{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:01:53Z","timestamp":1791838913869,"version":"4.3.4"},"reference-count":44,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Janus kinase inhibitors (JAKi) have significantly advanced the treatment of various dermatological conditions by modulating the JAK-STAT signalling pathway. While these inhibitors have proven effective, they also pose challenges due to associated increase in serum lipid levels and relative potential cardiovascular risks. This perspective work aims to discuss the implications of these lipid alterations proposing management strategies for patients with dermatological disorders under JAKi treatments. Materials and Methods: This manuscript reviews existing and recent literature on the metabolic effects of JAKi, particularly focusing on their impact on lipid profiles in patients treated for dermatological diseases. Results: JAK inhibitors are consistently associated with an increase in both LDL and HDL levels shortly after treatment initiation, which tend to stabilise over time. Despite these changes, there is no clear evidence linking these alterations to an increased risk of major adverse cardiovascular events (MACE), indicating a complex interaction between lipid metabolism and JAK-STAT signalling. Conclusions: Although JAKi may induce lipid changes in patients, raising concerns, especially in ones with existing cardiovascular risks, currently there is no proven link to increased MACE in this population. Monitoring lipid levels, alongside lifestyle modifications and possible statin use, can manage these effects without the need to stopping treatment.<\/jats:p>","DOI":"10.3390\/medicina61010054","type":"journal-article","created":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T11:24:19Z","timestamp":1735730659000},"page":"54","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Serum Lipids Alterations in Patients Under Systemic JAK Inhibitors Treatments in Dermatology: Clinical Aspects and Management"],"prefix":"10.3390","volume":"61","author":[{"given":"Giovanni","family":"Paolino","sequence":"first","affiliation":[{"name":"Unit of Dermatology and Cosmetology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"},{"name":"Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9140-9263","authenticated-orcid":false,"given":"Mario","family":"Valenti","sequence":"additional","affiliation":[{"name":"Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8231-2205","authenticated-orcid":false,"given":"Andrea","family":"Carugno","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9859-4475","authenticated-orcid":false,"given":"Matteo","family":"Bianco","sequence":"additional","affiliation":[{"name":"Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Didona","sequence":"additional","affiliation":[{"name":"Rare Skin Diseases Center, Istituto Dermopatico dell\u2019Immacolata, IDI-IRCCS, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7199-0804","authenticated-orcid":false,"given":"Matteo Riccardo","family":"Di Nicola","sequence":"additional","affiliation":[{"name":"Unit of Dermatology and Cosmetology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"},{"name":"Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d\u2019Aosta, 10154 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Luigi","family":"Acutis","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d\u2019Aosta, 10154 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-951X","authenticated-orcid":false,"given":"Carmen","family":"Cantisani","sequence":"additional","affiliation":[{"name":"Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria Giulia","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Unit of Dermatology and Cosmetology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Zerbinati","sequence":"additional","affiliation":[{"name":"Department of Medicine and Innovation Technology (DiMIT), University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Narcisi","sequence":"additional","affiliation":[{"name":"Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santo Raffaele","family":"Mercuri","sequence":"additional","affiliation":[{"name":"Unit of Dermatology and Cosmetology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"},{"name":"Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.abd.2023.03.001","article-title":"JAK-STAT Pathway Inhibitors in Dermatology","volume":"98","author":"Miot","year":"2023","journal-title":"An. Bras. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jaad.2021.07.002","article-title":"Janus Kinase Inhibitors in Dermatology: Part I. A Comprehensive Review","volume":"86","author":"Chapman","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Shawky, A.M., Almalki, F.A., Abdalla, A.N., Abdelazeem, A.H., and Gouda, A.M. (2022). A Comprehensive Overview of Globally Approved JAK Inhibitors. Pharmaceutics, 14.","DOI":"10.3390\/pharmaceutics14051001"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1080\/13543784.2023.2199919","article-title":"JAK Inhibitors for Rheumatoid Arthritis","volume":"32","author":"Kubo","year":"2023","journal-title":"Expert Opin. Investig. Drugs"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Wei, Q., Wang, H., Zhao, J., Luo, Z., Wang, C., Zhu, C., Su, N., and Zhang, S. (2023). Cardiovascular Safety of Janus Kinase Inhibitors in Patients with Rheumatoid Arthritis: Systematic Review and Network Meta-Analysis. Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1237234"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Xue, C., Yao, Q., Gu, X., Shi, Q., Yuan, X., Chu, Q., Bao, Z., Lu, J., and Li, L. (2023). Evolving Cognition of the JAK-STAT Signaling Pathway: Autoimmune Disorders and Cancer. Signal Transduct. Target. Ther., 8.","DOI":"10.1038\/s41392-023-01468-7"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Chikhoune, L., Poggi, C., Moreau, J., Dubucquoi, S., Hachulla, E., Collet, A., and Launay, D. (Rev. M\u00e9d. Interne, 2024). JAK Inhibitors (JAKi): Mechanisms of Action and Perspectives in Systemic and Autoimmune Diseases, Rev. M\u00e9d. Interne, in press.","DOI":"10.1016\/j.revmed.2024.10.452"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hu, X., Li, J., Fu, M., Zhao, X., and Wang, W. (2021). The JAK\/STAT Signaling Pathway: From Bench to Clinic. Signal Transduct. Target. Ther., 6.","DOI":"10.1038\/s41392-021-00791-1"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/s10067-021-06003-z","article-title":"Effect of JAK Inhibitors on High- and Low-Density Lipoprotein in Patients with Rheumatoid Arthritis: A Systematic Review and Network Meta-Analysis","volume":"41","author":"Li","year":"2022","journal-title":"Clin. Rheumatol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Luo, S.-S., Chen, X.-L., Wang, A.-J., Liu, Q.-Y., Peng, M., Yang, C.-L., Zeng, D.-G., Zhao, Y.-Z., and Wang, H.-L. (2024). Identification, Functional Analysis of Chitin-Binding Proteins and the Association of Its Single Nucleotide Polymorphisms with Vibrio Parahaemolyticus Resistance in Penaeus Vannamei. Fish Shellfish Immunol., 154.","DOI":"10.1016\/j.fsi.2024.109966"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1124\/dmd.124.001750","article-title":"The Metabolism and Disposition of Brepocitinib in Humans and Characterization of the Formation Mechanism of an Aminopyridine Metabolite","volume":"52","author":"Dowty","year":"2024","journal-title":"Drug Metab. Dispos."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Lin, C.-H., Liu, W.-S., Wan, C., and Wang, H.-H. (2024). Effectiveness of Tofacitinib in Patients with Ulcerative Colitis: An Updated Systematic Review and Meta-Analysis of Real-World Studies. BMJ Open Gastroenterol., 11.","DOI":"10.1136\/bmjgast-2024-001347"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1007\/s12325-023-02490-5","article-title":"Real-Life Effectiveness and Tolerance of Upadacitinib for Severe Atopic Dermatitis in Adolescents and Adults","volume":"40","author":"Ghislain","year":"2023","journal-title":"Adv. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1002\/jpr3.12124","article-title":"Upadacitinib as Salvage Therapy in Adolescents with Acute Severe Ulcerative Colitis Refractory to Conventional Treatments","volume":"5","author":"Dickerson","year":"2024","journal-title":"JPGN Rep."},{"key":"ref_15","first-page":"930","article-title":"Abrocitinib: A Comprehensive Review of Its Efficacy and Safety in Dermatology","volume":"15","author":"Dogra","year":"2024","journal-title":"Indian Dermatol. Online J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"He, J., and Yang, Y. (2024). Janus Kinase 1 Inhibitor Abrocitinib for Isolated Nail Lichen Planus: A Case Report and Literature Review. J. Dermatol. Treat., 35.","DOI":"10.1080\/09546634.2024.2434094"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4128","DOI":"10.4103\/jfmpc.jfmpc_112_24","article-title":"JAK 1-3 Inhibitors and TYK-2 Inhibitors in Dermatology: Practical Pearls for the Primary Care Physician","volume":"13","author":"Beard","year":"2024","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1007\/s40257-021-00618-3","article-title":"Integrated Safety Analysis of Abrocitinib for the Treatment of Moderate-to-Severe Atopic Dermatitis From the Phase II and Phase III Clinical Trial Program","volume":"22","author":"Simpson","year":"2021","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Almoghayer, I.H.I., Soomro, A.M., Dev, S., Turesh, M., Kumar, A., Kumar, R., Meghjiani, A., Lamiya Mir, S., Hassaan, M., and Qureshi, R. (2024). Baricitinib as Monotherapy and with Topical Corticosteroids in Moderate-to-Severe Atopic Dermatitis: A Systematic Review and Meta-Analysis of Dose-Response. Front. Allergy, 5.","DOI":"10.3389\/falgy.2024.1486271"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Orion, D., Itsekson-Hayosh, Z., Peretz, S., Mendel, R., Yaniv, G., Attia, M., and Grizim-Merkel, D. (2022). Janus Kinase-2 V617F Mutation and Antiphospholipid Syndrome in Cerebral Sinus Venous Thrombosis: Natural History and Retrospective Bicenter Analysis. Front. Neurol., 13.","DOI":"10.3389\/fneur.2022.783795"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Aceituno, D., Fawsitt, C.G., Power, G.M., Law, E., Vaghela, S., and Thom, H. (J. Eur. Acad. Dermatol. Venereol., 2024). Systematic Review and Indirect Treatment Comparisons of Ritlecitinib against Baricitinib in Alopecia Areata, J. Eur. Acad. Dermatol. Venereol., early view.","DOI":"10.1111\/jdv.20372"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1080\/17425255.2024.2401603","article-title":"Unraveling Ritlecitinib: An in-Depth Analysis of JAK3 Inhibitor for the Treatment of Alopecia Areata","volume":"20","author":"Nunez","year":"2024","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Yi, R.C., Moran, S.K., Gantz, H.Y., Strowd, L.C., and Feldman, S.R. (2024). Biologics and Small Molecule Targeted Therapies for Pediatric Alopecia Areata, Psoriasis, Atopic Dermatitis, and Hidradenitis Suppurativa in the US: A Narrative Review. Children, 11.","DOI":"10.3390\/children11080892"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1007\/s13555-024-01203-2","article-title":"Biologics Versus JAK Inhibitors. Part II: Risk of Infections. A Narrative Review","volume":"14","year":"2024","journal-title":"Dermatol. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s40257-024-00846-3","article-title":"Integrated Safety Analysis of Ritlecitinib, an Oral JAK3\/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program","volume":"25","author":"King","year":"2024","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2147\/DDDT.S334727","article-title":"Evaluating the Therapeutic Potential of Ritlecitinib for the Treatment of Alopecia Areata","volume":"16","author":"Tosti","year":"2022","journal-title":"Drug Des. Devel. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Kotyla, P.J., Islam, M.A., and Engelmann, M. (2020). Clinical Aspects of Janus Kinase (JAK) Inhibitors in the Cardiovascular System in Patients with Rheumatoid Arthritis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21197390"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Paolino, G., Carugno, A., Frontera, A., Rongioletti, F., Malagoli, P., Foti, A., Brianti, P., Guida, S., Germiniasi, F., and Bianchi, V.G. (J. Eur. Acad. Dermatol. Venereol., 2024). Arrhythmias and Other Cardiovascular Diseases in Young Patients (<40 Years) with Moderate\/Severe Atopic Dermatitis: A Multicentric Study in Northern Italy, J. Eur. Acad. Dermatol. Venereol., online ahead of print.","DOI":"10.1111\/jdv.20184"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Makris, A., Barkas, F., Sfikakis, P.P., Liberopoulos, E., and Agouridis, A.P. (2022). The Effect of Upadacitinib on Lipid Profile and Cardiovascular Events: A Meta-Analysis of Randomized Controlled Trials. J. Clin. Med., 11.","DOI":"10.3390\/jcm11236894"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3899\/jrheum.171361","article-title":"Safety Profile of Baricitinib in Patients with Active Rheumatoid Arthritis with over 2 Years Median Time in Treatment","volume":"46","author":"Smolen","year":"2019","journal-title":"J. Rheumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"593","DOI":"10.2147\/CCID.S329442","article-title":"Practical Use of Upadacitinib in Patients with Severe Atopic Dermatitis in a Real-World Setting: A Systematic Review","volume":"17","author":"Ibba","year":"2024","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lamberg, O., Pandher, K., Troost, J.P., and Lim, H.W. (2024). Long-Term Adverse Event Risks of Oral JAK Inhibitors versus Immunomodulators: A Literature Review. Arch. Dermatol. Res., 317.","DOI":"10.1007\/s00403-024-03578-w"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Neri, B., Mancone, R., Fiorillo, M., Schiavone, S.C., Migliozzi, S., and Biancone, L. (2024). Efficacy and Safety of Janus Kinase-Inhibitors in Ulcerative Colitis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13237186"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Ortiz, A.M., Ortiz, A.M., P\u00e9rez, S., Toledano, E., Ab\u00e1solo, L., Gonz\u00e1lez-Gay, M.A., Casta\u00f1eda, S., and Gonz\u00e1lez-\u00c1lvaro, I. (2020). Effects of Disease Activity on Lipoprotein Levels in Patients with Early Arthritis: Can Oxidized LDL Cholesterol Explain the Lipid Paradox Theory?. Arthritis Res. Ther., 22.","DOI":"10.1186\/s13075-020-02307-8"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.1007\/s11739-023-03426-1","article-title":"Crucial Safety Issues on Janus Kinase Inhibitors in Rheumatoid Arthritis Might Be Associated with the Lack of LDL-Cholesterol Management: A Reasoned Literature Analysis","volume":"18","author":"Corrao","year":"2023","journal-title":"Intern. Emerg. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1080\/14728222.2024.2433124","article-title":"Targeting Mucosal Healing in Crohn\u2019s Disease: Efficacy of Novel Pathways and Therapeutic Targets","volume":"28","author":"Centanni","year":"2024","journal-title":"Expert Opin. Ther. Targets"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1136\/annrheumdis-2021-221051","article-title":"Integrated Safety Analysis of Filgotinib in Patients with Moderately to Severely Active Rheumatoid Arthritis Receiving Treatment over a Median of 1.6 Years","volume":"81","author":"Winthrop","year":"2022","journal-title":"Ann. Rheum. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1136\/ard-2022-222259","article-title":"Risk of Major Adverse Cardiovascular Events with Tofacitinib versus Tumour Necrosis Factor Inhibitors in Patients with Rheumatoid Arthritis with or without a History of Atherosclerotic Cardiovascular Disease: A Post Hoc Analysis from ORAL Surveillance","volume":"82","author":"Buch","year":"2023","journal-title":"Ann. Rheum. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jaad.2022.07.002","article-title":"Deucravacitinib versus Placebo and Apremilast in Moderate to Severe Plaque Psoriasis: Efficacy and Safety Results from the 52-Week, Randomized, Double-Blinded, Placebo-Controlled Phase 3 POETYK PSO-1 Trial","volume":"88","author":"Armstrong","year":"2023","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1097\/FJC.0000000000001470","article-title":"Cardiovascular Risk Management in Patients Treated with Janus Kinase Inhibitors","volume":"83","author":"Shah","year":"2024","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1007\/s40264-023-01333-0","article-title":"Managing Cardiovascular and Cancer Risk Associated with JAK Inhibitors","volume":"46","author":"Yang","year":"2023","journal-title":"Drug Saf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1136\/ard-2022-222824","article-title":"Risk of Major Adverse Cardiovascular and Venous Thromboembolism Events in Patients with Rheumatoid Arthritis Exposed to JAK Inhibitors versus Adalimumab: A Nationwide Cohort Study","volume":"82","author":"Hoisnard","year":"2023","journal-title":"Ann. Rheum. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Juan, H.Y., Sheu, S.-J., and Hwang, D.-K. (2024). Review of Janus Kinase Inhibitors as Therapies for Noninfectious Uveitis. J. Ocul. Pharmacol. Ther.","DOI":"10.1089\/jop.2024.0100"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Yamamoto, M., Nakajima, K., Matsuda, M., Takahashi, A., and Nakai, K. (Pediatr. Dermatol., 2024). Benefits of the Topical JAK Inhibitor Delgocitinib in a Patient with Pediatric Localized Scleroderma, Pediatr. Dermatol., early view.","DOI":"10.1111\/pde.15844"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/1\/54\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T15:23:14Z","timestamp":1759850594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/1\/54"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,1]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["medicina61010054"],"URL":"https:\/\/doi.org\/10.3390\/medicina61010054","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,1]]}}}