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1.
Mol Psychiatry ; 21(8): 1037-49, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27217151

RESUMO

Antidepressants have been shown to improve longevity in C. elegans. It is plausible that orthologs of genes involved in mood regulation and stress response are involved in such an effect. We sought to understand the underlying biology. First, we analyzed the transcriptome from worms treated with the antidepressant mianserin, previously identified in a large-scale unbiased drug screen as promoting increased lifespan in worms. We identified the most robust treatment-related changes in gene expression, and identified the corresponding human orthologs. Our analysis uncovered a series of genes and biological pathways that may be at the interface between antidepressant effects and longevity, notably pathways involved in drug metabolism/degradation (nicotine and melatonin). Second, we examined which of these genes overlap with genes which may be involved in depressive symptoms in an aging non-psychiatric human population (n=3577), discovered using a genome-wide association study (GWAS) approach in a design with extremes of distribution of phenotype. Third, we used a convergent functional genomics (CFG) approach to prioritize these genes for relevance to mood disorders and stress. The top gene identified was ANK3. To validate our findings, we conducted genetic and gene-expression studies, in C. elegans and in humans. We studied C. elegans inactivating mutants for ANK3/unc-44, and show that they survive longer than wild-type, particularly in older worms, independently of mianserin treatment. We also show that some ANK3/unc-44 expression is necessary for the effects of mianserin on prolonging lifespan and survival in the face of oxidative stress, particularly in younger worms. Wild-type ANK3/unc-44 increases in expression with age in C. elegans, and is maintained at lower youthful levels by mianserin treatment. These lower levels may be optimal in terms of longevity, offering a favorable balance between sufficient oxidative stress resistance in younger worms and survival effects in older worms. Thus, ANK3/unc-44 may represent an example of antagonistic pleiotropy, in which low-expression level in young animals are beneficial, but the age-associated increase becomes detrimental. Inactivating mutations in ANK3/unc-44 reverse this effect and cause detrimental effects in young animals (sensitivity to oxidative stress) and beneficial effect in old animals (increased survival). In humans, we studied if the most significant single nucleotide polymorphism (SNP) for depressive symptoms in ANK3 from our GWAS has a relationship to lifespan, and show a trend towards longer lifespan in individuals with the risk allele for depressive symptoms in men (odds ratio (OR) 1.41, P=0.031) but not in women (OR 1.08, P=0.33). We also examined whether ANK3, by itself or in a panel with other top CFG-prioritized genes, acts as a blood gene-expression biomarker for biological age, in two independent cohorts, one of live psychiatric patients (n=737), and one of suicide completers from the coroner's office (n=45). We show significantly lower levels of ANK3 expression in chronologically younger individuals than in middle age individuals, with a diminution of that effect in suicide completers, who presumably have been exposed to more severe and acute negative mood and stress. Of note, ANK3 was previously reported to be overexpressed in fibroblasts from patients with Hutchinson-Gilford progeria syndrome, a form of accelerated aging. Taken together, these studies uncover ANK3 and other genes in our dataset as biological links between mood, stress and longevity/aging, that may be biomarkers as well as targets for preventive or therapeutic interventions. Drug repurposing bioinformatics analyses identified the relatively innocuous omega-3 fatty acid DHA (docosahexaenoic acid), piracetam, quercetin, vitamin D and resveratrol as potential longevity promoting compounds, along with a series of existing drugs, such as estrogen-like compounds, antidiabetics and sirolimus/rapamycin. Intriguingly, some of our top candidate genes for mood and stress-modulated longevity were changed in expression in opposite direction in previous studies in the Alzheimer disease. Additionally, a whole series of others were changed in expression in opposite direction in our previous studies on suicide, suggesting the possibility of a "life switch" actively controlled by mood and stress.


Assuntos
Envelhecimento/genética , Anquirinas/genética , Longevidade/genética , Animais , Anquirinas/metabolismo , Biomarcadores , Caenorhabditis elegans/genética , Expressão Gênica/genética , Perfilação da Expressão Gênica/métodos , Estudo de Associação Genômica Ampla/métodos , Humanos , Mianserina/metabolismo , Mianserina/farmacologia , Estresse Oxidativo , Polimorfismo de Nucleotídeo Único/genética , Transcriptoma/genética
2.
Mol Psychiatry ; 20(10): 1197-204, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25385369

RESUMO

Memory impairment is the cardinal early feature of Alzheimer's disease, a highly prevalent disorder whose causes remain only partially understood. To identify novel genetic predictors, we used an integrative genomics approach to perform the largest study to date of human memory (n=14 781). Using a genome-wide screen, we discovered a novel association of a polymorphism in the pro-apoptotic gene FASTKD2 (fas-activated serine/threonine kinase domains 2; rs7594645-G) with better memory performance and replicated this finding in independent samples. Consistent with a neuroprotective effect, rs7594645-G carriers exhibited increased hippocampal volume and gray matter density and decreased cerebrospinal fluid levels of apoptotic mediators. The MTOR (mechanistic target of rapamycin) gene and pathways related to endocytosis, cholinergic neurotransmission, epidermal growth factor receptor signaling and immune regulation, among others, also displayed association with memory. These findings nominate FASTKD2 as a target for modulating neurodegeneration and suggest potential mechanisms for therapies to combat memory loss in normal cognitive aging and dementia.


Assuntos
Hipocampo/fisiologia , Memória/fisiologia , Proteínas Serina-Treonina Quinases/genética , Proteínas Serina-Treonina Quinases/metabolismo , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Feminino , Estudos de Associação Genética , Estudo de Associação Genômica Ampla , Hipocampo/metabolismo , Hipocampo/fisiopatologia , Humanos , Estudos Longitudinais , Masculino , Transtornos da Memória/genética , Transtornos da Memória/metabolismo , Polimorfismo de Nucleotídeo Único , Relação Estrutura-Atividade
3.
Mol Psychiatry ; 19(3): 351-7, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23419831

RESUMO

Deposition of amyloid-ß (Aß) in the cerebral cortex is thought to be a pivotal event in Alzheimer's disease (AD) pathogenesis with a significant genetic contribution. Molecular imaging can provide an early noninvasive phenotype, but small samples have prohibited genome-wide association studies (GWAS) of cortical Aß load until now. We employed florbetapir ((18)F) positron emission tomography (PET) imaging to assess brain Aß levels in vivo for 555 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI). More than six million common genetic variants were tested for association to quantitative global cortical Aß load controlling for age, gender and diagnosis. Independent genome-wide significant associations were identified on chromosome 19 within APOE (apolipoprotein E) (rs429358, P=5.5 × 10(-14)) and on chromosome 3 upstream of BCHE (butyrylcholinesterase) (rs509208, P=2.7 × 10(-8)) in a region previously associated with serum BCHE activity. Together, these loci explained 15% of the variance in cortical Aß levels in this sample (APOE 10.7%, BCHE 4.3%). Suggestive associations were identified within ITGA6, near EFNA5, EDIL3, ITGA1, PIK3R1, NFIB and ARID1B, and between NUAK1 and C12orf75. These results confirm the association of APOE with Aß deposition and represent the largest known effect of BCHE on an AD-related phenotype. BCHE has been found in senile plaques and this new association of genetic variation at the BCHE locus with Aß burden in humans may have implications for potential disease-modifying effects of BCHE-modulating agents in the AD spectrum.


Assuntos
Doença de Alzheimer/genética , Apolipoproteínas E/genética , Butirilcolinesterase/genética , Córtex Cerebral/metabolismo , Placa Amiloide/metabolismo , Idoso , Idoso de 80 Anos ou mais , Compostos de Anilina , Córtex Cerebral/diagnóstico por imagem , Disfunção Cognitiva/genética , Etilenoglicóis , Feminino , Neuroimagem Funcional , Estudo de Associação Genômica Ampla , Humanos , Masculino , Pessoa de Meia-Idade , Placa Amiloide/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , População Branca/genética
5.
Mol Psychiatry ; 18(7): 781-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23608917

RESUMO

Whole-exome sequencing of individuals with mild cognitive impairment, combined with genotype imputation, was used to identify coding variants other than the apolipoprotein E (APOE) ε4 allele associated with rate of hippocampal volume loss using an extreme trait design. Matched unrelated APOE ε3 homozygous male Caucasian participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were selected at the extremes of the 2-year longitudinal change distribution of hippocampal volume (eight subjects with rapid rates of atrophy and eight with slow/stable rates of atrophy). We identified 57 non-synonymous single nucleotide variants (SNVs) which were found exclusively in at least 4 of 8 subjects in the rapid atrophy group, but not in any of the 8 subjects in the slow atrophy group. Among these SNVs, the variants that accounted for the greatest group difference and were predicted in silico as 'probably damaging' missense variants were rs9610775 (CARD10) and rs1136410 (PARP1). To further investigate and extend the exome findings in a larger sample, we conducted quantitative trait analysis including whole-brain search in the remaining ADNI APOE ε3/ε3 group (N=315). Genetic variation within PARP1 and CARD10 was associated with rate of hippocampal neurodegeneration in APOE ε3/ε3. Meta-analysis across five independent cross sectional cohorts indicated that rs1136410 is also significantly associated with hippocampal volume in APOE ε3/ε3 individuals (N=923). Larger sequencing studies and longitudinal follow-up are needed for confirmation. The combination of next-generation sequencing and quantitative imaging phenotypes holds significant promise for discovery of variants involved in neurodegeneration.


Assuntos
Proteínas Adaptadoras de Sinalização CARD/genética , Disfunção Cognitiva/genética , Exoma/genética , Predisposição Genética para Doença/genética , Hipocampo/patologia , Poli(ADP-Ribose) Polimerases/genética , Doença de Alzheimer/complicações , Doença de Alzheimer/genética , Doença de Alzheimer/patologia , Doença de Alzheimer/psicologia , Apolipoproteína E3/genética , Atrofia/patologia , Disfunção Cognitiva/complicações , Disfunção Cognitiva/patologia , Estudos de Coortes , Estudo de Associação Genômica Ampla , Humanos , Masculino , Neuroimagem , Poli(ADP-Ribose) Polimerase-1 , Polimorfismo de Nucleotídeo Único , População Branca/genética
6.
Neurology ; 76(1): 69-79, 2011 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-21123754

RESUMO

OBJECTIVES: CSF levels of Aß1-42, t-tau, and p-tau181p are potential early diagnostic markers for probable Alzheimer disease (AD). The influence of genetic variation on these markers has been investigated for candidate genes but not on a genome-wide basis. We report a genome-wide association study (GWAS) of CSF biomarkers (Aß1-42, t-tau, p-tau181p, p-tau181p/Aß1-42, and t-tau/Aß1-42). METHODS: A total of 374 non-Hispanic Caucasian participants in the Alzheimer's Disease Neuroimaging Initiative cohort with quality-controlled CSF and genotype data were included in this analysis. The main effect of single nucleotide polymorphisms (SNPs) under an additive genetic model was assessed on each of 5 CSF biomarkers. The p values of all SNPs for each CSF biomarker were adjusted for multiple comparisons by the Bonferroni method. We focused on SNPs with corrected p<0.01 (uncorrected p<3.10×10(-8)) and secondarily examined SNPs with uncorrected p values less than 10(-5) to identify potential candidates. RESULTS: Four SNPs in the regions of the APOE, LOC100129500, TOMM40, and EPC2 genes reached genome-wide significance for associations with one or more CSF biomarkers. SNPs in CCDC134, ABCG2, SREBF2, and NFATC4, although not reaching genome-wide significance, were identified as potential candidates. CONCLUSIONS: In addition to known candidate genes, APOE, TOMM40, and one hypothetical gene LOC100129500 partially overlapping APOE; one novel gene, EPC2, and several other interesting genes were associated with CSF biomarkers that are related to AD. These findings, especially the new EPC2 results, require replication in independent cohorts.


Assuntos
Doença de Alzheimer , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Peptídeos beta-Amiloides/genética , Fragmentos de Peptídeos/líquido cefalorraquidiano , Fragmentos de Peptídeos/genética , Treonina/metabolismo , Proteínas tau/líquido cefalorraquidiano , Proteínas tau/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/genética , Doença de Alzheimer/patologia , Antígenos de Neoplasias/líquido cefalorraquidiano , Antígenos de Neoplasias/genética , Apolipoproteínas E/genética , Transtornos Cognitivos/líquido cefalorraquidiano , Transtornos Cognitivos/genética , Transtornos Cognitivos/patologia , Estudos de Coortes , Diagnóstico por Imagem , Feminino , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Desequilíbrio de Ligação , Masculino , Proteínas de Membrana Transportadoras/líquido cefalorraquidiano , Proteínas de Membrana Transportadoras/genética , Proteínas do Complexo de Importação de Proteína Precursora Mitocondrial , Fosforilação , Polimorfismo de Nucleotídeo Único/genética
7.
Phys Rev Lett ; 84(9): 1982-5, 2000 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-11017676

RESUMO

The two-dimensional electron gas (2DEG) in moderate magnetic fields in ultraclean AlAs-GaAs heterojunctions exhibits transport anomalies suggestive of a compressible anisotropic metallic state. Using scaling arguments and Monte Carlo simulations, we develop an order parameter theory of an electron nematic phase. The observed temperature dependence of the resistivity anisotropy behaves like the orientational order parameter if the transition to the nematic state occurs at a finite temperature T(c) approximately 65 mK, and is slightly rounded by a small background microscopic anisotropy. We propose a light scattering experiment to measure the critical susceptibility.

8.
Ann Biomed Eng ; 27(6): 746-57, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10625147

RESUMO

This work is concerned with modeling the key interrelated biochemical reactions involved in initiating and inhibiting pacemaking activity in the mammalian sinoatrial node. A detailed model involving G-proteins was developed to better represent the activation pathway for adenylate cyclase. Concentration profiles of an activated G-protein complex [alpha(T)C] were established as a function of the membrane bound calcium calmodulin concentration. A previously developed model used to establish temporal profiles of cAMP was improved using the G-protein effects through the [alpha(T)C] functionality. Methods were also developed to model inhibition of G-protein by acetylcholine. Analytical solutions were developed to predict acetylcholine concentration profiles as a function of diffusion parameter and duration of acetylcholine pulses. The model was used to demonstrate suppression of cAMP by acetylcholine through G-protein pathways. It provides a basis for a tool to quantify key biochemical species during stimulation and inhibition of sinoatrial node pacemaking. A stability analysis of the model equations has potential application in studying the link between the biochemical species concentrations and abnormal effects in sinoatrial node pacemaking.


Assuntos
Acetilcolina/fisiologia , Adenilil Ciclases/fisiologia , Calmodulina/fisiologia , AMP Cíclico/fisiologia , Proteínas de Ligação ao GTP/fisiologia , Modelos Cardiovasculares , Modelos Químicos , Transdução de Sinais/fisiologia , Nó Sinoatrial/fisiologia , Acetilcolina/química , Adenilil Ciclases/química , Animais , Calmodulina/química , AMP Cíclico/química , Difusão , Proteínas de Ligação ao GTP/química , Hidrólise , Mamíferos , Análise Numérica Assistida por Computador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes
9.
Transfusion ; 35(7): 552-8, 1995 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7631386

RESUMO

BACKGROUND: Successful blood substitutes, when infused in place of an equal volume of whole blood, provide similar delivery of oxygen to the tissues without introducing abnormalities in cellular metabolism. STUDY DESIGN AND METHODS: Equal volumes of whole blood (control), polyethylene glycol-hemoglobin solution at 6 g per dL, dextran solution, and physiologic saline were compared for their ability to reverse the effects of hemorrhagic hypotension on oxygenation and dopamine metabolism in the brain of newborn piglets. The decrease in mean arterial blood pressure was used as a measure of the hemorrhagic insult. Cerebral oxygen pressure was determined optically by the oxygen-dependent quenching of phosphorescence, and the extracellular level of dopamine in the corpus striatum was determined by in vivo microdialysis. RESULTS: Following a 2-hour stabilization after implantation of the microdialysis probe in the corpus striatum, the mean arterial blood pressure was decreased from 88 +/- 7 torr (control) to 42 +/- 5 torr by the removal of blood in a stepwise manner, over a period of 60 minutes. Decrease in mean arterial blood pressure caused a progressive stepwise decrease in cortical oxygen pressure from 48 +/- 5 torr to 16 +/- 4 torr at the end of bleeding. As a consequence of the decrease in oxygen pressure, extracellular dopamine increased progressively to about 2300 percent of the control value. When a volume of blood equal to that removed was returned and bicarbonate was injected to help correct arterial pH, blood pressure, cortical oxygen pressure, and extracellular dopamine all returned within the 20- to 30-minute recovery period to values not significantly different from control values. An equal volume of polyethylene glycol-hemoglobin solution, even with significantly lower hemoglobin content than whole blood, gave results comparable to those with whole blood. CONCLUSION: Polyethylene glycol-hemoglobin solution, like whole blood but in contrast to physiologic saline or dextran solution, was capable of returning the mean arterial blood pressure, cortical oxygen pressures, and extracellular dopamine nearly to control levels after acute blood loss in newborn piglets.


Assuntos
Transfusão de Sangue/métodos , Hemoglobinas/uso terapêutico , Hemorragia/terapia , Hipotensão/terapia , Polietilenoglicóis/uso terapêutico , Animais , Pressão Sanguínea , Encéfalo/metabolismo , Dopamina/análise , Hemorragia/complicações , Hemorragia/fisiopatologia , Hipotensão/etiologia , Hipotensão/fisiopatologia , Oxigênio/análise , Suínos
10.
Artigo em Inglês | MEDLINE | ID: mdl-7994375

RESUMO

Hemoglobinuria, defined as hemoglobin or hemoglobin subunits in the urine, is an easily monitored, sensitive indicator of renal handling of hemoglobin-based blood substitutes. Hemoglobin tetramer dissociation increases filtration by the kidneys. When the rate of filtration exceeds reabsorption, hemoglobinuria occurs. This study investigates the renal filtration and absorption of polyethylene glycol-modified bovine hemoglobin by monitoring for hemoglobinuria in several model systems.


Assuntos
Substitutos Sanguíneos/toxicidade , Hemoglobinas/toxicidade , Hemoglobinúria/etiologia , Polietilenoglicóis/toxicidade , Absorção , Animais , Substitutos Sanguíneos/química , Substitutos Sanguíneos/farmacocinética , Volume Sanguíneo , Bovinos , Modelos Animais de Doenças , Transfusão Total , Feminino , Taxa de Filtração Glomerular , Meia-Vida , Hemoglobinas/química , Hemoglobinas/farmacocinética , Masculino , Peso Molecular , Polietilenoglicóis/farmacocinética , Ratos , Ratos Sprague-Dawley
11.
Artigo em Inglês | MEDLINE | ID: mdl-7994387

RESUMO

Bovine hemoglobin has many advantages as a blood substitute: a) it's ready availability; b) it's low cost; c) it's oxygen carrying capacity; and d) the ease with which it can be modified with polyethylene glycol (PEG) to improve its pharmacokinetic profile. This study investigates the potential of PEG-modified bovine hemoglobin as a cost-effective blood substitute.


Assuntos
Substitutos Sanguíneos/economia , Substitutos Sanguíneos/isolamento & purificação , Hemoglobinas/isolamento & purificação , Polietilenoglicóis , Animais , Substitutos Sanguíneos/química , Bovinos , Cromatografia Líquida de Alta Pressão , Análise Custo-Benefício , Contaminação de Medicamentos , Estabilidade de Medicamentos , Endotoxinas/análise , Transfusão Total , Hemoglobinas/metabolismo , Hemoglobinúria/etiologia , Humanos , Técnicas In Vitro , Metemoglobina/análise , Oxigênio/metabolismo , Ratos , Choque/metabolismo , Choque/terapia
12.
Artigo em Inglês | MEDLINE | ID: mdl-7994402

RESUMO

Polyethylene glycol-hemoglobin (PEG-Hb is a purified bovine hemoglobin molecule modified by polyethylene glycol. Oxygen delivery to the tissue, in rat exchange transfusion and hypovolemic shock models, was studied to determine whether the oxygen-carrying capacity of PEG-Hb is as efficient as red blood cells.


Assuntos
Substitutos Sanguíneos/farmacologia , Hemoglobinas/farmacologia , Oxigênio/metabolismo , Choque/terapia , Músculos Abdominais/metabolismo , Animais , Substitutos Sanguíneos/administração & dosagem , Substitutos Sanguíneos/metabolismo , Bovinos , Modelos Animais de Doenças , Transfusão Total , Hemoglobinas/administração & dosagem , Hemoglobinas/metabolismo , Infusões Intravenosas , Polietilenoglicóis/farmacologia , Ratos , Ratos Sprague-Dawley , Ressuscitação , Choque/metabolismo
13.
Artigo em Inglês | MEDLINE | ID: mdl-7994403

RESUMO

Cell damage initiated during ischemia, as a result of oxygen depletion, continues during reperfusion, and recovery is dependent on the length of the ischemic period. This study investigates the effect of polyethylene glycol-modified hemoglobin (PEG-Hb) on recovery of tissue oxygen tension after induced ischemia.


Assuntos
Substitutos Sanguíneos/farmacologia , Hemoglobinas/farmacologia , Isquemia/terapia , Fígado/irrigação sanguínea , Oxigênio/metabolismo , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Substitutos Sanguíneos/metabolismo , Bovinos , Hemoglobinas/metabolismo , Isquemia/metabolismo , Fígado/metabolismo , Polietilenoglicóis/farmacologia , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
14.
Ann Biomed Eng ; 21(6): 669-77, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8116918

RESUMO

Consideration of the enzymatic reactions governing calcium channel phosphorylation and dephosphorylation leads one to deduce that there exist separate groups of enzymes, membrane-bound and cytoplasmic that are activated by a common mediator, calmodulin (CaM), whose time-dependent appearance (via diffusion) at both locales is controlled by both intracellular calcium levels and electrostatic interaction with the membrane. In brief, the change in the sign and extent of the electrical charge borne by the modulator in the presence of calcium (Ca) brings about the electrostatic attraction that enables the transport of [Ca-CaM] to the membrane. This translocation of Ca-CaM makes possible a sequential activation of cellular enzymes whose locations differ. The sequence, both spatial and temporal, of the activation of various cellular enzymes by Ca-CaM appears to be a control network shared in common by excitable cells containing a stimulus-response pathway mediated by second messengers.


Assuntos
Canais de Cálcio/fisiologia , Calmodulina/fisiologia , Simulação por Computador , Modelos Biológicos , Adenilil Ciclases/metabolismo , Animais , AMP Cíclico/metabolismo , Citoplasma/metabolismo , Potenciais da Membrana/fisiologia , Diester Fosfórico Hidrolases/metabolismo , Fosforilação , Nó Sinoatrial/fisiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-1391472

RESUMO

An initial evaluation of PEG-bHb was performed using a modified hypovolemic shock model. PEG-bHb had a substantially longer intravascular half-life than native Hb and no measurable hemoglobinuria was observed in the canine. PEG-bHb allowed successful resuscitation with an oxygen carrying capacity of 14-22% over that of lactated Ringer's solution.


Assuntos
Substitutos Sanguíneos/uso terapêutico , Desidratação/terapia , Hemoglobinas/uso terapêutico , Choque/terapia , Animais , Substitutos Sanguíneos/isolamento & purificação , Substitutos Sanguíneos/toxicidade , Modelos Animais de Doenças , Cães , Meia-Vida , Hemoglobinas/isolamento & purificação , Hemoglobinas/metabolismo , Soluções Isotônicas/uso terapêutico , Polietilenoglicóis , Ressuscitação , Lactato de Ringer , Segurança , Choque/patologia , Choque/fisiopatologia , Choque Hemorrágico/terapia
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