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1.
Int J Mol Sci ; 21(19)2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33036290

RESUMO

Krüppel-like factor 4 (Klf4) plays an important role in the transition from proliferation to differentiation in a wide variety of cells. Previous studies demonstrated its critical role in the luteal transition of preovulatory granulosa cells (GCs). This study used cultured rat preovulatory GCs to investigate the mechanism by which luteinizing hormone (LH) regulates Klf4 gene expression. Klf4 mRNA and protein were rapidly and transiently induced by LH treatment, reaching peak levels after 45 min and declining to basal levels by 3 h. Pretreatment with the protein synthesis inhibitor cycloheximide had no effect on LH-stimulated Klf4 expression, indicating that Klf4 is an immediate early gene in response to LH. To investigate the signaling pathway involved in LH-induced Klf4 regulation, the protein kinase A (PKA) and protein kinase C (PKC) pathways were evaluated. A-kinase agonists, but not a C-kinase agonist, mimicked LH in inducing Klf4 transcription. In addition, specific inhibitors of A-kinase abolished the stimulatory effect of LH on Klf4 expression. Truncation of a Klf4 expression construct to -715 bp (pKlf4-715/luc) had no effect on transcriptional activity, whereas deletion to -402 bp (pKlf4-402/luc) dramatically reduced it. ChIP analysis revealed in vivo binding of endogenous Sp1 to the -715/-500 bp region and maximal transcriptional responsiveness to LH required the Sp1 binding element at -698/-688 bp, which is highly conserved in mice, rats, and humans. These findings demonstrate that Klf4 is activated by LH via the cAMP/PKA pathway and a putative Sp1 binding element at -698/-688 bp is indispensable for activation and suggest that Klf4 could be a target for strategies for treating luteal phase insufficiency induced by an aberrant response to the LH surge.


Assuntos
Células da Granulosa/metabolismo , Fatores de Transcrição Kruppel-Like/genética , Luteinização/metabolismo , Hormônio Luteinizante/metabolismo , Transdução de Sinais , Fator de Transcrição Sp1/metabolismo , Animais , Células Cultivadas , AMP Cíclico/metabolismo , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Feminino , Regulação da Expressão Gênica , Fator 4 Semelhante a Kruppel , Luteinização/genética , Hormônio Luteinizante/fisiologia , Ratos
2.
Am J Physiol Endocrinol Metab ; 316(6): E1071-E1080, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30939050

RESUMO

The transition from granulosa cell (GC) to luteal cell involves a change from estrogen production to predominantly progesterone production. We analyzed the role of Krüppel-like factor 4 (Klf4), a transcriptional repressor used to generate pluripotent cells, in that transition. After luteinizing hormone (LH)/human chorionic gonadotropin treatment of preovulatory follicles, a major but transient increase in Klf4 transcript levels was detected. Therefore, we enquired whether Klf4 is involved in the rapid decline of aromatase, the key estrogen-producing enzyme, using preovulatory GCs obtained from pregnant mare serum gonadotropin-primed immature rat ovaries. Cyp19A1 expression in GCs transfected with FLAG-Klf4 or Klf4-specific siRNA was analyzed by real-time PCR and immunofluorescence staining. Cyp19A1 decreased when Klf4 was overexpressed, and Cyp19A1 and estradiol biosynthesis increased when Klf4 was knocked down. The mechanism by which Klf4 regulates Cyp19A1 expression was investigated using Cyp19A1 promoter-luciferase reporter assays and chromatin immunoprecipitation assays. The results revealed that the steroidogenic factor-1 (SF1)-binding motif, but not the specificity protein 1 (Sp1) binding element or the CACCC motif, was required for Klf4-mediated repression of Cyp19A1 promoter activity. Here we showed that Klf4 suppressed endogenous Cyp19A1 transcript and protein production, and this resulted from direct binding of Klf4 to the SF1 recognition motif in the Cyp19A1 promoter. These findings suggest that Klf4 is a physiologic regulator of Cyp19A1 expression in response to the LH surge in preovulatory GCs and that it has an essential role in the luteal transition in steroidogenesis.


Assuntos
Aromatase/genética , Estradiol/biossíntese , Células da Granulosa/metabolismo , Fatores de Transcrição Kruppel-Like/genética , Hormônio Luteinizante/metabolismo , Progesterona/biossíntese , Animais , Aromatase/metabolismo , Diferenciação Celular , Feminino , Fase Folicular , Técnicas de Silenciamento de Genes , Gonadotropinas Equinas , Fator 4 Semelhante a Kruppel , Fatores de Transcrição Kruppel-Like/metabolismo , Regiões Promotoras Genéticas , Ratos
3.
Int J Mol Sci ; 20(1)2018 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-30587813

RESUMO

In the ovary, the luteinizing hormone (LH) surge suppresses the proliferation and induces the luteinization of preovulatory granulosa cells (GCs), which is crucial for the survival of terminally-differentiated GCs. Krüppel-like factor 4 (Klf4) has been shown to play a role in regulating the cell cycle and apoptosis in various cell types. The rapid induction of Klf4 expressions by LH was observed in preovulatory GCs. To evaluate whether Klf4 affects GC proliferation and survival, primary rat GCs were isolated from pregnant mare serum gonadotropin-primed Sprague⁻Dawley rat ovaries and transfected with a Klf4 expression vector or Klf4-specific siRNA, followed by determination of the transcript levels of apoptosis-related and cell cycle-related genes. Cell proliferation, viability, and apoptosis were analyzed by BrdU incorporation, a Cell Counting Kit-8 assay, a bioluminescence caspase 3/7 assay, and flow cytometry. LH treatment increased Klf4 mRNA expression in preovulatory GCs. Transcripts of B-cell lymphoma 2 (Bcl-2) and cell cycle promoters (Cyclin D1 and Cyclin D2) decreased, whereas those of the cell cycle inhibitor, p21, increased. Altering the expression of Klf4 by overexpression or knockdown consistently affected the expression of Bcl-2 and Cyclin D1. In agreement with this, Klf4 overexpression reduced cell viability, increased the fraction of apoptotic cells, and arrested cell cycle progression in G1 phase. We conclude that Klf4 increases the susceptibility of preovulatory GCs to apoptosis by down-regulating Bcl-2, and promotes LH-induced cell cycle exit. It appears to be a key regulator induced by the LH surge that determines the fate of GCs in preovulatory follicles during the luteal transition.


Assuntos
Apoptose , Pontos de Checagem da Fase G1 do Ciclo Celular , Fatores de Transcrição Kruppel-Like/metabolismo , Animais , Apoptose/efeitos dos fármacos , Caspase 3/metabolismo , Ciclina D1/genética , Ciclina D1/metabolismo , Inibidor de Quinase Dependente de Ciclina p21/genética , Inibidor de Quinase Dependente de Ciclina p21/metabolismo , Regulação para Baixo/efeitos dos fármacos , Feminino , Pontos de Checagem da Fase G1 do Ciclo Celular/efeitos dos fármacos , Células da Granulosa/citologia , Células da Granulosa/efeitos dos fármacos , Células da Granulosa/metabolismo , Fator 4 Semelhante a Kruppel , Fatores de Transcrição Kruppel-Like/antagonistas & inibidores , Fatores de Transcrição Kruppel-Like/genética , Hormônio Luteinizante/farmacologia , Ovário/citologia , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Interferência de RNA , RNA Interferente Pequeno/metabolismo , Ratos , Ratos Sprague-Dawley , Regulação para Cima/efeitos dos fármacos
4.
Exp Anim ; 67(4): 395-401, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29794372

RESUMO

Thyroid cancer in children, the most common endocrine malignancy, shows aggressive behavior and has a high recurrence rate after surgical ablation. Radioactive iodine (RAI) treatment is the most effective primary modality for medical ablation of juvenile thyroid cancer, and leads to intentional hypothyroidism. Although several negative impacts of hypothyroidism have been reported in children in response to other antithyroid agents, the combined effects of RAI exposure and hypothyroidism, on growing bones specifically, are unknown. In this study, we investigated the effect of RAI-induced hypothyroidism on the long bones during the pubertal growth spurt using immature female rats. Female Sprague-Dawley rats were randomly divided into a control group, and an RAI-treated group fed with RAI (0.37 MBq/g body weight) twice via gavage. After 4 weeks, we observed a significantly-reduced serum free thyroxine level in the RAI group. The latter group also displayed decreased body weight gain compared to the control. In addition, the lengths of long bones, such as the leg bones and vertebral column, as well as bone mineral content, were reduced in the RAI-treated animals. Our results confirm the negative impacts of RAI-induced thyroid deficiency during puberty on longitudinal bone growth and bone mineralization.


Assuntos
Hipotireoidismo/etiologia , Hipotireoidismo/fisiopatologia , Radioisótopos do Iodo/efeitos adversos , Ossos da Perna/crescimento & desenvolvimento , Ossos da Perna/efeitos da radiação , Puberdade/fisiologia , Puberdade/efeitos da radiação , Ratos Sprague-Dawley/crescimento & desenvolvimento , Ratos Sprague-Dawley/fisiologia , Animais , Densidade Óssea/efeitos da radiação , Feminino , Hipotireoidismo/sangue , Radioisótopos do Iodo/administração & dosagem , Coluna Vertebral/efeitos da radiação , Neoplasias da Glândula Tireoide/radioterapia , Tiroxina/sangue , Aumento de Peso/efeitos da radiação
5.
Toxicol Res ; 33(2): 157-164, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28503265

RESUMO

This study was to evaluate the age-dependent effects of caffeine exposure on the long bones and reproductive organs using male rats. A total of 15 immature male rats and 15 young adult male rats were allocated randomly to three groups: a control group and two groups fed caffeine with 120 and 180 mg/kg/day for 4 weeks. Exposure to caffeine at either dose significantly reduced body weight gain; a proportional reduction in muscle and fat mass in immature animals, whereas a selective reduction in fat mass with relatively preserved muscle mass in young adult animals. The long bones of immature rats exposed to caffeine were significantly shorter and lighter than those of control animals along with decreased bone minerals. However, there was no difference in the length or weight of the long bones in young adult rats exposed to caffeine. Exposure to caffeine reduced the size and absolute weight of the testes significantly in immature animals in comparison to control animals, but not in young adult animals exposed to caffeine. In contrast, the adrenal glands were significantly heavier in caffeine-fed young adult rats in comparison to control animals, but not in caffeine-fed immature rats. Our results clearly show that the negative effects of caffeine on the long bones and testes in rats are different according to the age of the rat at the time of exposure, and might therefore be caused by changes to organ sensitivity and metabolic rate at different developmental stages. Although the long bones and testes are more susceptible to caffeine during puberty, caffeine has negative effects on body fat, bone minerals and the adrenal glands when exposure occurs during young adulthood. There is a need, therefore, to educate the public the potential dangers of caffeine consumption during puberty and young adulthood.

6.
Reprod Toxicol ; 69: 43-52, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28111094

RESUMO

Chronic caffeine consumption exerts a negligible effect on the reproductive organs of normal adult females, but it is not known whether this is also true for children and adolescents. Here, we investigated the effects of high caffeine exposure on sexual maturation and ovarian estradiol production in immature female rats. Immature female SD rats were divided into controls and caffeine groups fed 120 and 180mg/kg/day for 4 or 8 weeks. There was a significant delay in vaginal opening in the caffeine-fed groups. In addition, serum estradiol levels were elevated in the caffeine-fed animals after 2 and 4 weeks of exposure. Estradiol secretion as well as aromatase expression also increased significantly in the ovarian cells in response to caffeine. These results demonstrate that peripubertal exposure to high caffeine increases estradiol production in the ovary; this may disturb the coordinated regulation of the hypothalamo-pituitary-ovarian axis, thereby interfering with sexual maturation.


Assuntos
Cafeína/toxicidade , Estradiol/metabolismo , Ovário/efeitos dos fármacos , Tecido Adiposo/efeitos dos fármacos , Animais , Aromatase/metabolismo , Peso Corporal/efeitos dos fármacos , Estradiol/sangue , Feminino , Ovário/crescimento & desenvolvimento , Ovário/metabolismo , Ratos Sprague-Dawley , Maturidade Sexual/efeitos dos fármacos , Útero/efeitos dos fármacos , Útero/crescimento & desenvolvimento
7.
J Anat ; 230(1): 117-127, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27484046

RESUMO

We showed previously that caffeine adversely affects longitudinal bone growth and disrupts the histomorphometry of the growth plate during the pubertal growth spurt. However, little attention has been paid to the direct effects of caffeine on chondrocytes. Here, we investigated the direct effects of caffeine on chondrocytes of the growth plate in vivo and in vitro using a rapidly growing young rat model, and determined whether they were related to the adenosine receptor signaling pathway. A total of 15 male rats (21 days old) were divided randomly into three groups: a control group and two groups fed caffeine via gavage with 120 and 180 mg kg-1  day-1 for 4 weeks. After sacrifice, the tibia processed for the analysis of the long bone growth and proliferation of chondrocytes using tetracycline and BrdU incorporation, respectively. Caffeine-fed animals showed decreases in matrix mineralization and proliferation rate of growth plate chondrocytes compared with the control. To evaluate whether caffeine directly affects chondrocyte proliferation and chondrogenic differentiation, primary rat chondrocytes were isolated from the growth plates and cultured in either the presence or absence of caffeine at concentrations of 0.1-1 mm, followed by determination of the cellular proliferation or expression profiles of cellular differentiation markers. Caffeine caused significant decreases in extracellular matrix production, mineralization, and alkaline phosphatase activity, accompanied with decreases in gene expression of the cartilage-specific matrix proteins such as aggrecan, type II collagen and type X. Our results clearly demonstrate that caffeine is capable of interfering with cartilage induction by directly inhibiting the synthetic activity and orderly expression of marker genes relevant to chondrocyte maturation. In addition, we found that the adenosine type 1 receptor signaling pathway may be partly involved in the detrimental effects of caffeine on chondrogenic differentiation, specifically matrix production and mineralization, as evidenced by attenuation of the inhibitory effects of caffeine by blockade of this receptor. Thus, our study provides novel information on the integration of caffeine and adenosine receptor signaling during chondrocyte maturation, extending our understanding of the effect of caffeine at a cellular level on chondrocytes of the growth plate.


Assuntos
Desenvolvimento Ósseo/efeitos dos fármacos , Cafeína/toxicidade , Diferenciação Celular/efeitos dos fármacos , Condrócitos/efeitos dos fármacos , Lâmina de Crescimento/efeitos dos fármacos , Tíbia/efeitos dos fármacos , Animais , Desenvolvimento Ósseo/fisiologia , Diferenciação Celular/fisiologia , Células Cultivadas , Condrócitos/fisiologia , Lâmina de Crescimento/citologia , Lâmina de Crescimento/fisiologia , Masculino , Ratos , Ratos Sprague-Dawley , Receptor A1 de Adenosina/fisiologia , Tíbia/citologia , Tíbia/fisiologia
8.
Exp Anim ; 66(1): 29-39, 2017 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-27665862

RESUMO

We previously showed that prepubertal chronic caffeine exposure adversely affected the development of the testes in male rats. Here we investigated dose- and time-related effects of caffeine consumption on the testis throughout sexual maturation in prepubertal rats. A total of 80 male SD rats were randomly divided into four groups: controls and rats fed 20, 60, or 120 mg caffeine/kg/day, respectively, via gavage for 10, 20, 30, or 40 days. Preputial separation was monitored daily before the rats were sacrificed. Terminal blood samples were collected for hormone assay, and testes were grossly evaluated and weighed. One testis was processed for histological analysis, and the other was collected to isolate Leydig cells. Caffeine exposure significantly increased the relative weight of the testis in a dose-related manner after 30 days of exposure, whereas the absolute testis weight tended to decrease at the 120 mg dose of caffeine. The mean diameter of the seminiferous tubules and height of the germinal epithelium significantly decreased in the caffeine-fed groups after 40 days of caffeine exposure, which was accompanied by a reduced BrdU incorporation rate in germ cells. In addition, caffeine intake significantly reduced in vivo and ex vivo testosterone production in a dose-related manner. Our results demonstrate that caffeine exposure during sexual maturation alter the testicular microarchitecture and also slow germ cell proliferation even at the 20 mg dose level. Furthermore, caffeine may act directly on Leydig cells and interfere with testosterone production in a dose-related manner, consequently delaying onset of sexual maturation.


Assuntos
Cafeína/efeitos adversos , Maturidade Sexual/efeitos dos fármacos , Espermatozoides/efeitos dos fármacos , Testículo/efeitos dos fármacos , Testosterona/sangue , Animais , Biomarcadores/metabolismo , Bromodesoxiuridina/metabolismo , Relação Dose-Resposta a Droga , Masculino , Tamanho do Órgão/efeitos dos fármacos , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Espermatozoides/crescimento & desenvolvimento
9.
J Med Food ; 19(1): 73-84, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26495862

RESUMO

This study investigated the dose- and time-dependent effects of caffeine consumption throughout puberty in peripubertal rats. A total of 85 male SD rats were randomly divided into four groups: control and caffeine-fed groups with 20, 60, or 120 mg/kg/day through oral gavage for 10, 20, 30, or 40 days. Caffeine decreased body weight gain and food consumption in a dose- and time-dependent manner, accompanied by a reduction in muscle and body fat. In addition, it caused a shortening and lightening of leg bones and spinal column. The total height of the growth plate decreased sharply at 40 days in the controls, but not in the caffeine-fed groups, and the height of hypertrophic zone in the caffeine-fed groups was lower than in the control. Caffeine increased the height of the secondary spongiosa, whereas parameters related to bone formation, such as bone area ratio, thickness and number of trabeculae, and bone perimeter, were significantly reduced. Furthermore, serum levels of IGF-1, estradiol, and testosterone were also reduced by the dose of caffeine exposure. Our results demonstrate that caffeine consumption can dose- and time-dependently inhibit longitudinal bone growth in immature male rats, possibly by blocking the physiologic changes in body composition and hormones relevant to bone growth.


Assuntos
Desenvolvimento Ósseo/efeitos dos fármacos , Cafeína/efeitos adversos , Puberdade/efeitos dos fármacos , Animais , Peso Corporal/efeitos dos fármacos , Densidade Óssea/efeitos dos fármacos , Lâmina de Crescimento/crescimento & desenvolvimento , Lâmina de Crescimento/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Masculino , Puberdade/fisiologia , Ratos , Ratos Sprague-Dawley , Testosterona/metabolismo
10.
Exp Anim ; 64(4): 343-52, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26062767

RESUMO

Previously we demonstrated coxsackievirus B3 (CVB3) infection during early gestation as a cause of pregnancy loss. Here, we investigated the impacts of CVB3 infection on female mouse fertility. Coxsackievirus-adenovirus receptor (CAR) expression and CVB3 replication in the ovary were evaluated by immunohistochemistry or reverse transcription-polymerase chain reaction (RT-PCR). CAR was highly expressed in granulosa cells (GCs) and CVB3 replicated in the ovary. Histological analysis showed a significant increase in the number of atretic follicles in the ovaries of CVB3-infected mice (CVBM). Estrous cycle evaluation demonstrated that a higher number of CVBM were in proestrus compared to mock mice (CVBM vs. mock; 61.5%, 28.5%, respectively). Estradiol concentration in GC culture supernatant and serum were measured by an enzyme-linked immunosorbent assay. Baseline and stimulated levels of estradiol in GC were decreased in CVBM, consistent with significantly reduced serum levels in these animals. In addition, aromatase transcript levels in GCs from CVBM were also decreased by 40% relative to the mock. Bone mineral density evaluated by micro-computed tomography was significantly decreased in the CVBM. Moreover, the fertility rate was also significantly decreased for the CVBM compared to the mock (CVBM vs. mock; 20%, 94.7%, respectively). This study suggests that CVB3 infection could interfere with reproduction by disturbing ovarian function and cyclic changes of the uterus.


Assuntos
Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/virologia , Enterovirus Humano B , Infertilidade Feminina/etiologia , Infertilidade Feminina/virologia , Animais , Células Cultivadas , Infecções por Coxsackievirus/metabolismo , Enterovirus Humano B/fisiologia , Estradiol/sangue , Estradiol/metabolismo , Ciclo Estral , Feminino , Células da Granulosa/metabolismo , Células da Granulosa/virologia , Células HeLa , Humanos , Camundongos Endogâmicos ICR , Ovário/virologia , Receptores Virais/metabolismo , Replicação Viral
11.
Int J Endocrinol ; 2015: 368475, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25983753

RESUMO

Prenatal caffeine exposure adversely affects the development of the reproductive organs of male rat offspring. Thus, it is conceivable that peripubertal caffeine exposure would also influence physiologic gonadal changes and function during this critical period for sexual maturation. This study investigated the impact of high doses of caffeine on the testes of prepubertal male rats. A total of 45 immature male rats were divided randomly into three groups: a control group and 2 groups fed 120 and 180 mg/kg/day of caffeine, respectively, via the stomach for 4 weeks. Caffeine caused a significant decrease in body weight gain, accompanied by proportional decreases in lean body mass and body fat. The caffeine-fed animals had smaller and lighter testes than those of the control that were accompanied by negative influences on the histologic parameters of the testes. In addition, stimulated-testosterone ex vivo production was reduced in Leydig cells retrieved from the caffeine-fed animals. Our results demonstrate that peripubertal caffeine consumption can interfere with the maturation and function of the testis, possibly by interrupting endogenous testosterone secretion and reducing the sensitivity of Leydig cells to gonadotrophic stimulation. In addition, we confirmed that pubertal administration of caffeine reduced testis growth and altered testis histomorphology.

12.
J Ovarian Res ; 7: 118, 2014 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-25491731

RESUMO

BACKGROUND: The important role of WT1 in early folliculogenesis was evident from its restricted expression pattern in immature follicles and from its involvement in transcriptional control of inhibin-α and FSH receptor. There is also considerable evidence that WT1 is a potent inhibitor of apoptotic cell death in the developing kidney and male germ cells, suggesting that it could play a role in the regulation of follicle survival. Therefore, we evaluated if WT1 involves in cell survival of granulosa cells (GCs) during the FSH-independent stage. METHODS: GCs were obtained from small preantral follicles of immature rat ovary. Bax and bcl-2 mRNA and protein levels in GCs transfected with WT1 (-KTS) or WT1 (+KTS) were analyzed by Real-time RT-PCR and immune-blotting analysis. Cell viability was measured with MTT assays and apoptosis was analyzed with caspase 3/7 activity and TUNEL assay. The mechanism by which WT1 regulates Bax expression was investigated using Bax promoter-luciferase reporter assay and ChIP assays from GCs. RESULTS: Here, we showed that WT1 (-KTS) suppressed endogenous Bax transcript and protein expression, and this inhibition resulted from direct binding of WT1 in the Bax promoter region in vivo. In addition, anti-apoptotic effects of WT1 (-KTS) were demonstrated based on MTT assays, a sensitive bioluminescence caspase 3/7 assay and TUNEL assays. On the other hand, WT1 has no role on bcl-2 expression in GCs. CONCLUSION: These findings suggest that activation of WT1 is necessary for maintenance of GC survival during early stage of follicles and WT1 can play a role in protecting apoptosis through the regulation of upstream activator (Bax), as well as through regulation of downstream effecter (caspases 3 and 7).


Assuntos
Apoptose , Células da Granulosa/metabolismo , Proteínas WT1/fisiologia , Proteína X Associada a bcl-2/genética , Animais , Sequência de Bases , Sobrevivência Celular , Células Cultivadas , Regulação para Baixo , Feminino , Regulação da Expressão Gênica , Regiões Promotoras Genéticas , Ratos Sprague-Dawley , Transcrição Gênica , Proteína X Associada a bcl-2/metabolismo
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