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Record Information
Version5.0
StatusDetected but not Quantified
Creation Date2021-09-11 07:56:07 UTC
Update Date2021-09-26 23:02:31 UTC
HMDB IDHMDB0250827
Secondary Accession NumbersNone
Metabolite Identification
Common Name4,5-Diaminofluorescein diacetate
Description4,5-Diaminofluorescein diacetate, also known as daf-2Da, belongs to the class of organic compounds known as xanthenes. These are polycyclic aromatic compounds containing a xanthene moiety, which consists of two benzene rings joined to each other by a pyran ring. Based on a literature review a significant number of articles have been published on 4,5-Diaminofluorescein diacetate. This compound has been identified in human blood as reported by (PMID: 31557052 ). 4,5-diaminofluorescein diacetate is not a naturally occurring metabolite and is only found in those individuals exposed to this compound or its derivatives. Technically 4,5-Diaminofluorescein diacetate is part of the human exposome. The exposome can be defined as the collection of all the exposures of an individual in a lifetime and how those exposures relate to health. An individual's exposure begins before birth and includes insults from environmental and occupational sources.
Structure
Thumb
Synonyms
ValueSource
4,5-Diaminofluorescein diacetic acidGenerator
3'-(Acetyloxy)-5,6-diamino-3-oxo-3H-spiro[2-benzofuran-1,9'-xanthene]-6'-yl acetic acidHMDB
4,5-Diaminofluorescein-2 diacetateHMDB
DAF-2DaHMDB
Chemical FormulaC24H18N2O7
Average Molecular Weight446.415
Monoisotopic Molecular Weight446.111400928
IUPAC Name3'-(acetyloxy)-5,6-diamino-3-oxo-3H-spiro[2-benzofuran-1,9'-xanthene]-6'-yl acetate
Traditional Name3'-(acetyloxy)-5,6-diamino-3-oxospiro[2-benzofuran-1,9'-xanthene]-6'-yl acetate
CAS Registry NumberNot Available
SMILES
CC(=O)OC1=CC2=C(C=C1)C1(OC(=O)C3=CC(N)=C(N)C=C13)C1=C(O2)C=C(OC(C)=O)C=C1
InChI Identifier
InChI=1S/C24H18N2O7/c1-11(27)30-13-3-5-16-21(7-13)32-22-8-14(31-12(2)28)4-6-17(22)24(16)18-10-20(26)19(25)9-15(18)23(29)33-24/h3-10H,25-26H2,1-2H3
InChI KeyPTSUYDXEEKDBQU-UHFFFAOYSA-N
Chemical Taxonomy
Description Belongs to the class of organic compounds known as xanthenes. These are polycyclic aromatic compounds containing a xanthene moiety, which consists of two benzene rings joined to each other by a pyran ring.
KingdomOrganic compounds
Super ClassOrganoheterocyclic compounds
ClassBenzopyrans
Sub Class1-benzopyrans
Direct ParentXanthenes
Alternative Parents
Substituents
  • Xanthene
  • Diaryl ether
  • Benzofuranone
  • Phthalide
  • Isobenzofuranone
  • Tricarboxylic acid or derivatives
  • Isocoumaran
  • Isobenzofuran
  • Benzenoid
  • Amino acid or derivatives
  • Carboxylic acid ester
  • Lactone
  • Ether
  • Carboxylic acid derivative
  • Oxacycle
  • Primary amine
  • Organopnictogen compound
  • Organooxygen compound
  • Organonitrogen compound
  • Organic oxygen compound
  • Amine
  • Carbonyl group
  • Organic nitrogen compound
  • Organic oxide
  • Hydrocarbon derivative
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External DescriptorsNot Available
Ontology
Physiological effectNot Available
Disposition
ProcessNot Available
RoleNot Available
Physical Properties
StateNot Available
Experimental Molecular Properties
PropertyValueReference
Melting PointNot AvailableNot Available
Boiling PointNot AvailableNot Available
Water SolubilityNot AvailableNot Available
LogPNot AvailableNot Available
Experimental Chromatographic PropertiesNot Available
Predicted Molecular Properties
PropertyValueSource
logP3.19ALOGPS
logP2.04ChemAxon
logS-4.7ALOGPS
pKa (Strongest Basic)2.45ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count2ChemAxon
Polar Surface Area140.17 ŲChemAxon
Rotatable Bond Count4ChemAxon
Refractivity118.92 m³·mol⁻¹ChemAxon
Polarizability45.48 ųChemAxon
Number of Rings5ChemAxon
BioavailabilityYesChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted Chromatographic Properties

Predicted Collision Cross Sections

PredictorAdduct TypeCCS Value (Å2)Reference
DeepCCS[M-2H]-232.41330932474
DeepCCS[M+Na]+207.83830932474
AllCCS[M+H]+203.632859911
AllCCS[M+H-H2O]+201.232859911
AllCCS[M+NH4]+205.832859911
AllCCS[M+Na]+206.532859911
AllCCS[M-H]-203.932859911
AllCCS[M+Na-2H]-203.832859911
AllCCS[M+HCOO]-203.832859911

Predicted Kovats Retention Indices

Underivatized

MetaboliteSMILESKovats RI ValueColumn TypeReference
4,5-Diaminofluorescein diacetateCC(=O)OC1=CC2=C(C=C1)C1(OC(=O)C3=CC(N)=C(N)C=C13)C1=C(O2)C=C(OC(C)=O)C=C15522.1Standard polar33892256
4,5-Diaminofluorescein diacetateCC(=O)OC1=CC2=C(C=C1)C1(OC(=O)C3=CC(N)=C(N)C=C13)C1=C(O2)C=C(OC(C)=O)C=C13988.3Standard non polar33892256
4,5-Diaminofluorescein diacetateCC(=O)OC1=CC2=C(C=C1)C1(OC(=O)C3=CC(N)=C(N)C=C13)C1=C(O2)C=C(OC(C)=O)C=C14179.3Semi standard non polar33892256

Derivatized

Derivative Name / StructureSMILESKovats RI ValueColumn TypeReference
4,5-Diaminofluorescein diacetate,1TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N)C=C214134.9Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,1TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N)C=C213798.1Standard non polar33892256
4,5-Diaminofluorescein diacetate,1TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N)C=C215350.9Standard polar33892256
4,5-Diaminofluorescein diacetate,1TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N[Si](C)(C)C)C=C214121.2Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,1TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N[Si](C)(C)C)C=C213799.7Standard non polar33892256
4,5-Diaminofluorescein diacetate,1TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N[Si](C)(C)C)C=C215338.2Standard polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N[Si](C)(C)C)C=C214157.8Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N[Si](C)(C)C)C=C213931.3Standard non polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N[Si](C)(C)C)C=C214818.6Standard polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N)C=C214086.3Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N)C=C213910.0Standard non polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N)C=C214963.4Standard polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #3CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C214064.5Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #3CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C213917.3Standard non polar33892256
4,5-Diaminofluorescein diacetate,2TMS,isomer #3CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C214959.0Standard polar33892256
4,5-Diaminofluorescein diacetate,3TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N[Si](C)(C)C)C=C214160.3Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,3TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N[Si](C)(C)C)C=C213990.4Standard non polar33892256
4,5-Diaminofluorescein diacetate,3TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N[Si](C)(C)C)C=C214536.9Standard polar33892256
4,5-Diaminofluorescein diacetate,3TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C214152.9Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,3TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C213992.8Standard non polar33892256
4,5-Diaminofluorescein diacetate,3TMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C214549.6Standard polar33892256
4,5-Diaminofluorescein diacetate,4TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C214119.5Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,4TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C213947.2Standard non polar33892256
4,5-Diaminofluorescein diacetate,4TMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C)[Si](C)(C)C)=C(N([Si](C)(C)C)[Si](C)(C)C)C=C214268.6Standard polar33892256
4,5-Diaminofluorescein diacetate,1TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N)C=C214368.8Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,1TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N)C=C214012.9Standard non polar33892256
4,5-Diaminofluorescein diacetate,1TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N)C=C215389.8Standard polar33892256
4,5-Diaminofluorescein diacetate,1TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N[Si](C)(C)C(C)(C)C)C=C214352.0Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,1TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N[Si](C)(C)C(C)(C)C)C=C214017.1Standard non polar33892256
4,5-Diaminofluorescein diacetate,1TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N[Si](C)(C)C(C)(C)C)C=C215377.9Standard polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N[Si](C)(C)C(C)(C)C)C=C214587.9Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N[Si](C)(C)C(C)(C)C)C=C214350.6Standard non polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N[Si](C)(C)C(C)(C)C)C=C214913.8Standard polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)=C(N)C=C214486.6Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)=C(N)C=C214315.8Standard non polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)=C(N)C=C214997.1Standard polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #3CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)C=C214469.6Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #3CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)C=C214319.6Standard non polar33892256
4,5-Diaminofluorescein diacetate,2TBDMS,isomer #3CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N)=C(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)C=C214992.6Standard polar33892256
4,5-Diaminofluorescein diacetate,3TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)=C(N[Si](C)(C)C(C)(C)C)C=C214667.9Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,3TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)=C(N[Si](C)(C)C(C)(C)C)C=C214573.3Standard non polar33892256
4,5-Diaminofluorescein diacetate,3TBDMS,isomer #1CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)=C(N[Si](C)(C)C(C)(C)C)C=C214677.0Standard polar33892256
4,5-Diaminofluorescein diacetate,3TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)C=C214662.7Semi standard non polar33892256
4,5-Diaminofluorescein diacetate,3TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)C=C214572.0Standard non polar33892256
4,5-Diaminofluorescein diacetate,3TBDMS,isomer #2CC(=O)OC1=CC=C2C(=C1)OC1=CC(OC(C)=O)=CC=C1C21OC(=O)C2=CC(N[Si](C)(C)C(C)(C)C)=C(N([Si](C)(C)C(C)(C)C)[Si](C)(C)C(C)(C)C)C=C214687.9Standard polar33892256
Spectra

GC-MS Spectra

Spectrum TypeDescriptionSplash KeyDeposition DateSourceView
Predicted GC-MSPredicted GC-MS Spectrum - 4,5-Diaminofluorescein diacetate GC-MS (Non-derivatized) - 70eV, Positivesplash10-0006-7396200000-6dc4d99ed7ef9de252f22021-09-24Wishart LabView Spectrum
Predicted GC-MSPredicted GC-MS Spectrum - 4,5-Diaminofluorescein diacetate GC-MS (Non-derivatized) - 70eV, PositiveNot Available2021-10-12Wishart LabView Spectrum

MS/MS Spectra

Spectrum TypeDescriptionSplash KeyDeposition DateSourceView
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 4,5-Diaminofluorescein diacetate 10V, Positive-QTOFsplash10-0002-0000900000-3fc721d4ed72a268fe522021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 4,5-Diaminofluorescein diacetate 20V, Positive-QTOFsplash10-052b-0001900000-9f3c9e61f524a2aa0cb12021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 4,5-Diaminofluorescein diacetate 40V, Positive-QTOFsplash10-03di-0009000000-8928d603528cb54af2352021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 4,5-Diaminofluorescein diacetate 10V, Negative-QTOFsplash10-03di-0009500000-4198c435dfc4e13d2d452021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 4,5-Diaminofluorescein diacetate 20V, Negative-QTOFsplash10-0r03-0009400000-dd6d58c8abc6694767872021-10-12Wishart LabView Spectrum
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 4,5-Diaminofluorescein diacetate 40V, Negative-QTOFsplash10-0a4i-1109000000-76405b5428dc1c0db9132021-10-12Wishart LabView Spectrum
Biological Properties
Cellular LocationsNot Available
Biospecimen Locations
  • Blood
Tissue LocationsNot Available
Pathways
Normal Concentrations
BiospecimenStatusValueAgeSexConditionReferenceDetails
BloodDetected but not QuantifiedNot QuantifiedNot SpecifiedNot SpecifiedNormal details
Abnormal Concentrations
Not Available
Associated Disorders and Diseases
Disease ReferencesNone
Associated OMIM IDsNone
DrugBank IDNot Available
Phenol Explorer Compound IDNot Available
FooDB IDNot Available
KNApSAcK IDNot Available
Chemspider ID5036007
KEGG Compound IDNot Available
BioCyc IDNot Available
BiGG IDNot Available
Wikipedia LinkNot Available
METLIN IDNot Available
PubChem Compound6603693
PDB IDNot Available
ChEBI IDNot Available
Food Biomarker OntologyNot Available
VMH IDNot Available
MarkerDB IDNot Available
Good Scents IDNot Available
References
Synthesis ReferenceNot Available
Material Safety Data Sheet (MSDS)Not Available
General References
  1. Barupal DK, Fiehn O: Generating the Blood Exposome Database Using a Comprehensive Text Mining and Database Fusion Approach. Environ Health Perspect. 2019 Sep;127(9):97008. doi: 10.1289/EHP4713. Epub 2019 Sep 26. [PubMed:31557052 ]