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1.
Virulence ; 9(1): 1562-1575, 2018.
Article in English | MEDLINE | ID: mdl-30246592

ABSTRACT

Streptococcus pneumoniae (pneumococcus), the major pathogen for pneumonia, commonly colonizes the lung, but the mechanism underlying the coordination of virulence factors during invasion via the host protein remains poorly understood. Bacterial lysis releases the components of the cell wall, and triggers innate immunity and the subsequent secretion of pro-inflammatory cytokines. Previously, the virulence of the pep27 mutant was shown to be attenuated as a feasible candidate for vaccine development. However, the role of pep27 gene, belonging to the vancomycin-resistance locus (vncRS operon), in virulence, is largely unknown. This study demonstrates that transferrin in the host serum reduces the survival of the host during S. pneumoniae infections in mice. The exposure of the pneumococcal D39 strain to lactoferrin induced the vncRS operon, lysis, and subsequent in vivo cytokine production, resulting in lung inflammation. However, these responses were significantly attenuated in pneumococci harboring a mutation in pep27. Mechanistically, the VncS ligand, identified as lactoferrin, induced the vncRS operon and increased the in vivo mortality rates. Thus, serum-induced activation of vncRS plays an essential role in inducing pneumonia.


Subject(s)
Bacterial Proteins/genetics , Lactoferrin/genetics , Operon , Pneumonia, Pneumococcal/pathology , Streptococcus pneumoniae/genetics , Streptococcus pneumoniae/pathogenicity , A549 Cells , Animals , Cytokines , Humans , Immunity, Innate , Inflammation , Lactoferrin/pharmacology , Lung/immunology , Lung/microbiology , Male , Mice, Nude , Mutation , Streptococcus pneumoniae/drug effects , Transferrin , Vancomycin/pharmacology , Virulence
2.
Phytomedicine ; 22(11): 1055-61, 2015 Oct 15.
Article in English | MEDLINE | ID: mdl-26407948

ABSTRACT

BACKGROUND: More than 50% of sepsis cases are caused by Streptococcus pneumoniae, and hospital mortality related to sepsis comprises 52% of all hospital deaths. Therefore, sepsis is a medical emergency, and any treatment against the agent that produces it, is welcome. PURPOSE: The role of Panax ginseng C.A. Meyer (Araliaceae) aqueous extract in bacterial infection in vivo is not well understood. Here, the protective effect of Korean red ginseng (KRG) extract against pneumococcal infection and sepsis was elucidated. STUDY DESIGN: In this study, mice were administrated KRG (25, 50, 100 mg/kg) for 15 days, and then infected with a lethal S. pneumoniae strain. Survival rate, body weight, and colonization were determined. METHODS: The RAW 264.7 macrophage cells were infected with S. pneumoniae and cell viability was assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inflammation was examined using an enzyme-linked immunosorbent assay (ELISA) and hematoxylin and eosin (HE) staining while gene expression was determined using western blotting. RESULTS: KRG-pre-treated mice (100 mg/kg of KRG) had significantly higher survival rates and body weights than those of the non-treated controls; KRG-pre-treated mice had lower bacterial number and morbidity than those of the non-treated controls. 100 mg/kg of KRG administration decreased cytokine levels including tumor necrosis factor (TNF)-α (897 and 623 pg/ml, control and KRG groups, respectively, P < 0.05) and interleukin (IL)-1ß (175 and 127 pg/ml, control and KRG groups, respectively, P = 0.051), nitric oxide level (149 and 81 nM, control and KRG groups, respectively, P < 0.05), and neutrophil infiltration 48 h post-infection, in vivo. In pneumococcal infection, KRG pre-treatment downregulated toll-like receptor (TLR) 4 and TNF-ɑ expressions in RAW 264.7 macrophage cells and increased cell survival by activating phosphoinositide 3-kinase (PI3K)/AKT signaling. CONCLUSION: Taken together, 100 mg/kg of KRG appeared to protect host cells from lethal pneumococcal sepsis by inhibiting inflammation as well as by enhancing bacterial clearance thereby reinforcing cell survival against pneumococcal infection.


Subject(s)
Panax/chemistry , Plant Extracts/pharmacology , Pneumococcal Infections/drug therapy , Sepsis/drug therapy , Animals , Cytokines/metabolism , Disease Models, Animal , Male , Mice , Mice, Inbred ICR , Phosphatidylinositol 3-Kinases/metabolism , RAW 264.7 Cells , Signal Transduction , Toll-Like Receptor 4/metabolism
3.
FEBS J ; 282(8): 1352-67, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25662392

ABSTRACT

Caseinolytic protease L (ClpL) is a member of the heat shock protein (Hsp) 100 family, which is found mostly in Gram-positive bacteria. Here, ClpL, a major HSP in Streptococcus pneumoniae (pneumococcus), was biochemically characterized in vitro. Recombinant ClpL shows nucleotide hydrolase, refolding, holdase and disaggregation activity using either Mg(2+) or Mn(2+) and does not require the DnaK system for chaperone activity. ClpL exhibits two features distinct from other HSP100 family proteins: (a) Mn(2+) enhances hydrolase activity, as well as chaperone activity; and (b) NTPase activity. ClpL forms a hexamer in the presence of ADP, ATP and ATP-γ-S. Mutational analysis using double-mutant proteins mutated at the two Walker A motifs (K127A/T128A and K458A/T459A) revealed that both nucleotide-binding domains are involved in chaperone activity, ATP hydrolase activity and hexamerization. Overall, pneumococcal ClpL is a unique Mn(2+) -dependent Hsp100 family member that has chaperone activity without other co-chaperones.


Subject(s)
Adenosine Triphosphatases/metabolism , Bacterial Proteins/metabolism , Malate Dehydrogenase/metabolism , Molecular Chaperones , Nucleoside-Triphosphatase/metabolism , Protein Folding , Streptococcus pneumoniae/metabolism , Luciferases/metabolism , Malate Dehydrogenase/chemistry
5.
Adv Otorhinolaryngol ; 72: 126-8, 2011.
Article in English | MEDLINE | ID: mdl-21865709

ABSTRACT

Penicillin resistance and tolerance has been an increasing threat to the treatment of pneumococcal pneumoniae. However, no penicillin tolerance-related genes have been claimed. Here we show that a major heat shock protein ClpL/HSP100 could modulate the expression of a cell wall synthesis enzyme PBP2x, and subsequently increase cell wall thickness and penicillin tolerance in Streptococus pneumoniae.


Subject(s)
Bacterial Proteins/metabolism , Heat-Shock Proteins/metabolism , Penicillin Resistance , Penicillin-Binding Proteins/metabolism , Penicillins/pharmacology , Pneumococcal Infections/drug therapy , Streptococcus pneumoniae/drug effects , Bacterial Proteins/drug effects , Humans , Pneumococcal Infections/metabolism , Pneumococcal Infections/microbiology
6.
Antimicrob Agents Chemother ; 55(6): 2714-28, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21422206

ABSTRACT

Antibiotic resistance and tolerance are increasing threats to global health as antibiotic-resistant bacteria can cause severe morbidity and mortality and can increase treatment cost 10-fold. Although several genes contributing to antibiotic tolerance among pneumococci have been identified, we report here that ClpL, a major heat shock protein, could modulate cell wall biosynthetic enzymes and lead to decreased penicillin susceptibility. On capsular type 1, 2, and 19 genetic backgrounds, mutants lacking ClpL were more susceptible to penicillin and had thinner cell walls than the parental strains, whereas a ClpL-overexpressing strain showed a higher resistance to penicillin and a thicker cell wall. Although exposure of Streptococcus pneumoniae D39 to penicillin inhibited expression of the major cell wall synthesis gene pbp2x, heat shock induced a ClpL-dependent increase in the mRNA levels and protein synthesized by pbp2x. Inducible ClpL expression correlated with PBP2x expression and penicillin susceptibility. Fractionation and electron micrograph data revealed that ClpL induced by heat shock is localized at the cell wall, and the ΔclpL showed significantly reduced net translocation of PBP2x into the cell wall. Moreover, coimmunoprecipitation with either ClpL or PBP2x antibody followed by reprobing with ClpL or PBP2x antibody showed an interaction between ClpL and PBP2x after heat stress. This interaction was confirmed by His tag pulldown assay with either ClpLHis6 or PBP2xHis6. Thus, ClpL stabilized pbp2x expression, interacted with PBP2x, and facilitated translocation of PBP2x, a key protein of cell wall synthesis process, contributing to the decrease of antibiotic susceptibility in S. pneumoniae.


Subject(s)
Heat-Shock Proteins/physiology , Penicillin Resistance , Streptococcus pneumoniae/drug effects , Bacterial Proteins/genetics , Bacteriolysis/drug effects , Deoxycholic Acid/pharmacology , Drug Resistance, Bacterial , Hot Temperature , Octoxynol/pharmacology , Penicillin-Binding Proteins/genetics , Penicillin-Binding Proteins/metabolism , Penicillins/pharmacology , Peptide Synthases/genetics , Streptococcus pneumoniae/metabolism
7.
Mol Cells ; 27(2): 149-57, 2009 Feb 28.
Article in English | MEDLINE | ID: mdl-19277496

ABSTRACT

In both gram-positive and several gram-negative bacteria, the transcription of dnaK and groE operons is negatively regulated by HrcA; however, the mechanism modulating HrcA protein activity upon thermal stress remains elusive. Here, we demonstrate that HrcA is modulated via reduction and oligomerization in vitro. Native-PAGE analysis was used to reveal the oligomeric structure of HrcA. The oligomeric HrcA structure became monomeric following treatment with the reducing agent dithothreitol, and this process was reversed by treatment with hydrogen peroxide. Moreover, the mutant HrcA C118S exhibited reduced binding to CIRCE elements and became less oligomerized, suggesting that cysteine residue 118 is important for CIRCE element binding as well as oligomerization. Conversely, HrcA mutant C280S exhibited increased oligomerization. An HrcA double mutant (C118S, C280S) was monomeric and exhibited a level of oligomerization and CIRCE binding similar to wild type HrcA, suggesting that cysteine residues 118 and 280 may function as checks to one another during oligomer formation. Biochemical fractionation of E. coli cells overexpressing HrcA revealed the presence of HrcA in the membrane fraction. Together, these results suggest that the two HrcA cysteine residues at positions 118 and 280 function as reduction sensors in the membrane and mediate oligomerization upon stress.


Subject(s)
Cell Membrane/metabolism , Cysteine/metabolism , Gene Expression Regulation, Bacterial , Heat-Shock Response , Repressor Proteins/metabolism , Streptococcus pneumoniae/physiology , Cysteine/genetics , DNA Primers/chemistry , DNA Primers/genetics , DNA, Bacterial/genetics , DNA, Bacterial/metabolism , Electrophoretic Mobility Shift Assay , Escherichia coli/genetics , Escherichia coli/metabolism , In Vitro Techniques , Mutation , Promoter Regions, Genetic , RNA, Bacterial/genetics , RNA, Bacterial/metabolism , RNA, Messenger/genetics , RNA, Messenger/metabolism , Regulatory Elements, Transcriptional , Repressor Proteins/genetics
8.
Arch Pharm Res ; 31(2): 171-7, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18365686

ABSTRACT

Multidrug resistance (MDR) is a major problem in cancer chemotherapy. It was previously reported that a red ginseng saponin, 20(S)-ginsenoside Rg3 could modulate MDR in vitro and extend the survival of mice implanted with ADR-resistant murine leukemia P388 cells. This study examined the cytotoxicity of Rg3 on normal and transformed cells, along with its effect on the membrane fluidity. The cytotoxicity study revealed that 120 microM of Rg3 was cytotoxic against a multidrug-resistant human fibroblast carcinoma cell line, KB V20C, but not against normal WI 38 cells in vitro. Flow cytometric analysis using rhodamine 123 as the artificial substrate showed that Rg3 promoted the accumulation of rhodamine 123 in ADR-resistant murine leukemia P388 cells in vivo. Fluorescence polarization studies using the hydrophilic fluorescent probe, DPH, and hydrophobic probe, TMA-DPH, showed that 20 microM Rg3 induced a significant increase in fluorescence anisotropy in KB V20C cells but not in the parental KB cells. These results clearly show that Rg3 decreases the membrane fluidity thereby blocking drug efflux.


Subject(s)
Antineoplastic Agents, Phytogenic/toxicity , Drug Resistance, Multiple/drug effects , Drug Resistance, Neoplasm/drug effects , Ginsenosides/toxicity , Membrane Fluidity/drug effects , Animals , Antibiotics, Antineoplastic/pharmacology , Doxorubicin/pharmacology , Female , Flow Cytometry , Fluorescence Polarization , Fluorescent Dyes , Humans , KB Cells , Leukemia P388/drug therapy , Mice , Neoplasm Transplantation , Rhodamine 123
9.
Infect Immun ; 75(6): 2996-3005, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17403879

ABSTRACT

Heat shock proteins (HSPs) play a pivotal role as chaperones in the folding of native and denatured proteins and can help pathogens penetrate host defenses. However, the underlying mechanism(s) of modulation of virulence by HSPs has not been fully determined. In this study, the role of the chaperone ClpL in the pathogenicity of Streptococcus pneumoniae was assessed. A clpL mutant adhered to and invaded nasopharyngeal or lung cells much more efficiently than the wild type adhered to and invaded these cells in vitro, as well as in vivo, although it produced the same amount of capsular polysaccharide. However, the level of secretion of tumor necrosis factor alpha (TNF-alpha) from macrophages infected with the clpL mutant was significantly lower than the level of secretion elicited by the wild type during the early stages of infection. Interestingly, treatment of the human lung epithelial carcinoma A549 and murine macrophage RAW 264.7 cell lines with cytochalasin D, an inhibitor of actin polymerization, increased adherence of the mutant to the host cells. In contrast, cytochalasin D treatment of RAW 264.7 cells decreased TNF-alpha secretion after infection with either the wild type or the mutant. However, pretreatment of cell lines with the actin polymerization activator jasplakinolide reversed these phenotypes. These findings indicate, for the first time, that the ClpL chaperone represses adherence of S. pneumoniae to host cells and induces secretion of TNF-alpha via a mechanism dependent upon actin polymerization during the initial infection stage.


Subject(s)
Bacterial Adhesion , Macrophages/metabolism , Pneumococcal Infections/metabolism , Streptococcus pneumoniae , Tumor Necrosis Factor-alpha/metabolism , Endopeptidase Clp/genetics , Macrophages/microbiology , Pneumococcal Infections/genetics , Pneumococcal Infections/immunology , Tumor Cells, Cultured , Virulence/genetics
10.
Arch Pharm Res ; 29(12): 1132-9, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17225463

ABSTRACT

Single nucleotide polymorphisms (SNPs) in the MDR1 gene that are responsible for drug efflux can cause toxicity. Therefore, this study determined the SNPs of the Korean MDR1 gene, and analyzed the haplotypes and a linkage disequilibrium (LD) of the SNPs determined. The frequency of 9 SNPs from the MDR1 gene was determined by PCR-RFLP analyses of 100 to 500 healthy individuals. The frequcies of the SNPs were C3435T (47.7%), G2677T (37.6%), G2677A (4.4%), T1236C (21.7%), T129C (8%), A2956G (2.5%), T307C (1.5%), A41aG (9.2%), C145G (0%), and G4030C (0 %). Analyses of the haplotype structure and an estimation of the LD of the combined polymorphisms demonstrated that the frequency of the 1236T-2677G-3435T haplotype is much higher in Koreans (14.1%) than in Chinese and western black Africans and the C3435T SNP in Koreans appears to have LD with T129C in Koreans for the first time. These results provide insight into the genetic variation of MDR1 in Koreans, and demonstrated the possibility of a new LD in this gene.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , Polymorphism, Single Nucleotide/genetics , DNA/genetics , Genotype , Haplotypes , Humans , Korea/epidemiology , Linkage Disequilibrium/genetics , Pharmacokinetics , Polymorphism, Restriction Fragment Length
11.
Mol Microbiol ; 55(2): 456-68, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15659163

ABSTRACT

DnaK and GroEL play a pivotal role in protein folding, and promote cell proliferation and survival. In Gram-positive and several Gram-negative bacteria, HrcA represses the transcription of dnaK and groE operons by binding to the highly conserved CIRCE (controlling inverted repeat of chaperone expression) operator sequence in the presence of GroEL. HrcA may respond to environmental stress and various other factors that modulate the transcription of the dnaK and groE operons. However, the mechanisms by which these factors modulate the activity of HrcA remain elusive. Here, we show that the thermoresistance of Streptococcus pneumoniae is significantly repressed in the presence of Ca2+. Furthermore, heat shock-induced expression of the CIRCE regulon in S. pneumoniae is repressed in the presence of Ca2+, although to a lesser degree than in the hrcA mutant, strongly suggesting that HrcA inhibits expression of the CIRCE regulon in a Ca2+-dependent manner. Although HrcA does not bind directly to Ca2+, its hydrophobicity is increased in the presence of the metal ion. Taken together, our observations suggest that Ca2+ induces conformational changes, such as exposure of the hydrophobic surfaces of HrcA, which facilitate binding to GroEL. Alternatively, the presence of Ca2+ may facilitate GroEL in interacting freely with HrcA. This, in turn, enhances access to CIRCE and leads to repression of the dnaK and groE operons in S. pneumoniae.


Subject(s)
Calcium/metabolism , Gene Expression Regulation, Bacterial , Heat-Shock Response , Regulon/physiology , Repressor Proteins/metabolism , Streptococcus pneumoniae/genetics , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Chaperonin 60/genetics , Chaperonin 60/metabolism , DNA-Binding Proteins , Heat-Shock Proteins/genetics , Heat-Shock Proteins/metabolism , Humans , Hydrophobic and Hydrophilic Interactions , Molecular Chaperones/genetics , Molecular Chaperones/metabolism , Mutation , Repressor Proteins/genetics , Streptococcus pneumoniae/growth & development , Streptococcus pneumoniae/physiology
12.
Infect Immun ; 72(10): 5646-53, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15385462

ABSTRACT

Streptococcus pneumoniae usually colonizes the nasopharynx of humans asymptomatically but occasionally translocates from this niche to the lungs, the brain, and the blood, causing potentially fatal infections. Spread to other host tissues requires a significant morphological change and the expression of virulence factors, such as capsular polysaccharide, and virulence proteins, such as pneumolysin (Ply), PspA, and CbpA. Modulation of the expression of pneumococcal virulence genes by heat shock and by heat shock proteins ClpL and ClpP, as well as the attenuation of virulence of a clpP mutant in a murine intraperitoneal infection model, was demonstrated previously. In this study, we further investigated the underlying mechanism of virulence attenuation by the clpP mutation. The half-lives of the mRNAs of ply and of the first gene of the serotype 2 capsule synthesis locus [cps2A] in the clpP mutant were more than twofold longer than those of the parent after heat shock, suggesting that the mRNA species were regulated posttranscriptionally by ClpP. In addition, the clpP mutant was defective in colonization of the nasopharynx and survival in the lungs of mice after intranasal challenge. The mutant was also killed faster than the parent in the murine macrophage RAW264.7 cell line, indicating that ClpP is required for colonization and intracellular survival in the host. Furthermore, fractionation studies demonstrated that ClpP was translocated into the cell wall after heat shock, and immunization of mice with ClpP elicited a protective immune response against fatal systemic challenge with S. pneumoniae D39, making ClpP a potential vaccine candidate for pneumococcal disease.


Subject(s)
Adenosine Triphosphatases/metabolism , Gene Expression Regulation, Bacterial , Pneumococcal Infections/microbiology , Pneumococcal Infections/prevention & control , Serine Endopeptidases/metabolism , Streptococcus pneumoniae/genetics , Streptococcus pneumoniae/pathogenicity , Adenosine Triphosphatases/genetics , Adenosine Triphosphatases/immunology , Animals , Cell Line , Cell Wall/enzymology , Endopeptidase Clp , Half-Life , Heat-Shock Response , Hemolysis , Humans , Lung/microbiology , Macrophages/microbiology , Mice , Mice, Inbred CBA , Mutation/genetics , Nasopharynx/microbiology , Pneumococcal Infections/immunology , RNA Stability , RNA, Messenger/genetics , RNA, Messenger/metabolism , Serine Endopeptidases/genetics , Serine Endopeptidases/immunology , Streptococcus pneumoniae/enzymology , Streptococcus pneumoniae/growth & development , Survival Rate , Virulence/genetics
13.
Infect Immun ; 71(7): 3757-65, 2003 Jul.
Article in English | MEDLINE | ID: mdl-12819057

ABSTRACT

Spread of Streptococcus pneumoniae from the nasopharynx to other host tissues would require the organism to adapt to a variety of environmental conditions. Since heat shock proteins are induced by environmental stresses, we investigated the effect of heat shock on ClpL and ClpP synthesis and the effect of clpL and clpP mutations on the expression of key pneumococcal virulence genes. Pulse labeling with [(35)S]methionine and chase experiments as well as immunoblot analysis demonstrated that ClpL, DnaK, and GroEL were stable. Purified recombinant ClpL refolded urea-denatured rhodanese in a dose-dependent manner, demonstrating ClpL's chaperone activity. Although growth of the clpL mutant was not affected at 30 or 37 degrees C, growth of the clpP mutant was severely affected at these temperatures. However, both clpL and clpP mutants were sensitive to 43 degrees C. Although it was further induced by heat shock, the level of expression of ClpL in the clpP mutant was high at 30 degrees C, suggesting that ClpP represses expression of ClpL. Furthermore, the clpP mutation significantly attenuated the virulence of S. pneumoniae in a murine intraperitoneal infection model, whereas the clpL mutation did not. Interestingly, immunoblot and real-time reverse transcription-PCR analysis demonstrated that pneumolysin and pneumococcal surface antigen A were induced by heat shock in wild-type S. pneumoniae. Other virulence genes were also affected by heat shock and clpL and clpP mutations. Virulence gene expression seems to be modulated not only by heat shock but also by the ClpL and ClpP proteases.


Subject(s)
Adenosine Triphosphatases/physiology , Heat-Shock Proteins/physiology , Hot Temperature , Serine Endopeptidases/physiology , Streptococcus pneumoniae/pathogenicity , Animals , Endopeptidase Clp , Mice , Mice, Inbred BALB C , Molecular Chaperones/physiology , Mutation , Phenotype , Streptococcus pneumoniae/enzymology , Streptococcus pneumoniae/genetics , Virulence/genetics
14.
Biochem Pharmacol ; 65(1): 75-82, 2003 Jan 01.
Article in English | MEDLINE | ID: mdl-12473381

ABSTRACT

Multidrug resistance has been a major problem in cancer chemotherapy. In this study, in vitro and in vivo modulations of MDR by ginsenoside Rg(3), a red ginseng saponin, were investigated. In flow cytometric analysis using rhodamine 123 as an artificial substrate, Rg(3) promoted accumulation of rhodamine 123 in drug-resistant KBV20C cells in a dose-dependent manner, but it had no effect on parental KB cells. Additionally Rg(3) inhibited [3H]vinblastine efflux and reversed MDR to doxorubicin, COL, VCR, and VP-16 in KBV20C cells. Reverse transcriptase-polymerase chain reaction and immuno-blot analysis after exposure of KBV20C cells to Rg(3) showed that inhibition of drug efflux by Rg(3) was due to neither repression of MDR1 gene expression nor Pgp level. Photo-affinity labeling study with [3H]azidopine, however, revealed that Rg(3) competed with [3H]azidopine for binding to the Pgp demonstrating that Rg(3) competed with anticancer drug for binding to Pgp thereby blocking drug efflux. Furthermore, Rg(3) increased life span in mice implanted with DOX-resistant murine leukemia P388 cells in vivo and inhibited body weight increase significantly.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/physiology , Drug Resistance, Multiple/physiology , Ginsenosides/pharmacology , ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Affinity Labels/metabolism , Animals , Azides/metabolism , Biological Transport/drug effects , Dihydropyridines/metabolism , Disease Models, Animal , Fluorescent Dyes/metabolism , Ginsenosides/therapeutic use , Humans , KB Cells , Leukemia P388/drug therapy , Leukemia P388/mortality , Mice , Rhodamine 123/metabolism , Tritium , Tumor Cells, Cultured , Vinblastine/pharmacokinetics
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