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1.
J Neurosci Res ; 87(15): 3428-37, 2009 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-19598249

RESUMO

Hearing loss has been attributed to many factors, including degeneration of sensory neurons in the auditory pathway and demyelination along the cochlear nerve. Fibroblast growth factors (FGFs), which signal through four receptors (Fgfrs), are produced by auditory neurons and play a key role in embryonic development of the cochlea and in neuroprotection against sound-induced injury. However, the role of FGF signaling in the maintenance of normal auditory function in adult and aging mice remains to be elucidated. Furthermore, the contribution of glial cells, which myelinate the cochlear nerves, is poorly understood. To address these questions, we generated transgenic mice in which Fgfr1 and Fgfr2 were specifically inactivated in Schwann cells and oligodendrocytes but not in neurons. Adult mutant mice exhibited late onset of hearing impairment, which progressed markedly with age. The hearing impairment was accompanied by significant loss of myelinated spiral ganglion neurons. The pathology extended into the cochlear nucleus, without apparent loss of myelin or of the deletion-bearing glial cells themselves. This suggests that perturbation of FGF receptor-mediated glial function leads to the attenuation of glial support of neurons, leading to their loss and impairment of auditory functions. Thus, FGF/FGF receptor signaling provides a potentially novel mechanism of maintaining reciprocal interactions between neurons and glia in adult and aging animals. Dysfunction of glial cells and FGF receptor signaling may therefore be implicated in neurodegenerative hearing loss associated with normal aging.


Assuntos
Envelhecimento/metabolismo , Perda Auditiva Neurossensorial/metabolismo , Degeneração Neural/metabolismo , Neuroglia/metabolismo , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos/genética , Gânglio Espiral da Cóclea/metabolismo , Envelhecimento/genética , Envelhecimento/patologia , Animais , Comunicação Celular/genética , Sobrevivência Celular/genética , Fatores de Crescimento de Fibroblastos/metabolismo , Perda Auditiva Neurossensorial/genética , Perda Auditiva Neurossensorial/fisiopatologia , Camundongos , Camundongos Knockout , Camundongos Transgênicos , Bainha de Mielina/metabolismo , Bainha de Mielina/patologia , Degeneração Neural/genética , Degeneração Neural/fisiopatologia , Fibras Nervosas Mielinizadas/metabolismo , Fibras Nervosas Mielinizadas/patologia , Neuroglia/patologia , Oligodendroglia/metabolismo , Oligodendroglia/patologia , Receptor Tipo 2 de Fator de Crescimento de Fibroblastos/genética , Células de Schwann/metabolismo , Células de Schwann/patologia , Células Receptoras Sensoriais/metabolismo , Células Receptoras Sensoriais/patologia , Transdução de Sinais/fisiologia , Gânglio Espiral da Cóclea/patologia
2.
Cell Death Differ ; 9(10): 1063-8, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12232794

RESUMO

Bcl-X(L) mice display a similar neurodevelopmental phenotype as rb, DNA ligase IV, and XRCC4 mutant embryos, suggesting that endogenous Bcl-X(L) expression may protect immature neurons from death caused by DNA damage and/or cell cycle dysregulation. To test this hypothesis, we generated bcl-x/p53 double mutants and examined neuronal cell death in vivo and in vitro. Bcl-X(L)-deficient primary telencephalic neuron cultures were highly susceptible to the apoptotic effects of cytosine arabinoside (AraC), a known genotoxic agent. In contrast, neurons lacking p53, or both Bcl-X(L) and p53, were markedly, and equivalently, resistant to AraC-induced caspase-3 activation and death in vitro indicating that Bcl-X(L) lies downstream of p53 in DNA damage-induced neuronal death. Despite the ability of p53 deficiency to protect Bcl-X(L)-deficient neurons from DNA damage-induced apoptosis in vitro, p53 deficiency had no effect on the increased caspase-3 activation and neuronal cell death observed in the developing Bcl-X(L)-deficient nervous system. These findings suggest that Bcl-X(L) expression in the developing nervous system critically regulates neuronal responsiveness to an apoptotic stimulus other than inadequate DNA repair or cell cycle abnormalities.


Assuntos
Apoptose/fisiologia , Regulação da Expressão Gênica no Desenvolvimento/genética , Neurônios/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/deficiência , Telencéfalo/embriologia , Telencéfalo/metabolismo , Proteína Supressora de Tumor p53/deficiência , Animais , Antimetabólitos Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Caspase 3 , Caspases/metabolismo , Células Cultivadas , Citarabina/farmacologia , DNA Ligase Dependente de ATP , DNA Ligases/genética , DNA Ligases/metabolismo , Reparo do DNA/efeitos dos fármacos , Reparo do DNA/genética , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Feminino , Feto , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Genes Letais/genética , Imuno-Histoquímica , Masculino , Camundongos , Camundongos Knockout , Neurônios/citologia , Neurônios/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-bcl-2/genética , Telencéfalo/citologia , Proteína Supressora de Tumor p53/genética , Proteína bcl-X
3.
Brain Res Dev Brain Res ; 128(2): 187-90, 2001 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-11412905

RESUMO

Bid is a BH3 domain only pro-apoptotic member of the Bcl-2 family which interacts with Bax to regulate apoptosis. Bax-deficient embryos show decreased neuronal programmed cell death in vivo and resistance to cytosine arabinoside (AraC)-induced neuronal apoptosis in vitro. In this report, we demonstrate that Bid-deficient embryos show no neurodevelopmental abnormalities, and Bid-deficiency has no effect on the in vitro apoptotic response of either telencephalic neural precursor cells or neurons to AraC-induced death. We conclude that bid does not play an essential role in either naturally occurring or genotoxin-induced neuronal cell death.


Assuntos
Apoptose/fisiologia , Proteínas de Transporte/genética , Proteínas de Transporte/metabolismo , Neurônios/citologia , Animais , Antimetabólitos Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Proteína Agonista de Morte Celular de Domínio Interatuante com BH3 , Encéfalo/citologia , Encéfalo/embriologia , Caspase 3 , Caspases/metabolismo , Citarabina/farmacologia , Feminino , Gânglios Espinais/citologia , Gânglios Espinais/embriologia , Regulação da Expressão Gênica no Desenvolvimento/fisiologia , Marcação In Situ das Extremidades Cortadas , Camundongos , Camundongos Knockout , Mutagênicos/farmacologia , Gravidez , Células-Tronco/citologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-11754520

RESUMO

Neuronal cell death in the embryonic brain was first recognized almost a century ago. Its significance for normal nervous system development and function has been a major focus of neuroscientific investigation ever since. Remarkable progress has been made in defining the cellular processes controlling neuronal cell death and studies performed over the last ten years have revealed extensive homology between the molecules regulating programmed cell death in Caenorhabditis elegans and apoptosis in mammalian cells. Targeted gene disruptions of members of the bcl-2 and caspase gene families have demonstrated particularly significant roles for bcl-x, bax, caspase-9 and caspase-3 in mammalian brain development. As expected from previous studies of synapse-bearing neurons and neurotrophic factors, reduced neuronal cell death in mice bearing mutations in key pro-apoptotic molecules resulted in increased numbers of neurons in a variety of neuronal subpopulations. However, targeted gene disruptions also demonstrated a heretofore underappreciated significance of neural precursor cell death and immature neuron death in nervous system development. Pathological activation of apoptotic death pathways may lead to neuroanatomic abnormalities and possibly to developmental disabilities.


Assuntos
Apoptose/fisiologia , Encéfalo/anormalidades , Animais , Apoptose/genética , Fator Apoptótico 1 Ativador de Proteases , Encéfalo/embriologia , Encéfalo/patologia , Caspases/genética , Caspases/metabolismo , Genes bcl-2/genética , Imuno-Histoquímica , Marcação In Situ das Extremidades Cortadas/métodos , Camundongos , Camundongos Mutantes , Vias Neurais/patologia , Neurônios/metabolismo , Neurônios/patologia , Proteínas/genética , Proteínas/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/deficiência , Proteínas Proto-Oncogênicas c-bcl-2/genética , Medula Espinal/embriologia , Medula Espinal/metabolismo , Medula Espinal/ultraestrutura , Telencéfalo/anormalidades , Telencéfalo/embriologia , Telencéfalo/patologia , Proteína bcl-X
5.
Oncogene ; 20(57): 8281-6, 2001 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-11781843

RESUMO

Neural precursor cells (NPCs) populate the embryonic ventricular zone and persist in the subependymal zone of the adult brain. We hypothesized that hereditary and/or acquired mutations in apoptosis-associated genes, such as p53 and caspases, may protect NPCs from DNA damage-induced death and predispose them to subsequent neoplastic transformation. To test this hypothesis, we exposed NPCs from wild-type and targeted gene-disrupted mouse embryos (p53, caspase-9, caspase-3, and bax mutants) to ethyl-nitrosourea (ENU), a known DNA mutagen and neural carcinogen, and measured NPC viability. We found that ENU produced caspase-3 activation and apoptotic NPC death 6-24 h after administration both in vivo and in vitro. This effect was critically dependent on p53 and caspase-9 expression. The long-term effect of intrauterine ENU exposure was examined in control and p53-deficient mice. High grade glial tumors were found in 60% of p53(-/-) young adult mice exposed to ENU on gestational day 12.5 but not in p53(+/-) or p53(+/+) littermates or in untreated p53-deficient mice. All the tumors were located supratentorially and possessed strong immunoreactivity for glial fibrillary acidic protein and the anti-apoptotic molecule Bcl-X(L). These results suggest that intrauterine exposure of NPCs to certain DNA damaging agents may synergistically interact with specific genetic abnormalities (e.g. p53 deficiency) to produce glial neoplasms in the adult brain.


Assuntos
Apoptose , Neoplasias Encefálicas/etiologia , Glioma/etiologia , Troca Materno-Fetal , Neurônios/citologia , Proteínas Proto-Oncogênicas c-bcl-2 , Animais , Neoplasias Encefálicas/induzido quimicamente , Neoplasias Encefálicas/patologia , Caspase 3 , Caspase 9 , Caspases/genética , Caspases/metabolismo , Etilnitrosoureia , Feminino , Marcação de Genes , Genes p53 , Glioma/induzido quimicamente , Glioma/patologia , Camundongos , Camundongos Endogâmicos ICR , Camundongos Knockout , Neurônios/metabolismo , Placenta , Gravidez , Proteínas Proto-Oncogênicas/genética , Células-Tronco/citologia , Células-Tronco/metabolismo , Proteína X Associada a bcl-2
6.
Biol Psychiatry ; 48(8): 732-9, 2000 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-11063970

RESUMO

Studies at the basic and clinical levels demonstrate that neuronal atrophy and cell death occur in response to stress and in the brains of depressed patients. Although the mechanisms have yet to be fully elucidated, progress has been made in characterizing the signal transduction cascades that control neuronal atrophy and programmed cell death and that may be involved in the action of antidepressant treatment. These pathways include the cyclic adenosine monophosphate and neurotrophic factor signal transduction cascades. It is notable that these same pathways have been demonstrated to play a pivotal role in cellular models of neural plasticity. This overlap of plasticity and cell survival pathways, together with studies demonstrating that neuronal activity enhances cell survival, suggests that neuronal atrophy and death could result from a disruption of the mechanisms underlying neural plasticity. The role of these pathways and failure of neuronal plasticity in stress-related mood disorders are discussed.


Assuntos
Transtornos do Humor , Plasticidade Neuronal/fisiologia , Neurônios/patologia , Antidepressivos/farmacologia , Antidepressivos/uso terapêutico , Atrofia/etiologia , Atrofia/genética , Atrofia/patologia , Fator Neurotrófico Derivado do Encéfalo/efeitos dos fármacos , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Morte Celular/efeitos dos fármacos , Morte Celular/genética , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/efeitos dos fármacos , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , Genes bcl-2/efeitos dos fármacos , Genes bcl-2/genética , Humanos , Transtornos do Humor/tratamento farmacológico , Transtornos do Humor/etiologia , Transtornos do Humor/metabolismo , Plasticidade Neuronal/genética , Neurônios/metabolismo , Células Piramidais/efeitos dos fármacos , Células Piramidais/metabolismo , Receptores de AMP Cíclico/efeitos dos fármacos , Receptores de AMP Cíclico/metabolismo , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Estresse Psicológico/psicologia , Regulação para Cima/efeitos dos fármacos , Regulação para Cima/fisiologia
7.
J Neurosci Methods ; 69(2): 149-53, 1996 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-8946317

RESUMO

Tryptophan hydroxylase (EC 1.14.16.4; L-tryptophan, tetrahydropteridine: oxygen oxidoreductase (5-hydroxylating)) from rat mesencephalic tegmentum has been purified by sequential chromatography on Blue-Sepharose, DE-52, and calmodulin-Sepharose. The hydroxylase is excluded from Blue-Sepharose and is eluted from DE-52 with a step-wise NaCl gradient. Tryptophan hydroxylase binds to calmodulin-Sepharose in the presence of calcium and is eluted with either EGTA or calmodulin itself, but not with tryptophan. The purification scheme is rapid (5-6 h) and yields an enzyme with a specific activity of 225 nmol 5-HTP/mg min, representing a 400-fold purification with 7% recovery. The tryptophan hydroxylase preparation was judged to be > 95% pure using the present isolation procedure.


Assuntos
Cromatografia de Afinidade/métodos , Triptofano Hidroxilase/isolamento & purificação , Animais , Encéfalo/enzimologia , Calmodulina , Eletroforese em Gel de Poliacrilamida , Immunoblotting , Masculino , Ratos , Ratos Sprague-Dawley , Sefarose
8.
Brain Res Mol Brain Res ; 41(1-2): 105-10, 1996 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-8883940

RESUMO

The possibility that 5,6,7,8-tetrahydrobiopterin (BH4) biosynthesis is stimulated in glial cells by treatment with lipopolysaccharide (LPS) and tumor necrosis factor (TNF-alpha) was examined in the astrocyte-derived C6 glioma cell line. Under basal culture conditions BH4 levels were found to be at the limit of detection. Concurrent treatment with 10 micrograms/ml LPS and 50 ng/ml TNF-alpha caused a time-dependent 13-fold increase in the levels of BH4. This treatment paradigm also induced nitric oxide synthase activity, as evidenced by increased levels of nitrite, an oxidized metabolite of NO, in the culture medium. LPS and TNF-alpha treatment led to a 25-fold increase in GTPCH enzyme activity, the first and rate-limiting enzyme in BH4 synthesis, and a corresponding 23-fold increase in GTPCH protein levels. Northern blot analysis showed that increased levels of GTPCH mRNA preceded changes in GTPCH protein, GTPCH enzyme activity and BH4 levels and reached a maximal of 44-fold that was sustained for at least 48 h. These results demonstrate that LPS and TNF-alpha stimulate de-novo BH4 biosynthesis and suggest that C6 cells offer a model system for studying the molecular events that control the induction of GTPCH gene expression and BH4 synthesis in glial cells.


Assuntos
Astrócitos/efeitos dos fármacos , Biopterinas/análogos & derivados , Neoplasias Encefálicas/metabolismo , GTP Cicloidrolase/biossíntese , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Glioma/metabolismo , Lipopolissacarídeos/farmacologia , Proteínas de Neoplasias/biossíntese , Proteínas do Tecido Nervoso/biossíntese , Fator de Necrose Tumoral alfa/farmacologia , Animais , Astrócitos/metabolismo , Biopterinas/biossíntese , Neoplasias Encefálicas/patologia , Sinergismo Farmacológico , Indução Enzimática/efeitos dos fármacos , GTP Cicloidrolase/genética , Glioma/patologia , Camundongos , Proteínas de Neoplasias/genética , Proteínas do Tecido Nervoso/genética , Óxido Nítrico Sintase/biossíntese , Óxido Nítrico Sintase/genética , Nitritos/metabolismo , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , RNA Neoplásico/biossíntese , RNA Neoplásico/genética , Ratos , Proteínas Recombinantes/farmacologia , Células Tumorais Cultivadas/efeitos dos fármacos
9.
J Neurochem ; 67(3): 900-6, 1996 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8752094

RESUMO

A cDNA encoding full-length tryptophan hydroxylase was produced by reverse transcriptase-PCR from rat brain mRNA and expressed transiently in a human fibroblast cell line. Catalytic activity was low unless transfected cells were grown in the presence of FeSO4. Recombinant tryptophan hydroxylase was found almost exclusively within the soluble compartment of the cell and was dependent on tryptophan and tetrahydrobiopterin for activity. The catalytic activity of recombinant tryptophan hydroxylase was stimulated > 25-fold by Fe(II) and to a somewhat lesser extent by the polyanions heparin and phosphatidylserine. The enzyme was inhibited by desferrioxamine and dopamine, both of which complex iron. When extracts from transfected cells were subjected to sucrose gradient centrifugation and analytical gel filtration, the recombinant enzyme behaved the same as the native enzyme from brain. A monoclonal antibody against phenylalanine hydroxylase that cross-reacts with brain tryptophan hydroxylase was capable of immunoprecipitating the recombinant hydroxylase from solution. These data indicate that recombinant tryptophan hydroxylase expressed in mammalian cells is assembled into tetramers of approximately 220,000 daltons. Its catalytic and physical properties appear to be very similar to those of the native enzyme from brain.


Assuntos
Mesencéfalo/enzimologia , Triptofano Hidroxilase/genética , Triptofano Hidroxilase/metabolismo , Animais , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Sequência de Bases , Biopterinas/análogos & derivados , Biopterinas/metabolismo , Biopterinas/farmacologia , Linhagem Celular/enzimologia , Cromatografia em Gel , Clonagem Molecular , Reações Cruzadas , Desferroxamina/farmacologia , Dopamina/farmacologia , Ativação Enzimática/efeitos dos fármacos , Fibroblastos/enzimologia , Regulação Enzimológica da Expressão Gênica/fisiologia , Humanos , Ferro/metabolismo , Ferro/farmacologia , Masculino , Mamíferos , Mesencéfalo/citologia , Dados de Sequência Molecular , Fenilalanina Hidroxilase/imunologia , Ratos , Ratos Sprague-Dawley , Proteínas Recombinantes/genética , Serotonina/biossíntese , Sideróforos/farmacologia , Transfecção , Triptofano/metabolismo , Triptofano/farmacologia , Triptofano Hidroxilase/imunologia
10.
J Neurochem ; 67(3): 917-26, 1996 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8752096

RESUMO

cDNAs encoding the full-length sequence for tryptophan hydroxylase, and deletion mutants consisting of the regulatory (amino acids 1-98) or catalytic (amino acids 99-444) domains of the enzyme, were cloned and expressed as glutathione S-transferase fusion proteins in E. coli. The recombinant fusion proteins could be purified to near homogeneity within minutes by affinity chromatography on glutathione-agarose. The full-length enzyme and the catalytic core expressed very high levels of tryptophan hydroxylase activity. The regulatory domain was devoid of activity. The full-length enzyme and the catalytic core, while adsorbed to glutathione-agarose beads, obeyed Michaelis-Menten kinetics, and the kinetic properties of each recombinant enzyme for cofactor and substrate compared very closely to native, brain tryptophan hydroxylase. Both active forms of the glutathione S-transferase-tryptophan hydroxylase fusion proteins had strict requirements for ferrous iron in catalysis and expressed much higher levels of activity (Vmax) than the brain enzyme. Analysis of full-length tryptophan hydroxylase and the catalytic core by molecular sieve chromatography under nondenaturing conditions revealed that each fusion protein behaved as a tetrameric species. These results indicate that a truncated tryptophan hydroxylase, consisting of amino acids 99-444 of the full-length enzyme, contains the sequence motifs needed for subunit assembly. Both wild-type tryptophan hydroxylase and the catalytic core are expressed as apoenzymes which are converted to holoenzymes by exogenous iron. The tryptophan hydroxylase catalytic core is also as active as the full-length enzyme, suggesting the possibility that the regulatory domain exerts a suppressive effect on the catalytic core of tryptophan hydroxylase.


Assuntos
Triptofano Hidroxilase/genética , Animais , Sequência de Bases , Encéfalo/citologia , Encéfalo/enzimologia , Clonagem Molecular , DNA Complementar/genética , Eletroforese em Gel de Poliacrilamida , Escherichia coli/genética , Deleção de Genes , Regulação Enzimológica da Expressão Gênica/genética , Glutationa Transferase/genética , Cinética , Masculino , Microesferas , Dados de Sequência Molecular , Mutagênese/fisiologia , Neurônios/enzimologia , Ratos , Ratos Sprague-Dawley , Proteínas Recombinantes/genética , Sefarose , Trombina/metabolismo , Transformação Genética , Triptofano Hidroxilase/química , Triptofano Hidroxilase/metabolismo
11.
Brain Res ; 695(1): 19-24, 1995 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-8574643

RESUMO

Neurokinin-3 receptor expression within rat midbrain dopamine neurons was demonstrated using a combination of in situ hybridization and receptor autoradiographic techniques. Continuous intranigral infusion of the neurokinin-3 receptor agonist senktide selectively increased striatal dopamine metabolism over a period of several days, followed by apparent development of tolerance. In contrast, in animals with moderate unilateral 6-hydroxydopamine-induced lesions of nigrostriatal dopamine cells, intranigral senktide infusion increased dopamine turnover in the surviving dopamine neurons and reduced functional dopamine asymmetry (reflected by spontaneous rotations) over the 2-week period tested. Thus nigral neurokinin receptors can modulate normal dopamine cell activity and may provide a therapeutic target in the treatment of Parkinson's disease.


Assuntos
Dopamina/metabolismo , Mesencéfalo/fisiologia , Oxidopamina/farmacologia , Receptores da Neurocinina-3/genética , Ácido 3,4-Di-Hidroxifenilacético/metabolismo , Animais , Autorradiografia , Expressão Gênica , Hibridização In Situ , Masculino , Mesencéfalo/metabolismo , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
12.
Br Med J ; 3(5721): 500-2, 1970 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-4195344

RESUMO

Five patients with fascioliasis presented with malaise, pruritus, and pain in the right hypochondrium. Eosinophilia, increase in serum gamma globulin, and pyrexia were other features. Four patients treated with oral bithionol recovered completely and it is suggested that this is an effective form of therapy. The double diffusion precipitin test, being speedy and simple, was used as a screening procedure for diagnosis. The source of infection was wild watercress growing in a farm ditch.


Assuntos
Anti-Helmínticos/uso terapêutico , Fasciolíase , Testes de Precipitina , Sulfetos/uso terapêutico , Administração Oral , Adolescente , Adulto , Animais , Temperatura Corporal , Cloroquina/uso terapêutico , Testes de Fixação de Complemento , Vetores de Doenças , Emetina/uso terapêutico , Eosinofilia/etiologia , Fasciolíase/diagnóstico , Fasciolíase/tratamento farmacológico , Fezes/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/etiologia , Esplenopatias/etiologia , gama-Globulinas/análise
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