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1.
Nutrition ; 121: 112370, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38401196

RESUMO

OBJECTIVE: The aim of this article is to investigate the effect of intermittent fasting, associated or not with coconut oil intake, on the gut-liver axis of obese rats. METHODS: A total of 50 rats were divided into five groups: control, obese, obese with intermittent fasting, obese with intermittent fasting plus coconut oil, and obese with caloric restriction. The rats were induced to obesity with a high-sugar diet for 17 wk. The respective interventions were carried out in the last 4 wk. RESULTS: The groups with intermittent fasting protocols had reduced total cholesterol (on average 54.31%), low-density lipoprotein (on average 53.39%), and triacylglycerols (on average 23.94%) versus the obese group; and the obese with intermittent fasting plus coconut oil group had the highest high-density lipoprotein compared with all groups. The obese with intermittent fasting plus coconut oil and obese with caloric restriction groups had lower metabolic load compared with the other groups. The obese group had high citric and succinic acid concentrations, which affected the hepatic tricarboxylic acid cycle, while all the interventions had reduced concentrations of these acids. No histologic changes were observed in the intestine or liver of the groups. CONCLUSION: Intermittent fasting, especially when associated with coconut oil, had effects comparable with caloric restriction in modulating the parameters of the gut-liver axis.


Assuntos
Cocos , Jejum Intermitente , Ratos , Animais , Óleo de Coco/metabolismo , Óleo de Coco/farmacologia , Dieta , Obesidade/metabolismo , Lipoproteínas HDL , Fígado/metabolismo , Óleos de Plantas/metabolismo
2.
Trends Mol Med ; 29(7): 489-511, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37263858

RESUMO

In recent years dietary interventions have become a promising tool in cancer treatment and have demonstrated a powerful ability to alter metabolism and tumor growth, development, and therapeutic response. However, because the mechanisms underlying dietary therapeutics are poorly understood, they are frequently ignored as a potential line of treatment for cancer. We discuss the proposed mechanisms behind the anticancer effects of various diets and their development for clinical use. This review aims to provide researchers and clinicians in the field of oncology with a complete overview of the contemporary landscape of nutritional interventions and precision nutrition as cancer therapeutics, and offers a perspective on the steps necessary to establish nutritional interventions as a standard line of treatment.


Assuntos
Restrição Calórica , Neoplasias , Humanos , Dieta , Neoplasias/terapia
3.
Therap Adv Gastroenterol ; 16: 17562848231171756, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37284561

RESUMO

Intermittent fasting (IF) may be a weight management strategy for patients with inflammatory bowel disease (IBD). The aim of this short narrative review is to summarize the evidence related to IF in the management of IBD. A literature search of English publications related to IF or time-restricted feeding and IBD, Crohn's disease, or ulcerative colitis was conducted in PubMed and Google Scholar. Four publications on studies of IF in IBD were found: three randomized controlled trials in animal models of colitis and one prospective observational study in patients with IBD. The results from animal studies suggest either moderate or no changes in weight but improvements in colitis with IF. These improvements may be mediated through changes in the gut microbiome, decreased oxidative stress and increased colonic short-chain fatty acids. The study in humans was small and uncontrolled, and it did not assess changes in weight, making it difficult to draw conclusions around the effects of IF on changes in weight or disease course. Given that preclinical evidence suggests intermittent fasting may play a beneficial role in IBD, randomized controlled trials in large patients with active disease are warranted to determine whether intermittent fasting could be an integrated therapy for patients with IBD management, either for weight or for disease management. These studies should also explore the potential mechanisms of action related to intermittent fasting.

4.
Int J Mol Sci ; 24(8)2023 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-37108739

RESUMO

Mental illness is alarmingly on the rise, and circadian disruptions linked to a modern lifestyle may largely explain this trend. Impaired circadian rhythms are associated with mental disorders. The evening chronotype, which is linked to circadian misalignment, is a risk factor for severe psychiatric symptoms and psychiatric metabolic comorbidities. Resynchronization of circadian rhythms commonly improves psychiatric symptoms. Furthermore, evidence indicates that preventing circadian misalignment may help reduce the risk of psychiatric disorders and the impact of neuro-immuno-metabolic disturbances in psychiatry. The gut microbiota exhibits diurnal rhythmicity, as largely governed by meal timing, which regulates the host's circadian rhythms. Temporal circadian regulation of feeding has emerged as a promising chronotherapeutic strategy to prevent and/or help with the treatment of mental illnesses, largely through the modulation of gut microbiota. Here, we provide an overview of the link between circadian disruption and mental illness. We summarize the connection between gut microbiota and circadian rhythms, supporting the idea that gut microbiota modulation may aid in preventing circadian misalignment and in the resynchronization of disrupted circadian rhythms. We describe diurnal microbiome rhythmicity and its related factors, highlighting the role of meal timing. Lastly, we emphasize the necessity and rationale for further research to develop effective and safe microbiome and dietary strategies based on chrononutrition to combat mental illness.


Assuntos
Microbioma Gastrointestinal , Saúde Mental , Humanos , Cronofarmacoterapia , Dieta , Ritmo Circadiano/fisiologia
5.
J Sci Food Agric ; 103(3): 1578-1587, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36207281

RESUMO

BACKGROUND: Time-restricted feeding (TRF) is an effective means that can efficiently regulate the metabolism and health of animals and humans. However, the effect of TRF on hypothalamic function remains unclear. RESULTS: Results showed that TRF significantly increased the activities of digestive enzymes lipase, maltase in the duodenum and lipase, trypsin in the pancreas whereas significantly decreased serum gastrointestinal hormones gastrin, glucagon-like peptide-1, cholecystokinin, peptide YY, and ghrelin. Metabolites related to amino acid metabolism, including citrulline, kynurenine, N-acetylleucine, l-tryptophan, and l-tyrosine, significantly increased in the TRF group. Differential metabolites were mainly enriched in phenylalanine, tyrosine, and tryptophan biosynthesis and tryptophan metabolism. Transcriptomic analysis of hypothalamus showed that a total of 462 differentially expressed genes (DEGs) were significantly changed by TRF. In particular, DEGs such as DDC, TH, GOT2, and DBH involved in aromatic amino acid metabolism pathways were significantly downregulated, whereas the expression of CYP1B1 was significantly upregulated. Moreover, DEGs (PDYN and PPP3CA) involved in amphetamine addiction and cocaine addiction were also downregulated in the TRF group. CONCLUSION: Taken together, these results suggested that TRF improved the digestion and absorption of nutrients and thus increased the accessibilities of aromatic amino acids. The increasing of circulating aromatic amino acids might mediate the regulatory neuroendocrine effects of TRF regimes on the hypothalamus functions, especially on drug addictions. This study reveals a possible mechanism underlying the effects of regulating feeding patterns on the function of the hypothalamus by altering aromatic amino acids metabolism. © 2022 Society of Chemical Industry.


Assuntos
Aminoácidos Aromáticos , Triptofano , Humanos , Animais , Suínos/genética , Aminoácidos Aromáticos/metabolismo , Triptofano/metabolismo , Transcriptoma , Hipotálamo/metabolismo , Comportamento Alimentar
6.
F1000Res ; 11: 1087, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36531263

RESUMO

Background: Meal timing resets circadian clocks in peripheral tissues, such as the liver, in seven days without affecting the phase of the central clock located in the suprachiasmatic nucleus (SCN) of the hypothalamus. Anterior hypothalamus plays an essential role in energy metabolism, circadian rhythm, and stress response. However, it remains to be elucidated whether and how anterior hypothalamus adapts its circadian rhythms to meal timing. Methods: Here, we applied transcriptomics to profile rhythmic transcripts in the anterior hypothalamus of nocturnal female mice subjected to day- (DRF) or night (NRF)-time restricted feeding for seven days. Results: This global profiling identified 128 and 3,518 rhythmic transcripts in DRF and NRF, respectively. NRF entrained diurnal rhythms among 990 biological processes, including 'Electron transport chain' and 'Hippo signaling' that reached peak time in the late sleep and late active phase, respectively. By contrast, DRF entrained only 20 rhythmic pathways, including 'Cellular amino acid catabolic process', all of which were restricted to the late active phase. The rhythmic transcripts found in both DRF and NRF tissues were largely resistant to phase entrainment by meal timing, which were matched to the action of the circadian clock. Remarkably, DRF for 36 days partially reversed the circadian clock compared to NRF. Conclusions: Collectively, our work generates a useful dataset to explore anterior hypothalamic circadian biology and sheds light on potential rhythmic processes influenced by meal timing in the brain (www.circametdb.org.cn).


Assuntos
Relógios Circadianos , Núcleo Supraquiasmático , Feminino , Animais , Camundongos , Núcleo Supraquiasmático/metabolismo , Relógios Circadianos/fisiologia , Ritmo Circadiano/fisiologia , Hipotálamo , Fígado
7.
Nutrients ; 14(23)2022 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-36501063

RESUMO

Obesity is a growing health problem for modern society; therefore, it has become extremely important to study not only its negative implications but also its developmental mechanism. Its links to disrupted circadian rhythmicity are indisputable but are still not well studied on the cellular level. Circadian food intake and metabolism are controlled by a set of brain structures referred to as the food-entrainable oscillator, among which the dorsomedial hypothalamus (DMH) seems to be especially heavily affected by diet-induced obesity. In this study, we evaluated the effects of a short-term high-fat diet (HFD) on the physiology of the male rat DMH, with special attention to its day/night changes. Using immunofluorescence and electrophysiology we found that both cFos immunoreactivity and electrical activity rhythms become disrupted after as few as 4 weeks of HFD consumption, so before the onset of excessive weight gain. This indicates that the DMH impairment is a possible factor in obesity development. The DMH cellular activity under an HFD became increased during the non-active daytime, which coincides with a disrupted rhythm in food intake. In order to explore the relationship between them, a separate group of rats underwent time-restricted feeding with access to food only during the nighttime. Such an approach completely abolished the disruptive effects of the HFD on the DMH clock, confirming its dependence on the feeding schedule of the animal. The presented data highlight the importance of a temporally regulated feeding pattern on the physiology of the hypothalamic center for food intake and metabolism regulation, and propose time-restricted feeding as a possible prevention of the circadian dysregulation observed under an HFD.


Assuntos
Dieta Hiperlipídica , Hipotálamo , Ratos , Animais , Masculino , Dieta Hiperlipídica/efeitos adversos , Ritmo Circadiano/fisiologia , Comportamento Alimentar/fisiologia , Obesidade/etiologia , Obesidade/prevenção & controle
8.
Front Endocrinol (Lausanne) ; 13: 975509, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36176473

RESUMO

Circadian rhythm, an innate 24-h biological clock, regulates several mammalian physiological activities anticipating daily environmental variations and optimizing available energetic resources. The circadian machinery is a complex neuronal and endocrinological network primarily organized into a central clock, suprachiasmatic nucleus (SCN), and peripheral clocks. Several small molecules generate daily circadian fluctuations ensuring inter-organ communication and coordination between external stimuli, i.e., light, food, and exercise, and body metabolism. As an orchestra, this complex network can be out of tone. Circadian disruption is often associated with obesity development and, above all, with diabetes and cardiovascular disease onset. Moreover, accumulating data highlight a bidirectional relationship between circadian misalignment and cardiometabolic disease severity. Food intake abnormalities, especially timing and composition of meal, are crucial cause of circadian disruption, but evidence from preclinical and clinical studies has shown that food could represent a unique therapeutic approach to promote circadian resynchronization. In this review, we briefly summarize the structure of circadian system and discuss the role playing by different molecules [from leptin to ghrelin, incretins, fibroblast growth factor 21 (FGF-21), growth differentiation factor 15 (GDF15)] to guarantee circadian homeostasis. Based on the recent data, we discuss the innovative nutritional interventions aimed at circadian re-synchronization and, consequently, improvement of cardiometabolic health.


Assuntos
Doenças Cardiovasculares , Grelina , Animais , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , Ritmo Circadiano/fisiologia , Fator 15 de Diferenciação de Crescimento , Humanos , Incretinas , Leptina
9.
Acta Pharm Sin B ; 12(2): 511-531, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35256932

RESUMO

Aging is by far the most prominent risk factor for Alzheimer's disease (AD), and both aging and AD are associated with apparent metabolic alterations. As developing effective therapeutic interventions to treat AD is clearly in urgent need, the impact of modulating whole-body and intracellular metabolism in preclinical models and in human patients, on disease pathogenesis, have been explored. There is also an increasing awareness of differential risk and potential targeting strategies related to biological sex, microbiome, and circadian regulation. As a major part of intracellular metabolism, mitochondrial bioenergetics, mitochondrial quality-control mechanisms, and mitochondria-linked inflammatory responses have been considered for AD therapeutic interventions. This review summarizes and highlights these efforts.

10.
Eat Weight Disord ; 27(4): 1415-1425, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34370270

RESUMO

PURPOSE: Time-restricted feeding (TRF) reverses obesity and insulin resistance, yet the central mechanisms underlying its beneficial effects are not fully understood. Recent studies suggest a critical role of hypothalamic galanin and its receptors in the regulation of energy balance. It is yet unclear whether TRF could regulate the expression of galanin and its receptors in the hypothalamus of mice fed a high-fat diet. METHODS: To test this effect, we subjected mice to either ad lib or TRF of a high-fat diet for 8 h per day. After 4 weeks, galanin and many neuropeptides associated with the function of metabolism were examined. RESULTS: The present findings showed that mice under TRF consume equivalent calories from a high-fat diet as those with ad lib access, yet are protected against obesity and have improved glucose metabolism. Plasma galanin, orexin A, irisin and adropin levels were significantly reversed by TRF regimen. Besides, TRF regimen reversed the progression of metabolic disorders in mice by increasing GLUT4 and PGC-1α expression in skeletal muscles. Moreover, the levels of galanin and GALR1 expression were severely diminished in the hypothalamus of the TRF mice, whereas GALR2 was highly expressed. CONCLUSIONS: TRF diminished galanin and GALR1 expression, and increased GALR2 expression in the hypothalamus of mice fed a high-fat diet. The current studies provide additional evidence that TRF is effective in improving HFD-induced hyperglycemia and insulin resistance in mice, and this effect could be associated with TRF-induced changes of the galanin systems in the hypothalamus. LEVEL OF EVIDENCE: No level of evidence, animal studies.


Assuntos
Galanina/metabolismo , Resistência à Insulina , Doenças Metabólicas , Receptor Tipo 1 de Galanina/metabolismo , Animais , Galanina/farmacologia , Humanos , Hipotálamo/metabolismo , Doenças Metabólicas/metabolismo , Doenças Metabólicas/prevenção & controle , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/metabolismo
11.
Nutrients ; 13(11)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34836101

RESUMO

We used time-restricted feeding (TRF) to investigate whether microbial metabolites and the hunger hormone ghrelin can become the dominant entraining factor during chronic jetlag to prevent disruption of the master and peripheral clocks, in order to promote health. Therefore, hypothalamic clock gene and Agrp/Npy mRNA expression were measured in mice that were either chronically jetlagged and fed ad libitum, jetlagged and fed a TRF diet, or not jetlagged and fed a TRF diet. Fecal short-chain fatty acid (SCFA) concentrations, plasma ghrelin and corticosterone levels, and colonic clock gene mRNA expression were measured. Preventing the disruption of the food intake pattern during chronic jetlag using TRF restored the rhythmicity in hypothalamic clock gene mRNA expression of Reverbα but not of Arntl. TRF countered the changes in plasma ghrelin levels and in hypothalamic Npy mRNA expression induced by chronic jetlag, thereby reestablishing the food intake pattern. Increase in body mass induced by chronic jetlag was prevented. Alterations in diurnal fluctuations in fecal SCFAs during chronic jetlag were prevented thereby re-entraining the rhythmic expression of peripheral clock genes. In conclusion, TRF during chronodisruption re-entrains the rhythms in clock gene expression and signals from the gut that regulate food intake to normalize body homeostasis.


Assuntos
Proteínas CLOCK/metabolismo , Relógios Circadianos/genética , Ritmo Circadiano/genética , Jejum/metabolismo , Síndrome do Jet Lag/prevenção & controle , Animais , Doença Crônica , Colo/metabolismo , Corticosterona/sangue , Modelos Animais de Doenças , Ácidos Graxos Voláteis/metabolismo , Fezes/química , Comportamento Alimentar/fisiologia , Expressão Gênica/fisiologia , Grelina/sangue , Hipotálamo/metabolismo , Síndrome do Jet Lag/genética , Camundongos , RNA Mensageiro/metabolismo
12.
Nutrients ; 13(6)2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34201382

RESUMO

Current treatment recommendations for non-alcoholic fatty liver disease (NAFLD) rely heavily on lifestyle interventions. The Mediterranean diet and physical activity, aiming at weight loss, have shown good results in achieving an improvement of this liver disease. However, concerns related to compliance and food accessibility limit the feasibility of this approach, and data on the long-term effects on liver-related outcomes are lacking. Insulin resistance is a central aspect in the pathophysiology of NAFLD; therefore, interventions aiming at the improvement of insulin sensitivity may be preferable. In this literature review, we provide a comprehensive summary of the available evidence on nutritional approaches in the management of NAFLD, involving low-calorie diets, isocaloric diets, and the novel schemes of intermittent fasting. In addition, we explore the harmful role of single nutrients on liver-specific key metabolic pathways, the role of gene susceptibility and microbiota, and behavioral aspects that may impact liver disease and are often underreported in clinical setting. At present, the high variability in terms of study populations and liver-specific outcomes within nutritional studies limits the generalizability of the results and highlights the urgent need of a tailored and standardized approach, as seen in regulatory trials in Non-Alcoholic Steatohepatitis (NASH).


Assuntos
Dieta , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Redução de Peso , Microbioma Gastrointestinal , Humanos , Resistência à Insulina , Estilo de Vida
13.
Mol Metab ; 45: 101162, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33422644

RESUMO

Childhood obesity is a strong risk factor for adult obesity, type 2 diabetes, and cardiovascular disease. The mechanisms that link early adiposity with late-onset chronic diseases are poorly characterised. We developed a mouse model of early adiposity through litter size reduction. Mice reared in small litters (SLs) developed obesity, insulin resistance, and hepatic steatosis during adulthood. The liver played a major role in the development of the disease. OBJECTIVE: To gain insight into the molecular mechanisms that link early development and childhood obesity with adult hepatic steatosis and insulin resistance. METHODS: We analysed the hepatic transcriptome (Affymetrix) of control and SL mice to uncover potential pathways involved in the long-term programming of disease in our model. RESULTS: The circadian rhythm was the most significantly deregulated Gene Ontology term in the liver of adult SL mice. Several core clock genes, such as period 1-3 and cryptochrome 1-2, were altered in two-week-old SL mice and remained altered throughout their life course until they reached 4-6 months of age. Defective circadian rhythm was restricted to the periphery since the expression of clock genes in the hypothalamus, the central pacemaker, was normal. The period-cryptochrome genes were primarily entrained by dietary signals. Hence, restricting food availability during the light cycle only uncoupled the central rhythm from the peripheral and completely normalised hepatic triglyceride content in adult SL mice. This effect was accompanied by better re-alignment of the hepatic period genes, suggesting that they might have played a causal role in mediating hepatic steatosis in the adult SL mice. Functional downregulation of Per2 in hepatocytes in vitro confirmed that the period genes regulated lipid-related genes in part through peroxisome proliferator-activated receptor alpha (Ppara). CONCLUSIONS: The hepatic circadian rhythm matures during early development, from birth to postnatal day 30. Hence, nutritional challenges during early life may misalign the hepatic circadian rhythm and secondarily lead to metabolic derangements. Specific time-restricted feeding interventions improve metabolic health in the context of childhood obesity by partially re-aligning the peripheral circadian rhythm.


Assuntos
Ritmo Circadiano/fisiologia , Lactação , Fígado/metabolismo , Hepatopatia Gordurosa não Alcoólica/metabolismo , Adiposidade , Adulto , Animais , Ritmo Circadiano/genética , Diabetes Mellitus Tipo 2/metabolismo , Jejum , Feminino , Humanos , Hipotálamo/metabolismo , Recém-Nascido , Resistência à Insulina/fisiologia , Doenças Metabólicas/metabolismo , Camundongos , Camundongos Endogâmicos ICR , Hepatopatia Gordurosa não Alcoólica/genética , Obesidade/metabolismo , Obesidade Infantil
15.
Cell Rep ; 29(11): 3678-3692.e4, 2019 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-31825844

RESUMO

Daily adaptation of metabolic activity to light-dark cycles to maintain homeostasis is controlled by hypothalamic nuclei receiving information from the retina and from nutritional inputs that vary according to feeding cycles. We show that selective hypomorphic expression of the transcription factor gene Pitx3 prevents light-dependent entrainment of the central pacemaker in the suprachiasmatic nucleus. This translates into altered behavioral and metabolic outputs affecting locomotor activity, feeding patterns, energy expenditure, and corticosterone secretion that correlate with dysfunctional expression of clock genes in the ventromedial hypothalamus, liver, and brown adipose tissue. Metabolic entrainment by time-restricted feeding restores clock function in the liver and brown adipose tissue but not in the ventromedial hypothalamus and, remarkably, fails to synchronize energy expenditure and locomotor and hormonal outputs. Thus, our study reveals a central role of the priming of the suprachiasmatic nucleus with retinal innervation in the hypothalamic regulation of cyclic metabolic homeostasis.


Assuntos
Relógios Circadianos , Metabolismo Energético , Proteínas de Homeodomínio/genética , Núcleo Supraquiasmático/metabolismo , Fatores de Transcrição/genética , Tecido Adiposo/metabolismo , Animais , Corticosterona/metabolismo , Comportamento Alimentar , Proteínas de Homeodomínio/metabolismo , Hipotálamo/metabolismo , Fígado/metabolismo , Locomoção , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fatores de Transcrição/metabolismo
16.
Cell Metab ; 29(5): 1078-1091.e5, 2019 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-30827863

RESUMO

The alignment of fasting and feeding with the sleep/wake cycle is coordinated by hypothalamic neurons, though the underlying molecular programs remain incompletely understood. Here, we demonstrate that the clock transcription pathway maximizes eating during wakefulness and glucose production during sleep through autonomous circadian regulation of NPY/AgRP neurons. Tandem profiling of whole-cell and ribosome-bound mRNAs in morning and evening under dynamic fasting and fed conditions identified temporal control of activity-dependent gene repertoires in AgRP neurons central to synaptogenesis, bioenergetics, and neurotransmitter and peptidergic signaling. Synaptic and circadian pathways were specific to whole-cell RNA analyses, while bioenergetic pathways were selectively enriched in the ribosome-bound transcriptome. Finally, we demonstrate that the AgRP clock mediates the transcriptional response to leptin. Our results reveal that time-of-day restriction in transcriptional control of energy-sensing neurons underlies the alignment of hunger and food acquisition with the sleep/wake state.


Assuntos
Proteína Relacionada com Agouti/metabolismo , Relógios Circadianos/genética , Ritmo Circadiano/genética , Fome/fisiologia , Neurônios/metabolismo , Transcrição Gênica/genética , Proteína Relacionada com Agouti/genética , Animais , Ingestão de Alimentos/fisiologia , Jejum/fisiologia , Redes Reguladoras de Genes , Glucose/metabolismo , Hipotálamo/metabolismo , Leptina/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Transdução de Sinais/genética , Sono/fisiologia , Transcriptoma , Vigília/fisiologia
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