{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:28:11Z","timestamp":1785432491471,"version":"3.56.0"},"reference-count":57,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01ES031259"],"award-info":[{"award-number":["R01ES031259"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"award":["R01ES031259"],"award-info":[{"award-number":["R01ES031259"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Genes"],"abstract":"<jats:p>Background\/Objectives: Spaceflight presents a combination of physical and psychosocial stressors that may impact biological aging and health. Understanding how spaceflight influences molecular aging processes is essential as commercial and professional space travel continue to expand. Methods: We analyzed publicly available DNA methylation data to evaluate longitudinal changes in 10 epigenetic aging biomarkers, 6 leukocyte proportion estimates, and 109 DNA methylation-derived protein scores in two astronauts participating in Axiom Space\u2019s AX1 17-day low Earth orbit mission. We calculated mean values for all biomarkers across three timepoints: two weeks before spaceflight (T0), 24 h after spaceflight (T1), and three months after spaceflight (T2). Using the mean values, we next calculated the fold change from baseline for all biomarkers. Because the sample size precluded statistical testing, we identified the top 5% of absolute fold changes to highlight the largest shifts across candidate biomarkers. Results: Across epigenetic clocks, MiAge showed the greatest T0\u2013T1 decrease (\u22124.26-fold), and DNAmFitAge showed the greatest T0\u2013T2 increase (2.47-fold). NK cells exhibited the largest T0\u2013T1 change, decreasing by 49% (\u22120.49-fold). B cells exhibited the largest T0\u2013T2 change, decreasing by 11% (\u22120.11-fold). Proteins meeting a predefined top 5% fold change from baseline criterion at both T1 and T2, included BMP1, CLEC11A, CXCL11, FAP, and LTF. Enrichment analysis indicated involvement of serine-type endopeptidase activity, molecular function activator activity, and cell aggregation pathways. Conclusions: These findings suggest that spaceflight influences methylation-derived biomarkers of aging and immunity even in short-duration missions. These results, though exploratory, contribute to emerging efforts to characterize molecular resilience and vulnerability in human spaceflight.<\/jats:p>","DOI":"10.3390\/genes17050564","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:07:26Z","timestamp":1779206846000},"page":"564","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Blood Epigenetic Aging, DNA Methylation-Predicted Protein, and Estimated Leukocyte Proportion Trends in Two Astronauts from the Axiom Space Mission 1: An Exploratory Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0356-4867","authenticated-orcid":false,"given":"Jamaji C.","family":"Nwanaji-Enwerem","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Center for Health Justice, Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Ground Ravdin, HUP, 3400 Spruce Street, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Khodasevich","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jermaine","family":"Blakley","sequence":"additional","affiliation":[{"name":"College of Medicine, Howard University, Washington, DC 20059, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4153-0249","authenticated-orcid":false,"given":"Jonathan M.","family":"Galazka","sequence":"additional","affiliation":[{"name":"Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2284-3298","authenticated-orcid":false,"given":"Andres","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA 94305, USA"},{"name":"Department of Pediatrics, Stanford University, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1038\/s41568-020-0265-y","article-title":"Tumour Predisposition and Cancer Syndromes as Models to Study Gene-Environment Interactions","volume":"20","author":"Carbone","year":"2020","journal-title":"Nat. Rev. Cancer"},{"key":"ref_2","first-page":"e64936","article-title":"Decoding Cancer Risk: Understanding Gene-Environment Interactions in Cancer Development","volume":"16","author":"Sandhu","year":"2024","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Obrycka, P., Soczy\u0144ska, J., Buty\u0144ska, K., Fr\u0105tczak, A., Ha\u0142aburdo, J., Gawe\u0142czyk, W., and Wo\u017aniak, S. (2026). Impact of Early-Life Environmental Exposures and Potential Transgenerational Influence on the Risk of Coronary Artery Disease and Heart Failure. Cells, 15.","DOI":"10.3390\/cells15030222"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103394","DOI":"10.1016\/j.neuro.2026.103394","article-title":"The Impact of Military Occupational Combustion Smoke Inhalation on Neuroinflammation and Brain Health","volume":"113","author":"White","year":"2026","journal-title":"Neurotoxicology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"103509","DOI":"10.1016\/j.msksp.2026.103509","article-title":"Understanding the Relationship between Sleep, Psychological and Musculoskeletal Health from a Neuroimmune Perspective","volume":"2026","author":"Klyne","year":"2026","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Alhazzaa, O.A., Abahussin, H.M., Majrashi, M.A., Alotaibi, M.S., Alkhrayef, M.N., Alhamdan, Z.A., and Alawad, A.O. (2026). Molecular Pathways Linking Chronic Psychological Stress to Accelerated Aging: Mechanisms and Interventions. Front. Aging, 7.","DOI":"10.3389\/fragi.2026.1743142"},{"key":"ref_7","first-page":"142","article-title":"Risk of Cancer Mortality Among the Longitudinal Study of Astronaut Health (LSAH) Participants","volume":"69","author":"Hamm","year":"1998","journal-title":"Aviat. Space Environ. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Gigu\u00e8re, R., Marois, A., Fortin-Guichard, D., Charest, J., Rocheleau, J., Thompson, K., Stolberg, M., St-Martin, P., Bergouignan, A., and Niaussat, V. (2025). Space Exploration and Lifestyle Medicine: A Narrative Review of Its Implications for Astronaut Health and Remote Earth-Based Environments. Front. Physiol., 16.","DOI":"10.3389\/fphys.2025.1729596"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1136\/oemed-2020-107143","article-title":"Cancer Incidence and Mortality in the USA Astronaut Corps, 1959\u20132017","volume":"78","author":"Reynolds","year":"2021","journal-title":"Occup. Environ. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1007\/s40279-021-01496-9","article-title":"Effects of Spaceflight on Musculoskeletal Health: A Systematic Review and Meta-Analysis, Considerations for Interplanetary Travel","volume":"51","author":"Comfort","year":"2021","journal-title":"Sports Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"117257","DOI":"10.12998\/wjcc.v14.i3.117257","article-title":"Ocular Health in Outer Space and beyond Gravity: A Minireview","volume":"14","author":"Khullar","year":"2026","journal-title":"World J. Clin. Cases"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.mayocp.2022.04.003","article-title":"Long-Term Cardiovascular Risk in Astronauts: Comparing NASA Mission Astronauts with a Healthy Cohort from the Cooper Center Longitudinal Study","volume":"97","author":"Charvat","year":"2022","journal-title":"Mayo Clin. Proc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s40572-018-0203-2","article-title":"DNA Methylation Age-Environmental Influences, Health Impacts, and Its Role in Environmental Epidemiology","volume":"5","author":"Dhingra","year":"2018","journal-title":"Curr. Environ. Health Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2427889","DOI":"10.1001\/jamanetworkopen.2024.27889","article-title":"Sociodemographic and Lifestyle Factors and Epigenetic Aging in US Young Adults: NIMHD Social Epigenomics Program","volume":"7","author":"Harris","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_15","first-page":"408","article-title":"Exposome-Wide Association Study of Environmental Chemical Exposures and Epigenetic Aging in the National Health and Nutrition Examination Survey","volume":"17","author":"Khodasevich","year":"2025","journal-title":"Aging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"573","DOI":"10.18632\/aging.101414","article-title":"An Epigenetic Biomarker of Aging for Lifespan and Healthspan","volume":"10","author":"Levine","year":"2018","journal-title":"Aging"},{"key":"ref_17","first-page":"9484","article-title":"DNA Methylation GrimAge Version 2","volume":"14","author":"Lu","year":"2022","journal-title":"Aging"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"R115","DOI":"10.1186\/gb-2013-14-10-r115","article-title":"DNA Methylation Age of Human Tissues and Cell Types","volume":"14","author":"Horvath","year":"2013","journal-title":"Genome Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"108406","DOI":"10.1016\/j.celrep.2020.108406","article-title":"A Longitudinal Epigenetic Aging and Leukocyte Analysis of Simulated Space Travel: The Mars-500 Mission","volume":"33","author":"Galazka","year":"2020","journal-title":"Cell Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e70360","DOI":"10.1111\/acel.70360","article-title":"Astronauts as a Human Aging Model: Epigenetic Age Responses to Space Exposure","volume":"25","author":"Fuentealba","year":"2026","journal-title":"Aging Cell"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e71802","DOI":"10.7554\/eLife.71802","article-title":"Epigenetic Scores for the Circulating Proteome as Tools for Disease Prediction","volume":"11","author":"Gadd","year":"2022","journal-title":"eLife"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1080\/17501911.2025.2570119","article-title":"DNA Methylation-Predicted Protein Differences between Yakutian and Central Russian Populations","volume":"17","author":"Khodasevich","year":"2025","journal-title":"Epigenomics"},{"key":"ref_23","first-page":"e123","article-title":"SeSAMe: Reducing Artifactual Detection of DNA Methylation by Infinium BeadChips in Genomic Deletions","volume":"46","author":"Zhou","year":"2018","journal-title":"Nucleic Acids Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"btae302","DOI":"10.1093\/bioinformatics\/btae302","article-title":"Methscore: A Comprehensive R Function for DNA Methylation-Based Health Predictors","volume":"40","author":"Xu","year":"2024","journal-title":"Bioinformatics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1758","DOI":"10.18632\/aging.101508","article-title":"Epigenetic Clock for Skin and Blood Cells Applied to Hutchinson Gilford Progeria Syndrome and Ex Vivo Studies","volume":"10","author":"Horvath","year":"2018","journal-title":"Aging"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"giaa049","DOI":"10.1093\/gigascience\/giaa049","article-title":"Ewastools: Infinium Human Methylation BeadChip Pipeline for Population Epigenetics Integrated into Galaxy","volume":"9","author":"Murat","year":"2020","journal-title":"Gigascience"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Reinius, L.E., Acevedo, N., Joerink, M., Pershagen, G., Dahl\u00e9n, S.-E., Greco, D., S\u00f6derh\u00e4ll, C., Scheynius, A., and Kere, J. (2012). Differential DNA Methylation in Purified Human Blood Cells: Implications for Cell Lineage and Studies on Disease Susceptibility. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0041361"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"303","DOI":"10.18632\/aging.101684","article-title":"DNA Methylation GrimAge Strongly Predicts Lifespan and Healthspan","volume":"11","author":"Lu","year":"2019","journal-title":"Aging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1038\/s43587-022-00248-2","article-title":"A Computational Solution for Bolstering Reliability of Epigenetic Clocks: Implications for Clinical Trials and Longitudinal Tracking","volume":"2","author":"Thrush","year":"2022","journal-title":"Nat. Aging"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e73420","DOI":"10.7554\/eLife.73420","article-title":"DunedinPACE, a DNA Methylation Biomarker of the Pace of Aging","volume":"11","author":"Belsky","year":"2022","journal-title":"eLife"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"5269","DOI":"10.1038\/s41467-022-32893-x","article-title":"Derivation and Validation of an Epigenetic Frailty Risk Score in Population-Based Cohorts of Older Adults","volume":"13","author":"Li","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"14617","DOI":"10.1038\/ncomms14617","article-title":"DNA Methylation Signatures in Peripheral Blood Strongly Predict All-Cause Mortality","volume":"8","author":"Zhang","year":"2017","journal-title":"Nat. Commun."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13073-023-01161-y","article-title":"Refining Epigenetic Prediction of Chronological and Biological Age","volume":"15","author":"Bernabeu","year":"2023","journal-title":"Genome Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3904","DOI":"10.18632\/aging.204538","article-title":"DNAmFitAge: Biological Age Indicator Incorporating Physical Fitness","volume":"15","author":"McGreevy","year":"2023","journal-title":"Aging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1080\/15592294.2017.1389361","article-title":"The MiAge Calculator: A DNA Methylation-Based Mitotic Age Calculator of Human Tissue Types","volume":"13","author":"Youn","year":"2018","journal-title":"Epigenetics"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13073-020-00752-3","article-title":"A Comparison of Epigenetic Mitotic-like Clocks for Cancer Risk Prediction","volume":"12","author":"Teschendorff","year":"2020","journal-title":"Genome Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"5895","DOI":"10.18632\/aging.102173","article-title":"DNA Methylation-Based Estimator of Telomere Length","volume":"11","author":"Lu","year":"2019","journal-title":"Aging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"W207","DOI":"10.1093\/nar\/gkad347","article-title":"G:Profiler\u2014Interoperable Web Service for Functional Enrichment Analysis and Gene Identifier Mapping (2023 Update)","volume":"51","author":"Kolberg","year":"2023","journal-title":"Nucleic Acids Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"eaau8650","DOI":"10.1126\/science.aau8650","article-title":"The NASA Twins Study: A Multidimensional Analysis of a Year-Long Human Spaceflight","volume":"364","author":"Darshi","year":"2019","journal-title":"Science"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.bbrc.2011.03.109","article-title":"Bone Morphogenetic Protein (BMP)1-3 Enhances Bone Repair","volume":"408","author":"Grgurevic","year":"2011","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1134\/S0362119717060068","article-title":"Bone Mineral Density and Molecular Genetic Markers of Bone Remodeling in Blood of Cosmonauts after Long-Term Missions on Board the International Space Station","volume":"43","author":"Novikov","year":"2017","journal-title":"Hum. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.cmet.2024.03.006","article-title":"An Integrated Multi-Omics Analysis Reveals Osteokines Involved in Global Regulation","volume":"36","author":"Liang","year":"2024","journal-title":"Cell Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.7150\/thno.39238","article-title":"Human Umbilical Cord Mesenchymal Stromal Cells-Derived Extracellular Vesicles Exert Potent Bone Protective Effects by CLEC11A-Mediated Regulation of Bone Metabolism","volume":"10","author":"Hu","year":"2020","journal-title":"Theranostics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"657","DOI":"10.2147\/OTT.S515119","article-title":"CXCL11: A Novel Biomarker in Colorectal Cancer as Metastasis Predictor","volume":"18","author":"Wibowo","year":"2025","journal-title":"OncoTargets Ther."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Metzemaekers, M., Vanheule, V., Janssens, R., Struyf, S., and Proost, P. (2018). Overview of the Mechanisms That May Contribute to the Non-Redundant Activities of Interferon-Inducible CXC Chemokine Receptor 3 Ligands. Front. Immunol., 8.","DOI":"10.3389\/fimmu.2017.01970"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"10732748241241162","DOI":"10.1177\/10732748241241162","article-title":"The Role of CXCL11 and Its Receptors in Cancer: Prospective but Challenging Clinical Targets","volume":"31","author":"Wang","year":"2024","journal-title":"Cancer Control."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4825","DOI":"10.1038\/s41467-024-48920-y","article-title":"Space Radiation Damage Rescued by Inhibition of Key Spaceflight Associated miRNAs","volume":"15","author":"McDonald","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s10555-020-09909-3","article-title":"The Role of Fibroblast Activation Protein in Health and Malignancy","volume":"39","author":"Fitzgerald","year":"2020","journal-title":"Cancer Metastasis Rev."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Rizzi, M., Manzoni, P., Germano, C., Quevedo, M.F., and Sainaghi, P.P. (2025). Lactoferrin, a Natural Protein with Multiple Functions in Health and Disease. Nutrients, 17.","DOI":"10.3390\/nu17213403"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"4273","DOI":"10.1038\/onc.2012.434","article-title":"Lactotransferrin Acts as a Tumor Suppressor in Nasopharyngeal Carcinoma by Repressing AKT through Multiple Mechanisms","volume":"32","author":"Deng","year":"2013","journal-title":"Oncogene"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1007\/s00018-008-7565-9","article-title":"Serine Peptidases: Classification, Structure and Function","volume":"65","author":"Page","year":"2008","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.actaastro.2012.08.029","article-title":"Changes in Urine Protein Composition in Human Organism during Long Term Space Flights","volume":"81","author":"Pastushkova","year":"2012","journal-title":"Acta Astronaut."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e24834","DOI":"10.1002\/jcla.24834","article-title":"Longitudinal Change of Serum Inter-Alpha-Trypsin Inhibitor Heavy Chain H4, and Its Correlation with Inflammation, Multiorgan Injury, and Death Risk in Sepsis","volume":"37","author":"Zhao","year":"2023","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1038\/s41392-024-02005-w","article-title":"Comprehensive Snapshots of Natural Killer Cells Functions, Signaling, Molecular Mechanisms and Clinical Utilization","volume":"9","author":"Chen","year":"2024","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3892\/ijmm.2025.5673","article-title":"Importance of B Cells (Review)","volume":"57","author":"Liu","year":"2025","journal-title":"Int. J. Mol. Med."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Mortazavi, S.M.J., Said-Salman, I., Mortazavi, A.R., El Khatib, S., and Sihver, L. (2024). How the Adaptation of the Human Microbiome to Harsh Space Environment Can Determine the Chances of Success for a Space Mission to Mars and Beyond. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1237564"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"27175","DOI":"10.1038\/s41598-025-13383-8","article-title":"Longitudinal Transcriptomic and Epigenetic Analysis of the Blood in Two Astronauts","volume":"15","author":"Ao","year":"2025","journal-title":"Sci. Rep."}],"container-title":["Genes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4425\/17\/5\/564\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:15:49Z","timestamp":1779207349000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4425\/17\/5\/564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":57,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["genes17050564"],"URL":"https:\/\/doi.org\/10.3390\/genes17050564","relation":{},"ISSN":["2073-4425"],"issn-type":[{"value":"2073-4425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]}}}