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1.
J Am Chem Soc ; 145(43): 23427-23432, 2023 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-37857310

RESUMEN

Rapid bond-forming reactions are crucial for efficient bioconjugation. We describe a simple and practical strategy for facilitating ultra-rapid electrophilic cysteine arylation. Using a variety of sulfone-activated pyridinium salts, this uncatalyzed reaction proceeds with exceptionally high rate constants, ranging from 9800 to 320,000 M-1·s-1, in pH 7.0 aqueous buffer at 25 °C. Such reactions allow for stoichiometric bioconjugation of micromolar cysteine within minutes or even seconds. Even though the arylation is extremely fast, the chemistry exhibits excellent selectivity, thus furnishing functionalized peptides and proteins with both high conversion and purity.


Asunto(s)
Cisteína , Péptidos , Proteínas
2.
FEBS Lett ; 597(1): 151-165, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36416529

RESUMEN

Mobile zinc is an abundant transition metal ion in the central nervous system, with pools of divalent zinc accumulating in regions of the brain engaged in sensory perception and memory formation. Here, we present essential tools that we developed to interrogate the role(s) of mobile zinc in these processes. Most important are (a) fluorescent sensors that report the presence of mobile zinc and (b) fast, Zn-selective chelating agents for measuring zinc flux in animal tissue and live animals. The results of our studies, conducted in collaboration with neuroscientist experts, are presented for sensory organs involved in hearing, smell, vision, and learning and memory. A general principle emerging from these studies is that the function of mobile zinc in all cases appears to be downregulation of the amplitude of the response following overstimulation of the respective sensory organs. Possible consequences affecting human behavior are presented for future investigations in collaboration with interested behavioral scientists.


Asunto(s)
Encéfalo , Zinc , Animales , Humanos , Percepción
3.
Bioconjug Chem ; 33(11): 2189-2196, 2022 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-36335596

RESUMEN

Here, we present a series of fluorinated cationic reagents that enable rapid arylation of cysteine under mild conditions compatible with proteins and peptides. The highly polarized C-F bond and attractive nucleophile-electrophile Coulombic interactions substantially accelerate cysteine arylation, leading to unusually high rate constants on the order of 100 M-1·s-1 and allowing for equimolar labeling of substrates at micromolar concentrations. The synthetic modularity of this approach promotes the direct coupling of structurally diverse phenol-containing functional motifs to cysteine residues of biomacromolecules with high efficiency. This user-friendly chemistry enables fast bond formation between commonly used bioconjugation partners, thus greatly streamlining the synthetic chemistry workflow, and can be easily developed as convenient kits for chemical biology and medicinal chemistry applications.


Asunto(s)
Cisteína , Sales (Química) , Cisteína/química , Proteínas/química , Péptidos/química , Indicadores y Reactivos
4.
Proc Natl Acad Sci U S A ; 119(5)2022 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-35078934

RESUMEN

The formation of ordered cross-ß amyloid protein aggregates is associated with a variety of human disorders. While conventional infrared methods serve as sensitive reporters of the presence of these amyloids, the recently discovered amyloid secondary structure of cross-α fibrils presents new questions and challenges. Herein, we report results using Fourier transform infrared spectroscopy and two-dimensional infrared spectroscopy to monitor the aggregation of one such cross-α-forming peptide, phenol soluble modulin alpha 3 (PSMα3). Phenol soluble modulins (PSMs) are involved in the formation and stabilization of Staphylococcus aureus biofilms, making sensitive methods of detecting and characterizing these fibrils a pressing need. Our experimental data coupled with spectroscopic simulations reveals the simultaneous presence of cross-α and cross-ß polymorphs within samples of PSMα3 fibrils. We also report a new spectroscopic feature indicative of cross-α fibrils.


Asunto(s)
Amiloide/genética , Toxinas Bacterianas/genética , Polimorfismo Genético/genética , Espectrofotometría Infrarroja/métodos , Espectroscopía Infrarroja por Transformada de Fourier/métodos , Staphylococcus aureus/genética
5.
J Neurosci ; 40(26): 4981-4996, 2020 06 24.
Artículo en Inglés | MEDLINE | ID: mdl-32434779

RESUMEN

In many brain areas, such as the neocortex, limbic structures, and auditory brainstem, synaptic zinc is released from presynaptic terminals to modulate neurotransmission. As such, synaptic zinc signaling modulates sensory processing and enhances acuity for discrimination of different sensory stimuli. Whereas sensory experience causes long-term changes in synaptic zinc signaling, the mechanisms underlying this long-term synaptic zinc plasticity remain unknown. To study these mechanisms in male and female mice, we used in vitro and in vivo models of zinc plasticity observed at the zinc-rich glutamatergic dorsal cochlear nucleus (DCN) parallel fiber synapses onto cartwheel cells. High-frequency stimulation of DCN parallel fiber synapses induced LTD of synaptic zinc signaling (Z-LTD), evidenced by reduced zinc-mediated inhibition of EPSCs. Low-frequency stimulation induced LTP of synaptic zinc signaling (Z-LTP), evidenced by enhanced zinc-mediated inhibition of EPSCs. Pharmacological manipulations of Group 1 metabotropic glutamate receptors (G1 mGluRs) demonstrated that G1 mGluR activation is necessary and sufficient for inducing Z-LTD and Z-LTP. Pharmacological manipulations of Ca2+ dynamics indicated that rises in postsynaptic Ca2+ are necessary and sufficient for Z-LTD induction. Electrophysiological measurements assessing postsynaptic expression mechanisms, and imaging studies with a ratiometric extracellular zinc sensor probing zinc release, supported that Z-LTD is expressed, at least in part, via reductions in presynaptic zinc release. Finally, exposure of mice to loud sound caused G1 mGluR-dependent Z-LTD at DCN parallel fiber synapses, thus validating our in vitro results. Together, our results reveal a novel mechanism underlying activity- and experience-dependent plasticity of synaptic zinc signaling.SIGNIFICANCE STATEMENT In the neocortex, limbic structures, and auditory brainstem, glutamatergic nerve terminals corelease zinc to modulate excitatory neurotransmission and sensory responses. Moreover, sensory experience causes bidirectional, long-term changes in synaptic zinc signaling. However, the mechanisms of this long-term synaptic zinc plasticity remain unknown. Here, we identified a novel Group 1 mGluR-dependent mechanism that causes bidirectional, long-term changes in synaptic zinc signaling. Our results highlight new mechanisms of brain adaptation during sensory processing, and potentially point to mechanisms of disorders associated with pathologic adaptation, such as tinnitus.


Asunto(s)
Núcleo Coclear/fisiología , Depresión Sináptica a Largo Plazo/fisiología , Sinapsis/fisiología , Transmisión Sináptica/fisiología , Zinc/metabolismo , Animales , Femenino , Masculino , Ratones , Ratones Endogámicos ICR , Receptores de Glutamato Metabotrópico/metabolismo
6.
Chem Commun (Camb) ; 56(25): 3699, 2020 03 26.
Artículo en Inglés | MEDLINE | ID: mdl-32187250

RESUMEN

Correction for 'Thioamide quenching of intrinsic protein fluorescence' by Jacob M. Goldberg et al., Chem. Commun., 2012, 48, 1550-1552.

7.
J Am Chem Soc ; 142(14): 6477-6482, 2020 04 08.
Artículo en Inglés | MEDLINE | ID: mdl-32175731

RESUMEN

The loss of insulin-producing ß-cells is the central pathological event in type 1 and 2 diabetes, which has led to efforts to identify molecules to promote ß-cell proliferation, protection, and imaging. However, the lack of ß-cell specificity of these molecules jeopardizes their therapeutic potential. A general platform for selective release of small-molecule cargoes in ß-cells over other islet cells ex vivo or other cell-types in an organismal context will be immensely valuable in advancing diabetes research and therapeutic development. Here, we leverage the unusually high Zn(II) concentration in ß-cells to develop a Zn(II)-based prodrug system to selectively and tracelessly deliver bioactive small molecules and fluorophores to ß-cells. The Zn(II)-targeting mechanism enriches the inactive cargo in ß-cells as compared to other pancreatic cells; importantly, Zn(II)-mediated hydrolysis triggers cargo activation. This prodrug system, with modular components that allow for fine-tuning selectivity, should enable the safer and more effective targeting of ß-cells.


Asunto(s)
Linfocitos B/metabolismo , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Zinc/uso terapéutico , Catálisis , Diabetes Mellitus Tipo 1/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Humanos
8.
Sci Rep ; 8(1): 15034, 2018 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-30302024

RESUMEN

Small-molecule fluorescent probes are powerful and ubiquitous tools for measuring the concentration and distribution of analytes in living cells. However, accurate characterization of these analytes requires rigorous evaluation of cell-to-cell heterogeneity in fluorescence intensities and intracellular distribution of probes. In this study, we perform a parallel and systematic comparison of two small-molecule fluorescent vesicular Zn2+ probes, FluoZin-3 AM and SpiroZin2, to evaluate each probe for measurement of vesicular Zn2+ pools. Our results reveal that SpiroZin2 is a specific lysosomal vesicular Zn2+ probe and affords uniform measurement of resting Zn2+ levels at the single cell level with proper calibration. In contrast, FluoZin-3 AM produces highly variable fluorescence intensities and non-specifically localizes in the cytosol and multiple vesicular compartments. We further applied SpiroZin2 to lactating mouse mammary epithelial cells and detected a transient increase of lysosomal free Zn2+ at 24-hour after lactation hormone treatment, which implies that lysosomes play a role in the regulation of Zn2+ homeostasis during lactation. This study demonstrates the need for critical characterization of small-molecule fluorescent probes to define the concentration and localization of analytes in different cell populations, and reveals SpiroZin2 to be capable of reporting diverse perturbations to lysosomal Zn2+.


Asunto(s)
Colorantes Fluorescentes/química , Lactancia/metabolismo , Compuestos Policíclicos/química , Zinc/metabolismo , Animales , Células Epiteliales/metabolismo , Femenino , Colorantes Fluorescentes/aislamiento & purificación , Homeostasis/genética , Lisosomas/metabolismo , Glándulas Mamarias Animales/metabolismo , Ratones , Compuestos Policíclicos/metabolismo , Zinc/química
10.
J Am Chem Soc ; 140(6): 2020-2023, 2018 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-29384658

RESUMEN

Fluorescent sensors for mobile zinc are valuable for studying complex biological systems. Because these sensors typically bind zinc rapidly and tightly, there has been little temporal control over the activity of the probe after its application to a sample. The ability to control the activity of a zinc sensor in vivo during imaging experiments would greatly improve the time resolution of the measurement. Here, we describe photoactivatable zinc sensors that can be triggered with short pulses of UV light. These probes are prepared by functionalizing a zinc sensor with protecting groups that render the probe insensitive to metal ions. Photoinduced removal of the protecting groups restores the binding site, allowing for zinc-responsive changes in fluorescence that can be observed in live cells and tissues.


Asunto(s)
Colorantes Fluorescentes/química , Zinc/análisis , Química Encefálica , Fluorescencia , Células HeLa , Humanos , Microscopía Fluorescente/métodos , Espectrometría de Fluorescencia/métodos , Rayos Ultravioleta
11.
Acc Chem Res ; 50(3): 577-579, 2017 03 21.
Artículo en Inglés | MEDLINE | ID: mdl-28945403

RESUMEN

Metal ions play critical roles in neurotransmission, memory formation, and sensory perception. Understanding the molecular details of these processes is the Holy Grail of metalloneurochemistry. Here we describe five challenges for collaborative teams of chemists, biologists, and neuroscientists to help make this dream a reality.


Asunto(s)
Fenómenos Bioquímicos , Química Encefálica , Encéfalo/fisiología , Fenómenos Químicos , Metales/química , Fenómenos Químicos Orgánicos , Animales , Memoria , Ratones , Ratones Mutantes , Percepción , Transmisión Sináptica
12.
J Am Chem Soc ; 139(27): 9325-9332, 2017 07 12.
Artículo en Inglés | MEDLINE | ID: mdl-28576078

RESUMEN

The CF2H group, a potential surrogate for the OH group, can act as an unusual hydrogen bond donor, as confirmed by crystallographic, spectroscopic, and computational methods. Here, we demonstrate the bioisosterism of the OH and CF2H groups and the important roles of CF2-H···O hydrogen bonds in influencing intermolecular interactions and conformational preferences. Experimental evidence, corroborated by theory, reveals the distinctive nature of CF2H hydrogen bonding interactions relative to their normal OH hydrogen bonding counterparts.


Asunto(s)
Hidrocarburos Fluorados/química , Radical Hidroxilo/química , Enlace de Hidrógeno , Nitrofenoles/química , Teoría Cuántica , Espectrofotometría Infrarroja , Tolueno/análogos & derivados , Tolueno/química
13.
Isr J Chem ; 56(9-10): 791-802, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28190893

RESUMEN

Metal ions perform critical and diverse functions in nervous system physiology and pathology. The field of metalloneurochemistry aims to understand the mechanistic bases for these varied roles at the molecular level. Here, we review several areas of research that illustrate progress toward achieving this ambitious goal and identify key challenges for the future. We examine the use of lithium as a mood stabilizer, the roles of mobile zinc and copper in the synapse, the interplay of nitric oxide and metals in retrograde signaling, and the regulation of iron homeostasis in the brain. These topics were chosen to demonstrate not only the breadth of the field, but also to highlight opportunities for discovery by studying such complex systems in greater detail. We are beginning to uncover the principles by which receptors and transmitters utilize metal ions to modulate neurotransmission. These advances have revealed exciting new insights into the intricate mechanisms that give rise to learning, memory, and sensory perception, while opening many new avenues for further exploration.

14.
Proc Natl Acad Sci U S A ; 112(51): 15749-54, 2015 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-26647187

RESUMEN

The vast amount of fast excitatory neurotransmission in the mammalian central nervous system is mediated by AMPA-subtype glutamate receptors (AMPARs). As a result, AMPAR-mediated synaptic transmission is implicated in nearly all aspects of brain development, function, and plasticity. Despite the central role of AMPARs in neurobiology, the fine-tuning of synaptic AMPA responses by endogenous modulators remains poorly understood. Here we provide evidence that endogenous zinc, released by single presynaptic action potentials, inhibits synaptic AMPA currents in the dorsal cochlear nucleus (DCN) and hippocampus. Exposure to loud sound reduces presynaptic zinc levels in the DCN and abolishes zinc inhibition, implicating zinc in experience-dependent AMPAR synaptic plasticity. Our results establish zinc as an activity-dependent, endogenous modulator of AMPARs that tunes fast excitatory neurotransmission and plasticity in glutamatergic synapses.


Asunto(s)
Receptores AMPA/antagonistas & inhibidores , Transmisión Sináptica , Zinc/fisiología , Animales , Núcleo Coclear/fisiología , Potenciales Postsinápticos Excitadores , Femenino , Hipocampo/fisiología , Masculino , Ratones , Ratones Endogámicos ICR , Plasticidad Neuronal , Receptores AMPA/fisiología
15.
Phys Chem Chem Phys ; 16(15): 6827-37, 2014 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-24598971

RESUMEN

Our laboratory has developed thioamide analogs of the natural amino acids as minimally-perturbing fluorescence quenching probes that can be placed at many locations in a protein sequence. We have shown that the mechanism of quenching can be either Förster resonance energy transfer (FRET) or photoinduced electron transfer (PET), depending on the identity of the donor fluorophore. Furthermore, we have shown that one can use a combination of semi-synthetic methods to label full-sized proteins with fluorophore-thioamide pairs. These probes can be used to study protein-protein interactions, protein folding or misfolding, and proteolysis.


Asunto(s)
Sondas Moleculares/química , Pliegue de Proteína , Tioamidas/química , Fluorescencia , Modelos Moleculares , Estructura Molecular , Estabilidad Proteica
16.
J Am Chem Soc ; 136(5): 2086-93, 2014 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-24472041

RESUMEN

Thioamide quenchers can be paired with compact fluorophores to design "turn-on" fluorescent protease substrates. We have used this method to study a variety of serine-, cysteine-, carboxyl-, and metallo-proteases, including trypsin, chymotrypsin, pepsin, thermolysin, papain, and calpain. Since thioamides quench some fluorophores red-shifted from those naturally occurring in proteins, this technique can be used for real time monitoring of protease activity in crude preparations of virtually any protease. We demonstrate the value of this method in three model applications: (1) characterization of papain enzyme kinetics using rapid-mixing experiments, (2) selective monitoring of cleavage at a single site in a peptide with multiple proteolytic sites, and (3) analysis of the specificity of an inhibitor of calpain in cell lysates.


Asunto(s)
Pruebas de Enzimas , Colorantes Fluorescentes/química , Péptido Hidrolasas/metabolismo , Péptidos/química , Tioamidas/química , Animales , Células Cultivadas , Fibroblastos/enzimología , Ratones , Espectrometría de Fluorescencia , Especificidad por Sustrato
17.
J Am Chem Soc ; 135(50): 18806-14, 2013 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-24303933

RESUMEN

The amino acid acridon-2-ylalanine (Acd) can be a valuable probe of protein conformational change because it is a long lifetime, visible wavelength fluorophore that is small enough to be incorporated during ribosomal biosynthesis. Incorporation of Acd into proteins expressed in Escherichia coli requires efficient chemical synthesis to produce large quantities of the amino acid and the generation of a mutant aminoacyl tRNA synthetase that can selectively charge the amino acid onto a tRNA. Here, we report the synthesis of Acd in 87% yield over five steps from Tyr and the identification of an Acd synthetase by screening candidate enzymes previously evolved from Methanococcus janaschii Tyr synthetase for unnatural amino acid incorporation. Furthermore, we characterize the photophysical properties of Acd, including quenching interactions with select natural amino acids and Förster resonance energy transfer (FRET) interactions with common fluorophores such as methoxycoumarin (Mcm). Finally, we demonstrate the value of incorporation of Acd into proteins, using changes in Acd fluorescence lifetimes, Mcm/Acd FRET, or energy transfer to Eu(3+) to monitor protein folding and binding interactions.


Asunto(s)
Acridinas/química , Alanina/química , Transferencia Resonante de Energía de Fluorescencia/métodos , Acridinas/síntesis química , Alanina/síntesis química , Luminiscencia , Modelos Moleculares
18.
J Am Chem Soc ; 135(49): 18651-8, 2013 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-24266520

RESUMEN

Previously we have shown that thioamides can be incorporated into proteins as minimally perturbing fluorescence-quenching probes to study protein dynamics, folding, and aggregation. Here, we show that the spontaneity of photoinduced electron transfer between a thioamide and an excited fluorophore is governed by the redox potentials of each moiety according to a Rehm-Weller-type model. We have used this model to predict thioamide quenching of various common fluorophores, and we rigorously tested more than a dozen examples. In each case, we found excellent agreement between our theoretical predictions and experimental observations. In this way, we have been able to expand the scope of fluorophores quenched by thioamides to include dyes suitable for microscopy and single-molecule studies, including fluorescein, Alexa Fluor 488, BODIPY FL, and rhodamine 6G. We describe the photochemistry of these systems and explore applications that demonstrate the utility of thioamide quenching of fluorescein to studying protein folding and proteolysis.


Asunto(s)
Electrones , Colorantes Fluorescentes/química , Tioamidas/química , Pliegue de Proteína
19.
Nat Struct Mol Biol ; 20(9): 1098-105, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23912279

RESUMEN

N-terminal acetylation is ubiquitous among eukaryotic proteins and controls a myriad of biological processes. Of the N-terminal acetyltransferases (NATs) that facilitate this cotranslational modification, the heterodimeric NatA complex has the most diversity for substrate selection and modifies the majority of all N-terminally acetylated proteins. Here, we report the X-ray crystal structure of the 100-kDa holo-NatA complex from Schizosaccharomyces pombe, in the absence and presence of a bisubstrate peptide-CoA-conjugate inhibitor, as well as the structure of the uncomplexed Naa10p catalytic subunit. The NatA-Naa15p auxiliary subunit contains 13 tetratricopeptide motifs and adopts a ring-like topology that wraps around the NatA-Naa10p subunit, an interaction that alters the Naa10p active site for substrate-specific acetylation. These studies have implications for understanding the mechanistic details of other NAT complexes and how regulatory subunits modulate the activity of the broader family of protein acetyltransferases.


Asunto(s)
Acetiltransferasas/química , Acetiltransferasa A N-Terminal/química , Proteínas de Schizosaccharomyces pombe/química , Acetiltransferasas/genética , Acetiltransferasas/metabolismo , Regulación Alostérica , Secuencia de Aminoácidos , Animales , Dominio Catalítico , Cristalografía por Rayos X , Holoenzimas/química , Holoenzimas/genética , Holoenzimas/metabolismo , Humanos , Cinética , Modelos Moleculares , Datos de Secuencia Molecular , Mutagénesis Sitio-Dirigida , Acetiltransferasa A N-Terminal/genética , Acetiltransferasa A N-Terminal/metabolismo , Estructura Cuaternaria de Proteína , Subunidades de Proteína , Schizosaccharomyces/enzimología , Schizosaccharomyces/genética , Proteínas de Schizosaccharomyces pombe/genética , Proteínas de Schizosaccharomyces pombe/metabolismo , Homología de Secuencia de Aminoácido , Especificidad por Sustrato
20.
Spine (Phila Pa 1976) ; 38(5): E293-8, 2013 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-23446706

RESUMEN

STUDY DESIGN: A retrospective medical record review of cases with congenital vertebral malformations (CVMs) and controls with normal spine morphology. OBJECTIVE: To determine the relative contribution of maternal environmental factors (MEFs) during pregnancy to CVM development. SUMMARY OF BACKGROUND DATA: CVMs represent defects in formation and segmentation of somites occurring with an estimated incidence of between 0.13 and 0.50 per 1000 live births. CVMs may be associated with various phenotypes and represent significant morbidity due to pain and cosmetic disfigurement. METHODS: A multicenter retrospective medical record review of 229 cases with CVM and 267 controls with normal spine morphology between the ages of 1 and 50 years was performed to obtain the odds ratio (OR) of MEF related to CVM among cases versus controls. An imputation-based analysis was performed in which subjects with no documentation of MEF history were treated as "no maternal exposure." Univariate and multivariate analyses were conducted to calculate the OR. RESULTS: Of the 229 total cases, 104 cases had single or multiple CVMs without additional congenital malformations (group 1) and 125 cases had single or multiple CVMs and additional congenital malformations (group 2). Nineteen percent of total cases had an identified MEF. The OR for MEF history for group 1 was 6.0 (95% confidence interval, 2.4-15.1; P < 0.001) in the univariate analysis. The OR for MEF history in group 2 was 9.1 (95% confidence interval, 3.8-21.6, P < 0.001) in the univariate analysis. The results were confirmed in the multivariate analysis after adjusting for age, sex, and institution. CONCLUSIONS: These results support a hypothesis for an association between these MEFs during pregnancy and CVM and have implications for development of prevention strategies. Further prospective studies are needed to quantify association between CVMs and specific MEF. LEVEL OF EVIDENCE: 4.


Asunto(s)
Anomalías Múltiples/etiología , Exposición Materna , Efectos Tardíos de la Exposición Prenatal , Columna Vertebral/anomalías , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Niño , Clomifeno/efectos adversos , Diabetes Mellitus Tipo 1/complicaciones , Femenino , Fiebre/complicaciones , Humanos , Modelos Logísticos , Masculino , Análisis Multivariante , Oportunidad Relativa , Embarazo , Embarazo Gemelar , Técnicas Reproductivas Asistidas/efectos adversos , Estudios Retrospectivos , Ajuste de Riesgo , Factores de Riesgo , Fumar/efectos adversos , Estados Unidos , Ácido Valproico/efectos adversos , Adulto Joven
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