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1.
Allergy ; 68(9): 1093-101, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23991682

RESUMO

This year (2013) marks the 50th anniversary of death of Otto Carl Willy Prausnitz (1876-1963) and Heinz Küstner (1897-1963). The two physicians, when working at the Hygiene Institute at the University of Breslau, Germany (Prausnitz was the Head of the Institute), described in 1921 what is still called today the Prausnitz-Küstner or PK reaction showing that allergy could be transferred from the allergic person by transferring serum to a healthy person. Their discovery ended the belief that an anaphylactic/allergic reaction was caused by poisons, but to the contrary showed that the presence of the hypersensitivity factor could be transferred to other people. We know now that this factor is immunoglobulin E (IgE), sensitizing mast cells and basophils to respond to an allergic stimulus. We take this occasion to retrace some of the important discoveries and lessons learnt from the last century relating to the function of these two cell types as effectors of the IgE system and the mediators they produce.


Assuntos
Basófilos/imunologia , Mastócitos/imunologia , Pesquisa , Anafilaxia/imunologia , Animais , Basófilos/citologia , Basófilos/metabolismo , História do Século XX , Humanos , Imunidade Inata , Imunoglobulina E/imunologia , Mastócitos/citologia , Mastócitos/metabolismo , Doenças Parasitárias/imunologia , Pesquisa/história
3.
J Exp Med ; 191(1): 47-60, 2000 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-10620604

RESUMO

Vav is a hematopoietic cell-specific guanine nucleotide exchange factor (GEF) whose activation is mediated by receptor engagement. The relationship of Vav localization to its function is presently unclear. We found that Vav redistributes to the plasma membrane in response to Fcin receptor I (FcinRI) engagement. The redistribution of Vav was mediated by its Src homology 2 (SH2) domain and required Syk activity. The FcinRI and Vav were found to colocalize and were recruited to glycosphingolipid-enriched microdomains (GEMs). The scaffold protein, linker for activation of T cells (LAT), and Rac1 (a target of Vav activity) were constitutively present in GEMs. Expression of an SH2 domain-containing COOH-terminal fragment of Vav inhibited Vav phosphorylation and movement to the GEMs but had no effect on the tyrosine phosphorylation of the adaptor protein, SLP-76 (SH2 domain-containing leukocyte protein of 76 kD), and LAT. However, assembly of the multiprotein complex containing these proteins was inhibited. In addition, FcinRI-dependent activation of c-Jun NH(2)-terminal kinase 1 (JNK1) was also inhibited. Thus, Vav localization to the plasma membrane is mediated by its SH2 domain and may serve to regulate downstream effectors like JNK1.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal , Proteínas de Ciclo Celular , Proteínas de Membrana , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Proteínas Proto-Oncogênicas/fisiologia , Domínios de Homologia de src , Animais , Proteínas de Transporte/análise , Membrana Celular/química , Ativação Enzimática , Precursores Enzimáticos/fisiologia , Peptídeos e Proteínas de Sinalização Intracelular , Proteínas Quinases JNK Ativadas por Mitógeno , Camundongos , Fosfoproteínas/análise , Proteínas Tirosina Quinases/fisiologia , Proteínas Proto-Oncogênicas/análise , Proteínas Proto-Oncogênicas/química , Proteínas Proto-Oncogênicas c-vav , Receptores de IgE/metabolismo , Quinase Syk , Proteínas rac1 de Ligação ao GTP/análise
4.
J Exp Med ; 188(5): 819-31, 1998 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-9730884

RESUMO

Stimulation of CD4(+) helper T lymphocytes by antigen-presenting cells requires the degradation of exogenous antigens into antigenic peptides which associate with major histocompatibility complex (MHC) class II molecules in endosomal or lysosomal compartments. B lymphocytes mediate efficient antigen presentation first by capturing soluble antigens through clonally distributed antigen receptors (BCRs), composed of membrane immunoglobulin (Ig) associated with Ig-alpha/Ig-beta heterodimers which, second, target antigens to MHC class II-containing compartments. We report that antigen internalization and antigen targeting through the BCR or its Ig-alpha-associated subunit to newly synthesized class II lead to the presentation of a large spectrum of T cell epitopes, including some cryptic T cell epitopes. To further characterize the intracellular mechanisms of BCR-mediated antigen presentation, we used two complementary experimental approaches: mutational analysis of the Ig-alpha cytoplasmic tail, and overexpression in B cells of dominant negative syk mutants. Thus, we found that the syk tyrosine kinase, an effector of the BCR signal transduction pathway, is involved in the presentation of peptide- MHC class II complexes through antigen targeting by BCR subunits.


Assuntos
Apresentação de Antígeno , Antígenos CD/fisiologia , Proteínas de Ligação a DNA , Precursores Enzimáticos/fisiologia , Antígenos de Histocompatibilidade Classe II/imunologia , Antígenos de Histocompatibilidade Classe II/metabolismo , Proteínas Tirosina Quinases/fisiologia , Receptores de Antígenos de Linfócitos B/fisiologia , Animais , Antígenos CD/química , Antígenos Virais/metabolismo , Linfócitos B/enzimologia , Linfócitos B/imunologia , Linfócitos B/metabolismo , Bacteriófago lambda/imunologia , Antígenos CD79 , Citoplasma/imunologia , Precursores Enzimáticos/metabolismo , Epitopos de Linfócito T/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular , Ativação Linfocitária , Linfoma de Células B , Camundongos , Proteínas Tirosina Quinases/metabolismo , Ratos , Receptores de Antígenos de Linfócitos B/química , Proteínas Repressoras/imunologia , Quinase Syk , Células Tumorais Cultivadas , Tirosina/fisiologia , Proteínas Virais , Proteínas Virais Reguladoras e Acessórias
5.
Science ; 244(4902): 334-7, 1989 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-2523561

RESUMO

The receptor with high affinity for immunoglobulin E (IgE) on mast cells and basophils is critical in initiating allergic reactions. It is composed of an IgE-binding alpha subunit, a beta subunit, and two gamma subunits. The human alpha subunit was expressed on transfected cells in the presence of rat beta and gamma subunits or in the presence of the gamma subunit alone. The IgE binding properties of the expressed human alpha were characteristic of receptors on normal human cells. These results now permit a systematic analysis of human IgE binding and a search for therapeutically useful inhibitors of that binding.


Assuntos
Antígenos de Diferenciação de Linfócitos B/metabolismo , Basófilos/imunologia , Imunoglobulina E/metabolismo , Mastócitos/imunologia , Receptores Fc/metabolismo , Transfecção , Animais , Antígenos de Diferenciação de Linfócitos B/genética , Linhagem Celular , Clonagem Molecular , Cricetinae , DNA/genética , Humanos , Técnicas de Imunoadsorção , Ratos , Receptores Fc/genética , Receptores de IgE , Células Tumorais Cultivadas
6.
Int Arch Allergy Immunol ; 146(4): 307-20, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18367844

RESUMO

BACKGROUND: Antigenic profiles obtained by ELISA with IgE from patients with wheat food allergy (WFA) established that major allergens are albumins/globulins (AG) for children suffering from atopic eczema/dermatitis syndrome (AEDS), omega5-gliadins for adults suffering from wheat-dependent exercise-induced anaphylaxis (WDEIA), anaphylaxis or urticaria and low-molecular-weight (LMW) glutenin subunits for patients with anaphylaxis. We aimed to characterize a new mast cell transfectant for its ability to degranulate with wheat proteins and patient sera and compare these results to those obtained by ELISA. METHODS: Thirty sera from patients with WFA were tested: 14 with AEDS (group 1) and 16 with WDEIA, anaphylaxis or urticaria (group 2). An IgE Fc receptor (FcepsilonRI) humanized rat RBL-2H3 line was established by transfection with cDNAs encoding alpha-, beta- and gamma-subunits for the human IgE receptor. RESULTS: A humanized RBL clone was selected for its capacity to express mRNA alpha-, beta- and gamma-subunits of FcepsilonRI, to bind allergen-specific human IgE and to degranulate. In group 1, sera induced enhanced degranulation with AG extract, but rarely reacted with gliadins and glutenins. In group 2, half of the sera showed degranulation with LMW glutenins whereas the AG fraction and lipid transfer proteins were rarely positive. omega5-Gliadins did not appear as a major allergen in degranulation assays, although functional allergen-specific IgE was measurable in appreciable amounts. CONCLUSION: Our data demonstrate that in wheat food allergen evaluation, correlation exists between mast cell degranulation and IgE measurements, depending on the type of allergen. Therefore, the biological activity of some allergen types may also be affected by other parameters.


Assuntos
Degranulação Celular/imunologia , Gliadina/imunologia , Mastócitos/imunologia , Receptores de IgE/imunologia , Hipersensibilidade a Trigo/imunologia , Adulto , Animais , Linhagem Celular , Dermatite Atópica/imunologia , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Fluorometria , Humanos , Imunoglobulina E/análise , Imunoglobulina E/imunologia , Lactente , Pessoa de Meia-Idade , RNA Mensageiro/química , RNA Mensageiro/genética , Ratos , Receptores de IgE/biossíntese , Receptores de IgE/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transfecção , Urticária/imunologia
7.
Oncogene ; 16(26): 3357-68, 1998 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-9692543

RESUMO

Src kinases and protein kinase C (PKC) have been well studied for their role in oncogenic and normal cellular processes. Herein we report on a novel regulatory pathway mediated by the interaction of PKC-delta with p53/56Lsy (Lyn) and with p60Src (Src) that results in the phosphorylation and increased activity of Lyn and Src. In the RBL-2H3 mast cell line, the interaction of PKC-delta with Lyn required the activation of the high affinity receptor for IgE (FcsigmaRI) while the interaction with Src was constitutive. Increased complex formation of PKC-delta with Lyn or Src led to increased serine phosphorylation and activity of the Src family kinases. Conversely, Lyn was found to phosphorylate Lyn-associated and recombinant PKC-delta in vitro and the tyrosine 52 phosphorylated PKC-delta was recruited to associate with the Lyn SH2 domain. The constitutive association of PKC-delta with Src did not result in the tyrosine phosphorylation of PKC-delta prior to or after FsigmaRI engagement. However in cells over-expressing PKC-delta, FsigmaRI engagement resulted in the dramatic inhibition of Src activity and some inhibition of Lyn activity. Thus, the interaction and cross-talk of PKC-delta with Src family kinases suggests a novel and inter-dependent mechanism for regulation of enzymatic activity that may serve an important role in cellular responses.


Assuntos
Isoenzimas/metabolismo , Mastócitos/enzimologia , Proteína Quinase C/metabolismo , Quinases da Família src/metabolismo , Animais , Transporte Biológico , Regulação Enzimológica da Expressão Gênica , Isoenzimas/genética , Proteínas de Membrana/metabolismo , Fosforilação , Ligação Proteica , Proteína Quinase C/genética , Proteína Quinase C-delta , Proteínas Proto-Oncogênicas pp60(c-src)/metabolismo , Ratos , Receptores de IgE/metabolismo , Proteínas Recombinantes/metabolismo , Células Tumorais Cultivadas , Tirosina/metabolismo , Vanadatos/farmacologia
8.
J Leukoc Biol ; 63(5): 636-42, 1998 May.
Artigo em Inglês | MEDLINE | ID: mdl-9581809

RESUMO

IgA Fc receptors (Fc alphaR) can mediate a variety of inflammatory responses. It has been demonstrated that the FcRgamma subunit is critical in mediating signaling through Fc alphaR. We show that aggregation of Fc alphaR on U937 cells and blood neutrophils results in tyrosine phosphorylation of several intracellular proteins, including the FcR gamma subunit, p72syk, and Bruton tyrosine kinase (Btk). Syk was found to be associated with Fc alphaR and its phosphorylation was increased in phorbol myristate acetate (PMA)- and interferon-gamma (IFN-gamma)-treated U937 cells. In contrast, phosphorylation of Btk was only detected after cell treatment with PMA but not IFN-gamma. These data indicate that signaling through Fc alphaR gamma2 involves at least two subfamilies of tyrosine kinases, syk and Btk. Our results also suggest that activation of tyrosine kinase pathways through Fc alphaR depends on the activation state of the cell. This may be an important regulatory mechanism in IgA-mediated responses at inflammatory sites.


Assuntos
Antígenos CD/fisiologia , Precursores Enzimáticos/fisiologia , Interferon gama/farmacologia , Proteínas Tirosina Quinases/fisiologia , Receptores Fc/fisiologia , Tirosina Quinase da Agamaglobulinemia , Células Cultivadas , Ativação Enzimática , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Substâncias Macromoleculares , Fosforilação , Fosfotirosina/metabolismo , Transdução de Sinais , Quinase Syk , Acetato de Tetradecanoilforbol/farmacologia
9.
Mol Immunol ; 24(10): 1061-8, 1987 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-3500399

RESUMO

The carbohydrate moieties of murine IgG-binding factor (IgG-BF) were studied using lectins binding N-glycosylated sequences such as Concanavalin A (Con A), Lens culinaris agglutinin (LcA), and wheat germ agglutinin (WGA), and lectins binding O-glycosylated sequences such as peanut agglutinin (PNA) and Helix pomatia Agglutinin (HpA). Sources of IgG-BF were: (1) supernatants from T2D4, a T cell hybridoma constitutively producing IgG-BF, and (2) factor purified by affinity chromatography on rabbit IgG-Sepharose, using T2D4 supernatants or supernatants of alloantigen-activated T cells (ATC) as starting material. The presence of IgG-BF was assessed by its ability to inhibit secondary anti-sheep red blood cell (SRBC) IgG antibody responses in vitro and to inhibit rosette formation between Fc gamma receptor (Fc gamma R)-positive spleen cells and erythrocytes sensitized with rabbit anti-Forssman IgG antibodies. Fractionation on immobilized lectins showed that IgG-BF: (1) is completely adsorbed by WGA and PNA and partially by Con A, LcA and HpA, and (2) can be eluted from the five different lectins using the competitor sugars. When produced in the presence of tunicamycin, an inhibitor of N-glycosylation, IgG-BF still binds to HpA which has affinity for O-glycosylated carbohydrate chains. These results indicate that IgG-BF is a glycoprotein with N- and O-glycosylated carbohydrate moieties.


Assuntos
Carboidratos , Linfocinas , Proteínas Secretadas pela Próstata , Linfócitos T/imunologia , Animais , Cromatografia de Afinidade , Glicosilação , Lectinas , Linfocinas/imunologia , Camundongos , Camundongos Endogâmicos , Formação de Roseta
10.
Mol Immunol ; 26(2): 107-14, 1989 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-2465488

RESUMO

Suppressor murine IgG-BF produced by the T cell hybrid (T2D4) expressing low affinity Fc gamma R (Fc gamma RII) contain four biologically active polypeptides of pI 5.2, 6.3, 7.7 and 8.3, respectively. They were fractionated by affinity chromatography on immunoadsorbents coupled with F(ab')2 fragments of the monoclonal anti-Fc gamma RII antibody 2.4G2 and by hydrophobic interaction chromatography. Both methods led to the identification of biologically active IgG-BF which react with 2.4G2 and of IgG-BF which do not react with 2.4G2. Molecules bearing the epitope recognized by 2.4G2 had an apparent pI of 5.3 while the pI of those which did not express this epitope were 6.3, 7.8 and 8.5, respectively. Therefore, one IgG-BF polypeptide of pI 5.3 is probably related to Fc gamma RII.


Assuntos
Antígenos de Diferenciação , Linfocinas , Proteínas Secretadas pela Próstata , Receptores Fc , Fatores Supressores Imunológicos , Animais , Anticorpos Monoclonais , Cromatografia de Afinidade , Epitopos , Camundongos , Peptídeos , Receptores de IgG
11.
FEBS Lett ; 443(1): 66-70, 1999 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-9928954

RESUMO

Bruton tyrosine kinase (Btk) plays a crucial role in the differentiation of B lymphocytes and belongs to the group of Tec kinases, which are characterised by the presence of a pleckstrin homology domain. Here we show that Btk is activated and undergoes tyrosine phosphorylation upon challenge of platelet thrombin receptor, these responses requiring engagement of alphaIIb/beta3 integrin and phosphoinositide 3-kinase activity. These data unravel a novel signalling pathway involving Btk downstream of an adhesive receptor via a complex regulation implicating the products of phosphoinositide 3-kinase, which might act to anchor Btk at the membrane.


Assuntos
Plaquetas/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/metabolismo , Proteínas Tirosina Quinases/metabolismo , Trombina/farmacologia , Tirosina Quinase da Agamaglobulinemia , Plaquetas/efeitos dos fármacos , Ativação Enzimática , Humanos , Fosforilação , Ativação Plaquetária , Transdução de Sinais
13.
Leukemia ; 25(9): 1379-88, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21566654

RESUMO

Hematopoietic stem cells (HSCs) reside in the bone marrow (BM) of adult individuals and function to produce and regenerate the entire blood and immune system over the course of an individual's lifetime. Historically, HSCs are among the most thoroughly characterized tissue-specific stem cells. Despite this, the regulation of fate options, such as self-renewal and differentiation, has remained elusive, partly because of the expansive plethora of factors and signaling cues that govern HSC behavior in vivo. In the BM, HSCs are housed in specialized niches that dovetail the behavior of HSCs with the need of the organism. The Smad-signaling pathway, which operates downstream of the transforming growth factor-ß (TGF-ß) superfamily of ligands, regulates a diverse set of biological processes, including proliferation, differentiation and apoptosis, in many different organ systems. Much of the function of Smad signaling in hematopoiesis has remained nebulous due to early embryonic lethality of most knockout mouse models. However, recently new data have been uncovered, suggesting that the Smad-signaling circuitry is intimately linked to HSC regulation. In this review, we bring the Smad-signaling pathway into focus, chronicling key concepts and recent advances with respect to TGF-ß-superfamily signaling in normal and leukemic hematopoiesis.


Assuntos
Hematopoese , Transdução de Sinais , Proteínas Smad/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Animais , Hematologia , Humanos , Camundongos
18.
J Biol Chem ; 266(4): 2639-46, 1991 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-1824944

RESUMO

The high affinity receptor for immunoglobulin E (IgE) is a tetrameric structure (alpha beta gamma 2) consisting of non-covalently associated subunits: one IgE-binding alpha chain, one 4-fold membrane spanning beta chain, and two disulfide-linked gamma chains. Here, we have engineered alpha cDNA constructs (alpha trunc) encoding exclusively the leader peptide and the extracellular domain of the alpha subunit. Transfection of human alpha trunc into COS-7 cells resulted in the secretion of soluble IgE-binding polypeptides. By contrast, the polypeptides generated from rat and mouse alpha trunc transfections were sequestered in the endoplasmic reticulum and degraded even though they appeared to fold properly as judged by their capacity to bind IgE. Stable transfectants with human alpha trunc were obtained from a dihydrofolate reductase-deficient Chinese hamster ovary cell line. Several clones secreted substantial amounts (0.1 microgram/ml/10(6) cells) of IgE-binding polypeptides. The dissociation rate of bound IgE from this soluble truncated alpha (kappa-1 = 4.9 x 10(-6) s-1 at 25 degrees C) was characteristic of receptors on intact cells. After treatment with tunicamycin, the transfectants secreted unglycosylated 18-kDa polypeptides which could also bind IgE. These unglycosylated products had a tendency to form dimers and higher oligomers which were resistant to treatment by sodium dodecyl sulfate and reducing agents. These data demonstrate unequivocally that the extracellular domain of the alpha subunit is sufficient to mediate high affinity binding of IgE. Furthermore, posttranslational addition of carbohydrates is not required for proper folding and function of the receptor binding site. The truncated human alpha should be a suitable reagent for crystallographic analysis and for detailed analysis of the receptor binding sites.


Assuntos
Antígenos de Diferenciação de Linfócitos B/genética , Imunoglobulina E/metabolismo , Receptores Fc/genética , Animais , Antígenos de Diferenciação de Linfócitos B/metabolismo , Sequência de Bases , Linhagem Celular , Precipitação Química , Clonagem Molecular , Cricetinae , Eletroforese em Gel de Poliacrilamida , Regulação da Expressão Gênica , Humanos , Cinética , Camundongos , Dados de Sequência Molecular , Processamento de Proteína Pós-Traducional , Ratos , Receptores Fc/metabolismo , Receptores de IgE , Solubilidade , Transfecção , Tunicamicina/farmacologia
19.
Allerg Immunol (Leipz) ; 24(2): 125-32, 1978.
Artigo em Alemão | MEDLINE | ID: mdl-80124

RESUMO

The tolerance induction in mice to human serum albumin (HSA) and bovine gamma globulin (BGG) by combined injections of antigen and 6-mercaptopurine is studied. After pretreatment with antigen and mercaptopurine specific unresponsiveness or hyporesponsiveness are observed both in inbred (CBA) and outbred mice. Under the experimental protocol HSA is more tolerogenic than BGG. In CBA-mice tolerance to BGG was only found on the level of IgG-antibodies. The factors which influence the development of a drug-induced immunological unresponsiveness (mice strain, quality of antigen and antigen dosage) and the role of test system are discussed.


Assuntos
Tolerância Imunológica , Mercaptopurina/farmacologia , Proteínas/farmacologia , Animais , Antígenos , Bovinos/imunologia , Masculino , Camundongos , Camundongos Endogâmicos CBA , Albumina Sérica/farmacologia , gama-Globulinas/farmacologia
20.
Am J Physiol ; 268(3 Pt 2): R605-13, 1995 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-7900902

RESUMO

The dorsal integument of the medical leech Hirudo medicinalis exhibits a marked amiloride-sensitive Na+ absorption. With 20 mM Na+ in the apical solution, the transepithelial short-circuit current (Isc) was approximately 40% higher than with 115 mM Na+, whereas the transepithelial potential (VT) with 20 mM Na+ was -35.7 +/- 4.5 and -20.6 +/- 2.6 mV with 115 mM Na+. Amiloride (100 microM) inhibition at 20 mM apical Na+ was also significantly larger than with 115 mM Na+ in the solution. Benzamil (100 microM) showed additional inhibition after amiloride. Large transient overshooting currents occurred only when 115 mM Na+ was added after some minutes of Na(+)-free apical solution. Addition of adenosine 3',5'-cyclic monophosphate (cAMP) to the serosal side in the presence of 115 mM apical Na+ nearly doubled Isc. This cAMP effect was reduced to only 20% in the presence of 20 mM Na+. Guanosine 3',5'-cyclic monophosphate (cGMP) slightly increased Isc, whereas ATP showed biphasic potency. Removal of calcium from the apical side resulted in a large stimulation of amiloride-sensitive Isc only in the presence of 115 mM Na+. When currents were activated with cAMP, a deprivation of Ca2+ modestly reduced the amiloride-sensitive Isc. The Na+ channel of leech integument was found highly selective for Na+ over other monovalent cations. The permeability ratio for Na+ over K+ was approximately 30:1; the selectivity relationship for the investigated cations was Na+ > Li+ > NH4+ > K+ approximately Cs+ approximately Rb+.


Assuntos
Sanguessugas/metabolismo , Pele/metabolismo , Sódio/metabolismo , Amilorida/análogos & derivados , Amilorida/farmacologia , Animais , Cálcio/metabolismo , AMP Cíclico/farmacologia , GMP Cíclico/análogos & derivados , GMP Cíclico/farmacologia , Eletroquímica , Homeostase , Técnicas In Vitro , Transporte de Íons , Cinética , Compostos de Amônio Quaternário/farmacologia , Pele/efeitos dos fármacos , Canais de Sódio/efeitos dos fármacos , Canais de Sódio/metabolismo
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