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1.
J Biol Regul Homeost Agents ; 31(4): 865-877, 2017.
Article in English | MEDLINE | ID: mdl-29254289

ABSTRACT

It is well documented that nutraceuticals, in general, and Green tea catechins, in particular, possess a potential therapeutic value in inflammatory bowel diseases (IBD) due to their anti-oxidative and anti-inflammatory effects. This study aimed to investigate the possible mechanism of action of catechins in a rat model of colitis induced by 2.4.6 trinitrobenzene sulfonic acid (TNBS). Thirty-five young adult Sprague-Dawley rats were divided into four groups: normal control (n=5), catechins (n=9), TNBS (n=9) and TNBS plus catechins (n=12) treated. Catechin in the form of Epigallocatechin-3-gallate (EGCG) was administered daily by intraperitoneal injection, 1 week before the induction date of UC. Biopsies of the descending colon were collected on days 3, 10 and 17, and partly frozen for molecular studies or fixed for light microscopy. The status of intestinal tissue alterations and mast cells number were also assessed, as well as the mRNA expressions of IL-6, TNF-a and NF-kB, and determination of ROS expression. Histological data depicted a significant amelioration in the TNBS- and EGCG-treated rats compared to the non-treated animals. Catechin expressed strong anti-inflammatory and anti-oxidant effects, ameliorated ulcerative colitis and stabilized mast cells. The mechanism of action occurred basically through the NF-kB pathway and possibly through a crosstalk with other pathways.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Antioxidants/pharmacology , Catechin/analogs & derivatives , Colitis/drug therapy , Colon/drug effects , Signal Transduction/drug effects , Tea/chemistry , Animals , Anti-Inflammatory Agents/isolation & purification , Antioxidants/isolation & purification , Catechin/isolation & purification , Catechin/pharmacology , Colitis/chemically induced , Colitis/immunology , Colitis/pathology , Colon/immunology , Colon/pathology , Gene Expression Regulation , Interleukin-6/genetics , Interleukin-6/immunology , Male , Mast Cells/drug effects , Mast Cells/immunology , Mast Cells/pathology , NF-kappa B/genetics , NF-kappa B/immunology , Rats , Rats, Sprague-Dawley , Reactive Oxygen Species/immunology , Reactive Oxygen Species/metabolism , Trinitrobenzenesulfonic Acid , Tumor Necrosis Factor-alpha/genetics , Tumor Necrosis Factor-alpha/immunology
2.
J Biol Regul Homeost Agents ; 31(3): 817-821, 2017.
Article in English | MEDLINE | ID: mdl-28958141

ABSTRACT

Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, have important extraintestinal manifestations, notably in the oral cavity. These oral manifestations can constitute important clinical clues in the diagnosis and management of IBD, and include changes at the immune and bacterial levels. Aphthous ulcers, pyostomatitis vegetans, cobblestoning and gingivitis are important oral findings frequently observed in IBD patients. Their presentations vary considerably and might be well diagnosed and distinguished from other oral lesions. Infections, drug side effects, deficiencies in some nutrients and many other diseases involved with oral manifestations should also be taken into account. This article discusses the most recent findings on the oral manifestations of IBD with a focus on bacterial modulations and immune changes. It also includes an overview on options for management of the oral lesions of IBD.


Subject(s)
Gingivitis , Inflammatory Bowel Diseases , Mouth , Stomatitis, Aphthous , Animals , Gingivitis/immunology , Gingivitis/microbiology , Gingivitis/pathology , Gingivitis/therapy , Humans , Inflammatory Bowel Diseases/immunology , Inflammatory Bowel Diseases/microbiology , Inflammatory Bowel Diseases/pathology , Inflammatory Bowel Diseases/therapy , Mouth/immunology , Mouth/microbiology , Mouth/pathology , Stomatitis, Aphthous/immunology , Stomatitis, Aphthous/microbiology , Stomatitis, Aphthous/pathology , Stomatitis, Aphthous/therapy
3.
Atherosclerosis ; 187(2): 285-91, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16249002

ABSTRACT

BACKGROUND: Although considered as an anti-inflammatory cytokine, interleukin-4 (IL-4) has been shown to be pro-atherogenic in mice models of atherosclerosis. OBJECTIVES: In order to elucidate this paradox, we have investigated the effects of IL-4 on characteristic atherogenic parameters in human umbilical vein endothelial cells (HUVECs): production of reactive oxygen species, expression of monocyte chemoattractant protein-1 (MCP-1) and nitric oxide (NO) bioavailability. RESULTS: Incubation of HUVECs with IL-4 resulted in an increased production of reactive oxygen species and extracellular O(2)(-)(*) measured using fluorogenic probes and Cytochrome c that was inhibited by superoxide dismutase or gp91ds-tat, a selective NADPH oxidase inhibitor. The latter also inhibited IL-4 induced over-expression of MCP-1 mRNA measured by classical and real time RT-PCR. Incubation of HUVECs with IL-4 reduced thrombin-induced NO release, detected by electrochemistry, an effect which was reversed by incubation with superoxide dismutase. Both production of reactive oxygen species and MCP-1 mRNA over-expression induced by IL-4 were fully inhibited by selective inhibitors of phosphatidyl inositol 3-kinase. CONCLUSION: The data demonstrate that IL-4 up-regulates the expression of MCP-1 and decreases NO bioavailability through activation of NADPH oxidase in endothelial cells. These results are in favor of a pro-inflammatory and pro-atherogenic effect of IL-4 in vascular tissues.


Subject(s)
Atherosclerosis/metabolism , Chemokine CCL2/genetics , Endothelium, Vascular/metabolism , Interleukin-4/metabolism , Oxidative Stress/immunology , Arachidonic Acids/pharmacology , Atherosclerosis/immunology , Chemokine CCL2/metabolism , Chromones/pharmacology , Endothelium, Vascular/cytology , Endothelium, Vascular/drug effects , Enzyme Inhibitors/pharmacology , Humans , Interleukin-4/pharmacology , Morpholines/pharmacology , NADPH Oxidases/metabolism , Nitric Oxide/metabolism , Nitric Oxide Synthase Type II/metabolism , Oxidative Stress/drug effects , RNA, Messenger/metabolism , Reactive Oxygen Species/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Tumor Necrosis Factor-alpha/metabolism , Tumor Necrosis Factor-alpha/pharmacology , Umbilical Veins/cytology
4.
Carcinogenesis ; 22(11): 1819-24, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11698344

ABSTRACT

The Ah receptor (AhR) is a ligand-dependent transcription factor that positively regulates the expression of the CYP1A1 gene. We investigated the genetic polymorphisms of the AhR gene including the promoter, and examined the link between these polymorphisms, CYP1A1 inducibility and the lung cancer incidence. The AhR promoter region and the 11 exons of 30 subjects were screened. Among the three polymorphisms found, two [(2417)(A/G) ((157)G/A)] have never been described previously. The (1721)(G/A) and (2417)(A/G) are localized in exon 10 and lead to Arg(554)Lys and Met(786)Val substitutions, respectively. The other polymorphism was found in the 5'-untranslated region, resulting in the substitution of a G by an A at position 157 (157)(G/A). To evaluate the frequency of this allelic variant found, a DNA library of a case-control study of lung cancer (162 controls and 177 patients) was studied. There is no significant association between (1721)(G/A), (157)(G/A) and lung cancer: (1721)(G/A) and (157)(G/A) were detected at the same allele frequency of 0.086 and 0.25, respectively in both controls and patients. (2417)(A/G) was found in only one control of 100 (allele frequency 0.005). Statistical analysis did not show any relationship between both (1721)(G/A) and (157)(G/A) polymorphisms found and CYP1A1 inducibility. Considering the rareness of the (2417)(A/G) allelic variant we were not able to evaluate its association with inducibility. In conclusion, none of the polymorphisms were found to play a key role in the CYP1A1 inducibility or in the susceptibility to develop lung cancer.


Subject(s)
Adenocarcinoma/genetics , Carcinoma, Small Cell/genetics , Carcinoma, Squamous Cell/genetics , Cytochrome P-450 CYP1A1/biosynthesis , Lung Neoplasms/genetics , Polymorphism, Genetic , Receptors, Aryl Hydrocarbon/genetics , Adenocarcinoma/enzymology , Carcinoma, Small Cell/enzymology , Carcinoma, Squamous Cell/enzymology , Case-Control Studies , DNA Primers , Electrophoresis , Enzyme Induction , Exons , France , Genetic Predisposition to Disease , Genotype , Humans , Ligases/metabolism , Lung Neoplasms/enzymology , Middle Aged , Oligonucleotides/chemistry , Polymerase Chain Reaction , Promoter Regions, Genetic , Sequence Analysis, DNA
5.
J Natl Cancer Inst ; 92(8): 642-7, 2000 Apr 19.
Article in English | MEDLINE | ID: mdl-10772682

ABSTRACT

BACKGROUND: Cisplatin (cis-diamminedichloroplatinum) is one of the most active agents against a broad range of malignancies, including ovarian cancer. Cisplatin resistance appears to be associated with several molecular alterations, including overexpression of metallothionein, a metal-binding protein. In the present study, we attempted to take advantage of metallothionein overexpression to overcome cisplatin resistance. METHODS: Using a virus-free system (liposomes), we sought to express the suicide gene, thymidine kinase (TK), driven by the promoter of the human metallothionein IIa (hMTIIa) gene using the pMT-TK plasmid. We used cisplatin-resistant human ovarian carcinoma cells as a model. RESULTS: We first analyzed metallothionein expression using a ribonuclease protection assay. In comparison to parental cells, the cisplatin-resistant cells were found to have increased expression of metallothionein messenger RNA (mRNA). Metallothionein overexpression in these cells was not associated with an increased copy number of the hMTIIa gene or with different transfection efficiencies. Furthermore, we showed by reverse transcription-polymerase chain reaction analysis that transfection of the pMT-TK plasmid results in a 56-fold higher expression of thymidine kinase mRNA in cisplatin-resistant cells compared with parental cells, consistent with increased metallothionein promoter-mediated transactivation in the cisplatin-resistant cells. Transfection of resistant cells with pMT-TK or a control plasmid (pCD3-TK) resulted in a marked sensitization to ganciclovir, with a 50% cell growth-inhibitory concentration (IC(50)) of 20 microg/mL and 9 microg/mL, respectively. Transfections of the cisplatin-sensitive cells resulted in no sensitization to ganciclovir with pMT-TK (IC(50) 200 microg/mL) and a high sensitization with pCD3-TK (IC(50) = 6 microg/mL). CONCLUSION: These studies suggest that pMT-TK gene therapy may provide an alternative treatment for cisplatin-refractory ovarian tumors.


Subject(s)
Cisplatin/pharmacology , Genetic Therapy , Metallothionein/genetics , Ovarian Neoplasms/genetics , Promoter Regions, Genetic , Thymidine Kinase/genetics , Drug Resistance, Neoplasm , Female , Ganciclovir/pharmacology , Humans , Liposomes/administration & dosage , Prodrugs/metabolism , RNA, Messenger/analysis , Simplexvirus/enzymology , Thymidine Kinase/metabolism , Transcriptional Activation , Transfection , Tumor Cells, Cultured
6.
FEBS Lett ; 466(1): 49-53, 2000 Jan 21.
Article in English | MEDLINE | ID: mdl-10648810

ABSTRACT

Both cisplatin and the estrogen receptor (ER) are known to bend DNA. The influence of the bending of sequences by the d(GpG)cisPt adduct binding of ER to estrogen response element (ERE)-like sequences was examined. Three ERE-like oligonucleotides with different affinities for ER and which include a GG in the linker sequence were designed in order to form a single central d(GpG)cisPt adduct. Using electrophoretic mobility shift assay and Scatchard analysis, it was shown that the presence of a single d(GpG)cisPt adduct in the linker sequence decreases the ER affinity for DNA. These results do not support a critical role of a DNA bend in the initial recognition of ERE by ER. Then, the platination of DNA outside of the ERE half-sites decreases the interaction of ER with ERE.


Subject(s)
Cisplatin/metabolism , Cisplatin/pharmacology , DNA Adducts/metabolism , DNA Adducts/pharmacology , Receptors, Estrogen/metabolism , Animals , Base Sequence , Binding Sites , COS Cells , Cisplatin/chemistry , DNA/chemistry , DNA/genetics , DNA/metabolism , DNA Adducts/chemistry , Humans , In Vitro Techniques , Kinetics , Nucleic Acid Conformation , Recombinant Proteins/metabolism
7.
Ann Biol Clin (Paris) ; 56(3): 321-7, 1998.
Article in French | MEDLINE | ID: mdl-9754264

ABSTRACT

Hypercholesterolemia increases the oxidation of low density lipoprotein (LDL) which subsequently leads to atherogenesis. The oxidized LDL are also known to increase in vitro macrophage synthesis of glutathione. The purpose of this study was to investigate the relationship between lipid parameters and the glutathione system (glutathione, glutathione S-transferase) in total blood and within leukocytes. The glutathione and glutathione S-transferase were evaluated by spectrophotometric methods in sixty-two healthy volunteers (32 women, 30 men, mean age 39.9 +/- 7.7). No correlation was found between the level of blood cholesterol and the values of the blood glutathione system. However, a positive correlation between the values of glutathione and glutathione S-transferase in leukocytes and the blood cholesterol level was only found in women (r = 0.55 and r = 0.50 respectively, p < 0.01). We also found in men a positive correlation between body mass index and glutathione S-transferase in total blood and within leukocytes (r = 0.38, p < 0.05, r = 0.5, p < 0.01 respectively). No correlation was found between age, smoking and the values of the glutathione system. Our results suggest that the glutathione system in leukocytes is related to blood cholesterol levels. The fact that this positive correlation was only observed in women points to a possible role of estrogens in the regulation of the glutathione system which merits to be further studied.


Subject(s)
Cholesterol/blood , Glutathione Transferase/blood , Glutathione/blood , Leukocytes/chemistry , Adult , Blood Glucose/analysis , Body Mass Index , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Female , Humans , Male , Middle Aged , Reference Values , Sex Characteristics , Triglycerides/blood
8.
Anticancer Res ; 18(3A): 1833-8, 1998.
Article in English | MEDLINE | ID: mdl-9673412

ABSTRACT

During inflammation and infection, overexpression of the tumor necrosis factor (TNF) is associated with changes in cytochromes P-450 levels in rat and human hepatocytes. The aim of this study was to investigate the effect of TNF on the expression of the glutathione-S-transferases (GSTs) in rat hepatocytes. TNF was added in vitro alone or simultaneously with phenobarbital (PB) into hepatocytes in primary culture or in vivo, before TNF, injected directly to rats. GST activity was assayed by spectrophotometry; protein GSTs alpha, mu and pi were evaluated by immunoblotting. When TNF was added alone to rat hepatocytes in vitro, total GST activity and GST alpha levels were not affected, while GST mu protein levels significantly decreased by 35%. GST pi protein was undetectable in hepatocytes whether treated or not with TNF. When PB was administered in vitro simultaneously to rat hepatocytes with TNF, the decrease observed for GST mu subunit was suppressed while total GST activity and GST alpha content were not affected. When hepatocytes were treated with TNF after PB given in vivo directly to the rat by i.p. injection, GST activity and GSTs subunits were induced by PB, while TNF did not exert any effect. These results indicate that TNF has an inhibitory effect on GST mu and PB abrogates this effect in primary cultured rat hepatocytes. Then, PB could prevent some TNF toxic effects.


Subject(s)
Glutathione Transferase/biosynthesis , Isoenzymes/biosynthesis , Liver/enzymology , Phenobarbital/pharmacology , Tumor Necrosis Factor-alpha/pharmacology , Animals , Cells, Cultured , Cytochrome P-450 Enzyme System/biosynthesis , Glutathione Transferase/antagonists & inhibitors , Humans , Injections, Intraperitoneal , Isoenzymes/antagonists & inhibitors , Kinetics , Macromolecular Substances , Male , Phenobarbital/administration & dosage , Rats , Rats, Sprague-Dawley , Tumor Necrosis Factor-alpha/antagonists & inhibitors
9.
Anticancer Res ; 18(1A): 283-8, 1998.
Article in English | MEDLINE | ID: mdl-9568091

ABSTRACT

The purpose of this study was to find out whether the glutathione (GSH), in red blood cells could predict the response to neoadjuvant chemotherapy cisplatin/5-fluorouracil (CDDP/5-FU) in patients with head and neck squamous cell carcinoma (HNSCC). Three courses of induction chemotherapy with CDDP/5-FU were administered and followed by surgery and radiotherapy or radiotherapy alone, in 51 patients with HNSCC. GSH was measured by spectrophotometry in red blood cell before any treatment (Sample 1: S1), after each course of chemotherapy (S2, S3, S4). Our results showed that GSH was the same at diagnosis in patients with complete or partial response (OR) compared to those with stable or progressive disease (NR). With regard to evolution of the GSH during the 3 courses of CT a significant difference was found between courses (S2: 5.06 +/- 0.35 vs S4 = 3.61 +/- 0.4 mumol/g haemoglobin, p < 0.05). When we separated our patients into OR and NR, a significant difference was found over the 3 courses of chemotherapy for GSH content. Non responder patients showed decreased GSH content at the end of the treatment, (S2: 5 +/- 0.5 vs S4: 2.2 +/- 0.4 mumol/g haemoglobin, p < 0.05) while OR were stable. In conclusion, red blood cell GSH seems to have no early predictive value for chemoresponse to neoadjuvant chemotherapy CDDP/5-FU in HNSCC.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Cisplatin/administration & dosage , Fluorouracil/administration & dosage , Glutathione/blood , Head and Neck Neoplasms/drug therapy , Adult , Aged , Combined Modality Therapy , Drug Resistance, Neoplasm , Female , Hemoglobins/analysis , Humans , Male , Middle Aged
10.
Bull Cancer ; 84(6): 643-51, 1997 Jun.
Article in French | MEDLINE | ID: mdl-9295869

ABSTRACT

Pharmacogenetics could be defined as the study of genetically controlled variations in drug response. Introduction of pharmacogenetics in hematology and oncology has been done recently. With recombinant DNA technology, like restriction analysis of genomic DNA, enzymatic amplification of DNA by the polymerase chain reaction and expression of cDNAs in cell cultures, this research area has been developed during the last 10 years. In hematology and oncology, we can integrate pharmacogenetics in 3 areas. First, the concept of genetic risk of cancer and the study of drug or carcinogen metabolizing enzymes that could modulate this risk, regarding the activity of some specific enzymes; second, the use of pharmacogenetics, related to the toxicity or efficacy of anticancer drugs, allowing the identification of key enzymes involved in the biotransformation of the drug and the study of molecular aspects involved in the regulation of the activity of the enzymes; third, the implication of the study of enzymatic activities in tumoral tissues as compared to non-tumoral tissues. The following differences between the 2 tissues can be subsequently used to increase the specificity of the anticancer drugs.


Subject(s)
Antineoplastic Agents/pharmacology , Neoplasms/drug therapy , Pharmacogenetics/trends , Antineoplastic Agents/therapeutic use , Biotransformation , Drug Resistance , Enzymes/genetics , Enzymes/metabolism , Female , Gene Expression Regulation, Enzymologic , Genetic Predisposition to Disease , Humans , Male , Neoplasms/genetics , Neoplasms/metabolism , Pedigree , Phenotype , Polymorphism, Genetic , Risk Factors
11.
Anticancer Res ; 17(6D): 4647-51, 1997.
Article in English | MEDLINE | ID: mdl-9494583

ABSTRACT

In order to better understand acquired resistance to antitumor agents in acute myelogenous leukemia (AML), we investigated various drug resistance mechanisms; namely, topoisomerase II (topo II), glutathione system and P-glycoprotein (P-gp). Blast cells of 31 patients with AML, 21 before treatment (BT) and 10 at relapse (AR) were studied. Topo II was evaluated by Western blot analysis. Glutathione-S-transferase activity (GST) and glutathione content (GSH) were investigated by spectrophotometric assays. GST isoenzymes (-alpha, -mu and -pi) were tested by Western blot and by immunocytochemical staining. P-gp was evaluated by an immunocytochemical method using MRK 16 antibody. Our results showed that GST, GSH and GST-pi were similar in patients BT and AR GST-mu was detected in 13/21 AML BT and in 5/10 AML AR. GST-alpha expression was higher (p < 0.05) in AML AR (60 +/- 105 AU/mg) compared to AML BT (10 +/- 10 AU/mg). A relationship was found between GST-pi quantitation evaluated by Western blot and immunocytochemical staining, whereas no correlation was observed for the other isoenzymes. Topo II was detected in only 4 AML BT and 3 AML AR. Eleven out of 21 AML BT and 3/10 AML AR expressed P-gp with immunohistochemical study. These results indicate that only the "glutathione system", especially the GST-alpha could be involved in drug resistance in AML.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , DNA Topoisomerases, Type II/metabolism , Drug Resistance, Multiple/genetics , Glutathione Transferase/metabolism , Glutathione/metabolism , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/metabolism , ATP Binding Cassette Transporter, Subfamily B, Member 1/analysis , ATP Binding Cassette Transporter, Subfamily B, Member 1/biosynthesis , Antibiotics, Antineoplastic/administration & dosage , Cytarabine/administration & dosage , Humans , Isoenzymes/metabolism , Leukemia, Myeloid, Acute/genetics , Lomustine/administration & dosage , Monocytes/metabolism , Phenotype , Recurrence , Remission Induction
12.
Leukemia ; 10(12): 1944-9, 1996 Dec.
Article in English | MEDLINE | ID: mdl-8946935

ABSTRACT

Peripheral blood samples from 18 patients with chronic lymphocytic leukemias (CLL) who were either untreated but who were later sensitive to chlorambucil (CLL S) or resistant to a combination containing doxorubicin, vincristine, cyclophosphamide and prednisone (CLL R) were studied for glutathione system, P-glycoprotein, PCNA and topoisomerase II expression. P-glycoprotein expression detected by an immunocytochemical technique using MRK 16 antibody was present at the same level in CLL S and CLL R. The percentage of cells positive for P-gp was below 5% in all samples tested. Topoisomerase IIalpha level was quantified by Western blot analysis. None of the 18 CLL samples had detectable topoisomerase IIalpha protein. In addition, 12 CLL were tested for PCNA staining and no samples had more than 1% of positive cells at immunocytochemical detection indicating that CLL cells were not engaged in the cell cycle. Some differences were found between CLL S and CLL R in the glutathione system. Glutathione concentration (GSH) and GST activity was the same in CLL S and CLL R. The glutathione-S-transferase (GST) isoenzyme profile was different in the two CLL groups. The mean GST-pi and GST-alpha quantitation were twice as high as in CLL R compared to CLL S, but this difference did not reach statistical significance because of large variations between CLL samples. A significant correlation was observed between GST-pi expression and GST activity using CDNB as the substrate. GST-mu was detected in only one of seven CLL before therapy and in six of 11 resistant to chemotherapy. No correlation was found between P-glycoprotein expression, GST activity and the different GST isoenzymes studied. These results suggest that the glutathione system could play a role in the resistance of anticancer agents in chronic lymphocytic leukemia. The role of the other drug resistance mechanisms (P-glycoprotein and topoisomerase IIalpha) seems to be of limited importance.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , DNA Topoisomerases, Type II , Drug Resistance, Multiple , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , ATP Binding Cassette Transporter, Subfamily B, Member 1/blood , Antigens, Neoplasm , Antineoplastic Agents, Alkylating/therapeutic use , Chlorambucil/therapeutic use , Cyclophosphamide/administration & dosage , DNA Topoisomerases, Type II/blood , DNA-Binding Proteins , Doxorubicin/administration & dosage , Drug Resistance, Neoplasm , Drug Screening Assays, Antitumor , Glutathione/blood , Glutathione Transferase/blood , HL-60 Cells/metabolism , Humans , Immunohistochemistry , Isoenzymes/blood , Leukemia, Lymphocytic, Chronic, B-Cell/blood , Leukemia, Lymphocytic, Chronic, B-Cell/enzymology , Prednisone/administration & dosage , Proliferating Cell Nuclear Antigen/blood , Vincristine/administration & dosage
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