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1.
Cell Microbiol ; 17(10): 1447-63, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25857345

RESUMO

The contribution of myeloid cells to tumour microenvironments is a decisive factor in cancer progression. Tumour-associated macrophages (TAMs) mediate tumour invasion and angiogenesis through matrix remodelling, immune modulation and release of pro-angiogenic cytokines. Nothing is known about how pathogenic bacteria affect myeloid cells in these processes. Here we show that Bartonella henselae, a bacterial pathogen causing vasculoproliferative diseases (bacillary angiomatosis), reprogrammes human myeloid angiogenic cells (MACs), a pro-angiogenic subset of circulating progenitor cells, towards a TAM-like phenotype with increased pro-angiogenic capacity. B. henselae infection resulted in inhibition of cell death, activation of angiogenic cellular programmes and induction of M2 macrophage polarization. MACs infected with B. henselae incorporated into endothelial sprouts and increased angiogenic growth. Infected MACs developed a vascular mimicry phenotype in vitro, and expression of B. henselae adhesin A was essential in inducing these angiogenic effects. Secretome analysis revealed that increased pro-angiogenic activities were associated with the creation of a tumour-like microenvironment dominated by angiogenic inflammatory cytokines and matrix remodelling compounds. Our results demonstrate that manipulation of myeloid cells by pathogenic bacteria can contribute to microenvironmental regulation of pathological tissue growth and suggest parallels underlying both bacterial infections and cancer.


Assuntos
Bartonella henselae/fisiologia , Interações Hospedeiro-Patógeno , Células Progenitoras Mieloides/fisiologia , Neovascularização Patológica , Diferenciação Celular , Células Endoteliais/microbiologia , Células Endoteliais/fisiologia , Humanos , Macrófagos/microbiologia , Macrófagos/fisiologia
2.
Arterioscler Thromb Vasc Biol ; 35(9): 1954-62, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26205961

RESUMO

OBJECTIVE: The polarity protein Scrib is highly expressed in endothelial cells and is required for planar cell polarity. Scrib also facilitates recycling of integrin α5 to the plasma membrane. Because integrin α5 signals the presence of the inflammatory matrix protein fibronectin, we hypothesized that Scrib contributes to endothelial inflammatory signaling. APPROACH AND RESULTS: Cytokine treatment of human umbilical vein endothelial cells induced an inflammatory response as evident by the induction of vascular cell adhesion molecule-1 (VCAM-1). Downregulation of Scrib greatly attenuated this effect. In endothelial-specific conditional Scrib knockout mice, in vivo lipopolysaccharide treatment resulted in an impaired VCAM-1 induction. These effects were functionally relevant because Scrib small interfering RNAs in human umbilical vein endothelial cells attenuated the VCAM-1-mediated leukocyte adhesion in response to tumor necrosis factor-α. In vivo, tamoxifen-induced endothelial-specific deletion of Scrib resulted in a reduced VCAM-1-mediated leukocyte adhesion in response to tumor necrosis factor-α in the mouse cremaster model. This effect was specific for Scrib and not mediated by other polarity proteins. Moreover, it did not involve integrin α5 or classic pathways supporting inflammatory signaling, such as nuclear factor κ light chain enhancer of activated B-cells or MAP kinases. Co-immunoprecipitation/mass spectrometry identified the zinc finger transcription factor GATA-like protein-1 as a novel Scrib interacting protein. Small interfering RNA depletion of GATA-like protein-1 decreased the tumor necrosis factor-α-stimulated VCAM-1 induction to a similar extent as loss of Scrib did. Silencing of Scrib reduced GATA-like protein-1 protein, but not mRNA abundance. CONCLUSIONS: Scrib is a novel proinflammatory regulator in endothelial cells, which maintains the protein expression of GATA-like protein-1.


Assuntos
Artérias Carótidas/metabolismo , Fator de Transcrição GATA1/genética , Regulação da Expressão Gênica , Células Endoteliais da Veia Umbilical Humana/metabolismo , Inflamação/genética , Peptídeos e Proteínas de Sinalização Intracelular/genética , RNA/genética , Animais , Western Blotting , Artérias Carótidas/patologia , Células Cultivadas , Modelos Animais de Doenças , Fator de Transcrição GATA1/biossíntese , Células Endoteliais da Veia Umbilical Humana/patologia , Humanos , Inflamação/metabolismo , Inflamação/patologia , Peptídeos e Proteínas de Sinalização Intracelular/biossíntese , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Regiões Promotoras Genéticas , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais
3.
Circ Res ; 112(6): 924-34, 2013 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-23362312

RESUMO

RATIONALE: Polarity proteins are involved in the apico-basal orientation of epithelial cells, but relatively little is known regarding their function in mesenchymal cells. OBJECTIVE: We hypothesized that polarity proteins also contribute to endothelial processes like angiogenesis. METHODS AND RESULTS: Screening of endothelial cells revealed high expression of the polarity protein Scribble (Scrib). On fibronectin-coated carriers Scrib siRNA (siScrib) blocked directed but not random migration of human umbilical vein endothelial cells and led to an increased number and disturbed orientation of cellular lamellipodia. Coimmunoprecipitation/mass spectrometry and glutathione S-transferase (GST) pulldown assays identified integrin α5 as a novel Scrib interacting protein. By total internal reflection fluorescence (TIRF) microscopy, Scrib and integrin α5 colocalize at the basal plasma membrane of endothelial cells. Western blot and fluorescence activated cell sorting (FACS) analysis revealed that silencing of Scrib reduced the protein amount and surface expression of integrin α5 whereas surface expression of integrin αV was unaffected. Moreover, in contrast to fibronectin, the ligand of integrin α5, directional migration on collagen mediated by collagen-binding integrins was unaffected by siScrib. Mechanistically, Scrib supported integrin α5 recycling and protein stability by blocking its interaction with Rab7a, its translocation into lysosomes, and its subsequent degradation by pepstatin-sensitive proteases. In siScrib-treated cells, reinduction of the wild-type protein but not of PSD95, Dlg, ZO-1 (PDZ), or leucine rich repeat domain mutants restored integrin α5 abundance and directional cell migration. The downregulation of Scrib function in Tg(kdrl:EGFP)(s843) transgenic zebrafish embryos delayed the angiogenesis of intersegmental vessels. CONCLUSIONS: Scrib is a novel regulator of integrin α5 turnover and sorting, which is required for oriented cell migration and sprouting angiogenesis.


Assuntos
Movimento Celular/fisiologia , Polaridade Celular/fisiologia , Células Endoteliais da Veia Umbilical Humana/fisiologia , Integrina alfa5/metabolismo , Proteínas de Membrana/fisiologia , Neovascularização Fisiológica/fisiologia , Proteínas Supressoras de Tumor/fisiologia , Animais , Ensaios de Migração Celular , Movimento Celular/efeitos dos fármacos , Células Endoteliais/fisiologia , Humanos , Integrina alfaV/metabolismo , Proteínas de Membrana/antagonistas & inibidores , Camundongos , RNA Interferente Pequeno/farmacologia , Proteínas Supressoras de Tumor/antagonistas & inibidores
4.
Cell Mol Life Sci ; 71(21): 4131-48, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25038776

RESUMO

Cell migration plays a central role in a variety of physiological and pathological processes during our whole life. Cellular movement is a complex, tightly regulated multistep process. Although the principle mechanisms of migration follow a defined general motility cycle, the cell type and the context of moving influences the detailed mode of migration. Endothelial cells migrate during vasculogenesis and angiogenesis but also in a damaged vessel to restore vessel integrity. Depending on the situation they migrate individually, in chains or sheets and complex signaling, intercellular signals as well as environmental cues modulate the process. Here, the different modes of cell migration, the peculiarities of endothelial cell migration and specific guidance molecules controlling this process will be reviewed.


Assuntos
Movimento Celular , Células Endoteliais/citologia , Animais , Vasos Sanguíneos/fisiopatologia , Efrinas/metabolismo , Humanos , Neovascularização Fisiológica , Fatores de Crescimento Neural/metabolismo , Netrina-1 , Neurônios/fisiologia , Semaforinas/metabolismo , Transdução de Sinais , Proteínas Supressoras de Tumor/metabolismo , Cicatrização
5.
Circ Res ; 110(9): 1217-25, 2012 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-22456182

RESUMO

RATIONALE: The function of Nox4, a source of vascular H(2)O(2), is unknown. Other Nox proteins were identified as mediators of endothelial dysfunction. OBJECTIVE: We determined the function of Nox4 in situations of increased stress induced by ischemia or angiotensin II with global and tamoxifen-inducible Nox4(-/-) mice. METHODS AND RESULTS: Nox4 was highly expressed in the endothelium and contributed to H(2)O(2) formation. Nox4(-/-) mice exhibited attenuated angiogenesis (femoral artery ligation) and PEG-catalase treatment in control mice had a similar effect. Tube formation in cultured Nox4(-/-) lung endothelial cells (LECs) was attenuated and restored by low concentrations of H(2)O(2,) whereas PEG-catalase attenuated tube formation in control LECs. Angiotensin II infusion was used as a model of oxidative stress. Compared to wild-type, aortas from inducible Nox4-deficient animals had development of increased inflammation, media hypertrophy, and endothelial dysfunction. Mechanistically, loss of Nox4 resulted in reduction of endothelial nitric oxide synthase expression, nitric oxide production, and heme oxygenase-1 (HO-1) expression, which was associated with apoptosis and inflammatory activation. HO-1 expression is controlled by Nrf-2. Accordingly, Nox4-deficient LECs exhibited reduced Nrf-2 protein level and deletion of Nox4 reduced Nrf-2 reporter gene activity. In vivo treatment with hemin, an inducer of HO-1, blocked the vascular hypertrophy induced by Nox4 deletion in the angiotensin II infusion model and carbon monoxide, the product of HO-1, blocked the Nox4-deletion-induced apoptosis in LECs. CONCLUSION: Endogenous Nox4 protects the vasculature during ischemic or inflammatory stress. Different from Nox1 and Nox2, this particular NADPH oxidase therefore may have a protective vascular function.


Assuntos
Células Endoteliais/enzimologia , Peróxido de Hidrogênio/metabolismo , Hipertensão/enzimologia , Isquemia/enzimologia , Pulmão/irrigação sanguínea , Músculo Esquelético/irrigação sanguínea , NADPH Oxidases/metabolismo , Estresse Oxidativo , Angiotensina II , Animais , Antioxidantes/farmacologia , Apoptose , Boranos/metabolismo , Boranos/farmacologia , Dióxido de Carbono/metabolismo , Carbonatos/metabolismo , Carbonatos/farmacologia , Catalase/farmacologia , Células Cultivadas , Citoproteção , Modelos Animais de Doenças , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/patologia , Heme Oxigenase-1/metabolismo , Hemina/farmacologia , Células Endoteliais da Veia Umbilical Humana/enzimologia , Humanos , Hipertensão/induzido quimicamente , Hipertensão/genética , Hipertensão/patologia , Hipertensão/fisiopatologia , Hipertrofia , Isquemia/genética , Isquemia/patologia , Isquemia/fisiopatologia , Masculino , Proteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , NADH NADPH Oxirredutases/deficiência , NADH NADPH Oxirredutases/genética , NADPH Oxidase 1 , NADPH Oxidase 4 , NADPH Oxidases/deficiência , NADPH Oxidases/genética , Fator 2 Relacionado a NF-E2/genética , Neovascularização Fisiológica , Óxido Nítrico Sintase Tipo III/metabolismo , Compostos Organometálicos/metabolismo , Compostos Organometálicos/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Polietilenoglicóis/farmacologia , RNA Mensageiro/metabolismo , Fatores de Tempo , Transfecção
6.
Am J Pathol ; 180(4): 1370-7, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22285670

RESUMO

The influences of cytotoxic drugs on endothelial cells remain incompletely understood. Herein, we examined the effects of chemotherapeutic agents in experimental angiogenesis models and analyzed vessel densities in clinical neuroblastoma tumor samples. Cisplatin (20 to 500 ng/mL), doxorubicin (4 to 100 ng/mL), and vincristine (0.5 to 4 ng/mL), drugs commonly involved in neuroblastoma therapy protocols, induced pro-angiogenic effects in different angiogenesis models. They enhanced endothelial cell tube formation, endothelial cell sprouting from spheroids, formation of tip cells in the sprouting assay, expression of αvß3 integrin, and vitronectin binding. All three drugs increased global cellular kinase phosphorylation levels, including the angiogenesis-relevant molecules protein kinase Cß and Akt. Pharmacological inhibition of protein kinase Cß or Akt upstream of phosphatidylinositol 3-kinase reduced chemotherapy-induced endothelial cell tube formation. Moreover, the investigated chemotherapeutics dose dependently induced vessel formation in the chick chorioallantoic membrane assay. Tumor samples from seven high-risk patients with neuroblastoma were analyzed for vessel density by IHC. Results revealed that neuroblastoma samples taken after chemotherapy consistently showed an enhanced microvessel density compared with the corresponding samples taken before chemotherapy. In conclusion, our data show that chemotherapy can activate endothelial cells by inducing multiple pro-angiogenic signaling pathways and exert pro-angiogenic effects in vitro and in vivo. Moreover, we report a previously unrecognized clinical phenomenon that might, in part, be explained by our experimental observations: chemotherapy-associated enhanced vessel formation in tumors from patients with neuroblastoma.


Assuntos
Antineoplásicos/efeitos adversos , Neovascularização Patológica/induzido quimicamente , Neuroblastoma/irrigação sanguínea , Animais , Antineoplásicos/farmacologia , Embrião de Galinha , Membrana Corioalantoide/irrigação sanguínea , Membrana Corioalantoide/efeitos dos fármacos , Cisplatino/efeitos adversos , Cisplatino/farmacologia , Doxorrubicina/efeitos adversos , Doxorrubicina/farmacologia , Células Endoteliais/efeitos dos fármacos , Humanos , Neovascularização Patológica/patologia , Neuroblastoma/tratamento farmacológico , Neuroblastoma/patologia , Transdução de Sinais/efeitos dos fármacos , Células Tumorais Cultivadas , Vincristina/efeitos adversos , Vincristina/farmacologia
7.
Arterioscler Thromb Vasc Biol ; 28(6): 1123-9, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18340006

RESUMO

OBJECTIVE: Cytochrome P450 (CYP) epoxygenase-derived epoxyeicosatrienoic acids (EETs) are known to stimulate angiogenesis, but the mechanisms involved are incompletely understood. Because EphB4 is involved in vascular development, the aim of this study was to investigate whether, and to what extent, EphB4 is part of the signaling cascade that results in CYP2C9-mediated angiogenesis. METHODS AND RESULTS: CYP2C9 overexpression as well as stimulation with 11,12-EET (up to 48 hours) time-dependently increased EphB4 expression in endothelial cells. This effect and the activation of the EphB4 promoter were mediated by the phosphatidylinositol-3-kinase (P13-K)/Akt pathway and sensitive to the P13-K inhibitor LY 294002 as well as to simultaneous transfection with dominant-negative Akt. 11,12-EET treatment also increased EphB4 expression in isolated mouse mesenteric arteries as well as in the vessels that developed in 11,12-EET-impregnated Matrigel plugs. Moreover, the CYP2C9-stimulated formation of capillary-like structures in a modified spheroid assay was markedly attenuated by EphB4 downregulation (antisense oligonucleotides). Using a parallel approach in vivo, the inclusion of siRNA directed against EphB4 in EET-impregnated Matrigel plugs prevented endothelial cell invasion and vascularization. CONCLUSIONS: Our data indicate that EphB4 is a critical component of the CYP2C9- and 11,12-EET-activated signaling cascade that promotes angiogenesis in vitro as well as in vivo.


Assuntos
Sistema Enzimático do Citocromo P-450/metabolismo , Endotélio Vascular/metabolismo , Neovascularização Fisiológica/fisiologia , Receptor EphB4/metabolismo , Transdução de Sinais/fisiologia , Ácido 8,11,14-Eicosatrienoico/análogos & derivados , Ácido 8,11,14-Eicosatrienoico/farmacologia , Animais , Aorta/citologia , Aorta/efeitos dos fármacos , Aorta/metabolismo , Células Cultivadas , Cromonas/farmacologia , Sistema Enzimático do Citocromo P-450/genética , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Inibidores Enzimáticos/farmacologia , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos , Morfolinas/farmacologia , Neovascularização Fisiológica/genética , Oligonucleotídeos Antissenso/farmacologia , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , RNA Interferente Pequeno/farmacologia , Receptor EphB4/genética , Transdução de Sinais/genética , Suínos , Veias Umbilicais/citologia , Veias Umbilicais/efeitos dos fármacos , Veias Umbilicais/metabolismo , Vasodilatadores/farmacologia
8.
Invest Ophthalmol Vis Sci ; 49(3): 1242-7, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18326754

RESUMO

PURPOSE: Cytochrome P450 (CYP) epoxygenase-derived epoxyeicosatrienoic acids (EETs) elicit cell proliferation and promote angiogenesis. The aim of this study was to determine the expression of CYP epoxygenases in the bovine retina and the potential role of EETs in hypoxia-induced angiogenesis in bovine retinal endothelial cells. METHODS: Bovine retinal endothelial cells were cultured under normoxic (21% O(2)) or hypoxic (1% O(2)) conditions, and CYP2C expression was determined by Western blot analysis. The effect of hypoxia on EET levels was determined by LC-MS/MS. Cell migration (Transwell filter assays) and endothelial cell tube formation (on basement membrane matrix) were assessed in vitro in the absence and presence of pharmacologic inhibitors and CYP2C antisense oligonucleotides. RESULTS: Bovine retinal endothelial cells expressed CYP2C protein in culture and generated detectable levels of EETs under basal conditions. Hypoxia (6-48 hours) enhanced CYP2C protein expression (2-fold) and EET formation (1.5-fold). Moreover, endothelial cells preexposed to hypoxia demonstrated an increase in serum-induced cell migration that was sensitive to the CYP2C inhibitors sulfaphenazole and MS-PPOH and the EET antagonist 14,15-epoxyeicosa-5(Z)-enoic acid. Furthermore, preventing the hypoxia-induced expression of CYP2C (antisense oligonucleotides) suppressed hypoxia-induced cell migration. In an in vitro angiogenesis model, the preexposure of endothelial cells to hypoxia increased CYP2C expression and enhanced endothelial tube formation, which was blocked by the EET antagonist and by the CYP2C antisense oligonucleotides. CONCLUSIONS: Taken together, these data indicate that CYP2C-derived EETs are implicated in angiogenesis by retinal endothelial cells, especially under hypoxic conditions.


Assuntos
Movimento Celular/fisiologia , Sistema Enzimático do Citocromo P-450/fisiologia , Endotélio Vascular/enzimologia , Neovascularização Fisiológica/fisiologia , Vasos Retinianos/citologia , Ácido 8,11,14-Eicosatrienoico/análogos & derivados , Ácido 8,11,14-Eicosatrienoico/metabolismo , Ácido 8,11,14-Eicosatrienoico/farmacologia , Amidas/farmacologia , Animais , Western Blotting , Bovinos , Técnicas de Cultura de Células , Hipóxia Celular , Cromatografia Líquida de Alta Pressão , Inibidores das Enzimas do Citocromo P-450 , Eicosanoides/metabolismo , Inibidores Enzimáticos/farmacologia , Técnica Indireta de Fluorescência para Anticorpo , Espectrometria de Massas , Oligonucleotídeos Antissenso/farmacologia , Sulfafenazol/farmacologia
9.
Cell Death Differ ; 13(3): 446-53, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16167071

RESUMO

The histone deacetylase (HDAC) inhibitor valproic acid (VPA) was recently shown to inhibit angiogenesis, but displays no toxicity in endothelial cells. Here, we demonstrate that VPA increases extracellular signal-regulated kinase 1/2 (ERK 1/2) phosphorylation in human umbilical vein endothelial cells (HUVEC). The investigation of structurally modified VPA derivatives revealed that the induction of ERK 1/2 phosphorylation is not correlated to HDAC inhibition. PD98059, a pharmacological inhibitor of the mitogen-activated protein kinase kinase 1/2, prevented the VPA-induced ERK 1/2 phosphorylation. In endothelial cells, ERK 1/2 phosphorylation is known to promote cell survival and angiogenesis. Our results showed that VPA-induced ERK 1/2 phosphorylation in turn causes phosphorylation of the antiapoptotic protein Bcl-2 and inhibits serum starvation-induced HUVEC apoptosis and cytochrome c release from the mitochondria. Moreover, the combination of VPA with PD98059 synergistically inhibited angiogenesis in vitro and in vivo.


Assuntos
Inibidores da Angiogênese/farmacologia , Apoptose/efeitos dos fármacos , Endotélio Vascular/efeitos dos fármacos , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Ácido Valproico/farmacologia , Animais , Ciclo Celular/efeitos dos fármacos , Células Cultivadas , Embrião de Galinha , Sinergismo Farmacológico , Células Endoteliais/efeitos dos fármacos , Endotélio Vascular/citologia , Endotélio Vascular/enzimologia , Ativação Enzimática , Inibidores Enzimáticos/farmacologia , Flavonoides/farmacologia , Humanos , Quinases de Proteína Quinase Ativadas por Mitógeno/antagonistas & inibidores , Fosforilação
10.
Pharmacol Ther ; 111(3): 584-95, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16380164

RESUMO

Epoxyeicosatrienoic acids (EETs) are generated from arachidonic acid by cytochrome P450 (CYP) epoxygenases. The expression of CYP epoxygenases in endothelial cells is determined by a number of physical (fluid shear stress and cyclic stretch) and pharmacological stimuli as well as by hypoxia. The activation of CYP epoxygenases in endothelial cells is an important step in the nitric oxide and prostacyclin (PGI2)-independent vasodilatation of several vascular beds and EETs have been identified as endothelium-derived hyperpolarizing factors (EDHFs). However, in addition to regulating vascular tone, EETs modulate several signaling cascades and affect cell proliferation, cell migration, and angiogenesis. Signaling molecules modulated by EETs include tyrosine kinases and phosphatases, mitogen-activated protein kinases, protein kinase A (PKA), cyclooxygenase (COX)-2, and several transcription factors. This review summarizes the role of CYP-derived EETs in cell signaling and focuses particularly on their role as intracellular amplifiers of endothelial cell hyperpolarization as well as in cell proliferation and angiogenesis. The angiogenic properties of CYP epoxygenases and CYP-derived EETs implicate that these enzymes may well be accessible targets for anti-angiogenic as well as angiogenic therapies.


Assuntos
Ácido 8,11,14-Eicosatrienoico/análogos & derivados , Ácidos Araquidônicos/metabolismo , Fatores Biológicos/fisiologia , Células Endoteliais/fisiologia , Neovascularização Fisiológica , Transdução de Sinais/fisiologia , Ácido 8,11,14-Eicosatrienoico/metabolismo , Animais , Sistema Enzimático do Citocromo P-450/fisiologia , Humanos , Canais de Potássio Ativados por Cálcio de Condutância Alta/fisiologia , Potenciais da Membrana
11.
Cancer Biol Ther ; 5(1): 89-96, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16357513

RESUMO

Cationic lipid complexes have been shown to be bound and internalized selectively by angiogenic tumor endothelial cells after intravenous injection. Based on this phenomenon, the chemotherapeutic agent paclitaxel was encapsulated into these lipid complexes providing a vascular targeting agent (MBT-0206). As noninvasive imaging techniques are of critical importance for optimizing antivascular cancer treatment in the clinic, we have evaluated the antivascular effects of MBT-0206 in the A-MEL-3 solid tumor model using dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). Twenty-four hours after three intravenous applications of MBT-0206, tumors of treated animals demonstrated a significant decrease of intratumoral blood volume and an increase of vascular permeability in comparison to size-matched control tumors. In contrast, animals treated with conventional paclitaxel given as Taxol at equal drug dose did not show any significant differences in vascular parameters acquired by DCE-MRI in comparison to controls. Immunohistological analysis confirmed a significant reduction of microvessel density in MBT-0206 treated tumors. Moreover, a significant increase of intratumoral microvascular occlusion following MBT-0206 treatment was observed compared to controls and paclitaxel treated animals. In conclusion, antivascular tumor therapy with MBT-0206 significantly impairs functional tumor microcirculation. DCE-MRI is a promising tool to quantify the antivascular effects of MBT-0206 during treatment.


Assuntos
Antineoplásicos Fitogênicos/administração & dosagem , Meios de Contraste/farmacocinética , Gadolínio DTPA/farmacocinética , Lipídeos/administração & dosagem , Imageamento por Ressonância Magnética/métodos , Melanoma/irrigação sanguínea , Neovascularização Patológica/diagnóstico , Paclitaxel/administração & dosagem , Neoplasias Cutâneas/irrigação sanguínea , Animais , Cápsulas/administração & dosagem , Cricetinae , Melanoma/tratamento farmacológico , Transplante de Neoplasias , Neovascularização Patológica/tratamento farmacológico , Neovascularização Patológica/patologia , Neoplasias Cutâneas/tratamento farmacológico , Células Tumorais Cultivadas
12.
Circ Res ; 88(1): 44-51, 2001 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-11139472

RESUMO

In the porcine coronary artery, a cytochrome P450 (CYP) isozyme homologous to CYP 2C8/9 has been identified as an endothelium-derived hyperpolarizing factor (EDHF) synthase. As some CYP enzymes are reported to generate reactive oxygen species (ROS), we hypothesized that the coronary EDHF synthase may modulate vascular homeostasis by the simultaneous production of ROS and epoxyeicosatrienoic acids. In bradykinin-stimulated coronary arteries, antisense oligonucleotides against CYP 2C almost abolished EDHF-mediated responses but potentiated nitric oxide (NO)-mediated relaxation. The selective CYP 2C9 inhibitor sulfaphenazole and the superoxide anion (O(2-)) scavengers Tiron and nordihydroguaretic acid also induced a leftward shift in the NO-mediated concentration-relaxation curve to bradykinin. CYP activity and O(2-) production, determined in microsomes prepared from cells overexpressing CYP 2C9, were almost completely inhibited by sulfaphenazole. Sulfaphenazole did not alter the activity of either CYP 2C8, the leukocyte NADPH oxidase, or xanthine oxidase. ROS generation in coronary artery rings, visualized using either ethidium or dichlorofluorescein fluorescence, was detected under basal conditions. The endothelial signal was attenuated by CYP 2C antisense treatment as well as by sulfaphenazole. In isolated coronary endothelial cells, bradykinin elicited a sulfaphenazole-sensitive increase in ROS production. Although 11,12 epoxyeicosatrienoic acid attenuated the activity of nuclear factor-kappaB in cultured human endothelial cells, nuclear factor-kappaB activity was enhanced after the induction or overexpression of CYP 2C9, as was the expression of vascular cell adhesion molecule-1. These results suggest that a CYP isozyme homologous to CYP 2C9 is a physiologically relevant generator of ROS in coronary endothelial cells and modulates both vascular tone and homeostasis.


Assuntos
Ácido 8,11,14-Eicosatrienoico/análogos & derivados , Vasos Coronários/enzimologia , Sistema Enzimático do Citocromo P-450/metabolismo , Oxigenases/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Ácido 15-Hidroxi-11 alfa,9 alfa-(epoximetano)prosta-5,13-dienoico/farmacologia , Ácido 8,11,14-Eicosatrienoico/farmacologia , Animais , Bradicinina/farmacologia , Linhagem Celular , Células Cultivadas , Vasos Coronários/efeitos dos fármacos , Vasos Coronários/fisiologia , Sistema Enzimático do Citocromo P-450/efeitos dos fármacos , Sistema Enzimático do Citocromo P-450/genética , Família 2 do Citocromo P450 , DNA Antissenso/farmacologia , Relação Dose-Resposta a Droga , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Humanos , Técnicas In Vitro , NADPH Oxidases/efeitos dos fármacos , NADPH Oxidases/metabolismo , NF-kappa B/metabolismo , Óxido Nítrico/fisiologia , Oxigenases/efeitos dos fármacos , Oxigenases/genética , Cloreto de Potássio/farmacologia , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Sulfafenazol/farmacologia , Suínos , Fator de Necrose Tumoral alfa/farmacologia , Molécula 1 de Adesão de Célula Vascular/metabolismo , Vasodilatação/efeitos dos fármacos , Xantina Oxidase/efeitos dos fármacos , Xantina Oxidase/metabolismo
13.
Arterioscler Thromb Vasc Biol ; 25(2): 321-6, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15569819

RESUMO

OBJECTIVE: Cytochrome P450 (CYP) epoxygenases metabolize arachidonic acid to epoxyeicosatrienoic acids (EETs). CYP2C9-derived EETs elicit endothelial cell proliferation and angiogenesis, but the signaling pathways involved are incompletely understood. Because cyclooxygenase-2 (COX-2) is involved in angiogenesis, we determined whether a link exists between CYP2C9 and COX-2 expression. METHODS AND RESULTS: Human umbilical vein endothelial cells were infected with CYP2C9 sense or antisense adenoviral constructs. Overexpression of CYP2C9 increased COX-2 promoter activity, an effect accompanied by a significant increase in COX-2 protein expression and elevated prostacyclin production. The CYP2C9-induced expression of COX-2 was inhibited by the CYP2C9 inhibitor, sulfaphenazole, whereas 11,12-EET increased COX-2 expression. Overexpression of CYP2C9 and stimulation with 11,12-EET increased intracellular cAMP levels and stimulated DNA-binding of the cAMP-response element-binding protein. The protein kinase A inhibitor, KT5720, attenuated the CYP2C9-induced increase in COX-2 promoter activity and protein expression. Overexpression of CYP2C9 stimulated endothelial tube formation, an effect that was attenuated by the COX-2 inhibitor celecoxib. Identical responses were observed in cells preconditioned by cyclic strain to increase CYP2C expression. CONCLUSIONS: These data indicate that CYP2C9-derived EETs induce the expression of COX-2 in endothelial cells via a cAMP-dependent pathway and that this mechanism contributes to CYP2C9-induced angiogenesis. Overexpression of cytochrome P450 (CYP) 2C9 in endothelial cells increased cAMP levels, stimulated the cAMP-response element-binding protein, and enhanced cyclooxygenase-2 (COX-2) promoter activity, protein expression, and prostacyclin production. CYP2C9 overexpression stimulated endothelial tube formation, which was attenuated by the COX-2 inhibitor celecoxib. Thus, COX-2 contributes to CYP2C9-induced angiogenesis.


Assuntos
Ácido 8,11,14-Eicosatrienoico/análogos & derivados , Ácido 8,11,14-Eicosatrienoico/metabolismo , Hidrocarboneto de Aril Hidroxilases/metabolismo , Células Endoteliais/metabolismo , Endotélio Vascular/metabolismo , Prostaglandina-Endoperóxido Sintases/biossíntese , 6-Cetoprostaglandina F1 alfa/biossíntese , Ácido 8,11,14-Eicosatrienoico/farmacologia , Sequência de Aminoácidos , Hidrocarboneto de Aril Hidroxilases/genética , Carbazóis/farmacologia , Celecoxib , Células Cultivadas/efeitos dos fármacos , Células Cultivadas/metabolismo , AMP Cíclico/biossíntese , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico , Proteínas Quinases Dependentes de AMP Cíclico/antagonistas & inibidores , Proteínas Quinases Dependentes de AMP Cíclico/fisiologia , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase/farmacologia , Citocromo P-450 CYP2C9 , DNA Antissenso/farmacologia , Células Endoteliais/efeitos dos fármacos , Endotélio Vascular/citologia , Indução Enzimática/efeitos dos fármacos , Epoprostenol/biossíntese , Humanos , Indóis/farmacologia , Proteínas de Membrana , Dados de Sequência Molecular , Morfogênese/efeitos dos fármacos , Neovascularização Fisiológica/efeitos dos fármacos , Prostaglandina-Endoperóxido Sintases/genética , Pirazóis/farmacologia , Pirróis/farmacologia , RNA Mensageiro/biossíntese , Proteínas Recombinantes de Fusão/fisiologia , Estresse Mecânico , Sulfafenazol/farmacologia , Sulfonamidas/farmacologia , Fatores de Transcrição/metabolismo , Transdução Genética , Veias Umbilicais
14.
Biochim Biophys Acta ; 1619(3): 332-9, 2003 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-12573493

RESUMO

Over the last 10 years it has become increasingly clear that cytochrome P450 (CYP) enzymes expressed within endothelial and vascular smooth muscle cells play a crucial role in the modulation of vascular homeostasis. There is strong evidence suggesting that the activation of a CYP 2C epoxygenase in endothelial cells is an essential step in nitric oxide (NO)- and prostacyclin (PGI(2))-independent vasodilatation of several vascular beds, particularly in the heart and kidney. Moreover, CYP epoxygenase products as well as CYP-derived reactive oxygen species are intracellular signal transduction molecules involved in several signaling cascades affecting numerous cellular processes, including vascular cell proliferation and angiogenesis. Various pharmacological compounds enhance vascular CYP 2C expression. One group of substances which highlight the possible effects of CYP induction in endothelial cells on vascular function are the HMG-CoA reductase inhibitors (statins). Cerivastatin and fluvastatin increase CYP 2C mRNA and protein in native and cultured endothelial cells, and enhance the bradykinin-induced NO/PGI(2)-independent relaxation of arterial segments as well as the generation of reactive oxygen species. However, statins also increase the expression of the endothelial NO synthase by approximately twofold. As a consequence, the probability that NO and reactive oxygen species react to generate peroxynitrite is increased and the treatment of vascular segments with statins resulted in enhanced protein tyrosine nitration. These data highlight the role played by CYP 2C in vascular homeostasis and its potential regulation by cardiovascular drugs.


Assuntos
Sistema Enzimático do Citocromo P-450/biossíntese , Endotélio Vascular/enzimologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Animais , Células Cultivadas , Sistema Enzimático do Citocromo P-450/genética , Endotélio Vascular/fisiologia , Ativação Enzimática , Ácidos Graxos Monoinsaturados/farmacologia , Fluvastatina , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Homeostase , Hidroximetilglutaril-CoA Redutases/metabolismo , Indóis/farmacologia , Óxido Nítrico/metabolismo , Piridinas/farmacologia , RNA Mensageiro/biossíntese , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais , Suínos , Fatores de Tempo , Vasodilatação
15.
FASEB J ; 17(6): 770-2, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12586744

RESUMO

Cytochrome P450 (CYP) epoxygenase products, such as 11,12-epoxyeicosatrienoic acid (EET), stimulate endothelial cell proliferation. We set out to identify the signal transduction cascade linking EET generation to enhanced proliferation and angiogenesis. In human endothelial cells overexpressing CYP 2C9, cell number was increased compared with control cells and was inhibited by the CYP 2C9 inhibitor, sulfaphenazole. CYP 2C9 overexpression was associated with the activation of Akt and an increase in cyclin D1 expression, effects that were abolished by the epidermal growth factor (EGF) receptor inhibitor, AG1478, which also prevented the CYP 2C9-induced increase in cell proliferation. Stimulation of EGF receptor overexpressing cells with 11,12-EET or transfection of these cells with CYP 2C9 enhanced the tyrosine phosphorylation of the EGF receptor. Endothelial tube formation in a fibrin gel was significantly enhanced (6-fold) in CYP 2C9 overexpressing cells and was comparable with the tube formation induced by EGF. In the chick chorioallantoic membrane, 11,12-EET stimulated vessel formation (3.5-fold) and induced vessel convergence, an effect that was abolished by cotreatment with either an EGF receptor-neutralizing antibody or AG1478. These results indicate that CYP 2C9-derived EETs stimulate angiogenesis by a mechanism involving the activation of the EGF receptor.


Assuntos
Ácido 8,11,14-Eicosatrienoico/análogos & derivados , Ácido 8,11,14-Eicosatrienoico/metabolismo , Hidrocarboneto de Aril Hidroxilases/metabolismo , Receptores ErbB/fisiologia , Neovascularização Fisiológica/fisiologia , Proteínas Serina-Treonina Quinases , Ácido 8,11,14-Eicosatrienoico/farmacologia , Alantoide/irrigação sanguínea , Animais , Hidrocarboneto de Aril Hidroxilases/genética , Divisão Celular/fisiologia , Linhagem Celular , Embrião de Galinha , Córion/irrigação sanguínea , Ciclina D1/metabolismo , Citocromo P-450 CYP2C9 , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Inibidores Enzimáticos/farmacologia , Humanos , Neovascularização Fisiológica/efeitos dos fármacos , Fosforilação/efeitos dos fármacos , Proteínas Tirosina Fosfatases/antagonistas & inibidores , Proteínas Proto-Oncogênicas/metabolismo , Proteínas Proto-Oncogênicas c-akt , Quinazolinas , Receptor Cross-Talk/fisiologia , Tirfostinas/farmacologia
16.
Cardiovasc Res ; 54(3): 669-75, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12031713

RESUMO

OBJECTIVES/METHODS: In addition to nitric oxide (NO) and prostacyclin, endothelium-dependent dilation is mediated by the endothelium-derived hyperpolarizing factor (EDHF) which, in the coronary circulation, has been characterised as a metabolite of arachidonic acid synthesised by an cytochrome P450 (CYP) epoxygenase homologous to CYP 2C8/9. As the promotor regions of CYP 2C8 and 2C9 contain consensus sequences for glucocorticoid response elements, we determined the effect of cortisol on EDHF-mediated relaxations as well as on the expression of CYP 2C in isolated segments of porcine coronary artery. RESULTS: Bradykinin-induced NO-mediated relaxation of KCl-constricted arterial rings was slightly attenuated following exposure to cortisol. However, EDHF-mediated relaxations of U46619-constricted arterial rings assessed in the presence of the cyclo-oxygenase inhibitor diclofenac and the NO synthase inhibitor N(omega)nitro-L-arginine (0.3 mM), were significantly enhanced (maximum relaxation: 66+/-7%, P<0.05 vs. control rings: 36+/-8%). Cortisol treatment (0.1 microM, 24 h) did not affect the endothelium-independent relaxation elicited by sodium nitroprusside and acute incubation with cortisol (0.1 microM, 30 min) did not alter either NO- or EDHF-mediated responses. The expression of CYP 2C (quantified by RT-PCR, Western blot analysis and confocal microscopy) was enhanced in porcine coronary endothelial cells following incubation with cortisol for 18-24 h. CONCLUSIONS: These results demonstrate the concomitant upregulation of EDHF-mediated relaxations and CYP 2C expression by long-term treatment with cortisol. These observations support the concept that an epoxygenase homologous to CYP 2C8/9 plays a crucial role in the generation of EDHF-mediated responses in the coronary endothelium.


Assuntos
Hidrocarboneto de Aril Hidroxilases , Fatores Biológicos/farmacologia , Vasos Coronários/enzimologia , Sistema Enzimático do Citocromo P-450/metabolismo , Hidrocortisona/farmacologia , Esteroide 16-alfa-Hidroxilase , Esteroide Hidroxilases/metabolismo , Vasodilatação/efeitos dos fármacos , Animais , Imunofluorescência , Microscopia Confocal , Técnicas de Cultura de Órgãos , Suínos
17.
Anticancer Res ; 24(6): 3977-82, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15736442

RESUMO

BACKGROUND: An anti-angiogenesis strategy has been widely recognized as a viable approach to fight cancer and more and more anti-angiogenic factors are continually being identified. Among them, the muscular isoform of Troponin I (TnI) has been described as being a powerful anti-angiogenic agent in vitro as well as in vivo. We investigated the therapeutic efficacy of TnI gene therapy in a human-like orthotopic rat osteosarcoma model. MATERIALS AND METHODS: In this tumor model, we evaluated whether the administration of the secreted TnI coding sequence complexed to cationic liposomes (named TnITag cDNA/lCLP) could induce a delay in tumor growth and reduce tumor vasculature. RESULTS: Although TnI specifically inhibited endothelial cell growth in vitro, we were not able to demonstrate any therapeutic efficacy of TnI in the transplantable osteosarcoma model. CONCLUSION: This lack of efficacy probably resulted from the rapid degradation of recombinant TnI by matrix metalloproteinases, especially MMP2, which are present in large amounts in tumors.


Assuntos
Terapia Genética/métodos , Osteossarcoma/irrigação sanguínea , Osteossarcoma/terapia , Troponina I/genética , Animais , Linhagem Celular , Linhagem Celular Tumoral , DNA Complementar/administração & dosagem , DNA Complementar/genética , Modelos Animais de Doenças , Endotélio Vascular/citologia , Endotélio Vascular/fisiologia , Lipossomos/administração & dosagem , Neovascularização Patológica/genética , Neovascularização Patológica/terapia , Osteossarcoma/genética , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Transfecção
18.
J Child Neurol ; 15(4): 214-7, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10805185

RESUMO

Intramuscular injection of botulinum neurotoxin A is a relatively new method for treating spastic movement disorders in children. One major goal of any therapy for patients with movement disorders is to improve gross motor function. In this study, 18 patients with adductor spasm were treated with botulinum neurotoxin A. Treatment effect was determined with the Gross Motor Function Measure, a standardized, validated instrument designed to assist in assessment of gross motor function. Spastic muscle hyperactivity and joint mobility were evaluated by the modified Ashworth Scale and by range of motion, respectively. Compared to pretreatment values, significant improvement in gross motor function (P < .010), decrease in the modified Ashworth Scale, and increase in the range of motion (P < .010) were achieved. Patients with moderate impairment of gross motor function (classed at level III and level IV in the Gross Motor Function Classification System) benefited most from treatment. In patients with severe handicap (level V), only one of five treated patients showed improvement in gross motor function. Nevertheless, all patients in this subgroup benefited from improved ease in hygienic care. In conclusion, we have demonstrated that for most children with moderate functional impairment, the Gross Motor Function Measure is a useful instrument for objective documentation of improvements of gross motor function following treatment with botulinum neurotoxin A.


Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Destreza Motora , Espasticidade Muscular/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Adolescente , Adulto , Toxinas Botulínicas Tipo A/administração & dosagem , Paralisia Cerebral/complicações , Criança , Pré-Escolar , Crianças com Deficiência , Feminino , Humanos , Injeções Intramusculares , Masculino , Espasticidade Muscular/etiologia , Espasticidade Muscular/fisiopatologia , Músculo Esquelético/patologia , Fármacos Neuromusculares/administração & dosagem , Amplitude de Movimento Articular , Índice de Gravidade de Doença , Resultado do Tratamento
19.
Am J Sports Med ; 22(6): 751-7, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7856798

RESUMO

This contribution addresses the following questions: Does unilateral sports-specific strain affect the skeletal system of the athlete? Specifically, can any differences be found in longitudinal growth of the bones of the forearm and hand in professional tennis players between the stroke arm and the contralateral arm? An investigation was conducted involving 20 high-ranking professional tennis players (12 male and eight female players) between 13 and 26 years of age as well as 12 controls of the same age range. The radiologic examinations of the bones of the forearm and hand yielded an increase in density of bone substance and bone diameter as well as length in the stroke arm as compared with the contralateral arm. Whereas the first results confirm previous findings, the stimulation of longitudinal growth has never been reported. This change in bone structure and size can be attributed to two factors: mechanical stimulation and hyperemia of the constantly strained extremity. It may thus be regarded as a biopositive adaptation process.


Assuntos
Desenvolvimento Ósseo , Osso e Ossos/anatomia & histologia , Tênis/fisiologia , Adolescente , Adulto , Densidade Óssea , Feminino , Antebraço/fisiologia , Mãos/fisiologia , Humanos , Masculino , Estudos Prospectivos
20.
Antioxid Redox Signal ; 15(4): 915-23, 2011 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-21050133

RESUMO

Hepatocyte growth factor (HGF) by stimulating the receptor tyrosine kinase c-Met induces angiogenesis and tissue regeneration. HGF has been shown to antagonize the angiotensin II-induced senescence of endothelial progenitor cells (EPCs), which is mediated by NADPH oxidase-dependent reactive oxygen species (ROS) formation. As growth factors, however, usually require ROS for their signaling, we hypothesized that the proangiogenic effects of HGF require NADPH oxidases and focused on the homolog Nox2, which is most abundantly expressed in EPCs and endothelial cells. Indeed, HGF increased the H(2)O(2) formation in EPCs and human umbilical vein endothelial cells (HUVECs), and this effect was not observed in Nox2-deficient cells. HGF induced the mobilization of EPCs and vascular outgrowth from aortic explants in wild-type (WT) but not Nox2(y/-) mice. HGF also stimulated migration and tube formation in HUVECs, and antisense oligonucleotides against Nox2 prevented this effect. To identify the signal transduction underlying these effects, we focused on the kinases Jak2 and Jnk. In HUVECs, HGF increased the phosphorylation of these in a Nox2-dependent manner as demonstrated by antisense oligonucleotides. Also, the HGF-induced Jak2-dependent activation of a STAT3 reporter construct was attenuated after downregulation of Nox2. Accordingly, the HGF-stimulated tube formation of HUVEC was blocked by inhibitors of Jak2 and Jnk. In vivo treatment with the Jnk inhibitor SP600125 blocked the HGF-induced mobilization of EPCs. Ex vivo, SP600125 blocked HGF-induced migration and tube formation. We conclude that HGF-induced mobilization of EPCs and the proangiogenic effects of the growth factor require a Nox2-dependent ROS-mediated activation of Jak2 and Jnk.


Assuntos
Células Endoteliais/fisiologia , Fator de Crescimento de Hepatócito/farmacologia , Glicoproteínas de Membrana/metabolismo , NADPH Oxidases/metabolismo , Células-Tronco/efeitos dos fármacos , Animais , Antracenos/metabolismo , Aorta/fisiologia , Células Cultivadas , Células Endoteliais/enzimologia , Humanos , Janus Quinase 2/metabolismo , MAP Quinase Quinase 4/antagonistas & inibidores , MAP Quinase Quinase 4/metabolismo , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , NADPH Oxidase 2 , NADPH Oxidases/genética , Neovascularização Fisiológica , Fosforilação , Espécies Reativas de Oxigênio/metabolismo , Fator de Transcrição STAT3/metabolismo , Transdução de Sinais , Células-Tronco/enzimologia , Veias Umbilicais/citologia
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