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1.
Prog Biophys Mol Biol ; 159: 105-117, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33031824

RESUMO

The transient receptor potential Melastatin 4 (TRPM4) channel is a calcium-activated non-selective cation channel expressed widely. In the heart, using a knock-out mouse model, the TRPM4 channel has been shown to be involved in multiple processes, including ß-adrenergic regulation, cardiac conduction, action potential duration and hypertrophic adaptations. This channel was recently shown to be involved in stress-induced cardiac arrhythmias in a mouse model overexpressing TRPM4 in ventricular cardiomyocytes. However, the link between TRPM4 channel expression in ventricular cardiomyocytes, the hypertrophic response to stress and/or cellular arrhythmias has yet to be elucidated. In this present study, we induced pathological hypertrophy in response to myocardial infarction using a mouse model of Trpm4 gene invalidation, and demonstrate that TRPM4 is essential for survival. We also demonstrate that the TRPM4 is required to activate both the Akt and Calcineurin pathways. Finally, using two hypertrophy models, either a physiological response to endurance training or a pathological response to myocardial infarction, we show that TRPM4 plays a role in regulating transient calcium amplitudes and leads to the development of cellular arrhythmias potentially in cooperation with the Sodium-calcium exchange (NCX). Here, we report two functions of the TRPM4 channel: first its role in adaptive hypertrophy, and second its association with NCX could mediate transient calcium amplitudes which trigger cellular arrhythmias.


Assuntos
Ventrículos do Coração/metabolismo , Hipertrofia/metabolismo , Infarto do Miocárdio/metabolismo , Miócitos Cardíacos/metabolismo , Canais de Cátion TRPM/metabolismo , Animais , Arritmias Cardíacas/metabolismo , Fenômenos Biomecânicos/fisiologia , Calcineurina/metabolismo , Cálcio/metabolismo , Ecocardiografia , Eletrocardiografia , Camundongos , Camundongos Knockout , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/fisiologia , Sódio/metabolismo
2.
Oxid Med Cell Longev ; 2018: 7406946, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29849911

RESUMO

One of the major insulin resistance instigators is excessive adiposity and visceral fat depots. Individually, exercise training and polyphenol intake are known to exert health benefits as improving insulin sensitivity. However, their combined curative effects on established obesity and insulin resistance need further investigation particularly on white adipose tissue alterations. Therefore, we compared the effects on different white adipose tissue depot alterations of a combination of exercise and grape polyphenol supplementation in obese insulin-resistant rats fed a high-fat diet to the effects of a high-fat diet alone or a nutritional supplementation of grape polyphenols (50 mg/kg/day) or exercise training (1 hr/day to 5 days/wk consisting of treadmill running at 32 m/min for a 10% slope), for a total duration of 8 weeks. Separately, polyphenol supplementation and exercise decreased the quantity of all adipose tissue depots and mesenteric inflammation. Exercise reduced adipocytes' size in all fat stores. Interestingly, combining exercise to polyphenol intake presents no more cumulative benefit on adipose tissue alterations than exercise alone. Insulin sensitivity was improved at systemic, epididymal, and inguinal adipose tissues levels in trained rats thus indicating that despite their effects on adipocyte morphological/metabolic changes, polyphenols at nutritional doses remain less effective than exercise in fighting insulin resistance.


Assuntos
Tecido Adiposo Branco/efeitos dos fármacos , Dieta Hiperlipídica , Obesidade/etiologia , Polifenóis/farmacologia , Tecido Adiposo Branco/metabolismo , Tecido Adiposo Branco/patologia , Animais , Glicemia/análise , Colesterol/sangue , Citrato (si)-Sintase/metabolismo , Ácidos Graxos não Esterificados/sangue , Teste de Tolerância a Glucose , Quinase I-kappa B/metabolismo , Resistência à Insulina , Leptina/sangue , Masculino , Obesidade/metabolismo , Condicionamento Físico Animal , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Sprague-Dawley , Proteína 3 Supressora da Sinalização de Citocinas/metabolismo , Triglicerídeos/sangue
3.
Sci Rep ; 8(1): 2885, 2018 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-29440695

RESUMO

Separately, polyphenols and exercise are known to prevent insulin resistance (IR) but their combined curative effects on established obesity and IR require further investigation. Therefore, we compared the metabolic effects of a combination of exercise and grape polyphenols supplementation in obese IR rats with high-fat diet (EXOPP) to the effect of high-fat diet alone (HF) or with a nutritional supplementation of grape polyphenols (PP) or with endurance exercise (EXO) during 8 wks. We observed an improvement of systemic and skeletal muscle insulin sensitivity in EXO and EXOPP rats. EXOPP rats compared to HF rats presented a lower insulinemia and HOMA-IR with higher liver and muscle glycogen contents. Interestingly, EXOPP rats had a 68% enhanced endurance capacity compared to EXO rats with also a higher activation of AMPK compared to sedentary and EXO rats with increased lipid oxidation. Together, our results suggest that grape polyphenols supplementation combined with exercise has a synergistic effect by increasing muscle lipid oxidation and sparing glycogen utilization which thus enhances endurance capacity. Our data highlight that in cases of established obesity and IR, the combination of nutritional grape polyphenols supplementation and exercise heighten and intensify their individual metabolic effects.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Suplementos Nutricionais , Resistência à Insulina , Obesidade/tratamento farmacológico , Obesidade/metabolismo , Condicionamento Físico Animal , Polifenóis/farmacologia , Animais , Peso Corporal/efeitos dos fármacos , Teste de Tolerância a Glucose , Masculino , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Músculo Esquelético/fisiopatologia , Obesidade/induzido quimicamente , Obesidade/fisiopatologia , Oxirredução/efeitos dos fármacos , Polifenóis/uso terapêutico , Ratos , Ratos Sprague-Dawley
4.
J Gen Physiol ; 146(4): 295-306, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26371209

RESUMO

Abnormalities in cardiomyocyte Ca2+ handling contribute to impaired contractile function in heart failure (HF). Experiments on single ryanodine receptors (RyRs) incorporated into lipid bilayers have indicated that RyRs from failing hearts are more active than those from healthy hearts. Here, we analyzed spontaneous Ca2+ sparks (brief, localized increased in [Ca2+]i) to evaluate RyR cluster activity in situ in a mouse post-myocardial infarction (PMI) model of HF. The cardiac ejection fraction of PMI mice was reduced to ∼30% of that of sham-operated (sham) mice, and their cardiomyocytes were hypertrophied. The [Ca2+]i transient amplitude and sarcoplasmic reticulum (SR) Ca2+ load were decreased in intact PMI cardiomyocytes compared with those from sham mice, and spontaneous Ca2+ sparks were less frequent, whereas the fractional release and the frequency of Ca2+ waves were both increased, suggesting higher RyR activity. In permeabilized cardiomyocytes, in which the internal solution can be controlled, Ca2+ sparks were more frequent in PMI cells (under conditions of similar SR Ca2+ load), confirming the enhanced RyR activity. However, in intact cells from PMI mice, the Ca2+ sparks frequency normalized by the SR Ca2+ load in that cell were reduced compared with those in sham mice, indicating that the cytosolic environment in intact cells contributes to the decrease in Ca2+ spark frequency. Indeed, using an internal "failing solution" with less ATP (as found in HF), we observed a dramatic decrease in Ca2+ spark frequency in permeabilized PMI and sham myocytes. In conclusion, our data show that, even if isolated RyR channels show more activity in HF, concomitant alterations in intracellular media composition and SR Ca2+ load may mask these effects at the Ca2+ spark level in intact cells. Nonetheless, in this scenario, the probability of arrhythmogenic Ca2+ waves is enhanced, and they play a potential role in the increase in arrhythmia events in HF patients.


Assuntos
Sinalização do Cálcio , Insuficiência Cardíaca/metabolismo , Infarto do Miocárdio/metabolismo , Miócitos Cardíacos/metabolismo , Canal de Liberação de Cálcio do Receptor de Rianodina/metabolismo , Trifosfato de Adenosina/metabolismo , Animais , Células Cultivadas , Ventrículos do Coração/citologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL
5.
J Mol Cell Cardiol ; 53(5): 617-25, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22910094

RESUMO

Cardiac actions of Epac (exchange protein directly activated by cAMP) are not completely elucidated. Epac induces cardiomyocytes hypertrophy, Ca(2+)/calmodulin protein kinase II (CaMKII) and excitation-transcription coupling in rat cardiac myocytes. Here we aimed to elucidate the pathway cascade involved in Epac sustained actions, as during the initiation of hypertrophy development, where ß-adrenergic signaling is chronically stimulated. Rats were treated with the Epac selective activator 8-pCPT during 4 weeks and Ca(2+) signaling was analyzed in isolated cardiac myocytes by confocal microscopy. We observed a positive inotropic effect manifested by increased [Ca(2+)](i) transient amplitudes. In order to further analyze these actions, we incubated adult cardiomyocytes in the presence of 8-pCPT. The effects were similar to those obtained in-vivo and are blunted by Epac1 knock down. Interestingly, the increase in [Ca(2+)] transients was abolished by protein synthesis blockade or when the downstream effectors of calmodulin (CaMKII or calcineurin) were inhibited, pointing to calmodulin (CaM) as an important downstream protein in Epac sustained actions. In fact, CaM expression was enhanced by 8-pCPT treatment in isolated cells, as found by Western blots. Moreover, the 8-pCPT-induced, PKA-independent, positive inotropic effect was favored by enhanced extracellular Ca(2+) influx via L-type Ca(2+) channels. However, 8-pCPT also induced aberrant Ca(2+) release as Ca(2+) waves and extra [Ca(2+)](i) transients, suggesting proarrhythmic effect. These results provide new insights regarding Epac cardiac actions, suggesting an important role in the initial compensation of the heart to pathological stimuli during the initiation of cardiac hypertrophy, favoring contraction but also arrhythmia risk.


Assuntos
Calmodulina/metabolismo , Fatores de Troca do Nucleotídeo Guanina/metabolismo , Contração Miocárdica , Miócitos Cardíacos/fisiologia , Animais , Cafeína/farmacologia , Canais de Cálcio Tipo L/metabolismo , Sinalização do Cálcio/efeitos dos fármacos , Calmodulina/antagonistas & inibidores , Calmodulina/genética , Cardiomegalia/metabolismo , Cardiomegalia/patologia , Células Cultivadas , AMP Cíclico/análogos & derivados , AMP Cíclico/farmacologia , Ativação Enzimática , Ativadores de Enzimas/farmacologia , Técnicas de Silenciamento de Genes , Fatores de Troca do Nucleotídeo Guanina/genética , Masculino , Microscopia Confocal , Miócitos Cardíacos/metabolismo , Técnicas de Patch-Clamp , RNA Interferente Pequeno/genética , Ratos , Ratos Wistar , Ativação Transcricional
6.
Am J Physiol Heart Circ Physiol ; 302(11): H2381-95, 2012 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-22427523

RESUMO

Pulmonary hypertension provokes right heart failure and arrhythmias. Better understanding of the mechanisms underlying these arrhythmias is needed to facilitate new therapeutic approaches for the hypertensive, failing right ventricle (RV). The aim of our study was to identify the mechanisms generating arrhythmias in a model of RV failure induced by pulmonary hypertension. Rats were injected with monocrotaline to induce either RV hypertrophy or failure or with saline (control). ECGs were measured in conscious, unrestrained animals by telemetry. In isolated hearts, electrical activity was measured by optical mapping and myofiber orientation by diffusion tensor-MRI. Sarcoplasmic reticular Ca(2+) handling was studied in single myocytes. Compared with control animals, the T-wave of the ECG was prolonged and in three of seven heart failure animals, prominent T-wave alternans occurred. Discordant action potential (AP) alternans occurred in isolated failing hearts and Ca(2+) transient alternans in failing myocytes. In failing hearts, AP duration and dispersion were increased; conduction velocity and AP restitution were steeper. The latter was intrinsic to failing single myocytes. Failing hearts had greater fiber angle disarray; this correlated with AP duration. Failing myocytes had reduced sarco(endo)plasmic reticular Ca(2+)-ATPase activity, increased sarcoplasmic reticular Ca(2+)-release fraction, and increased Ca(2+) spark leak. In hypertrophied hearts and myocytes, dysfunctional adaptation had begun, but alternans did not develop. We conclude that increased electrical and structural heterogeneity and dysfunctional sarcoplasmic reticular Ca(2+) handling increased the probability of alternans, a proarrhythmic predictor of sudden cardiac death. These mechanisms are potential therapeutic targets for the correction of arrhythmias in hypertensive, failing RVs.


Assuntos
Arritmias Cardíacas/fisiopatologia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Hipertensão Pulmonar/complicações , Disfunção Ventricular Direita/fisiopatologia , Potenciais de Ação/fisiologia , Animais , Cálcio/metabolismo , ATPases Transportadoras de Cálcio/metabolismo , Eletrocardiografia , Masculino , Modelos Animais , Miócitos Cardíacos/patologia , Ratos , Ratos Wistar , Retículo Sarcoplasmático/metabolismo
7.
Food Funct ; 2(9): 555-61, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21879099

RESUMO

SCOPE: We compared the effects of two dealcoholized wines, persimmon (P) and Merlot (M), in hypercholesterolemic hamsters. METHODS AND RESULTS: Four groups of hamsters received a standard (ST) or an atherogenic diet (AT) for 12 weeks. AT animals received either dealcoholized persimmon wine (AT + P) or Merlot wine (AT + M) by gavage, while controls received water (AT and ST). Plasma cholesterol, triglycerides and glucose and paraoxonase activity were measured. Oxidative stress was assessed by aortic O(2)°(-) production, and vascular function was evaluated in aortic rings. The atherogenic diet led to higher plasma triglycerides (246%), total cholesterol (142%), LDL-cholesterol (91%) and HDL-cholesterol (49%). Aortic production of O(2)°(-) also increased (207%) and vascular reactivity was modified with altered endothelial function as assessed by acetylcholine-dependent vasorelaxation. The two wines partially prevented these alterations, reducing O(2)°(-) production and improving vascular reactivity without altering endothelial function. There was no difference between the P and M groups, although the procyanidin composition of the two dealcoholized fractions differed significantly, and only dimer concentrations were similar. CONCLUSION: These findings indicate that polyphenols are responsible, at least in part, for the antiatherogenic/antioxidant effects of wines.


Assuntos
Aterosclerose/prevenção & controle , Diospyros/química , Hiperlipidemias/prevenção & controle , Polifenóis/administração & dosagem , Vitis/química , Vinho/análise , Animais , Aterosclerose/etiologia , Cricetinae , Dieta Aterogênica/efeitos adversos , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/fisiopatologia , Frutas/química , Hiperlipidemias/etiologia , Masculino , Mesocricetus , Estresse Oxidativo/efeitos dos fármacos
8.
Proc Natl Acad Sci U S A ; 108(32): 13258-63, 2011 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-21788490

RESUMO

Myocardial ischemic disease is the major cause of death worldwide. After myocardial infarction, reperfusion of infracted heart has been an important objective of strategies to improve outcomes. However, cardiac ischemia/reperfusion (I/R) is characterized by inflammation, arrhythmias, cardiomyocyte damage, and, at the cellular level, disturbance in Ca(2+) and redox homeostasis. In this study, we sought to determine how acute inflammatory response contributes to reperfusion injury and Ca(2+) homeostasis disturbance after acute ischemia. Using a rat model of I/R, we show that circulating levels of TNF-α and cardiac caspase-8 activity were increased within 6 h of reperfusion, leading to myocardial nitric oxide and mitochondrial ROS production. At 1 and 15 d after reperfusion, caspase-8 activation resulted in S-nitrosylation of the RyR2 and depletion of calstabin2 from the RyR2 complex, resulting in diastolic sarcoplasmic reticulum (SR) Ca(2+) leak. Pharmacological inhibition of caspase-8 before reperfusion with Q-LETD-OPh or prevention of calstabin2 depletion from the RyR2 complex with the Ca(2+) channel stabilizer S107 ("rycal") inhibited the SR Ca(2+) leak, reduced ventricular arrhythmias, infarct size, and left ventricular remodeling after 15 d of reperfusion. TNF-α-induced caspase-8 activation leads to leaky RyR2 channels that contribute to myocardial remodeling after I/R. Thus, early prevention of SR Ca(2+) leak trough normalization of RyR2 function is cardioprotective.


Assuntos
Caspase 8/metabolismo , Ventrículos do Coração/patologia , Traumatismo por Reperfusão Miocárdica/enzimologia , Traumatismo por Reperfusão Miocárdica/patologia , Canal de Liberação de Cálcio do Receptor de Rianodina/metabolismo , Animais , Ativação Enzimática , Fluorescência , Traumatismo por Reperfusão Miocárdica/sangue , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Miocárdio/metabolismo , Miocárdio/patologia , Fenantridinas/metabolismo , Ratos , Ratos Endogâmicos WKY , Fator de Necrose Tumoral alfa/sangue , Remodelação Ventricular
9.
Cardiovasc Res ; 91(3): 412-9, 2011 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-21467075

RESUMO

AIMS: SR33805, a potent Ca(2+) channel blocker, increases cardiac myofilament Ca(2+) sensitivity in healthy rat cardiomyocytes. Therefore, the aim of the present study was to evaluate the effects of SR33805 on contractile properties in ischaemic failing hearts after myocardial infarction (MI) in vivo and in vitro at the cellular level. METHODS AND RESULTS: The effect of SR33805 (10 µM) was tested on the excitation-contraction coupling of cardiomyocytes isolated from rat with end-stage heart failure. Cell shortening and Ca(2+) transients were measured in intact cardiomyocytes, while contractile properties were determined in Triton X-100 permeabilized myocytes. Acute treatment with SR33805 restored the MI-altered cell shortening without affecting the Ca(2+) transient amplitude, suggesting an increase of myofilament Ca(2+) sensitivity in MI myocytes. Indeed, a SR33805-induced sensitization of myofilament activation was found to be associated with a slight increase in myosin light chain-2 phosphorylation and a more significant decrease on troponin I (TnI) phosphorylation. Decreased TnI phosphorylation was related to inhibition of protein kinase A activity by SR33805. Finally, administration of a single intra-peritoneal bolus of SR33805 (20 mg/kg) improved end-systolic strain and fractional shortening of MI hearts. CONCLUSION: The present study indicates that treatment with SR33805 improved contractility of ischaemic failing hearts after MI in the rat by selectively modulating the phosphorylation status of sarcomeric regulatory proteins, which then sensitized the myofilaments to Ca(2+). Our results gave a proof of concept that manipulation of the Ca(2+) sensitivity of sarcomeric regulatory proteins can be used to improve contractility of a failing heart.


Assuntos
Cardiotônicos/farmacologia , Insuficiência Cardíaca/tratamento farmacológico , Indóis/farmacologia , Contração Miocárdica/efeitos dos fármacos , Miócitos Cardíacos/efeitos dos fármacos , Sulfonas/farmacologia , Animais , Bloqueadores dos Canais de Cálcio/farmacologia , Sinalização do Cálcio/efeitos dos fármacos , Miosinas Cardíacas/metabolismo , Cardiotônicos/administração & dosagem , Proteínas Quinases Dependentes de AMP Cíclico/antagonistas & inibidores , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Modelos Animais de Doenças , Acoplamento Excitação-Contração/efeitos dos fármacos , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/fisiopatologia , Indóis/administração & dosagem , Injeções Intraperitoneais , Masculino , Miócitos Cardíacos/metabolismo , Miofibrilas/efeitos dos fármacos , Miofibrilas/metabolismo , Cadeias Leves de Miosina/metabolismo , Fosforilação , Inibidores de Proteínas Quinases/farmacologia , Ratos , Ratos Wistar , Recuperação de Função Fisiológica , Sulfonas/administração & dosagem , Fatores de Tempo , Troponina I/metabolismo , Ultrassonografia
10.
Proc Natl Acad Sci U S A ; 104(22): 9393-8, 2007 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-17517665

RESUMO

Immunotherapy by using multimerized self-peptides has demonstrated a clear protective effect on experimental models of autoimmune diseases. However, the mechanisms involved remain ill-defined. Here we have evaluated the therapeutic efficacy of multimerized self-peptides at the effector phase of autoimmune diabetes and examined their mechanisms of action. Diabetes was induced in rat insulin promoter-hemagglutinin (HA) mice expressing HA in pancreatic beta-cells by adoptive transfer of HA(110-119)-specific T helper 1 cells. Complete protection was provided by low doses of the HA 4-mer consisting of four covalently linked linear HA(107-119) peptides. In vivo, the 4-mer appeared to act directly on the pathogenic HA-specific T helper 1 cells and indirectly by activation/recruitment of lymphocytes with regulatory properties so that mice became resistant to a second transfer of diabetogenic T cells. This effect was associated with a recruitment of Foxp3(+) CD4 T cells around islets. Moreover, we show that dominant protection from autoimmunity was transferable by spleen cells, and that development of this regulatory population was crucially dependent on the lymphocytes from treated rat insulin promoter-HA mice. Thus, immunotherapy using multimerized epitopes emerges as a promising strategy in view of the current identification of self-epitopes that are major targets of the pathogenic CD4 T cell response in autoimmune diseases.


Assuntos
Diabetes Mellitus Tipo 1/imunologia , Epitopos de Linfócito T/química , Epitopos de Linfócito T/imunologia , Tolerância Imunológica/imunologia , Animais , Linhagem Celular , Diabetes Mellitus Tipo 1/patologia , Modelos Animais de Doenças , Hemaglutininas/farmacologia , Camundongos , Camundongos Transgênicos , Fragmentos de Peptídeos/farmacologia , Sensibilidade e Especificidade , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia , Linfócitos T/patologia
11.
Biochem Biophys Res Commun ; 324(2): 909-15, 2004 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-15474514

RESUMO

VEGFR-3 is essential for vascular development and maintenance of lymphatic vessel's integrity. Little is known about its cooperative effect with other receptors of the same family. Contrary to VEGFR-2, stimulation of VEGFR-3 by VEGF-C and -D failed to enhance its phosphorylation either in HEK293T or in PAE cells. These ligands were unable to induce angiogenesis of PAEC expressing VEGFR-3 alone. In the presence of VEGFR-2, VEGF-C and -D induced heterodimerization of VEGFR-3 with VEGFR-2. This heterodimerization was associated with enhanced VEGFR-3 phosphorylation and subsequent cellular responses as evidenced by the formation of capillary-like structures in PAE cells and proliferation of primary human endothelial cells expressing both receptors. Taken together, these results show for the first time that VEGFR-3 needs to be associated to VEGFR-2 to induce ligand-dependent cellular responses.


Assuntos
Receptor 2 de Fatores de Crescimento do Endotélio Vascular/química , Receptor 3 de Fatores de Crescimento do Endotélio Vascular/química , Western Blotting , Carbazóis/farmacologia , Linhagem Celular , Proliferação de Células , Células Cultivadas , Dimerização , Células Endoteliais/citologia , Endotélio Vascular/citologia , Humanos , Imunoprecipitação , Ligantes , Neovascularização Patológica , Peptídeos/química , Fosforilação , Ligação Proteica , Proteínas Tirosina Quinases/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Tempo , Transfecção , Fator C de Crescimento do Endotélio Vascular/química , Fator D de Crescimento do Endotélio Vascular/química
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