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2.
RNA ; 28(1): 36-47, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34772786

RESUMO

Exciting recent work has highlighted that numerous cellular compartments lack encapsulating lipid bilayers (often called "membraneless organelles"), and that their structure and function are central to the regulation of key biological processes, including transcription, RNA splicing, translation, and more. These structures have been described as "biomolecular condensates" to underscore that biomolecules can be significantly concentrated in them. Many condensates, including RNA granules and processing bodies, are enriched in proteins and nucleic acids. Biomolecular condensates exhibit a range of material states from liquid- to gel-like, with the physical process of liquid-liquid phase separation implicated in driving or contributing to their formation. To date, in vitro studies of phase separation have provided mechanistic insights into the formation and function of condensates. However, the link between the often micron-sized in vitro condensates with nanometer-sized cellular correlates has not been well established. Consequently, questions have arisen as to whether cellular structures below the optical resolution limit can be considered biomolecular condensates. Similarly, the distinction between condensates and discrete dynamic hub complexes is debated. Here we discuss the key features that define biomolecular condensates to help understand behaviors of structures containing and generating RNA.


Assuntos
Condensados Biomoleculares/química , Corpos de Processamento/química , Proteínas de Ligação a RNA/química , RNA/química , Ribonucleoproteínas/química , Grânulos de Estresse/química , Condensados Biomoleculares/metabolismo , Células Eucarióticas/química , Células Eucarióticas/metabolismo , Substâncias Macromoleculares/química , Substâncias Macromoleculares/metabolismo , Corpos de Processamento/metabolismo , Biossíntese de Proteínas , RNA/metabolismo , Splicing de RNA , Proteínas de Ligação a RNA/metabolismo , Ribonucleoproteínas/metabolismo , Grânulos de Estresse/metabolismo , Terminologia como Assunto , Transcrição Gênica
3.
J Am Chem Soc ; 139(49): 18009-18015, 2017 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-29182244

RESUMO

Tyrosine phosphorylation of membrane receptors and scaffold proteins followed by recruitment of SH2 domain-containing adaptor proteins constitutes a central mechanism of intracellular signal transduction. During early T-cell receptor (TCR) activation, phosphorylation of linker for activation of T cells (LAT) leading to recruitment of adaptor proteins, including Grb2, is one prototypical example. LAT contains multiple modifiable sites, and this multivalency may provide additional layers of regulation, although this is not well understood. Here, we quantitatively analyze the effects of multivalent phosphorylation of LAT by reconstituting the initial reactions of the TCR signaling pathway on supported membranes. Results from a series of LAT constructs with combinatorial mutations of tyrosine residues reveal a previously unidentified allosteric mechanism in which the binding affinity of LAT:Grb2 depends on the phosphorylation at remote tyrosine sites. Additionally, we find that LAT:Grb2 binding affinity is altered by membrane localization. This allostery mainly regulates the kinetic on-rate, not off-rate, of LAT:Grb2 interactions. LAT is an intrinsically disordered protein, and these data suggest that phosphorylation changes the overall ensemble of configurations to modulate the accessibility of other phosphorylated sites to Grb2. Using Grb2 as a phosphorylation reporter, we further monitored LAT phosphorylation by TCR ζ chain-recruited ZAP-70, which suggests a weakly processive catalysis on membranes. Taken together, these results suggest that signal transmission through LAT is strongly gated and requires multiple phosphorylation events before efficient signal transmission is achieved.


Assuntos
Proteína Adaptadora GRB2/metabolismo , Proteínas Intrinsicamente Desordenadas/metabolismo , Regulação Alostérica , Calorimetria , Membrana Celular/metabolismo , Cinética , Fosfoproteínas/metabolismo , Fosforilação , Ligação Proteica , Receptores de Antígenos de Linfócitos T/química , Receptores de Antígenos de Linfócitos T/metabolismo , Transdução de Sinais , Imagem Individual de Molécula , Tirosina/metabolismo , Proteína-Tirosina Quinase ZAP-70/metabolismo
4.
bioRxiv ; 2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38328089

RESUMO

Cellular condensates often consist of 10s to 100s of distinct interacting molecular species. Because of the complexity of these interactions, predicting the point at which they will undergo phase separation into discrete compartments is daunting. Using experiments and computation, we therefore studied a simple model system consisting of 2 proteins, polySH3 and polyPRM, designed for pentavalent heterotypic binding. We tested whether the peak solubility product, the product of dilute phase monomer concentrations, is a predictive parameter for the onset of phase separation. Titrating up equal total concentrations of each component showed that the maximum solubility product does approximately coincide with the threshold for phase separation in both the experiments and models. However, we found that measurements of dilute phase concentration include contributions from small oligomers, not just monomers; therefore, a quantitative comparison of the experiments and models required inclusion of small oligomers in the model analysis. We also examined full phase diagrams where the model results were almost symmetric along the diagonal, but the experimental results were highly asymmetric. This led us to perform dynamic light scattering experiments, where we discovered a weak homotypic interaction for polyPRM; when this was added to the computational model, it was able to recapitulate the experimentally observed asymmetry. Thus, comparing experiments to simulation reveals that the solubility product can be predictive of phase separation, even if small oligomers and low affinity homotypic interactions preclude experimental measurement of monomer concentration.

5.
Biophys J ; 104(3): 520-32, 2013 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-23442903

RESUMO

Mathematical modeling has established its value for investigating the interplay of biochemical and mechanical mechanisms underlying actin-based motility. Because of the complex nature of actin dynamics and its regulation, many of these models are phenomenological or conceptual, providing a general understanding of the physics at play. But the wealth of carefully measured kinetic data on the interactions of many of the players in actin biochemistry cries out for the creation of more detailed and accurate models that could permit investigators to dissect interdependent roles of individual molecular components. Moreover, no human mind can assimilate all of the mechanisms underlying complex protein networks; so an additional benefit of a detailed kinetic model is that the numerous binding proteins, signaling mechanisms, and biochemical reactions can be computationally organized in a fully explicit, accessible, visualizable, and reusable structure. In this review, we will focus on how comprehensive and adaptable modeling allows investigators to explain experimental observations and develop testable hypotheses on the intracellular dynamics of the actin cytoskeleton.


Assuntos
Citoesqueleto de Actina/química , Modelos Biológicos , Citoesqueleto de Actina/metabolismo , Actinas/química , Actinas/metabolismo , Animais , Humanos , Proteínas dos Microfilamentos/química , Proteínas dos Microfilamentos/metabolismo
6.
Sci Adv ; 9(17): eadf6205, 2023 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-37126554

RESUMO

During T cell activation, the transmembrane adaptor protein LAT (linker for activation of T cells) forms biomolecular condensates with Grb2 and Sos1, facilitating signaling. LAT has also been associated with cholesterol-rich condensed lipid domains; However, the potential coupling between protein condensation and lipid phase separation and its role in organizing T cell signaling were unknown. Here, we report that LAT/Grb2/Sos1 condensates reconstituted on model membranes can induce and template lipid domains, indicating strong coupling between lipid- and protein-based phase separation. Correspondingly, activation of T cells induces cytoplasmic protein condensates that associate with and stabilize raft-like membrane domains. Inversely, lipid domains nucleate and stabilize LAT protein condensates in both reconstituted and living systems. This coupling of lipid and protein assembly is functionally important, as uncoupling of lipid domains from cytoplasmic protein condensates abrogates T cell activation. Thus, thermodynamic coupling between protein condensates and ordered lipid domains regulates the functional organization of living membranes.


Assuntos
Proteínas de Membrana , Linfócitos T , Linfócitos T/metabolismo , Proteínas de Membrana/metabolismo , Transdução de Sinais , Lipídeos
7.
Curr Opin Cell Biol ; 69: 48-54, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33461072

RESUMO

Clustering is a prominent feature of receptors at the plasma membrane (PM). It plays an important role in signaling. Liquid-liquid phase separation (LLPS) of proteins is emerging as a novel mechanism underlying the observed clustering. Receptors/transmembrane signaling proteins can be core components essential for LLPS (such as LAT or nephrin) or clients enriched at the phase-separated condensates (for example, at the postsynaptic density or at tight junctions). Condensate formation has been shown to regulate signaling in multiple ways, including by increasing protein binding avidity and by modulating the local biochemical environment. In moving forward, it is important to study protein LLPS at the PM of living cells, its interplay with other factors underlying receptor clustering, and its signaling and functional consequences.


Assuntos
Transdução de Sinais , Membrana Celular , Humanos , Ligação Proteica
8.
Elife ; 102021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33973848

RESUMO

Sigma 1 receptor (S1R) is a 223-amino-acid-long transmembrane endoplasmic reticulum (ER) protein. S1R modulates activity of multiple effector proteins and is a well-established drug target. However, signaling functions of S1R in cells are poorly understood. Here, we test the hypothesis that biological activity of S1R in cells can be explained by its ability to interact with cholesterol and to form cholesterol-enriched microdomains in the ER membrane. By performing experiments in reduced reconstitution systems, we demonstrate direct effects of cholesterol on S1R clustering. We identify a novel cholesterol-binding motif in the transmembrane region of human S1R. Mutations of this motif impair association of recombinant S1R with cholesterol beads, affect S1R clustering in vitro and disrupt S1R subcellular localization. We demonstrate that S1R-induced membrane microdomains have increased local membrane thickness and that increased local cholesterol concentration and/or membrane thickness in these microdomains can modulate signaling of inositol-requiring enzyme 1α in the ER. Further, S1R agonists cause disruption of S1R clusters, suggesting that biological activity of S1R agonists is linked to remodeling of ER membrane microdomains. Our results provide novel insights into S1R-mediated signaling mechanisms in cells.


Assuntos
Colesterol/metabolismo , Retículo Endoplasmático/metabolismo , Receptores sigma/genética , Receptores sigma/metabolismo , Transdução de Sinais , Células HEK293 , Humanos , Membranas Intracelulares/metabolismo , Microdomínios da Membrana , Ligação Proteica , Receptor Sigma-1
9.
Nat Cell Biol ; 22(6): 674-688, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32451441

RESUMO

The dynamin GTPase is known to bundle actin filaments, but the underlying molecular mechanism and physiological relevance remain unclear. Our genetic analyses revealed a function of dynamin in propelling invasive membrane protrusions during myoblast fusion in vivo. Using biochemistry, total internal reflection fluorescence microscopy, electron microscopy and cryo-electron tomography, we show that dynamin bundles actin while forming a helical structure. At its full capacity, each dynamin helix captures 12-16 actin filaments on the outer rim of the helix. GTP hydrolysis by dynamin triggers disassembly of fully assembled dynamin helices, releasing free dynamin dimers/tetramers and facilitating Arp2/3-mediated branched actin polymerization. The assembly/disassembly cycles of dynamin promote continuous actin bundling to generate mechanically stiff actin super-bundles. Super-resolution and immunogold platinum replica electron microscopy revealed dynamin along actin bundles at the fusogenic synapse. These findings implicate dynamin as a unique multifilament actin-bundling protein that regulates the dynamics and mechanical strength of the actin cytoskeletal network.


Assuntos
Citoesqueleto de Actina/metabolismo , Actinas/metabolismo , Comunicação Celular , Drosophila melanogaster/metabolismo , Dinaminas/metabolismo , Endocitose , Complexo 2-3 de Proteínas Relacionadas à Actina/metabolismo , Actinas/genética , Sequência de Aminoácidos , Animais , Drosophila melanogaster/genética , Dinaminas/genética , Feminino , Guanosina Trifosfato/metabolismo , Masculino , Mioblastos/citologia , Mioblastos/metabolismo , Ligação Proteica , Homologia de Sequência
10.
Biophys J ; 96(9): 3529-42, 2009 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-19413959

RESUMO

The availability of quantitative experimental data on the kinetics of actin assembly has enabled the construction of many mathematical models focused on explaining specific behaviors of this complex system. However these ad hoc models are generally not reusable or accessible by the large community of actin biologists. In this work, we present a comprehensive model that integrates and unifies much of the in vitro data on the components of the dendritic nucleation mechanism for actin dynamics. More than 300 simulations have been run based on compartmental and three-dimensional spatial versions of this model. Several key findings are highlighted, including an explanation for the sharp boundary between actin assembly and disassembly in the lamellipodia of migrating cells. Because this model, with the simulation results, is "open source", in the sense that it is publicly available and editable through the Virtual Cell database (http://vcell.org), it can be accessed, analyzed, modified, and extended.


Assuntos
Citoesqueleto de Actina/metabolismo , Actinas/metabolismo , Modelos Biológicos , Pseudópodes/metabolismo , Proteínas de Capeamento de Actina/metabolismo , Fatores de Despolimerização de Actina/metabolismo , Complexo 2-3 de Proteínas Relacionadas à Actina/metabolismo , Movimento Celular/fisiologia , Simulação por Computador , Citoesqueleto/metabolismo , Internet , Cinética , Software , Gravação em Vídeo
11.
Nat Cell Biol ; 26(3): 310-312, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38424272

Assuntos
Organelas , Citoplasma
12.
Annu Rev Biophys ; 48: 465-494, 2019 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-30951647

RESUMO

Cell surface transmembrane receptors often form nanometer- to micrometer-scale clusters to initiate signal transduction in response to environmental cues. Extracellular ligand oligomerization, domain-domain interactions, and binding to multivalent proteins all contribute to cluster formation. Here we review the current understanding of mechanisms driving cluster formation in a series of representative receptor systems: glycosylated receptors, immune receptors, cell adhesion receptors, Wnt receptors, and receptor tyrosine kinases. We suggest that these clusters share properties of systems that undergo liquid-liquid phase separation and could be investigated in this light.


Assuntos
Membrana Celular/metabolismo , Transdução de Sinais , Animais , Membrana Celular/química , Humanos , Ligantes , Polimerização , Receptores de Superfície Celular/metabolismo
13.
Science ; 363(6431): 1093-1097, 2019 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-30846599

RESUMO

Biomolecular condensates concentrate macromolecules into foci without a surrounding membrane. Many condensates appear to form through multivalent interactions that drive liquid-liquid phase separation (LLPS). LLPS increases the specific activity of actin regulatory proteins toward actin assembly by the Arp2/3 complex. We show that this increase occurs because LLPS of the Nephrin-Nck-N-WASP signaling pathway on lipid bilayers increases membrane dwell time of N-WASP and Arp2/3 complex, consequently increasing actin assembly. Dwell time varies with relative stoichiometry of the signaling proteins in the phase-separated clusters, rendering N-WASP and Arp2/3 activity stoichiometry dependent. This mechanism of controlling protein activity is enabled by the stoichiometrically undefined nature of biomolecular condensates. Such regulation should be a general feature of signaling systems that assemble through multivalent interactions and drive nonequilibrium outputs.


Assuntos
Complexo 2-3 de Proteínas Relacionadas à Actina/metabolismo , Actinas/metabolismo , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Membrana Celular/metabolismo , Proteínas de Membrana/metabolismo , Proteínas Oncogênicas/metabolismo , Proteína Neuronal da Síndrome de Wiskott-Aldrich/metabolismo , Linhagem Celular Tumoral , Humanos , Ligantes , Bicamadas Lipídicas , Transição de Fase , Ligação Proteica , Transdução de Sinais , Domínios de Homologia de src
14.
Elife ; 82019 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-31268421

RESUMO

During T cell activation, biomolecular condensates form at the immunological synapse (IS) through multivalency-driven phase separation of LAT, Grb2, Sos1, SLP-76, Nck, and WASP. These condensates move radially at the IS, traversing successive radially-oriented and concentric actin networks. To understand this movement, we biochemically reconstituted LAT condensates with actomyosin filaments. We found that basic regions of Nck and N-WASP/WASP promote association and co-movement of LAT condensates with actin, indicating conversion of weak individual affinities to high collective affinity upon phase separation. Condensates lacking these components were propelled differently, without strong actin adhesion. In cells, LAT condensates lost Nck as radial actin transitioned to the concentric network, and engineered condensates constitutively binding actin moved aberrantly. Our data show that Nck and WASP form a clutch between LAT condensates and actin in vitro and suggest that compositional changes may enable condensate movement by distinct actin networks in different regions of the IS.


Assuntos
Ativação Linfocitária , Multimerização Proteica , Transdução de Sinais , Linfócitos T/metabolismo , Actinas/metabolismo , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Humanos , Proteínas de Membrana/metabolismo , Proteínas Oncogênicas/metabolismo , Ligação Proteica , Transporte Proteico , Proteína da Síndrome de Wiskott-Aldrich/metabolismo
15.
J Mol Biol ; 430(23): 4666-4684, 2018 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-30099028

RESUMO

Biomolecular condensates are two- and three-dimensional compartments in eukaryotic cells that concentrate specific collections of molecules without an encapsulating membrane. Many condensates behave as dynamic liquids and appear to form through liquid-liquid phase separation driven by weak, multivalent interactions between macromolecules. In this review, we discuss current models and data regarding the control of condensate composition, and we describe our current understanding of the composition of representative condensates including PML nuclear bodies, P-bodies, stress granules, the nucleolus, and two-dimensional membrane localized LAT and nephrin clusters. Specific interactions, such as interactions between modular binding domains, weaker interactions between intrinsically disorder regions and nucleic acid base pairing, and nonspecific interactions, such as electrostatic interactions and hydrophobic interactions, influence condensate composition. Understanding how specific condensate composition is determined is essential to understanding condensates as biochemical entities and ultimately discerning their cellular and organismic functions.


Assuntos
Substâncias Macromoleculares/química , Substâncias Macromoleculares/metabolismo , Ácidos Nucleicos/química , Ácidos Nucleicos/metabolismo , Animais , Nucléolo Celular/metabolismo , Citoplasma/metabolismo , Células Eucarióticas/metabolismo , Humanos , Interações Hidrofóbicas e Hidrofílicas , Proteínas de Membrana/química , Proteínas de Membrana/metabolismo , Modelos Moleculares , Conformação Molecular , Organelas/química , Organelas/metabolismo , Proteína da Leucemia Promielocítica/química , Proteína da Leucemia Promielocítica/metabolismo
16.
Cancer Res ; 65(13): 5628-37, 2005 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-15994935

RESUMO

Despite the moderate incidence of papillary renal cell carcinoma (PRCC), there is a disproportionately limited understanding of its underlying genetic programs. There is no effective therapy for metastatic PRCC, and patients are often excluded from kidney cancer trials. A morphologic classification of PRCC into type 1 and 2 tumors has been recently proposed, but its biological relevance remains uncertain. We studied the gene expression profiles of 34 cases of PRCC using Affymetrix HGU133 Plus 2.0 arrays (54,675 probe sets) using both unsupervised and supervised analyses. Comparative genomic microarray analysis was used to infer cytogenetic aberrations, and pathways were ranked with a curated database. Expression of selected genes was validated by immunohistochemistry in 34 samples with 15 independent tumors. We identified two highly distinct molecular PRCC subclasses with morphologic correlation. The first class, with excellent survival, corresponded to three histologic subtypes: type 1, low-grade type 2, and mixed type 1/low-grade type 2 tumors. The second class, with poor survival, corresponded to high-grade type 2 tumors (n = 11). Dysregulation of G1-S and G2-M checkpoint genes were found in class 1 and 2 tumors, respectively, alongside characteristic chromosomal aberrations. We identified a seven-transcript predictor that classified samples on cross-validation with 97% accuracy. Immunohistochemistry confirmed high expression of cytokeratin 7 in class 1 tumors and of topoisomerase IIalpha in class 2 tumors. We report two molecular subclasses of PRCC, which are biologically and clinically distinct and may be readily distinguished in a clinical setting.


Assuntos
Carcinoma Papilar/classificação , Carcinoma de Células Renais/classificação , Neoplasias Renais/classificação , Adulto , Idoso , Carcinoma Papilar/genética , Carcinoma Papilar/metabolismo , Carcinoma Papilar/patologia , Carcinoma de Células Renais/genética , Carcinoma de Células Renais/metabolismo , Carcinoma de Células Renais/patologia , Aberrações Cromossômicas , Feminino , Perfilação da Expressão Gênica , Humanos , Imuno-Histoquímica , Neoplasias Renais/genética , Neoplasias Renais/metabolismo , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos
17.
Methods Mol Biol ; 1584: 65-76, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28255696

RESUMO

Biochemical reconstitution has served as an important tool for understanding the mechanisms of many cellular processes including DNA replication, transcription, translation, vesicle trafficking, and ubiquitin-mediated proteolysis. Here, we demonstrate that biochemical reconstitution can be applied to studying a complex signaling pathway involving as many as 12 proteins or protein complexes acting at the surface of model membranes. We show that a temporal sequence of events in activated T cells beginning with phosphorylation of the T cell receptor and culminating in the activation of actin polymerization can be replicated in vitro. Our reconstitution demonstrates the sufficiency of these proteins in producing many of the complex behaviors observed during T cell activation. The ability to manipulate all of the components, measure reaction rates, and observe molecular behaviors, including at single molecule resolution, has enabled us to gain insight into some of the important biochemical features of this signaling pathway such as microcluster formation. The same system could be adapted to study other membrane-proximal signaling pathways, including growth factor receptors, death receptors, and Eph receptors.


Assuntos
Bicamadas Lipídicas/química , Ativação Linfocitária , Receptores de Antígenos de Linfócitos T/química , Transdução de Sinais , Linfócitos T/química , Animais , Sistema Livre de Células/química , Sistema Livre de Células/imunologia , Humanos , Bicamadas Lipídicas/imunologia , Receptores de Antígenos de Linfócitos T/imunologia , Linfócitos T/imunologia
19.
Science ; 352(6285): 595-9, 2016 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-27056844

RESUMO

Activation of various cell surface receptors triggers the reorganization of downstream signaling molecules into micrometer- or submicrometer-sized clusters. However, the functional consequences of such clustering have been unclear. We biochemically reconstituted a 12-component signaling pathway on model membranes, beginning with T cell receptor (TCR) activation and ending with actin assembly. When TCR phosphorylation was triggered, downstream signaling proteins spontaneously separated into liquid-like clusters that promoted signaling outputs both in vitro and in human Jurkat T cells. Reconstituted clusters were enriched in kinases but excluded phosphatases and enhanced actin filament assembly by recruiting and organizing actin regulators. These results demonstrate that protein phase separation can create a distinct physical and biochemical compartment that facilitates signaling.


Assuntos
Actinas/metabolismo , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Proteínas de Membrana/metabolismo , Receptores de Antígenos de Linfócitos T/agonistas , Linfócitos T/metabolismo , Recuperação de Fluorescência Após Fotodegradação , Humanos , Células Jurkat , Quinases de Proteína Quinase Ativadas por Mitógeno , Fosforilação , Polimerização , Transdução de Sinais
20.
Clin Cancer Res ; 10(18 Pt 2): 6315S-21S, 2004 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-15448024

RESUMO

Renal cell carcinoma (RCC) is a histologically diverse disease, with variable and often unpredictable clinical behavior. The prognosis worsens dramatically with the onset of clinical metastasis, and current regimens of systemic therapy yield only modest benefits for metastatic RCC. Gene expression profiling is a promising technique for refining the diagnosis and staging of RCC, as well as for highlighting potential therapeutic targets. We review the recent advances in expression profiling of RCC and discuss the clinical and biological insights obtained from these studies.


Assuntos
Carcinoma de Células Renais/genética , Perfilação da Expressão Gênica , Neoplasias Renais/genética , Carcinoma de Células Renais/classificação , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/terapia , Humanos , Neoplasias Renais/classificação , Neoplasias Renais/diagnóstico , Neoplasias Renais/terapia , Nefrectomia , Prognóstico
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