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1.
Physiol Behav ; 263: 114117, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-36781093

RESUMO

Treatments for schizophrenia are not effective in ameliorating cognitive deficits. Therefore, novel therapies are needed to treat cognitive impairments associated with schizophrenia (CIAS), which are modelled in rats through administration of sub-chronic phencyclidine (scPCP). We have previously shown that enrichment via voluntary exercise prevents and reverses impairments in novel object recognition (NOR) in this model. The present study aimed to investigate if handling could prevent delay-induced NOR deficits and prevent and reverse scPCP-induced NOR deficits. Two cohorts of adult female Lister Hooded rats were used. In experiment one, handling (five minutes/day, five days/week for two weeks), took place before scPCP administration (2 mg/kg, i.p. twice-daily for seven days). NOR tests were conducted at two, four, and seven weeks post-handling with a one-minute inter-trial interval (ITI) and at five weeks post-dosing with a six-hour ITI. In experiment two, rats were handled after scPCP administration and tested immediately in the one-minute ITI NOR task and again at two weeks post-handling. In both handling regimens, the scPCP control groups failed to discriminate novelty, conversely the scPCP handled groups significantly discriminated in this task. In the 6 h ITI test, vehicle control and scPCP control failed to discriminate novelty; however, the vehicle handled and scPCP handled groups did significantly discriminate. Handling rats prevented and reversed scPCP-induced deficits and prevented delay-induced NOR deficits. These findings add to evidence that environmental enrichment is a viable treatment for cognitive deficits in rodent tests and models of relevance to schizophrenia, with potential to translate into effective treatments for CIAS.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Esquizofrenia , Ratos , Feminino , Animais , Fenciclidina/efeitos adversos , Esquizofrenia/induzido quimicamente , Disfunção Cognitiva/induzido quimicamente , Cognição , Modelos Animais de Doenças
2.
Brain Neurosci Adv ; 5: 23982128211003199, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35392130

RESUMO

Encoding information into memory is sensitive to distraction while retrieving that memory may be compromised by proactive interference from pre-existing memories. These two debilitating effects are common in neuropsychiatric conditions, but modelling them preclinically to date is slow as it requires prolonged operant training. A step change would be the validation of functionally equivalent but fast, simple, high-throughput tasks based on spontaneous behaviour. Here, we show that spontaneous object preference testing meets these requirements in the subchronic phencyclidine rat model for cognitive impairments associated with schizophrenia. Subchronic phencyclidine rats show clear memory sensitivity to distraction in the standard novel object recognition task. However, due to this, standard novel object recognition task cannot assess proactive interference. Therefore, we compared subchronic phencyclidine performance in standard novel object recognition task to that using the continuous novel object recognition task, which offers minimal distraction, allowing disease-relevant memory deficits to be assessed directly. We first determined that subchronic phencyclidine treatment did not affect whisker movements during object exploration. Subchronic phencyclidine rats exhibited the expected distraction standard novel object recognition task effect but had intact performance on the first continuous novel object recognition task trial, effectively dissociating distraction using two novel object recognition task variants. In remaining continuous novel object recognition task trials, the cumulative discrimination index for subchronic phencyclidine rats was above chance throughout, but, importantly, their detection of object novelty was increasingly impaired relative to controls. We attribute this effect to the accumulation of proactive interference. This is the first demonstration that increased sensitivity to distraction and proactive interference, both key cognitive impairments in schizophrenia, can be dissociated in the subchronic phencyclidine rat using two variants of the same fast, simple, spontaneous object memory paradigm.

3.
J Exp Med ; 155(6): 1665-78, 1982 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-6210740

RESUMO

Adult NZB mice (greater than 15 wk old) have very few bone marrow cells that can give rise to sIg+ clonable B cells during liquid culture. This deficiency corresponds to extremely low numbers of cells with cytoplasmic but not surface mu chains of IgM and reduced numbers of cells bearing a high molecular weight B-lineage antigen. Depletion of Thy-1-bearing cells and appropriate mixing experiments did not provide evidence either that suppressor cells are responsible for this phenomenon or that accessory cells are defective in NZB mice. Nor did it seem that B cells were being produced in extramedullary sites. B cell precursors were detectable in very young NZB mice, exceeded control values at 4-5 wk of age, and then declined rapidly. In contrast, these persisted for greater than 1 yr in normal BALB/c, DBA/2, and CBA/H mice. It appears possible that intermediate stages in B-lineage differentiation become prematurely exhausted through an accelerated aging process in NZB mice. These chronological changes have implications for understanding the sequence of events that lead to B lymphocyte formation and the processes that normally regulate it.


Assuntos
Envelhecimento , Doenças Autoimunes/imunologia , Linfócitos B/imunologia , Células-Tronco Hematopoéticas/imunologia , Animais , Doenças Autoimunes/genética , Linfócitos B/citologia , Células da Medula Óssea , Adesão Celular , Diferenciação Celular , Feminino , Células-Tronco Hematopoéticas/citologia , Imunidade Celular , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos CBA , Camundongos Endogâmicos DBA , Camundongos Endogâmicos NZB , Receptores de Antígenos de Linfócitos B , Linfócitos T Reguladores/citologia , Linfócitos T Reguladores/imunologia
4.
Exp Hematol ; 28(9): 1062-70, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11008019

RESUMO

OBJECTIVE: Neutrophil receptors for the Fc portion of IgG (FcgammaR) trigger immune responses following cross-linking by IgG-coated foreign particles or immune complexes. Membrane-associated CD45, a protein tyrosine phosphatase termed leukocyte common antigen, has been shown to be essential for antigen receptor kinase mediated signaling in lymphocytes, and we hypothesized that CD45 may play a similar role in FcgammaR-mediated signaling and immune function in human neutrophils. METHODS: The experimental approach was that of cell surface molecule ligation via cross-linking with specific antibodies. Antibody dependent cellular cytotoxicity (ADCC) was assessed using a single-cell plaque assay and IL-6 production measured using ELISA. Tyrosine phosphorylation levels were assessed with anti-phospho-tyrosine blots and F-actin polymerization by flow cytometry and confocal microscopy. RESULTS: Neutrophils pretreated with anti-CD45 had a reduced ability to perform ADCC compared to untreated neutrophils. FcgammaRIIa cross-linking resulted in significantly increased concentrations of secreted IL-6 compared to untreated neutrophils, and IL-6 production was further enhanced by cocross-linking CD45 with FcgammaRIIa. Cross-linking CD45 alone also induced IL-6 production. FcgammaRIIa cross-linking resulted in increased protein tyrosine phosphorylation and F-actin polymerization in neutrophils. Cocross-linking CD45 with FcgammaRIIa resulted in abrogation of FcgammaRIIa mediated tyrosine phosphorylation and F-actin polymerization. CONCLUSIONS: These data provide evidence that CD45 can regulate or enhance the stimulation and function of human neutrophils mediated through FcgammaR(s). In addition, CD45 ligation may play an essential role in cytokine induction pathways that lead to inflammatory reactions in vivo.


Assuntos
Antígenos CD/fisiologia , Antígenos Comuns de Leucócito/farmacologia , Ativação de Neutrófilo/efeitos dos fármacos , Receptores de IgG/fisiologia , Actinas/metabolismo , Anticorpos Monoclonais/farmacologia , Citotoxicidade Celular Dependente de Anticorpos/efeitos dos fármacos , Antígenos CD/efeitos dos fármacos , Antígenos CD/metabolismo , Reagentes de Ligações Cruzadas/farmacologia , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Fator Estimulador de Colônias de Granulócitos/farmacologia , Humanos , Interleucina-6/metabolismo , Antígenos Comuns de Leucócito/imunologia , Antígenos Comuns de Leucócito/fisiologia , Neutrófilos/metabolismo , Neutrófilos/fisiologia , Fosforilação/efeitos dos fármacos , Proteínas Tirosina Fosfatases/farmacologia , Proteínas Tirosina Fosfatases/fisiologia , Receptores de IgG/efeitos dos fármacos , Receptores de IgG/metabolismo , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/farmacologia , Transdução de Sinais/efeitos dos fármacos
5.
Exp Hematol ; 24(5): 628-37, 1996 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8605968

RESUMO

B lymphocyte production in the bone marrow depends on a cascade of regulatory cells and cytokines unique to the hematopoietic microenvironment. Fibroblastic stromal cells appear to be particularly important in regulating the earliest events in this lineage; however, it is still not clear whether the same or different sets of signals regulate maintenance of cell viability, proliferation, and differentiation of B lineage cells. In this study, we addressed the role of bone marrow stromal cells in survival and expansion of normal murine pro-B cells. Stromal cells were required for long-term proliferation of pro-B cell clone C1.92, and, in the presence of stromal cell line S10, pro-B cells expressed the proto-oncogene bcl-2. Removal of C1.92 cells from Stromal cell-derived signaling in support of pro-B cell viability. Due to its previously described role in regulating cell survival, we investigated whether stromal cells regulate bcl-2 expression in pro-B cells. When removed from stromal cell cultures, pro-B cells rapidly lost bcl-2 mRNA expression coincident with initiation of apoptosis. However, interruption of bcl-2 expression with antisense oligonucleotides in the presence of stroma and interleukin-7 (IL-7) did not result in immediate cell death. Oligonucleotide-treated cells arrested in G(1) phase of the cell cycle 24 hours before the initiation of apoptosis. In contrast, removal of pro-B cells from stromal cell support resulted in rapid increase in BAX expression, correlating directly with initiation of apoptosis. These results suggest that bcl-2 may, in part, regulate cell survival by interrupting the cascade of intracellular events that regulate cell cycle progression in lymphopoietic cells. Initiation of apoptosis in these cells appears to be more closely correlated with intracellular levels of BAX expression.


Assuntos
Linfócitos B/citologia , Células da Medula Óssea , Proteínas Proto-Oncogênicas/metabolismo , Animais , Apoptose , Sequência de Bases , Comunicação Celular , Ciclo Celular , Sobrevivência Celular , Células Cultivadas , Primers do DNA/química , Expressão Gênica , Camundongos , Dados de Sequência Molecular , Proteínas Proto-Oncogênicas c-bcl-2 , RNA Mensageiro/genética , Proteína X Associada a bcl-2
6.
J Immunol Methods ; 123(1): 93-101, 1989 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-2794531

RESUMO

This report describes a colony assay system, based on methods used to grow myeloid precursors in semisolid medium, in which B cell progenitors can be grown. The formation of these B cell progenitor colonies is dependent upon soluble mediators from a stromal cell line known to support B lymphopoiesis. In initial experiments a double layer culture system was employed in which target cells in methylcellulose medium were separated from an adherent layer of S17 stromal cells by an agar interface. Target cells were harvested from Dexter type long-term bone marrow cultures at a time after transfer to the lymphoid Whitlock-Witte conditions, when myeloid progenitors were depleted and mature B cells had not yet appeared. On day 15 of culture a colony could be identified that contained several hundred tightly clustered lymphoid cells. There was a linear relationship between the number of cells plated and the number of colonies that developed. Identically appearing colonies were also observed in agar using fresh bone marrow cells as targets with either an underlayer of S17 cells or S17 conditioned medium to potentiate colony growth. Lymphoid colonies derived from fresh bone marrow appeared on days 6 and 14 of growth. A proportion of the cells from the fresh or cultured marrow derived colonies expressed the B220 antigen and cytoplasmic mu heavy chains, but surface IgM was never observed. Cell depletion experiments on antibody coated plates demonstrated the colony forming unit to be B220 antigen positive, surface IgM negative, and replating experiments indicated the colonies were lymphoid restricted in their differentiative potential.


Assuntos
Linfócitos B/fisiologia , Células da Medula Óssea , Ensaio de Unidades Formadoras de Colônias , Animais , Linfócitos B/imunologia , Células Cultivadas , Fatores Estimuladores de Colônias/fisiologia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Fenótipo
7.
Dev Comp Immunol ; 8(4): 887-94, 1984.
Artigo em Inglês | MEDLINE | ID: mdl-6335108

RESUMO

The emergence of putative B lymphocyte lineage cells in embryonic and neonatal tissues of mice was studied using monoclonal antibodies which recognize virtually all B cells, pre-B cells and an additional population of lymphoid cells. An extensive survey of extraembryonic and intraembryonic hemopoietic tissues indicated that cells displaying this marker first appear within liver of 45-50 somite stage embryos. Prior to this developmental stage, none were found in yolk sac or peripheral blood. Although some 14.8 antigen bearing cells were found in suspensions of ectoplacenta, these were small surface IgM+ lymphocytes which were presumably of maternal origin. Culture of embryonic liver fragments which initially contained small numbers of antigen positive cells resulted in their expansion. However, this did not occur when very early liver rudiments containing virtually no lymphoid cells were cultured. These findings document the earliest appearance of cells during ontogeny which may be committed to differentiate into functional B lymphocytes.


Assuntos
Linfócitos B/imunologia , Embrião de Mamíferos/imunologia , Células-Tronco Hematopoéticas/imunologia , Animais , Animais Recém-Nascidos , Anticorpos Monoclonais , Diferenciação Celular , Embrião de Mamíferos/citologia , Fígado/citologia , Fígado/imunologia , Camundongos , Camundongos Endogâmicos CBA , Técnicas de Cultura de Órgãos
8.
Environ Health Perspect ; 108 Suppl 3: 483-90, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10852848

RESUMO

Fetuses, infants, and juveniles (preadults) should not be considered simply "small adults" when it comes to toxicological risk. We present specific examples of developmental toxicants that are more toxic to children than to adults, focusing on effects on the immune and respiratory systems. We describe differences in both the pharmacokinetics of the developing immune and respiratory systems as well as changes in target organ sensitivities to toxicants. Differential windows of vulnerability during development are identified in the context of available animal models. We provide specific approaches to directly investigate differential windows of vulnerability. These approaches are based on fundamental developmental biology and the existence of discrete developmental processes within the immune and respiratory systems. The processes are likely to influence differential developmental susceptibility to toxicants, resulting in lifelong toxicological changes. We also provide a template for comparative research. Finally, we discuss the application of these data to risk assessment.


Assuntos
Proteção da Criança , Poluentes Ambientais/efeitos adversos , Sistema Imunitário/efeitos dos fármacos , Sistema Respiratório/efeitos dos fármacos , Criança , Desenvolvimento Infantil , Pré-Escolar , Exposição Ambiental , Feminino , Humanos , Sistema Imunitário/embriologia , Sistema Imunitário/crescimento & desenvolvimento , Lactente , Recém-Nascido , Gravidez , Sistema Respiratório/embriologia , Sistema Respiratório/crescimento & desenvolvimento , Fatores de Tempo
9.
Pharmacotherapy ; 18(1): 1-8, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9469674

RESUMO

STUDY OBJECTIVE: To evaluate specific biological markers to improve understanding and use of granulocyte colony-stimulating factor (G-CSF) in patients receiving chemotherapy DESIGN: Prospective, randomized study. SETTING: University-affiliated hospital and cancer center. PATIENTS: Twenty-five patients randomized to begin G-CSF either 24 hours after chemotherapy (standard arm), or on the day the absolute neutrophil count (ANC) was below 1000/mm3 after chemotherapy (delayed arm). INTERVENTIONS: To determine the effect of G-CSF on granulopoiesis, peripheral blood mononuclear cells were assayed by semisolid culture medium and flow cytometry for granulocyte progenitors and clonogenic CD34 antigen-positive cells. These biological markers were correlated with G-CSF administration schedules and the ANC. MEASUREMENTS AND MAIN RESULTS: The effect of timing of G-CSF administration on rate of neutrophil recovery, duration of neutropenia, length of G-CSF therapy, delays of chemotherapy cycles, and neutropenic fever events was evaluated. Regardless of G-CSF schedule or chemotherapy regimen, the appearance of mobilized hematopoietic progenitors begins at the neutrophil nadir and parallels granulocyte recovery. Our data also demonstrate that proper timing of G-CSF administration produces similar rates of neutrophil recovery and comparable clinical outcomes. CONCLUSION: Based on the correlation between biological markers and ANC, we propose that the postchemotherapy ANC is a surrogate marker of renewed granulopoietic activity. The relevance of this finding in relationship to the clinical application of G-CSF remains to be further defined.


Assuntos
Antígenos CD34/sangue , Antineoplásicos/efeitos adversos , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Neoplasias/sangue , Neoplasias/tratamento farmacológico , Neutropenia/tratamento farmacológico , Neutrófilos , Adulto , Idoso , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neutropenia/sangue , Neutropenia/induzido quimicamente , Estudos Prospectivos
10.
Adv Exp Med Biol ; 323: 119-23, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1283046

RESUMO

Based upon the above data, it is now possible to formulate a working model that defines the stages of B cell development on which stromal cells and their products act. During the initial stages of this process, pro-B cells which do not express Ig heavy or light chain protein or other non-Ig B lineage associated molecules develop into B220 and c mu expressing pre-B cells in response to a low (< 10 kD) molecular weight stromal cell derived factor. No defined interleukin or colony stimulating factor, including molecules such as KL and IL-7, can replace stromal cell conditioned medium in mediating this developmental step. There appears to be little cell proliferation associated with the differentiation of pro-B cells into pre-B cells. However, our data indicate that as precursors develop into B220 expressing B cell progenitors, they become sensitive to the proliferation stimulating effects of IL-7 and KL. These results are in accord with findings that progenitor cells that have undergone DJH rearrangements are particularly sensitive to KL and IL-7(18,19). The analysis of pre-B cells present in individual lymphoid colonies indicates that once cells have rearranged and expressed their Ig heavy chain genes, they are no longer sensitive to KL and IL-7. These observations are based on the fact that receptors for these cytokines are not expressed in stromal cell dependent pre-B cells and are consistent with kinetic studies showing that the maturation of pre-B cells into surface Ig expressing B lymphocytes is not dependent upon cell proliferation21.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Subpopulações de Linfócitos B/citologia , Células da Medula Óssea , Fatores de Crescimento de Células Hematopoéticas/fisiologia , Interleucina-7/fisiologia , Diferenciação Celular/efeitos dos fármacos , Divisão Celular , Células Cultivadas , Tecido Conjuntivo/fisiologia , Células do Tecido Conjuntivo , Fibroblastos/fisiologia , Células-Tronco Hematopoéticas/citologia , Células-Tronco Hematopoéticas/efeitos dos fármacos , Modelos Biológicos , Fator de Células-Tronco
11.
Hum Exp Toxicol ; 21(9-10): 493-8, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12458906

RESUMO

The immune system of rodents, like that in humans, develops from a population of pluripotential hematopoietic stem cells (HSC) that are generated early in gestation from uncommitted mesenchymal stem cells in the intraembryonic splanchnoplure surrounding the heart. This early population of HSC gives rise to all circulating blood cell lineages, including cells of the innate and acquired immune system. To access the impact of chemical exposure on the developing immune system and establish developmental windows of potential vulnerability to these exposures, it is essential to first consider the anatomical development of hematopoietic and lymphopoietic tissues and the sequence of appearance of cells that give rise to the immune system. This is particularly true in embryonic development because, after they initially appear in intraembryonic mesenchyme early in gestation, HSC migrate through an orderly series of tissues before establishing residence in the bone marrow and thymus. The effect of exposure to chemical insults in utero, then, may differ depending on the specific timing of exposure and anatomical location of hematopoiesis. Mechanisms and consequences of developmental immunotoxicity in experimental animals will need to be considered in that context. This review presents an overview of developmental hematopoiesis and a working hypothesis of critical developmental windows of vulnerability of this developmental system to toxic insult by chemical exposure.


Assuntos
Modelos Animais de Doenças , Sistema Imunitário/embriologia , Sistema Imunitário/crescimento & desenvolvimento , Roedores/imunologia , Toxicologia/métodos , Fatores Etários , Animais , Animais Recém-Nascidos , Medula Óssea/crescimento & desenvolvimento , Hematopoese/efeitos dos fármacos , Hematopoese/imunologia , Células-Tronco Hematopoéticas/efeitos dos fármacos , Células-Tronco Hematopoéticas/imunologia , Sistema Imunitário/efeitos dos fármacos , Fígado/embriologia , Fígado/crescimento & desenvolvimento , Linfopoese/efeitos dos fármacos , Linfopoese/imunologia , Medição de Risco , Baço/embriologia , Baço/crescimento & desenvolvimento , Timo/embriologia , Timo/crescimento & desenvolvimento , Toxicologia/normas
12.
Hybridoma ; 13(3): 175-81, 1994 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-7927361

RESUMO

Two monoclonal antibodies (MAb) that recognize cell-surface determinants present on bone marrow stromal cells have been generated. The 5B3 antibody recognizes a major histocompatibility class I-like molecule. This antigen is coexpressed on all bone marrow B-lineage cells and myeloid progenitors responsive to recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF). The 9D3 antibody recognizes a protein similar in size to those encoded by the Ly-6 locus. A comparable bone marrow staining pattern and inhibition of 9D3 binding to bone marrow cells by anti-Ly-6C antibodies strongly suggests that the 9D3 antigen is Ly-6C. These data provide a further phenotypic characterization of bone marrow stroma and indicate that these cells express cell-surface determinants also present on myeloid and lymphoid cells.


Assuntos
Antígenos de Superfície/biossíntese , Células da Medula Óssea , Células-Tronco Hematopoéticas/imunologia , Linfócitos/imunologia , Células Estromais/imunologia , Animais , Anticorpos Monoclonais/imunologia , Antígenos de Superfície/imunologia , Medula Óssea/imunologia , Imunofluorescência , Hibridomas/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Ensaio de Radioimunoprecipitação , Baço/citologia
20.
Cell Immunol ; 117(2): 389-98, 1988 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-3264215

RESUMO

The development of the B cell immune repertoire was studied using an in vitro fetal organ culture system. In order to analyze the mechanism by which B cell precursors clonally expand and diversify, fetal lymphoid tissues were incubated in the presence of several factors known to influence B cell differentiation: IL-1, IL-2, WEHI-3 culture supernatant containing IL-3, and a factor from a cyclic neutropenia patient (CNF). By analyzing the effect of exogenous factors on the frequency of antigen-responsive B cells, the ability of the factor to either inhibit or enhance clonal expansion was determined. It was found that the addition of IL-1, WEHI-3 supernatant, or CNF increased the frequency of DNP-responsive B cells suggesting an enhancement of clonal expansion. IL-2, on the other hand, did not alter the frequency of antigen-responsive B cells. The effect of added factors on the kinetics of appearance of phosphorylcholine (PC)-responsive B cells, which are known to be acquired in ontogeny about 2 weeks later than DNP-responsive B cells, was also analyzed. The data indicate that CNF, unlike IL-1, IL-2, and WEHI-3 culture supernatant, results in an earlier appearance of PC-responsive B cells. These results suggest that soluble factors may play a role in the generation of the B cell repertoire.


Assuntos
Linfócitos B/citologia , Substâncias de Crescimento/farmacologia , Fígado/imunologia , Animais , Linfócitos B/efeitos dos fármacos , Linfócitos B/transplante , Diferenciação Celular/efeitos dos fármacos , Ensaio de Imunoadsorção Enzimática , Feminino , Feto/imunologia , Haptenos/imunologia , Idiótipos de Imunoglobulinas/análise , Imuno-Histoquímica , Fígado/embriologia , Camundongos , Camundongos Endogâmicos BALB C , Técnicas de Cultura de Órgãos , Células-Tronco/efeitos dos fármacos
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