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1.
Int J Mol Sci ; 23(2)2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-35054965

RESUMO

Amine transaminases (ATAs) are pyridoxal-5'-phosphate (PLP)-dependent enzymes that catalyze the transfer of an amino group from an amino donor to an aldehyde and/or ketone. In the past decade, the enzymatic reductive amination of prochiral ketones catalyzed by ATAs has attracted the attention of researchers, and more traditional chemical routes were replaced by enzymatic ones in industrial manufacturing. In the present work, the influence of the presence of an α,ß-unsaturated system in a methylketone model substrate was investigated, using a set of five wild-type ATAs, the (R)-selective from Aspergillus terreus (Atr-TA) and Mycobacterium vanbaalenii (Mva-TA), the (S)-selective from Chromobacterium violaceum (Cvi-TA), Ruegeria pomeroyi (Rpo-TA), V. fluvialis (Vfl-TA) and an engineered variant of V. fluvialis (ATA-256 from Codexis). The high conversion rate (80 to 99%) and optical purity (78 to 99% ee) of both (R)- and (S)-ATAs for the substrate 1-phenyl-3-butanone, using isopropylamine (IPA) as an amino donor, were observed. However, the double bond in the α,ß-position of 4-phenylbut-3-en-2-one dramatically reduced wild-type ATA reactivity, leading to conversions of <10% (without affecting the enantioselectivity). In contrast, the commercially engineered V. fluvialis variant, ATA-256, still enabled an 87% conversion, yielding a corresponding amine with >99% ee. Computational docking simulations showed the differences in orientation and intermolecular interactions in the active sites, providing insights to rationalize the observed experimental results.


Assuntos
Aminas/química , Modelos Moleculares , Conformação Molecular , Transaminases/química , Aminas/metabolismo , Sítios de Ligação , Biocatálise , Domínio Catalítico , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Estrutura Molecular , Ligação Proteica , Relação Estrutura-Atividade , Especificidade por Substrato , Transaminases/metabolismo
2.
Enzyme Microb Technol ; 131: 109423, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31615676

RESUMO

Amine-transaminases (ATAs) are enzymes that catalyze the reversible transfer of an amino group between primary amines and carbonyl compounds. They have been widely studied in the last decades for their application in stereoselective synthesis of chiral amines, which are one of the most valuable building blocks in pharmaceuticals manufacturing. Their excellent enantioselectivity, use of low-cost substrates and no need for external cofactors has turned these enzymes into a promising alternative to the chemical synthesis of chiral amines. Nevertheless, its application at industrial scale remains limited mainly because most of the available ATAs are scarcely tolerant to harsh reaction conditions such as high temperatures and presence of organic solvents. In this work, a novel (S)-ATA was discovered in a thermophilic bacterium, Albidovulum sp. SLM16, isolated from a geothermal Antarctic environmental sample, more specifically from a shoreline fumarole in Deception Island. The transaminase-coding gene was identified in the genome of the microorganism, cloned and overexpressed in Escherichia coli for biochemical characterization. The activity of the recombinant ATA was optimal at 65 °C and pH 9.5. Molecular mass estimates suggest a 75 kDa homodimeric structure. The enzyme turned out to be highly thermostable, maintaining 80% of its specific activity after 5 days of incubation at 50 °C. These results indicate that ATA_SLM16 is an excellent candidate for potential applications in biocatalytic synthesis. To the best of our knowledge, this would be the first report of the characterization of a thermostable (S)-ATA discovered by means of in vivo screening of thermophilic microorganisms.


Assuntos
Aminas/metabolismo , Rhodobacteraceae/enzimologia , Transaminases/isolamento & purificação , Transaminases/metabolismo , Regiões Antárticas , Clonagem Molecular , Estabilidade Enzimática , Escherichia coli/genética , Escherichia coli/metabolismo , Expressão Gênica , Fontes Termais , Temperatura Alta , Concentração de Íons de Hidrogênio , Peso Molecular , Multimerização Proteica , Rhodobacteraceae/isolamento & purificação , Transaminases/química , Transaminases/genética
3.
Appl Microbiol Biotechnol ; 101(14): 5677-5687, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28516206

RESUMO

Chiral amines are essential precursors in the production of biologically active compounds, including several important drugs. Among the biocatalytic strategies that have been developed for their synthesis, the use of ω-transaminases (ω-TA) appears as an attractive alternative allowing the stereoselective amination of prochiral ketones. However, the problems associated with narrow substrate specificity, unfavourable reaction equilibrium and expensive amine donors still hamper its industrial application. The search for novel enzymes from nature can contribute to expand the catalytic repertoire of ω-TA and help to circumvent some of these problems. A genome mining approach, based on the work described by Höhne et al., was applied for selection of potential R-ω-TA. Additional criteria were used to select an enzyme that differs from previously described ones. A candidate R-ω-TA from Capronia semiimmersa was selected, cloned and expressed in Escherichia coli. Interestingly, alignment of this enzyme with previously reported TA sequences revealed the presence of two additional amino acid residues in a loop close to the active site. The impact of this change was analysed with a structural model based on crystallized R-ω-TAs. Analysis of the substrate specificity of R-ω-TA from C. semiimmersa indicates that it accepts a diversity of ketones as substrates yielding the corresponding amine with good yields and excellent enantioselectivity. The expressed enzyme accepts isopropylamine as amine donor what makes it suitable for industrial processes.


Assuntos
Ascomicetos/enzimologia , Transaminases/genética , Transaminases/metabolismo , Ascomicetos/genética , Biocatálise , Domínio Catalítico , Clonagem Molecular , Cristalização , Escherichia coli/genética , Genoma Fúngico , Cetonas/química , Propilaminas/metabolismo , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/química , Proteínas Recombinantes/metabolismo , Alinhamento de Sequência , Especificidade por Substrato , Transaminases/química , Transaminases/isolamento & purificação
4.
Mol Biochem Parasitol ; 202(2): 34-7, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26456583

RESUMO

Leishmania species are early branching eukaryotic parasites that cause difficult-to-treat tissue-damaging diseases known as leishmaniases. As a hallmark of their parasitic lifestyle, Leishmaniae express a number of aminotransferases that are involved in important cellular processes and exhibit broader substrate specificity than their mammalian host's counterparts. Here, we have determined the crystal structure of the broad specificity aminotransferase from Leishmania mexicana (LmexBSAT) at 1.91Å resolution. LmexBSAT is a homodimer and belongs to the α-branch of family-I aminotransferases. Despite the fact that the protein was crystallized in the absence of substrates and has lost the pyridoxal-5'-phosphate (PLP) cofactor during crystallization, the structure resembles the closed, ligand-bound form of related enzymes such as chicken cytosolic aspartate aminotransferase. Its broader substrate specificity seems to be rooted in increased flexibility of a substrate-binding arginine (R291) and the interactions of this residue with the N-terminus of the second chain of the dimer.


Assuntos
Leishmania mexicana/enzimologia , Leishmaniose Cutânea/parasitologia , Proteínas de Protozoários/ultraestrutura , Transaminases/ultraestrutura , Arginina/química , Ácido Aspártico/metabolismo , Cristalização , Cristalografia por Raios X , Dimerização , Ácido Glutâmico/metabolismo , Leishmania mexicana/metabolismo , Estrutura Terciária de Proteína , Fosfato de Piridoxal/química , Especificidade por Substrato , Transaminases/química
5.
Electron. j. biotechnol ; Electron. j. biotechnol;16(3): 4-4, May 2013. ilus, tab
Artigo em Inglês | LILACS | ID: lil-684002

RESUMO

Background: New enzymes for biotransformations can be obtained by different approaches including directed mutagenesis and in vitro evolution. These mutants have to be efficiently produced for laboratory research on bioreactions as well as for process development. In the framework of a European ERA-IB project, two different types of enzymes (ammonia lyases and aminotransferases) have been selected as biocatalysts for the synthesis of industrially relevant amines. New mutant enzymes have been obtained: a) aspartases able to recognize β-amino acids; b) ω-transaminases with improved activity. The objectives are to find out a common operational strategy applicable to different mutants expressed in E. coli with the same initial genetic background, the development of an integrated process for production and the preparation of stable useful biocatalysts. Results: Mutant enzymes were expressed in E. coli BL21 under the control of isopropylthiogalactoside (IPTG) inducible promoter. The microorganisms were grown in a formulated defined medium and a high-cell density culture process was set up. Fed-batch operation at constant specific growth rate, employing an exponential addition profile allowed high biomass concentrations. The same operational strategy was applied for different mutants of both aspartase and transaminase enzymes, and the results have shown a common area of satisfactory operation for maximum production at low inducer concentration, around 2 μmol IPTG/g DCW. The operational strategy was validated with new mutants and high-cell density cultures were performed for efficient production. Suitable biocatalysts were prepared after recovery of the enzymes. The obtained aspartase was immobilized by covalent attachment on MANA-agarose, while ω-transaminase biocatalysts were prepared by entrapping whole cells and partially purified enzyme onto Lentikats (polyvinyl alcohol gel lens-shaped particles). Conclusions: The possibility of expressing different mutant enzymes under similar operation conditions has been demonstrated. The process was standardized for production of new aspartases with β-amino acid selectivity and new ω-transaminases with improved substrate acceptance. A whole process including production, cell disruption and partial purification was set up. The partially purified enzymes were immobilized and employed as stable biocatalysts in the synthesis of chiral amines.


Assuntos
Aminas/metabolismo , Transaminases/metabolismo , Amônia-Liases/metabolismo , Reatores Biológicos , Meios de Cultura , Enzimas Imobilizadas , Escherichia coli , Biocatálise , Técnicas de Cultura Celular por Lotes , Aminas/química , Transaminases/genética , Transaminases/química , Amônia-Liases/genética , Amônia-Liases/química , Mutação
6.
Org Biomol Chem ; 8(9): 2043-51, 2010 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-20401380

RESUMO

Omega-transaminases have been evaluated as biocatalysts in the reductive amination of organoselenium acetophenones to the corresponding amines, and in the kinetic resolution of racemic organoselenium amines. Kinetic resolution proved to be more efficient than the asymmetric reductive amination. By using these methodologies we were able to obtain both amine enantiomers in high enantiomeric excess (up to 99%). Derivatives of the obtained optically pure o-selenium 1-phenylethyl amine were evaluated as ligands in the palladium-catalyzed asymmetric alkylation, giving the alkylated product in up to 99% ee.


Assuntos
Aminas/química , Compostos Organosselênicos/química , Compostos Organosselênicos/síntese química , Selênio/química , Transaminases/metabolismo , Alquilação , Catálise , Ésteres/síntese química , Ésteres/química , Cinética , Ligantes , Estrutura Molecular , Estereoisomerismo , Transaminases/química
7.
Mol Biochem Parasitol ; 166(2): 172-82, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19443056

RESUMO

As part of a study on aminotransferases, genes coding for putative enzymes from Trypanosoma brucei and Leishmania major (alanine aminotransferases: ALATs, Tb927.1.3950 and LmjF12.0630; kynurenine aminotransferase: KAT, Tb10.389.1810; and tyrosine aminotransferase: TAT, LmjF36.2360) were cloned and functionally expressed in Escherichia coli. The putative T. brucei KAT, in fact coded for a glutamine aminotransferase (GlnAT), which exhibited a notably high affinity (in the micromolar range) towards glutamine and cysteine; in addition, like bacterial GlnATs and mammalian KATs, it was able to utilize different 2-oxoacids as amino acceptors. L. major TAT resembled T. cruzi TAT in substrate specificity, although the leishmanial enzyme did not exhibit ALAT activity. On the other hand, T. brucei ALAT, shortened by the first 65 amino acids assigned in the data bases, was functional and actively transaminated the substrate pair l-alanine and 2-oxoglutarate. Moreover in Western blots, the molecular size of the protein detected in crude extracts of T. brucei procyclics was identical to the value of the recombinant enzyme. Like T. brucei and T. cruzi orthologues, L. major ALAT displayed narrow substrate specificity. The leishmanial ALAT, like the T. cruzi enzyme, exhibited a dual subcellular localization, in the cytosol and in the mitochondrion. In line with the findings of comparative proteomic analyses of insect and mammalian stages of T. brucei and Leishmania parasites, our results also showed that T. cruzi ALAT is constitutively expressed, with remarkably higher levels being detected in amastigotes than in epimastigotes. ALATs are expressed in the clinically important stages of TriTryps, probably fulfilling an essential role, which deserves further studies.


Assuntos
Leishmania major/enzimologia , Leishmania major/crescimento & desenvolvimento , Leishmaniose Cutânea/parasitologia , Proteínas de Protozoários/metabolismo , Transaminases/metabolismo , Trypanosoma brucei brucei/enzimologia , Trypanosoma brucei brucei/crescimento & desenvolvimento , Tripanossomíase Africana/parasitologia , Alanina Transaminase/química , Alanina Transaminase/genética , Alanina Transaminase/metabolismo , Sequência de Aminoácidos , Animais , Clonagem Molecular , Humanos , Cinética , Leishmania major/química , Leishmania major/genética , Camundongos , Dados de Sequência Molecular , Transporte Proteico , Proteínas de Protozoários/química , Proteínas de Protozoários/genética , Alinhamento de Sequência , Especificidade por Substrato , Transaminases/química , Transaminases/genética , Trypanosoma brucei brucei/química , Trypanosoma brucei brucei/genética , Tirosina Transaminase/química , Tirosina Transaminase/genética , Tirosina Transaminase/metabolismo
8.
Mol Divers ; 13(4): 493-500, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19350404

RESUMO

We have performed the docking of sulfonyl hydrazides complexed with cytosolic branched-chain amino acid aminotransferase (BCATc) to study the orientations and preferred active conformations of these inhibitors. The study was conducted on a selected set of 20 compounds with variation in structure and activity. In addition, the predicted inhibitor concentration (IC(50)) of the sulfonyl hydrazides as BCAT inhibitors were obtained by a quantitative structure-activity relationship (QSAR) method using three-dimensional (3D) vectors. We found that three-dimensional molecule representation of structures based on electron diffraction (3D-MoRSE) scheme contains the most relevant information related to the studied activity. The statistical parameters [cross-validate correlation coefficient (Q(2) = 0.796) and fitted correlation coefficient (R(2) = 0.899)] validated the quality of the 3D-MoRSE predictive model for 16 compounds. Additionally, this model adequately predicted four compounds that were not included in the training set.


Assuntos
Citosol/enzimologia , Hidrazinas/química , Hidrazinas/farmacologia , Modelos Moleculares , Relação Quantitativa Estrutura-Atividade , Transaminases/antagonistas & inibidores , Domínio Catalítico , Desenho de Fármacos , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Humanos , Modelos Lineares , Transaminases/química
9.
Biochemistry (Mosc) ; 74(1): 81-4, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19232053

RESUMO

In this study, atrC (a novel gene from Azospirillum brasilense identified in our laboratory) was expressed in Escherichia coli, and SDS-PAGE analysis of the expressed AtrC revealed the apparent molecular weight of 45 kD. When analyzed under non-denaturing PAGE conditions and using L-tryptophan as a substrate, the purified AtrC protein exhibited aminotransferase activity, while crude protein extracts from A. brasilense Yu62 showed two activity bands with molecular masses estimated as 44 and 66 kD. Thus, we deduced that AtrC protein is identical to the 44 kD band of crude protein extracts. The optimal temperature and pH for the catalytic activity of the purified AtrC are 30 degrees C and pH 7.0, respectively.


Assuntos
Azospirillum brasilense/enzimologia , Proteínas de Bactérias/metabolismo , Ácidos Indolacéticos/metabolismo , Transaminases/metabolismo , Azospirillum brasilense/genética , Proteínas de Bactérias/química , Proteínas de Bactérias/genética , Peso Molecular , Transaminases/biossíntese , Transaminases/química , Transaminases/genética , Transaminases/isolamento & purificação , Triptofano/metabolismo
10.
Protein Sci ; 16(5): 887-96, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17456741

RESUMO

Desosamine is a 3-(dimethylamino)-3,4,6-trideoxyhexose found in certain macrolide antibiotics such as the commonly prescribed erythromycin. Six enzymes are required for its biosynthesis in Streptomyces venezuelae. The focus of this article is DesV, which catalyzes the PLP-dependent replacement of a 3-keto group with an amino functionality in the fifth step of the pathway. For this study the three-dimensional structures of both the internal aldimine and the ketimine intermediate with glutamate were determined to 2.05 A resolution. DesV is a homodimer with each subunit containing 12 alpha-helical regions and 12 beta-strands that together form three layers of sheet. The structure of the internal aldimine demonstrates that the PLP-cofactor is held in place by residues contributed from both subunits (Asp 164 and Gln 167 from Subunit I and Tyr 221 and Asn 235 from Subunit II). When the ketimine intermediate is present in the active site, the loop defined by Gln 225 to Ser 228 from Subunit II closes down upon the active site. The structure of DesV is similar to another sugar-modifying enzyme referred to as PseC. This enzyme is involved in the biosynthesis of pseudaminic acid, which is a sialic acid-like nonulosonate found in the flagellin of Helicobacter pylori. In the case of PseC, however, the amino group is transferred to the C-4 rather than the C-3 position. Details concerning the structural analysis of DesV and a comparison of its molecular architecture to that of PseC are presented.


Assuntos
Amino Açúcares/biossíntese , Streptomyces/enzimologia , Transaminases/química , Amino Açúcares/química , Clonagem Molecular , Cristalografia por Raios X , Dimerização , Modelos Moleculares , Estrutura Molecular , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína , Fosfato de Piridoxal/metabolismo , Streptomyces/genética , Streptomyces/metabolismo , Transaminases/genética , Transaminases/metabolismo
11.
Microbiology (Reading) ; 147(Pt 8): 2113-2126, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11495989

RESUMO

Amplification of sequences from Streptomyces venezuelae ISP5230 genomic DNA using PCR with primers based on conserved prokaryotic pabB sequences gave two main products. One matched pabAB, a locus previously identified in S. venezuelae. The second closely resembled the conserved pabB sequence consensus and hybridized with a 3.8 kb NcoI fragment of S. venezuelae ISP5230 genomic DNA. Cloning and sequence analysis of the 3.8 kb fragment detected three ORFs, and their deduced amino acid sequences were used in BLAST searches of the GenBank database. The ORF1 product was similar to PabB in other bacteria and to the PabB domain encoded by S. venezuelae pabAB. The ORF2 product resembled PabA of other bacteria. ORF3 was incomplete; its deduced partial amino acid sequence placed it in the MocR group of GntR-type transcriptional regulators. Introducing vectors containing the 3.8 kb NcoI fragment of S. venezuelae DNA into pabA and pabB mutants of Escherichia coli, or into the Streptomyces lividans pab mutant JG10, enhanced sulfanilamide resistance in the host strains. The increased resistance was attributed to expression of the pair of discrete translationally coupled p-aminobenzoic acid biosynthesis genes (designated pabB/pabA) cloned in the 3.8 kb fragment. These represent a second set of genes encoding 4-amino-4-deoxychorismate synthase in S. venezuelae ISP5230. In contrast to the fused pabAB set previously isolated from this species, they do not participate in chloramphenicol biosynthesis, but like pabAB they can be disrupted without affecting growth on minimal medium. The gene disruption results suggest that S. venezuelae may have a third set of genes encoding PABA synthase.


Assuntos
Ácido 4-Aminobenzoico/metabolismo , Cloranfenicol/biossíntese , Streptomyces/enzimologia , Transaminases/genética , Transaminases/metabolismo , Sequência de Aminoácidos , Carbono-Nitrogênio Ligases , Clonagem Molecular , Desoxirribonucleases de Sítio Específico do Tipo II/metabolismo , Dados de Sequência Molecular , Alinhamento de Sequência , Análise de Sequência de DNA , Streptomyces/genética , Transaminases/química
12.
Mol Biochem Parasitol ; 96(1-2): 83-92, 1998 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-9851609

RESUMO

A broad specificity aminotransferase (BSAT), with high activity with both, aromatic amino acids and aspartate as substrates, was purified to homogeneity from promastigotes of Leishmania mexicana by a method involving chromatography on DEAE-cellulose, Red-120-Sepharose and Mono Q, and gel filtration on Sephacryl S-200. The purified enzyme showed a single band in SDS-polyacrylamide gel electrophoresis, with an apparent molecular mass of 45 kDa. Since the apparent molecular mass of the native enzyme, determined by gel filtration, was 90 kDa, the native enzyme is a dimer of similar subunits. The amino acid composition was determined, as well as the sequence of four internal peptides obtained by tryptic digestion. Two of these peptides, consisting of 49 amino acid residues in total, showed high similarity (57%) with corresponding sequences of plant aspartate aminotransferases, whereas they had only 33% identity with the aromatic aminotransferase of Escherichia coli, and 16% identity with the tyrosine aminotransferase from the related parasite Trypanosoma cruzi. The BSAT contained only one 1/2 Cys residue per monomer. The optimal pH for the enzyme reaction, with tyrosine and alpha-oxoglutarate as substrates, was 7.0. The apparent Km values for tyrosine, phenylalanine, tryptophan and glutamate, with oxaloacetate as co-substrate, were 1.3, 0.9, 0.9 and 171.8 mM, respectively; the value for aspartate with alpha-oxoglutarate as co-substrate was 2.5 mM, and that for alanine with alpha-oxoglutarate as co-substrate was 216 mM. The values for pyruvate, alpha-oxoglutarate and oxaloacetate, with tyrosine as co-substrate, were 5.6, 0.71 and 0.12 mM, respectively. These results suggest that the enzyme is a broad-specificity aminotransferase, able to transaminate the aromatic amino acids, aspartate, and to a lower extent alanine, with high sequence similarity to aspartate aminotransferases.


Assuntos
Leishmania mexicana/enzimologia , Transaminases/isolamento & purificação , Transaminases/metabolismo , Sequência de Aminoácidos , Aminoácidos/análise , Aminoácidos/metabolismo , Animais , Dimerização , Concentração de Íons de Hidrogênio , Cinética , Dados de Sequência Molecular , Peso Molecular , Alinhamento de Sequência , Especificidade por Substrato , Transaminases/química
13.
Biol Res ; 29(1): 69-75, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-9267518

RESUMO

The use of fluorescent compounds can be a valuable tool to probe the active site of enzymes. Several examples of this approach are discussed, particularly the use of pyridoxal phosphate analogs. The study of protein-protein interactions by means of fluorescent-labeled proteins is also analyzed.


Assuntos
Nucleotídeos de Adenina/química , Sítios de Ligação , Piridoxal Quinase/química , Piridoxal/química , Piridoxina/química , Transaminases/química , Anisotropia , Conformação Proteica
14.
Biol. Res ; 29(1): 69-75, 1996.
Artigo em Inglês | LILACS | ID: lil-228550

RESUMO

The use of fluorescent compounds can be a valuable tool to probe the active site of enzymes. Several examples of this approach are discussed, particularly the use of pyridoxal phosphate analogs. The study of protein-protein interactions by means of fluorescent-labeled proteins is also analyzed


Assuntos
Nucleotídeos de Adenina/química , Sítios de Ligação , Piridoxal Quinase/química , Piridoxal/química , Piridoxina/química , Transaminases/química , Anisotropia , Conformação Proteica
15.
Bol. cient. CENETROP ; 15: 91-4, 1993.
Artigo em Espanhol | LILACS | ID: lil-151422

RESUMO

Se da a conocer el primer caso de Drepanocitosis (sickle cell anemia) descrito en Santa Cruz, Bolivia en un paciente de raza negra procedente de los Yungas de La Paz, que simulo un cuadro de artritis. El proposito del articulo es informar que es posible la existencia de mas casos, tanto sintomatico como asintomatico debido a la migracion interna y externa de grupos que racialmente tienen una mayor prevalencia de manera tal que se sospeche precozmente la enfermedad y se adopte la conducta que corresponda


Assuntos
Humanos , Masculino , Feminino , Anemia/diagnóstico , Anemia/enfermagem , Artrite/diagnóstico , Artrite/prevenção & controle , Hemoglobina Falciforme/fisiologia , Transaminases/química
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