Общая информация
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Первичные иммунодефициты – это растущая группа, насчитывающая более 400 врожденных нарушений иммунитета, которые варьируются по степени тяжести от опасных для жизни заболеваний, проявляющихся в младенчестве, до менее тяжелых нарушений, диагностируемых во взрослом возрасте. Большинство пациентов с первичным иммунодефицитом имеют рецидивирующие или хронические инфекции. Некоторые расстройства влияют на основные иммунологические пути и приводят к восприимчивости к условно-патогенным микроорганизмам, тогда как другие расстройства могут вызывать восприимчивость к очень небольшому количеству патогенов с широким возрастом проявления. Клинические проявления разнообразны и включают тяжелые или необычные инфекции, аутоиммунные заболевания и злокачественные новообразования. Пациенты со многими формами первичных иммунодефицитов подвержены повышенному риску злокачественных новообразований, вторичных по отношению к ряду различных факторов, включая нарушение иммунной регуляции, генетическую предрасположенность, чувствительность к радиации и нарушение клиренса вирусов.
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Генетическая панель Igenomix для выявления первичного иммунодефецита может быть инструментом для точной и направленной диагностики, а также для дифференциальной диагностики рецидивирующих бактериальных инфекций, что в конечном итоге приводит к лучшему лечению и прогнозу заболевания. Исследование обеспечивает всесторонний анализ соответствующих генов с использованием секвенирования нового поколения (NGS).
Показания
- Панель Igenomix для выявления первичного иммунодефецита используется для пациентов с клиническим подозрением или диагнозом со следующими симптомами:
- Частая и рецидивирующая пневмония, бронхит, инфекции носовых пазух, инфекции уха, менингит или кожные инфекции
- Воспаление и инфекция внутренних органов
- Заболевания крови
- Проблемы с пищеварением, такие как спазмы, потеря аппетита, тошнота и диарея.
- Задержка роста и развития
- Аутоиммунные расстройства
- Семейный анамнез первичного иммунодефицита
Клиническое значение
Клиническое значение данной панели:
- Точное молекулярно-генетическое подтверждение клинического диагноза у пациента.
- Раннее начало противомикробной профилактики с помощью антибактериальных, противогрибковых средств, быстрое распознавание и лечение инфекций, а также агрессивное лечение инфекционных осложнений. Раннее непрерывное наблюдение в связи с повышенным риском злокачественных новообразований.
- Возможность раннего иммунологического восстановления в форме трансплантации гемопоэтических клеток, замены ферментов, трансплантации тимуса или генной терапии.
- Оценка статуса носительства и генетическое консультирование бессимптомных членов семьи.
- Точное определене корреляции генотип-фенотип.
Гены и заболевания
ГЕН |
ЗАБОЛЕВАНИЕ (OMIM) |
ТИП НАСЛЕДОВАНИЯ* |
% ПОКРЫТИЯ ГЕНА (20X) |
HGMD** |
ACD |
Dyskeratosis |
AD,AR |
99.89 |
14 of 14 |
ACP5 |
Immunodeficiency |
AR |
100 |
27 of 28 |
ACTB |
Baraitser– |
AD |
100 |
40 of 40 |
ADA |
Immunodeficiency, |
AR |
100 |
97 of 98 |
ADA2 |
Polyarteritis |
AR |
100 |
– |
AGL |
Glycogen |
AR |
100 |
253 of 253 |
AICDA |
Immunodeficiency |
AR |
99.94 |
48 of 48 |
AK2 |
Reticular |
AR |
100 |
21 of 21 |
AKT1 |
Breast |
AD |
100 |
6 of 6 |
ANTXR2 |
Systemic |
AR |
99.96 |
53 of 53 |
AP3D1 |
Hermansky- |
AR |
99.69 |
5 of 5 |
ARHGEF1 |
Immunodeficiency |
AR |
90.23 |
2 of 2 |
ARVCF |
22q11.2 |
– |
99.95 |
2 of 2 |
ATM |
Ataxia- |
AD,AR |
99.93 |
1608 of 1632 |
ATP6AP1 |
Immunodeficiency |
X,XR,G |
99.2 |
– |
ATRX |
Mental |
X,XR,XD,G |
98.5 |
– |
BACH2 |
Immunodeficiency |
AD |
99.89 |
2 of 2 |
BCL10 |
Immunodeficiency, |
AR |
99.47 |
1 of 1 |
BCL11B |
Immunodeficiency, |
AD |
96.06 |
12 of 12 |
BCR |
Chronic Myeloid |
MU,P |
97.78 |
– |
BLNK |
Agamma- |
AR |
97.97 |
6 of 6 |
BTK |
Agamma- |
X,XR,G |
100 |
– |
BUB1B |
Colorectal |
AD,AR |
99.84 |
30 of 31 |
CARD11 |
Immunodeficiency, |
AD,AR |
100 |
30 of 31 |
CARD9 |
Candidiasis, |
AR |
99.86 |
34 of 34 |
CARMIL2 |
Immunodeficiency |
AR |
96.16 |
– |
CCDC47 |
Trichohepatoneuro- |
AR |
99.94 |
5 of 5 |
CD19 |
Immunodeficiency |
AD,AR |
99.99 |
7 of 7 |
CD247 |
Immunodeficiency, |
AR |
100 |
4 of 4 |
CD28 |
Mycosis |
– |
99.03 |
– |
CD3D |
Immunodeficiency |
AR |
100 |
7 of 7 |
CD3E |
Immunodeficiency |
AR |
99.95 |
9 of 9 |
CD3G |
Immunodeficiency |
AR |
100 |
3 of 3 |
CD40 |
Immunodeficiency |
AR |
100 |
11 of 11 |
CD40LG |
Immunodeficiency |
X,XR,G |
100 |
– |
CD79A |
Agamma- |
AR |
99.99 |
8 of 8 |
CD79B |
Agamma- |
AR |
100 |
3 of 3 |
CD81 |
Immunodeficiency |
AR |
100 |
2 of 2 |
CDC42 |
Takenouchi- |
AD |
99.97 |
10 of 10 |
CDCA7 |
Immunodeficiency, |
AR |
99.89 |
6 of 6 |
CDH23 |
Deafness, |
AD,AR |
98 |
400 of 403 |
CFTR |
Bronchiectasis |
AD,AR |
95.45 |
1615 of 1730 |
CHD1 |
Pilarowski- |
AD |
99.06 |
8 of 8 |
CHD7 |
Charge |
AD |
96.25 |
823 of 896 |
CIITA |
Bare Lymphocyte |
AR |
98.51 |
15 of 16 |
CLCA4 |
Cystic |
– |
97.66 |
– |
COMT |
Panic Disorder, |
AD |
99.98 |
5 of 5 |
CORO1A |
Immunodeficiency |
AR |
93 |
9 of 9 |
CPLX1 |
Myoclonic |
AD,AR |
99.81 |
3 of 3 |
CR2 |
Immunodeficiency |
AD,AR |
99.92 |
19 of 19 |
CREBBP |
Menke- |
AD |
100 |
318 of 318 |
CRKL |
22q11.2 |
– |
99.93 |
5 of 6 |
CTBP1 |
Hypotonia, |
AD |
98.45 |
1 of 1 |
CTC1 |
Cerebroretinal |
AR |
99.73 |
43 of 44 |
CTLA4 |
Autoimmune |
AD |
99.97 |
60 of 60 |
CTPS1 |
Immunodeficiency |
AR |
100 |
4 of 4 |
CUL4B |
Mental |
X,XR,G |
99.77 |
– |
CYBA |
Granulomatous |
AR |
99.98 |
67 of 67 |
CYBB |
Mycobacteriosis, |
X,XR,G |
100 |
– |
DCLRE1C |
Omenn |
AR |
99.99 |
72 of 73 |
DCTN4 |
Cystic |
– |
100 |
1 of 1 |
DKC1 |
Dyskeratosis |
X,XR,G |
100 |
– |
DNAJC21 |
Bone Marrow |
AR |
99.83 |
12 of 12 |
DNMT3B |
Immunodeficiency, |
AR |
100 |
59 of 59 |
DOCK2 |
Immunodeficiency |
AR |
100 |
11 of 11 |
DOCK8 |
Hyperimmu- |
AR |
99.92 |
106 of 114 |
EFL1 |
Shwachman- |
AR |
99.94 |
– |
EP300 |
Colorectal |
AD |
100 |
109 of 109 |
EPG5 |
Immunodeficiency, |
AR |
98.98 |
73 of 73 |
EXTL3 |
Immunoskeletal |
AR |
99.99 |
10 of 10 |
FADD |
Infections, |
AR |
95.19 |
3 of 3 |
FCGR3A |
Immunodeficiency |
AR |
99.63 |
1 of 1 |
FCN3 |
Immunodeficiency |
AR |
99.98 |
1 of 1 |
FGFRL1 |
Wolf-Hirschhorn |
AD |
99.94 |
1 of 1 |
FOXN1 |
T-Cell |
AD,AR |
100 |
30 of 30 |
FRAS1 |
Fraser |
AR |
98.73 |
57 of 58 |
GATA1 |
Anemia, |
X,XR,G |
99.93 |
– |
GATA2 |
Dendritic Cell, |
AD |
100 |
137 of 142 |
GINS1 |
Immunodeficiency |
AR |
99.87 |
5 of 5 |
GP1BB |
Bernard-Soulier |
AR |
74.08 |
26 of 50 |
HBB |
Alpha- |
AD,AR |
100 |
753 of 789 |
HELLS |
Immunodeficiency, |
AR |
99.48 |
7 of 7 |
HIRA |
22q11.2 Deletion |
– |
99.99 |
5 of 5 |
HYOU1 |
Immunodeficiency, |
AR |
99.94 |
2 of 2 |
ICOS |
Immunodeficiency |
AD,AR |
100 |
4 of 5 |
IFNAR2 |
Immunodeficiency |
AR |
99.78 |
2 of 2 |
IFNG |
Aplastic |
AD,AR |
99.77 |
– |
IFNGR1 |
Helicobacter |
AD,AR |
99.99 |
46 of 46 |
IFNGR2 |
Immunodeficiency |
AR |
96.6 |
18 of 20 |
IGHM |
Agamma- |
AR |
100 |
– |
IGLL1 |
Agamma- |
AR |
100 |
2 of 2 |
IKBKB |
Immunodeficiency |
AD,AR |
100 |
9 of 9 |
IKBKG |
Ectodermal |
X,XR,XD,G |
38.16 |
– |
IKZF1 |
Immunodeficiency, |
AD |
99.98 |
43 of 43 |
IL12B |
Immunodeficiency, |
AR |
100 |
12 of 12 |
IL12RB1 |
Immunodeficiency, |
AR |
99.94 |
92 of 96 |
IL21 |
Immunodeficiency |
AR |
99.73 |
1 of 1 |
IL21R |
Immunodeficiency |
AR |
99.97 |
10 of 10 |
IL2RA |
Diabetes |
AR |
100 |
9 of 9 |
IL2RB |
Immunodeficiency, |
AR |
94.56 |
6 of 6 |
IL2RG |
Immunodeficiency, |
X,XR,G |
99.86 |
– |
IL7R |
Immunodeficiency, |
AR |
100 |
54 of 55 |
IRAK4 |
Immunodeficiency |
AR |
99.96 |
27 of 28 |
IRF2BP2 |
Immunodeficiency, |
AD |
86.22 |
1 of 2 |
IRF7 |
Immunodeficiency |
AR |
99.97 |
3 of 3 |
IRF8 |
Immunodeficiency, |
AD,AR |
100 |
9 of 9 |
IRF9 |
Immunodeficiency |
AR |
100 |
5 of 5 |
ISG15 |
Immunodeficiency |
AR |
100 |
3 of 3 |
IVNS1ABP |
Immunodeficiency |
AD |
99.83 |
– |
JAK3 |
Immunodeficiency |
AR |
99.98 |
86 of 88 |
JMJD1C |
22q11.2 |
– |
99.09 |
27 of 27 |
KLLN |
Cowden |
– |
97.52 |
9 of 9 |
KNSTRN |
Immunodeficiency, |
– |
99.98 |
– |
LAMTOR2 |
Immunodeficiency |
AR |
100 |
1 of 1 |
LAT |
Immunodeficiency |
AR |
100 |
3 of 3 |
LCK |
Immunodeficiency |
AR |
99.99 |
4 of 4 |
LETM1 |
Wolf- |
AD |
98.2 |
2 of 2 |
LIG4 |
Lig4 Syndrome, |
AR |
99.48 |
46 of 46 |
LMNB2 |
Barraquer– |
AD,AR |
95.03 |
5 of 5 |
LRBA |
Immunodeficiency, |
AR |
99.91 |
79 of 81 |
LRRC8A |
Agamma- |
AD |
100 |
2 of 2 |
LYST |
Chediak- |
AR |
99.98 |
117 of 117 |
MAGT1 |
Congenital |
X,XR,G |
100 |
– |
MALT1 |
Immunodeficiency, |
AR |
95.76 |
9 of 9 |
MAN2B1 |
Mannosidosis, |
AR |
100 |
149 of 149 |
MAPK1 |
Distal 22q11.2 |
– |
96.91 |
1 of 1 |
MBTPS2 |
Ichthyosis |
X,XR,G |
100 |
– |
MEIS2 |
Cleft Palate, |
AD |
92 |
18 of 20 |
MMUT |
Methylmalonic |
AR |
99.97 |
– |
MRTFA |
Immunodeficiency |
AR |
99.8 |
– |
MS4A1 |
Immunodeficiency |
AR |
100 |
2 of 2 |
MSN |
Immunodeficiency |
X,XR,G |
99.98 |
– |
MTHFD1 |
Immunodeficiency, |
AR |
99.94 |
11 of 12 |
MYC |
Burkitt |
– |
99.3 |
2 of 2 |
MYD88 |
Immunodeficiency, |
AR |
99.55 |
7 of 7 |
MYSM1 |
Bone |
AR |
98.5 |
4 of 4 |
NBN |
Aplastic |
AR,MU,P |
100 |
200 of 200 |
NCF1 |
Granulomatous |
AR |
74.19 |
31 of 39 |
NCF2 |
Granulomatous |
AR |
100 |
72 of 73 |
NCKAP1L |
Immunodeficiency |
AR |
100 |
– |
NFE2L2 |
Immunodeficiency, |
AD |
97.24 |
7 of 7 |
NFKB1 |
Immunodeficiency |
AD |
99.98 |
38 of 41 |
NFKB2 |
Immunodeficiency, |
AD |
100 |
22 of 22 |
NFKBIA |
Ectodermal |
AD |
99.98 |
13 of 13 |
NHEJ1 |
Cernunnos- |
– |
100 |
12 of 14 |
NHP2 |
Dyskeratosis |
AR |
100 |
3 of 3 |
NOP10 |
Dyskeratosis |
AR |
100 |
1 of 1 |
NPM1 |
Leukemia, |
AD |
99.89 |
2 of 2 |
NSD2 |
Wolf-Hirschhorn |
AD |
99.91 |
– |
NSMCE3 |
Lung |
AR |
99.8 |
– |
ORAI1 |
Immunodeficiency, |
AD,AR |
91.93 |
20 of 22 |
PARN |
Dyskeratosis |
AD,AR |
99.98 |
33 of 33 |
PGM3 |
Immunodeficiency, |
AR |
99.99 |
17 of 17 |
PIK3CA |
Multiple Cancer |
AD |
99.58 |
54 of 58 |
PIK3CD |
Immunodeficiency, |
AD |
100 |
23 of 23 |
PIK3R1 |
Agamma- |
AD,AR |
99.89 |
29 of 29 |
PKP1 |
Ectodermal |
AR |
100 |
18 of 18 |
PNP |
Immunodeficiency, |
AR |
99.73 |
39 of 39 |
POLE |
Colorectal |
AD,AR |
100 |
100 of 100 |
PRKCD |
Immunodeficiency, |
AR |
100 |
9 of 9 |
PRKDC |
Immunodeficiency, |
AR |
99.74 |
9 of 10 |
PRPS1 |
Arts Syndrome, |
X,XR,G |
100 |
– |
PTEN |
Cowden |
AD |
99.97 |
609 of 629 |
PTPRC |
Immunodeficiency |
AR |
99.98 |
7 of 7 |
RAB27A |
Griscelli |
AR |
100 |
54 of 55 |
RAC2 |
Immunodeficiency, |
AD,AR |
100 |
5 of 5 |
RAG1 |
Cellular And |
AR |
100 |
193 of 193 |
RAG2 |
Omenn |
AR |
100 |
90 of 91 |
RASGRP1 |
Immunodeficiency, |
AR |
98.41 |
8 of 9 |
RBCK1 |
Polyglucosan |
AR |
100 |
13 of 13 |
RELB |
Immunodeficiency |
AR |
99.47 |
1 of 1 |
RFX5 |
Bare |
AR |
99.98 |
13 of 13 |
RFXANK |
Bare |
AR |
95.14 |
24 of 24 |
RFXAP |
Bare |
AR |
94.32 |
8 of 9 |
RIPK1 |
Autoinflammation, |
AD,AR |
98.03 |
12 of 14 |
RMRP |
Anauxetic |
AR |
– |
– |
RNF168 |
Riddle |
AR |
99.91 |
6 of 6 |
RNU4ATAC |
Lowry-Wood |
AR |
– |
– |
RORC |
Immunodeficiency |
AR |
99.99 |
6 of 6 |
RREB1 |
22q11.2 |
– |
99.92 |
8 of 8 |
RTEL1 |
Dyskeratosis |
AD,AR |
99.73 |
127 of 131 |
SBDS |
Aplastic |
AR |
100 |
77 of 79 |
SDHB |
Carney- |
AD |
100 |
261 of 264 |
SDHC |
Carney- |
AD |
99.95 |
62 of 63 |
SDHD |
Carney- |
AD,AR |
99.98 |
164 of 166 |
SEC23B |
Anemia, |
AD,AR |
100 |
119 of 127 |
SEC24C |
22q11.2 |
– |
99.98 |
– |
SH2D1A |
Lymphoproliferative |
X,XR,G |
99.94 |
– |
SHANK3 |
Phelan- |
AD,MU,P |
96.67 |
– |
SIK3 |
Spondyloe- |
AR |
97.63 |
2 of 2 |
SKIV2L |
Trichohe- |
AR |
99.98 |
33 of 33 |
SLC46A1 |
Folate |
AR |
99.8 |
21 of 21 |
SMARCAL1 |
Schimke |
AR |
99.94 |
93 of 93 |
SP110 |
Hepatic |
AR |
99.94 |
8 of 8 |
SPATA5 |
Epilepsy, |
AR |
99.83 |
30 of 30 |
SRP54 |
Neutropenia, |
AD,AR |
99.95 |
8 of 8 |
STAT1 |
Immunodeficiency, |
AD,AR |
100 |
138 of 138 |
STAT2 |
Immunodeficiency, |
AR |
100 |
9 of 9 |
STAT5B |
Growth |
AD |
99.94 |
12 of 12 |
STIM1 |
Immune |
AD,AR |
100 |
28 of 28 |
STK4 |
T-Cell |
AR |
99.88 |
10 of 10 |
STX1A |
Cystic |
– |
97 |
3 of 3 |
TBCE |
Encephalopathy, |
AR |
100 |
8 of 8 |
TBK1 |
Encephalopathy, |
AD |
99.91 |
141 of 142 |
TBX1 |
Conotruncal |
AD,AR |
88.7 |
35 of 42 |
TCF3 |
Agamma- |
AD |
99.98 |
7 of 7 |
TERC |
Dyskeratosis |
AD |
– |
– |
TERT |
Aplastic |
AD,AR |
99.09 |
194 of 197 |
TFRC |
Immunodeficiency |
AR |
100 |
2 of 2 |
TGFB1 |
Camurati– |
AD,AR |
99.75 |
24 of 24 |
TICAM1 |
Encephalopathy, |
AD,AR |
99.97 |
4 of 4 |
TINF2 |
Dyskeratosis |
AD |
99.94 |
47 of 47 |
TLR3 |
Encephalopathy, |
AD,AR |
100 |
16 of 16 |
TLR7 |
Immunodeficiency |
X,XR,G |
99.53 |
– |
TNFRSF13B |
Immunodeficiency, |
AD,AR |
100 |
50 of 50 |
TNFRSF13C |
Immunodeficiency |
AD,AR |
99.2 |
3 of 3 |
TNFRSF1B |
Classic |
– |
98.76 |
1 of 1 |
TNFRSF4 |
Immunodeficiency |
AR |
99.98 |
1 of 1 |
TNFSF12 |
Immunodeficiency |
– |
95.06 |
1 of 1 |
TPP2 |
Autoimmune |
– |
99.84 |
11 of 11 |
TRAC |
T-Cell |
AR |
100 |
– |
TRAF3 |
Herpes |
– |
100 |
3 of 3 |
TRNT1 |
Retinitis |
AR |
99.47 |
22 of 27 |
TTC37 |
Trichohe- |
AR |
100 |
66 of 66 |
TTC7A |
Gastrointestinal |
AR |
100 |
44 of 45 |
TYK2 |
Tyrosine |
AR |
97.56 |
9 of 9 |
UFD1 |
22q11.2 |
– |
99.98 |
– |
UNC119 |
Immunodeficiency, |
AD |
100 |
6 of 6 |
UNC93B1 |
Encephalopathy, |
AR |
97.97 |
2 of 2 |
UNG |
Immunodeficiency |
AR |
99.94 |
7 of 7 |
UROS |
Erythropoietic |
AR |
100 |
44 of 50 |
USB1 |
Poikiloderman |
AR |
100 |
24 of 24 |
USF3 |
Cowden |
– |
99.61 |
– |
USP8 |
Pituitary |
AD,AR |
98.19 |
3 of 3 |
WAS |
Neutropenia, |
X,XR,G |
100 |
– |
WDR1 |
Periodic |
AR |
100 |
9 of 9 |
WHCR |
Wolf- |
AD |
– |
– |
WIPF1 |
Wiskott-Aldrich |
AR |
99.79 |
3 of 3 |
WRAP53 |
Dyskeratosis |
AR |
100 |
10 of 10 |
XIAP |
Lympho- |
X,XR,G |
99.94 |
– |
XRCC4 |
Short Stature, |
AR |
99.73 |
10 of 10 |
ZAP70 |
Autoimmune Disease, Immunodeficiency |
AR |
99.99 |
30 of 30 |
ZBTB24 |
Immunodeficiency, Icf Syndrome |
AR |
100 |
23 of 23 |
* Inheritance: AD: Autosomal Dominant; AR: Autosomal Recessive; X: X linked; XLR: X linked Recessive; Mi: Mitochondrial; Mu: Multifactorial
** HGMD: Number of clinically relevant mutations according to HGMD
Ссылки
Tangye, S., Al-Herz, W., Bousfiha, A., Chatila, T., Cunningham-Rundles, C., & Etzioni, A. et al. (2020). Human Inborn Errors of Immunity: 2019 Update on the Classification from the International Union of Immunological Societies Expert Committee. Journal Of Clinical Immunology, 40(1), 24-64. doi: 10.1007/s10875-019-00737-x
Bonilla, F., Bernstein, I., Khan, D., Ballas, Z., Chinen, J., & Frank, M. et al. (2005). Practice parameter for the diagnosis and management of primary immunodeficiency. Annals Of Allergy, Asthma & Immunology, 94(5), S1-S63. doi: 10.1016/s1081-1206(10)61142-8
Milner, J., & Holland, S. (2013). The cup runneth over: lessons from the ever-expanding pool of primary immunodeficiency diseases. Nature Reviews Immunology, 13(9), 635-648. doi: 10.1038/nri3493
Aguilar, C., Malphettes, M., Donadieu, J., Chandesris, O., Coignard-Biehler, H., & Catherinot, E. et al. (2014). Prevention of Infections During Primary Immunodeficiency. Clinical Infectious Diseases, 59(10), 1462-1470. doi: 10.1093/cid/ciu646
Kebudi, R., Kiykim, A., & Sahin, M. K. (2019). Primary Immunodeficiency and Cancer in Children; A Review of the Literature. Current pediatric reviews, 15(4), 245–250. https://doi.org/10.2174/1573396315666190917154058
Chinn, I. K., Chan, A. Y., Chen, K., Chou, J., Dorsey, M. J., Hajjar, J., Jongco, A. M., 3rd, Keller, M. D., Kobrynski, L. J., Kumanovics, A., Lawrence, M. G., Leiding, J. W., Lugar, P. L., Orange, J. S., Patel, K., Platt, C. D., Puck, J. M., Raje, N., Romberg, N., Slack, M. A., … Walter, J. E. (2020). Diagnostic interpretation of genetic studies in patients with primary immunodeficiency diseases: A working group report of the Primary Immunodeficiency Diseases Committee of the American Academy of Allergy, Asthma & Immunology. The Journal of allergy and clinical immunology, 145(1), 46–69. https://doi.org/10.1016/j.jaci.2019.09.009