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1.
Adv Wound Care (New Rochelle) ; 9(4): 145-160, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32117579

RESUMO

Objective: Insufficient knowledge about the molecular pathology of diabetic foot ulcer (DFU) impedes the development of effective wound treatment. Circular RNAs (circRNAs) are a novel class of RNA recently discovered to be widely expressed and have important biological functions; however, their role in skin wound healing remains largely unexplored. In this study, we investigated the role of circRNAs in DFU. Approach: CircRNA expression was profiled in normal wounds (NWs) and DFUs by microarray analysis, and hsa_circ_0084443 was identified as differentially expressed. The circularity and subcellular localization of hsa_circ_0084443 were characterized by northern blotting, real-time PCR, and fluorescence in situ hybridization. Cell migration, cell growth, and the transcriptome of human primary keratinocytes were analyzed after overexpression or RNA interference of hsa_circ_0084443. Results: hsa_circ_0084443 is downregulated in NWs compared with intact skin, and its level is higher in DFUs than NWs. We confirmed its circularity and presence in the cytoplasm of human epidermal keratinocytes. We showed that hsa_circ_0084443 reduced motility while enhancing the growth of keratinocytes. Furthermore, we identified a gene network with the potential to mediate the biological effect of hsa_circ_0084443. Innovation: CircRNAs have a functional role and a potential clinical significance in skin wound healing. Conclusions: We identified hsa_circ_0084443, a circRNA downregulated during NW healing, as a negative regulator of keratinocyte migration. Higher levels of hsa_circ_0084443 were detected in DFU samples, suggesting that it plays a role in pathology. These findings pave the way to understanding the functional role of circRNAs in human skin wound healing.


Assuntos
Movimento Celular/genética , Proliferação de Células/genética , Pé Diabético/genética , Queratinócitos/metabolismo , RNA Circular/genética , Regulação para Cima/genética , Cicatrização/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Northern Blotting , Estudos de Coortes , Feminino , Humanos , Hibridização in Situ Fluorescente , Masculino , Pessoa de Meia-Idade , RNA Circular/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Transcriptoma
2.
Proc Natl Acad Sci U S A ; 116(19): 9443-9452, 2019 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-31019085

RESUMO

An increasing number of studies reveal the importance of long noncoding RNAs (lncRNAs) in gene expression control underlying many physiological and pathological processes. However, their role in skin wound healing remains poorly understood. Our study focused on a skin-specific lncRNA, LOC105372576, whose expression was increased during physiological wound healing. In human nonhealing wounds, however, its level was significantly lower compared with normal wounds under reepithelialization. We characterized LOC105372576 as a nuclear-localized, RNAPII-transcribed, and polyadenylated lncRNA. In keratinocytes, its expression was induced by TGF-ß signaling. Knockdown of LOC105372576 and activation of its endogenous transcription, respectively, reduced and increased the motility of keratinocytes and reepithelialization of human ex vivo skin wounds. Therefore, LOC105372576 was termed "wound and keratinocyte migration-associated lncRNA 1" (WAKMAR1). Further study revealed that WAKMAR1 regulated a network of protein-coding genes important for cell migration, most of which were under the control of transcription factor E2F1. Mechanistically, WAKMAR1 enhanced E2F1 expression by interfering with E2F1 promoter methylation through the sequestration of DNA methyltransferases. Collectively, we have identified a lncRNA important for keratinocyte migration, whose deficiency may be involved in the pathogenesis of chronic wounds.


Assuntos
Movimento Celular , Queratinócitos/metabolismo , RNA Longo não Codificante/biossíntese , Transdução de Sinais , Pele/metabolismo , Cicatrização , Ferimentos e Lesões/metabolismo , Doença Crônica , Fator de Transcrição E2F1/metabolismo , Regulação da Expressão Gênica , Humanos , Queratinócitos/patologia , Pele/patologia , Fator de Crescimento Transformador beta/metabolismo , Ferimentos e Lesões/patologia
3.
ACS Biomater Sci Eng ; 5(1): 45-55, 2019 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33405865

RESUMO

Glycosaminoglycans, both cell-surface and exogenous, can interfere with DNA delivery efficiency of nonviral carrier systems. In this work, we report an extensive comparative study to explore the effect of exogenously added chondroitin sulfate on biophysical characteristics, cellular uptake, transfection efficiency, and intracellular trafficking of nanocomplexes formed using primary and secondary amphipathic peptides developed in our laboratory. Our results indicate that the presence of exogenous chondroitin sulfate exhibits differential enhancement in transfection efficiency of the amphipathic peptides depending upon their chemical nature. The enhancement was more pronounced in primary amphipathic peptide-based nanocomplexes as compared to the secondary counterpart. This difference can be attributed to possible alteration of the intracellular entry pathway in addition to increased extracellular stability, less cellular toxicity, and assistance in nuclear accumulation. These results imply potential use of glycosaminoglycans such as chondroitin sulfate to improve the transfection efficiency of primary amphipathic peptides for possible in vivo applications.

4.
J Invest Dermatol ; 139(6): 1373-1384, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30594489

RESUMO

Chronic wounds represent a major and growing health and economic burden worldwide. A better understanding of molecular mechanisms of normal as well as impaired wound healing is needed to develop effective treatment. Herein we studied the potential role of long noncoding RNA LOC100130476 in skin wound repair. LOC100130476 is an RNA polymerase II-encoded polyadenylated transcript present in both cytoplasm and nucleus. We found that its expression was lower in wound-edge keratinocytes of human chronic wounds compared to normal wounds of healthy donors and intact skin. In cultured keratinocytes, LOC100130476 expression was induced by TGF-ß signaling. By reducing LOC100130476 expression with antisense oligos or activating its transcription with CRISPR/Cas9 Synergistic Activation Mediator system, we showed that LOC100130476 restricted the production of inflammatory chemokines by keratinocytes, while enhancing cell migration. In line with this, knockdown of LOC100130476 impaired re-epithelization of human ex vivo wounds. Based on these results, we named LOC100130476 wound and keratinocyte migration-associated long noncoding RNA 2 (WAKMAR2). Moreover, we identified a molecular network that may mediate the biological function of WAKMAR2 in keratinocytes using microarray. In summary, our data suggest that WAKMAR2 is an important regulator of skin wound healing and its deficiency may contribute to the pathogenesis of chronic wounds.


Assuntos
Quimiocinas/genética , Regulação da Expressão Gênica/imunologia , Queratinócitos/fisiologia , RNA Longo não Codificante/metabolismo , Úlcera Varicosa/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Movimento Celular/genética , Movimento Celular/imunologia , Quimiocinas/imunologia , Quimiocinas/metabolismo , Feminino , Perfilação da Expressão Gênica , Técnicas de Silenciamento de Genes , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos , Cultura Primária de Células , RNA Longo não Codificante/genética , Pele/imunologia , Pele/lesões , Pele/patologia , Técnicas de Cultura de Tecidos , Úlcera Varicosa/imunologia , Úlcera Varicosa/patologia , Cicatrização/genética , Cicatrização/imunologia , Adulto Jovem
5.
Redox Biol ; 19: 116-133, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30149290

RESUMO

Oxidative stress response in bacteria is mediated through coordination between the regulators of oxidant-remediation systems (e.g. OxyR, SoxR) and nucleoid condensation (e.g. Dps, Fis). However, these genetic factors are either absent or rendered non-functional in the human pathogen Mycobacterium tuberculosis (Mtb). Therefore, how Mtb organizes genome architecture and regulates gene expression to counterbalance oxidative imbalance is unknown. Here, we report that an intracellular redox-sensor, WhiB4, dynamically links genome condensation and oxidative stress response in Mtb. Disruption of WhiB4 affects the expression of genes involved in maintaining redox homeostasis, central metabolism, and respiration under oxidative stress. Notably, disulfide-linked oligomerization of WhiB4 in response to oxidative stress activates the protein's ability to condense DNA. Further, overexpression of WhiB4 led to hypercondensation of nucleoids, redox imbalance and increased susceptibility to oxidative stress, whereas WhiB4 disruption reversed this effect. In accordance with the findings in vitro, ChIP-Seq data demonstrated non-specific binding of WhiB4 to GC-rich regions of the Mtb genome. Lastly, data indicate that WhiB4 deletion affected the expression of ~ 30% of genes preferentially bound by the protein, suggesting both direct and indirect effects on gene expression. We propose that WhiB4 structurally couples Mtb's response to oxidative stress with genome organization and transcription.


Assuntos
Proteínas de Bactérias/genética , Regulação Bacteriana da Expressão Gênica , Mycobacterium tuberculosis/genética , Estresse Oxidativo , Proteínas Repressoras/genética , Tuberculose/microbiologia , Animais , Proteínas de Bactérias/metabolismo , Deleção de Genes , Genoma Bacteriano , Humanos , Camundongos , Mycobacterium tuberculosis/metabolismo , Oxirredução , Células RAW 264.7 , Proteínas Repressoras/metabolismo , Regulação para Cima
6.
Mol Ther ; 25(6): 1342-1352, 2017 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-28366765

RESUMO

Topical delivery of nucleic acids to skin has huge prospects in developing therapeutic interventions for cutaneous disorders. In spite of initial success, clinical translation is vastly impeded by the constraints of bioavailability as well as stability in metabolically active environment of skin. Various physical and chemical methods used to overcome these limitations involve invasive procedures or compounds that compromise skin integrity. Hence, there is an increasing demand for developing safe skin penetration enhancers for efficient nucleic acid delivery to skin. Here, we demonstrate that pretreatment of skin with silicone oil can increase the transfection efficiency of non-covalently associated peptide-plasmid DNA nanocomplexes in skin ex vivo and in vivo. The method does not compromise skin integrity, as indicated by microscopic evaluation of cellular differentiation, tissue architecture, enzyme activity assessment, dye penetration tests using Franz assay, and cytotoxicity and immunogenicity analyses. Stability of nanocomplexes is not hampered on pretreatment, thereby avoiding nuclease-mediated degradation. The mechanistic insights through Fourier transform infrared (FTIR) spectroscopy reveal some alterations in the skin hydration status owing to possible occlusion effects of the enhancer. Overall, we describe a topical, non-invasive, efficient, and safe method that can be used to increase the penetration and delivery of plasmid DNA to skin for possible therapeutic applications.


Assuntos
Técnicas de Transferência de Genes , Ácidos Nucleicos , Óleos de Silicone , Pele/metabolismo , Administração Tópica , Animais , Linhagem Celular , Sobrevivência Celular , Peptídeos Penetradores de Células/metabolismo , Citocinas/metabolismo , Citometria de Fluxo , Expressão Gênica , Genes Reporter , Humanos , Camundongos , Nanopartículas , Ácidos Nucleicos/administração & dosagem , Ácidos Nucleicos/química , Ácidos Nucleicos/genética , Permeabilidade , Plasmídeos/administração & dosagem , Plasmídeos/química , Plasmídeos/genética , Óleos de Silicone/química , Espectroscopia de Infravermelho com Transformada de Fourier , Transfecção
7.
Nanomedicine ; 13(5): 1833-1839, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28343015

RESUMO

Many cancers fail to respond to immunotherapy as a result of immune suppression by the tumor microenvironment. The exogenous expression of immune cytokines to reprogram the tumor microenvironment represents an approach to circumvent this suppression. The present studies describe the development of a novel dual nanoparticle (DNP) system for driving DNA expression vectors encoding inflammatory cytokines in tumor cells. The DNP system consists of a DNA expression vector-cationic peptide nanocomplex (NC) surrounded by a diblock polymeric NP. Tumor necrosis factor alpha (TNF) was selected as the prototype cytokine for this system, based on its pleotropic inflammatory and anti-cancer activities. Our results demonstrate that the DNP system is highly effective in driving expression of TNF in tumor cells. We also demonstrate that the DNPs are effective in inducing apoptosis and anti-tumor activity. These findings support a novel immunotherapeutic approach for the intratumoral delivery of DNA vectors that express inflammatory cytokines.


Assuntos
Vetores Genéticos , Nanopartículas , Microambiente Tumoral , Fator de Necrose Tumoral alfa , Citocinas , DNA , Humanos , Inflamação , Neoplasias/tratamento farmacológico
8.
Biomacromolecules ; 17(9): 2912-9, 2016 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-27477067

RESUMO

Melanin and related polydopamine hold great promise; however, restricted fine-tunabilility limits their usefulness in biocompatible applications. In the present study, by taking a biomimetic approach, we synthesize peptide-derived melanin with a range of physicochemical properties. Characterization of these melanin polymers indicates that they exist as nanorange materials with distinct size distribution, shapes, and surface charges. These variants demonstrate similar absorption spectra but have different optical properties that correlate with particle size. Our approach enables incorporation of chemical groups to create functionalized polyvalent organic nanomaterials and enables customization of melanin. Further, we establish that these synthetic variants are efficiently taken up by the skin keratinocytes, display appreciable photoprotection with minimal cytotoxicity, and thereby function as effective color matched photoprotective agents. In effect we demonstrate that an array of functionalized melanins with distinct properties could be synthesized using bioinspired green chemistry, and these are of immense utility in generating customized melanin/polydopamine like materials.


Assuntos
Queratinócitos/metabolismo , Melaninas/química , Melaninas/fisiologia , Lesões por Radiação/prevenção & controle , Dermatopatias/prevenção & controle , Pele/metabolismo , Biomimética , Células Cultivadas , Cor , Humanos , Indóis/química , Queratinócitos/citologia , Queratinócitos/efeitos da radiação , Polímeros/química , Proteção Radiológica , Pele/efeitos da radiação , Raios Ultravioleta/efeitos adversos
9.
Mol Pharm ; 13(6): 1779-90, 2016 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-27175623

RESUMO

Arginine-rich cell penetrating peptides are powerful tools for in vitro as well as in vivo delivery of a wide plethora of biomolecules. However, presence of consecutive arginine residues leads to enhanced amenability for proteolytic degradation as well as steric hindrances for membrane interactions which compromise its bioavailability. In order to overcome these limitations we previously reported a safe and stable octaarginine based oligomer, i.e., (r-x-r)4-carbamate, where the backbone amide linkages were replaced by carbamate linkages and 6-aminohexanoic acid based spacer moieties were incorporated for better flexibility, hydrophobicity, optimal spacing of guanidinium groups, and protection against proteolytic cleavage; resulting in improved transfection efficiency over its amide counterpart. In the present work we have investigated the mechanism behind this enhanced transfection efficiency and, based on our observations, demonstrate how the synergistic effect of rationalized oligomer designing, complex characteristics, and cell type contributes to overall effective intracellular delivery. Our results indicate that the (r-x-r)4-carbamate-plasmid DNA complexes primarily utilize lipid raft dependent pathway of cellular entry more than other pathways, and this possibly facilitates their increased entry in the lipid raft rich milieu of skin cells. We also emphasize the utility of oligomer (r-x-r)4-carbamate as an efficient carrier for topical delivery of nucleic acids in skin tissue. This carrier can be utilized for safe, efficient, and noninvasive delivery of therapeutically relevant macromolecular hydrophilic cargo like nucleic acids to skin.


Assuntos
Carbamatos/metabolismo , DNA/metabolismo , Plasmídeos/metabolismo , Pele/metabolismo , Animais , Arginina/metabolismo , Células CHO , Linhagem Celular , Linhagem Celular Tumoral , Peptídeos Penetradores de Células/metabolismo , Cricetulus , Humanos , Interações Hidrofóbicas e Hidrofílicas , Lipídeos/química , Ácidos Nucleicos/metabolismo , Oligopeptídeos/metabolismo , Transfecção/métodos
10.
J Control Release ; 222: 159-68, 2016 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-26699422

RESUMO

Topical delivery to skin is an essential step in non-invasive application of nucleic acid therapeutics for cutaneous disorders. The barrier posed by different layers of the skin - stratum corneum on top followed by the viable epidermis below - makes it extremely challenging for large hydrophilic molecules like nucleic acids to efficiently enter the uncompromised skin. We report an amphipathic peptide Mgpe9 (CRRLRHLRHHYRRRWHRFRC) that can penetrate the uncompromised skin, enter skin cells and deliver plasmid DNA efficiently as nanocomplexes in vitro and in vivo without any additional physical or chemical interventions prevalent currently. We observe efficient gene expression up to the highly proliferating basal layer of the skin without observable adverse reactions or toxic effects after delivery of reporter plasmids. The entry mechanism of nanocomplexes possibly involves reversible modulation of junction proteins accompanied by transient changes in skin structure. This peptide holds potential to be used as an efficient transporter of therapeutic nucleic acids to the skin.


Assuntos
Peptídeos Penetradores de Células/administração & dosagem , DNA/administração & dosagem , Prepúcio do Pênis/metabolismo , Plasmídeos , Animais , Linhagem Celular , Sobrevivência Celular , Peptídeos Penetradores de Células/química , DNA/química , Prepúcio do Pênis/ultraestrutura , Técnicas de Transferência de Genes , Humanos , Masculino , Camundongos Pelados , Microscopia Eletrônica de Transmissão , Permeabilidade
11.
J Vis Exp ; (106): e53307, 2015 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-26779762

RESUMO

MicroRNAs (miRNAs) are key regulators of gene expression. In the brain, vital processes like neurodevelopment and neuronal functions depend on the correct expression of microRNAs. Perturbation of microRNAs in the brain can be used to model neurodegenerative diseases by modulating neuronal cell death. Currently, stereotactic injection is used to deliver miRNA knockdown agents to specific location in the brain. Here, we discuss strategies to design antagomirs against miRNA with locked nucleotide modifications (LNA). Subsequently describe a method for brain specific delivery of antagomirs, uniformly across different regions of the brain. This method is simple and widely applicable since it overcomes the surgery, associated injury and limitation of local delivery in stereotactic injections. We prepared a complex of neurotropic, cell-penetrating peptide Rabies Virus Glycoprotein (RVG) with antagomir against miRNA-29 and injected through tail vein, to specifically deliver in the brain. The antagomir design incorporated features that allow specific targeting of the miRNA and formation of non-covalent complexes with the peptide. The knock-down of the miRNA in neuronal cells, resulted in apoptotic cell death and associated behavioural defects. Thus, the method can be used for acute models of neuro-degeneration through the perturbation of miRNAs.


Assuntos
Encéfalo/fisiologia , Técnicas de Silenciamento de Genes/métodos , MicroRNAs/antagonistas & inibidores , Sequência de Aminoácidos , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Glicoproteínas/administração & dosagem , Glicoproteínas/genética , Camundongos , MicroRNAs/genética , MicroRNAs/metabolismo , Dados de Sequência Molecular , Oligonucleotídeos Antissenso/administração & dosagem , Oligonucleotídeos Antissenso/genética , Técnicas Estereotáxicas , Transfecção/métodos , Proteínas Virais/administração & dosagem , Proteínas Virais/genética
12.
Bioorg Med Chem Lett ; 24(17): 4198-202, 2014 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-25096299

RESUMO

The syntheses of novel N-aminoalkyl proline-derived spacers (X') in polycationic (R-X'-R)-motif cell-penetrating α-ω-α-peptides are described as improved molecular transporters and their structural features studied by CD. FACS analysis shows enhanced cellular uptake and confocal microscopy indicates predominantly cytoplasmic localization. The oligomers are efficient at transporting pDNA into cells. The chirality together with the hydrophobicity and flexibility derived from the spacer chain are found to have marked influence on the cell-penetrating and cargo delivery properties of the cell-penetrating peptides (CPPs). The peptides containing N-(3-aminopropyl)-D-proline spacers are found to be the best at cell penetration and cargo delivery in the present study.


Assuntos
Aminoácidos/química , Permeabilidade da Membrana Celular , Peptídeos Penetradores de Células/química , Peptídeos Penetradores de Células/metabolismo , Portadores de Fármacos/química , Portadores de Fármacos/metabolismo , Animais , Células CHO , Linhagem Celular Tumoral , Permeabilidade da Membrana Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Peptídeos Penetradores de Células/farmacologia , Cricetulus , DNA/metabolismo , Portadores de Fármacos/farmacologia , Células HeLa , Humanos
13.
PLoS One ; 8(7): e69985, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23922883

RESUMO

The bacterial chromosomal DNA is folded into a compact structure called as 'nucleoid' so that the bacterial genome can be accommodated inside the cell. The shape and size of the nucleoid are determined by several factors including DNA supercoiling, macromolecular crowding and nucleoid associated proteins (NAPs). NAPs bind to different sites of the genome in sequence specific or non-sequence specific manner and play an important role in DNA compaction as well as regulation. Until recently, few NAPs have been discovered in mycobacteria owing to poor sequence similarities with other histone-like proteins of eubacteria. Several putative NAPs have now been identified in Mycobacteria on the basis of enriched basic residues or histone-like "PAKK" motifs. Here, we investigate mycobacterial Integration Host Factor (mIHF) for its architectural roles as a NAP using atomic force microscopy and DNA compaction experiments. We demonstrate that mIHF binds DNA in a non-sequence specific manner and compacts it by a DNA bending mechanism. AFM experiments also indicate a dual architectural role for mIHF in DNA compaction as well as relaxation. These results suggest a convergent evolution in the mechanism of E. coli and mycobacterial IHF in DNA compaction.


Assuntos
Proteínas de Bactérias/metabolismo , DNA Bacteriano/metabolismo , Fatores Hospedeiros de Integração/metabolismo , Mycobacterium tuberculosis/metabolismo , Tuberculose/microbiologia , Proteínas de Bactérias/genética , Clonagem Molecular , DNA Bacteriano/genética , Genoma Bacteriano , Fatores Hospedeiros de Integração/genética , Mycobacterium tuberculosis/genética , Fases de Leitura Aberta , Ligação Proteica
14.
J Biotechnol ; 163(4): 419-24, 2013 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-23305990

RESUMO

In the present study, a novel strategy was adopted to synthesize, ß lactamase resistant penicillin G molecules by using the unique properties of silver nanoparticles. Ascorbic acid-stabilized spherical monodispersed silver nanoparticles were prepared by a simple chemical reaction. The formation processes of the silver nanoparticles were investigated by UV-vis spectroscopy and Atomic Force Microscopy (AFM). Free amine groups were introduced on the surface of native silver nanoparticles by coating a uniform layer of polyaniline and this was confirmed by FTIR spectroscopy and Scanning Electron Microscopy. Functionalized silver nanoparticles were then grafted to the C3 carboxyl group of the ß lactam ring of penicillin G in the presence of N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride (EDAC) with a conjugation yield of 213 µg mg⁻¹. These novel silver penicillin G nanoconjugates showed a very good growth inhibition against both non-resistant Escherichia coli (gram negative) as well as toward ß lactam resistant, E. coli (gram negative) and Staphylococcus aureus (gram positive).


Assuntos
Biotecnologia/métodos , Escherichia coli/efeitos dos fármacos , Nanopartículas Metálicas/química , Nanoconjugados/química , Penicilina G/química , Penicilina G/farmacologia , Prata , Staphylococcus aureus/efeitos dos fármacos , Resistência beta-Lactâmica/efeitos dos fármacos , Antibacterianos/síntese química , Antibacterianos/química , Antibacterianos/farmacologia , Testes de Sensibilidade Microbiana , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Prata/química , Prata/farmacologia , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios X , beta-Lactamases/efeitos dos fármacos
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