnosis ; Thyroiditis, Autoimmune/immunology
Chemical Substances	Autoantibodies
Language	English
Publishing date	2016-05-27
Publishing country	Mexico
Document type	Case Reports ; Journal Article
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
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Article: Coeliac Disease in Elderly Patients: Value of Coeliac Lymphogram for Diagnosis

Fernández-Bañares, Fernando / Farrais, Sergio / Planella, Montserrat / Melero, Josefa / López-Palacios, Natalia / Vivas, Santiago / Fernández-Salazar, Luis / Lanzarote, Ana Pilar / Ruiz-Ramírez, Pablo / Aguilar-Criado, Marta / Vidal, Judith / Esquerda, Aureli / Serrano, Cristina / Núñez, Concepción

Nutrients. 2021 Aug. 27, v. 13, no. 9

2021

Abstract: 1) Background: Although a meta-analysis reported that the sensitivity of CD3+ TCRγδ+ cells for coeliac disease diagnosis was >93%, a recent study has suggested that sensitivity decreased to 65% in elderly patients. (2) Aim: To evaluate whether the ... ...

Abstract	(1) Background: Although a meta-analysis reported that the sensitivity of CD3+ TCRγδ+ cells for coeliac disease diagnosis was >93%, a recent study has suggested that sensitivity decreased to 65% in elderly patients. (2) Aim: To evaluate whether the sensitivity of intraepithelial lymphocyte cytometric patterns for coeliac disease diagnosis changes with advanced age. (3) Methods: We performed a multicentre study including 127 coeliac disease patients ≥ 50 years: 87 with baseline cytometry (45 aged 50–59 years; 23 aged 60–69 years; 19 aged ≥ 70 years), 16 also with a follow-up cytometry (on a gluten-free diet); and 40 with only follow-up cytometry. (4) Results: In Marsh 3 patients, a sensitivity of 94.7%, 88.9% and 86.7% was observed for each age group using a cut-off value of TCRγδ+ >10% (p = 0.27); and a sensitivity of 84.2%, 83.4% and 53.3% for a cut-off value >14% (p = 0.02; 50–69 vs. ≥70 years), with difference between applying a cut-off of 10% or 14% (p = 0.008). The TCRγδ+ count in the ≥70 years group was lower than in the other groups (p = 0.014). (5) Conclusion: In coeliac patients ≥ 70 years, the TCRγδ+ count decreases and the cut-off point of >10% is more accurate than >14%.
Keywords	celiac disease ; disease diagnosis ; elderly ; gluten-free diet ; meta-analysis
Language	English
Dates of publication	2021-0827
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13092984
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Article ; Online: Exploring undiagnosed celiac disease in women with recurrent reproductive failure: The gluten-free diet could improve reproductive outcomes.

Alecsandru, Diana / López-Palacios, Natalia / Castaño, Mercedes / Aparicio, Pilar / García-Velasco, Juan Antonio / Núñez, Concepción

American journal of reproductive immunology (New York, N.Y. : 1989)

2019 Volume 83, Issue 2, Page(s) e13209

Abstract: Problem: Which is the prevalence and seroprevalence of celiac disease (CD) in women with recurrent reproductive failure?: Method of study: Retrospective study performed in a single infertility clinic from September 2016 to December 2017. A total of ... ...

Abstract	Problem: Which is the prevalence and seroprevalence of celiac disease (CD) in women with recurrent reproductive failure? Method of study: Retrospective study performed in a single infertility clinic from September 2016 to December 2017. A total of 690 women with unexplained history of recurrent miscarriage and/or recurrent implantation failure were consecutively recruited. IgA anti-transglutaminase 2 (TG2) antibody data were collected, as well as IgG anti-TG2 and IgA/IgG anti-deamidated gluten peptide (DGP) data in most cases, and IgG anti-gliadin antibodies occasionally. In selected women, HLA-DQ genotyping was requested. Biopsy was suggested to all women with positive serological results or belonging to CD risk groups. Reproductive outcomes were recorded from women with high suspicion of CD and a control group comprised of 49 women. Results: Anti-TG2-positive women comprised 1% of the sample. An additional 4% was observed considering less-specific antibodies (31 women). Only 39% of sero-positive women accepted duodenal biopsy. HLA and biopsy data discarded CD in 14 sero-positive cases (37%), only one with anti-TG2 antibodies. CD was suggested in 10 sero-positive and three sero-negative women (1.9%). Compared with controls, the live birthrate of the studied women with probable CD was significantly decreased before gluten removal of the diet (P = .015), but significantly increased after that (P = .020). Conclusion: One percent CD prevalence should be expected after anti-TG2 serological screening. However, more sensitive approaches should be explored, especially considering the potential beneficial effect of the gluten-free diet on the reproductive outcomes of women with CD.
MeSH term(s)	Abortion, Habitual/etiology ; Abortion, Habitual/prevention & control ; Adult ; Antibody Specificity ; Antigens/immunology ; Autoantibodies/blood ; Autoantibodies/immunology ; Autoantigens/immunology ; Biopsy ; Celiac Disease/complications ; Celiac Disease/diagnosis ; Celiac Disease/diet therapy ; Celiac Disease/immunology ; Delayed Diagnosis ; Diet, Gluten-Free ; Duodenum/pathology ; Embryo Implantation, Delayed ; Female ; Fertilization in Vitro ; GTP-Binding Proteins/immunology ; Gliadin/immunology ; HLA Antigens/genetics ; Humans ; Immunoglobulin A/blood ; Immunoglobulin G/blood ; Live Birth ; Middle Aged ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Transglutaminases/immunology
Chemical Substances	Antigens ; Autoantibodies ; Autoantigens ; HLA Antigens ; Immunoglobulin A ; Immunoglobulin G ; Gliadin (9007-90-3) ; transglutaminase 2 (EC 2.3.2.-) ; Transglutaminases (EC 2.3.2.13) ; GTP-Binding Proteins (EC 3.6.1.-)
Language	English
Publishing date	2019-11-24
Publishing country	Denmark
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604542-x
ISSN	1600-0897 ; 0271-7352 ; 8755-8920 ; 1046-7408
ISSN (online)	1600-0897
ISSN	0271-7352 ; 8755-8920 ; 1046-7408
DOI	10.1111/aji.13209
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Zs.A 1653: Show issues

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Article ; Online: Gamma delta

Fernández-Bañares, Fernando / Crespo, Laura / Núñez, Concepción / López-Palacios, Natalia / Tristán, Eva / Vivas, Santiago / Farrais, Sergio / Arau, Beatriz / Vidal, Judith / Roy, Garbiñe / Esteve, Maria

Alimentary pharmacology & therapeutics

2020 Volume 51, Issue 7, Page(s) 699–705

Abstract: Background: The causes of seronegative villous atrophy can be grouped as coeliac or noncoeliac related. There is no consensus on how to approach subjects with seronegative coeliac disease.: Aim: To evaluate the accuracy of both an increase in CD3: ... ...

Abstract	Background: The causes of seronegative villous atrophy can be grouped as coeliac or noncoeliac related. There is no consensus on how to approach subjects with seronegative coeliac disease. Aim: To evaluate the accuracy of both an increase in CD3 Methods: Sixty-seven consecutive patients with seronegative villous atrophy were included. Duodenal biopsies to assess TCRγδ Results: Coeliac disease was diagnosed in 37 patients and noncoeliac villous atrophy in 30. Coeliac patients were younger (39 ± 3 vs 55 ± 3 years; P = 0.001), more often showed HLA-DQ2/8 (97.6% vs 61%; P = 0.002) and had a more severe histology (61% vs 32% Marsh 3b-c; P = 0.055), as compared to noncoeliac ones. Coeliac lymphogram was associated with a sensitivity of 87% (CI, 73.7-95) and specificity of 96.7% (82.7-99.9), whereas evaluating only TCRγδ Conclusions: Coeliac lymphogram was associated with a high level of diagnostic evidence either against or in favour of coeliac disease in patients with seronegative villous atrophy.
MeSH term(s)	Adult ; Atrophy/complications ; Atrophy/diagnosis ; Atrophy/immunology ; Atrophy/pathology ; Biopsy ; Case-Control Studies ; Celiac Disease/blood ; Celiac Disease/diagnosis ; Celiac Disease/immunology ; Celiac Disease/pathology ; Disease Progression ; Female ; Flow Cytometry ; Humans ; Intestinal Mucosa/immunology ; Intestinal Mucosa/pathology ; Intestines/immunology ; Intestines/pathology ; Intraepithelial Lymphocytes/metabolism ; Intraepithelial Lymphocytes/pathology ; Lymphocyte Count ; Male ; Middle Aged ; Predictive Value of Tests ; Prodromal Symptoms ; Prognosis ; Receptors, Antigen, T-Cell, gamma-delta/metabolism ; Reproducibility of Results ; Sensitivity and Specificity ; Serologic Tests
Chemical Substances	Receptors, Antigen, T-Cell, gamma-delta
Language	English
Publishing date	2020-02-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1111/apt.15663
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Zs.A 2206: Show issues

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Article ; Online: Activated gut-homing CD8

Fernández-Bañares, Fernando / López-Palacios, Natalia / Corzo, María / Arau, Beatriz / Rubio, Mercedes / Fernández-Prieto, Marta / Tristán, Eva / Pujals, Mar / Farrais, Sergio / Horta, Saúl / Hernández, Juana María / Gomez-Perosanz, Marta / Reche, Pedro A / Esteve, María / Núñez, Concepción

BMC medicine

2021 Volume 19, Issue 1, Page(s) 237

Abstract: Background: The diagnosis of coeliac disease (CD) in individuals that have started a gluten-free diet (GFD) without an adequate previous diagnostic work-out is a challenge. Several immunological assays such as IFN-γ ELISPOT have been developed to avoid ... ...

Abstract	Background: The diagnosis of coeliac disease (CD) in individuals that have started a gluten-free diet (GFD) without an adequate previous diagnostic work-out is a challenge. Several immunological assays such as IFN-γ ELISPOT have been developed to avoid the need of prolonged gluten challenge to induce the intestinal damage. We aimed to evaluate the diagnostic accuracy of activated gut-homing CD8 Methods: A total of 22 CD patients and 48 non-CD subjects, all of them following a GFD, underwent a 3-day 10-g gluten challenge. The percentage of two T cell subsets (CD8 Results: Significant differences between the percentage of the two studied subsets of CD8 Conclusions: The results provide a highly accurate blood test for CD diagnosis in patients on a GFD of easy implementation in daily clinical practice.
MeSH term(s)	CD8-Positive T-Lymphocytes ; Celiac Disease/diagnosis ; Diet, Gluten-Free ; Flow Cytometry ; Glutens ; Humans
Chemical Substances	Glutens (8002-80-0)
Language	English
Publishing date	2021-10-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1741-7015
ISSN (online)	1741-7015
DOI	10.1186/s12916-021-02116-z
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Article ; Online: Coeliac Disease in Elderly Patients: Value of Coeliac Lymphogram for Diagnosis.

Nutrients

2021 Volume 13, Issue 9

Abstract	(1) Background: Although a meta-analysis reported that the sensitivity of CD3+ TCRγδ+ cells for coeliac disease diagnosis was >93%, a recent study has suggested that sensitivity decreased to 65% in elderly patients. (2) Aim: To evaluate whether the sensitivity of intraepithelial lymphocyte cytometric patterns for coeliac disease diagnosis changes with advanced age. (3) Methods: We performed a multicentre study including 127 coeliac disease patients ≥ 50 years: 87 with baseline cytometry (45 aged 50-59 years; 23 aged 60-69 years; 19 aged ≥ 70 years), 16 also with a follow-up cytometry (on a gluten-free diet); and 40 with only follow-up cytometry. (4) Results: In Marsh 3 patients, a sensitivity of 94.7%, 88.9% and 86.7% was observed for each age group using a cut-off value of TCRγδ+ >10% (
MeSH term(s)	Aged ; Celiac Disease/diagnosis ; Celiac Disease/immunology ; Female ; Flow Cytometry ; Geriatric Assessment/methods ; Humans ; Intestinal Mucosa/immunology ; Lymphocyte Count/methods ; Lymphocyte Count/statistics & numerical data ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity
Language	English
Publishing date	2021-08-27
Publishing country	Switzerland
Document type	Journal Article ; Multicenter Study
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu13092984
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Article: CX3CL1–CX3CR1 Axis: A New Player in Coeliac Disease Pathogenesis

Fernández-Prieto, Marta / Fernández-Aceñero, María Jesús / López-Palacios, Natalia / Bodas, Andrés / Farrais, Sergio / Cuevas, David / Pascual, Virginia / Cerón-Nieto, M. Ángeles / Horta-Herrera, Saúl / Espino-Paisán, Laura / Salazar, Isabel / Núñez, Concepción

Nutrients. 2019 Oct. 23, v. 11, no. 11

2019

Abstract: Background: The CX3CL1–CX3CR1 axis has been related to numerous diseases. The aim of our study was to investigate its involvement in coeliac disease (CD) pathogenesis, particularly in the early phase of the disease. Methods: We collected peripheral blood ...

Abstract	Background: The CX3CL1–CX3CR1 axis has been related to numerous diseases. The aim of our study was to investigate its involvement in coeliac disease (CD) pathogenesis, particularly in the early phase of the disease. Methods: We collected peripheral blood from CD patients and controls, enrolled in a 3-day gluten challenge, to study soluble CX3CL1, I-TAC and MIG by Luminex, CX3CL1 and CX3CR1 gene expression by qPCR, and CX3CR1 protein expression in monocytes and CD8+, CD4+ and γδ+ T cells, by flow cytometry. We also analysed the expression of the CX3CL1 and CX3CR1 mRNA and protein in the duodenal biopsies of CD patients with active and treated disease, and in non-CD control individuals, by qPCR and immunohistochemistry. Results: After the gluten challenge, increased levels of CX3CL1, I-TAC and MIG proteins were observed in the peripheral blood of CD patients, with no changes in CX3CL1 mRNA, or CX3CR1 mRNA and protein. Regarding duodenal tissue, CX3CL1 was absent or barely present in the superficial and basal epithelium of CD patients, contrasting with the moderate to high levels present in controls. Conclusions: CX3CL1 seems to be involved in the appearance and progression of CD, and it appears to be a potential diagnostic biomarker. Its use as an alternative therapeutic target in CD deserves further research.
Keywords	CXCR3 receptor ; T-lymphocytes ; biomarkers ; biopsy ; celiac disease ; chemokine CX3CL1 ; epithelium ; flow cytometry ; gene expression ; gluten ; immunohistochemistry ; messenger RNA ; monocytes ; pathogenesis ; patients ; protein synthesis ; quantitative polymerase chain reaction
Language	English
Dates of publication	2019-1023
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu11112551
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Article ; Online: CX3CL1-CX3CR1 Axis: A New Player in Coeliac Disease Pathogenesis.

Fernández-Prieto, Marta / Fernández-Aceñero, María Jesús / López-Palacios, Natalia / Bodas, Andrés / Farrais, Sergio / Cuevas, David / Pascual, Virginia / Cerón-Nieto, M Ángeles / Horta-Herrera, Saúl / Espino-Paisán, Laura / Salazar, Isabel / Núñez, Concepción

Nutrients

2019 Volume 11, Issue 11

Abstract: Background: The CX3CL1-CX3CR1 axis has been related to numerous diseases. The aim of our study was to investigate its involvement in coeliac disease (CD) pathogenesis, particularly in the early phase of the disease.: Methods: We collected peripheral ... ...

Abstract	Background: The CX3CL1-CX3CR1 axis has been related to numerous diseases. The aim of our study was to investigate its involvement in coeliac disease (CD) pathogenesis, particularly in the early phase of the disease. Methods: We collected peripheral blood from CD patients and controls, enrolled in a 3-day gluten challenge, to study soluble CX3CL1, I-TAC and MIG by Luminex, Results: After the gluten challenge, increased levels of CX3CL1, I-TAC and MIG proteins were observed in the peripheral blood of CD patients, with no changes in Conclusions: CX3CL1 seems to be involved in the appearance and progression of CD, and it appears to be a potential diagnostic biomarker. Its use as an alternative therapeutic target in CD deserves further research.
MeSH term(s)	Adolescent ; Adult ; CX3C Chemokine Receptor 1/genetics ; CX3C Chemokine Receptor 1/metabolism ; Celiac Disease/genetics ; Celiac Disease/immunology ; Celiac Disease/metabolism ; Chemokine CX3CL1/genetics ; Chemokine CX3CL1/metabolism ; Female ; Gene Expression Regulation/physiology ; Genetic Predisposition to Disease ; Glutens/immunology ; Humans ; Hypersensitivity/immunology ; Male ; Middle Aged ; Young Adult
Chemical Substances	CX3C Chemokine Receptor 1 ; CX3CL1 protein, human ; CX3CR1 protein, human ; Chemokine CX3CL1 ; Glutens (8002-80-0)
Language	English
Publishing date	2019-10-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu11112551
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Article ; Online: Expression patterns common and unique to ulcerative colitis and celiac disease.

Medrano, Luz María / Pascual, Virginia / Bodas, Andrés / López-Palacios, Natalia / Salazar, Isabel / Espino-Paisán, Laura / González-Pérez, Beatriz / Urcelay, Elena / Mendoza, Juan Luis / Núñez, Concepción

Annals of human genetics

2018 Volume 83, Issue 2, Page(s) 86–94

Abstract: Autoimmune diseases like celiac disease (CeD) and ulcerative colitis (UC) show a common genetic background defined by the existence of shared susceptibility loci. We aimed to go deeper into this common genetic background through performing a cross- ... ...

Abstract	Autoimmune diseases like celiac disease (CeD) and ulcerative colitis (UC) show a common genetic background defined by the existence of shared susceptibility loci. We aimed to go deeper into this common genetic background through performing a cross-disease study based on gene expression. We measured the expression of 21 genes located in 13 CeD-UC susceptibility regions, and 10 genes in five CeD risk regions. Determinations were carried out in colon/rectum samples from 13 UC patients (inflamed and uninflamed tissue) and four colon samples from controls. Duodenal samples from 19 CeD patients and 12 controls were used for comparisons. Differences were analyzed using the Bayesian method. The shared chromosomal regions containing TNFAIP3, PTPN2, ICOSLG, C1orf106, and IL21 showed similar results in both diseases. FASLG, PLEK, CCR4, and TAGAP, all located in CeD risk loci, were up-regulated in both CeD and UC patients. Finally, ZFP36L1, ZMIZ1, PUS10, UBE2L3, and BACH2 showed opposite results in CeD and UC. A high complexity underlies autoimmune common susceptibility loci, as the expression pattern of the studied genes does not always correlate with the one expected attending to the apparent genetic background. Differentially expressed genes such as ZFP36L1, ZMIZ1, PUS10, and BACH2 deserve further research in autoimmune diseases.
MeSH term(s)	Adult ; Bayes Theorem ; Case-Control Studies ; Celiac Disease/genetics ; Colitis, Ulcerative/genetics ; Colon ; Genetic Predisposition to Disease ; Humans
Language	English
Publishing date	2018-11-06
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	333-5
ISSN	1469-1809 ; 0003-4800
ISSN (online)	1469-1809
ISSN	0003-4800
DOI	10.1111/ahg.12293
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