Abstracts Archive - Page 444 of 2605 - ACR Meeting Abstracts

Abstract Number: 1723 • ACR Convergence 2023
3,3-dimethyl-1-butanol and Its Metabolite 3,3-dimethylbutyrate Ameliorate Arthritis Severity in CIA Independent of Choline TMA Lyase Activity
Brendan Allen¹, Sabrina Fechtner², Meagan Chriswell³, Widian Jubair¹, M. Aaron Vrolijk¹, V. Michael Holers⁴ and kristine Kuhn¹, ¹University of Colorado School of Medicine, Aurora, CO, ²University of Colorado Anschutz Medical Campus, Aurora, CO, ³University of Colorado Anschutz SOM, Denver, CO, ⁴University of Colorado, Denver, CO
Background/Purpose: Both human and animal studies associate specific microbiota and microbial metabolic pathways with the development of RA and autoimmune arthritis, thereby providing a novel…
Abstract Number: 2232 • ACR Convergence 2023
Guselkumab, an IL-23p19 Subunit–specific Monoclonal Antibody, Is Able to Bind CD64+ Myeloid Cells, Potently Neutralize IL-23 Produced from the Cells, and Mediate Internalization of IL-23
Dennis McGonagle¹, raja atreya², Maria Abreu³, James Krueger⁴, Kilian Eyerich⁵, Robert Bissonnette⁶, Kacey Sachen⁷, Carrie Greving⁷, Brian Stoveken⁸, Deepa Hammaker⁷, Kristin Leppard⁸, John Hartman⁸, Phuc Bao⁷, Eilyn Lacy⁸, Indra Sarabia⁷, Janise Deming⁷, Matthew Duprie⁸, Joseph Brown⁷, Christopher T Ritchlin⁹, Iain McInnes¹⁰, Matthieu Allez¹¹ and Anne Fourie⁷, ¹Leeds Biomedical Research Centre, University of Leeds, Leeds, United Kingdom, ²Erlangen University Hospital, Friedrich-Alexander-Univrsität Erlangen-Nürnberg, Erlangen, Germany, ³University of Miami, Leonard Miller School of Medicine, Miami, FL, ⁴The Rockefeller University, Laboratory for Investigative Dermatology, New York, NY, ⁵Medical Center, University of Freiburg; Karolinska Institute, Department of Medicine - Division of Dermatology and Venereology, Stockholm, Sweden, ⁶Innovaderm Research Inc, Medical Director, Montréal, QC, Canada, ⁷Janssen Research and Development, LLC, Immunology, San Diego, CA, ⁸Janssen Research & Development, LLC, Therapeutics Discovery, Spring House, PA, ⁹University of Rochester Medical School, Allergy, Immunology & Rheumatology Division, Canandaigua, NY, ¹⁰University of Glasgow, Glasgow, United Kingdom, ¹¹Hôpital Saint-Louis, Université Paris Cité, Paris, France
Background/Purpose: Monoclonal antibodies (mAbs) targeting the interleukin (IL)-23p19 subunit are effective in treating psoriatic disease; however, their molecular attributes may translate to differences in clinical…
Abstract Number: 2233 • ACR Convergence 2023
Neutrophil Levels Associate with Early Improvement in Spinal Pain and Week 24 Multi-Domain Disease Control During Guselkumab Treatment in Active Psoriatic Arthritis: Post Hoc Pooled Analyses of Two Phase 3 Randomized Controlled Trials
Thomas Macleod¹, Xenofon Baraliakos², Emmanouil Rampakakis³, Warner Chen⁴, Antonius Pieter J Van Den Heuvel⁴, Loqmane Seridi⁴, May Shawi⁵, Frederic Lavie⁶, Joseph F. Merola⁷, Proton Rahman⁸ and Dennis McGonagle⁹, ¹University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom, ²Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Herne, Germany, ³McGill University, Department of Pediatrics / JSS Medical Research, Scientific Affairs, Montreal, QC, Canada, ⁴Translational Sciences, Janssen Research & Development, LLC, Spring House, PA, ⁵Immunology, Janssen Research & Development, LLC, Titusville, NJ, ⁶The Janssen Pharmaceutical Companies of Johnson & Johnson, Paris, France, ⁷Brigham and Women's Hospital and Harvard Medical School, Boston, MA, ⁸Craig Dobbin Research Institute, Memorial University, St. John's, NL, Canada, ⁹Leeds Biomedical Research Centre, University of Leeds, Leeds, United Kingdom
Background/Purpose: Neutrophils have potential pathogenic roles in chronic inflammatory diseases (e.g., neutrophilic cutaneous microabscesses in psoriasis, and neutrophils in the synovial fluid/tissue in PsA and…
Abstract Number: 1738 • ACR Convergence 2023
Identification of Homeostatic and Inflammatory Synovial Fibroblast Signatures in Synovial Tissue Biopsies of Healthy Controls and Patients with Rheumatoid Arthritis
Brianne Barker¹, Órla Tynan², Conor Smith³, Dumitru Anton⁴, Carl Orr⁵, Mary Canavan⁶, Douglas Veale⁷ and Ursula Fearon⁸, ¹Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, EULAR Centre for Rheumatic and Arthritic Diseases, St Vincent's University Hospital, University College Dublin, Dublin, Ireland, ²Molecular Rheumatology Department, Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland, EULAR Centre for Arthritis and Rheumatic Diseases, St Vincent University Hospital, University College Dublin, Dublin, Ireland, ³Translational Immunology, Trinity Biomedical Sciences Institute, Dublin, Ireland, ⁴Molecular Rheumatology Department, Trinity Biomedical Sciences Institute, Trinity College Dublin, EULAR Centre for Arthritis and Rheumatic Diseases, St Vincent University Hospital, University College Dublin, Dublin, Ireland, ⁵EULAR Centre for Arthritis and Rheumatic Diseases, St Vincent University Hospital, University College Dublin, Dublin, Ireland, ⁶Molecular Rheumatology Department, Trinity Biomedical Sciences Institute, Trinity College Dublin, EULAR Centre for Arthritis and Rheumatic Diseases, St Vincent University Hospital, University College Dublin, School of Biochemistry & Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland, ⁷St.Vincent's University Hosp, Dublin, Ireland, ⁸Trinity College Dublin, Dublin, Ireland
Background/Purpose: Recent literature has identified different synovial fibroblast (FLS) populations within RA synovium with distinct inflammatory profiles. Despite current advances in classifying heterogeneity of FLS…
Abstract Number: 1733 • ACR Convergence 2023
Platelet-Derived Growth Factor Is a Mediator of Disease in an Animal Model of Rheumatoid-Associated Interstitial Lung Disease
Nozima Aripova¹, Michael Duryee¹, Amy Nelson¹, Carlos Hunter¹, Breanna Butler¹, Bryant England¹, Jill Poole¹, Geoffrey Thiele¹ and Ted R Mikuls², ¹University of Nebraska Medical Center, Omaha, NE, ²Division of Rheumatology and Immunology, University of Nebraska Medical Center, Omaha, NE
Background/Purpose: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a leading cause of mortality in RA with limited treatment options as well as lack of available…
Abstract Number: 2226 • ACR Convergence 2023
How Do Spondyloarthritis Start? Identification of the First Signs or Symptoms According to Diagnosis and HLA-B27. Data from REGISPONSER and RESPONDIA Registries
María Ángeles Puche Larrubia¹, Lourdes Ladehesa Pineda², Pilar Font Ugalde³, Alejandro Escudero Contreras⁴, Janitzia Vázquez Mellado⁵, Eduardo Collantes Estévez⁶ and Clementina López Medina⁷, ¹Department of Rheumatology, Reina Sofia University Hospital, Cordoba, Spain, ²Rheumatology Department Reina Sofia Universitary Hospital, Cordoba, Spain, ³IMIBIC/Reina Sofia Hospital/University of Cordoba, Córdoba, Spain, ⁴Reina Sofia University Hospital, Córdoba, Spain, ⁵University Hospital of Mexico, Mexico City, Mexico, ⁶Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/University of Cordoba, Cordoba, Spain, ⁷Rheumatology Department, Cochin Hospital; INSERM (U1153): Clinical Epidemiology and Biostatistics, University of Paris; Rheumatology Department, Reina Sofia Hospital, Cordoba / IMIBIC / University of Cordoba, Cordoba, Spain
Background/Purpose: The definition for early spondyloarthritis (SpA) implies the correct identification of the initial symptom of SpA. There is currently no consensus on whether only…
Abstract Number: 2227 • ACR Convergence 2023
The Impact of Smoking Status on One Year Secukinumab Retention Rate in 1,684 Patients with PsA: Real-World Results from the EuroSpA Collaboration
Zohra Faizy Ahmadzay¹, Stylianos Georgiadis², Marion Pons², Merete Hetland², Bente Glintborg³, Jette Heberg², Sara Nysom Christiansen², Simon Horskjær Rasmussen², Anne Gitte Loft⁴, Isabel Castrejon⁵, Lucia Otero-Valera⁶, Jakub Zavada⁷, Karel Pavelka⁸, Heikki Relas⁹, Laura Kuusalo¹⁰, Burkhard Moeller¹¹, Michael Nissen¹², Ziga Rotar¹³, Katja Perdan Pirkmajer¹⁴, Daniela Santos Oliveira¹⁵, Ana Rita Cruz-Machado¹⁶, Brigitte Michelsen¹⁷, Eirik Kristianslund¹⁸, Bjorn Gudbjornsson¹⁹, Gerdur Maria Grondal²⁰, Karin Laas²¹, Pasoon Hellamand²², Ismail Sari²³, Daniela Di Giuseppe²⁴, Mikkel Østergaard²⁵ and Lykke Ørnbjerg², ¹Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark, ²Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark, ³Rigshospitalet Glostrup, University of Copenhagen, Virum, Denmark, ⁴Aarhus University, Horsens, Denmark, ⁵Hospital General Universitario Gregorio Marañón, Madrid, Spain, ⁶Spanish Society of Rheumatology, Madrid, Spain, ⁷Institute of Rheumatology; Charles University, Prague, Czech Republic, ⁸Institut of Rheumatology and Department of Rheumatology, First Faculty of Medicine, Charles University, Praha, Czech Republic, ⁹Helsinki University Hospital, Helsinki, Finland, ¹⁰Division of Internal Medicine, Centre for Rheumatology and Clinical Immunology, University of Turku and Turku University Hospital, Turku, Finland, ¹¹Inselspital - University Hospital Bern, Bern, Switzerland, ¹²Geneva University Hospitals, Geneva, Switzerland, ¹³University Medical Centre Ljubljana, Ljubljana, Slovenia, ¹⁴Department of Rheumatology, University Medical Centre LJubljana, Ljubljana, Slovenia, ¹⁵Department of Medicine, Faculty of Medicine, University of Porto, Rheumatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal, ¹⁶Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, CHULN, Academic Medical Center and ERN-ReCONNET; Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa; Reuma.pt Sociedade Portuuesa de Reumatologia, Lisbon, Portugal, ¹⁷Rigshospitalet Glostrup; Diakonhjemmet Hospital; Sørlandet Hospital, Copenhagen, Denmark, ¹⁸Diakonhjemmet Hospital, Oslo, Norway, ¹⁹Centre for Rheumatology Research, University Hospital, Reykjavik, Iceland, ²⁰Department for Rheumatology, Landspitali University Hospital, Reykjavik, Iceland, ²¹Department of Rheumatology, East-Tallinn Central Hospital, Tallinn, Estonia, ²²Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands, ²³Division of Rheumatology, Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey, ²⁴Karolinska Institutet, Stockholm, Sweden, ²⁵Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet; University of Copenhagen, Copenhagen, Denmark
Background/Purpose: Smoking has been associated with higher disease activity, poorer treatment response, and drug retention rate among psoriatic arthritis (PsA) patients treated with Tumor Necrosis…
Abstract Number: 2231 • ACR Convergence 2023
Ixekizumab Significantly Improves Nail Disease and Adjacent Joint Tenderness and Swelling in Psoriatic Arthritis
Dennis McGonagle¹, Arthur Kavanaugh², Iain McInnes³, Lars Erik⁴, Joseph Merola⁵, Bruce Strober⁶, Rebecca Bolce⁷, Jeffrey Lisse⁷, Jennifer Pustizzi⁷, Christophe Sapin⁷ and Christopher T Ritchlin⁸, ¹Leeds Teaching Hospitals NHS Trust, Academic Unit for the Musculoskeletal Diseases, Leeds, United Kingdom, ²Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, CA, ³University of Glasgow, Glasgow, United Kingdom, ⁴Bispebjerg-Frederiksberg Hospital, Vedbæk, Denmark, ⁵Harvard Medical School, Brigham and Women's Hospital, Newton, MA, ⁶Yale University, New Haven, CT, ⁷Eli Lilly and Company, Indianapolis, IN, ⁸University of Rochester Medical School, Allergy, Immunology & Rheumatology Division, Canandaigua, NY
Background/Purpose: Nail psoriasis (PsO) is a strong predictor for the development of psoriatic arthritis (PsA) and has been reported in 63–83% of patients with PsA1.…
Abstract Number: 1714 • ACR Convergence 2023
Aberrant Myeloid Populations in the TNF-Transgenic Model of Pulmonary Hypertension Overexpress Interferon Pathways and Are Driven by TNFR1 Signaling
Gaochan Wang¹, Qingfu Xu², Stacey Duemmel¹ and Benjamin Korman¹, ¹University of Rochester, Rochester, NY, ²University of Rochester Medical Center, Rochester, NY
Background/Purpose: Pulmonary hypertension (PH) is a severe, progressive disorder characterized by elevated pulmonary artery pressures, right ventricular hypertrophy, and increased mortality. We previously demonstrated that…
Abstract Number: 1619 • ACR Convergence 2023
Receipt of Antimicrobial Prophylaxis in U.S. Medicare Beneficiaries Initiating Immunosuppressive Medications for ANCA Vasculitis
Carolyn Thorpe, Ryan Hickson, Sherrie Aspinall, Vimal Derebail, Xinhua Zhao, Joshua Thorpe, Binxin Cao, Alexa Ehlert, Ronald Falk and Susan Hogan, University of North Carolina, Chapel Hill, NC
Background/Purpose: Infections are the leading cause of hospitalization and mortality in patients with ANCA vasculitis (AV). Multiple AV treatment guidelines recommend antimicrobial prophylaxis during treatment…
Abstract Number: 1734 • ACR Convergence 2023
Serum PDGF-BB Levels Correlate with Lung Fibrosis in Mice Injected with Malondialdehyde-Acetaldehyde and/or Citrulline Modified Vimentin
Nozima Aripova¹, Michael Duryee¹, Carlos Hunter¹, Amy Nelson¹, Breanna Butler¹, Jill Poole¹, Bryant England¹, Geoffrey Thiele¹ and Ted R Mikuls², ¹University of Nebraska Medical Center, Omaha, NE, ²Division of Rheumatology and Immunology, University of Nebraska Medical Center, Omaha, NE
Background/Purpose: Pulmonary manifestations of rheumatoid arthritis (RA), such as interstitial lung disease (RA-ILD), are a major contributor to morbidity and mortality. The mechanism of pulmonary…
Abstract Number: 1622 • ACR Convergence 2023
Myositis-associated Autoantibodies in Juvenile Myositis Are Associated with Severe Disease Features and Mortality
Matthew Sherman¹, Payam Noroozi Farhad², Katherine Pak³, Iago Pinal-Fernandez³, Kakali Sarkar², Megan Neely⁴, Ira Targoff⁵, Frederick Miller⁶, Andrew Mammen⁷ and Lisa Rider⁸, ¹NIAMS/NIH, Washington, DC, ²Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, ³National Institutes of Health, Bethesda, MD, ⁴Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, ⁵Veterans Affairs Medical Center, University of Oklahoma Health Sciences Center, and Oklahoma Medical Research Foundation, Oklahoma City, OK, ⁶NIH, NIEHS, Chapel Hill, NC, ⁷NIH, Bethesda, MD, ⁸NIEHS, NIH, Bethesda, MD
Background/Purpose: Myositis-associated autoantibodies (MAAs), such as anti-Ro52 autoantibodies (Abs), have been found to be associated with interstitial lung disease (ILD) and worse prognosis in the…
Abstract Number: 1200 • ACR Convergence 2023
Self-Reported Effectiveness of Cannabis for Arthritis-Related Pain
Kristin Wipfler¹, Joanna Zeiger² and Kaleb Michaud³, ¹FORWARD, The National Databank for Rheumatic Diseases, Omaha, NE, ²Canna Research Foundation, Boulder, CO, ³University of Nebraska Medical Center, Omaha, NE
Background/Purpose: Pain management remains a significant challenge for individuals with rheumatic diseases (RDs), often causing patients to seek complementary or alternative treatments to traditional medications.…
Abstract Number: 1623 • ACR Convergence 2023
Diffuse Juvenile Systemic Sclerosis Patients Show Distinct Organ Involvement, Antibody Pattern and Have More Severe Disease in the Largest jSSc Cohort of the World. Results from the Juvenile Scleroderma Inception Cohort
Ivan Foeldvari¹, Jens Klotsche², Kathryn Torok³, Ozgur Kasapcopur⁴, Amra Adrovic⁵, Brian Feldman⁶, FLAVIO SZTAJNBOK⁷, Maria Teresa TErreri⁸, Ana Sakamoto⁹, Sindhu Johnson¹⁰, Jordi Anton¹¹, Valda Stanevica¹², Raju Khubchandani¹³, Dieneke Schonenberg-Meinema¹⁴, Eslam Al-Abadi¹⁵, Ekaterina Alexeeva¹⁶, Maria Katsikas¹⁷, Sujata Sawhney¹⁸, Vanessa Smith¹⁹, Simone Appenzeller²⁰, Tadey Avcin²¹, Mikhail Kostik²², Thomas Lehman²³, Hana Malcova²⁴, Edoardo Marrani²⁵, Clare Pain²⁶, Natalia Vasquez-Canizares²⁷, Patricia Costa Reis²⁸, Mahesh Janarthanan²⁹, Maria Jose Santos³⁰, Sima Abu Alsaoud³¹, Christina Battagliotti³², Lillemor Berntson³³, blanca e r bica³⁴, Juergen Brunner³⁵, Daniela Kaiser³⁶, Dragana Lazarevic³⁷, Kirsten Minden³⁸, Farzana Nuruzzaman³⁹, Siri Opsahl Hetlevik⁴⁰, Yosef Uziel⁴¹ and Nicola Helmus⁴², ¹Hamburger Zentrum für Kinder- und Jugendrheumatologie, Hamburg, Germany, ²German Rheumatism Research Center, Berlin, Germany, ³University of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, ⁴Department of Pediatric Rheumatology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey, ⁵Istanbul University - Cerrahpasa, Istanbul, Turkey, ⁶The Hospital for Sick Children, Toronto, ON, Canada, ⁷UFRJ/UERJ, São Paulo, Brazil, ⁸UNIFESP, São Paulo, Brazil, ⁹Federal University of São Paulo (UNIFESP), São Paulo, Brazil, ¹⁰Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada, ¹¹Hospital Sant Joan de Déu, Pediatric Rheumatology Department, Universitat de Barcelona, Barcelona, Spain, ¹²Children's Clinical University Hospital, Zemgales priekšpilseta, Riga, Latvia, ¹³SRCC Childrens Hospital, Mumbai, India, ¹⁴Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands, ¹⁵Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom, ¹⁶Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia, ¹⁷Hospital de Pediatria Juan P Garrahan, Servicio de Inmunologia/Reumatologia, Buenos Aires, Argentina, ¹⁸Sir Ganga Ram Hospital, Uttar Pradesh, India, ¹⁹Ghent University Hospital, Gent, Belgium, ²⁰UNICAMP, Campinas, Brazil, ²¹University Children's Hospital University Medical Center Ljubljana, Ljubljana, Slovenia, ²²Saint-Petersburg State Pediatric Medical University, Saint Petersburg, Russia, ²³Hospital for Special Surgery, New York, NY, ²⁴Motol University Hospital, Prague, Czech Republic, ²⁵University of Florence, Firenze, Italy, ²⁶Alder Hey NHS Trust, Liverpool, United Kingdom, ²⁷Children’s Hospital at Montefiore, Bronx, NY, ²⁸Hospital de Santa Maria, Lisbon, Portugal, ²⁹SRI RAMACHANDRA INSTITUTE OF HIGHER EDUCATION AND RESEARCH, Chennai, India, ³⁰Hospital Garcia de Orta, Almada, Lisboa, Portugal, ³¹Caritas baby Hospital, East Jerusalem, Israel, ³²Hospital de Niños Dr Orlando Alassia, Santa Fe, Argentina, ³³Dept. of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden, ³⁴Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, ³⁵Medical University Innsbruck; Department of Pediatrics, Pediatric Rheumatology, Innsbruck, Austria, ³⁶Children's Hospital Lucerne, Lucerne, Switzerland, ³⁷Dept of Pediatric Rheumatology and Immunology Clinical Center Nis, Faculty of Medicine, University of Niš, Nis, Serbia, ³⁸Charité University Medicine and German Rheumatism Research Center Berlin, Berlin, Germany, ³⁹Stony Brook Children's Hospital, Stony Brook, NY, ⁴⁰Oslo University Hospital, Oslo, Norway, ⁴¹Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, Sackler School of Medicine, Tel Aviv University, Kfar Saba, Israel, ⁴²Hamburg Centre for Pediatric and Adolescence Rheumatology, Hamburg, Germany
Background/Purpose: Juvenile systemic sclerosis (jSSc) is an orphan disease with a prevalence of 3 in 1,000,000 children. In adult patients there are significant differences between…
Abstract Number: 1635 • ACR Convergence 2023
Deep Learning Accurately Predicts Focus Score and Diagnosis of Primary Sjögren Syndrome Using Labial Salivary Gland Biopsies
Louis Basseto¹, Julien Duquesne¹, Michael Barnes², Elena Pontarini², Amaya Gallagher-Syed², Michele Bombardieri², Benjamin A Fisher³, Saba Nayar³, Clovis Adam⁴, Thierry Lazure⁴, Xavier Mariette⁵, Samuel Bitoun⁶ and Vincent Bouget¹, ¹Scienta Lab, Paris, France, ²Queen Mary University of London, London, United Kingdom, ³University of Birmingham, Birmingham, United Kingdom, ⁴Université Paris-Saclay, Paris, France, ⁵Université Paris-Saclay, Le Kremlin-Bicêtre, France, ⁶CHU Bicêtre APHP, Le Kremlin-Bicêtre, France
Background/Purpose: Primary Sjögren Syndrome (pSS) diagnosis relies on the weighted sum of three EULAR/ACR 2016 criteria: i) quantification of lymphocyte infiltration in labial salivary gland…

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