{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:51:54Z","timestamp":1791597114285,"version":"4.3.4"},"reference-count":45,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["2023.153859.PEX"],"award-info":[{"award-number":["2023.153859.PEX"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2023.153859.PEX"],"award-info":[{"award-number":["2023.153859.PEX"]}],"id":[{"id":"https:\/\/ror.org\/00snfqn58","id-type":"ROR","asserted-by":"publisher"}]},{"name":"National Funds","award":["RISE-Health-UID\/06397\/2025"],"award-info":[{"award-number":["RISE-Health-UID\/06397\/2025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Myocardial fibrosis is a major pathological component of cardiac remodelling and contributes to ventricular stiffness, impaired myocardial function, heart failure progression, and arrhythmic vulnerability across a broad spectrum of cardiomyopathies. In hypertrophic cardiomyopathy (HCM), fibrotic remodelling encompasses both diffuse interstitial matrix expansion and focal replacement fibrosis and is closely associated with disease severity and adverse clinical outcomes. Cardiac magnetic resonance (CMR), using late gadolinium enhancement (LGE) and quantitative parametric mapping, is central to non-invasive myocardial tissue characterization. LGE primarily identifies focal areas of replacement fibrosis and scar, whereas native T1, T2, and extracellular volume (ECV) mapping provide complementary information on diffuse myocardial and interstitial tissue abnormalities, including extracellular matrix expansion. However, these techniques characterize the structural and tissue-level consequences of myocardial injury and remodelling rather than directly visualizing the cellular processes underlying fibroblast activation. Fibroblast activation protein inhibitor positron emission tomography (FAPI PET) has emerged as a promising molecular imaging approach for assessing active fibroblast-mediated tissue remodelling. By targeting fibroblast activation protein (FAP), a cell-surface serine protease upregulated in activated fibroblasts and myofibroblasts. FAPI radiotracers may provide a molecular readout of accessible FAP expression that complements structural and tissue characterization by CMR. This review examines the cellular and molecular mechanisms underlying active myocardial remodelling, with particular emphasis on transforming growth factor-\u03b21 (TGF-\u03b21)\/Smad signalling, fibroblast-to-myofibroblast transition, FAP expression, and extracellular matrix turnover. We critically evaluate the current clinical evidence for FAPI PET\/CT and hybrid PET\/CMR across cardiomyopathies, focusing on HCM while also considering ischemic, inflammatory, infiltrative, and other non-ischemic forms of cardiac remodelling. Particular attention is given to the relationship between myocardial FAPI uptake, CMR tissue characterization, ventricular function, circulating biomarkers, and calculated arrhythmic risk. Although initial studies support the complementary value of FAPI PET and CMR for characterizing active and established myocardial remodelling, the available evidence remains limited by small, predominantly single-centre cohorts, heterogeneous radiotracers and acquisition protocols, and the absence of validated quantitative thresholds or prospective outcome data. Larger longitudinal studies are required to determine whether FAPI PET can provide incremental prognostic information or serve as a reproducible imaging biomarker for disease progression and therapeutic response.<\/jats:p>","DOI":"10.3390\/ijms27198901","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:13:02Z","timestamp":1791367982000},"page":"8901","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tracking Active Fibroblast-Mediated Tissue Remodelling in Cardiomyopathies: Translational Insights from FAPI PET Imaging"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7010-2104","authenticated-orcid":false,"given":"In\u00eas","family":"Fortuna","sequence":"first","affiliation":[{"name":"RISE-Health, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8388-1848","authenticated-orcid":false,"given":"Janete","family":"Santos","sequence":"additional","affiliation":[{"name":"RISE-Health, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7692-0343","authenticated-orcid":false,"given":"Paula","family":"Soeiro","sequence":"additional","affiliation":[{"name":"RISE-Health, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Nuclear Medicine, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, E.P.E., 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3708-4529","authenticated-orcid":false,"given":"Raquel","family":"Machado","sequence":"additional","affiliation":[{"name":"RISE-Health, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Escola Superior de Sa\u00fade, Instituto Polit\u00e9cnico do Porto, 4200-072 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, E.P.E., 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Pereira","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, E.P.E., 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8291-9517","authenticated-orcid":false,"given":"Giuseppe","family":"Limongelli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche Traslazionali, Universit\u00e0 della Campania \u201cLuigi Vanvitelli\u201d, AORN Colli, Ospedale Monaldi, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0495-8219","authenticated-orcid":false,"given":"Teresa","family":"Faria","sequence":"additional","affiliation":[{"name":"RISE-Health, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Nuclear Medicine, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, E.P.E., 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6944-2953","authenticated-orcid":false,"given":"Elisabete","family":"Martins","sequence":"additional","affiliation":[{"name":"RISE-Health, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal"},{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Cardiology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, E.P.E., 4200-319 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"2023 ESC Guidelines for the management of cardiomyopathies","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1016\/j.jacc.2024.02.014","article-title":"2024 AHA\/ACC\/AMSSM\/HRS\/PACES\/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy","volume":"83","author":"Ommen","year":"2024","journal-title":"JACC"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.jacc.2021.11.021","article-title":"Management of Hypertrophic Cardiomyopathy","volume":"79","author":"Maron","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.jcmg.2012.09.018","article-title":"Myocardial Fibrosis in Hypertrophic Cardiomyopathy","volume":"6","author":"Moravsky","year":"2013","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e003090","DOI":"10.1161\/CIRCHEARTFAILURE.116.003090","article-title":"Histological and Histometric Characterization of Myocardial Fibrosis in End-Stage Hypertrophic Cardiomyopathy: A Clinical-Pathological Study of 30 Explanted Hearts","volume":"9","author":"Galati","year":"2016","journal-title":"Circ. Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.mam.2018.07.001","article-title":"Cardiac fibrosis: Cell biological mechanisms, molecular pathways and therapeutic opportunities","volume":"65","author":"Frangogiannis","year":"2019","journal-title":"Mol. Asp. Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pelliccia, F., Cecchi, F., Olivotto, I., and Camici, P. (2022). Microvascular Dysfunction in Hypertrophic Cardiomyopathy. J. Clin. Med., 11.","DOI":"10.3390\/jcm11216560"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.jacc.2009.04.072","article-title":"The Case for Myocardial Ischemia in Hypertrophic Cardiomyopathy","volume":"54","author":"Maron","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13550-021-00761-2","article-title":"Clinical results of fibroblast activation protein (FAP) specific PET for non-malignant indications: Systematic review","volume":"11","author":"Windisch","year":"2021","journal-title":"EJNMMI Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1093\/cvr\/cvaa324","article-title":"Cardiac fibrosis","volume":"117","author":"Frangogiannis","year":"2021","journal-title":"Cardiovasc. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.jacc.2010.11.013","article-title":"Assessment of Myocardial Fibrosis With Cardiovascular Magnetic Resonance","volume":"57","author":"Mewton","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1161\/CIRCULATIONAHA.113.007094","article-title":"Prognostic Value of Quantitative Contrast-Enhanced Cardiovascular Magnetic Resonance for the Evaluation of Sudden Death Risk in Patients With Hypertrophic Cardiomyopathy","volume":"130","author":"Chan","year":"2014","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.yjmcc.2015.08.016","article-title":"Fibroblast activation protein alpha expression identifies activated fibroblasts after myocardial infarction","volume":"87","author":"Tillmanns","year":"2015","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/prca.201300095","article-title":"Understanding fibroblast activation protein (FAP): Substrates, activities, expression and targeting for cancer therapy","volume":"8","author":"Hamson","year":"2014","journal-title":"Proteom. Clin. Appl."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.2967\/jnumed.119.226993","article-title":"Molecular Imaging of Fibroblast Activity After Myocardial Infarction Using a68 Ga-Labeled Fibroblast Activation Protein Inhibitor, FAPI-04","volume":"60","author":"Varasteh","year":"2019","journal-title":"J. Nucl. Med."},{"key":"ref_16","first-page":"1415","article-title":"Development of Quinoline-Based Theranostic Ligands for the Targeting of Fibroblast Activation Protein","volume":"59","author":"Lindner","year":"2018","journal-title":"J. Nucl. Med. Off. Publ. Soc. Nucl. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e221052","DOI":"10.1148\/radiol.221052","article-title":"Myocardial Activity at 18F-FAPI PET\/CT and Risk for Sudden Cardiac Death in Hypertrophic Cardiomyopathy","volume":"306","author":"Wang","year":"2023","journal-title":"Radiology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1007\/s00259-024-06878-5","article-title":"Enhanced detection of damaged myocardium and risk stratification in hypertrophic cardiomyopathy using integrated [68Ga]Ga-FAPI-04 PET\/CMR imaging","volume":"52","author":"Ding","year":"2024","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e220749","DOI":"10.1148\/radiol.220749","article-title":"FAPI PET: Fibroblast Activation Protein Inhibitor Use in Oncologic and Nononcologic Disease","volume":"306","author":"Mori","year":"2023","journal-title":"Radiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1172\/JCI98215","article-title":"Specialized fibroblast differentiated states underlie scar formation in the infarcted mouse heart","volume":"128","author":"Fu","year":"2018","journal-title":"J. Clin. Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3770","DOI":"10.1172\/JCI94753","article-title":"Fibroblast-specific TGF-\u03b2\u2013Smad2\/3 signaling underlies cardiac fibrosis","volume":"127","author":"Khalil","year":"2017","journal-title":"J. Clin. Investig."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"102106","DOI":"10.1016\/j.nuclcard.2024.102106","article-title":"Cardiovascular positron emission tomography imaging of fibroblast activation: A review of the current literature","volume":"47","author":"Loganath","year":"2025","journal-title":"J. Nucl. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1007\/s00259-023-06411-0","article-title":"Functional significance of myocardial activity at 18F-FAPI PET\/CT in hypertrophic cardiomyopathy identified by cardiac magnetic resonance feature-tracking strain analysis","volume":"51","author":"Zhang","year":"2023","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"104119","DOI":"10.1016\/j.lpm.2022.104119","article-title":"Cardiac functional imaging","volume":"51","author":"Azarine","year":"2022","journal-title":"Presse Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1053\/j.semnuclmed.2024.03.005","article-title":"Molecular Imaging of Heart Failure: An Update and Future Trends","volume":"54","author":"Saraste","year":"2024","journal-title":"Semin. Nucl. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jcmg.2025.09.004","article-title":"Cardiac Fibroblast Activation May Precede Myocardial Tissue Remodeling in Hypertrophic Cardiomyopathy","volume":"19","author":"Wang","year":"2026","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.jacc.2024.10.103","article-title":"Myocardial Fibroblast Activation After Acute Myocardial Infarction","volume":"85","author":"Barton","year":"2025","journal-title":"JACC"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2967\/jnumed.124.269002","article-title":"SNMMI Procedure Standard\/EANM Practice Guideline for Fibroblast Activation Protein (FAP) PET","volume":"66","author":"Hope","year":"2025","journal-title":"J. Nucl. Med."},{"key":"ref_29","first-page":"845","article-title":"Preliminary exploration of 18F-FAPI PET\/CT imaging in hypertrophic cardiomyopathy: Comparison with cardiac magnetic resonance","volume":"43","author":"Zhang","year":"2022","journal-title":"J. Cap. Med. Univ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1007\/s00259-025-07424-7","article-title":"Incidental myocardial uptake of 68Ga-FAPI-04 caused by hypertrophic cardiomyopathy in a patient with Immunoglobulin G4-related disease","volume":"53","author":"Liu","year":"2026","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1097\/RLU.0000000000003745","article-title":"Visualization of Fibroblast Activation After Myocardial Infarction Using 68Ga-FAPI PET","volume":"46","author":"Kessler","year":"2021","journal-title":"Clin. Nucl. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101340","DOI":"10.1016\/j.ijcha.2024.101340","article-title":"Delayed 68Ga-FAPI-46 PET\/MR imaging confirms ongoing fibroblast activation in patients after acute myocardial infarction","volume":"50","author":"Kupusovic","year":"2024","journal-title":"IJC Heart Vasc."},{"key":"ref_33","first-page":"495","article-title":"68Ga-FAPI PET\/CT for molecular assessment of fibroblast activation in right heart in pulmonary arterial hypertension: A single-center, pilot study","volume":"30","author":"Gu","year":"2023","journal-title":"J. Nucl. Cardiol. Off. Publ. Am. Soc. Nucl. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Chandekar, K.R., Prashanth, A., Vinjamuri, S., and Kumar, R. (2023). FAPI PET\/CT Imaging\u2014An Updated Review. Diagnostics, 13.","DOI":"10.3390\/diagnostics13122018"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Finke, D., Heckmann, M.B., Herpel, E., Katus, H.A., Haberkorn, U., Leuschner, F., and Lehmann, L.H. (2021). Early Detection of Checkpoint Inhibitor-Associated Myocarditis Using 68Ga-FAPI PET\/CT. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.614997"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.jcmg.2025.05.021","article-title":"Comparison of 18F-FAPI-42 PET for Detecting Cardiac Fibroblast Activation in Dilated Cardiomyopathy With Histopathology and CMR","volume":"18","author":"Liang","year":"2025","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"ytac005","DOI":"10.1093\/ehjcr\/ytac005","article-title":"Cardiac fibroblast activation detected by 68Gallium-FAPI-46 positron emission tomography\u2013magnetic resonance imaging as a sign of chronic activity in cardiac sarcoidosis","volume":"6","author":"Siebermair","year":"2022","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Wu, Q., Song, J., Liu, W., Li, L., and Li, S. (2024). Recent advances in positron emission tomography for detecting early fibrosis after myocardial infarction. Front. Cardiovasc. Med., 11.","DOI":"10.3389\/fcvm.2024.1479777"},{"key":"ref_39","first-page":"1415","article-title":"Cardiac Fibroblast Activation in Patients Early After Acute Myocardial Infarction: Integration with MR Tissue Characterization and Subsequent Functional Outcome","volume":"63","author":"Diekmann","year":"2022","journal-title":"J. Nucl. Med. Off. Publ. Soc. Nucl. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2786","DOI":"10.1007\/s00259-021-05674-9","article-title":"Fibroblast activation protein imaging in reperfused ST-elevation myocardial infarction: Comparison with cardiac magnetic resonance imaging","volume":"49","author":"Xie","year":"2022","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"ytae189","DOI":"10.1093\/ehjcr\/ytae189","article-title":"Tissue-level evidence of fibroblast activation protein inhibitor imaging in hypertrophic obstructive cardiomyopathy: A case series","volume":"8","author":"Li","year":"2024","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"ytac419","DOI":"10.1093\/ehjcr\/ytac419","article-title":"Cardiac fibroblast activation in Fabry disease on 18F-fibroblast activation protein inhibitor positron emission tomography\/computed tomography imaging","volume":"6","author":"Wang","year":"2022","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e003537","DOI":"10.1136\/openhrt-2025-003537","article-title":"Prognostic value of cardiac fibroblast activation heterogeneity assessed by FAPI PET radiomics in hypertrophic cardiomyopathy: A proof-of-concept study","volume":"13","author":"Song","year":"2026","journal-title":"Open Heart"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.7150\/thno.69475","article-title":"Fibroblast activation protein-based theranostics in cancer research: A state-of-the-art review","volume":"12","author":"Zhao","year":"2022","journal-title":"Theranostics"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"20250110","DOI":"10.1002\/VIW.20250110","article-title":"Recent implications of FAPI PET in cardiac diseases","volume":"6","author":"Wang","year":"2025","journal-title":"VIEW"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8901\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:44:53Z","timestamp":1791596693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8901"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":45,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["ijms27198901"],"URL":"https:\/\/doi.org\/10.3390\/ijms27198901","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]}}}