{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:08:33Z","timestamp":1789391313795,"version":"build-2803163510"},"reference-count":54,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Parkinson\u2019s disease (PD) is a neurodegenerative disease with a heterogeneous nature. Many molecular pathways are engaged in PD pathogenesis. Granzyme B (GrB) is an enzyme released by CTLs and has roles in neuroinflammation, axonal degeneration, demyelination, and neuronal ischemic death. However, little is reported about its role in PD pathogenesis and deterioration. To evaluate the role of GrB in PD. Method: A total of 94 participants were recruited from outpatient neurology clinics (47 PD patients and 47 healthy controls). Serum GrB levels were measured using ELISA. Results: Among PD patients, the age of onset was 57.30 \u00b1 4.92 years, and the duration of illness was 7.13 \u00b1 4.20 years. Sociodemographic data revealed statistically significant associations between the development of PD and HCV infection (0.001*), family history of neuropsychiatric illness (0.004*), and\/or PD (0.028*). MoCA TS showed a significant reduction in cognitive performance among PD patients even after correction (p &lt; 0.001*). H_Y score showed that &gt;50% of PD patients were clustered in stages 1 and 2, and motor scores showed a substantial reduction. GrB levels were markedly increased among PD patients compared with the control group (1721.4 \u00b1 588.8 pg\/mL vs. 418.4 \u00b1 131.3 pg\/mL) (p &lt; 0.001*). This indicates a strong association between elevated granzyme B and PD. However, no statistically significant correlations were observed between GrB levels and the parameters studied. Conclusion: GrB levels are significantly elevated among PD patients. This reflects underlying immune activation or inflammatory processes associated with the progression of PD. GrB showed a promising diagnostic association with PD, but was not correlated with disease severity, activity, or duration in this cohort. Formal evaluation of GrB\u2019s diagnostic accuracy in an independent, disease-control-inclusive cohort is warranted before it can be considered a diagnostic biomarker.<\/jats:p>","DOI":"10.3390\/jcm15187115","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:09:51Z","timestamp":1789387791000},"page":"7115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Granzyme B in Parkinson\u2019s Disease: A Case\u2013Control Study of Diagnostic Association"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2244-4005","authenticated-orcid":false,"given":"Marwa Fareed","family":"Almulhim","sequence":"first","affiliation":[{"name":"Internal Medicine Department, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Shimaa","family":"Elgamal","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Department, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh 33516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5603-1303","authenticated-orcid":false,"given":"Amany A.","family":"Ghazy","sequence":"additional","affiliation":[{"name":"Microbiology and Immunology Unit, Department of Pathology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia"},{"name":"Medical Microbiology & Immunology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh 35111, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0514-3556","authenticated-orcid":false,"given":"Sally A.","family":"Saleh","sequence":"additional","affiliation":[{"name":"Medical Microbiology & Immunology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh 35111, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar A.","family":"Eissa","sequence":"additional","affiliation":[{"name":"Medical Microbiology & Immunology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh 35111, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2819-9793","authenticated-orcid":false,"given":"Salma A.","family":"Shatara","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Kafrelsheikh University, Kafr El Sheikh 35111, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Youssef A.","family":"Shatara","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Alexandria National University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman K.","family":"Rashwan","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, Jouf University, Sakaka 42421, Saudi Arabia"},{"name":"Department of Physiology, Faculty of Medicine, Al-Azhar University, Assuit 71524, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Moamen Abdelfadil","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Capital University, Cairo 11795, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"ref_1","first-page":"S257","article-title":"Defining Parkinson\u2019s disease: Past and future","volume":"14","author":"Kulcsarova","year":"2024","journal-title":"J. Park. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1176\/jnp.14.2.223","article-title":"An essay on the shaking palsy","volume":"14","author":"Parkinson","year":"2002","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"17013","DOI":"10.1038\/nrdp.2017.13","article-title":"Parkinson\u2019s disease","volume":"3","author":"Poewe","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Guatteo, E., Berretta, N., Monda, V., Ledonne, A., and Mercuri, N.B. (2022). Pathophysiological features of nigral dopaminergic neurons in animal models of Parkinson\u2019s disease. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23094508"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/ene.14108","article-title":"Parkinson disease","volume":"27","author":"Balestrino","year":"2020","journal-title":"Eur. J. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"a008888","DOI":"10.1101\/cshperspect.a008888","article-title":"Genetics of Parkinson\u2019s disease","volume":"2","author":"Klein","year":"2012","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.omto.2021.03.003","article-title":"In vivo CAR T-cell imaging: Paving the way for success in CAR T-cell therapy","volume":"20","author":"Sakemura","year":"2021","journal-title":"Mol. Ther. Oncolytics"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wang, T., Lee, M.H., Choi, E., Pardo-Villamizar, C.A., Lee, S.B., Yang, I.H., Calabresi, P.A., and Nath, A. (2012). Granzyme B-induced neurotoxicity is mediated via activation of PAR-1 receptor and Kv1.3 channel. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0043950"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.molmed.2012.09.009","article-title":"Granzyme B in injury, inflammation, and repair","volume":"18","author":"Hiebert","year":"2012","journal-title":"Trends Mol. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"491","DOI":"10.4049\/jimmunol.1401214","article-title":"Granzymes regulate proinflammatory cytokine responses","volume":"194","author":"Wensink","year":"2015","journal-title":"J. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Velotti, F., Barchetta, I., Cimini, F.A., and Cavallo, M.G. (2020). Granzyme B in inflammatory diseases: Apoptosis, inflammation, extracellular matrix remodeling, epithelial-to-mesenchymal transition and fibrosis. Front Immunol., 11.","DOI":"10.3389\/fimmu.2020.587581"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/1753465809341965","article-title":"The possible role of granzyme B in the pathogenesis of chronic obstructive pulmonary disease","volume":"3","author":"Ngan","year":"2009","journal-title":"Ther. Adv. Respir. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1002\/ijc.25135","article-title":"Granzyme B is expressed in urothelial carcinoma and promotes cancer cell invasion","volume":"127","author":"Pisu","year":"2010","journal-title":"Int. J. Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"752","DOI":"10.2164\/jandrol.111.015164","article-title":"A possible role for perforin and granzyme B in resveratrol-enhanced radiosensitivity of prostate cancer","volume":"33","author":"Fang","year":"2012","journal-title":"J. Androl."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13046-016-0302-6","article-title":"Epithelial-to-mesenchymal transition and invasion are upmodulated by tumor-expressed granzyme B and inhibited by docosahexaenoic acid in human colorectal cancer cells","volume":"35","author":"Loria","year":"2016","journal-title":"J. Exp. Clin. Cancer Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.freeradbiomed.2024.09.041","article-title":"Inhibition of GrB activity ameliorates cognitive dysfunction by reducing demyelination in diabetic mice","volume":"225","author":"Yang","year":"2024","journal-title":"Free Radic. Biol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.12740\/PP\/45368","article-title":"Is the Montreal Cognitive Assessment test better suited than the Mini-Mental State Examination in mild cognitive impairment detection?","volume":"50","author":"Ciesielska","year":"2016","journal-title":"Psychiatr. Pol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1212\/WNL.50.2.318","article-title":"Parkinsonism: Onset, progression, and mortality","volume":"50","author":"Hoehn","year":"1998","journal-title":"Neurology"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Trezzi, I., Rizzo, G., Giampieri, F., Battino, M., and Baroni, L. (2026). Exploring the role of food and food-related compounds in Parkinson\u2019s disease. Foods, 15.","DOI":"10.3390\/foods15030514"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1038\/s41531-026-01276-0","article-title":"Altered cerebrovascular haemodynamics in Parkinson\u2019s disease: Insights from 4D flow MRI","volume":"12","author":"Deane","year":"2026","journal-title":"NPJ Park. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Castelli, L., Iacovelli, C., Malizia, A.M., Loreti, C., Biscotti, L., Caliandro, P., Bentivoglio, A.R., Calabresi, P., and Giovannini, S. (2026). Assessment of Fall Risk in Neurological Disorders and Technology: Relationship Between Silver Index and Gait Analysis. Sensors, 26.","DOI":"10.3390\/s26030840"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1146\/annurev-pathmechdis-031521-034145","article-title":"Genetics and pathogenesis of Parkinson\u2019s syndrome","volume":"18","author":"Ye","year":"2023","journal-title":"Annu. Rev. Pathol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Harraz, M.M. (2023). Selective dopaminergic vulnerability in Parkinson\u2019s disease: New insights into the role of DAT. Front. Neurosci., 17.","DOI":"10.3389\/fnins.2023.1219441"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/j.molmed.2024.07.010","article-title":"Granzyme B in aging and age-related pathologies","volume":"30","author":"Richardson","year":"2024","journal-title":"Trends Mol. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1212\/WNL.0000000000002307","article-title":"Hepatitis C virus infection as a risk factor for Parkinson disease: A nationwide cohort study","volume":"86","author":"Tsai","year":"2016","journal-title":"Neurology"},{"key":"ref_27","first-page":"597","article-title":"Hepatitis C virus infection and risk of Parkinson\u2019s disease: A systematic review and meta-analysis","volume":"52","author":"Wijarnpreecha","year":"2018","journal-title":"Eur. J. Clin. Gastroenterol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1111\/jvh.13346","article-title":"Association between viral hepatitis infection and Parkinson\u2019s disease: A population-based prospective study","volume":"27","author":"Choi","year":"2020","journal-title":"J. Viral Hepat."},{"key":"ref_29","unstructured":"Liu, X., Li, Y., Qin, X., Li, Q., Wang, T., and Liu, Y. (2018). Familial aggregation of Parkinson\u2019s disease. BMJ Open, 8."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Torti, M., Fossati, C., Casali, M., Cilia, R., Zecchinelli, A.L., and Pezzoli, G. (2020). Effect of family history, occupation and diet on the risk of Parkinson disease: A case-control study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243612"},{"key":"ref_31","first-page":"660","article-title":"Family history in Parkinson\u2019s disease","volume":"29","author":"Cilia","year":"2014","journal-title":"Mov. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1212\/WNL.0b013e3181c34b47","article-title":"Validity of the MoCA in Parkinson disease","volume":"73","author":"Hoops","year":"2009","journal-title":"Neurology"},{"key":"ref_33","first-page":"1717","article-title":"MoCA as a screening tool in PD","volume":"75","author":"MacAskill","year":"2010","journal-title":"Neurology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1212\/WNL.0000000000000066","article-title":"Characterizing mild cognitive impairment in incident Parkinson disease: The ICICLE-PD study","volume":"82","author":"Yarnall","year":"2014","journal-title":"Neurology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.21037\/qims-21-579","article-title":"White matter damage in patients with mild cognitive impairment in Parkinson\u2019s disease","volume":"12","author":"Li","year":"2022","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.parkreldis.2014.10.026","article-title":"Parkinson\u2019s disease severity levels and MDS-Unified Parkinson\u2019s Disease Rating Scale","volume":"21","author":"Alvarez","year":"2015","journal-title":"Park. Relat. Disord."},{"key":"ref_37","first-page":"1765220","article-title":"An investigation into the use and meaning of Parkinson\u2019s disease clinical scale scores","volume":"1","author":"Hendricks","year":"2021","journal-title":"Park. Dis."},{"key":"ref_38","first-page":"215","article-title":"Motor symptom variability in Parkinson\u2019s disease: Implications for personalized trial outcomes?","volume":"40","author":"Meinders","year":"2025","journal-title":"Mov. Disord."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/mds.30114","article-title":"Rigidity in Parkinson\u2019s Disease: The Objective Effect of Levodopa","volume":"40","author":"Falletti","year":"2025","journal-title":"Mov. Disord."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4258","DOI":"10.1007\/s00415-021-10550-5","article-title":"Structural MRI substrate of long-duration response to levodopa in Parkinson\u2019s disease: An exploratory study","volume":"268","author":"Donzuso","year":"2021","journal-title":"J. Neurol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1038\/s41582-026-01185-z","article-title":"Towards Biomarker-based diagnosis of Parkinson disease","volume":"22","author":"Tolosa","year":"2026","journal-title":"Nat. Rev. Neurol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.neuroscience.2026.02.017","article-title":"Glutamate chemical exchange saturation transfer imaging reveals cerebellar glutamatergic alterations in Parkinson\u2019s disease subtypes","volume":"601","author":"Minglong","year":"2026","journal-title":"Neuroscience"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1186\/s12974-021-02287-9","article-title":"T lymphocyte senescence is attenuated in Parkinson\u2019s disease","volume":"18","author":"Kouli","year":"2021","journal-title":"J. Neuroinflamm."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5368","DOI":"10.1007\/s00415-022-11190-z","article-title":"Changes of T lymphocyte subpopulations and their roles in predicting the risk of Parkinson\u2019s disease","volume":"269","author":"He","year":"2022","journal-title":"J. Neurol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"108240","DOI":"10.1016\/j.parkreldis.2026.108240","article-title":"Association between the triglyceride-glucose frailty index and parkinson\u2019s disease in middle-aged and older adults: A comparative cross-national analysis of nhanes and charls","volume":"145","author":"Ou","year":"2026","journal-title":"Park. Relat. Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1038\/s41531-025-00981-6","article-title":"Differential memory enrichment of cytotoxic CD4 T cells in Parkinson\u2019s disease patients reactive to \u03b1-synuclein","volume":"11","author":"Freuchet","year":"2025","journal-title":"NPJ Park. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3717","DOI":"10.1093\/brain\/awaa269","article-title":"CD8 T cell nigral infiltration precedes synucleinopathy in early stages of Parkinson\u2019s disease","volume":"143","author":"Torra","year":"2020","journal-title":"Brain"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"5020","DOI":"10.1523\/JNEUROSCI.0311-10.2010","article-title":"Activated T-cells inhibit neurogenesis by releasing granzyme B: Rescue by Kv1. 3 blockers","volume":"30","author":"Wang","year":"2010","journal-title":"J. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s12974-017-0901-y","article-title":"Protease-activated receptor-1 activation by granzyme B causes neurotoxicity that is augmented by interleukin-1\u03b2","volume":"14","author":"Lee","year":"2017","journal-title":"J. Neuroinflamm."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1038\/s43587-021-00049-z","article-title":"Accumulation of cytotoxic T cells in the aged CNS leads to axon degeneration and contributes to cognitive and motor decline","volume":"1","author":"Groh","year":"2021","journal-title":"Nat. Aging"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e199850","DOI":"10.1172\/JCI199850","article-title":"Immune signaling and function in neurodegeneration","volume":"136","author":"Latour","year":"2026","journal-title":"J. Clin. Investig."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1038\/s41586-019-1895-7","article-title":"Clonally expanded CD8 T cells patrol the cerebrospinal fluid in Alzheimer\u2019s disease","volume":"577","author":"Gate","year":"2020","journal-title":"Nature"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"7461","DOI":"10.1038\/s41467-023-43053-0","article-title":"Early-to-mid stage idiopathic Parkinson\u2019s disease shows enhanced cytotoxicity and differentiation in CD8 T-cells in females","volume":"14","author":"Capelle","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"106308","DOI":"10.1016\/j.nbd.2023.106308","article-title":"Relevance of tissue-resident memory CD8 T cells in the onset of Parkinson\u2019s disease and examination of its possible etiologies: Infectious or autoimmune?","volume":"187","author":"Roch","year":"2023","journal-title":"Neurobiol. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:51:03Z","timestamp":1789390263000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":54,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187115"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187115","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]}}}