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1.
Science ; 332(6025): 65-8, 2011 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-21350122

RESUMEN

Chronic mucocutaneous candidiasis disease (CMCD) is characterized by recurrent or persistent infections of the skin, nails, and oral and genital mucosae caused by Candida albicans and, to a lesser extent, Staphylococcus aureus, in patients with no other infectious or autoimmune manifestations. We report two genetic etiologies of CMCD: autosomal recessive deficiency in the cytokine receptor, interleukin-17 receptor A (IL-17RA), and autosomal dominant deficiency of the cytokine interleukin-17F (IL-17F). IL-17RA deficiency is complete, abolishing cellular responses to IL-17A and IL-17F homo- and heterodimers. By contrast, IL-17F deficiency is partial, with mutant IL-17F-containing homo- and heterodimers displaying impaired, but not abolished, activity. These experiments of nature indicate that human IL-17A and IL-17F are essential for mucocutaneous immunity against C. albicans, but otherwise largely redundant.


Asunto(s)
Candidiasis Mucocutánea Crónica/genética , Candidiasis Mucocutánea Crónica/inmunología , Interleucina-17/inmunología , Candida albicans , Niño , Preescolar , Femenino , Genes Dominantes , Genes Recesivos , Humanos , Masculino , Datos de Secuencia Molecular , Mutación , Linaje , Receptores de Interleucina-17/genética , Transducción de Señal/genética , Células Th17/inmunología
2.
Rheumatology (Oxford) ; 50(6): 1033-44, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21258049

RESUMEN

OBJECTIVES: To characterize the in vitro binding and effector function properties of CD20-directed small modular immunopharmaceutical (SMIP) 2LM20-4, and to compare its in vivo B-cell depletion activity with the mutated 2LM20-4 P331S [no in vitro complement-dependent cytotoxicity (CDC)] and rituximab in cynomolgus monkeys. METHODS: Direct binding is examined in flow cytometry, confocal microscopy, scatchard and lipid raft assays. Effector function assays include CDC and Fc-mediated cellular toxicity. In the 6-month-long in vivo B-cell depletion study, single i.v. dosages of 1 or 10 mg/kg of anti-CD20 proteins were administered to monkeys and B-cell counts were monitored in peripheral blood, bone marrow and lymph nodes. RESULTS: 2LM20-4 has lower saturation binding to human primary B cells and recruits fewer CD20 molecules into lipid rafts compared with rituximab; however, it induces higher in vitro CDC. In competitive binding, 2LM20-4 only partially displaces rituximab, suggesting that it binds to a fraction of CD20 molecules within certain locations of the plasma membrane as compared with rituximab. In monkeys, 2LM20-4 had more sustained B-cell depletion activity than rituximab in peripheral blood and had significantly more profound and sustained activity than 2LM20-4 P331S and rituximab in the lymph nodes. CONCLUSIONS: SMIP 2LM20-4, which binds to a fraction of CD20 molecules as compared with rituximab, has more potent in vitro CDC, and more potent and sustained B-cell depletion activity in cynomolgus monkeys. Our work has considerable clinical relevance since it provides novel insights related to the emerging B-cell depletion therapies in autoimmune diseases.


Asunto(s)
Citotoxicidad Celular Dependiente de Anticuerpos/efectos de los fármacos , Antígenos CD20/efectos de los fármacos , Antígenos CD20/inmunología , Anticuerpos de Cadena Única/farmacología , Animales , Anticuerpos Monoclonales/farmacología , Anticuerpos Monoclonales de Origen Murino/farmacología , Citotoxicidad Celular Dependiente de Anticuerpos/inmunología , Linfocitos B/inmunología , Linfocitos B/metabolismo , Sitios de Unión , Células Cultivadas , Modelos Animales de Enfermedad , Humanos , Factores Inmunológicos/farmacología , Técnicas In Vitro , Modelos Lineales , Macaca fascicularis , Distribución Aleatoria , Rituximab , Sensibilidad y Especificidad
3.
Anal Biochem ; 399(2): 284-92, 2010 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-20018163

RESUMEN

Vanin-1 is a pantetheinase that catalyzes the hydrolysis of pantetheine to produce pantothenic acid (vitamin B5) and cysteamine. Reported here is a highly sensitive fluorescent assay using a novel fluorescently labeled pantothenate derivative. The assay has been used for characterization of a soluble version of human vanin-1 recombinant protein, identification and characterization of hits from high-throughput screening (HTS), and quantification of vanin pantothenase activity in cell lines and tissues. Under optimized assay conditions, we quantified vanin pantothenase activity in tissue lysate and found low activity in lung and liver but high activity in kidney. We demonstrated that the purified recombinant vanin-1 consisting of the extracellular portion without the glycosylphosphatidylinositol (GPI) linker was highly active with an apparent K(m) of 28 microM for pantothenate-7-amino-4-methylcoumarin (pantothenate-AMC), which was converted to pantothenic acid and AMC based on liquid chromatography-mass spectrometry (LC-MS) analysis. The assay also performed well in a 384-well microplate format under initial rate conditions (10% conversion) with a signal-to-background ratio (S/B) of 7 and a Z factor of 0.75. Preliminary screening of a library of 1280 pharmaceutically active compounds identified inhibitors with novel chemical scaffolds. This assay will be a powerful tool for target validation and drug lead identification and characterization.


Asunto(s)
Amidohidrolasas/metabolismo , Cromatografía Líquida de Alta Presión/métodos , Inhibidores Enzimáticos/química , Espectrometría de Masas/métodos , Amidohidrolasas/antagonistas & inhibidores , Amidohidrolasas/genética , Secuencia de Aminoácidos , Animales , Línea Celular , Inhibidores Enzimáticos/farmacología , Colorantes Fluorescentes/química , Proteínas Ligadas a GPI , Ensayos Analíticos de Alto Rendimiento , Humanos , Riñón/enzimología , Ratones , Datos de Secuencia Molecular , Ácido Pantoténico/química , Proteínas Recombinantes/antagonistas & inhibidores , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Espectrofotometría Ultravioleta
4.
J Mol Biol ; 382(5): 1168-83, 2008 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-18675824

RESUMEN

Interleukin (IL) 22 is a type II cytokine that is produced by immune cells and acts on nonimmune cells to regulate local tissue inflammation. As a product of the recently identified T helper 17 lineage of CD4(+) effector lymphocytes, IL-22 plays a critical role in mucosal immunity as well as in dysregulated inflammation observed in autoimmune diseases. We used comprehensive mutagenesis combined with mammalian cell expression, ELISA cell-based, and structural methods to evaluate how IL-22 interacts with its cell surface receptor, IL-22R/IL-10R2, and with secreted IL-22 binding protein. This study identifies those amino acid side chains of IL-22 that are individually important for optimal binding to IL-22R, considerably expands the definition of IL-22 surface required for binding to IL-10R2, and demonstrates how IL-22 binding protein prevents IL-22R from binding to IL-22. The IL-22R and IL-10R2 binding sites are juxtaposed on adjacent IL-22 surfaces contributed mostly by helices A, D, and F and loop AB. Our results also provide a model for how IL-19, IL-20, IL-24, and IL-26 which are other IL-10-like cytokines, interact with their respective cell surface receptors.


Asunto(s)
Subunidad beta del Receptor de Interleucina-10/química , Subunidad beta del Receptor de Interleucina-10/metabolismo , Interleucinas/química , Interleucinas/metabolismo , Receptores de Interleucina/química , Receptores de Interleucina/metabolismo , Secuencia de Aminoácidos , Sustitución de Aminoácidos , Sitios de Unión/genética , Línea Celular , Humanos , Técnicas In Vitro , Subunidad beta del Receptor de Interleucina-10/genética , Interleucinas/genética , Modelos Moleculares , Datos de Secuencia Molecular , Mutagénesis Sitio-Dirigida , Conformación Proteica , Pliegue de Proteína , Estructura Secundaria de Proteína , Receptores de Interleucina/genética , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Homología de Secuencia de Aminoácido , Termodinámica , Interleucina-22
5.
J Immunol ; 181(4): 2799-805, 2008 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-18684971

RESUMEN

IL-17A and IL-17F, produced by the Th17 CD4(+) T cell lineage, have been linked to a variety of inflammatory and autoimmune conditions. We recently reported that activated human CD4(+) T cells produce not only IL-17A and IL-17F homodimers but also an IL-17F/IL-17A heterodimeric cytokine. All three cytokines can induce chemokine secretion from bronchial epithelial cells, albeit with different potencies. In this study, we used small interfering RNA and Abs to IL-17RA and IL-17RC to demonstrate that heterodimeric IL-17F/IL-17A cytokine activity is dependent on the IL-17RA/IL-17RC receptor complex. Interestingly, surface plasmon resonance studies indicate that the three cytokines bind to IL-17RC with comparable affinities, whereas they bind to IL-17RA with different affinities. Thus, we evaluated the effect of the soluble receptors on cytokine activity and we find that soluble receptors exhibit preferential cytokine blockade. IL-17A activity is inhibited by IL-17RA, IL-17F is inhibited by IL-17RC, and a combination of soluble IL-17RA/IL-17RC receptors is required for inhibition of the IL-17F/IL-17A activity. Altogether, these results indicate that human IL-17F/IL-17A cytokine can bind and signal through the same receptor complex as human IL-17F and IL-17A. However, the distinct affinities of the receptor components for IL-17A, IL-17F, and IL-17F/IL-17A heterodimer can be exploited to differentially affect the activity of these cytokines.


Asunto(s)
Interleucina-17/fisiología , Receptores de Interleucina-17/fisiología , Receptores de Interleucina/fisiología , Transducción de Señal/inmunología , Línea Celular , Dimerización , Relación Dosis-Respuesta Inmunológica , Humanos , Interleucina-17/antagonistas & inhibidores , Interleucina-17/química , Interleucina-17/metabolismo , Unión Proteica/inmunología , Receptores de Interleucina/metabolismo , Receptores de Interleucina-17/metabolismo
6.
J Biol Chem ; 282(18): 13447-55, 2007 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-17355969

RESUMEN

IL-17F and IL-17A are members of the IL-17 pro-inflammatory cytokine family. IL-17A has been implicated in the pathogenesis of autoimmune diseases. IL-17F is a disulfide-linked dimer that contains a cysteine-knot motif. We hypothesized that IL-17F and IL-17A could form a heterodimer due to their sequence homology and overlapping pattern of expression. We evaluated the structure of recombinant IL-17F and IL-17A proteins, as well as that of natural IL-17F and IL-17A derived from activated human CD4+ T cells, by enzyme-linked immunosorbent assay, immunoprecipitation followed by Western blotting, and mass spectrometry. We find that both IL-17F and IL-17A can form both homodimeric and heterodimeric proteins when expressed in a recombinant system, and that all forms of the recombinant proteins have in vitro functional activity. Furthermore, we find that in addition to the homodimers of IL-17F and IL-17A, activated human CD4+ T cells also produce the IL-17F/IL-17A heterodimer. These data suggest that the IL-17F/IL-17A heterodimer may contribute to the T cell-mediated immune responses.


Asunto(s)
Linfocitos T CD4-Positivos/inmunología , Regulación de la Expresión Génica/inmunología , Interleucina-17/inmunología , Activación de Linfocitos/inmunología , Secuencias de Aminoácidos , Animales , Enfermedades Autoinmunes/genética , Enfermedades Autoinmunes/inmunología , Linfocitos T CD4-Positivos/metabolismo , Células CHO , Cricetinae , Cricetulus , Cisteína/genética , Cisteína/inmunología , Dimerización , Expresión Génica , Regulación de la Expresión Génica/genética , Humanos , Inmunidad Celular , Interleucina-17/biosíntesis , Interleucina-17/genética , Interleucina-17/farmacología , Activación de Linfocitos/efectos de los fármacos
7.
Proc Natl Acad Sci U S A ; 102(50): 18117-22, 2005 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-16330774

RESUMEN

Myostatin is a secreted protein that normally functions as a negative regulator of muscle growth. Agents capable of blocking the myostatin signaling pathway could have important applications for treating human muscle degenerative diseases as well as for enhancing livestock production. Here we describe a potent myostatin inhibitor, a soluble form of the activin type IIB receptor (ACVR2B), which can cause dramatic increases in muscle mass (up to 60% in 2 weeks) when injected into wild-type mice. Furthermore, we show that the effect of the soluble receptor is attenuated but not eliminated in Mstn(-/-) mice, suggesting that at least one other ligand in addition to myostatin normally functions to limit muscle growth. Finally, we provide genetic evidence that these ligands signal through both activin type II receptors, ACVR2 and ACVR2B, to regulate muscle growth in vivo.


Asunto(s)
Receptores de Activinas Tipo II/metabolismo , Músculo Esquelético/crecimiento & desarrollo , Transducción de Señal/fisiología , Factor de Crecimiento Transformador beta/antagonistas & inhibidores , Receptores de Activinas Tipo II/genética , Receptores de Activinas Tipo II/farmacología , Animales , Ligandos , Ratones , Ratones Noqueados , Músculo Esquelético/efectos de los fármacos , Miostatina , Tamaño de los Órganos
8.
Int Immunopharmacol ; 4(5): 693-708, 2004 May.
Artículo en Inglés | MEDLINE | ID: mdl-15120653

RESUMEN

Interleukin 22 (IL-22) is a cytokine induced during both innate and adaptive immune responses. It can effect an acute phase response, implicating a role for IL-22 in mechanisms of inflammation. IL-22 requires the presence of the IL-22 receptor (IL-22R) and IL-10 receptor 2 (IL-10R2) chains, two members of the class II cytokine receptor family (CRF2), to effect signal transduction within a cell. We studied the interaction between human IL-22 and the extracellular domains (ECD) of its receptor chains in an enzyme-linked immunoabsorbant assay (ELISA)-based format, using biotinylated IL-22 (bio-IL-22) and receptor-fusions containing the ECD of a receptor fused to the Fc of hIgG1 (IL-22R-Fc and IL-10R2-Fc). IL-22 has measurable affinity for IL-22R-Fc homodimer and undetectable affinity for IL-10R2. IL-22 has substantially greater affinity for IL-22R/IL-10R2-Fc heterodimers. Further analyses involving sequential additions of receptor homodimers and cytokine indicates that the IL-10R2(ECD) binds to a surface created by the interaction between IL-22 and the IL-22R(ECD), and thereby further stabilizes the association of IL-22 within this cytokine-receptor-Fc complex. Both a neutralizing rat monoclonal antibody, specific for human IL-22, and human IL-22BP-Fc, an Fc-fusion of the secreted IL-22 binding-protein and proposed natural antagonist for IL-22, bind to similar cytokine epitopes that may overlap the binding site for IL-22R(ECD). Another rat monoclonal antibody, specific for IL-22, binds to an epitope that may overlap a separate binding site for IL-10R2(ECD). We propose, based on this data, a temporal model for the development of a functional IL-22 cytokine-receptor complex.


Asunto(s)
Interleucinas/metabolismo , Receptores de Interleucina/metabolismo , Animales , Células CHO , Cricetinae , Dimerización , Ensayo de Inmunoadsorción Enzimática/métodos , Humanos , Interleucinas/farmacología , Receptores de Interleucina/efectos de los fármacos , Receptores de Interleucina-10 , Factores de Tiempo , Interleucina-22
9.
Proc Natl Acad Sci U S A ; 100(26): 15842-6, 2003 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-14671324

RESUMEN

Myostatin is a transforming growth factor beta family member that acts as a negative regulator of skeletal muscle growth. Myostatin circulates in the blood of adult mice in a noncovalently held complex with other proteins, including its propeptide, which maintain the C-terminal dimer in a latent, inactive state. This latent form of myostatin can be activated in vitro by treatment with acid; however, the mechanisms by which latent myostatin is activated in vivo are unknown. Here, we show that members of the bone morphogenetic protein-1/tolloid (BMP-1/TLD) family of metalloproteinases can cleave the myostatin propeptide in this complex and can thereby activate latent myostatin. Furthermore, we show that a mutant form of the propeptide resistant to cleavage by BMP-1/TLD proteinases can cause significant increases in muscle mass when injected into adult mice. These findings raise the possibility that members of the BMP-1/TLD family may be involved in activating latent myostatin in vivo and that molecules capable of inhibiting these proteinases may be effective agents for increasing muscle mass for both human therapeutic and agricultural applications.


Asunto(s)
Proteínas Morfogenéticas Óseas/metabolismo , Metaloendopeptidasas/metabolismo , Metaloproteasas/metabolismo , Músculo Esquelético/crecimiento & desarrollo , Proteínas/metabolismo , Factor de Crecimiento Transformador beta/metabolismo , Animales , Proteína Morfogenética Ósea 1 , Células CHO , Cricetinae , Femenino , Genes Reporteros , Luciferasas/genética , Luciferasas/metabolismo , Ratones , Ratones Endogámicos BALB C , Miostatina , Precursores de Proteínas/metabolismo , Proteínas Recombinantes de Fusión/metabolismo , Metaloproteinasas Similares a Tolloid
10.
Mol Endocrinol ; 17(6): 1144-54, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12595574

RESUMEN

Myostatin, a member of the TGFbeta superfamily, is a potent and specific negative regulator of skeletal muscle mass. In serum, myostatin circulates as part of a latent complex containing myostatin propeptide and/or follistatin-related gene (FLRG). Here, we report the identification of an additional protein associated with endogenous myostatin in normal mouse and human serum, discovered by affinity purification and mass spectrometry. This protein, which we have named growth and differentiation factor-associated serum protein-1 (GASP-1), contains multiple domains associated with protease-inhibitory proteins, including a whey acidic protein domain, a Kazal domain, two Kunitz domains, and a netrin domain. GASP-1 also contains a domain homologous to the 10-cysteine repeat found in follistatin, a protein that binds and inhibits activin, another member of the TGFbeta superfamily. We have cloned mouse GASP-1 and shown that it inhibits the biological activity of mature myostatin, but not activin, in a luciferase reporter gene assay. Surprisingly, recombinant GASP-1 binds directly not only to mature myostatin, but also to the myostatin propeptide. Thus, GASP-1 represents a novel class of inhibitory TGFbeta binding proteins.


Asunto(s)
Proteínas Portadoras/aislamiento & purificación , Inhibidores de Proteasas/aislamiento & purificación , Factor de Crecimiento Transformador beta/metabolismo , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Proteínas Portadoras/sangre , Proteínas Portadoras/genética , Proteínas Portadoras/metabolismo , Regulación hacia Abajo , Humanos , Péptidos y Proteínas de Señalización Intracelular , Ratones , Datos de Secuencia Molecular , Miostatina , Inhibidores de Proteasas/sangre , Inhibidores de Proteasas/metabolismo , Estructura Terciaria de Proteína/fisiología , ARN Mensajero/análisis , Distribución Tisular , Factor de Crecimiento Transformador beta/sangre , Factor de Crecimiento Transformador beta/aislamiento & purificación
11.
Biochem Biophys Res Commun ; 300(4): 965-71, 2003 Jan 24.
Artículo en Inglés | MEDLINE | ID: mdl-12559968

RESUMEN

A human therapeutic that specifically modulates skeletal muscle growth would potentially provide a benefit for a variety of conditions including sarcopenia, cachexia, and muscular dystrophy. Myostatin, a member of the TGF-beta family of growth factors, is a known negative regulator of muscle mass, as mice lacking the myostatin gene have increased muscle mass. Thus, an inhibitor of myostatin may be useful therapeutically as an anabolic agent for muscle. However, since myostatin is expressed in both developing and adult muscles, it is not clear whether it regulates muscle mass during development or in adults. In order to test the hypothesis that myostatin regulates muscle mass in adults, we generated an inhibitory antibody to myostatin and administered it to adult mice. Here we show that mice treated pharmacologically with an antibody to myostatin have increased skeletal muscle mass and increased grip strength. These data show for the first time that myostatin acts postnatally as a negative regulator of skeletal muscle growth and suggest that myostatin inhibitors could provide a therapeutic benefit in diseases for which muscle mass is limiting.


Asunto(s)
Músculo Esquelético/crecimiento & desarrollo , Factor de Crecimiento Transformador beta/antagonistas & inhibidores , Factor de Crecimiento Transformador beta/metabolismo , Secuencia de Aminoácidos , Animales , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales/inmunología , Peso Corporal , Células CHO , Cricetinae , Medios de Cultivo Condicionados , Femenino , Fuerza de la Mano , Humanos , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Noqueados , Fibras Musculares Esqueléticas/citología , Músculo Esquelético/anatomía & histología , Músculo Esquelético/fisiología , Miostatina , Unión Proteica , Factor de Crecimiento Transformador beta/genética , Factor de Crecimiento Transformador beta/inmunología
12.
J Biol Chem ; 277(43): 40735-41, 2002 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-12194980

RESUMEN

Myostatin, also known as growth and differentiation factor 8, is a member of the transforming growth factor beta superfamily that negatively regulates skeletal muscle mass (1). Recent experiments have shown that myostatin activity is detected in serum by a reporter gene assay only after activation by acid, suggesting that native myostatin circulates as a latent complex (2). We have used a monoclonal myostatin antibody, JA16, to isolate the native myostatin complex from normal mouse and human serum. Analysis by mass spectrometry and Western blot shows that circulating myostatin is bound to at least two major proteins, the myostatin propeptide and the follistatin-related gene (FLRG). The myostatin propeptide is known to bind and inhibit myostatin in vitro (3). Here we show that this interaction is relevant in vivo, with a majority (>70%) of myostatin in serum bound to its propeptide. Studies with recombinant V5-His-tagged FLRG protein confirm a direct interaction between mature myostatin and FLRG. Functional studies show that FLRG inhibits myostatin activity in a reporter gene assay. These experiments suggest that the myostatin propeptide and FLRG are major negative regulators of myostatin in vivo.


Asunto(s)
Proteínas Relacionadas con la Folistatina/fisiología , Factor de Crecimiento Transformador beta/fisiología , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Western Blotting , Cartilla de ADN , Proteínas Relacionadas con la Folistatina/genética , Proteínas Relacionadas con la Folistatina/metabolismo , Genes Reporteros , Humanos , Espectrometría de Masas , Ratones , Datos de Secuencia Molecular , Miostatina , Unión Proteica , Factor de Crecimiento Transformador beta/antagonistas & inhibidores , Factor de Crecimiento Transformador beta/química , Factor de Crecimiento Transformador beta/genética
13.
Science ; 296(5572): 1486-8, 2002 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-12029139

RESUMEN

Mice and cattle with genetic deficiencies in myostatin exhibit dramatic increases in skeletal muscle mass, suggesting that myostatin normally suppresses muscle growth. Whether this increased muscling results from prenatal or postnatal lack of myostatin activity is unknown. Here we show that myostatin circulates in the blood of adult mice in a latent form that can be activated by acid treatment. Systemic overexpression of myostatin in adult mice was found to induce profound muscle and fat loss analogous to that seen in human cachexia syndromes. These data indicate that myostatin acts systemically in adult animals and may be a useful pharmacologic target in clinical settings such as cachexia, where muscle growth is desired.


Asunto(s)
Caquexia/etiología , Músculo Esquelético/anatomía & histología , Factor de Crecimiento Transformador beta/fisiología , Células 3T3 , Activinas/administración & dosificación , Activinas/farmacología , Tejido Adiposo/anatomía & histología , Tejido Adiposo/patología , Animales , Peso Corporal , Células CHO , Caquexia/metabolismo , Caquexia/patología , Cricetinae , Ingestión de Alimentos , Femenino , Folistatina , Hígado/anatomía & histología , Hígado/patología , Ratones , Ratones Desnudos , Fibras Musculares Esqueléticas/citología , Fibras Musculares Esqueléticas/patología , Músculo Esquelético/patología , Miostatina , Tamaño de los Órganos , Fragmentos de Péptidos/administración & dosificación , Fragmentos de Péptidos/farmacología , Proteínas Recombinantes/administración & dosificación , Factor de Crecimiento Transformador beta/administración & dosificación , Factor de Crecimiento Transformador beta/sangre , Síndrome Debilitante/etiología , Síndrome Debilitante/metabolismo , Síndrome Debilitante/patología , Pérdida de Peso
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