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1.
Clin Exp Immunol ; 137(2): 320-8, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15270849

RESUMO

The cytokine hormone prolactin (PRL) has been shown previously to modulate native cellular responses and maturation of antigen-presenting cells. Here we have addressed its effect on the antigen-specific response of cytotoxic T lymphocytes (CTL). CTL were generated from HLA-A2 lymphocytes after three rounds of stimulation with autologous dendritic cells loaded with HLA-A2-restricted carcinoembrionic antigen (CEA) Cap-1 (YLSGANLNL) peptide. Selected cultures were expanded on cytokine-supplemented feeder-layers, enriched for CD8+ lymphocytes and analysed for PRL-receptor (PRL-R) expression and PRL responsiveness. Resting CD8+ lymphocytes were negative for PRL-R, whereas antigen-activated CD8+ lymphocytes derived from long-term cultures were highly positive. Results of a 51Cr release assay showed CTL killing of CEA-loaded, but not unloaded, T2 cell line and the CEA-positive gastric carcinoma cell line KATO, but not of the CEA-negative T leukaemia cell line Jurkat. Interferon (IFN)-gamma release, evaluated in an ELISPOT assay against CEA-loaded T2, was enhanced (P < 0.05) by concentrations of PRL (12-25 ng/ml) very close to the physiological levels (6-20 ng/ml), but was decreased (P < 0.05) by high concentrations (200 ng/ml). Pre-incubation of the stimulators with the anti-MHC class I MoAb W6.32 induced a 40-60% decrease of the PRL-boosted IFN-gamma release, thus proving the MHC restriction of the lymphocyte response. Cytotoxicity against CEA-loaded T2 and KATO cell lines was also increased by 12-25 ng (P < 0.05) and decreased (P < 0.05) by 200 ng PRL. Pre-incubation of CTL with an antibody specific for the PRL-R almost completely abrogated this effect.


Assuntos
Antígeno Carcinoembrionário/imunologia , Células Dendríticas/imunologia , Prolactina/farmacologia , Linfócitos T Citotóxicos/efeitos dos fármacos , Citotoxicidade Imunológica/efeitos dos fármacos , Relação Dose-Resposta Imunológica , Epitopos de Linfócito T/imunologia , Humanos , Interferon gama/biossíntese , Linfócitos T Citotóxicos/imunologia , Células Tumorais Cultivadas
2.
Diabetes Metab Res Rev ; 20(4): 330-6, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15250036

RESUMO

BACKGROUND: High glucose induces pathological alterations in small and large vessels, possibly through increased formation of AGE, activation of aldose reductase and protein kinase C, and increased flux through the hexosamine pathway. We showed previously that thiamine and benfotiamine correct delayed replication and increase lactate production in endothelial cells subjected to high glucose. We now aim at verifying the effects of thiamine and benfotiamine on cell cycle, apoptosis, and expression of adhesion molecules in endothelial cells and pericytes, under high ambient glucose. METHODS: Human umbilical vein endothelial cells and bovine retinal pericytes were cultured in normal (5.6 mmol/L) or high (28 mmol/L) glucose, with or without thiamine or benfotiamine, 50 or 100 micro mol/L. Apoptosis was determined by two separate ELISA methods, measuring DNA fragmentation and caspase-3 activity, respectively. Cell cycle and integrin subunits alpha3, alpha5, and beta1 concentration were measured by flow cytometry. RESULTS: Apoptosis was increased in high glucose after 3 days of culture, both in endothelium and pericytes. Thiamine and benfotiamine reversed such effects. Neither cell cycle traversal nor integrin concentrations were modified in these experimental conditions. CONCLUSIONS: Thiamine and benfotiamine correct increased apoptosis due to high glucose in cultured vascular cells. Further elucidations of the mechanisms through which they work could help set the basis for clinical use of this vitamin in the prevention and/or treatment of diabetic microangiopathy.


Assuntos
Apoptose/efeitos dos fármacos , Endotélio Vascular/fisiologia , Glucose/farmacologia , Pericitos/fisiologia , Retina/citologia , Tiamina/análogos & derivados , Tiamina/farmacologia , Animais , Bovinos , Técnicas de Cultura de Células/métodos , Ciclo Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Humanos , Pericitos/citologia , Pericitos/efeitos dos fármacos , Retina/efeitos dos fármacos , Veias Umbilicais
3.
Diabetologia ; 46(3): 409-15, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12687340

RESUMO

AIMS/HYPOTHESIS: Thickening of the basement membrane and selective loss of pericytes occur early in diabetic retinopathy. As we showed previously that pericyte adhesion is impaired on extracellular matrix produced by endothelial cells in high hexose concentrations, we aimed to verify if altered adhesion could influence pericyte viability and replication. METHODS: Conditioned extracellular matrices were obtained by growing human umbilical vein endothelial cells in media containing 28 mmol/l D-glucose, with or without the inhibitors of protein glycation thiamine or aminoguanidine, and D-galactose or L-glucose up to 28 mmol/l. Having removed the endothelium, bovine retinal pericytes were grown on these matrices and, in separate experiments, on laminin, fibronectin or type IV collagen. Pericyte viability and replication were measured by cell counts and DNA synthesis after 7 days, cell cycle traversal after 2 days and apoptosis after 18 h, 2 days and 7 days. RESULTS: Pericyte counts and DNA synthesis were reduced on matrices produced in high D-glucose and D-galactose, whilst matrix obtained in L-glucose reduced DNA synthesis but not counts. Both thiamine and aminoguanidine corrected reduced pericyte viability when added to high D-glucose. Cell cycle and apoptosis were not affected by growing pericytes on different conditioned matrices. Laminin, fibronectin and type IV collagen did not modify pericyte replication. CONCLUSIONS/INTERPRETATIONS: Reduced pericyte counts could depend on impaired initial adhesion to the extracellular matrix produced by endothelium in high hexose concentrations, rather than impaired replication or viability. Altered cell-matrix interactions might facilitate pericyte dropout in diabetic retinopathy, independently of the effects of high glucose on pericyte replication.


Assuntos
Células Endoteliais/fisiologia , Matriz Extracelular/fisiologia , Glucose/farmacologia , Pericitos/fisiologia , Apoptose/efeitos dos fármacos , Apoptose/fisiologia , Capilares/citologia , Capilares/efeitos dos fármacos , Capilares/fisiologia , Adesão Celular/fisiologia , Contagem de Células , Divisão Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/fisiologia , DNA/biossíntese , Células Endoteliais/efeitos dos fármacos , Matriz Extracelular/efeitos dos fármacos , Glicoproteínas/química , Humanos , Indicadores e Reagentes , Pericitos/efeitos dos fármacos
4.
Diabetologia ; 46(3): 416-9, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12687341

RESUMO

AIMS/HYPOTHESIS: Drop-out of capillary pericytes occurs early and selectively in diabetic retinopathy. High glucose concentrations decrease replication and increase apoptosis of cultured pericytes. Since glucose activates protein kinase C, we investigated the effects of modulating this intracellular mediator on replication, cell cycle and apoptosis of cultured bovine retinal pericytes. METHODS: Pericytes cultured in 5.6 or 28 mmol/l glucose were exposed to a protein kinase C activator (phorbol 12-myristate 13-acetate) and/or a selective inhibitor of its beta2 isoform (LY379196). Cells were counted after 7 days. Proliferation by the tetrazolium to formazan assay and DNA synthesis by 5-bromo-2'-deoxyuridine incorporation were measured at day 4. Cell cycle by flow cytometry and apoptosis by ELISA were assessed at day 2. RESULTS: High glucose reduced pericyte replication and increased apoptosis. Protein kinase C activation increased proliferation, while inhibition of its beta2 isoform decreased it. Cell cycle was accelerated by protein kinase C activation and delayed by inhibition. Apoptosis was enhanced by protein kinase C inhibition and reduced by activation. CONCLUSIONS/INTERPRETATION: Protein kinase C inhibition amplifies the anti-proliferative and pro-apoptotic effects of high glucose on cultured pericytes, whereas stimulation reduces apoptosis and promotes proliferation both in physiological glucose and high glucose. Protein kinase C inhibition, proposed for the treatment of diabetic macular edema and proliferative retinopathy, might accelerate pericyte dropout in earlier stages when these cells are still present in retinal capillaries.


Assuntos
Apoptose/efeitos dos fármacos , Inibidores Enzimáticos/farmacologia , Pericitos/efeitos dos fármacos , Proteína Quinase C/antagonistas & inibidores , Proteína Quinase C/metabolismo , Retina/citologia , Animais , Bovinos , Contagem de Células , Divisão Celular/efeitos dos fármacos , DNA/biossíntese , Relação Dose-Resposta a Droga , Ativadores de Enzimas/farmacologia , Citometria de Fluxo , Glucose/farmacologia , Isoenzimas/antagonistas & inibidores , Mesilatos/farmacologia , Pirróis/farmacologia , Retina/efeitos dos fármacos , Acetato de Tetradecanoilforbol/farmacologia , Sais de Tetrazólio , Tiazóis
5.
Diabetologia ; 45(3): 416-9, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11914747

RESUMO

AIMS/HYPOTHESIS: Thickening of the basement membrane and selective loss of pericytes are early events in diabetic retinopathy. We aimed at checking whether pericyte interaction with extracellular matrix produced by endothelial cells is influenced by the hexose concentrations in which endothelial cells are cultured. METHODS: Conditioned extracellular matrixes were obtained by growing human umbilical vein endothelial cells in media containing 28 mmol/l hexoses (D-glucose, D-galactose, L-glucose), which undergo different intracellular processing, before and after adding the inhibitors of protein glycation thiamine or aminoguanidine. Having removed the endothelium, bovine retinal pericytes were grown on such matrixes and, in separate experiments, on laminin, fibronectin or type IV collagen. Pericyte adhesion was determined by cell counts 18 h after seeding. RESULTS: Reduced adhesion was observed on matrixes produced in high D-glucose, high D-galactose and high L-glucose. Both thiamine and aminoguanidine restored impaired pericyte adhesion when added to high D-glucose and high D-galactose, but not L-glucose. Laminin, fibronectin and type IV collagen did not consistently modify pericyte adhesion. CONCLUSIONS/INTERPRETATIONS: Pericyte adhesion is impaired on extracellular matrix produced by endothelium in high hexose concentrations. This could result from excess protein glycation, corrected by aminoguanidine and thiamine, rather than altered glycoprotein composition.


Assuntos
Adesão Celular/fisiologia , Endotélio Vascular/fisiologia , Matriz Extracelular/fisiologia , Hexoses/farmacologia , Pericitos/fisiologia , Adesão Celular/efeitos dos fármacos , Células Cultivadas , Retinopatia Diabética/fisiopatologia , Endotélio Vascular/efeitos dos fármacos , Matriz Extracelular/efeitos dos fármacos , Galactose/farmacologia , Glucose/farmacologia , Humanos , Pericitos/efeitos dos fármacos , Estereoisomerismo , Cordão Umbilical
6.
Diabetes Metab ; 28(6 Pt 1): 499-503, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12522331

RESUMO

BACKGROUND: Activation of the renin-angiotensin system (RAS) may induce cardiovascular and renal fibrosis in hypertension and diabetes. This fibrogenic effect is mainly mediated by Transforming Growth Factor-B1 (TGF-B1), a multifunctional citokyne released by endothelial, vascular smooth muscle and renal mesangial cells, that is able to increase extracellular matrix deposition. Retinal capillary pericytes have functions similar to those of mesangial cells, including ability to synthesize and release TGF-B1 and produce extracellular matrix. An intraocular RAS was described in the human eye and may produce effects similar to those observed in the heart and kidney, which could be mediated by TGF-B1. In particular, TGF-B1 might be involved in thickening of the capillary basement membrane in diabetic microangiopathy. We therefore aimed at evaluating the possible effects of Angiotensin-II on TGF-B1 secretion by cultured retinal pericytes (BRP). METHODS: BRP cultures were incubated with Angiotensin-II or insulin (known to play a permissive effect on TGF-B1 release from mesangial cells) or Angiotensin-II + insulin at final concentrations of 10-10, 10-8, 10-6, 10-4 mol/L. RESULTS: Baseline TGF-B1 concentrations in the supernatants of pericyte cultures were 6 139 +/- 1 919 pg/mL/106 cells; no changes of TGF-B1 concentrations resulted from adding increasing amounts of Ang II, insulin or both. CONCLUSIONS: Though confirming that cultured bovine retinal pericytes spontaneously release TGF-B1, Angiotensin-II did not produce any stimulatory effects of in our experimental system


Assuntos
Angiotensina II/farmacologia , Insulina/farmacologia , Pericitos/metabolismo , Retina/fisiologia , Fator de Crescimento Transformador beta/metabolismo , Análise de Variância , Animais , Bovinos , Células Cultivadas , Pericitos/citologia , Pericitos/efeitos dos fármacos , Retina/efeitos dos fármacos , Retina/metabolismo , Fator de Crescimento Transformador beta1
7.
J Endocrinol ; 158(1): 21-6, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9713322

RESUMO

Pericyte loss is an early feature of diabetic retinopathy and represents a key step in the progression of this disease. This study aimed to evaluate the effect of dehydroepiandro-sterone (DHEA) on glucose toxicity in retinal capillary pericytes. Bovine retinal pericytes (BRP) were cultured in a high glucose concentration, with or without DHEA. After 4 days of incubation the number of BRP was significantly reduced by the high glucose concentration. The addition of DHEA to the medium reversed the adverse effect of high glucose: BRP proliferation partially recovered in the presence of 10 nmol/l DHEA, and completely recovered in the presence of DHEA at concentrations equal to or greater than 100 nmol/l. At physiological glucose concentrations, DHEA had no effect on BRP growth. Data show that DHEA, at concentrations similar to those found in human plasma, protects BRP against glucose toxicity. This effect seems specific for DHEA, since its metabolites, 5-en-androstene-3 beta, 17 beta-diol, dihydrotestosterone and estradiol did not alter BRP growth in normal or high glucose media. Various pieces of evidence link the antioxidant properties of DHEA to its protective effect on glucose-induced toxicity in BRP.


Assuntos
Desidroepiandrosterona/farmacologia , Glucose/toxicidade , Vasos Retinianos/efeitos dos fármacos , Análise de Variância , Androstenodiol/farmacologia , Animais , Antioxidantes/farmacologia , Capilares , Bovinos , Divisão Celular/efeitos dos fármacos , Células Cultivadas , Di-Hidrotestosterona/farmacologia , Estradiol/farmacologia , Peroxidação de Lipídeos/efeitos dos fármacos , Vasos Retinianos/citologia
8.
Diabetologia ; 39(11): 1263-8, 1996 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-8932990

RESUMO

This study aimed at verifying whether thiamine, a co-enzyme which decreases intracellular glycolysis metabolites by allowing pyruvate and glyceraldheyde 3-phosphate to enter the Krebs cycle and the pentose-phosphate shunt, respectively, corrects delayed replication caused by high glucose concentrations in cultured human umbilical vein (HUVEC) and bovine retinal endothelial cells (BREC). After incubation in physiological (5.6 mmol/l) or high (28.0 mmol/l) glucose with or without 150 mumol/l thiamine, cells were counted and proliferation assessed by mitochondrial dehydrogenase activity. Lactate was measured in both cell types as an index of glycolytic activity and fluorescent advanced glycosylation end-products (AGE) concentration was determined in the HUVEC lysate. Both cell counts and proliferation assays in either of the cell types confirmed the impairment to cell replication induced by high glucose. When thiamine was added to cells kept under high glucose conditions, the number of surviving cells was significantly increased and the reduced cell proliferation appeared to be corrected. Lactate assays confirmed the increased production of this metabolite by BREC and HUVEC in high glucose, which was reduced by thiamine. Fluorescent AGE determination showed that thiamine may prevent non-enzymatic glycation in HUVEC. Thiamine restores cell replication, decreases the glycolytic flux and prevents fluorescent AGE formation in endothelial cells cultured in high glucose, suggesting that abnormal levels of glycolytic metabolite(s) may damage cells.


Assuntos
Endotélio Vascular/metabolismo , Glucose , Produtos Finais de Glicação Avançada/biossíntese , Ácido Láctico/biossíntese , Retina/metabolismo , Tiamina/farmacologia , Animais , Bovinos , Contagem de Células/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Divisão Celular/fisiologia , Células Cultivadas , Diabetes Mellitus/metabolismo , Endotélio/citologia , Endotélio/efeitos dos fármacos , Endotélio/metabolismo , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Glicosilação/efeitos dos fármacos , Humanos , Ácido Láctico/metabolismo , Retina/citologia , Retina/efeitos dos fármacos , Espectrometria de Fluorescência , Espectrofotometria , Veias Umbilicais/citologia
9.
Minerva Chir ; 49(6): 523-8, 1994 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-7970055

RESUMO

The authors present their diagnostic approach to acute intestinal ischemia. They underline the need for early specific diagnosis because the therapeutic options vary widely in relation to different types of acute intestinal ischemia. Selective arteriography preceded by an aortogram is considered the diagnostic "gold standard". Although at present mesenteric ischemia is a serious, and often lethal, disease, an aggressive therapeutic approach can improve the outcome of this group of patients.


Assuntos
Infarto/diagnóstico , Infarto/cirurgia , Intestinos/irrigação sanguínea , Isquemia/diagnóstico , Isquemia/cirurgia , Doença Aguda , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação
10.
Acta Diabetol ; 30(4): 207-13, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-7514054

RESUMO

Pericytes disappear early, selectively and specifically from retinal capillaries in diabetic microangiopathy, but little is known of their growth and turnover in health and disease. We have studied the effects of human blood derivatives and of a panel of individual growth factors on [3H]thymidine incorporation in bovine retinal pericytes and endothelial cells. Human serum and platelet-rich plasma stimulated incorporation of the nucleotide in a dose-dependent manner in both cell types, and did so more potently than platelet-free plasma. Consistent and significant stimulation of DNA synthesis in pericytes was observed with basic fibroblast growth factor (ED50 = 1.8 x 10(-13) mol/l), acidic fibroblast growth factor (7.4 x 10(-12) mol/l), insulin-like growth factor 1 (8.6 x 10(-10) mol/l), insulin (158 microU/ml) and endothelin-1 (6.1 x 10(-10) mol/l). Transforming growth factor beta 1 inhibited DNA synthesis (ID50 = 3.6 x 10(-10) mol/l) and so did heparin (1.4 x 10(-6) mol/l) and low molecular weight heparin (2.9 x 10(-6) mol/l). Retinal endothelial cells were stimulated by basic fibroblast growth factor (3.2 x 10(-13) mol/l) and acidic fibroblast growth factor (1.3 x 10(-9) mol/l), and inhibited by transforming growth factor beta 1 (1.6 x 10(-12) mol/l). Neither cell type was stimulated by platelet-derived growth factor (A + B chain heterodimer), epidermal growth factor, growth hormone, or nerve growth factor (7S complex). The characteristics and active concentrations of the above growth factors suggest that none is solely responsible for the pericyte mitogenic activity of platelets, serum or plasma.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Arteríolas/metabolismo , Fenômenos Fisiológicos Sanguíneos , Plaquetas/fisiologia , DNA/biossíntese , Endotélio Vascular/metabolismo , Substâncias de Crescimento/farmacologia , Músculo Liso Vascular/metabolismo , Vasos Retinianos/metabolismo , Timidina/metabolismo , Animais , Arteríolas/citologia , Arteríolas/efeitos dos fármacos , Bovinos , Células Cultivadas , DNA/efeitos dos fármacos , Diálise , Endotelinas/farmacologia , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Fator 1 de Crescimento de Fibroblastos/farmacologia , Fator 2 de Crescimento de Fibroblastos/farmacologia , Heparina/farmacologia , Humanos , Cinética , Músculo Liso Vascular/citologia , Músculo Liso Vascular/efeitos dos fármacos , Plasma/fisiologia , Vasos Retinianos/citologia , Vasos Retinianos/efeitos dos fármacos , Fator de Crescimento Transformador beta/farmacologia
11.
Acta Diabetol ; 30(4): 190-200, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8180411

RESUMO

Damage caused to the vessel wall by diverse mechanisms may lead to diabetic microangiopathy. Consequently, research work is more and more focusing on the pathophysiology of vascular cells, with particular emphasis on endothelium. This paper reviews the present knowledge on the alterations of small vessel endothelium in diabetes. The most important risk factors for diabetic microangiopathy are the duration of disease and the degree of metabolic control maintained throughout the years. However, genetic factors may also contribute. These are examined first, followed by the presumed roles played by increased protein glycation and the production of Advanced Glycosylation End Products, the "polyol pathway" and free radical generation. Endothelium is a widespread, extremely active organ which regulates complex physiologic functions and its structure and function are discussed in the second section of this review. The third part deals with how diabetes can affect endothelium and describes observations on endothelial metabolism in vitro as well as morphologic and functional alterations in the patients. Unfortunately, the mechanisms leading to progressive degeneration of the microcirculation and organ damage in diabetic patients remain largely unaccounted for.


Assuntos
Angiopatias Diabéticas/fisiopatologia , Endotélio Vascular/fisiopatologia , Animais , Angiopatias Diabéticas/etiologia , Angiopatias Diabéticas/patologia , Endotélio Vascular/patologia , Endotélio Vascular/fisiologia , Humanos
12.
Diabetes Res ; 19(2): 87-90, 1992 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-1286544

RESUMO

Human umbilical vein endothelial cells (HUVEC) cultured in high glucose exhibit delayed replication and colchicine-resistant microtubules. Tubulin dysfunction and stabilization, brought about by acetylation of the NH2-terminal residues, loss of the C-terminal tyrosine and binding of microtubular-associated proteins (MAPs) may be involved in the above phenomenon. The effects of L-tyrosine on HUVEC replication in high glucose were tested and the hypothesis that non-enzymatic glycosylation might impair tubulin depolymerization was also checked by growing the cells in the presence of L-glucose, which binds to intracellular proteins but remains metabolically inactive. After 18 days in culture, the number (mean +/- SEM, n = 7) of HUVEC grown in 28.0 mmol/l D-glucose (435.7 +/- 59.1 x 10(3)) was lower than in 5.6 mmol/l D-glucose (818.3 +/- 75.2 x 10(3)), p < 0.0001. The addition of L-tyrosine 1.7 mmol/l corrected such growth inhibition (623.3 +/- 81.7 x 10(3)), p < 0.0001 vs. D-glucose 28.0 mmol/l, but the cells recovered were less numerous than in physiological glucose alone (p = 0.016). The addition of L-tyrosine to D-glucose 5.6 mmol/l (731.0 +/- 63.2 x 10(3)) did not modify the cell number significantly. HUVEC in extra L-glucose (687.4 +/- 72.0 x 10(3)) were less numerous than in 5.6 mmol/l D-glucose, p = 0.028, but more than in D-glucose 28 mmol/l, p < 0.0001, and were not modified by the addition of L-tyrosine (729.4 +/- 67.1 x 10(3)). HUVEC grown in physiologic and high glucose exhibited specific immunofluorescence for acetylated tubulin and MAPs.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Endotélio Vascular/citologia , Glucose/farmacologia , Tirosina/farmacologia , Divisão Celular/efeitos dos fármacos , Células Cultivadas , Relação Dose-Resposta a Droga , Endotélio Vascular/efeitos dos fármacos , Humanos , Cinética , Fatores de Tempo , Veias Umbilicais
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