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1.
Nat Genet ; 2(1): 61-5, 1992 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-1303252

RESUMO

Parental imprinting is a phenomenon in mammals whereby the maternal and paternal alleles of a gene are differentially expressed. Three murine genes have been shown to display this type of allele-specific expression. Two of them, insulin-like growth factor-2 (Igf-2) and H19, map to the distal end of mouse chromosome 7, but are imprinted in opposite directions. Pulsed-field gel electrophoresis and large-fragment DNA cloning were utilized to establish a physical map that includes H19 and Igf-2. Igf-2 lies approximately 90 kilobases of DNA 5' to H19, in the same transcriptional orientation. This physical proximity is conserved in humans, based on pulsed-field gel analysis. We conclude that H19 and Igf-2 constitute an imprinted domain.


Assuntos
Ligação Genética , Fator de Crescimento Insulin-Like II/genética , Animais , Cromossomos Fúngicos , Clonagem Molecular , Feminino , Expressão Gênica , Biblioteca Gênica , Humanos , Masculino , Camundongos , Mapeamento por Restrição , Caracteres Sexuais
2.
Nat Genet ; 9(4): 407-13, 1995 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-7795647

RESUMO

Imprinting, the differential expression of the two alleles of a gene based on their parental origin, requires that the alleles be distinguished or marked. A candidate for the differentiating mark is DNA methylation. The maternally expressed H19 gene is hypermethylated on the inactive paternal allele in somatic tissues and sperm, but to serve as the mark that designates the imprint, differential methylation must also be present in the gametes and the pre-implantation embryo. We now show that the pattern of differential methylation in the 5' portion of H19 is established in the gametes and a subset is maintained in the pre-implantation embryo. That subset is sufficient to confer monoallelic expression to the gene in blastocysts. We propose that paternal-specific methylation of the far 5' region is the mark that distinguishes the two alleles of H19.


Assuntos
Alelos , DNA/genética , DNA/metabolismo , Impressão Genômica , Paternidade , Animais , Sequência de Bases , Blastocisto/metabolismo , Cruzamentos Genéticos , Primers do DNA/genética , Desenvolvimento Embrionário e Fetal/genética , Feminino , Masculino , Metilação , Camundongos , Camundongos Endogâmicos C57BL , Dados de Sequência Molecular , Muridae , Oócitos/metabolismo , Reação em Cadeia da Polimerase , Mapeamento por Restrição
3.
Science ; 288(5474): 2145-6, 2000 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-10896590

RESUMO

Certain genes are only expressed at one allele, a phenomenon called imprinting. Although it is well established that one allele of certain imprinted genes is silenced through methylation, this does not appear to be the case for all imprinted genes. In a thoughtful Perspective, Thorvaldsen and Bartolomei discuss new findings showing that insertion of insulator elements (boundary regions) between the promoter of a gene and its enhancer (a sequence that boosts gene expression) may be another way in which genes are silenced during imprinting.


Assuntos
Metilação de DNA , Inativação Gênica , Impressão Genômica , RNA não Traduzido , Proteínas Repressoras , Alelos , Animais , Fator de Ligação a CCCTC , Proteínas de Ligação a DNA/metabolismo , Fosfatos de Dinucleosídeos , Elementos Facilitadores Genéticos , Pai , Feminino , Humanos , Fator de Crescimento Insulin-Like II/genética , Masculino , Modelos Genéticos , Mães , Proteínas Musculares/genética , Óvulo/metabolismo , Regiões Promotoras Genéticas , RNA Longo não Codificante , Sequências Reguladoras de Ácido Nucleico , Espermatozoides/metabolismo , Fatores de Transcrição/metabolismo , Dedos de Zinco
4.
Science ; 292(5522): 1728-31, 2001 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-11387480

RESUMO

Glucose homeostasis depends on insulin responsiveness in target tissues, most importantly, muscle and liver. The critical initial steps in insulin action include phosphorylation of scaffolding proteins and activation of phosphatidylinositol 3-kinase. These early events lead to activation of the serine-threonine protein kinase Akt, also known as protein kinase B. We show that mice deficient in Akt2 are impaired in the ability of insulin to lower blood glucose because of defects in the action of the hormone on liver and skeletal muscle. These data establish Akt2 as an essential gene in the maintenance of normal glucose homeostasis.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Glucose/metabolismo , Resistência à Insulina , Insulina/metabolismo , Proteínas Serina-Treonina Quinases , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas/metabolismo , Animais , Glicemia/metabolismo , Desoxiglucose/metabolismo , Feminino , Marcação de Genes , Técnica Clamp de Glucose , Teste de Tolerância a Glucose , Homeostase , Insulina/administração & dosagem , Insulina/sangue , Resistência à Insulina/genética , Resistência à Insulina/fisiologia , Ilhotas Pancreáticas/citologia , Ilhotas Pancreáticas/fisiologia , Fígado/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Músculo Esquelético/enzimologia , Músculo Esquelético/metabolismo , Proteínas Proto-Oncogênicas c-akt , Transdução de Sinais
5.
Genes Brain Behav ; 18(7): e12493, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-29896789

RESUMO

Adolescent stress can impact health and well-being not only during adulthood of the exposed individual but even in future generations. To investigate the molecular mechanisms underlying these long-term effects, we exposed adolescent males to stress and measured anxiety behaviors and gene expression in the amygdala-a critical region in the control of emotional states-in their progeny for two generations, offspring and grandoffspring. Male C57BL/6 mice underwent chronic unpredictable stress (CUS) for 2 weeks during adolescence and were used to produce two generations of offspring. Male and female offspring and grandoffspring were tested in behavioral assays to measure affective behavior and stress reactivity. Remarkably, transgenerational inheritance of paternal stress exposure produced a protective phenotype in the male, but not the female lineage. RNA-seq analysis of the amygdala from male offspring and grandoffspring identified differentially expressed genes (DEGs) in mice derived from fathers exposed to CUS. The DEGSs clustered into numerous pathways, and the "notch signaling" pathway was the most significantly altered in male grandoffspring. Therefore, we show that paternal stress exposure impacts future generations which manifest in behavioral changes and molecular adaptations.


Assuntos
Tonsila do Cerebelo/metabolismo , Estresse Psicológico/genética , Transcriptoma , Tonsila do Cerebelo/crescimento & desenvolvimento , Animais , Epigênese Genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Herança Paterna , Fenótipo
6.
J Dev Orig Health Dis ; 10(2): 164-175, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30362448

RESUMO

Exposure to the endocrine disruptor bisphenol A (BPA) is ubiquitous and associated with health abnormalities that persist in subsequent generations. However, transgenerational effects of BPA on metabolic health are not widely studied. In a maternal C57BL/6J mice (F0) exposure model using BPA doses that are relevant to human exposure levels (10 µg/kg/day, LowerB; 10 mg/kg/day, UpperB), we showed male- and dose-specific effects on pancreatic islets of the first (F1) and second generation (F2) offspring relative to controls (7% corn oil diet; control). In this study, we determined the transgenerational effects (F3) of BPA on metabolic health and pancreatic islets in our model. Adult F3 LowerB and UpperB male offspring had increased body weight relative to Controls, however glucose tolerance was similar in the three groups. F3 LowerB, but not UpperB, males had reduced ß-cell mass and smaller islets which was associated with increased glucose-stimulated insulin secretion. Similar to F1 and F2 BPA male offspring, staining for markers of T-cells and macrophages (CD3 and F4/80) was increased in pancreas of F3 LowerB and UpperB male offspring, which was associated with changes in cytokine levels. In contrast to F3 BPA males, LowerB and UpperB female offspring had comparable body weight, glucose tolerance and insulin secretion as Controls. Thus, maternal BPA exposure resulted in fewer metabolic defects in F3 than F1 and F2 offspring, and these were sex- and dose-specific.


Assuntos
Poluentes Atmosféricos/toxicidade , Compostos Benzidrílicos/toxicidade , Disruptores Endócrinos/toxicidade , Intolerância à Glucose/etiologia , Exposição Materna/efeitos adversos , Fenóis/toxicidade , Efeitos Tardios da Exposição Pré-Natal/etiologia , Animais , Peso Corporal , Modelos Animais de Doenças , Feminino , Intolerância à Glucose/diagnóstico , Teste de Tolerância a Glucose , Humanos , Insulina/metabolismo , Ilhotas Pancreáticas/efeitos dos fármacos , Ilhotas Pancreáticas/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Gravidez , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Fatores Sexuais
7.
Curr Opin Genet Dev ; 9(2): 164-70, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10322141

RESUMO

A small number of mammalian genes undergo the process of genomic imprinting whereby the expression level of the alleles of a gene depends upon their parental origin. In the past year, attention has focused on the mechanisms that determine parental-specific expression patterns. Many imprinted genes are located in conserved clusters and, although it is apparent that imprinting of adjacent genes is jointly regulated, multiple mechanisms among and within clusters may operate. Recent developments have also refined the timing of the gametic imprints and further defined the mechanism by which DNA methyltransferases confer allelic methylation patterns.


Assuntos
Impressão Genômica , RNA não Traduzido , Alelos , Síndrome de Angelman/genética , Animais , Metilação de DNA , Feminino , Fator de Crescimento Insulin-Like II/genética , Masculino , Família Multigênica , Proteínas Musculares/genética , Síndrome de Prader-Willi/genética , RNA Longo não Codificante
10.
Mol Cell Biol ; 7(2): 586-94, 1987 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3821724

RESUMO

RNA polymerase II is inhibited by the mushroom toxin alpha-amanitin. A mouse BALB/c 3T3 cell line was selected for resistance to alpha-amanitin and characterized in detail. This cell line, designated A21, was heterozygous, possessing both amanitin-sensitive and -resistant forms of RNA polymerase II; the mutant form was 500 times more resistant to alpha-amanitin than the sensitive form. By using the wild-type mouse RNA polymerase II largest subunit (RPII215) gene (J.A. Ahearn, M.S. Bartolomei, M. L. West, and J. L. Corden, submitted for publication) as the probe, RPII215 genes were isolated from an A21 genomic DNA library. The mutant allele was identified by its ability to transfer amanitin resistance in a transfection assay. Genomic reconstructions between mutant and wild-type alleles localized the mutation to a 450-base-pair fragment that included parts of exons 14 and 15. This fragment was sequenced and compared with the wild-type sequence; a single AT-to-GC transition was detected at nucleotide 6819, corresponding to an asparagine-to-aspartate substitution at amino acid 793 of the predicted protein sequence. Knowledge of the position of the A21 mutation should facilitate the study of the mechanism of alpha-amanitin resistance. Furthermore, the A21 gene will be useful for studying the phenotype of site-directed mutations in the RPII215 gene.


Assuntos
Amanitinas/farmacologia , RNA Polimerase II/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Linhagem Celular , Mapeamento Cromossômico , Resistência a Medicamentos , Genes , Camundongos , Mutação , RNA Polimerase II/antagonistas & inibidores , Transfecção
11.
Mol Cell Biol ; 17(1): 309-17, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8972211

RESUMO

The mouse H19 gene is expressed exclusively from the maternal allele. The imprinted expression of the endogenous gene can be recapitulated in mice by using a 14-kb transgene encompassing 4 kb of 5'-flanking sequence, 8 kb of 3'-flanking sequence, which includes the two endoderm-specific enhancers, and an internally deleted structural gene. We have generated multiple transgenic lines with this 14-kb transgene and found that high-copy-number transgenes most closely follow the imprinted expression of the endogenous gene. To determine which sequences are important for imprinted expression, deletions were introduced into the transgene. Deletion of the 5' region, where a differentially methylated sequence proposed to be important in determining parental-specific expression is located, resulted in transgenes that were expressed and hypomethylated, regardless of parental origin. A 6-kb transgene, which contains most of the differentially methylated sequence but lacks the 8-kb 3' region, was not expressed and also not methylated. These results indicate that expression of either the H19 transgene or a 3' DNA sequence is key to establishing the differential methylation pattern observed at the endogenous locus. Finally, methylation analysis of transgenic sperm DNA from the lines that are not imprinted reveals that the transgenes are not capable of establishing and maintaining the paternal methylation pattern observed for imprinted transgenes and the endogenous paternal allele. Thus, the imprinting of the H19 gene requires a complex set of elements including the region of differential methylation and the 3'-flanking sequence.


Assuntos
Metilação de DNA , Impressão Genômica/genética , Proteínas Musculares/genética , RNA não Traduzido , Transgenes/genética , Animais , Elementos Facilitadores Genéticos/genética , Feminino , Dosagem de Genes , Regulação da Expressão Gênica no Desenvolvimento , Masculino , Camundongos , RNA Longo não Codificante , Deleção de Sequência , Espermatozoides , Testículo
12.
Mol Cell Biol ; 17(8): 4322-9, 1997 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9234689

RESUMO

The imprinted mouse H19 gene is hypermethylated on the inactive paternal allele in somatic tissues and sperm. Previous observations from a limited analysis have suggested that methylation of a few CpG dinucleotides in the region upstream from the start of transcription may be the mark that confers parental identity to the H19 alleles. Here we exploit bisulfite mutagenesis coupled with genomic sequencing to derive the methylation status of 68 CpGs that reside in a 4-kb region 5' to the start of transcription. This method reveals a 2-kb region positioned between 2 and 4 kb upstream from the start of transcription that is strikingly differentially methylated in midgestation embryos. At least 12 of the cytosine residues in this region are exclusively methylated on the paternal allele in blastocysts. In contrast, a 350-bp promoter-proximal region is less differentially methylated in midgestation embryos and, like most of the genome, is largely devoid of methylation on both alleles in blastocysts. We also demonstrate exclusive expression of the maternal H19 allele in the embryos that exhibit paternal methylation of the upstream 2-kb region. These data suggest that the 2-kb differentially methylated region acts as a key regulatory domain for imprinted H19 expression.


Assuntos
Metilação de DNA , Impressão Genômica/genética , Proteínas Musculares/genética , RNA não Traduzido , Alelos , Animais , Blastocisto , Citosina/metabolismo , Desenvolvimento Embrionário e Fetal/genética , Genes , Camundongos , Camundongos Endogâmicos C57BL , Dados de Sequência Molecular , Mutagênese , Regiões Promotoras Genéticas , RNA Longo não Codificante , Sulfitos , Transcrição Gênica/genética
13.
Mol Cell Biol ; 8(1): 330-9, 1988 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3275873

RESUMO

The carboxyl-terminal domain (CTD) of the mouse RNA polymerase II largest subunit consists of 52 repeats of a seven-amino-acid block with the consensus sequence Tyr-Ser-Pro-Thr-Ser-Pro-Ser. A genetic approach was used to determine whether the CTD plays an essential role in RNA polymerase function. Deletion, insertion, and substitution mutations were created in the repetitive region of an alpha-amanitin-resistant largest-subunit gene. The effects of these mutations on RNA polymerase II activity were assayed by measuring the ability of mutant genes to confer alpha-amanitin resistance after transfection of susceptible rodent cells. Mutations that resulted in CTDs containing between 36 and 78 repeats had no effect on the transfer of alpha-amanitin resistance, whereas mutations with 25 or fewer repeats were inactive in this assay. Mutations that contained 29, 31, or 32 repeats had an intermediate effect; the number of alpha-amanitin-resistant colonies was lower and the colonies obtained were smaller, indicating that the mutant RNA polymerase II was defective. In addition, not all of the heptameric repeats were functionally equivalent in that repeats that diverged in up to three amino acids from the consensus sequence could not substitute for the conserved heptamer repeats. We concluded that the CTD is essential for RNA polymerase II activity, since substantial mutations in this region result in loss of function.


Assuntos
Camundongos/genética , RNA Polimerase II/genética , Amanitinas/farmacologia , Animais , Sequência de Bases , Clonagem Molecular , Análise Mutacional de DNA , Genes , RNA Polimerase II/antagonistas & inibidores , Proteínas Recombinantes , Saccharomyces cerevisiae/genética , Relação Estrutura-Atividade , Transfecção
14.
Cytogenet Genome Res ; 113(1-4): 153-8, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16575175

RESUMO

The mouse H19 and Igf2 genes are oppositely imprinted and share enhancers that reside 3' to the genes. The imprinted expression of these genes is coordinated by a 2-kb regulatory element, the differentially methylated domain (DMD), positioned between the two genes. The methylation status of this region determines the ability of the insulator factor CTCF to bind to its sites in the DMD. Deletions and mutations of the DMD that affect imprinting in the soma have little effect on the methylation pattern of H19 in the germline, suggesting that additional sequences and factors contribute to the earliest stages of imprinting regulation at this locus. Less is known about these initial steps, which include the marking of the parental alleles, the onset of allele-specific expression patterns and maintenance of the imprints in the preimplantation embryo. Here, we will focus on these early steps, summarizing what is known and what questions remain to be addressed.


Assuntos
Blastocisto/fisiologia , Impressão Genômica , Fator de Crescimento Insulin-Like II/genética , RNA não Traduzido , Animais , Sítios de Ligação , Fator de Ligação a CCCTC , Metilação de DNA , Proteínas de Ligação a DNA/genética , Feminino , Fertilização , Masculino , Camundongos , Modelos Genéticos , Mutação , RNA Longo não Codificante , Proteínas Repressoras/genética , Deleção de Sequência
16.
Mol Gen Genet ; 246(6): 778-82, 1995 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-7898449

RESUMO

We report the identification of three new alpha-amanitin resistance mutations in the gene encoding the largest subunit of mouse RNA polymerase II (RPII215). These mutations are clustered in a region of the largest subunit that is important for transcription elongation. This same domain has been identified as the site of alpha-amanitin resistance mutations in both Drosophila and Caenarhabditis elegans. The sequences encompassing this cluster of mutations are highly conserved among RNA polymerase II genes from a number of species, including those that are naturally more resistant to alpha-amanitin suggesting that this region of the largest subunit is critical for a conserved catalytic function. The mutations reported here change leucine 745 to phenylalanine, arginine 749 to proline, or isoleucine 779 to phenylalanine. Together with the previously reported asparagine 792 to aspartate substitution these mutations define a potential alpha-amanitin binding pocket in a region of the mouse subunit that could be involved in translocation of polymerase during elongation.


Assuntos
Amanitinas/toxicidade , RNA Polimerase II/genética , Células 3T3 , Alelos , Sequência de Aminoácidos , Animais , Sequência de Bases , Linhagem Celular , Clonagem Molecular , Resistência a Medicamentos/genética , Camundongos , Camundongos Endogâmicos BALB C , Dados de Sequência Molecular , Mutação , Reação em Cadeia da Polimerase , Homologia de Sequência de Aminoácidos , Transfecção
17.
Hum Mol Genet ; 8(10): 1867-73, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10469839

RESUMO

Prader-Willi syndrome (PWS) and Angelman syndrome (AS) are two distinct neurological disorders that map to human chromosome 15q11-q13 and involve perturbations of imprinted gene expression. PWS is caused by a deficiency of paternal gene expression and AS is caused by a deficiency of maternal gene expression. Experiments in the last year have focused on molecular analysis of the human chromosomal region as well as the homologous region on central mouse chromosome 7. New transcripts and exons have been identified and the epigenetic status of the PWS/AS region in mice and humans has been examined. The imprinting center that is hypothesized to control the switch between the maternal and paternal epigenotypes has also been characterized in greater detail and a mouse model that deletes the homologous element demonstrates a conservation in imprinting center function between mice and humans. In addition, analysis of non-deletion AS patients has revealed that UBE3A intragenic mutations are found in a significant number of cases. However, both human patients and mouse model systems indicate that other genes may also contribute to the AS phenotype. Thus, although much has been learned in the last year, considerable information is still required before these complex syndromes are fully understood.


Assuntos
Síndrome de Angelman/genética , Síndrome de Prader-Willi/genética , Animais , Cromossomos Humanos Par 15/genética , Modelos Animais de Doenças , Genes/genética , Ligação Genética/genética , Impressão Genômica/genética , Humanos , Camundongos
18.
Methods Mol Biol ; 181: 133-44, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-12843446

RESUMO

The ribonuclease protection assay (RPA) is a sensitive technique for the analysis of total cellular RNA. It involves generating a specific antisense riboprobe, hybridizing the probe to total RNA, removing unprotected RNA by RNases, and finally isolating and analyzing the protected RNA on a denaturing gel. Although the RPA is somewhat more labor-intensive than Northern analysis, it has the advantage of being more sensitive (as little as 0.1 pg of target RNA can be detected with ideal hybridization conditions). RPAs are also more tolerant of partially degraded RNA (provided the area that is protected is intact). Although RPAs are not as sensitive as polymerase chain reaction (PCR)-based RNA analyses, the target RNA is analyzed directly; a reverse transcription step is not required. Finally, the RPA is quantitative as long as the probe is in excess. More important for the study of imprinted genes, the RPA can be designed to detect allele-specific expression of the target gene of interest.


Assuntos
Ensaios de Proteção de Nucleases/métodos , Ribonucleases/metabolismo , Animais , Humanos , Sondas RNA/genética
19.
Annu Rev Genet ; 31: 493-525, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9442905

RESUMO

A handful of autosomal genes in the mammalian genome are inherited in a silent state from one of the two parents, and in a fully active form from the other, thereby rendering the organism functionally hemizygous for imprinted genes. To date 19 imprinted genes have been identified; 5 are expressed from the maternal chromosome while the rest are expressed from the paternal chromosome. Allele-specific methylation of CpG residues, established in one of the germlines and maintained throughout embryogenesis, has been clearly implicated in the maintenance of imprinting in somatic cells. Although the function of imprinting remains a subject of some debate, the process is thought to have an important role in regulating the rate of fetal growth.


Assuntos
Impressão Genômica , Mamíferos/genética , Animais , Evolução Molecular , Humanos
20.
Am J Physiol ; 247(4 Pt 2): H570-5, 1984 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-6149690

RESUMO

Experiments were carried out to examine the effects of corticosterone and triiodothyronine on rat myocardial Na+-K+-ATPase activity. Corticosterone increased Na+-K+-ATPase activity when administered intravenously in multiple doses, a single dose, and different dosages. The possibility that enhancement of myocardial Na+-K+-ATPase activity by corticosterone is mediated by early changes in intracellular Na+ and K+ was investigated. Following a single dose of corticosterone (1 mg/100 g body wt), the increase in Na+-K+-ATPase activity preceded the changes in intracellular Na+ and K+. Corticosterone did not change the transition temperature and activation energy of the reaction in myocardial Na+-K+-ATPase. This implies that corticosterone does not act by altering the lipid matrix in the microenvironment of the Na+-K+-ATPase system. The interaction between the effects of corticosterone and triiodothyronine on myocardial Na+-K+-ATPase activity was examined. Our studies indicated that corticosterone and triiodothyronine regulate Na+-K+-ATPase activity via parallel independent pathways.


Assuntos
Corticosterona/farmacologia , Miocárdio/enzimologia , ATPase Trocadora de Sódio-Potássio/metabolismo , Tri-Iodotironina/farmacologia , Adenosina Trifosfatases/metabolismo , Adrenalectomia , Animais , ATPase de Ca(2+) e Mg(2+) , Dexametasona/farmacologia , Cinética , Masculino , Potássio/sangue , Ratos , Ratos Endogâmicos , Sódio/sangue , Termodinâmica , Tireoidectomia
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