{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T19:52:41Z","timestamp":1793908361973,"version":"4.8.0"},"reference-count":58,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>In patients with chronic kidney disease (CKD), cardiovascular events (CVA) are the main cause of morbidity and mortality. Vascular calcification, linked to bone mineral metabolism disorders such as elevated serum phosphate, parathyroid hormone (PTH), and FGF23, well-known uremic toxins, aggravate this risk. Calcimimetics are allosteric activators of the calcium-sensing receptor (CaSR), a G protein-coupled receptor that regulates PTH secretion and synthesis in response to changes in extracellular calcium in the parathyroid glands. Through direct and indirect mechanisms, they have demonstrated their efficacy in reducing the progression of vascular, valvular, and soft tissue calcification in experimental studies. Although clinical studies in dialysis patients did not achieve statistical significance in their primary objectives, positive results in subgroup analyses suggest that the lack of significance may be attributable to the short follow-up period. This finding highlights the need to consider early treatment strategies, especially in advanced stages of chronic kidney disease, to more effectively address the progression of vascular calcification through serum uremic toxins control.<\/jats:p>","DOI":"10.3390\/toxins17060297","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T03:59:17Z","timestamp":1749700757000},"page":"297","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Calcimimetics and Vascular Calcification"],"prefix":"10.3390","volume":"17","author":[{"given":"Avinash","family":"Chandu","sequence":"first","affiliation":[{"name":"Nephrology and Renal Transplant Department, Hospital Cl\u00ednic, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-5758","authenticated-orcid":false,"given":"Carolt","family":"Arana","sequence":"additional","affiliation":[{"name":"Nephrology and Renal Transplant Department, Hospital Cl\u00ednic, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Daniel","family":"D\u00edaz-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Nephrology and Renal Transplant Department, Hospital Cl\u00ednic, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-6252","authenticated-orcid":false,"given":"Mario","family":"Cozzolino","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Milan, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Ciceri","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Milan, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9-Vicente","family":"Torregrosa","sequence":"additional","affiliation":[{"name":"Nephrology and Renal Transplant Department, Hospital Cl\u00ednic, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nefro.2022.03.007","article-title":"Recommendations of the Spanish Society of Nephrology for the management of mineral and bone metabolism disorders in patients with chronic kidney disease: 2021 (SEN-MM)","volume":"42","author":"Torregrosa","year":"2022","journal-title":"Nefrologia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.rmclc.2015.04.003","article-title":"Enfermedad cardiovascular (ecv) en la enfermedad renal cr\u00f3nica (ERC)","volume":"26","year":"2015","journal-title":"Rev. M\u00e9dica Cl\u00ednica Las Condes"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s00223-006-0126-z","article-title":"Calcification inhibitors and Wnt signaling proteins are implicated in bovine artery smooth muscle cell calcification in the presence of phosphate and vitamin D sterols","volume":"79","author":"Shalhoub","year":"2006","journal-title":"Calcif. Tissue Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.tcm.2014.10.021","article-title":"Vascular calcification: Mechanisms of vascular smooth muscle cell calcification","volume":"25","author":"Leopold","year":"2015","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1681\/ASN.2012030240","article-title":"Nanoparticle-based test measures overall propensity for calcification in serum","volume":"23","author":"Farese","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1038\/sj.ki.5002241","article-title":"Vascular calcification: Contribution of parathyroid hormone in renal failure","volume":"71","author":"Neves","year":"2007","journal-title":"Kidney Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s11914-023-00782-x","article-title":"Impact of Cinacalcet and Etelcalcetide on Bone Mineral and Cardiovascular Disease in Dialysis Patients","volume":"21","author":"Bacchetta","year":"2023","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1038\/366575a0","article-title":"Cloning and characterization of an extracellular Ca (2+)-sensing receptor from bovine parathyroid","volume":"366","author":"Brown","year":"1993","journal-title":"Nature"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1046\/j.1523-1755.1998.00735.x","article-title":"A calcimimetic agent acutely suppresses parathyroid hormone levels in patients with chronic renal failure. Rapid communication","volume":"53","author":"Antonsen","year":"1998","journal-title":"Kidney Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.semnephrol.2004.06.006","article-title":"Calcimimetic agents for the treatment of secondary hyperparathyroidism","volume":"24","author":"Goodman","year":"2004","journal-title":"Semin. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/j.1542-4758.2009.00397.x","article-title":"Assessment of adherence to cinacalcet by prescription refill rates in hemodialysis patients","volume":"14","author":"Gincherman","year":"2010","journal-title":"Hemodial. Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1053\/j.ajkd.2021.05.020","article-title":"Etelcalcetide utilization, dosing titration, and chronic kidney disease\u2013mineral and bone disease (CKD-MBD) marker responses in US hemodialysis patients","volume":"79","author":"Karaboyas","year":"2022","journal-title":"Am. J. Kidney Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.kint.2018.05.013","article-title":"Head-to-head comparison of the new calcimimetic agent evocalcet with cinacalcet in Japanese hemodialysis patients with secondary hyperparathyroidism","volume":"94","author":"Fukagawa","year":"2018","journal-title":"Kidney Int."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Akizawa, T., Yanagida, T., Wada, M., Tokunaga, S., Kawata, T., Hisada, Y., Masuda, N., Haruyama, W., Shoukei, Y., and Miyazaki, H. (2018). A novel calcimimetic agent, evocalcet (MT-4580\/KHK7580), suppresses the parathyroid cell function with little effect on the gastrointestinal tract or CYP isozymes in vivo and in vitro. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195316"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1080\/17446651.2020.1780911","article-title":"Development of evocalcet for unmet needs among calcimimetic agents","volume":"15","author":"Hamano","year":"2020","journal-title":"Expert. Rev. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/1744-9987.13434","article-title":"Evocalcet: A New Oral Calcimimetic for Dialysis Patients With Secondary Hyperparathyroidism","volume":"24","author":"Akizawa","year":"2020","journal-title":"Ther. Apher. Dial."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1093\/cvr\/cvt249","article-title":"Calcimimetics increase CaSR expression and reduce mineralization in vascular smooth muscle cells: Mechanisms of action","volume":"101","author":"Boudot","year":"2014","journal-title":"Cardiovasc. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"F1376","DOI":"10.1152\/ajprenal.90737.2008","article-title":"The calcimimetic AMG 641 accelerates regression of extraosseous calcification in uremic rats","volume":"296","author":"Lopez","year":"2009","journal-title":"Am. J. Physiol. Renal. Physiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1097\/01.ASN.0000141960.01035.28","article-title":"Human vascular smooth muscle cells undergo vesicle-mediated calcification in response to changes in extracellular calcium and phosphate concentrations: A potential mechanism for accelerated vascular calcification in ESRD","volume":"15","author":"Reynolds","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.1161\/01.RES.87.7.e10","article-title":"Phosphate regulation of vascular smooth muscle cell calcification","volume":"87","author":"Jono","year":"2000","journal-title":"Circ. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1016\/j.bone.2009.03.653","article-title":"Effects of calcimimetic on vascular calcification and atherosclerosis in uremic mice","volume":"45","author":"Joki","year":"2009","journal-title":"Bone"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.atherosclerosis.2008.10.043","article-title":"The calcimimetic R-568 retards uremia-enhanced vascular calcification and atherosclerosis in apolipoprotein E deficient (apoE-\/-) mice","volume":"205","author":"Ivanovski","year":"2009","journal-title":"Atherosclerosis"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1038\/sj.ki.5002675","article-title":"The effect of calcitriol, paricalcitol, and a calcimimetic on extraosseous calcifications in uremic rats","volume":"73","author":"Lopez","year":"2008","journal-title":"Kidney Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1359\/jbmr.1998.13.9.1390","article-title":"Extracellular calcium (Ca2+o)-sensing receptor in a mouse monocyte-macrophage cell line (J774): Potential mediator of the actions of Ca2+o on the function of J774 cells","volume":"13","author":"Yamaguchi","year":"1998","journal-title":"J. Bone Miner. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"F946","DOI":"10.1152\/ajprenal.00474.2006","article-title":"Extracellular calcium-sensing receptor is functionally expressed in human artery","volume":"293","author":"Molostvov","year":"2007","journal-title":"Am. J. Physiol. Renal. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1038\/ki.2008.407","article-title":"Cinacalcet suppresses calcification of the aorta and heart in uremic rats","volume":"74","author":"Kawata","year":"2008","journal-title":"Kidney Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s00223-010-9442-4","article-title":"Effect of calcium and the calcimimetic AMG 641 on matrix-Gla protein in vascular smooth muscle cells","volume":"88","author":"Mendoza","year":"2011","journal-title":"Calcif. Tissue Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1038\/ki.2008.490","article-title":"A calcimimetic (R-568), but not calcitriol, prevents vascular remodeling in uremia","volume":"75","author":"Koleganova","year":"2009","journal-title":"Kidney Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1093\/ndt\/gfp078","article-title":"R-568 reduces ectopic calcification in a rat model of chronic kidney disease-mineral bone disorder (CKD-MBD)","volume":"24","author":"Moe","year":"2009","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.ejphar.2009.05.013","article-title":"The calcimimetic AMG 641 abrogates parathyroid hyperplasia, bone and vascular calcification abnormalities in uremic rats","volume":"616","author":"Henley","year":"2009","journal-title":"Eur. J. Pharmacol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/j.1440-1797.2011.01530.x","article-title":"Efficacy and safety of cinacalcet for the treatment of secondary hyperparathyroidism in patients with advanced chronic kidney disease before initiation of regular dialysis","volume":"17","author":"Montenegro","year":"2012","journal-title":"Nephrology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.bbrc.2012.01.097","article-title":"The combination of lanthanum chloride and the calcimimetic calindol delays the progression of vascular smooth muscle cells calcification","volume":"418","author":"Ciceri","year":"2012","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1093\/ndt\/gfq725","article-title":"The ADVANCE study: A randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis","volume":"26","author":"Raggi","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1093\/ndt\/gfs356","article-title":"Protocol adherence and the progression of cardiovascular calcification in the ADVANCE study","volume":"28","author":"Floege","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1038\/ki.2014.349","article-title":"Bone histomorphometry before and after long-term treatment with cinacalcet in dialysis patients with secondary hyperparathyroidism","volume":"87","author":"Behets","year":"2015","journal-title":"Kidney Int."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"EVOLVE Trial Investigators, Chertow, G.M., Block, G.A., Correa-Rotter, R., Dr\u00fceke, T.B., Floege, J., Goodman, W.G., Herzog, C.A., Kubo, Y., and London, G.M. (2012). Effect of cinacalcet on cardiovascular disease in patients undergoing dialysis. N. Engl. J. Med., 367, 2482\u20132494.","DOI":"10.1056\/NEJMoa1205624"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"800","DOI":"10.2215\/CJN.10221014","article-title":"The Effect of Cinacalcet on Calcific Uremic Arteriolopathy Events in Patients Receiving Hemodialysis: The EVOLVE Trial","volume":"10","author":"Floege","year":"2015","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1093\/ndt\/gfl114","article-title":"Successful treatment of calciphylaxis with cinacalcet-an alternative to parathyroidectomy?","volume":"21","author":"Velasco","year":"2006","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1001\/archderm.143.2.152","article-title":"Cinacalcet for the treatment of calciphylaxis","volume":"143","author":"Robinson","year":"2007","journal-title":"Arch. Dermatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1111\/j.1365-2133.2006.07540.x","article-title":"Cinacalcet as an adjunct in the successful treatment of calciphylaxis","volume":"155","author":"Sharma","year":"2006","journal-title":"Br. J. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"181","DOI":"10.5414\/CNP75181","article-title":"Cinacalcet may reduce arterial stiffness in patients with chronic renal disease and secondary hyperparathyroidism\u2014Results of a small-scale, prospective, observational study","volume":"75","author":"Bonet","year":"2011","journal-title":"Clin. Nephrol."},{"key":"ref_43","first-page":"4433","article-title":"CaSR participates in the regulation of vascular tension in the mesentery of hypertensive rats via the PLC-IP3\/AC-V\/cAMP\/RAS pathway","volume":"20","author":"Zhang","year":"2019","journal-title":"Mol. Med. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Di Pietro, N., Potenza, M.A., Di Silvestre, S., Addabbo, F., Di Pietrantonio, N., Di Tomo, P., Pipino, C., Mandatori, D., Palmerini, C., and Failli, P. (2018). Calcimimetic R-568 vasodilatory effect on mesenteric vascular beds from normotensive (WKY) and spontaneously hypertensive (SHR) rats. Potential involvement of vascular smooth muscle cells (vSMCs). PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0202354"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.vph.2007.06.010","article-title":"Calcimimetic, AMG 073, induces relaxation on isolated rat aorta","volume":"47","author":"Smajilovic","year":"2007","journal-title":"Vascul. Pharmacol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.ejphar.2016.10.008","article-title":"The calcilytics Calhex-231 and NPS 2143 and the calcimimetic Calindol reduce vascular reactivity via inhibition of voltage-gated Ca channels","volume":"791","author":"Greenberg","year":"2016","journal-title":"Eur. J. Pharmacol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1093\/ndt\/gfh834","article-title":"1,25-Dihydroxyvitamin D3 but not cinacalcet HCl (Sensipar\/Mimpara) treatment mediates aortic calcification in a rat model of secondary hyperparathyroidism","volume":"20","author":"Henley","year":"2005","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"651","DOI":"10.3109\/08860229509037632","article-title":"Effect of 1,25-dihydroxyvitamin D3 and diltiazem on tissue calcium in uremic rat","volume":"17","author":"Inagaki","year":"1995","journal-title":"Ren. Fail."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1097\/01.hjh.0000166849.72721.1c","article-title":"Systemic cardiovascular disease in uremic rats induced by 1,25(OH)2D3","volume":"23","author":"Haffner","year":"2005","journal-title":"J. Hypertens."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1124\/jpet.106.101261","article-title":"Role of phosphorus and vitamin D analogs in the pathogenesis of vascular calcification","volume":"318","author":"Noonan","year":"2006","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1111\/j.1476-5381.2008.00108.x","article-title":"Vascular calcification and secondary hyperparathyroidism of severe chronic kidney disease and its relation to serum phosphate and calcium levels","volume":"156","author":"Terai","year":"2009","journal-title":"Br. J. Pharmacol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1038\/ki.2012.322","article-title":"Vitamin D receptor agonists increase klotho and osteopontin while decreasing aortic calcification in mice with chronic kidney disease fed a high phosphate diet","volume":"82","author":"Lau","year":"2012","journal-title":"Kidney Int."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1681\/ASN.2007080902","article-title":"Vitamin D receptor activators can protect against vascular calcification","volume":"19","author":"Mathew","year":"2008","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1159\/000326903","article-title":"Vitamin D and vascular calcification in chronic kidney disease","volume":"34","author":"Rodriguez","year":"2011","journal-title":"Kidney Blood Press. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1124\/jpet.117.247270","article-title":"Calcitriol Accelerates Vascular Calcification Irrespective of Vitamin K Status in a Rat Model of Chronic Kidney Disease with Hyperphosphatemia and Secondary Hyperparathyroidism","volume":"366","author":"McCabe","year":"2018","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1038\/sj.ki.5002406","article-title":"Differential effects of vitamin D receptor activators on vascular calcification in uremic rats","volume":"72","author":"Mizobuchi","year":"2007","journal-title":"Kidney Int."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1161\/01.CIR.98.13.1302","article-title":"1,25-Dihydroxyvitamin D3 increases in vitro vascular calcification by modulating secretion of endogenous parathyroid hormone-related peptide","volume":"98","author":"Jono","year":"1998","journal-title":"Circulation"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1097\/01.ASN.0000128955.83129.9C","article-title":"Phosphate-induced vascular calcification: Role of pyrophosphate and osteopontin","volume":"15","author":"Lomashvili","year":"2004","journal-title":"J. Am. Soc. Nephrol."}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/6\/297\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:50:28Z","timestamp":1760032228000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/6\/297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,12]]},"references-count":58,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["toxins17060297"],"URL":"https:\/\/doi.org\/10.3390\/toxins17060297","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,12]]}}}