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1.
Sci Rep ; 7(1): 6465, 2017 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-28743999

RESUMO

Thioredoxin reductase (TrxR) as a selenium (Se)-containing antioxidase plays key role in regulating intracellular redox status. Selenocystine (SeC) a natural available Se-containing amino acid showed novel anticancer potential through triggering oxidative damage-mediated apoptosis. However, whether TrxR-mediated oxidative damage was involved in SeC-induced apoptosis in human glioma cells has not been elucidated yet. Herein, SeC-induced human glioma cell apoptosis was detected in vitro, accompanied by PARP cleavage, caspases activation and DNA fragmentation. Mechanically, SeC caused mitochondrial dysfunction and imbalance of Bcl-2 family expression. SeC treatment also triggered ROS-mediated DNA damage and disturbed the MAPKs and AKT pathways. However, inhibition of ROS overproduction effectively attenuated SeC-induced oxidative damage and apoptosis, and normalized the expression of MAPKs and AKT pathways, indicating the significance of ROS in SeC-induced apoptosis. Importantly, U251 human glioma xenograft growth in nude mice was significantly inhibited in vivo. Further investigation revealed that SeC-induced oxidative damage was achieved by TrxR1-targeted inhibition in vitro and in vivo. Our findings validated the potential of SeC to inhibit human glioma growth by oxidative damage-mediated apoptosis through triggering TrxR1-targeted inhibition.


Assuntos
Antineoplásicos/farmacologia , Neoplasias Encefálicas/tratamento farmacológico , Glioma/tratamento farmacológico , Selenocisteína/farmacologia , Tiorredoxina Redutase 1/metabolismo , Animais , Apoptose/efeitos dos fármacos , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patologia , Linhagem Celular Tumoral , Dano ao DNA/efeitos dos fármacos , Glioma/metabolismo , Glioma/patologia , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Camundongos Endogâmicos BALB C , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/patologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Tiorredoxina Redutase 1/antagonistas & inibidores , Ensaios Antitumorais Modelo de Xenoenxerto
2.
Cell Mol Neurobiol ; 37(5): 919-929, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27678140

RESUMO

The CD4+CD25+ regulatory T cells (Tregs), an innate immunomodulator, suppress cerebral inflammation and maintain immune homeostasis in multiple central nervous system injury, but its role in intracerebral hemorrhage (ICH) has not been fully characterized. This study investigated the effect of Tregs on brain injury using the mouse ICH model, which is established by autologous blood infusion. The results showed that tail intravenous injection of Tregs significantly reduced brain water content and Evans blue dye extravasation of perihematoma at day (1, 3 and 7), and improved short- and long-term neurological deficits following ICH in mouse model. Tregs treatment reduced the content of pro-inflammatory cytokines interleukin (IL)-1ß, IL-6, tumor necrosis factor-α, and malondialdehyde, while increasing the superoxide dismutase (SOD) enzymatic activity at day (1, 3 and 7) following ICH. Furthermore, Tregs treatment obviously reduced the number of NF-κB+, IL-6+, TUNEL+ and active caspase-3+ cells at day 3 after ICH. These results indicate that adoptive transfer of Tregs may provide neuroprotection following ICH in mouse models.


Assuntos
Transferência Adotiva , Hemorragia Cerebral/imunologia , Hemorragia Cerebral/terapia , Hematoma/imunologia , Hematoma/terapia , Inflamação/patologia , Linfócitos T Reguladores/imunologia , Animais , Apoptose , Barreira Hematoencefálica/patologia , Hemorragia Cerebral/patologia , Citocinas/metabolismo , Modelos Animais de Doenças , Hematoma/complicações , Hematoma/patologia , Masculino , Malondialdeído/metabolismo , Camundongos Endogâmicos C57BL , Superóxido Dismutase/metabolismo , Fator de Transcrição RelA/metabolismo
3.
Mol Neurobiol ; 53(1): 320-330, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25432887

RESUMO

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor with strong neuroprotective properties. However, it has limited capacity to cross the blood-brain barrier and thus potentially limiting its protective capacity. Recent studies demonstrated that intranasal drug administration is a promising way in delivering neuroprotective agents to the central nervous system. The current study therefore aimed at determining whether intranasal administration of G-CSF increases its delivery to the brain and its neuroprotective effect against ischemic brain injury. Transient focal cerebral ischemia in rat was induced with middle cerebral artery occlusion. Our resulted showed that intranasal administration is 8-12 times more effective than subcutaneous injection in delivering G-CSF to cerebrospinal fluid and brain parenchyma. Intranasal delivery enhanced the protective effects of G-CSF against ischemic injury in rats, indicated by decreased infarct volume and increased recovery of neurological function. The neuroprotective mechanisms of G-CSF involved enhanced upregulation of HO-1 and reduced calcium overload following ischemia. Intranasal G-CSF application also promoted angiogenesis and neurogenesis following brain ischemia. Taken together, G-CSF is a legitimate neuroprotective agent and intranasal administration of G-CSF is more effective in delivery and neuroprotection and could be a practical approach in clinic.


Assuntos
Isquemia Encefálica/tratamento farmacológico , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Fármacos Neuroprotetores/administração & dosagem , Fármacos Neuroprotetores/uso terapêutico , Administração Intranasal , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Encéfalo/patologia , Infarto Encefálico/complicações , Infarto Encefálico/tratamento farmacológico , Infarto Encefálico/fisiopatologia , Isquemia Encefálica/complicações , Isquemia Encefálica/fisiopatologia , Cálcio/metabolismo , Citoesqueleto/metabolismo , Fator Estimulador de Colônias de Granulócitos/sangue , Fator Estimulador de Colônias de Granulócitos/líquido cefalorraquidiano , Heme Oxigenase-1/metabolismo , Infarto da Artéria Cerebral Média/complicações , Infarto da Artéria Cerebral Média/tratamento farmacológico , Infarto da Artéria Cerebral Média/fisiopatologia , Espaço Intracelular/metabolismo , Masculino , Neovascularização Fisiológica/efeitos dos fármacos , Neurogênese/efeitos dos fármacos , Fármacos Neuroprotetores/farmacologia , Ratos Sprague-Dawley , Tubulina (Proteína)/metabolismo , Regulação para Cima/efeitos dos fármacos
4.
Mol Neurobiol ; 53(1): 369-378, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25432891

RESUMO

Oxidative damage plays a key role in causation and progression of neurodegenerative diseases. Inhibition of oxidative stress represents one of the most effective ways in treating human neurologic diseases. Herein, we evaluated the protective effect of curcumin on PC12 cells against H2O2-induced neurotoxicity and investigated its underlying mechanism. The results indicated that curcumin pre-treatment significantly suppressed H2O2-induced cytotoxicity, inhibited the loss of mitochondrial membrane potential (Δψm) through regulation of Bcl-2 family expression, and ultimately reversed H2O2-induced apoptotic cell death in PC12 cells. Attenuation of caspase activation, poly(ADP-ribose) polymerase (PARP) cleavage, DNA damage, and accumulation of reactive oxygen species (ROS) all confirmed its protective effects. Moreover, curcumin markedly alleviated the dysregulation of the MAPK and AKT pathways induced by H2O2. Taken together, our findings suggest that the strategy of using curcumin could be a highly effective way in combating oxidative damage-mediated human neurodegenerative diseases.


Assuntos
Curcumina/farmacologia , Dano ao DNA , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Neurotoxinas/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Animais , Apoptose/efeitos dos fármacos , Peróxido de Hidrogênio/toxicidade , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Modelos Biológicos , Fármacos Neuroprotetores/farmacologia , Células PC12 , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ratos
5.
Mol Neurobiol ; 53(7): 4363-74, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26232068

RESUMO

Hyperglycemia as the major hallmark of diabetic neuropathy severely limited its therapeutic efficiency. Evidences have revealed that selenium (Se) as an essential trace element could effectively reduce the risk of neurological diseases. In the present study, 3,3'-diselenodipropionic acid (DSePA), a derivative of selenocystine, was employed to investigate its protective effect against high glucose-induced neurotoxicity in PC12 cells and evaluate the underlying mechanism. The results suggested that high glucose showed significant cytotoxicity through launching mitochondria-mediated apoptosis in PC12 cells, accompanied by poly (ADP-ribose) polymerase (PARP) cleavage, caspase activation, and mitochondrial dysfunction. Moreover, high glucose also triggered DNA damage and dysregulation of MAPKs and AKT pathways through reactive oxygen species (ROS) overproduction. p53 RNA interference partially suppressed high glucose-induced cytotoxicity and apoptosis, indicating the role of p53 in high glucose-induced signal. However, DSePA pretreatment effectively attenuated high glucose-induced cytotoxicity, inhibited the mitochondrial dysfunction through regulation of Bcl-2 family, and ultimately reversed high glucose-induced apoptotic cell death in PC12 cells. Attenuation of caspase activation, PARP cleavage, DNA damage, and ROS accumulation all confirmed its protective effects. Moreover, DSePA markedly alleviated the dysregulation of AKT and MAPKs pathways induced by high glucose. Our findings revealed that the strategy of using DSePA to antagonize high glucose-induced neurotoxicity may be a highly effective strategy in combating high glucose-mediated neurological diseases.


Assuntos
Dano ao DNA , Glucose/toxicidade , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Neurotoxinas/toxicidade , Propionatos/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Compostos de Selênio/farmacologia , Proteína Supressora de Tumor p53/metabolismo , Animais , Apoptose/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Modelos Biológicos , Células PC12 , Fosforilação/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ratos , Espécies Reativas de Oxigênio/metabolismo
6.
Cell Mol Neurobiol ; 36(5): 647-55, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26224360

RESUMO

Hypothermia treatment is one of the neuroprotective strategies that improve neurological outcomes effectively after brain damage. Minimally invasive surgery (MIS) has been an important treatment of intracerebral hemorrhage (ICH). Herein, we evaluated the neuroprotective effect and mechanism of MIS joint local cooling lavage (LCL) treatment on ICH via detecting the inflammatory responses, oxidative injury, and neuronal apoptosis around the hematoma cavity in rats. ICH model was established by type IV collagenase caudatum infusion. The rats were treated with MIS 6 h after injection, and then were lavaged by normothermic (37 °C) and hypothermic (33 °C) normal saline in brain separately. The results indicated that MIS joint LCL treatment showed enhanced therapeutic effects against ICH-induced inflammation injury and apoptosis in rats, as convinced by the decline of TUNEL-positive cells, followed by the decrease of IL-1ß and LDH and increase of IL-10 and SOD. This study demonstrated that the strategy of using MIS joint LCL may achieve enhanced neuroprotection against ICH-induced inflammation injury and apoptosis in rats with potential clinic application.


Assuntos
Apoptose/efeitos dos fármacos , Edema Encefálico/cirurgia , Hemorragia Cerebral/complicações , Procedimentos Cirúrgicos Minimamente Invasivos , Animais , Lesões Encefálicas/cirurgia , Hemorragia Cerebral/terapia , Inflamação/cirurgia , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Neurônios/metabolismo , Ratos Sprague-Dawley , Recuperação de Função Fisiológica/fisiologia , Irrigação Terapêutica/métodos
7.
Cell Mol Neurobiol ; 35(7): 995-1001, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25895624

RESUMO

Cisplatin-based chemotherapy in clinic is severely limited by its adverse effect, including neurotoxicity. Oxidative damage contributes to cisplatin-induced neurotoxicity, but the mechanism remains unclearly. Cyanidin, a natural flavonoid compound, exhibits powerful antioxidant activity. Hence, we investigated the protective effects of cyanidin on PC12 cells against cisplatin-induced neurotoxicity and explored the underlying mechanisms. The results showed that cisplatin-induced cytotoxicity was completely reversed by cyanidin through inhibition of PC12 cell apoptosis, as proved by the attenuation of Sub-G1 peak, PARP cleavage, and caspases-3 activation. Mechanistically, cyanidin significantly inhibited reactive oxygen species (ROS)-induced DNA damage in cisplatin-treated PC12 cells. Our findings revealed that cyanidin as an apoptotic inhibitor effectively blocked cisplatin-induced neurotoxicity through inhibition of ROS-mediated DNA damage and apoptosis, predicating its therapeutic potential in prevention of chemotherapy-induced neurotoxicity. Cisplatin caused DNA damage, activated p53, and subsequently induced PC12 cells apoptosis by triggering ROS overproduction. However, cyanidin administration effectively inhibited DNA damage, attenuated p53 phosphorylation, and eventually reversed cisplatin-induced PC12 cell apoptosis through inhibition ROS accumulation.


Assuntos
Antocianinas/farmacologia , Apoptose/efeitos dos fármacos , Apoptose/fisiologia , Cisplatino/toxicidade , Espécies Reativas de Oxigênio/antagonistas & inibidores , Espécies Reativas de Oxigênio/metabolismo , Animais , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/fisiologia , Relação Dose-Resposta a Droga , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Células PC12 , Ratos
8.
Neurochem Res ; 40(6): 1121-32, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25846008

RESUMO

Activation of metabotropic glutamate receptor 5 (mGluR5) provided neuroprotection in multiple central nervous system injury, but the roles of mGluR5 in subarachnoid hemorrhage (SAH) remain unclear. In present study, we aimed to evaluate whether activation of mGluR5 attenuates early brain injury (EBI) after experimental SAH in rats. We found that selective mGluR5 orthosteric agonist CHPG or positive allosteric modulator VU0360172 administration significantly improves neurological function and attenuates brain edema at 24 h after SAH. Furthermore, mGluR5 obviously expresses in activated microglia (ED-1 positive) after SAH. CHPG or VU0360172 administration significantly reduces the numbers of activated microglia and the protein and mRNA levels of pro-inflammatory cytokines IL-1ß, IL-6 and TNF-α at 24 h after SAH. Moreover, CHPG or VU0360172 administration obviously reduces the number of TUNEL-positive cells and active caspase-3/NeuN-positive neurons in cortex at 24 h after SAH. CHPG or VU0360172 administration significantly up-regulates the expression of Bcl-2, and down-regulates the expression of Bax and active caspase-3, which in turn increases the ratio of Bcl-2/Bax. Our results indicate that activation of mGluR5 attenuates microglial activation and neuronal apoptosis, and improves neurological function in EBI after SAH.


Assuntos
Apoptose/efeitos dos fármacos , Microglia/patologia , Neurônios/patologia , Receptor de Glutamato Metabotrópico 5/metabolismo , Hemorragia Subaracnóidea/patologia , Animais , Comportamento Animal/efeitos dos fármacos , Edema Encefálico/prevenção & controle , Caspase 3/biossíntese , Caspase 3/genética , Córtex Cerebral/patologia , Ciclina D1/biossíntese , Ciclina D1/genética , Citocinas/antagonistas & inibidores , Citocinas/biossíntese , Agonistas de Aminoácidos Excitatórios/uso terapêutico , Glicina/análogos & derivados , Glicina/uso terapêutico , Ativação de Macrófagos/efeitos dos fármacos , Masculino , Fenilacetatos/uso terapêutico , Ratos , Ratos Sprague-Dawley , Hemorragia Subaracnóidea/mortalidade , Hemorragia Subaracnóidea/psicologia , Proteína X Associada a bcl-2/biossíntese , Proteína X Associada a bcl-2/genética
9.
J Huazhong Univ Sci Technolog Med Sci ; 35(1): 64-70, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25673195

RESUMO

Systemic lupus erythematosus (SLE) and clear cell renal cell carcinoma (CC-RCC) are serious disorders and usually fatal, and always accompanied with pathological changes in the kidney. Signal-induced proliferation-associated protein 1 (SIPA-1) is a Rap1GTPase activating protein (Rap1GAP) expressed in the normal distal and collecting tubules of the murine kidney. Lupus-like autoimmune disease and leukemia have been observed in SIPA-1 deficient mice, suggesting a pathological relevance of SIPA-1 to SLE and carcinoma in human being. The expression pattern of SIPA-1 is as yet undefined and the pathogenesis of these diseases in humans remains elusive. In this study, we used both immunohistochemistry and quantum dot (QD)-based immunofluorescence staining to investigate the expression of SIPA-1 in renal specimens from SLE and CC-RCC patients. MTT assay and Western blotting were employed to evaluate the effects of SIPA-1 overexpression on the proliferation and apoptosis of renal cell lines. Semi-quantitative reverse transcriptase-PCR (RT-PCR) was applied to examine the changes of hypoxia-inducible factor-1α (HIF-1α) mRNA level. Results showed that SIPA-1 was highly expressed in the proximal and collecting tubules of nephrons in SLE patients compared to normal ones, and similar results were obtained in the specimens of CC-RCC patients. Although SIPA-1 overexpression did not affect cellular proliferation and apoptosis of both human 786-O renal cell carcinoma cells and rat NRK-52E renal epithelial cell lines, RT-PCR results showed that HIF-1α mRNA level was down-regulated by SIPA-1 overexpression in 786-O cells. These findings suggest that SIPA-1 may play critical roles in the pathological changes in kidney, and might provide a new biomarker to aid in the diagnosis of SLE and CC-RCC.


Assuntos
Proteínas Ativadoras de GTPase/metabolismo , Túbulos Renais Proximais/metabolismo , Lúpus Eritematoso Sistêmico/metabolismo , Proteínas Nucleares/metabolismo , Apoptose , Sequência de Bases , Linhagem Celular , Proliferação de Células , Primers do DNA , Humanos , Túbulos Renais Proximais/patologia , Lúpus Eritematoso Sistêmico/patologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
10.
Cell Mol Neurobiol ; 35(2): 147-57, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25179154

RESUMO

Carnosine (ß-alanyl-L-histidine) has been demonstrated to provide antioxidative and anti-apoptotic roles in the animal of ischemic brain injuries and neurodegenerative diseases. The aim of this study was to examine whether carnosine prevents subarachnoid hemorrhage (SAH)-induced early brain injury (EBI) in rats. We found that intraperitoneal administration of carnosine improved neurobehavioral deficits, attenuated brain edema and blood-brain barrier permeability, and decreased reactive oxygen species level at 48 h following SAH in rat models. Carnosine treatment increased tissue copper/zinc superoxide dismutase (CuZn-SOD) and glutathione peroxidase (GSH-Px) enzymatic activities, and reduced post-SAH elevated lactate dehydrogenase (LDH) activity, the concentration of malondialdehyde (MDA), 3-nitrotyrosine (3-NT), 8-hydroxydeoxyguanosine (8-OHDG), interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α (TNF-α) in rats. Furthermore, carnosine treatment attenuated SAH-induced microglia activation and cortical neuron apoptosis. These results indicated that administration of carnosine may provide neuroprotection in EBI following SAH in rat models.


Assuntos
Antioxidantes/uso terapêutico , Apoptose , Lesões Encefálicas/tratamento farmacológico , Carnosina/uso terapêutico , Hemorragia Subaracnóidea/tratamento farmacológico , Animais , Antígenos Nucleares/metabolismo , Antioxidantes/farmacologia , Apoptose/efeitos dos fármacos , Comportamento Animal , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/patologia , Edema Encefálico/complicações , Edema Encefálico/tratamento farmacológico , Edema Encefálico/patologia , Lesões Encefálicas/complicações , Lesões Encefálicas/patologia , Carnosina/farmacologia , Caspase 3/metabolismo , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/patologia , Citocinas/metabolismo , DNA/metabolismo , Modelos Animais de Doenças , Imunofluorescência , Glutationa Peroxidase/metabolismo , Marcação In Situ das Extremidades Cortadas , Lipídeos/química , Masculino , Microglia/efeitos dos fármacos , Microglia/patologia , Proteínas do Tecido Nervoso/metabolismo , Oxirredução/efeitos dos fármacos , Permeabilidade/efeitos dos fármacos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/patologia , Superóxido Dismutase/metabolismo
11.
Cell Mol Neurobiol ; 35(4): 543-53, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25527033

RESUMO

Oxidative stress plays an important role in the pathogenesis of early brain injury (EBI) following subarachnoid hemorrhage (SAH). The aim of this study was to assess whether cysteamine prevents post-SAH oxidative stress injury via its antioxidative and anti-apoptotic effects. It was observed that intraperitoneal administration of cysteamine (20 mg/kg/day) could significantly alleviate EBI (including neurobehavioral deficits, brain edema, blood-brain barrier permeability, and cortical neuron apoptosis) after SAH in rats. Meanwhile, cysteamine treatment reduced post-SAH elevated the reactive oxygen species level, the concentration of malondialdehyde, 3-nitrotyrosine, and 8-hydroxydeoxyguanosine and increased the glutathione peroxidase enzymatic activity, the concentration of glutathione and brain-derived neurotrophic factor in brain cortex at 48 h after SAH. These results indicated that administration of cysteamine may ameliorate EBI and provide neuroprotection after SAH in rat models.


Assuntos
Apoptose , Lesões Encefálicas/tratamento farmacológico , Lesões Encefálicas/patologia , Cisteamina/uso terapêutico , Estresse Oxidativo , Hemorragia Subaracnóidea/tratamento farmacológico , Hemorragia Subaracnóidea/patologia , Animais , Apoptose/efeitos dos fármacos , Comportamento Animal , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/patologia , Edema Encefálico/complicações , Edema Encefálico/tratamento farmacológico , Edema Encefálico/patologia , Lesões Encefálicas/complicações , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Caspase 3/metabolismo , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/patologia , Cisteamina/farmacologia , Modelos Animais de Doenças , Imunofluorescência , Marcação In Situ das Extremidades Cortadas , Masculino , Estresse Oxidativo/efeitos dos fármacos , Permeabilidade/efeitos dos fármacos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Hemorragia Subaracnóidea/complicações
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