{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:25:28Z","timestamp":1789586728021,"version":"build-2803163510"},"reference-count":62,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2018,5,12]],"date-time":"2018-05-12T00:00:00Z","timestamp":1526083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Dermatitis herpetiformis (DH) is a common extraintestinal manifestation of coeliac disease presenting with itchy papules and vesicles on the elbows, knees, and buttocks. Overt gastrointestinal symptoms are rare. Diagnosis of DH is easily confirmed by immunofluorescence biopsy showing pathognomonic granular immunoglobulin A (IgA) deposits in the papillary dermis. A valid hypothesis for the immunopathogenesis of DH is that it starts from latent or manifest coeliac disease in the gut and evolves into an immune complex deposition of high avidity IgA epidermal transglutaminase (TG3) antibodies, together with the TG3 enzyme, in the papillary dermis. The mean age at DH diagnosis has increased significantly in recent decades and presently is 40\u201350 years. The DH to coeliac disease prevalence ratio is 1:8 in Finland and the United Kingdom (U.K.). The annual DH incidence rate, currently 2.7 per 100,000 in Finland and 0.8 per 100,000 in the U.K., is decreasing, whereas the reverse is true for coeliac disease. The long-term prognosis of DH patients on a gluten-free diet is excellent, with the mortality rate being even lower than for the general population.<\/jats:p>","DOI":"10.3390\/nu10050602","type":"journal-article","created":{"date-parts":[[2018,5,14]],"date-time":"2018-05-14T02:57:20Z","timestamp":1526266640000},"page":"602","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Dermatitis Herpetiformis: A Common Extraintestinal Manifestation of Coeliac Disease"],"prefix":"10.3390","volume":"10","author":[{"given":"Timo","family":"Reunala","sequence":"first","affiliation":[{"name":"Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland"},{"name":"Department of Dermatology, Tampere University Hospital, 33521 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teea T.","family":"Salmi","sequence":"additional","affiliation":[{"name":"Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland"},{"name":"Department of Dermatology, Tampere University Hospital, 33521 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaisa","family":"Hervonen","sequence":"additional","affiliation":[{"name":"Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland"},{"name":"Department of Dermatology, Tampere University Hospital, 33521 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Kaukinen","sequence":"additional","affiliation":[{"name":"Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland"},{"name":"Department of Internal Medicine, Tampere University Hospital, 33521 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pekka","family":"Collin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, 33521 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1001\/jama.1983.03340020028029","article-title":"Landmark article, Aug 30, 1884: Dermatitis herpetiformis. By Louis A. Duhring","volume":"250","author":"Duhring","year":"1983","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1159\/000116768","article-title":"A history of coeliac disease","volume":"26","author":"Losowsky","year":"2008","journal-title":"Dig. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/j.jaad.2010.09.777","article-title":"Dermatitis herpetiformis. Part I. Epidemiology, pathogenesis, and clinical presentation","volume":"64","author":"Bolotin","year":"2011","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/j.1365-2133.1969.tb16024.x","article-title":"Granular deposits of immunoglobulins in the skin of patients with dermatitis herpetiformis. An immunofluorescent study","volume":"81","year":"1969","journal-title":"Br. J. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1016\/S0140-6736(66)91692-8","article-title":"Small-bowel changes in dermatitis herpetiformis","volume":"2","author":"Marks","year":"1966","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1136\/gut.33.2.206","article-title":"Increase of lymphocytes bearing the gamma\/delta T cell receptor in the jejunum of patients with dermatitis herpetiformis","volume":"33","author":"Savilahti","year":"1992","journal-title":"Gut"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/S0140-6736(73)91539-0","article-title":"Clearance of skin lesions in dermatitis herpetiformis after gluten withdrawal","volume":"1","author":"Fry","year":"1973","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/j.1365-2133.1977.tb14122.x","article-title":"Gluten-free diet in dermatitis herpetiformis. I. Clinical response of skin lesions in 81 patients","volume":"97","author":"Reunala","year":"1977","journal-title":"Br. J. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1056\/NEJM198304073081406","article-title":"Gluten challenge in dermatitis herpetiformis","volume":"308","author":"Leonard","year":"1983","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1111\/j.1365-2133.1994.tb08557.x","article-title":"25 years\u2019 experience of a gluten-free diet in the treatment of dermatitis herpetiformis","volume":"131","author":"Garioch","year":"1994","journal-title":"Br. J. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1111\/j.1399-0039.1997.tb02834.x","article-title":"Absolute linkage of celiac disease and dermatitis herpetiformis to HLA-DQ","volume":"50","author":"Balas","year":"1997","journal-title":"Tissue Antigens"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1080\/003655202753387356","article-title":"First-degree relatives are frequently affected in coeliac disease and dermatitis herpetiformis","volume":"37","author":"Hervonen","year":"2002","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1046\/j.1523-1747.2000.00172.x","article-title":"Concordance of dermatitis herpetiformis and celiac disease in monozygous twins","volume":"115","author":"Hervonen","year":"2000","journal-title":"J. Investig. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"195","DOI":"10.2340\/00015555-2818","article-title":"Diagnostic delay in dermatitis herpetiformis in a high-prevalence area","volume":"98","author":"Mansikka","year":"2018","journal-title":"Acta Derm. Venereol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1111\/bjd.12488","article-title":"Linear IgA bullous dermatosis: Comparison between the drug-induced and spontaneous forms","volume":"169","author":"Chanal","year":"2013","journal-title":"Br. J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1468-3083.2009.03188.x","article-title":"Guidelines for the diagnosis and treatment of dermatitis herpetiformis","volume":"23","author":"Caproni","year":"2009","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1001\/archderm.1996.03890320060010","article-title":"Deposition of granular IgA relative to clinical lesions in dermatitis herpetiformis","volume":"132","author":"Zone","year":"1996","journal-title":"Arch. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/j.1365-2133.2011.10385.x","article-title":"Prevalence and incidence of dermatitis herpetiformis: A 40-year prospective study from Finland","volume":"165","author":"Salmi","year":"2011","journal-title":"Br. J. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1038\/ajg.2014.55","article-title":"Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: Population-based study","volume":"109","author":"West","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1056\/NEJMra071600","article-title":"Celiac disease","volume":"357","author":"Green","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Vilppula, A., Kaukinen, K., Luostarinen, L., Krekel\u00e4, I., Patrikainen, H., Valve, R., M\u00e4ki, M., and Collin, P. (2009). Increasing prevalence and high incidence of celiac disease in elderly people: A population-based study. BMC. Gastroenterol., 9.","DOI":"10.1186\/1471-230X-9-49"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1001\/archinte.163.3.286","article-title":"Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: A large multicenter study","volume":"163","author":"Fasano","year":"2003","journal-title":"Arch. Intern. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1038\/nrgastro.2010.23","article-title":"The spectrum of celiac disease: Epidemiology, clinical aspects and treatment","volume":"7","author":"Tack","year":"2010","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1111\/j.1365-4632.2007.03214.x","article-title":"Clinical, pathologic, and immunopathologic features of dermatitis herpetiformis: Review of the Mayo Clinic experience","volume":"46","author":"Gibson","year":"2007","journal-title":"Int. J. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1111\/bjd.13047","article-title":"Dermatitis herpetiformis in children: A long-term follow-up study","volume":"171","author":"Hervonen","year":"2014","journal-title":"Br. J. Dermatol."},{"key":"ref_26","first-page":"163","article-title":"Clinical and immunopathological features of 159 patients with dermatitis herpetiformis: An Italian experience","volume":"148","author":"Antiga","year":"2013","journal-title":"G. Ital. Dermatol. Venereol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/MPG.0b013e3181a81384","article-title":"Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA\/IgG serum antibodies to tissue transglutaminase","volume":"50","author":"Dahlbom","year":"2010","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/01.mcg.0000212618.12455.a8","article-title":"Diagnosis of celiac disease in clinical practice: Physician\u2019s alertness to the condition essential","volume":"41","author":"Collin","year":"2007","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"355.e9","DOI":"10.1016\/j.amjmed.2005.08.044","article-title":"Trends in the presentation of celiac disease","volume":"119","author":"Rampertab","year":"2006","journal-title":"Am. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.cgh.2016.11.018","article-title":"Changes in presentation of celiac disease in Ireland from the 1960s to 2015","volume":"15","author":"Harkin","year":"2017","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1080\/00365520500352600","article-title":"Prevalence of celiac disease: Before and after a national change in feeding recommendations","volume":"41","author":"Carlsson","year":"2006","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_32","unstructured":"Finnish National Nutrition Council (2003). Action Programme for Implementing National Nutrition Recommendations, Edita Prima. (In Finnish)."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1097\/MCG.0000000000000533","article-title":"The decreasing prevalence of severe villousa atrophy in Dermatitis herpetiformis: A 45-year experience in 393 patients","volume":"51","author":"Mansikka","year":"2017","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.dld.2006.07.014","article-title":"Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease","volume":"39","author":"Brar","year":"2007","journal-title":"Dig. Liver Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/j.1572-0241.2001.03462.x","article-title":"Characteristics of adult celiac disease in the USA: Results of a national survey","volume":"96","author":"Green","year":"2001","journal-title":"Am. J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1097\/MPG.0b013e31817b6dec","article-title":"Gluten-dependent small bowel mucosal transglutaminase 2-specific IgA deposits in overt and mild enteropathy coeliac disease","volume":"47","author":"Koskinen","year":"2008","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"393","DOI":"10.2340\/00015555-1764","article-title":"Small bowel transglutaminase 2-specific IgA deposits in dermatitis herpetiformis","volume":"94","author":"Salmi","year":"2014","journal-title":"Acta Derm. Venereol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1080\/00365520903030795","article-title":"Incidence and prevalence of diagnosed coeliac disease in Finland: Results of effective case finding in adults","volume":"44","author":"Virta","year":"2009","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1111\/j.1365-2133.2012.11105.x","article-title":"Reduced mortality in dermatitis herpetiformis: A population-based study of 476 patients","volume":"167","author":"Hervonen","year":"2012","journal-title":"Br. J. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1111\/j.1365-2036.2008.03660.x","article-title":"No increase in risk of fracture, malignancy or mortality in dermatitis herpetiformis: A cohort study","volume":"27","author":"Lewis","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/j.1365-2036.2011.04972.x","article-title":"Meta-analysis: Coeliac disease and the risk of all-cause mortality, any malignancy and lymphoid malignancy","volume":"35","author":"Tio","year":"2012","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1038\/nrgastro.2015.131","article-title":"Extraintestinal manifestations of coeliac disease","volume":"12","author":"Leffler","year":"2015","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1111\/apt.14335","article-title":"Declining trend in the incidence of biopsy-verified coeliac disease in the adult population of Finland, 2005\u20132014","volume":"46","author":"Virta","year":"2017","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/apt.12373","article-title":"Systematic review: Worldwide variation in the frequency of coeliac disease and changes over time","volume":"38","author":"Kang","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1111\/j.1365-2036.2007.03502.x","article-title":"Increasing prevalence of coeliac disease over time","volume":"26","author":"Lohi","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"387","DOI":"10.3109\/00365521.2014.974204","article-title":"Coeliac disease evolving into dermatitis herpetiformis in patients adhering to normal or gluten-free diet","volume":"50","author":"Salmi","year":"2015","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2340\/00015555722527","article-title":"Coeliac-type dental enamel defects in patients with dermatitis herpetiformis","volume":"72","author":"Aine","year":"1992","journal-title":"Acta Derm. Venereol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1084\/jem.20011299","article-title":"Epidermal transglutaminase (TGase 3) is the autoantigen of dermatitis herpetiformis","volume":"195","author":"Merkl","year":"2002","journal-title":"J. Exp. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1038\/nm0797-797","article-title":"Identification of tissue transglutaminase as the autoantigen of celiac disease","volume":"3","author":"Dieterich","year":"1997","journal-title":"Nat. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1136\/gut.2003.024836","article-title":"In vivo targeting of intestinal and extraintestinal transglutaminase 2 by coeliac autoantibodies","volume":"53","author":"Halttunen","year":"2004","journal-title":"Gut"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"K\u00e1rp\u00e1ti, S., S\u00e1rdy, M., N\u00e9meth, K., Mayer, B., Smyth, N., Paulsson, M., and Traupe, H. (2018). Transglutaminases in autoimmune and inherited skin diseases: The phenomena of epitope spreading and functional compensation. Exp. Dermatol., 1\u20138.","DOI":"10.1111\/exd.13449"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"366","DOI":"10.2340\/00015555-2849","article-title":"Ex vivo culture of duodenal biopsies from patients with Dermatitis herpetiformis indicates that transglutaminase 3 antibody production occurs in the gut","volume":"98","author":"Hietikko","year":"2018","journal-title":"Acta Derm. Venereol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1111\/bjd.13387","article-title":"IgA anti-epidermal transglutaminase antibodies in dermatitis herpetiformis: A significant but not complete response to a gluten-free diet treatment","volume":"172","author":"Reunala","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e198","DOI":"10.1111\/bjd.15995","article-title":"Disappearance of epidermal transglutaminase and IgA deposits from the papillary dermis of dermatitis herpetiformis patients after a long-term gluten-free diet","volume":"178","author":"Hietikko","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/jid.2014.368","article-title":"Transglutaminase 3 present in the IgA aggregates in dermatitis herpetiformis skin is enzymatically active and binds soluble fibrinogen","volume":"135","author":"Taylor","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1111\/j.1365-2036.2012.04998.x","article-title":"The long-term risk of malignancy following a diagnosis of coeliac disease or dermatitis herpetiformis: A cohort study","volume":"35","author":"Grainge","year":"2012","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/j.1365-2133.1996.tb01496.x","article-title":"Protective effect of gluten-free diet against development of lymphoma in dermatitis herpetiformis","volume":"135","author":"Lewis","year":"1996","journal-title":"Br. J. Dermatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1136\/gutjnl-2014-308285","article-title":"Causes of death in people with coeliac disease in England compared with the general population: A competing risk analysis","volume":"64","author":"Crooks","year":"2015","journal-title":"Gut"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/S0140-6736(01)05554-4","article-title":"Mortality in patients with coeliac disease and their relatives: A cohort study","volume":"358","author":"Corrao","year":"2001","journal-title":"Lancet"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Paarlahti, P., Kurppa, K., Ukkola, A., Collin, P., Huhtala, H., M\u00e4ki, M., and Kaukinen, K. (2013). Predictors of persistent symptoms and reduced quality of life in treated coeliac disease patients: A large cross-sectional study. BMC Gastroenterol., 13.","DOI":"10.1186\/1471-230X-13-75"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.clnu.2016.04.021","article-title":"Systematic review with meta-analysis: Dietary adherence influences normalization of health-related quality of life in coeliac disease","volume":"36","author":"Burger","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s40257-015-0149-1","article-title":"Quality of life and gastrointestinal symptoms in long-term treated Dermatitis herpetiformis patients: A cross-sectional study in Finland","volume":"16","author":"Pasternack","year":"2015","journal-title":"Am. J. Clin. Dermatol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/5\/602\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:03:59Z","timestamp":1760195039000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/5\/602"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,12]]},"references-count":62,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,5]]}},"alternative-id":["nu10050602"],"URL":"https:\/\/doi.org\/10.3390\/nu10050602","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,12]]}}}