{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:00:22Z","timestamp":1792789222868,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Heart, Lung, and Blood Institute of the National Institutes of Health","award":["K08 HL141652"],"award-info":[{"award-number":["K08 HL141652"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Heart, Lung, and Blood Institute of the National Institutes of Health","award":["R01 HL156275"],"award-info":[{"award-number":["R01 HL156275"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Heart, Lung, and Blood Institute of the National Institutes of Health","award":["R44 HL164156"],"award-info":[{"award-number":["R44 HL164156"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"crossref"}]},{"award":["K08 HL141652"],"award-info":[{"award-number":["K08 HL141652"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01 HL156275"],"award-info":[{"award-number":["R01 HL156275"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R44 HL164156"],"award-info":[{"award-number":["R44 HL164156"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>The clinical potential of probiotics is increasingly recognized; however, dependence on microbial viability, formulation and storage constraints, and safety considerations in vulnerable populations can limit their broader application. Postbiotics offer an alternative by providing inanimate microbial preparations with retained biological activity, yet whether heat inactivation preserves the functional effects of probiotic-derived candidates remains an important question. Here, we compare Lactiplantibacillus plantarum RSB11 in its live (RSB11 life) and heat-inactivated (RSB11-HI) forms across human cell models representing the gut, lung, ovary, bone, kidney, and liver. Following inflammatory challenge with lipopolysaccharide or Escherichia coli, we assessed MMP-9 expression and the pro-inflammatory cytokines TNF-\u03b1, IL-6, and IL-1\u03b2. Both RSB11 life and RSB11-HI broadly suppressed inflammatory responses, with RSB11-HI maintaining effects comparable to the live preparation across the MMP-9 and cytokine endpoints, where the two forms were tested side by side, and demonstrating greater suppression in selected experimental contexts. Additionally, RSB11-HI increased \u03b2-glucuronidase and estradiol levels relative to untreated controls in a gut\u2013ovarian conditioned-medium model, suggesting effects extending beyond inflammatory modulation; a live comparator was not included in the \u03b2-glucuronidase measurements, so this effect is not established as specific to the inactivated form. Collectively, these findings demonstrate that heat inactivation preserves key biological functions of RSB11 and support RSB11-HI as a multifunctional candidate postbiotic with potential for expanded formulation and application.<\/jats:p>","DOI":"10.3390\/cells15191736","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:03:26Z","timestamp":1790172206000},"page":"1736","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heat-Inactivated Lactiplantibacillus plantarum (RSB11) as a Multifunctional Postbiotic: Anti-Inflammatory Effects Compared with Live RSB11 Across Multiple Human Cell Models"],"prefix":"10.3390","volume":"15","author":[{"given":"Teodora","family":"Nicola","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Tanmaya","family":"Madhvacharyula","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4354-1467","authenticated-orcid":false,"given":"Ajay","family":"Ashok","sequence":"additional","affiliation":[{"name":"Schepens Eye Research Institute of Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Aryan","family":"Mandot","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3994-8582","authenticated-orcid":false,"given":"Iman","family":"Abdelgawad","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Ryaan","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Kara","family":"Siedman","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Youfeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0731-9092","authenticated-orcid":false,"given":"Namasivayam","family":"Ambalavanan","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"},{"name":"Lung Health Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9071-4047","authenticated-orcid":false,"given":"Charitharth Vivek","family":"Lal","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA"},{"name":"Lung Health Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA"},{"name":"Marnix Heersink Institute of Biomedical Innovation, University of Alabama at Birmingham, Birmingham, AL 35233, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.pharmthera.2007.10.001","article-title":"Tumor necrosis factor antagonist mechanisms of action: A comprehensive review","volume":"117","author":"Tracey","year":"2008","journal-title":"Pharmacol. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1186\/ar1917","article-title":"Interleukin-6 and chronic inflammation","volume":"8","author":"Gabay","year":"2006","journal-title":"Arthritis Res. Ther."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1002\/hep.29491","article-title":"Inflammasome-mediated inflammation and fibrosis: It is more than just the IL-1\u03b2","volume":"67","author":"Amir","year":"2018","journal-title":"Hepatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1089\/107999001750069953","article-title":"Production of matrix metalloproteinase-9 in CaCO-2 cells in response to inflammatory stimuli","volume":"21","author":"Gan","year":"2001","journal-title":"J. Interferon Cytokine Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"(2010). Sorokin, The impact of the extracellular matrix on inflammation. Nat. Rev. Immunol., 10, 712\u2013723.","DOI":"10.1038\/nri2852"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.maturitas.2017.06.025","article-title":"Estrogen\u2013gut microbiome axis: Physiological and clinical implications","volume":"103","author":"Baker","year":"2017","journal-title":"Maturitas"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Smolinska, S., Popescu, F.-D., and Zemelka-Wiacek, M. (2025). A Review of the Influence of Prebiotics, Probiotics, Synbiotics, and Postbiotics on the Human Gut Microbiome and Intestinal Integrity. J. Clin. Med., 14.","DOI":"10.3390\/jcm14113673"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.chom.2015.12.016","article-title":"Taking it Personally: Personalized Utilization of the Human Microbiome in Health and Disease","volume":"19","author":"Zmora","year":"2016","journal-title":"Cell Host Microbe"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Piqu\u00e9, N., Berlanga, M., and Mi\u00f1ana-Galbis, D. (2019). Health benefits of heat-killed (Tyndallized) probiotics: An overview. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20102534"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Zhou, P., Chen, C., Patil, S., and Dong, S. (2024). Unveiling the therapeutic symphony of probiotics, prebiotics, and postbiotics in gut-immune harmony. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1355542"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wenger, N.M., Qiao, L., Nicola, T., Nizami, Z., Xu, X., Willis, K.A., Ambalavanan, N., Gaggar, A., and Lal, C.V. (2022). Efficacy of a probiotic and herbal supplement in models of lung inflammation. Microorganisms, 10.","DOI":"10.3389\/fnut.2023.1168582"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1038\/s41575-022-00628-4","article-title":"The International Scientific Association of Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of postbiotics","volume":"19","author":"Salminen","year":"2022","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2185034","DOI":"10.1080\/19490976.2023.2185034","article-title":"Emerging issues in probiotic safety: 2023 perspectives","volume":"15","author":"Merenstein","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jff.2014.04.030","article-title":"Probiotic functional foods: Survival of probiotics during processing and storage","volume":"9","author":"Tripathi","year":"2014","journal-title":"J. Funct. Foods"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"108756","DOI":"10.1016\/j.lwt.2019.108756","article-title":"Development of a probiotic non-fermented blend beverage with ju\u00e7ara fruit: Effect of the matrix on probiotic viability and survival to the gastrointestinal tract","volume":"118","author":"Gomes","year":"2020","journal-title":"LWT"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"407","DOI":"10.12688\/f1000research.7630.1","article-title":"Probiotics in critically ill children","volume":"5","author":"Singhi","year":"2016","journal-title":"F1000Research"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s12098-008-0119-1","article-title":"Probiotic use in the critically ILL","volume":"75","author":"Singhi","year":"2008","journal-title":"Indian J. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Katkowska, M., Garbacz, K., and Kusiak, A. (2021). Probiotics: Should All Patients Take Them?. Microorganisms, 9.","DOI":"10.3390\/microorganisms9122620"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Vinderola, G., Sanders, M.E., and Salminen, S. (2022). The Concept of Postbiotics. Foods, 11.","DOI":"10.3390\/foods11081077"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Aggarwal, S., Sabharwal, V., Kaushik, P., Joshi, A., Aayushi, A., and Suri, M. (2022). Postbiotics: From emerging concept to application. Front. Sustain. Food Syst., 6.","DOI":"10.3389\/fsufs.2022.887642"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40104-022-00688-1","article-title":"Gut health benefit and application of postbiotics in animal production","volume":"13","author":"Zhong","year":"2022","journal-title":"J. Anim. Sci. Biotechnol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.bbrc.2008.07.063","article-title":"In vitro model to estimate gut inflammation using co-cultured Caco-2 and RAW264.7 cells","volume":"374","author":"Tanoue","year":"2008","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e13425","DOI":"10.1111\/eci.13425","article-title":"Let-7 mediated airway remodelling in chronic obstructive pulmonary disease via the regulation of IL-6","volume":"51","author":"Di","year":"2021","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1007\/s00404-012-2456-6","article-title":"Matrix metalloproteinase-9 expression correlates with prognosis and involved in ovarian cancer cell invasion","volume":"286","author":"Hu","year":"2012","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1002\/jbmr.5650050904","article-title":"Osteocalcin secretion by the human osteosarcoma cell line MG-63","volume":"5","author":"Lajeunesse","year":"1990","journal-title":"J. Bone Mineral. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1111\/j.1464-410X.2009.09001.x","article-title":"Novel in vitro model for studying ureteric stent-induced cell injury","volume":"105","author":"Elwood","year":"2010","journal-title":"BJU Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s10565-016-9316-2","article-title":"The HepaRG cell line, a superior in vitro model to L-02, HepG2 and hiHeps cell lines for assessing drug-induced liver injury","volume":"32","author":"Wu","year":"2016","journal-title":"Cell Biol. Toxicol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"18586","DOI":"10.1074\/jbc.RA119.010950","article-title":"Gut microbial \u03b2-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens","volume":"294","author":"Ervin","year":"2019","journal-title":"J. Biol. Chem."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Skrzypczak-Wiercioch, A., and Sa\u0142at, K. (2022). Lipopolysaccharide-Induced Model of Neuroinflammation: Mechanisms of Action, Research Application and Future Directions for Its Use. Molecules, 27.","DOI":"10.3390\/molecules27175481"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5978","DOI":"10.3748\/wjg.v12.i37.5978","article-title":"Lactobacilli, bifidobacteria and E. coli nissle induce pro- and anti-inflammatory cytokines in peripheral blood mononuclear cells","volume":"12","author":"Helwig","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_31","unstructured":"(2026, July 10). Resbiotic. Available online: www.resbiotic.com."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"7113","DOI":"10.1038\/s41467-024-51169-0","article-title":"A lactobacilli-based inhaled live biotherapeutic product attenuates pulmonary neutrophilic inflammation","volume":"15","author":"Nicola","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"24021","DOI":"10.1038\/s41598-024-76153-y","article-title":"Clinical trial of the effects of postbiotic supplementation on inflammation, oxidative stress, and clinical outcomes in patients with CVA","volume":"14","author":"Rahimi","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Asefa, Z., Belay, A., Welelaw, E., and Haile, M. (2025). Postbiotics and their biotherapeutic potential for chronic disease and their feature perspective: A review. Front. Microbiomes, 4.","DOI":"10.3389\/frmbi.2025.1489339"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e70057","DOI":"10.1002\/imt2.270","article-title":"Gut\u2013X axis","volume":"4","author":"Lin","year":"2025","journal-title":"Imeta"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Guo, H., Pan, L., Wu, Q., Wang, L., Huang, Z., Wang, J., Wang, L., Fang, X., Dong, S., and Zhu, Y. (2025). Type 2 Diabetes and the Multifaceted Gut-X Axes. Nutrients, 17.","DOI":"10.3390\/nu17162708"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2400754","DOI":"10.1002\/mnfr.202400754","article-title":"Postbiotics as Antiinflammatory and Immune-Modulating Bioactive Compounds in Metabolic Dysfunction-Associated Steatotic Liver Disease","volume":"68","author":"Yilmaz","year":"2024","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_38","first-page":"djw029","article-title":"The Intestinal Microbiome and Estrogen Receptor\u2013Positive Female Breast Cancer","volume":"108","author":"Kwa","year":"2016","journal-title":"JNCI J. Natl. Cancer Inst."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"100908","DOI":"10.1016\/j.psj.2020.12.011","article-title":"Supplementation of postbiotic RI11 improves antioxidant enzyme activity, upregulated gut barrier genes, and reduced cytokine, acute phase protein, and heat shock protein 70 gene expression levels in heat-stressed broilers","volume":"100","author":"Humam","year":"2021","journal-title":"Poult. Sci."},{"key":"ref_40","first-page":"18567","article-title":"Probiotic viability\u2013does it matter?","volume":"23","author":"Lahtinen","year":"2012","journal-title":"Microb. Ecol. Health Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"109502","DOI":"10.1016\/j.foodres.2020.109502","article-title":"Postbiotics and paraprobiotics: From concepts to applications","volume":"136","author":"Liceaga","year":"2020","journal-title":"Food Res. Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e13287","DOI":"10.1111\/1541-4337.13287","article-title":"Drying of probiotics to enhance the viability during preparation, storage, food application, and digestion: A review","volume":"23","author":"Wang","year":"2024","journal-title":"Compr. Rev. Food Sci. Food Saf."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"17562848211035670","DOI":"10.1177\/17562848211035670","article-title":"Probiotics use is associated with improved clinical outcomes among hospitalized patients with COVID-19","volume":"14","author":"Zhang","year":"2021","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.clnesp.2021.09.004","article-title":"Probiotic supplementation improves clinical outcomes and quality of life indicators in patients with plaque psoriasis: A randomized double-blind clinical trial","volume":"46","author":"Moludi","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2236749","DOI":"10.1080\/19490976.2023.2236749","article-title":"Gut microbial beta-glucuronidase: A vital regulator in female estrogen metabolism","volume":"15","author":"Hu","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Woodruff, T.J., Janssen, S.J., Guillette, L.J., and Giudice, L.C. (2010). Mechanisms of Endocrine Disruption. Environmental Impacts on Reproductive Health Fertility, Cambridge University Press.","DOI":"10.1017\/CBO9780511674686"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"\u017b\u00f3\u0142kiewicz, J., Marzec, A., Ruszczy\u0144ski, M., and Feleszko, W. (2020). Postbiotics\u2014A Step Beyond Pre- and Probiotics. Nutrients, 12.","DOI":"10.3390\/nu12082189"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e002359","DOI":"10.1136\/rmdopen-2022-002359","article-title":"A systematic literature review informing the consensus statement on efficacy and safety of pharmacological treatment with interleukin-6 pathway inhibition with biological DMARDs in immune-mediated inflammatory diseases","volume":"8","author":"Kastrati","year":"2022","journal-title":"RMD Open"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"503","DOI":"10.3109\/14397595.2014.1001475","article-title":"Cost-effectiveness of tocilizumab, a humanized anti-interleukin-6 receptor monoclonal antibody, versus methotrexate in patients with rheumatoid arthritis using real-world data from the IORRA observational cohort study","volume":"25","author":"Tanaka","year":"2015","journal-title":"Mod. Rheumatol."}],"container-title":["Cells"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4409\/15\/19\/1736\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:10:20Z","timestamp":1790172620000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4409\/15\/19\/1736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":49,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["cells15191736"],"URL":"https:\/\/doi.org\/10.3390\/cells15191736","relation":{},"ISSN":["2073-4409"],"issn-type":[{"value":"2073-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]}}}