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1.
Mem Cognit ; 49(5): 923-938, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33398786

RESUMO

Do the images we see every day influence how we remember our lives? Research on this matter often concerns how entire memories of events can be created or shaped through the use of doctored photographs of personal (Wade et al., Psychonomic bulletin & review, 9 (3), 597-603, 2002) and public events (Sacchi et al., Applied Cognitive Psychology, 21 (8), 1005-1022, 2007). Although this paradigm has yielded insights into false memory production, it may underestimate the extent to which photographs can bias or distort memory in a subtler manner (i.e., without the use of doctored photographs or suggestion). In Experiments 1 (N = 95) and 2 (N = 186) of the present study, we examined whether the mere presence of generic images, typical of stock photography, could influence aspects of our memories. Given the parallel between autobiographical remembering and forecasting (Berntsen & Bohn, Memory & Cognition, 38(3), 265-278, 2010), we also examined (Experiment 3: N=204) how such images would influence future autobiographical judgments. Specifically, three experiments investigated whether photographs would bias autobiographical judgments for either quantitative (e.g., How many movies have you seen in the past year?) or affective (e.g., How enjoyable do you think your next date will be?) aspects of events in everyday life. We found that photographs reliably influenced judgments related to quantitative aspects of autobiographical events. Moreover, though less robustly, there was an indication that these photos could bias our affective construal of such events as well. Overall, we conclude that the mere presence of generic photographs may exert an influence on the way we think about our lives to an extent previously under-recognized.


Assuntos
Julgamento , Memória Episódica , Cognição , Humanos , Rememoração Mental , Fotografação
2.
J Immunol ; 205(5): 1449-1460, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32737148

RESUMO

Optimal ex vivo expansion protocols of tumor-specific T cells followed by adoptive cell therapy must yield T cells able to home to tumors and effectively kill them. Our previous study demonstrated ex vivo activation in the presence of IL-12-induced optimal CD8+ T cell expansion and melanoma regression; however, adverse side effects, including autoimmunity, can occur. This may be due to transfer of high-avidity self-specific T cells. In this study, we compared mouse low- and high-avidity T cells targeting the tumor Ag tyrosinase-related protein 2 (TRP2). Not surprisingly, high-avidity T cells provide superior tumor control, yet low-avidity T cells can promote tumor regression. The addition of IL-12 during in vitro expansion boosts low-avidity T cell responsiveness, tumor regression, and prevents T cell exhaustion. In this study, we demonstrate that IL-12-primed T cells are resistant to PD-1/PD-L1-mediated suppression and retain effector function. Importantly, IL-12 preconditioning prevented exhaustion as LAG-3, PD-1, and TOX were decreased while simultaneously increasing KLRG1. Using intravital imaging, we also determined that high-avidity T cells have sustained contacts with intratumoral dendritic cells and tumor targets compared with low-avidity T cells. However, with Ag overexpression, this defect is overcome, and low-avidity T cells control tumor growth. Taken together, these data illustrate that low-avidity T cells can be therapeutically beneficial if cocultured with IL-12 cytokine during in vitro expansion and highly effective in vivo if Ag is not limiting. Clinically, low-avidity T cells provide a safer alternative to high-avidity, TCR-engineered T cells, as IL-12-primed, low-avidity T cells cause less autoimmune vitiligo.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Interleucina-12/imunologia , Ativação Linfocitária/imunologia , Melanoma Experimental/imunologia , Melanoma Experimental/terapia , Animais , Antígenos de Neoplasias/imunologia , Autoimunidade/imunologia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Terapia Baseada em Transplante de Células e Tecidos/métodos , Imunoterapia Adotiva/métodos , Proteínas de Membrana/imunologia , Camundongos , Camundongos Endogâmicos C57BL , Fragmentos de Peptídeos/imunologia , Receptores de Antígenos de Linfócitos T/imunologia
3.
J Immunol ; 203(4): 844-852, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31324724

RESUMO

Programmed death-1 (PD-1) inhibits T and B cell function upon ligand binding. PD-1 blockade revolutionized cancer treatment, and although numerous patients respond, some develop autoimmune-like symptoms or overt autoimmunity characterized by autoantibody production. PD-1 inhibition accelerates autoimmunity in mice, but its role in regulating germinal centers (GC) is controversial. To address the role of PD-1 in the GC reaction in type 1 diabetes, we used tetramers to phenotype insulin-specific CD4+ T and B cells in NOD mice. PD-1 or PD-L1 deficiency, and PD-1 but not PD-L2 blockade, unleashed insulin-specific T follicular helper CD4+ T cells and enhanced their survival. This was concomitant with an increase in GC B cells and augmented insulin autoantibody production. The effect of PD-1 blockade on the GC was reduced when mice were treated with a mAb targeting the insulin peptide:MHC class II complex. This work provides an explanation for autoimmune side effects following PD-1 pathway inhibition and suggests that targeting the self-peptide:MHC class II complex might limit autoimmunity arising from checkpoint blockade.


Assuntos
Autoimunidade/imunologia , Linfócitos B/imunologia , Linfócitos T CD4-Positivos/imunologia , Diabetes Mellitus Tipo 1/imunologia , Receptor de Morte Celular Programada 1/imunologia , Animais , Antígeno B7-H1/imunologia , Diabetes Mellitus Experimental/imunologia , Feminino , Centro Germinativo/imunologia , Antígenos de Histocompatibilidade Classe II/imunologia , Ativação Linfocitária/imunologia , Camundongos , Camundongos Endogâmicos NOD
4.
Mem Cognit ; 46(7): 1210-1221, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29931619

RESUMO

Photographs have been found to affect a variety of psychological judgments. For example, nonprobative but semantically related photographs may increase beliefs in the truth of general knowledge statements (Newman, Garry, Bernstein, Kantner, & Lindsay, Psychonomic Bulletin & Review, 19(5), 969-974, 2012; Newman et al., Journal of Experimental Psychology: Learning, Memory, and Cognition, 41(5), 1337-1348, 2015). Photographs can also create illusions of memory (Cardwell, Henkel, Garry, Newman, & Foster, Memory & Cognition, 44(6), 883-896, 2016; Henkel, Applied Cognitive Psychology, 25(1), 78-86, 2011; Henkel & Carbuto, 2008). A candidate mechanism for these effects is that a photograph increases the fluency with which a statement or an event is processed. The present study was conducted to determine whether photos at test can induce illusions of recognition memory and to test the viability of a conceptual fluency explanation of these effects. The results of the present study suggest that photographs enhance the fluency of related words (Experiment 1), that false memories can be produced by the mere presence of a related photo on a recognition memory test for words (Experiments 2 & 3), and that these effects appear to be limited to conceptually based recognition tests (Experiments 4 & 5). The results support the notion that photograph-based illusions of memory stem from the ability of related photographs to increase the speed and ease of conceptual processing.


Assuntos
Ilusões/fisiologia , Idioma , Reconhecimento Visual de Modelos/fisiologia , Reconhecimento Psicológico/fisiologia , Adulto , Humanos , Fotografação , Adulto Jovem
5.
Ethn Dis ; 27(4): 395-402, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29225440

RESUMO

Objective: The urge to smoke is a predictor of smoking relapse. Little research has focused on the impact of acute urges during treatment among African Americans. This study examined the relationship between smoking urges and long-term abstinence among treatment seekers. Design: Longitudinal prospective investigation. Urges to smoke were assessed at the initial (session 1) and final (session 8) sessions among adult smokers (N=308) enrolled in a 4-week group intervention trial. Nicotine patch use was assessed over 30 days. Main Outcome Measures: Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention, and at 3-, 6-, and 12-month follow-ups. Hierarchical logistic regressions tested associations between session 1 and session 8 urges and 7-day ppa at each smoking status assessment. Results: There was a significant overall decrease in smoking urges (M=29, SD=15 at session 1; M=17, SD=11 at session 8). After controlling for covariates, urges to smoke at session 1 were unrelated to 7-day ppa at any of the assessment points. However, session 8 urges were inversely associated with 7-day ppa post-intervention (AOR=.94, CI:.92-.97), at 3-months (AOR=.93, CI: .89-.97), 6-months (AOR=.93, CI: .90-.97), and 12-months (AOR=.96, CI: .96-.99). Nicotine patch use was positively associated with 7-day ppa at each assessment. Conclusions: The most robust predictors of abstinence through 12-months post-intervention were decreased urges over the 4-week, 8-session group intervention and the frequency of nicotine patch use. Interventions aimed at addressing the needs of African American smokers should address urges and encourage nicotine replacement adherence to increase abstinence rates.


Assuntos
Negro ou Afro-Americano , Abandono do Hábito de Fumar/métodos , Fumar/efeitos adversos , Tabagismo/terapia , Adolescente , Adulto , Idoso , Análise Custo-Benefício , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pobreza , Estudos Prospectivos , Dispositivos para o Abandono do Uso de Tabaco , Tabagismo/economia , Tabagismo/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
6.
Diabetes ; 66(12): 3051-3060, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28842400

RESUMO

Type 1 diabetes (T1D) results from T cell-mediated destruction of insulin-producing ß-cells. Insulin represents a key self-antigen in disease pathogenesis, as recent studies identified proinsulin-responding T cells from inflamed pancreatic islets of organ donors with recent-onset T1D. These cells respond to an insulin B-chain (InsB) epitope presented by the HLA-DQ8 molecule associated with high T1D risk. Understanding insulin-specific T-cell frequency and phenotype in peripheral blood is now critical. We constructed fluorescent InsB10-23:DQ8 tetramers, stained peripheral blood lymphocytes directly ex vivo, and show DQ8+ patients with T1D have increased tetramer+ CD4+ T cells compared with HLA-matched control subjects without diabetes. Patients with a shorter disease duration had higher frequencies of insulin-reactive CD4+ T cells, with most of these cells being antigen experienced. We also demonstrate that the number of insulin tetramer+ effector memory cells is directly correlated with insulin antibody titers, suggesting insulin-specific T- and B-cell interactions. Notably, one of four control subjects with tetramer+ cells was a first-degree relative who had insulin-specific cells with an effector memory phenotype, potentially representing an early marker of T-cell autoimmunity. Our results suggest that studying InsB10-23:DQ8 reactive T-cell frequency and phenotype may provide a biomarker of disease activity in patients with T1D and those at risk.


Assuntos
Autoanticorpos/sangue , Linfócitos T CD4-Positivos/imunologia , Diabetes Mellitus Tipo 1/imunologia , Memória Imunológica , Anticorpos Anti-Insulina/sangue , Insulina/imunologia , Adulto , Animais , Feminino , Teste de Histocompatibilidade , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade
7.
Arthritis Res Ther ; 17: 384, 2015 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-26717913

RESUMO

BACKGROUND: Pristane-treated mice chronically produce high levels of anti-ribonucleoprotein/Smith (anti-Sm/RNP) and other lupus autoantibodies. The present study addressed how these autoantibody levels are maintained over time. METHODS: Lupus was induced in BALB/c mice using pristane. Naïve B cells, switched memory B cells, switched plasmablasts, and plasma cells were flow-sorted and total IgG and anti-U1A (RNP) autoantibodies were determined with ELISA. RESULTS: B cells with a switched "memory-like" (CD19(+)CD138(-)IgM(-)IgD(-)) (sMB) phenotype were increased in pristane-treated mice and expressed higher levels of Toll like receptor 7 (Tlr7) than cells with this phenotype from untreated mice. Flow-sorted sMB cells from pristane-treated mice did not secrete IgG spontaneously, but were hyper-responsive to both synthetic (R848) and natural (apoptotic cells) TLR7 ligands, resulting in increased IgG production in vitro. The flow-sorted sMB cells also could be driven by R848 to produce IgG anti-U1A autoantibodies. Production of IgG was strongly inhibited by both JSH-23 and SB203580, suggesting that the canonical NFκB and p38 MAPK pathways, respectively, contribute to the TLR7 ligand hyper-responsiveness of sMB from pristane-treated mice. CONCLUSIONS: The switched memory B cell subset from pristane-treated mice is expanded and shows an increased propensity to undergo terminal (plasma cell) differentiation in response to synthetic and natural TLR7 ligands. The data suggest that the decreased clearance of apoptotic cells characteristic of pristane-treated mice might help maintain high serum levels of anti-RNP/Sm autoantibodies.


Assuntos
Autoanticorpos/imunologia , Subpopulações de Linfócitos B/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Proteínas Centrais de snRNP/imunologia , Animais , Autoantígenos/imunologia , Subpopulações de Linfócitos B/citologia , Linfócitos B/citologia , Linfócitos B/imunologia , Diferenciação Celular/imunologia , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Memória Imunológica/imunologia , Lúpus Eritematoso Sistêmico/induzido quimicamente , Glicoproteínas de Membrana/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Plasmócitos/citologia , Plasmócitos/imunologia , Terpenos/imunologia , Terpenos/toxicidade , Receptor 7 Toll-Like/imunologia
8.
J Appl Physiol (1985) ; 118(3): 319-30, 2015 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-25414242

RESUMO

In this study we tested the hypothesis that green tea extract (GTE) would improve muscle recovery after reloading following disuse. Aged (32 mo) Fischer 344 Brown Norway rats were randomly assigned to receive either 14 days of hindlimb suspension (HLS) or 14 days of HLS followed by normal ambulatory function for 14 days (recovery). Additional animals served as cage controls. The rats were given GTE (50 mg/kg body wt) or water (vehicle) by gavage 7 days before and throughout the experimental periods. Compared with vehicle treatment, GTE significantly attenuated the loss of hindlimb plantaris muscle mass (-24.8% vs. -10.7%, P < 0.05) and tetanic force (-43.7% vs. -25.9%, P <0.05) during HLS. Although GTE failed to further improve recovery of muscle function or mass compared with vehicle treatment, animals given green tea via gavage maintained the lower losses of muscle mass that were found during HLS (-25.2% vs. -16.0%, P < 0.05) and force (-45.7 vs. -34.4%, P < 0.05) after the reloading periods. In addition, compared with vehicle treatment, GTE attenuated muscle fiber cross-sectional area loss in both plantaris (-39.9% vs. -23.9%, P < 0.05) and soleus (-37.2% vs. -17.6%) muscles after HLS. This green tea-induced difference was not transient but was maintained over the reloading period for plantaris (-45.6% vs. -21.5%, P <0.05) and soleus muscle fiber cross-sectional area (-38.7% vs. -10.9%, P <0.05). GTE increased satellite cell proliferation and differentiation in plantaris and soleus muscles during recovery from HLS compared with vehicle-treated muscles and decreased oxidative stress and abundance of the Bcl-2-associated X protein (Bax), yet this did not further improve muscle recovery in reloaded muscles. These data suggest that muscle recovery following disuse in aging is complex. Although satellite cell proliferation and differentiation are critical for muscle repair to occur, green tea-induced changes in satellite cell number is by itself insufficient to improve muscle recovery following a period of atrophy in old rats.


Assuntos
Envelhecimento/efeitos dos fármacos , Fibras Musculares Esqueléticas/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Atrofia Muscular/tratamento farmacológico , Extratos Vegetais/farmacologia , Chá/química , Envelhecimento/metabolismo , Animais , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Elevação dos Membros Posteriores/métodos , Masculino , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético/metabolismo , Atrofia Muscular/metabolismo , Fenômenos Fisiológicos Musculoesqueléticos/efeitos dos fármacos , Tamanho do Órgão/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Endogâmicos BN , Ratos Endogâmicos F344 , Proteína X Associada a bcl-2/metabolismo
9.
Aging (Albany NY) ; 6(10): 820-34, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25361036

RESUMO

Accumulation of reactive oxygen species (ROS) in skeletal muscles and the resulting decline in muscle performance are hallmarks of sarcopenia. However, the precise mechanism by which ROS results in a decline in muscle performance is unclear. We demonstrate that isometric-exercise concomitantly increases the activities of Silent information regulator 1 (SIRT-1) and Poly [ADP-ribose] polymerase (PARP-1), and that activated SIRT-1 physically binds with and inhibits PARP-1 activity by a deacetylation dependent mechanism in skeletal muscle from young mice. In contrast, skeletal muscle from aged mice displays higher PARP-1 activity and lower SIRT-1 activity due to decreased intracellular NAD+ content, and as a result reduced muscle performance in response to exercise. Interestingly, injection of PJ34, a PARP-1 inhibitor, in aged mice increased SIRT-1 activity by preserving intracellular NAD+ content, which resulted in higher skeletal muscle mitochondrial biogenesis and performance. We found that the higher activity of PARP-1 in H2O2-treated myotubes or in exercised-skeletal muscles from aged mice is due to an elevated level of PARP-1 acetylation by the histone acetyltransferase General control of amino acid synthesis protein 5-like 2 (GCN-5). These results suggest that activation of SIRT-1 and/or inhibition of PARP-1 may ameliorate skeletal muscle performance in pathophysiological conditions such as sarcopenia and disuse-induced atrophy in aging.


Assuntos
Envelhecimento/metabolismo , Fadiga Muscular/fisiologia , Músculo Esquelético/metabolismo , Poli(ADP-Ribose) Polimerases/metabolismo , Sarcopenia/metabolismo , Sirtuína 1/metabolismo , Animais , Immunoblotting , Camundongos , Camundongos Endogâmicos C57BL , Condicionamento Físico Animal , Poli(ADP-Ribose) Polimerase-1 , RNA Interferente Pequeno , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transfecção
10.
Exp Gerontol ; 50: 82-94, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24316035

RESUMO

Aging exacerbates muscle loss and slows the recovery of muscle mass and function after disuse. In this study we investigated the potential that epigallocatechin-3-gallate (EGCg), an abundant catechin in green tea, would reduce signaling for apoptosis and promote skeletal muscle recovery in the fast plantaris muscle and the slow soleus muscle after hindlimb suspension (HLS) in senescent animals. Fischer 344 × Brown Norway inbred rats (age 34 months) received either EGCg (50 mg/kg body weight), or water daily by gavage. One group of animals received HLS for 14 days and a second group of rats received 14 days of HLS, then the HLS was removed and they recovered from this forced disuse for 2 weeks. Animals that received EGCg over the HLS followed by 14 days of recovery, had a 14% greater plantaris muscle weight (p<0.05) as compared to the animals treated with the vehicle over this same period. Plantaris fiber area was greater after recovery in EGCg (2715.2±113.8 µm(2)) vs. vehicle treated animals (1953.0±41.9 µm(2)). In addition, activation of myogenic progenitor cells was improved with EGCg over vehicle treatment (7.5% vs. 6.2%) in the recovery animals. Compared to vehicle treatment, the apoptotic index was lower (0.24% vs. 0.52%), and the abundance of pro-apoptotic proteins Bax (-22%), and FADD (-77%) was lower in EGCg treated plantaris muscles after recovery. While EGCg did not prevent unloading-induced atrophy, it improved muscle recovery after the atrophic stimulus in fast plantaris muscles. However, this effect was muscle specific because EGCg had no major impact in reversing HLS-induced atrophy in the slow soleus muscle of old rats.


Assuntos
Envelhecimento/fisiologia , Catequina/análogos & derivados , Músculo Esquelético/efeitos dos fármacos , Atrofia Muscular/tratamento farmacológico , Animais , Apoptose/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Catequina/farmacologia , Catequina/uso terapêutico , Avaliação Pré-Clínica de Medicamentos/métodos , Quinase 3 da Glicogênio Sintase/metabolismo , Glicogênio Sintase Quinase 3 beta , Elevação dos Membros Posteriores/métodos , Contração Isométrica/efeitos dos fármacos , Contração Isométrica/fisiologia , Fibras Musculares Esqueléticas/efeitos dos fármacos , Fibras Musculares Esqueléticas/patologia , Músculo Esquelético/patologia , Músculo Esquelético/fisiologia , Atrofia Muscular/patologia , Atrofia Muscular/fisiopatologia , Tamanho do Órgão/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Endogâmicos BN , Ratos Endogâmicos F344 , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Células-Tronco/efeitos dos fármacos , Células-Tronco/fisiologia , Suporte de Carga/fisiologia
11.
Arthritis Rheum ; 60(11): 3436-46, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19877033

RESUMO

OBJECTIVE: Up-regulation of whole blood type I interferon (IFN)-driven transcripts and chemokines has been described in a number of autoimmune diseases. An IFN gene expression "signature" is a candidate biomarker in patients with dermatomyositis (DM). This study was performed to evaluate the capacity of IFN-dependent peripheral blood gene and chemokine signatures and levels of proinflammatory cytokines to serve as biomarkers for disease activity in adult and juvenile DM. METHODS: Peripheral blood samples and clinical data were obtained from 56 patients with adult or juvenile DM. The type I IFN gene signature in the whole blood of patients with DM was defined by determining the expression levels of 3 IFN-regulated genes (IFIT1, G1P2, and IRF7) using quantitative real-time reverse transcription-polymerase chain reaction. Multiplexed immunoassays were used to quantify the serum levels of 4 type I IFN-regulated chemokines (IFN-inducible T cell alpha chemoattractant, IFNgamma-inducible 10-kd protein, monocyte chemotactic protein 1 [MCP-1], and MCP-2) and the serum levels of other proinflammatory cytokines, including interleukin-6 (IL-6). RESULTS: DM disease activity correlated significantly with the type I IFN gene signature (r = 0.41, P = 0.007) and with the type I IFN chemokine signature (r = 0.61, P < 0.0001). Furthermore, the serum levels of IL-6 were significantly correlated with disease activity (r = 0.45, P = 0.001). In addition, correlations between the serum levels of IL-6 and both the type I IFN gene signature (r = 0.47, P < 0.01) and the type I IFN chemokine signature (r = 0.71, P < 0.0001) were detected in patients with DM. CONCLUSION: These results suggest that serum IL-6 production and the type I IFN gene signature are candidate biomarkers for disease activity in adult and juvenile DM. Coregulation of the expression of IFN-driven chemokines and IL-6 suggests a novel pathogenic linkage in DM.


Assuntos
Quimiocinas/sangue , Dermatomiosite/sangue , Interferon Tipo I/genética , Interleucina-6/sangue , Índice de Gravidade de Doença , Proteínas Adaptadoras de Transdução de Sinal , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Proteínas de Transporte/sangue , Estudos de Casos e Controles , Quimiocina CCL2/sangue , Quimiocina CCL8/sangue , Quimiocina CXCL10/sangue , Quimiocina CXCL11/sangue , Criança , Citocinas/sangue , Dermatomiosite/diagnóstico , Feminino , Humanos , Fator Regulador 7 de Interferon/sangue , Masculino , Pessoa de Meia-Idade , Proteínas de Ligação a RNA , Ubiquitinas/sangue , Adulto Jovem
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