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Nitric Oxide in Macrophage Immunometabolism: Hiding in Plain Sight
Open accessAbstract
Nitric Oxide (NO) is a soluble endogenous gas with various biological functions like signaling, and working as an effector molecule or metabolic regulator. In response to inflammatory signals, immune myeloid cells, like macrophages, increase production of cytokines and NO, which is important for pathogen killing. Under these proinflammatory circumstances, called “M1”, macrophages undergo a series of metabolic changes including rewiring of their tricarboxylic acid (TCA) cycle. Here, we review findings indicating that NO, through its interaction with heme and non-heme metal containing proteins, together with components of the electron transport chain, functions not only as a regulator of cell respiration, but also a modulator of intracellular cell metabolism. Moreover, diverse effects of NO and NO-derived reactive nitrogen species (RNS) involve precise interactions with different targets depending on concentration, temporal, and spatial restrictions. Although the role of NO in macrophage reprogramming has been in evidence for some time, current models have largely minimized its importance. It has, therefore, been hiding in plain sight. A review of the chemical properties of NO, past biochemical studies, and recent publications, necessitates that mechanisms of macrophage TCA reprogramming during stimulation must be re-imagined and re-interpreted as mechanistic results of NO exposure. The revised model of metabolic rewiring we describe here incorporates many early findings regarding NO biochemistry and brings NO out of hiding and to the forefront of macrophages immunometabolism.
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“The role of •NO in macrophage reprogramming has been known for a long time, but current models greatly underestimate its importance [125].”
From The Role of Reactive Species on Innate Immunity (2022) · cites this paper as [125]
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“The •NO/ROS balance is also important during the transition from Th1 to Th2 [125,126].”
From The Role of Reactive Species on Innate Immunity (2022) · cites this paper as [125]
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BackgroundCommitment to glycolysis sustains survival of NO-producing inflammatory dendritic cells
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“This changes the ETC to a more reduced state and leads to a defense response where reversal of the ATP synthase will hydrolyze cytoplasmic glycolytic ATP extruding protons (H+).”
BackgroundInfluentialDiffusion of Nitric Oxide in the Aorta Wall Monitored in Situ by Porphyrinic Microsensors
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“First of all, as noted above, unlike IDH1, ACO2 is a long known target of NO via attack of its FeS cluster [53,68,69].”
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“However, we find that activation of NRF2 occurs regardless of intracellular availability of itaconate.”
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“Compared to NO and other RNS, HNO has a distinct signaling mechanism of action [242,243] and higher electrophilicity than NO [244].”
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“Although DGAT1-dependent TG synthesis has recently been reported to enhance macrophage inflammatory function together with PGE2 signaling [197], this finding still lacks mechanistic understanding regarding its intrinsic connections to metabolic needs and cell function.”
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“Compared to NO and other RNS, HNO has a distinct signaling mechanism of action [242,243] and higher electrophilicity than NO [244].”
BackgroundSelf-citationIrg1 expression in myeloid cells prevents immunopathology during M. tuberculosis infection
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“Moreover, the NOS intermediate NOHA, supporting effective NO production by suppressing arginase activity freeing cellular arginine for NO production [139], has been shown to be critical in controlling parasites such as Leishmania [140].”
BackgroundItaconic acid mediates crosstalk between macrophage metabolism and peritoneal tumors
Weiss, J. M., Davies, L. C., Karwan, M., Ileva, L., Ozaki, M. K., Cheng, R. Y. S., Ridnour, L. A., Annunziata, C. M., Wink, D. A., & McVicar, D. W. (2018) · Journal of Clinical Investigation · doi:10.1172/jci99169 · Cited by 267 · cited 1×
“Itaconate production by the resident macrophages of the peritoneal cavity has also been shown to regulate their ROS production and facilitate their ability to promote tumor growth in this anatomical site [127].”
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“Cyt c, cytochrome c; FADH2, flavin-adenine dinucleotide reduced; NADH, nicotinamide adenine dinucleotide reduced; Q, ubiquinone; I, II, III, and IV refer to the complexes of ETC. ANT, adenosine nucleotide translocator.”
BackgroundMethodInfluentialNitric oxide-mediated mitochondrial damage: A potential neuroprotective role for glutathione
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Apoptosis-induced mitochondrial dysfunction causes cytoplasmic lipid droplet formation
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“Through Electron Spin Resonance, iron-nitric oxide complexes were detected in proteins in these cells [59].”
BackgroundMechanisms of triglyceride accumulation in activated macrophages
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“Therefore, the NO-dependent increased formation of lipid vesicles during macrophage activation may facilitate the production and storage of compounds important for subsequent effector function [156,194].”
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BackgroundLeukocyte lipid bodies — Biogenesis and functions in inflammation
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“Therefore, the NO-dependent increased formation of lipid vesicles during macrophage activation may facilitate the production and storage of compounds important for subsequent effector function [156,194].”
BackgroundNitric oxide in parasitic infections
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“In contrast to vascular integrity, the roles of NO in immunity involve it being a toxic agent towards infectious organisms [13,22,23], an inducer or suppressor of leukocyte apoptosis [24] or an immunoregulator [25–31].”
BackgroundReaction of Superoxide and Nitric Oxide with Peroxynitrite
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“The biology and biochemistry of itaconate has been recently reviewed in detail by others [128,129].”
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“For example, the mitochondrial bioenergetic changes observed in murine M1 polarized BMDMs are largely absent in similarly stimulated human PBMC-derived macrophages [100,226].”
BackgroundA broken Krebs cycle in macrophages
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“These findings led to the suggestion that in polarized macrophages, pseudo-hypoxia, caused by reduction in α-KG /succinate ratios and suppression of dioxygenase activity [113,114], leads to HIF1α stabilization and expression of Pyruvate Dehydrogenase Kinase 1 (Pdk1) that phosphorylates Pyruvate Dehydrogenase (PDH), re…”
BackgroundInfluentialMYC inhibition induces metabolic changes leading to accumulation of lipid droplets in tumor cells
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“Although the mechanism of A/D transition may only operate in pathological conditions, when enzyme turnover is limited by hypoxia or by a high NO/O2 ratios [92,162], we suggested that it is the lack of substrates, (i.”
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“Superoxide is generated within complexes I and III as byproduct of mitochondrial electron transfer which, if not consumed by mitochondrial manganese-dependent SOD (MnSOD) [77,78], can react with NO to form ONOO− which is rapidly converted to NO2 and N2O3 [34].”
BackgroundInfluentialSelf-citationOn the expression of nitric oxide synthase by human macrophages. Why no NO?
Albina, J. E. (1995) · Journal of Leukocyte Biology · doi:10.1002/jlb.58.6.643 · Cited by 213
Hypoxia stimulates release of endothelium-derived relaxant factor
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“As reduced supplies of O2 will make endogenous NO even more effective at inhibiting cytochrome c oxidase [48], this might indeed be a mechanism in the microcirculation by which NO, sensing hypoxia, diverts O2 into adjacent issues and at the same time induces vasodilation in an attempt to improve tissue perfusion [45].”
BackgroundTorres, J., Darley-Usmar, V. M., & Wilson, M. T. (1995) · Biochemical Journal · doi:10.1042/bj3120169 · Cited by 206 · cited 1×
“In later studies, NO was found to bind and dissociate very rapidly from the enzyme [40,41].”
BackgroundGroot, C. J. A. D., Ruuls, S. R., THEEUWES, J. W. M., Dijkstra, C. D., & van der Valk, P. (1997) · Journal of Neuropathology & Experimental Neurology · doi:10.1097/00005072-199701000-00002 · Cited by 205
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“Deactive or dormant (D) enzyme is reactivated by a pulse of NADH, when the enzyme undergoes one or several slow turnovers or chemical conversions as NADH is oxidized and ubiquinone is reduced [87].”
BackgroundCytokine Secretion in Macrophages: SNAREs, Rabs, and Membrane Trafficking
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“Unlike the NOS2− and NO-independent lipogenesis of species like phosphatidylcholine (PC), phosphatidylethanolamine (PE), and phosphatidylinositol (PI) which is important to support the need of cytokine secretion within the ER and Golgi network [195,196], the role of TG synthesis via DGAT1 is less clear.”
BackgroundManderson, A. P., Kay, J. G., Hammond, L. A., Brown, D. L., & Stow, J. L. (2007) · The Journal of Cell Biology · doi:10.1083/jcb.200612131 · Cited by 198 · cited 1×
“Unlike the NOS2− and NO-independent lipogenesis of species like phosphatidylcholine (PC), phosphatidylethanolamine (PE), and phosphatidylinositol (PI) which is important to support the need of cytokine secretion within the ER and Golgi network [195,196], the role of TG synthesis via DGAT1 is less clear.”
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“transition pore (PTP), which leads to the collapse of the membrane potential, mitochondrial swelling, outer mitochondrial membrane rupture, release of mitochondrial pro-apoptotic factors, and cell death [85] (Figure 2b).”
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“This work led to the conclusion that inhibition of mitochondrial non-heme iron-dependent enzymes in macrophages is mediated by autologous NO binding to enzymes containing iron-prosthetic groups [67,70].”
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“concluded that that mechanism only partially reduces the flux through PDH [153].”
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“Indeed, the mechanism of irreversible inhibition of aldehyde dehydrogenase by HNO has been speculated to involve the presence of a sulfinamide [240,245].”
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“Given known metabolic plasticity in vivo and reports that redox states and metabolomes are altered during ex vivo manipulations [228], our in vivo study [109] of a modified Schwartzman-like reaction has important implications for the understanding of the regulation of immunity and disease pathogenesis.”
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Self-citationAnalysis of Nitric Oxide Synthase and Nitrotyrosine Expression in Human Pulmonary Tuberculosis
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“In contrast to vascular integrity, the roles of NO in immunity involve it being a toxic agent towards infectious organisms [13,22,23], an inducer or suppressor of leukocyte apoptosis [24] or an immunoregulator [25–31].”
BackgroundDhakshinamoorthy, S., & Porter, A. G. (2004) · Journal of Biological Chemistry · doi:10.1074/jbc.m312492200 · Cited by 159
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“Ongoing expression analysis and targeted metabolomics in BMDM from Acod1−/−, Nos2−/−, and double knockouts mice and the use of NO donors will likely definitively find that the NRF2 pathway is driven directly by NO as has been suggested for other cell types [193].”
BackgroundNitric oxide stimulates Nrf2 nuclear translocation in vascular endothelium
Buckley, B. J., Marshall, Z. M., & Whorton, A. R. (2003) · Biochemical and Biophysical Research Communications · doi:10.1016/s0006-291x(03)01308-1 · Cited by 152
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“The rate constant for association of NO to heme centers is typically very high relative to other potential targets [20], such that even low nanomolar levels of NO are sufficient to activate sGC [21].”
BackgroundInfluentialSelf-citationMcNeill, E., Crabtree, M. J., Sahgal, N., Patel, J., Chuaiphichai, S., Iqbal, A. J., Hale, A., Greaves, D. R., & Channon, K. M. (2014) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2014.10.575 · Cited by 150 · cited 4×
“Moreover, Bailey et al. observed increased transcription of Il1b, and although HIF1α can transcriptionally regulate Il1b, both labs concluded that HIF1α was not responsible for their findings.”
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“Older reports on the E3 of PDH support its targeting by nitroxyl (HNO) or peroxynitrite [154,155].”
BackgroundOn the Mechanism of Inhibition of Cytochrome c Oxidase by Nitric Oxide
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“An alternative hypothesis was that human monocytes/macrophages cannot synthesize tetrahydrobiopterin, an essential co-factor for iNOS activity and, thus, needed to acquire it from other cells, such as lymphocytes [218,219].”
BackgroundCharacterisation of the active/de-active transition of mitochondrial complex I
Babot, M., Birch, A., Labarbuta, P., & Galkin, A. S. (2014) · Biochimica et Biophysica Acta (BBA) - Bioenergetics · doi:10.1016/j.bbabio.2014.02.018 · Cited by 135 · cited 2×
“In brief, the enzyme spontaneously converts into the D-form after exposure to high physiological temperatures (>30 °C) or in the absence of substrate [86,87].”
BackgroundLack of Oxygen Deactivates Mitochondrial Complex I
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“An alternative hypothesis was that human monocytes/macrophages cannot synthesize tetrahydrobiopterin, an essential co-factor for iNOS activity and, thus, needed to acquire it from other cells, such as lymphocytes [218,219].”
BackgroundDirect Evidence of Nitric Oxide Presence within Mitochondria
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“Re-activation of the D form by NADH was inhibited by nitrosothiols and peroxynitrite whilst the A form was insensitive to such treatment [92].”
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Superoxide fluxes limit nitric oxide-induced signaling
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“Superoxide is generated within complexes I and III as byproduct of mitochondrial electron transfer which, if not consumed by mitochondrial manganese-dependent SOD (MnSOD) [77,78], can react with NO to form ONOO− which is rapidly converted to NO2 and N2O3 [34].”
BackgroundSelf-citationAmiel, E., Everts, B., Fritz, D. I., Beauchamp, S., Ge, B., Pearce, E. L., & Pearce, E. J. (2014) · The Journal of Immunology · doi:10.4049/jimmunol.1302498 · Cited by 120 · cited 1×
“This second wave of glycolytic induction is mediated in DCs by mTOR/ HIF1α /NOS2 [142,146].”
BackgroundEvaluation of nitrite production by human monocyte-derived macrophages
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Superoxide production by mitochondria in the presence of nitric oxide forms peroxynitrite
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“[151] also exposed apparent incongruences with studies indicating that HIF1α-dependent upregulation of Pdk1 and consequent suppression of acetyl-CoA synthesis, may be responsible for OXPHOS regulation in macrophages [152].”
BackgroundSelf-citationThe role of nitric oxide in metabolic regulation of Dendritic cell immune function
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“This phenomenon has led many researchers to assume that HIF1α is critically required for DC glycolytic reprogramming, when in fact this is only the case for the sustained commitment to glycolysis observed in NO-producing DCs [145].”
BackgroundBasudhar, D., Glynn, S. A., Greer, M., Somasundaram, V., No, J. H., Scheiblin, D. A., Garrido, P., Heinz, W. F., Ryan, A. E., Weiss, J. M., et al. (2017) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1709119114 · Cited by 113 · cited 1×
“Although human endothelial cells, hepatocytes, and other non-myeloid human cell types [198] have been shown to readily express NOS2 [199] and produce substantial fluxes of NO, many authors have reported limited induction of iNOS in human monocytes/macrophages causing continued controversy regarding the role of NO in h…”
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“Intracellularly, the concentration of O2 has been reported to be as low as 10 μM [42].”
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“The result is so called M1, proinflammatory macrophages, which demonstrate reduced mitochondrial activity together with substantial upregulation of glycolytic metabolism for the fast generation of ATP needed to sustain phagocytosis and microbial killing [102,104,105].”
BackgroundHypoxia-driven immunosuppression: A new reason to use thermal therapy in the treatment of cancer?
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“Of consequence, the increased available pO2 associated with elevated NO levels can affect the immune response [234].”
BackgroundNitric oxide activation of Keap1/Nrf2 signaling in human colon carcinoma cells
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Forkink, M., Manjeri, G. R., Liemburg-Apers, D. C., Nibbeling, E. A. R., Blanchard, M. G., Wojtala, A., Smeitink, J. A. M., Wieckowski, M. R., Willems, P. H. G. M., & Koopman, W. J. H. (2014) · Biochimica et Biophysica Acta (BBA) - Bioenergetics · doi:10.1016/j.bbabio.2014.04.008 · Cited by 106 · cited 1×
“They align perfectly with a model where the hyperpolarization of mitochondrial membranes, the condition where the mitochondrial inner membrane becomes more negative on the matrix side [148,149], is induced by NO initially blocking Complex IV and favoring hydrolysis of glycolytically-derived ATP [80,150] (Figure 2a).”
BackgroundFensterheim, B. A., Young, J. D., Luan, L., Kleinbard, R. R., Stothers, C. L., Patil, N. K., Pereira, A. G. M., Guo, Y., Trenary, I. A., Hernandez, A., et al. (2018) · The Journal of Immunology · doi:10.4049/jimmunol.1800085 · Cited by 105 · cited 1×
“IFNγ treatment alone, without LPS [170], or stimulation with monophospholipid A [171], or low LPS [112] does not result in the dramatic reductions in mitochondrial ATP production discussed above and in some circles maximal respiratory capacity (MRC) can actually increase early upon bacterial recognition [172].”
BackgroundTargeting Tumor Perfusion and Oxygenation to Improve the Outcome of Anticancer Therapy1
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Intraphagosomal Measurement of the Magnitude and Duration of the Oxidative Burst
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“Therapeutically shifting the TME from tumorigenic simmering iNOS activity driven by the tumor itself, towards an immune surveillance situation where macrophages are reprogrammed to produce higher, effector level, NO fluxes could be beneficial [237,238].”
Background
Cited by
Sorted by citations
Macrophages in immunoregulation and therapeutics
Chen, S., Saeed, A. F. U. H., Liu, Q., Jiang, Q., Xu, H., Xiao, G. G., Rao, L., & Duo, Y. (2023) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01452-1 · Cited by 2,477
Macrophage plasticity: signaling pathways, tissue repair, and regeneration
Yan, L., Wang, J., Cai, X., Liou, Y., Shen, H., Hao, J., Huang, C., Luo, G., & He, W. (2024) · MedComm · doi:10.1002/mco2.658 · Cited by 406
Macrophage Reprogramming and Cancer Therapeutics: Role of iNOS-Derived NO
Kashfi, K., Kannikal, J. J., & Nath, N. (2021) · Cells · doi:10.3390/cells10113194 · Cited by 244
“If the cell situation could be altered such that the TME’s low iNOS activity is reprogrammed to produce higher iNOS/NO concentrations, it may then be of therapeutic value [74,75].”
BackgroundMarrocco, A., & Ortiz, L. A. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.936167 · Cited by 173
The Role of Reactive Species on Innate Immunity
Andrés, C., Pérez de la Lastra, J., Juan, C., Plou, F., & Pérez-Lebeña, E. (2022) · Vaccines · doi:10.3390/vaccines10101735 · Cited by 142
“The •NO/ROS balance is also important during the transition from Th1 to Th2 [125,126].”
Background
Metadata
- Authors
- Palmieri, E. M., McGinity, C., Wink, D. A., & McVicar, D. W.
- Affiliations
- National Cancer Institute (US)
- Corresponding author
- McVicar, Daniel W.
- Venue
- Metabolites
- Publisher
- MDPI AG
- Published
- 2020-10-26
- Volume
- 10
- Issue
- 11
- Pages
- 429
- ISSN
- 2218-1989 (ISSN-L)
- PMC
- PMC7693038
- OpenAlex
- W3096340664
- Cited by
- 237
- References
- 252
- Citations by year
- 2026: 40 · 2025: 59 · 2024: 56 · 2023: 46 · 2022: 15 · 2021: 20 · 2020: 1
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Metabolites (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Cancer Institute (ZIA BC 010300, ZIA BC 010899)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Redox biology and oxidative stress
- Keywords
- nitric oxide, macrophage immunometabolism, M1 macrophages, reactive nitrogen species, electron transport chain, heme proteins, cellular respiration, macrophage metabolic reprogramming, inflammation
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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