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1.
J Cell Biol ; 137(3): 555-62, 1997 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-9151664

RESUMO

The orientation of signal-anchor proteins in the endoplasmic reticulum membrane is largely determined by the charged residues flanking the apolar, membrane-spanning domain and is influenced by the folding properties of the NH2-terminal sequence. However, these features are not generally sufficient to ensure a unique topology. The topogenic role of the hydrophobic signal domain was studied in vivo by expressing mutants of the asialoglycoprotein receptor subunit H1 in COS-7 cells. By replacing the 19-residue transmembrane segment of wild-type and mutant H1 by stretches of 7-25 leucine residues, we found that the length and hydrophobicity of the apolar sequence significantly affected protein orientation. Translocation of the NH2 terminus was favored by long, hydrophobic sequences and translocation of the COOH terminus by short ones. The topogenic contributions of the transmembrane domain, the flanking charges, and a hydrophilic NH2-terminal portion were additive. In combination these determinants were sufficient to achieve unique membrane insertion in either orientation.


Assuntos
Glicoproteínas de Membrana/metabolismo , Sinais Direcionadores de Proteínas/química , Receptores de Superfície Celular/metabolismo , Sequência de Aminoácidos , Animais , Receptor de Asialoglicoproteína , Transporte Biológico , Células COS , Membrana Celular/metabolismo , Chlorocebus aethiops , Hexosaminidases/farmacologia , Leucina/química , Dados de Sequência Molecular , Peso Molecular , Solubilidade , Relação Estrutura-Atividade , Tripsina
2.
J Cell Biol ; 114(3): 423-31, 1991 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1907285

RESUMO

The clustering of plasma membrane receptors in clathrin-coated pits depends on determinants within their cytoplasmic domains. In several cases, individual tyrosine residues were shown to be necessary for rapid internalization. We have mutated the single tyrosine at position 5 in the cytoplasmic domain of the major subunit H1 of the asialoglycoprotein receptor to alanine. Expressed in fibroblasts cells, the mutant protein was accumulated in the plasma membrane, and its rate of internalization was reduced by a factor of four. The residual rate of endocytosis, however, was still significantly higher than that of resident plasma membrane proteins. Upon acidification of the cytoplasm, which specifically inhibits the formation of clathrin-coated vesicles but not uptake of the fluid phase marker Lucifer yellow, residual endocytosis was blocked. By immunoelectron microscopy mutant H1 could be directly demonstrated in coated pits. The fraction of wild-type and mutant H1 present in coated pits as determined by immunogold localization correlated well with the respective rates of internalization. Thus, mutation of tyrosine-5 only partially inactivates recognition of H1 for incorporation into coated pits.


Assuntos
Invaginações Revestidas da Membrana Celular/metabolismo , Endocitose , Receptores Imunológicos/metabolismo , Tirosina/química , Sequência de Aminoácidos , Animais , Receptor de Asialoglicoproteína , Sequência de Bases , Linhagem Celular , Clatrina/fisiologia , Invaginações Revestidas da Membrana Celular/ultraestrutura , Citoplasma/metabolismo , DNA , Concentração de Íons de Hidrogênio , Cinética , Camundongos , Microscopia Imunoeletrônica , Dados de Sequência Molecular , Mutagênese Sítio-Dirigida , Receptores Imunológicos/química , Receptores Imunológicos/genética , Transfecção
3.
J Cell Biol ; 147(2): 257-66, 1999 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-10525533

RESUMO

The topology of multispanning membrane proteins in the mammalian endoplasmic reticulum is thought to be dictated primarily by the first hydrophobic sequence. We analyzed the in vivo insertion of a series of chimeric model proteins containing two conflicting signal sequences, i.e., an NH(2)-terminal and an internal signal, each of which normally directs translocation of its COOH-terminal end. When the signals were separated by more than 60 residues, linear insertion with the second signal acting as a stop-transfer sequence was observed. With shorter spacers, an increasing fraction of proteins inserted with a translocated COOH terminus as dictated by the second signal. Whether this resulted from membrane targeting via the second signal was tested by measuring the targeting efficiency of NH(2)-terminal signals followed by polypeptides of different lengths. The results show that targeting is mediated predominantly by the first signal in a protein. Most importantly, we discovered that glycosylation within the spacer sequence affects protein orientation. This indicates that the nascent polypeptide can reorient within the translocation machinery, a process that is blocked by glycosylation. Thus, topogenesis of membrane proteins is a dynamic process in which topogenic information of closely spaced signal and transmembrane sequences is integrated.


Assuntos
Retículo Endoplasmático/metabolismo , Proteínas de Membrana/metabolismo , Sequência de Aminoácidos , Animais , Sítios de Ligação , Transporte Biológico , Células COS , Glicosilação , Proteínas de Membrana/genética , Dados de Sequência Molecular , Análise de Sequência
4.
J Cell Biol ; 130(2): 285-97, 1995 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7615632

RESUMO

Unlike the wild-type asialoglycoprotein receptor subunit H1 which is transported to the cell surface, endocytosed and recycled, a mutant lacking residues 4-33 of the 40-amino acid cytoplasmic domain was found to be retained intracellularly upon expression in different cell lines. The mutant protein accumulated in the trans-Golgi, as judged from the acquisition of trans-Golgi-specific modifications of the protein and from the immunofluorescence staining pattern. It was localized to juxtanuclear, tubular structures that were also stained by antibodies against galactosyltransferase and gamma-adaptin. The results of further mutagenesis in the cytoplasmic domain indicated that the size rather than the specific sequence of the cytoplasmic domain determines whether H1 is retained in the trans-Golgi or transported to the cell surface. Truncation to less than 17 residues resulted in retention, and extension of a truncated tail by an unrelated sequence restored surface transport. The transmembrane segment of H1 was not sufficient for retention of a reporter molecule and it could be replaced by an artificial apolar sequence without affecting Golgi localization. The cytoplasmic domain thus appears to inhibit interaction(s) of the exoplasmic portion of H1 with trans-Golgi component(s) for example by steric hindrance or by changing the positioning of the protein in the membrane. This mechanism may also be functional in other proteins.


Assuntos
Assialoglicoproteínas/metabolismo , Complexo de Golgi/metabolismo , Proteínas de Membrana/metabolismo , Receptores de Superfície Celular/metabolismo , Sequência de Aminoácidos , Animais , Receptor de Asialoglicoproteína , Sequência de Bases , Linhagem Celular , Retículo Endoplasmático/metabolismo , Imunofluorescência , Humanos , Proteínas de Membrana/química , Proteínas de Membrana/genética , Dados de Sequência Molecular , Mutagênese , Receptores de Superfície Celular/química , Receptores de Superfície Celular/genética , Transfecção , Células Tumorais Cultivadas
5.
J Cell Biol ; 111(6 Pt 2): 2923-30, 1990 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-1980123

RESUMO

In different epithelial cell types, integral membrane proteins appear to follow different sorting pathways to the apical surface. In hepatocytes, several apical proteins were shown to be transported there indirectly via the basolateral membrane, whereas in MDCK cells a direct sorting pathway from the trans-Golgi-network to the apical membrane has been demonstrated. However, different proteins had been studied in these cells. To compare the sorting of a single protein in both systems, we have expressed aminopeptidase N, which already had been shown to be sorted indirectly in hepatocytes, in transfected MDCK cells. As expected, it was predominantly localized to the apical domain of the plasma membrane. By monitoring the appearance of newly synthesized aminopeptidase N at the apical and basolateral surface, it was found to be directly sorted to the apical domain in MDCK cells, indicating that the sorting pathways are indeed cell type-specific.


Assuntos
Aminopeptidases/metabolismo , Epitélio/metabolismo , Proteínas de Membrana/metabolismo , Animais , Transporte Biológico , Antígenos CD13 , Células Cultivadas , Humanos , Proteínas Recombinantes/metabolismo , Transfecção
6.
Biochim Biophys Acta ; 1218(2): 225-8, 1994 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-8018728

RESUMO

From Alzheimer's visual cortex mRNA, a novel cDNA sequence with homology to the carboxy-terminal two-thirds of known serine proteinases was isolated (43% identity with human trypsinogen II). The corresponding mRNA has a size of approximately 8 kb and is expressed in low amounts in all human tissues tested.


Assuntos
Encéfalo/enzimologia , Serina Endopeptidases/genética , Doença de Alzheimer/enzimologia , Sequência de Aminoácidos , Sequência de Bases , Clonagem Molecular , DNA Complementar/química , DNA Complementar/isolamento & purificação , Humanos , Dados de Sequência Molecular , RNA Mensageiro/análise , Córtex Visual/enzimologia
7.
Biochim Biophys Acta ; 896(2): 275-86, 1987 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-3099840

RESUMO

Chicken intestinal sucrase-isomaltase and maltase-glucoamylase have been isolated in their intact form by detergent solubilization and characterized as to their subunit composition and mode of anchoring in the brush-border membrane. Both are heterodimeric enzyme complexes composed of two subunits each of approximately 140 and 130 kDa. Contrary to the mammalian sucrase-isomaltase, chicken isomaltase was identified as the smaller of the two subunits. As was shown by hydrophobic labeling, only one of the two subunits in each heterodimer is anchored in the bilayer, the smaller 130 kDa isomaltase subunit of the sucrase-isomaltase complex, and the larger 140 kDa subunit of the maltase-glucoamylase complex. Both preparations contain a high-molecular weight polypeptide of approximately 250 kDa which in the case of sucrase-isomaltase could be identified by peptide mapping as a single-chain precursor not (yet) proteolytically processed to the final heterodimer. These first data on the mode of membrane anchoring of non-mammalian glycosidases indicate that they are synthesized, inserted into the membrane, and processed in ways similar to the mammalian enzymes. The fundamental unity between avian and mammalian sucrase-isomaltases suggests that the partial gene duplication of an ancestral isomaltase gene and the subsequent mutation of one of the active sites resulting in pro-sucrase-isomaltase has occurred prior to the separation of mammals from reptiles, i.e. more than 300 million years ago.


Assuntos
Galinhas/metabolismo , Glucana 1,4-alfa-Glucosidase/análise , Glucosidases/análise , Glicosídeo Hidrolases/análise , Intestino Delgado/enzimologia , Microvilosidades/enzimologia , Oligo-1,6-Glucosidase/análise , Precursores de Proteínas/análise , Sacarase/análise , Animais , Membrana Celular/enzimologia , Membrana Celular/ultraestrutura , Conformação Proteica
8.
Biochim Biophys Acta ; 862(1): 87-99, 1986 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-3768371

RESUMO

The topological distribution of the two major phospholipids of brush-border membrane, phosphatidylcholine (PC) and phosphatidylethanolamine (PE), has been investigated using brush-border membrane vesicles from rabbit small intestine. Bee venom phospholipase A2 and phosphatidylcholine exchange protein from bovine liver were used as membrane probes. It is shown that the brush-border membrane retains its integrity under conditions of phospholipase hydrolysis and intermembrane phospholipid exchange. Kinetic analysis of the data of phospholipase hydrolysis and phospholipid exchange at temperatures under 10 degrees C shows that both PC and PE occur in two pools: a minor (about 25%) more readily accessible pool and a major one (about 75%) less readily available. The rate of PC exchange between these two pools is relatively fast. The half-time derived under conditions of phospholipase hydrolysis is of the order of 20 min. Under conditions of phospholipid exchange the exchange rates may be even faster. The difference in exchange kinetics observed with the two methods of probing is probably due to changes in membrane properties such as the bilayer fluidity induced by the probing process itself. It is proposed that the two pools represent the transverse distribution of the phospholipids. The two major phospholipids of brush-border membranes, PC and PE, would be distributed mainly on the inner (cytoplasmic) side of the brush-border membrane. The phospholipid exchange between the brush-border vesicles and unilamellar phosphatidylcholine vesicles in the presence of phosphatidylcholine exchange protein reveals that significant quantities of phospholipid are taken up by brush-border membrane independently, i.e., in a separate process independent of the exchange protein-catalyzed phosphatidylcholine exchange.


Assuntos
Proteína de Ligação a Androgênios , Lipídeos de Membrana/análise , Microvilosidades/análise , Fosfolipídeos/análise , Animais , Proteínas de Transporte/análise , Hidrólise , Intestinos/análise , Cinética , Lipossomos/metabolismo , Microvilosidades/metabolismo , Fosfatidilcolinas/análise , Fosfatidilcolinas/metabolismo , Fosfatidiletanolaminas/análise , Fosfolipases A/farmacologia , Fosfolipases A2 , Proteínas de Transferência de Fosfolipídeos , Coelhos , Temperatura
9.
J Mol Biol ; 300(4): 857-65, 2000 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-10891274

RESUMO

The human asialoglycoprotein receptor (ASGPR), also called hepatic lectin, is an integral membrane protein and is responsible for the clearance of desialylated, galactose-terminal glycoproteins from the circulation by receptor-mediated endocytosis. It can be subdivided into four functional domains: the cytosolic domain, the transmembrane domain, the stalk and the carbohydrate recognition domain (CRD). The galactose-binding domains belong to the superfamily of C-type (calcium-dependent) lectins, in particular to the long-form subfamily with three conserved intramolecular disulphide bonds. It is able to bind terminal non-reducing galactose residues and N-acetyl-galactosamine residues of desialated tri or tetra-antennary N-linked glycans. The ASGPR is a potential liver-specific receptor for hepatitis B virus and Marburg virus and has been used to target exogenous molecules specifically to hepatocytes for diagnostic and therapeutic purposes.Here, we present the X-ray crystal structure of the carbohydrate recognition domain of the major subunit H1 at 2.3 A resolution. While the overall fold of this and other known C-type lectin structures are well conserved, the positions of the bound calcium ions are not, indicating that the fold is stabilised by alternative mechanisms in different branches of the C-type lectin family. It is the first CRD structure where three calcium ions form an intergral part of the structure. In addition, the structure provides direct confirmation for the conversion of the ligand-binding site of the mannose-binding protein to an asialoglycoprotein receptor-like specificity suggested by Drickamer and colleagues. In agreement with the prediction that the coiled-coil domain of the ASGPR is separated from the CRD and its N-terminal disulphide bridge by several residues, these residues are indeed not alpha-helical, while in tetranectin they form an alpha-helical coiled-coil.


Assuntos
Galactose/metabolismo , Receptores de Superfície Celular/química , Receptores de Superfície Celular/metabolismo , Sequência de Aminoácidos , Receptor de Asialoglicoproteína , Sítios de Ligação , Cálcio/metabolismo , Proteínas de Transporte/química , Proteínas de Transporte/metabolismo , Colectinas , Cristalografia por Raios X , Dissulfetos/química , Dissulfetos/metabolismo , Humanos , Modelos Moleculares , Dados de Sequência Molecular , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína , Alinhamento de Sequência , Especificidade por Substrato
10.
FEBS Lett ; 369(1): 76-9, 1995 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-7641889

RESUMO

The same translocation machinery in the endoplasmic reticulum translocates either the N-or the C-terminal domain of signal-anchor proteins across the membranes. Charged residues flanking the signal sequence are important to determine which end is translocated, but are not sufficient to generate a uniform topology. The folding state of the N-terminal segment, which is to be translocated posttranslationally, and the length or hydrophobicity of the signal sequence are additional criteria to determine protein orientation in the membrane.


Assuntos
Retículo Endoplasmático/metabolismo , Membranas Intracelulares/metabolismo , Proteínas de Membrana/metabolismo , Proteínas de Membrana/ultraestrutura , Dobramento de Proteína , Transporte Biológico , Modelos Biológicos
11.
FEBS Lett ; 305(3): 209-12, 1992 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-1299617

RESUMO

Like virtually all endocytic receptors, the human asialoglycoprotein (ASGP) receptor is phosphorylated by protein kinase C at serine residues within the cytoplasmic domains of its two subunits H1 and H2. Activation of protein kinase C by phorbol esters results in hyperphosphorylation and in a concomitant net redistribution of receptors to intracellular compartments (down-regulation) in HepG2 cells. To test whether there is a causal relationship between receptor hyperphosphorylation and redistribution, we examined the effect of phorbol ester treatment on the ASGP receptor composed of either wild-type subunits or of mutant subunits lacking any cytoplasmic serine residues in transfected NIH3T3 fibroblast and COS-7 cells. Although the wild-type subunits were hyperphosphorylated in fibroblast cells, the distribution of neither the wild-type nor the mutant receptors was affected. In contrast, phorbol ester treatment of transfected COS-7 cells induced down-regulation of both wild-type and mutant receptors. These findings indicate that redistribution of the receptor is independent of its cytoplasmic serines and is not caused by receptor phosphorylation.


Assuntos
Assialoglicoproteínas/metabolismo , Orosomucoide/análogos & derivados , Dibutirato de 12,13-Forbol/farmacologia , Receptores Imunológicos/efeitos dos fármacos , Células 3T3 , Animais , Receptor de Asialoglicoproteína , Linhagem Celular Transformada , Chlorocebus aethiops , Regulação para Baixo , Humanos , Camundongos , Mutação , Orosomucoide/metabolismo , Fosforilação , Receptores Imunológicos/genética , Receptores Imunológicos/metabolismo , Transfecção , Células Tumorais Cultivadas
12.
FEBS Lett ; 504(3): 87-93, 2001 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-11532438

RESUMO

For targeting and integration of proteins into the mammalian endoplasmic reticulum, two types of signals can be distinguished: those that translocate their C-terminal sequence (cleavable signals and signal-anchors) and those that translocate their N-terminus (reverse signal-anchors). In addition to the well established effect of flanking charges, also the length and hydrophobicity of the apolar core of the signal as well as protein folding and glycosylation contribute to orienting the signal in the translocon. In multi-spanning membrane proteins, topogenic determinants are distributed throughout the sequence and may even compete with each other. During topogenesis, segments of up to 60 residues may move back and forth through the translocon, emphasizing unexpected dynamic aspects of topogenesis.


Assuntos
Membrana Celular/química , Animais , Retículo Endoplasmático/química , Cinética , Modelos Biológicos , Modelos Moleculares , Peptídeos/química , Conformação Proteica , Dobramento de Proteína , Sinais Direcionadores de Proteínas , Estrutura Terciária de Proteína , Transporte Proteico , Transdução de Sinais
13.
FEBS Lett ; 434(1-2): 37-41, 1998 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-9738447

RESUMO

The hepatic asialoglycoprotein receptor, a noncovalent hetero-oligomer of two subunits, is a constitutively cycling endocytic receptor. However, the ligand asialoorosomucoid caused downregulation of up to 40% of surface binding sites and a twofold increase in internalization rate. This was not the result of receptor crosslinking, since monovalent ligands had the same effect. Ligand binding thus appears to transmit a signal to the cytosolic portion of the receptor not unlike in signaling receptors. The two subunits were endocytosed at different average rates lower than that of ligand, indicating heterogeneity in oligomer formation and potentially in ligand specificity.


Assuntos
Assialoglicoproteínas/metabolismo , Endocitose , Fígado/metabolismo , Receptores de Superfície Celular/metabolismo , Transdução de Sinais , Receptor de Asialoglicoproteína , Linhagem Celular , Dimerização , Regulação para Baixo , Humanos , Receptores de Superfície Celular/agonistas
14.
FEBS Lett ; 253(1-2): 93-8, 1989 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-2668036

RESUMO

The signal peptides of most proteins targeted to the endoplasmic reticulum are specifically cleaved by signal peptidase. Although potential cleavage sites occur frequently in polytopic proteins after membrane-spanning segments, processing is restricted to the first hydrophobic domain, suggesting that signal peptidase might not have access to subsequently translocated, internal domains. To test this hypothesis, we replaced the third transmembrane segment of an artificial threefold membrane-spanning protein by a sequence which is normally an amino-terminal signal. Upon in vitro translation and insertion into microsomes, efficient cleavage at this sequence was observed, thus demonstrating the ability of signal peptidase to cleave within polytopic membrane proteins.


Assuntos
Endopeptidases/metabolismo , Proteínas de Membrana/metabolismo , Processamento de Proteína Pós-Traducional , Sinais Direcionadores de Proteínas/metabolismo , Serina Endopeptidases , Receptor de Asialoglicoproteína , Sistema Livre de Células , Retículo Endoplasmático/fisiologia , Hemaglutininas Virais/metabolismo , Humanos , Técnicas In Vitro , Biossíntese de Proteínas , Receptores Imunológicos/metabolismo , Proteínas Recombinantes/metabolismo , Relação Estrutura-Atividade
15.
FEBS Lett ; 148(2): 321-5, 1982 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-7152027

RESUMO

The hog sucrase-isomaltase complex is anchored to the small-intestinal brush border membrane, as in the rabbit, via a hydrophobic segment located in the N-terminal region of the isomaltase subunit. The immediate precursor of the 'final' sucrase-isomaltase (i.e., pro-sucrase-isomaltase as prepared from adult hogs whose pancreas had been disconnected from the duodenum) is an amphiphilic single polypeptide chain of Mr 260000-265000. Its N-terminal sequence is virtually identical with (not merely homologous to) the corresponding region of the isomaltase subunit of 'final' sucrase-isomaltase. This shows that the isomaltase portion of pro-sucrase-isomaltase is the N-terminal 'half' of the precursor polypeptide chain. Thus the succession of domains in pro-sucrase-isomaltase and its mode of anchoring in the membrane could be deduced. On this basis a likely mechanism of biosynthesis and insertion is proposed.


Assuntos
Membrana Celular/enzimologia , Precursores Enzimáticos/biossíntese , Intestino Delgado/enzimologia , Microvilosidades/enzimologia , Complexos Multienzimáticos/biossíntese , Complexo Sacarase-Isomaltase/biossíntese , Sequência de Aminoácidos , Animais , Humanos , Coelhos , Ratos , Especificidade da Espécie , Suínos
16.
Br J Math Stat Psychol ; 54(Pt 2): 325-33, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11817097

RESUMO

A simulation study designed to evaluate the pseudo-R2T proposed in an earlier paper by Spiess and Keller suggests that, for the models considered, this measure represents the goodness of fit not only of the systematic part, but also of the assumed correlation structure in binary panel probit models.


Assuntos
Coleta de Dados/estatística & dados numéricos , Modelos Estatísticos , Probabilidade , Viés , Simulação por Computador , Humanos
17.
Br J Math Stat Psychol ; 52 ( Pt 1): 1-17, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10380315

RESUMO

In the present paper a mixed generalized estimating/pseudo-score equations (GEPSE) approach together with a distribution-free multiple imputation technique is proposed for the estimation of regression and correlation structure parameters of multivariate probit models with missing values for an ordered categorical time-invariant variable. Furthermore, a generalization of the squared trace correlation (RT2) for multivariate probit models, denoted by pseudo-RT2, is proposed. A simulation study was conducted, simulating a probit model with an equicorrelation structure in the errors of an underlying regression model and using two different missing mechanisms. For a low 'true' correlation the difference between the GEPSE, a generalized estimating equations (GEE) and a maximum likelihood (ML) estimator were negligible. For a high 'true' correlation the GEPSE estimator turned out to be more efficient than the GEE and very efficient relative to the ML estimator. Furthermore, the pseudo-RT2 was close to RT2 of the underlying linear model. The mixed approach is illustrated using a psychiatric data set of depressive in-patients. The results of this analysis suggest that the depression score at discharge from a psychiatric hospital and the occurrence of stressful life events seem to increase the probability of having an episode of major depression within a one-year interval after discharge. Furthermore, the correlation structure points to short-time effects on having or not having a depressive episode, not accounted for in the systematic part of the regression model.


Assuntos
Transtorno Depressivo/diagnóstico , Modelos Psicológicos , Distribuições Estatísticas , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Valores de Referência
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