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1.
Diabetes Obes Metab ; 19(7): 936-943, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28155245

RESUMO

AIM: To determine the effect of Scriptaid, a compound that can replicate aspects of the exercise adaptive response through disruption of the class IIa histone deacetylase (HDAC) corepressor complex, on muscle insulin action in obesity. MATERIALS AND METHODS: Diet-induced obese mice were administered Scriptaid (1 mg/kg) via daily intraperitoneal injection for 4 weeks. Whole-body and skeletal muscle metabolic phenotyping of mice was performed, in addition to echocardiography, to assess cardiac morphology and function. RESULTS: Scriptaid treatment had no effect on body weight or composition, but did increase energy expenditure, supported by increased lipid oxidation, while food intake was also increased. Scriptaid enhanced the expression of oxidative genes and proteins, increased fatty acid oxidation and reduced triglycerides and diacylglycerides in skeletal muscle. Furthermore, ex vivo insulin-stimulated glucose uptake by skeletal muscle was enhanced. Surprisingly, heart weight was reduced in Scriptaid-treated mice and was associated with enhanced expression of genes involved in oxidative metabolism in the heart. Scriptaid also improved indices of both diastolic and systolic cardiac function. CONCLUSION: These data show that pharmacological targeting of the class IIa HDAC corepressor complex with Scriptaid could be used to enhance muscle insulin action and cardiac function in obesity.


Assuntos
Cardiotônicos/uso terapêutico , Metabolismo Energético/efeitos dos fármacos , Coração/efeitos dos fármacos , Inibidores de Histona Desacetilases/uso terapêutico , Hidroxilaminas/uso terapêutico , Músculo Esquelético/efeitos dos fármacos , Obesidade/tratamento farmacológico , Quinolinas/uso terapêutico , Animais , Fármacos Antiobesidade/efeitos adversos , Fármacos Antiobesidade/uso terapêutico , Cardiotônicos/efeitos adversos , Dieta Hiperlipídica/efeitos adversos , Ecocardiografia , Ecocardiografia Doppler , Perfilação da Expressão Gênica , Regulação da Expressão Gênica/efeitos dos fármacos , Coração/diagnóstico por imagem , Coração/fisiopatologia , Histona Desacetilase 2/antagonistas & inibidores , Histona Desacetilase 2/metabolismo , Inibidores de Histona Desacetilases/efeitos adversos , Hidroxilaminas/efeitos adversos , Resistência à Insulina , Masculino , Camundongos Endogâmicos C57BL , Músculo Esquelético/metabolismo , Miocárdio/patologia , Obesidade/etiologia , Obesidade/patologia , Obesidade/fisiopatologia , Tamanho do Órgão , Quinolinas/efeitos adversos
2.
Aust N Z J Obstet Gynaecol ; 57(4): 458-463, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28345753

RESUMO

BACKGROUND: Gestational trophoblastic neoplasia (GTN) is classified as a highly curable group of pregnancy-related malignancies; however, approximately 15% will be persistent and require chemotherapy. Up to 25% of these women will develop resistance and 2% will develop disease relapse after initial chemotherapy. Despite the need for further chemotherapy in these women, cure rates are high. OBJECTIVE: To evaluate the outcomes of women diagnosed with low-risk GTN, assessing the type of treatment, the number of chemotherapy cycles received, development of resistance or disease relapse, survival, and to assess the feasibility of changing to a new drug regimen. METHODS: From March 2012 until February 2015, a retrospective study was conducted and 38 cases with low-risk GTN were reviewed. The number of cycles, type of treatment received, duration of treatment, development of resistance and disease relapse, and adverse side effects were analysed. RESULTS: The median duration of follow-up was 12 months. Disease-free survival was 100% and primary complete remission rates were achieved in 85.3% of patients who were treated with actinomycin D and 25% patients who were treated with methotrexate (MTX). A change in chemotherapy was required for nine patients. One patient developed disease relapse. Nausea, fatigue and constipation were the most frequent adverse events reported with actinomycin D. All women were cured of their disease. CONCLUSION: All women were successfully treated and achieved complete remission. Changing from MTX to actinomycin D as first-line chemotherapy for women with low-risk GTN was feasible and safe.


Assuntos
Antineoplásicos/uso terapêutico , Dactinomicina/uso terapêutico , Doença Trofoblástica Gestacional/tratamento farmacológico , Metotrexato/uso terapêutico , Neoplasias Uterinas/tratamento farmacológico , Adolescente , Adulto , Antineoplásicos/efeitos adversos , Dactinomicina/efeitos adversos , Intervalo Livre de Doença , Feminino , Seguimentos , Doença Trofoblástica Gestacional/diagnóstico , Humanos , Metotrexato/efeitos adversos , Pessoa de Meia-Idade , Gravidez , Queensland , Indução de Remissão , Estudos Retrospectivos , Risco , Resultado do Tratamento , Neoplasias Uterinas/diagnóstico , Adulto Jovem
3.
FASEB J ; 28(8): 3384-95, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24732133

RESUMO

Some gene deletions or mutations have little effect on metabolism and metabolic adaptation because of redundancy and/or compensation in metabolic pathways. The mechanisms for redundancy and/or compensation in metabolic adaptation in mammalian cells are unidentified. Here, we show that in mouse muscle and myogenic cells, compensatory regulation of the histone deacetylase (HDAC5) transcriptional repressor maintains metabolic integrity. HDAC5 phosphorylation regulated the expression of diverse metabolic genes and glucose metabolism in mouse C2C12 myogenic cells. However, loss of AMP-activated protein kinase (AMPK), a HDAC5 kinase, in muscle did not affect HDAC5 phosphorylation in mouse skeletal muscle during exercise, but resulted in a compensatory increase (32.6%) in the activation of protein kinase D (PKD), an alternate HDAC5 kinase. Constitutive PKD activation in mouse C2C12 myogenic cells regulated metabolic genes and glucose metabolism. Although aspects of this response were HDAC5 phosphorylation dependent, blocking HDAC5 phosphorylation when PKD was active engaged an alternative compensatory adaptive mechanism, which involved post-transcriptional reductions in HDAC5 mRNA (-93.1%) and protein. This enhanced the expression of a specific subset of metabolic genes and mitochondrial metabolism. These data show that compensatory regulation of HDAC5 maintains metabolic integrity in mammalian cells and reinforces the importance of preserving the cellular metabolic adaptive response.


Assuntos
Adaptação Fisiológica/fisiologia , Metabolismo Energético/fisiologia , Regulação Enzimológica da Expressão Gênica/fisiologia , Histona Desacetilases/fisiologia , Músculo Esquelético/enzimologia , Mioblastos/metabolismo , Condicionamento Físico Animal/fisiologia , Proteína Quinase C/fisiologia , Proteínas Quinases Ativadas por AMP/genética , Proteínas Quinases Ativadas por AMP/fisiologia , Acetilação , Animais , Linhagem Celular , Ativação Enzimática , Glucose/metabolismo , Inibidores de Histona Desacetilases/farmacologia , Histona Desacetilases/biossíntese , Histona Desacetilases/genética , Camundongos , Camundongos Endogâmicos C57BL , Contração Muscular , Fosforilação , Mutação Puntual , Proteína Quinase C/genética , Processamento de Proteína Pós-Traducional , RNA Mensageiro/biossíntese , Proteínas Recombinantes de Fusão/biossíntese , Proteínas Recombinantes de Fusão/genética , Transdução de Sinais/fisiologia , Transcrição Gênica/fisiologia , Transgenes
4.
Cell Physiol Biochem ; 28(1): 157-62, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21865858

RESUMO

Zinc accumulation may impair cellular bioenergetics, which is associated with neuronal apoptosis. We simultaneously assessed anaerobic and aerobic metabolism in live cells to characterise this effect and hypothesised that the omega 3 fatty acid docosahexaenoic acid (DHA) would protect against any zinc mediated alterations in bioenergetics. In this study we observed a decrease in cellular oxygen consumption, but not glycolytic rate, following chronic zinc exposure, which was specific for neuronal cells. This was due to impaired ATP turnover, without any other effects on mitochondrial function, and was restored by DHA. DHA had no further effects on bioenergetics. These data suggest that zinc disrupts bioenergetics at a point distal to the respiratory chain, which is restored by DHA.


Assuntos
Ácidos Docosa-Hexaenoicos/farmacologia , Metabolismo Energético , Neurônios/efeitos dos fármacos , Zinco/farmacologia , Trifosfato de Adenosina/metabolismo , Linhagem Celular , Humanos , Queratinócitos/efeitos dos fármacos , Queratinócitos/metabolismo , Mitocôndrias/metabolismo , Mitocôndrias/fisiologia , Neurônios/citologia , Neurônios/metabolismo , Consumo de Oxigênio
5.
J Endocrinol ; 246(3): 265-276, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32698129

RESUMO

Protein kinase D (PKD) is emerging as an important kinase regulating energy balance and glucose metabolism; however, whether hepatic PKD activity can be targeted to regulate these processes is currently unclear. In this study, hepatic PKD activity was reduced using adeno-associated virus vectors to express a dominant-negative (DN) version of PKD1, which impairs the action of all three PKD isoforms. In chow-fed mice, hepatic DN PKD expression increased whole-body glucose oxidation, but had only mild effects on glucose and insulin tolerance and no effects on glucose homeostasis following fasting and refeeding. However, circulating VLDL cholesterol was reduced under these conditions and was associated with hepatic fatty acid accumulation, but not lipids involved in lipoprotein synthesis. The limited effects on glucose homeostasis in DN PKD mice was despite reduced expression of gluconeogenic genes under both fasted and refed conditions, and enhanced pyruvate tolerance. The requirement for PKD for gluconeogenic capacity was supported by in vitro studies in cultured FAO hepatoma cells expressing DN PKD, which produced less glucose under basal conditions. Although these pathways are increased in obesity, the expression of DN PKD in the liver of mice fed a high-fat diet had no impact on glucose tolerance, insulin action, pyruvate tolerance or plasma VLDL. Together, these data suggest that PKD signalling in the liver regulates metabolic pathways involved in substrate redistribution under conditions of normal nutrient availability, but not under conditions of overnutrition such as in obesity.


Assuntos
VLDL-Colesterol/sangue , Fígado/enzimologia , Proteína Quinase C/metabolismo , Animais , Glicemia/metabolismo , Dieta Hiperlipídica , Masculino , Camundongos , Obesidade/sangue , Obesidade/enzimologia , Transdução de Sinais/fisiologia , Triglicerídeos/sangue
6.
Adipocyte ; 4(4): 295-302, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26451286

RESUMO

Differentiated 3T3-L1 adipocytes are a widely used in vitro model of white adipocytes. In addition to classical white and brown adipocytes that are derived from different cell lineages, beige adipocytes have also been identified, which have characteristics of both white and brown adipocytes. Here we show that 3T3-L1 adipocytes display features of multiple adipocytes lineages. While the gene expression profile and basal bioenergetics of 3T3-L1 adipocytes was typical of white adipocytes, they responded acutely to catecholamines by increasing oxygen consumption in an UCP1-dependent manner, and by increasing the expression of genes enriched in brown but not beige adipocytes. Chronic exposure to catecholamines exacerbated this phenotype. However, a beige adipocyte differentiation procedure did not induce a beige adipocyte phenotype in 3T3-L1 fibroblasts. These multiple lineage features should be considered when interpreting data from experiments utilizing 3T3-L1 adipocytes.

7.
Endocrinology ; 156(10): 3596-609, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26181105

RESUMO

The endocannabinoid system (ECS) and retinoic acid (RA) signaling have been associated with influencing lipid metabolism. We hypothesized that modulation of these pathways could modify lipid abundance in developing vertebrates and that these pathways could have a combinatorial effect on lipid levels. Zebrafish embryos were exposed to chemical treatments altering the activity of the ECS and RA pathway. Embryos were stained with the neutral lipid dye Oil-Red-O (ORO) and underwent whole-mount in situ hybridization (WISH). Mouse 3T3-L1 fibroblasts were differentiated under exposure to RA-modulating chemicals and subsequently stained with ORO and analyzed for gene expression by qRT-PCR. ECS activation and RA exposure increased lipid abundance and the expression of lipoprotein lipase. In addition, RA treatment increased expression of CCAAT/enhancer-binding protein alpha. Both ECS receptors and RA receptor subtypes were separately involved in modulating lipid abundance. Finally, increased ECS or RA activity ameliorated the reduced lipid abundance caused by peroxisome proliferator-activated receptor gamma (PPARγ) inhibition. Therefore, the ECS and RA pathway influence lipid abundance in zebrafish embryos and have an additive effect when treated simultaneously. Furthermore, we demonstrated that these pathways act downstream or independently of PPARγ to influence lipid levels. Our study shows for the first time that the RA and ECS pathways have additive function in lipid abundance during vertebrate development.


Assuntos
Embrião não Mamífero/metabolismo , Endocanabinoides/metabolismo , Lipídeos/análise , Transdução de Sinais , Tretinoína/metabolismo , Peixe-Zebra/metabolismo , Células 3T3-L1 , Adipogenia/efeitos dos fármacos , Animais , Compostos Azo/química , Embrião não Mamífero/efeitos dos fármacos , Embrião não Mamífero/embriologia , Endocanabinoides/farmacologia , Regulação da Expressão Gênica no Desenvolvimento , Hibridização In Situ , Metabolismo dos Lipídeos/genética , Camundongos , PPAR gama/genética , PPAR gama/metabolismo , Receptor CB1 de Canabinoide/genética , Receptor CB1 de Canabinoide/metabolismo , Receptor CB2 de Canabinoide/genética , Receptor CB2 de Canabinoide/metabolismo , Receptores do Ácido Retinoico/genética , Receptores do Ácido Retinoico/metabolismo , Receptor alfa de Ácido Retinoico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Coloração e Rotulagem/métodos , Tretinoína/farmacologia , Peixe-Zebra/embriologia , Peixe-Zebra/genética , Proteínas de Peixe-Zebra/genética , Proteínas de Peixe-Zebra/metabolismo
8.
Mol Metab ; 3(4): 408-18, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24944900

RESUMO

The contribution of mitochondrial dysfunction to insulin resistance is a contentious issue in metabolic research. Recent evidence implicates mitochondrial dysfunction as contributing to multiple forms of insulin resistance. However, some models of mitochondrial dysfunction fail to induce insulin resistance, suggesting greater complexity describes mitochondrial regulation of insulin action. We report that mitochondrial dysfunction is not necessary for cellular models of insulin resistance. However, impairment of mitochondrial function is sufficient for insulin resistance in a cell type-dependent manner, with impaired mitochondrial function inducing insulin resistance in adipocytes, but having no effect, or insulin sensitising effects in hepatocytes. The mechanism of mitochondrial impairment was important in determining the impact on insulin action, but was independent of mitochondrial ROS production. These data can account for opposing findings on this issue and highlight the complexity of mitochondrial regulation of cell type-specific insulin action, which is not described by current reductionist paradigms.

9.
PLoS One ; 9(3): e92656, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24651520

RESUMO

BACKGROUND AND AIMS: A major impediment to establishing new treatments for non-alcoholic steatohepatitis is the lack of suitable animal models that accurately mimic the biochemical and metabolic characteristics of the disease. The aim of this study was to explore a unique polygenic animal model of metabolic disease as a model of non-alcoholic steatohepatitis by determining the effects of 2% dietary cholesterol supplementation on metabolic and liver endpoints in Psammomys obesus (Israeli sand rat). METHODS: P. obesus were provided ad libitum access to either a standard rodent diet (20% kcal/fat) or a standard rodent diet supplemented with 2% cholesterol (w/w) for 4 weeks. Histological sections of liver from animals on both diets were examined for key features of non-alcoholic steatohepatitis. The expression levels of key genes involved in hepatic lipid metabolism were measured by real-time PCR. RESULTS: P. obesus fed a cholesterol-supplemented diet exhibited profound hepatomegaly and steatosis, and higher plasma transaminase levels. Histological analysis identified extensive steatosis, inflammation, hepatocyte injury and fibrosis. Hepatic gene expression profiling revealed decreased expression of genes involved in delivery and uptake of lipids, and fatty acid and triglyceride synthesis, and increased expression of genes involved in very low density lipoprotein cholesterol synthesis, triglyceride and cholesterol export. CONCLUSIONS: P. obesus rapidly develop non-alcoholic steatohepatitis when fed a cholesterol-supplemented diet that appears to be histologically and mechanistically similar to patients.


Assuntos
Modelos Animais de Doenças , Fígado Gorduroso/etiologia , Gerbillinae , Animais , Colesterol na Dieta/administração & dosagem , Colesterol na Dieta/metabolismo , Fígado Gorduroso/patologia , Perfilação da Expressão Gênica , Metabolismo dos Lipídeos , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos , Hepatopatia Gordurosa não Alcoólica
10.
PLoS One ; 8(6): e65267, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23799003

RESUMO

Zinc finger nucleases (ZFN) are powerful tools for editing genes in cells. Here we use ZFNs to interrogate the biological function of ADPGK, which encodes an ADP-dependent glucokinase (ADPGK), in human tumour cell lines. The hypothesis we tested is that ADPGK utilises ADP to phosphorylate glucose under conditions where ATP becomes limiting, such as hypoxia. We characterised two ZFN knockout clones in each of two lines (H460 and HCT116). All four clones had frameshift mutations in all alleles at the target site in exon 1 of ADPGK, and were ADPGK-null by immunoblotting. ADPGK knockout had little or no effect on cell proliferation, but compromised the ability of H460 cells to survive siRNA silencing of hexokinase-2 under oxic conditions, with clonogenic survival falling from 21±3% for the parental line to 6.4±0.8% (p = 0.002) and 4.3±0.8% (p = 0.001) for the two knockouts. A similar increased sensitivity to clonogenic cell killing was observed under anoxia. No such changes were found when ADPGK was knocked out in HCT116 cells, for which the parental line was less sensitive than H460 to anoxia and to hexokinase-2 silencing. While knockout of ADPGK in HCT116 cells caused few changes in global gene expression, knockout of ADPGK in H460 cells caused notable up-regulation of mRNAs encoding cell adhesion proteins. Surprisingly, we could discern no consistent effect on glycolysis as measured by glucose consumption or lactate formation under anoxia, or extracellular acidification rate (Seahorse XF analyser) under oxic conditions in a variety of media. However, oxygen consumption rates were generally lower in the ADPGK knockouts, in some cases markedly so. Collectively, the results demonstrate that ADPGK can contribute to tumour cell survival under conditions of high glycolytic dependence, but the phenotype resulting from knockout of ADPGK is cell line dependent and appears to be unrelated to priming of glycolysis in these lines.


Assuntos
Sobrevivência Celular , Desoxirribonucleases de Sítio Específico do Tipo II/química , Glucoquinase/genética , Mitocôndrias/metabolismo , Fosforilação Oxidativa , Animais , Sequência de Bases , Hipóxia Celular , Proliferação de Células , Feminino , Mutação da Fase de Leitura , Dosagem de Genes , Técnicas de Inativação de Genes , Engenharia Genética/métodos , Glucoquinase/metabolismo , Glicólise , Células HCT116 , Hexoquinase/genética , Hexoquinase/metabolismo , Humanos , Camundongos , Camundongos Nus , Dados de Sequência Molecular , Transplante de Neoplasias , Consumo de Oxigênio , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Transcriptoma , Carga Tumoral
11.
Diabetes ; 61(8): 2146-54, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22586591

RESUMO

We previously used Gene Expression Signature technology to identify methazolamide (MTZ) and related compounds with insulin sensitizing activity in vitro. The effects of these compounds were investigated in diabetic db/db mice, insulin-resistant diet-induced obese (DIO) mice, and rats with streptozotocin (STZ)-induced diabetes. MTZ reduced fasting blood glucose and HbA(1c) levels in db/db mice, improved glucose tolerance in DIO mice, and enhanced the glucose-lowering effects of exogenous insulin administration in rats with STZ-induced diabetes. Hyperinsulinemic-euglycemic clamps in DIO mice revealed that MTZ increased glucose infusion rate and suppressed endogenous glucose production. Whole-body or cellular oxygen consumption rate was not altered, suggesting MTZ may inhibit glucose production by different mechanism(s) to metformin. In support of this, MTZ enhanced the glucose-lowering effects of metformin in db/db mice. MTZ is known to be a carbonic anhydrase inhibitor (CAI); however, CAIs acetazolamide, ethoxyzolamide, dichlorphenamide, chlorthalidone, and furosemide were not effective in vivo. Our results demonstrate that MTZ acts as an insulin sensitizer that suppresses hepatic glucose production in vivo. The antidiabetic effect of MTZ does not appear to be a function of its known activity as a CAI. The additive glucose-lowering effect of MTZ together with metformin highlights the potential utility for the management of type 2 diabetes.


Assuntos
Glicemia/efeitos dos fármacos , Hipoglicemiantes/uso terapêutico , Resistência à Insulina/fisiologia , Fígado/metabolismo , Metazolamida/uso terapêutico , Animais , Glicemia/metabolismo , Inibidores da Anidrase Carbônica/farmacologia , Diabetes Mellitus Experimental/tratamento farmacológico , Técnica Clamp de Glucose , Glucose-6-Fosfatase/efeitos dos fármacos , Glicólise/efeitos dos fármacos , Homeostase/efeitos dos fármacos , Insulina/uso terapêutico , Masculino , Metformina/uso terapêutico , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Obesos , Consumo de Oxigênio/efeitos dos fármacos , Fosfoenolpiruvato Carboxiquinase (ATP)/efeitos dos fármacos , Ácido Pirúvico/metabolismo , Ratos , Ratos Sprague-Dawley
12.
J Clin Endocrinol Metab ; 95(5): 2476-85, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20237162

RESUMO

CONTEXT: Chemerin is a new adipokine associated with obesity and the metabolic syndrome. Gene expression levels of chemerin were elevated in the adipose depots of obese compared with lean animals and was markedly elevated during differentiation of fibroblasts into mature adipocytes. OBJECTIVE: The objective of the study was to identify factors that affect the regulation and potential function of chemerin using a genetics approach. DESIGN, SETTING, PATIENTS, AND INTERVENTION: Plasma chemerin levels were measured in subjects from the San Antonio Family Heart Study, a large family-based genetic epidemiological study including 1354 Mexican-American individuals. Individuals were randomly sampled without regard to phenotype or disease status. MAIN OUTCOME MEASURES: A genome-wide association analysis using 542,944 single-nucleotide polymorphisms in a subset of 523 of the same subjects was undertaken. The effect of chemerin on angiogenesis was measured using human endothelial cells and interstitial cells in coculture in a specially formulated medium. RESULTS: Serum chemerin levels were found to be highly heritable (h(2) = 0.25; P = 1.4 x 10(-9)). The single-nucleotide polymorphism showing strongest evidence of association (rs347344; P = 1.4 x 10(-6)) was located within the gene encoding epithelial growth factor-like repeats and discoidin I-like domains 3, which has a known role in angiogenesis. Functional angiogenesis assays in human endothelial cells confirmed that chemerin significantly mediated the formation of blood vessels to a similar extent as vascular endothelial growth factor. CONCLUSION: Here we demonstrate for the first time that plasma chemerin levels are significantly heritable and identified a novel role for chemerin as a stimulator of angiogenesis.


Assuntos
Quimiocinas/genética , Polimorfismo de Nucleotídeo Único , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Quimiocinas/sangue , DNA/sangue , DNA/genética , Variação Genética , Estudo de Associação Genômica Ampla , Genótipo , Homeostase , Humanos , Peptídeos e Proteínas de Sinalização Intercelular , Americanos Mexicanos , Neovascularização Fisiológica/genética , Obesidade/genética , Fenótipo , Molécula-1 de Adesão Celular Endotelial a Plaquetas/genética , Fatores de Risco , Suramina/metabolismo , Fator A de Crescimento do Endotélio Vascular/genética
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