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1.
Biochem Biophys Res Commun ; 377(2): 515-520, 2008 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-18929534

RESUMEN

5-Aminolevulinic acid synthase 1 (ALAS1) is the key enzyme in the homeostasis of nonerythroid heme and of fundamental importance in respiration, the metabolism of drugs, chemicals and steroids and cell signalling. The regulation of ALAS1 in response to stimuli occurs at transcriptional, translational and post-translational levels which could depend on inter-individual variation in basal expression. A genetic difference in hepatic ALAS1 mRNA levels between C57BL/6J and DBA/2 mice was detected by microarray and was >5-fold in whole liver or hepatocytes when estimated by qRT-PCR. Analysis of the ALAS1 promoter showed a 210 nt insert in the DBA/2 containing a B2 SINE retrotransposon causing a marked repression of expression by intracellular reporter systems. Deletions across the B2 SINE demonstrated that the full sequence was required for transcriptional inhibition. The findings show that a B2 SINE can contribute to the regulation of ALAS1 and SINEs in 5'-UTR regions contribute to inter-individual differences in gene expression.


Asunto(s)
Regiones no Traducidas 5'/genética , 5-Aminolevulinato Sintetasa/genética , Regulación de la Expresión Génica , Polimorfismo Genético , Retroelementos/fisiología , Animales , Secuencia de Bases , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos DBA , Datos de Secuencia Molecular , Análisis de Secuencia por Matrices de Oligonucleótidos , Regiones Promotoras Genéticas , Retroelementos/genética
2.
Chem Res Toxicol ; 21(2): 330-40, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18163543

RESUMEN

The dysfunction of hepatic heme synthesis by 2,3,7,8-tetrachlordibenzo- p-dioxin (TCDD) in mice, enhanced by iron, leads to accumulation of uroporphyrins I and III (uroporphyria) and resembles the human disorder porphyria cutanea tarda (PCT) precipitated by alcohol and estrogenic drugs. Although consequences of TCDD are considered entirely dependent on the aryl hydrocarbon receptor (AHR), this is not proven for uroporphyria. Administration of TCDD (75 microg/kg) caused uroporphyria in susceptible C57BL/6J mice with high-affinity AHR after 5 weeks (>600-fold increase in hepatic uroporphyrins). Transcriptomics showed significant modified gene expressions for intermediary, heme, and iron metabolism as well as for oxidative stress and cell injury. Resistant low-affinity AHR DBA/2 mice (no increase in porphyrins) showed far fewer changes. At this dose of TCDD, persistent up-regulation of some traditional AH battery genes occurred in both strains. Essentiality of AHR was demonstrated with C57BL/6 Ahr knockout mice. Elevation of hepatic uroporphyrins was 964-fold in Ahr (+/+) mice, lower in Ahr (+/-) (60-fold), but undetectable with Ahr (-/-) . Consistent with an oxidative mechanism, iron overload enhanced porphyria as well as general liver injury in Ahr (+/+) and Ahr (+/-) mice but had no interactive effect in Ahr (-/-) . In contrast, when iron-treated mice received, instead of TCDD, the heme precursor 5-aminolevulinic acid (ALA), causing uroporphyia in Ahr (+/+) mice (242-fold rise in uroporphyrins), elevation of uroporphyrins I and III (42-fold) also occurred in Ahr (-/-) mice and was seemingly associated with AHR-independent expression of Cyp1a2. The findings prove that AHR is a key factor in porphyria induced in mice by TCDD. However, in other models of human PCT, participation of AHR may not be an essential requirement.


Asunto(s)
Contaminantes Ambientales/metabolismo , Hemo/metabolismo , Dibenzodioxinas Policloradas/metabolismo , Receptores de Hidrocarburo de Aril/metabolismo , Ácido Aminolevulínico/farmacología , Animales , Citocromo P-450 CYP1A2/metabolismo , Modelos Animales de Enfermedad , Contaminantes Ambientales/toxicidad , Femenino , Expresión Génica/efectos de los fármacos , Perfilación de la Expresión Génica , Silenciador del Gen , Hemo/genética , Sobrecarga de Hierro/metabolismo , Hígado/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos DBA , Ratones Noqueados , Estrés Oxidativo/efectos de los fármacos , Dibenzodioxinas Policloradas/toxicidad , Porfiria Cutánea Tardía/inducido químicamente , Porfiria Cutánea Tardía/genética , Porfiria Cutánea Tardía/metabolismo , Receptores de Hidrocarburo de Aril/deficiencia , Receptores de Hidrocarburo de Aril/genética , Regulación hacia Arriba , Uroporfirinas/análisis
3.
Hepatology ; 44(1): 174-85, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16799992

RESUMEN

Polymorphisms of genes linked to iron metabolism may account for individual variability in hemochromatosis and iron status connected with liver and cardiovascular diseases, cancers, toxicity, and infection. Mouse strains exhibit marked differences in levels of non-heme iron, with C57BL/6J and SWR showing low and high levels, respectively. The genetic basis for this variability was examined using quantitative trait loci (QTL) analysis together with expression profiling and chromosomal positions of known iron-related genes. Non-heme iron levels in liver and spleen of C57BL/6J x SWR F2 mice were poorly correlated, indicating independent regulation. Highly significant (P < .01) polymorphic loci were found on chromosomes 2 and 16 for liver and on chromosomes 8 and 9 for spleen. With sex as a covariate, additional significant or suggestive (P < 0.1) QTL were detected on chromosomes 7, 8, 11, and 19 for liver and on chromosome 2 for spleen. A gene array showed no clear association between most loci and differential iron-related gene expression. The gene for transferrin and a transferrin-like gene map close to the QTL on chromosome 9. Transferrin saturation was significantly lower in C57BL/6J mice than in SWR mice, but there was no significant difference in the serum level of transferrin, hepatic expression, or functional change in cDNA sequence. beta2-Microglobulin, which, unlike other loci, was associated with C57BL/6J alleles, is a candidate for the chromosome 2 QTL for higher iron. In conclusion, the findings show the location of polymorphic genes that determine basal iron status in wild-type mice. Human equivalents may be pertinent in predisposition to hepatic and other disorders.


Asunto(s)
Hemocromatosis/genética , Hierro/metabolismo , Hígado/metabolismo , Polimorfismo Genético , Sitios de Carácter Cuantitativo , ARN Mensajero/genética , Bazo/metabolismo , Animales , Cromosomas de los Mamíferos/genética , Predisposición Genética a la Enfermedad , Genotipo , Hemocromatosis/metabolismo , Hemocromatosis/patología , Ratones , Ratones Endogámicos C57BL , Transferrina/metabolismo
4.
Mol Cell Endocrinol ; 253(1-2): 22-9, 2006 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-16684588

RESUMEN

We have previously used genome-wide transcript profiling to investigate the relationships between changes in gene expression and physiological alterations during the response of the immature mouse uterus to estrogens. Here we describe the identification of a functionally inter-related group of estrogen-responsive genes associated with iron homeostasis, including the iron-binding protein lactotransferrin, the ferroxidase ceruloplasmin, the iron delivery protein lipocalin 2 and the iron-exporter ferroportin. Quantitative real-time PCR revealed that the expression of these genes increases with time during the uterotrophic response, reaching maximal levels in the post-proliferative phase (between 48 and 72 h). In contrast, the heme biosynthesis genes aminolevulinic acid synthase 1 and 2 were maximally induced by estrogen at 2 and 4 h, respectively, prior to increased cell proliferation. Together, these data reveal that estrogen induces the temporally coordinated expression of iron homeostasis genes in the mouse uterus, and suggest an important role for iron metabolism during sex steroid hormone-induced uterine cell growth and differentiation.


Asunto(s)
Estrógenos/farmacología , Perfilación de la Expresión Génica , Homeostasis/genética , Hierro/metabolismo , Útero/efectos de los fármacos , Útero/crecimiento & desarrollo , Animales , Diferenciación Celular/efectos de los fármacos , Epitelio/efectos de los fármacos , Epitelio/metabolismo , Estradiol/farmacología , Femenino , Ratones , Modelos Biológicos
5.
Carcinogenesis ; 27(8): 1556-66, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16537558

RESUMEN

Differential gene expression in two established initiation and promotion skin carcinogenesis models during promotion and tumor formation was determined by microarray technology with the purpose of distinguishing the genes more associated with neoplastic transformation from those linked with proliferation and differentiation. The first model utilized dimethylbenz[a]anthracene initiation and 12-O-tetradecanoylphorbol 13-acetate (TPA) promotion in the FVB/N mouse, and the second TPA promotion of the Tg.Ac mouse, which is endogenously initiated by virtue of an activated Ha-ras transgene. Comparison of gene expression profiles across the two models identified genes whose altered expression was associated with papilloma formation rather than TPA-induced proliferation and differentiation. DMBA suppressed TPA-induced differentiation which allowed identification of those genes associated more specifically with differentiation rather than proliferation. EASE (Expression Analysis Systemic Explorer) indicated a correlation between muscle-associated genes and skin differentiation, whereas genes involved with protein biosynthesis were strongly correlated with proliferation. For verification the altered expression of selected genes were confirmed by RT-PCR; Carbonic anhydrase 2, Thioredoxin 1 and Glutathione S-transferase omega 1 associated with papilloma formation and Enolase 3, Cystatin beta and Filaggrin associated with TPA-induced proliferation and differentiation. In situ analysis located the papillomas Glutathione S-transferase omega 1 expression to the proliferating areas of the papillomas. Thus we have identified profiles of differential gene expression associated with the tumorigenesis and promotion stages for skin carcinogenesis in the mouse.


Asunto(s)
Biomarcadores/metabolismo , Diferenciación Celular , Proliferación Celular , Regulación Neoplásica de la Expresión Génica , Neoplasias Cutáneas/genética , 9,10-Dimetil-1,2-benzantraceno/toxicidad , Animales , Carcinógenos/toxicidad , Transformación Celular Neoplásica/genética , Femenino , Proteínas Filagrina , Perfilación de la Expresión Génica , Genes ras , Humanos , Ratones , Ratones Transgénicos , Análisis de Secuencia por Matrices de Oligonucleótidos , Papiloma/inducido químicamente , Papiloma/genética , Papiloma/patología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Piel/efectos de los fármacos , Piel/metabolismo , Neoplasias Cutáneas/inducido químicamente , Neoplasias Cutáneas/patología , Acetato de Tetradecanoilforbol/toxicidad
6.
Chronobiol Int ; 22(3): 455-71, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16076647

RESUMEN

Synchronization of circadian oscillators with the outside world is achieved by the acute effects of light on the levels of one or more clock components. In mammals the PAS transcription factors Clock, NPAS2, and BMAL1 regulate gene expression as a function of the day-night cycle. Both PAS domains of NPAS2 were found to bind heme as a prosthetic group, form a gas-regulated sensor, and exert heme-status control of DNA binding in vitro. In a microarray analysis comparing overall changes in brain transcript levels between mice subjected to light pulses during the dark phase with animals maintained in darkness, we traced consistent changes in more than 200 different transcripts. Of these, 20 are associated with heme and iron biosynthesis and catabolism. A model for the pathway of induction of heme and iron homeostasis-related transcripts resulting from light pulses suggests that light signals (as stressors) induce transcription of heme oxygenase 2 (Hmox2) and cytochrome P450 oxidoreductase (Por), which may serve as a primary line of cellular defense. HMOX2 degrades heme from proteins such as hemoglobin. This degradation generates CO, a signal molecule, and may also change the redox state of the cell by reducing the NADPH/NADP ratio. This could lead to up-regulation of globin gene transcription, thereby releasing iron that in turn controls production of ferritins, and further up-regulating aminolevulinate synthase 2 (Alas2).


Asunto(s)
Relojes Biológicos/fisiología , Encéfalo/fisiología , Regulación de la Expresión Génica , Hemo/metabolismo , Hierro/metabolismo , Luz , Animales , Monóxido de Carbono/metabolismo , Análisis por Conglomerados , Perfilación de la Expresión Génica , Hemo/genética , Hemo Oxigenasa (Desciclizante)/genética , Hemo Oxigenasa (Desciclizante)/metabolismo , Hemoglobinas/genética , Hemoglobinas/metabolismo , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , NADPH-Ferrihemoproteína Reductasa/genética , NADPH-Ferrihemoproteína Reductasa/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , Oxidación-Reducción , Reproducibilidad de los Resultados , Transcripción Genética
7.
Biochem Biophys Res Commun ; 331(1): 147-52, 2005 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-15845371

RESUMEN

Aryl hydrocarbon receptor ligands, such as polychlorinated biphenyls (PCBs), cause inhibition of the heme biosynthesis enzyme, uroporphyrinogen decarboxylase; this leads to uroporphyria and hepatic tumors, which are markedly enhanced by iron overload in C57BL/10 and C57BL/6 strains of mice. Cyp1a2(-/-) knockout mice were used to compare the effects of CYP1A2 expression on uroporphyria and liver carcinogenesis. PCBs in the diet (100ppm) of Cyp1a2(+/+) wild-type mice caused hepatic uroporphyria, which was strongly increased by iron-dextran (800mg Fe/kg). In contrast, uroporphyria was not detected in Cyp1a2(-/-) knockout mice, although expression of CYP1A1 and CYP2B10 was greatly induced. After 57 weeks on this diet, hepatic preneoplastic foci and tumors were seen in the Cyp1a2(+/+) mice; numbers and severity were enhanced by iron. No foci or tumors were detected in Cyp1a2(-/-) mice, although evidence for other forms of liver injury was observed. Our findings suggest a link not only between CYP1A2, iron metabolism, and the induction of uroporphyria by PCBs, but also with subsequent hepatocarcinogenesis.


Asunto(s)
Citocromo P-450 CYP1A2/metabolismo , Contaminantes Ambientales/toxicidad , Hierro/toxicidad , Neoplasias Hepáticas Experimentales/inducido químicamente , Bifenilos Policlorados/toxicidad , Porfirias Hepáticas/inducido químicamente , Animales , Citocromo P-450 CYP1A2/genética , Sinergismo Farmacológico , Humanos , Neoplasias Hepáticas Experimentales/enzimología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Porfirias Hepáticas/enzimología , Porfirias Hepáticas/patología , Ratas , Uroporfirinas/metabolismo
8.
Am J Pathol ; 166(4): 1041-53, 2005 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15793285

RESUMEN

BALB/c Fech(m1Pas) mice have a mutated ferrochelatase gene resulting in protoporphyria that models the hepatic injury occurring sporadically in human erythropoietic protoporphyria. We used this mouse model to study the development of the injury and to compare the dysfunction of heme synthesis with hepatic gene expression of liver metabolism, oxidative stress, and cellular injury/inflammation. From an early age expression of total cytochrome P450 and many of its isoforms was significantly lower than in wild-type mice. However, despite massive accumulation of protoporphyrin in the liver, expression of the main genes controlling heme synthesis and catabolism (Alas1 and Hmox1, respectively) were only modestly affected even in the presence of the cytochrome P450-inducing CAR agonist 1,4-bis[2-(3,5-dichloropyridyloxy)]benzene. In contrast, in BALB/c mice exhibiting griseofulvin-induced hepatic protoporphyria with induction and destruction of cytochrome P450, both Alas1 and Hmox1 genes were markedly up-regulated. Other expression profiles in BALB/c Fech(m1Pas) mice identified roles for oxidative mechanisms in liver injury while modulated gene expression of hepatocyte transport proteins and cholesterol and bile acid synthesis illustrated the development of cholestasis. Subsequent inflammation and cirrhosis were also shown by the up-regulation of cytokine, cell cycling, and procollagen genes. Thus, gene expression profiles studied in Fech(m1Pas) mice may provide candidates for human polymorphisms that explain the sporadic hepatic consequences of erythropoietic protoporphyria.


Asunto(s)
Envejecimiento , Hemo/metabolismo , Hígado/patología , Protoporfiria Eritropoyética/genética , Animales , Antifúngicos/toxicidad , Colestasis/inducido químicamente , Colestasis/genética , Colestasis/patología , Modelos Animales de Enfermedad , Expresión Génica , Perfilación de la Expresión Génica , Regulación de la Expresión Génica , Griseofulvina/toxicidad , Hemo/genética , Hemoproteínas/genética , Hemoproteínas/metabolismo , Immunoblotting , Hígado/fisiología , Masculino , Ratones , Protoporfiria Eritropoyética/inducido químicamente , Protoporfiria Eritropoyética/patología , Protoporfirinas/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
9.
EHP Toxicogenomics ; 111(1T): 37-43, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12735108

RESUMEN

Erythropoietic protoporphyria patients can develop cholestasis, severe hepatic damage, fibrosis, and cirrhosis. We modeled this hepatic pathology in C57BL/6J and BALB/c mice using griseofulvin and analyzed 3,127 genes for alteration of expression in the liver before and during the onset of protoporphyria, cholestasis, inflammation, and hepatic fibrosis. The two mouse strains developed different levels of pathologic damage in response to the griseofulvin. Characteristic gene expression profiles could be associated with griseofulvin-induced gene expression, disruption of lipid metabolism, and the pathologic states of inflammation, early fibrosis, and cholestasis. Additionally, some genes individually indicated an alteration of homeostasis. or pathologic state; for example, fibroblast proliferation was potentially indicated by increased calcyclin (SA100a6) expression. Changes in cytochrome P450 (Cyp) gene expression were particularly pronounced, with increased expression of the Cyp2a, Cyp2b, and Cyp3a families. Decreased Cyp4a10 and Cyp4a14 expression was observed that could be associated with early pathologic change. A potential decrease in bile acid and steroid biosynthesis was indicated by the decreased expression of Cyp7b1 and Hsd3b4, respectively. DNA damage was indicated by induction of GADD45. This study illustrates how transcriptional programs can be associated with different stimuli in the same experiment. The time course of change in the gene expression profile compared with changes in pathology and clinical chemistry shows the potential of this approach for modeling causative, predictive, and adaptive changes in gene expression during pathologic change.


Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas/metabolismo , Colestasis/metabolismo , Perfilación de la Expresión Génica , Griseofulvina/toxicidad , Cirrosis Hepática Experimental/metabolismo , Hígado/metabolismo , Animales , Antígenos Ly/genética , Colestasis/inducido químicamente , Colágeno/genética , Sistema Enzimático del Citocromo P-450/genética , Hígado/patología , Cirrosis Hepática Experimental/inducido químicamente , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL
10.
EHP Toxicogenomics ; 111(1T): 45-51, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12735109

RESUMEN

Several forms of cytochrome P450 (CYP) appear to metabolize principally pharmaceutical agents, as well as other dietary and plant chemicals. Other CYP forms have major roles in steroid, sterol, and bile acid metabolism. CYP1A2 expression is constitutively high in mouse liver and is well known for metabolizing several drugs and many procarcinogens to reactive intermediates that can cause toxicity or cancer. CYP1A2 is also known to carry out several endogenous functions such as uroporphyrinogen and melatonin oxidation and the 2- and 4-hydroxylations of estradiol. We have used cDNA microarray analysis of the untreated Cyp1a2(-/-) knockout mouse to search for changes in gene expression that might indicate important intrinsic roles for this enzyme. For 15 of the up- or downregulated genes, these increases or decreases were corroborated by reverse-transcription real-time polymerase chain reaction. Other than upregulation of the Hprt gene (used in the selection procedure for disrupting the Cyp1a2 gene), we found several genes upregulated that are associated with cell-cycle regulation and lipid metabolism. Besides Cyp1a2, the gene exhibiting the greatest downregulation was Igfbp1 (insulin-like growth factor binding protein-1), showing only 12% expression of that in the Cyp1a2(+/+) wild-type liver. Recurrent themes between both up- and downregulated genes include cell-cycle control, insulin action, lipogenesis, and fatty acid and cholesterol biosynthetic pathways. Histologically, the Cyp1a2(-/-) mouse exhibited an approximately 50% decrease in lipid stored in hepatocytes, and 50% increase in lipid present in interstitial fat-storing cells compared with that in the Cyp1a2(+/+) wild-type. These data suggest that the CYP1A2 enzyme might perform additional hepatic endogenous functions heretofore not appreciated.


Asunto(s)
Citocromo P-450 CYP1A2/genética , Hígado/enzimología , Análisis de Secuencia por Matrices de Oligonucleótidos , Animales , Ácidos Grasos/biosíntesis , Hipoxantina Fosforribosiltransferasa/genética , Insulina/farmacología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Fenotipo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
11.
Cancer Res ; 62(15): 4256-62, 2002 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-12154027

RESUMEN

Ecteinascidin-743 (ET-743) is a novel marine-derived anticancer drug with clinical activity in soft tissue sarcoma and ovarian cancer. Reversible transaminitis and subclinical cholangitis have frequently been described in patients who receive ET-743. To facilitate understanding of this adverse effect and help design suitable therapeutic rescue strategies, we characterized the hepatic effects of ET-743 in rats. Female rats received ET-743 (single dose, 40 microg/kg) i.v., and liver changes were assessed from 6 h up to 3 months after dosing by histopathology, immunohistochemistry, electron microscopy, hepatic and plasma biochemistry, and DNA microarray analysis. At 24 h posttreatment and beyond, livers displayed degeneration and patchy focal necrosis of bile duct epithelial cells associated with mild inflammation followed by fibrosis. Sporadic and focal zones of hepatic necrosis and hemorrhage were observed from day 2 onward, although the majority of hepatocytes appeared normal as judged by electron microscopy. Pathological alterations persisted up to 3 months after dosing. Plasma levels of total bilirubin were elevated up to 7-fold over those in untreated rats from day 2 onward and returned to control values by day 24. Activities of alkaline phosphatase and aspartate aminotransferase in plasma were elevated for 2 and 3 months, respectively. Activities of the hepatic microsomal drug-metabolizing enzymes cytochrome P-450 A1/2, CYP2E1, and CYP3A2 were decreased. DNA microarray analysis of livers from ET-743-treated animals showed a dramatic increase in the expression of ATP binding cassette transport genes Abcb1a and Abcb1b, which impart resistance to anticancer drugs, and of Cdc2a and Ccnd1, the rodent homologues of human cell cycle genes CDC2 and cyclin D1, respectively. The cell cycle gene expression changes mirrored ET-743-induced increases in liver weight and Ki-67 labeling of liver nuclei. The results suggest that the toxicity exerted by ET-743 in the rat liver is a consequence of biliary rather than hepatocellular damage and that it is accompanied by a wave of mitogenic activity, which may be driven by the transcriptional increase in Cdc2a expression.


Asunto(s)
Antineoplásicos Alquilantes/toxicidad , Enfermedades de los Conductos Biliares/inducido químicamente , Enfermedad Hepática Inducida por Sustancias y Drogas , Dioxoles/toxicidad , Isoquinolinas/toxicidad , Hígado/efectos de los fármacos , Animales , Enfermedades de los Conductos Biliares/metabolismo , Enfermedades de los Conductos Biliares/patología , Bilirrubina/sangre , División Celular/efectos de los fármacos , Sistema Enzimático del Citocromo P-450/metabolismo , Femenino , Expresión Génica/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Hígado/fisiología , Hepatopatías/sangre , Hepatopatías/patología , Ratas , Ratas Wistar , Tetrahidroisoquinolinas , Trabectedina
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