{"id":13050,"date":"2024-08-23T06:05:24","date_gmt":"2024-08-23T04:05:24","guid":{"rendered":"https:\/\/valintermed.com\/?p=13050"},"modified":"2024-08-23T06:05:24","modified_gmt":"2024-08-23T04:05:24","slug":"spinalnaya-myshechnaya-atrofiya-tip-1","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/","title":{"rendered":"Spinal muscular atrophy type 1"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Spinal muscular atrophy (SMA) type 1, also known as Werdnig-Hoffmann disease, is a genetic disorder characterized by progressive weakness and wasting of skeletal muscles. It is caused by a failure of motor neurons in the anterior horns of the spinal cord, which disrupts the transmission of nerve impulses to the muscles. SMA type 1 manifests itself in early childhood, usually before 6 months, and is severe in most cases. Symptoms include muscle weakness, difficulty moving, and significant fatigue with physical activity, which significantly limits the ability to move independently and can lead to severe complications such as pneumonia and respiratory failure.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\" >Epidemiology<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\" >Genetic predisposition to this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Risk factors for the development of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Diagnosis of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Treatment<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >List of medications used to treat this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Disease monitoring<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Age-related features of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/spinal-myocardial-atrophy-tip-1\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Spinal muscular atrophy has been known since the late 19th century, with its first descriptions being found in the works of scientists such as Wilhelm Werdig and Paul Hoffman. In 1891, Werdig described the clinical manifestations of SMA, and Hoffman systematized data on the first form of the disease in 1893. A full understanding of the hereditary nature of SMA came only in the 1990s, when the SMN1 gene associated with the disease was identified. Throughout the history of SMA, treatment has remained primarily supportive and symptomatic, but with the development of genetic therapy technologies and the creation of specific drugs such as nusinarsen, new therapeutic options have emerged.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\"><\/span>Epidemiology<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Spinal muscular atrophy type 1 is one of the most common inherited diseases in children. In different regions of the world, the prevalence ranges from 1 in 6,000 to 1 in 10,000 newborns. According to studies, the probability that a child will inherit this disease is approximately 25% if both parents carry the mutant gene. World statistics indicate that about 1 in 40 people are carriers of genes associated with SMA. Some studies also emphasize that boys and girls are equally at risk of developing SMA type 1.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\"><\/span>Genetic predisposition to this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The main gene associated with spinal muscular atrophy is the SMN1 (survival motor neuron 1) gene, located on chromosome 5. It is believed that a deficiency of the SMN protein leads to the degeneration of motor neurons in the spinal cord. Mutations in this gene are often detected in patients with type 1 of the disease, and copy variations are also possible (for example, the presence of one or two active alleles). It is important to note that carriers may have a deficiency of a second gene, SMN2, which also produces SMN protein, but in much smaller quantities, which cannot fully compensate for its absence due to a mutation in SMN1.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Risk factors for the development of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The main risk factors for spinal muscular atrophy include genetic predisposition and a family history of the disease. Other potential factors include: <\/p>\n<ul>\n<li>Family history of SMA or other hereditary neuromuscular disorders.<\/li>\n<li>Disturbances in reproductive history, including a history of miscarriages or stillbirths.<\/li>\n<li>Interesting demographic factors, such as increased prevalence of the disease among certain ethnic groups.<\/li>\n<li>Occupational factors, which are unlikely but are linked to hypotheses about health effects.<\/li>\n<\/ul>\n<p>Genetic testing can help identify people at increased risk of carrying a mutation.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Diagnosis of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Diagnosis of spinal muscular atrophy type 1 includes several aspects:<\/p>\n<ul>\n<li><strong>Main symptoms:<\/strong> The onset of the disease occurs in early childhood, most often before 6 months. Characteristic symptoms include muscle weakness, decreased tone, difficulty moving, and lack of response to stimuli.<\/li>\n<li><strong>Laboratory tests:<\/strong> Genetic testing for mutations in the SMN1 and SMN2 genes is the first step to confirm the diagnosis.<\/li>\n<li><strong>Radiological examinations:<\/strong> MRI and CT scans can be used to rule out other diseases, but are not specific for SMA.<\/li>\n<li><strong>Other types of disease diagnostics:<\/strong> Electromyography (EMG) and respiratory function tests.<\/li>\n<li><strong>Differential diagnosis:<\/strong> It is important to distinguish SMA from other neurological diseases such as amyotrophic lateral sclerosis, spinal cord atrophy, and myasthenia gravis.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment of spinal muscular atrophy type 1 is aimed at maintaining the quality of life of patients and preventing complications. <\/p>\n<ul>\n<li><strong>General treatment:<\/strong> Physical therapy and rehabilitation help maintain muscle function and prevent contractures.<\/li>\n<li><strong>Pharmacological treatment:<\/strong> Includes the use of specific drugs such as nusinarsen, as well as supportive therapy such as anti-inflammatory drugs.<\/li>\n<li><strong>Surgical treatment:<\/strong> In some cases, surgery may be required to correct scoliosis or other orthopedic deformities.<\/li>\n<li><strong>Other types of treatment:<\/strong> Psychological support and social support, as well as genetic counseling for family planning.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>List of medications used to treat this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Among the drugs effective in the treatment of spinal muscular atrophy type 1, the following can be distinguished:<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<ul>\n<li>Nusinarsen (Spinraza)<\/li>\n<li>Risdiplam (Evrysdi)<\/li>\n<li>Zolgensma<\/li>\n<li>Supportive therapy with vitamins and minerals to improve overall health.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring of patients with spinal muscular atrophy includes regular follow-up examinations and assessment of disease progression. Expectations for children with SMA type 1 may vary depending on early initiation of treatment and availability of modern therapies. Assessment of physiological function, respiratory system, and maintenance of quality of life are necessary. Complications often occur, such as:<\/p>\n<ul>\n<li>Respiratory infections due to weakness of the lung muscles.<\/li>\n<li>Deformities of the musculoskeletal system, including scoliosis.<\/li>\n<li>Psychological problems associated with chronic illness.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Age-related features of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Spinal muscular atrophy type 1 has its own characteristics in the course of different age groups. In newborns and infants, the disease manifests itself as a &quot;soft baby&quot; syndrome with a lack of active movements, while in older children, a slower increase in symptoms is possible. A fatal outcome can occur during the first two years of life without adequate therapy, but modern treatment methods increase the life expectancy and quality of life of such patients even in early childhood.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><strong>What is the likelihood that a child will have SMA if there is a history of the disease in the family?<\/strong> The probability is 25% if there are two carriers of the mutation in the SMN1 gene.<\/li>\n<li><strong>What symptoms should parents see a doctor for?<\/strong> Symptoms include muscle weakness, difficulty moving, and &quot;softness&quot; of the muscles in the newborn.<\/li>\n<li><strong>What modern treatments are available for SMA?<\/strong> Genetic therapies such as nusinarsen and zolgensma are currently available.<\/li>\n<li><strong>What is the average life expectancy for patients with SMA type 1?<\/strong> Without treatment, most patients do not survive beyond 2 years of age, but modern treatments significantly increase life expectancy.<\/li>\n<li><strong>What kind of care do children with SMA need?<\/strong> Constant medical supervision, physical therapy and assistance in organizing an adapted living space are required.<\/li>\n<\/ul>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Spinal muscular atrophy (SMA) type 1, also known as Werdnig-Hoffmann disease, is a genetic disorder characterized by progressive weakness and wasting of the skeletal muscles.<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-13050","post","type-post","status-publish","format-standard","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13050","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=13050"}],"version-history":[{"count":1,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13050\/revisions"}],"predecessor-version":[{"id":13871,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/13050\/revisions\/13871"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=13050"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=13050"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=13050"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}