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1.
J Crohns Colitis ; 14(5): 669-679, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31784737

RESUMO

BACKGROUND AND AIMS: Nucleotide oligomerization domain 2 [NOD2] mutations are key risk factors for Crohn's disease [CD]. NOD2 contributes to intestinal homeostasis by regulating innate and adaptive immunity together with intestinal epithelial function. However, the exact roles of NOD2 in CD and other NOD2-associated disorders remain poorly known. METHODS: We initially observed that NOD2 expression was increased in epithelial cells away from inflamed areas in CD patients. To explore this finding, Nod2 mRNA expression, inflammation, and cytokines expression were examined in the small bowel of wild-type [WT], Nod2 knockout and Nod2 mutant mice after rectal instillation of 2,4,6-trinitrobenzene sulphonic acid [TNBS]. RESULTS: In WT mice, Nod2 upregulation upstream to rectal injury was associated with pro-inflammatory cytokine expression but no overt histological inflammatory lesions. Conversely, in Nod2-deficient mice the inflammation spread from colitis to ileum and duodenum. CONCLUSIONS: Nod2 protects the gut from colitis spreading to small intestine.


Assuntos
Colite/genética , Duodenite/genética , Ileíte/genética , Mucosa Intestinal/metabolismo , Proteína Adaptadora de Sinalização NOD2/genética , RNA Mensageiro/metabolismo , Animais , Ceco/metabolismo , Ceco/patologia , Colite/induzido quimicamente , Colite/metabolismo , Colite/patologia , Doença de Crohn/metabolismo , Doença de Crohn/patologia , Duodenite/induzido quimicamente , Duodenite/metabolismo , Duodenite/patologia , Duodeno/metabolismo , Duodeno/patologia , Expressão Gênica , Humanos , Ileíte/induzido quimicamente , Ileíte/metabolismo , Ileíte/patologia , Íleo/metabolismo , Íleo/patologia , Interferon gama/metabolismo , Interleucina-12/metabolismo , Mucosa Intestinal/patologia , Camundongos , Camundongos Knockout , Proteína Adaptadora de Sinalização NOD2/metabolismo , Ácido Trinitrobenzenossulfônico , Fator de Necrose Tumoral alfa/metabolismo
2.
Inflamm Bowel Dis ; 23(7): 1109-1119, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28520587

RESUMO

BACKGROUND: Crohn's disease (CD) pathogenesis is multifactorial involving genetic and environmental factors. Loss of function mutations in the nucleotide oligomerization domain 2 (NOD2) gene are the main genetic risk factor for CD. Like patients with CD, Nod2 mice are characterized by an enhanced Th1 immune response and a defective mucosal barrier function evidenced by increased intestinal permeability. We previously showed that the latter is related to hematopoietic Nod2 deficiency. Our aim was to explore the mechanisms by which Nod2 expressed in the hematopoietic and in the nonhematopoietic compartments interplay to control epithelial paracellular permeability. METHODS: Depletion of CD4 T cells in Nod2 mice and treatments with inhibitors were conducted in chimeric mice transplanted with bone marrow cells from Nod2-deficient donors into Nod2-sufficient recipients or vice versa. Caco-2 cells overexpressing a NOD2 gene which did or did not include a CD-associated polymorphism were treated with inhibitors or siRNAs and cocultured with hematopoietic cells from Peyer's patches. RESULTS: In vivo and in vitro Nod2 in hematopoietic cells regulates epithelial paracellular permeability through cytokine production influencing myosin light chain kinase (MLCK) activity. Indeed, tumor necrosis factor-α and interferon-γ secretion by CD4 T cells upregulated expression and activity of epithelial MLCK leading to increased epithelial tight junction opening. When stimulated by muramyl dipeptide, Nod2 in the nonhematopoietic compartment normalized the permeability and T-cell cytokine secretion and regulated MLCK activity. This MLCK regulation is mediated by TAK1 and RICK-dependent mechanisms. CONCLUSIONS: Our study demonstrates how hematopoietic and nonhematopoietic Nod2 regulate intestinal barrier function, improving our knowledge on the mechanisms involved in CD pathogenesis.


Assuntos
Células-Tronco Hematopoéticas/metabolismo , Mucosa Intestinal/metabolismo , Quinase de Cadeia Leve de Miosina/metabolismo , Proteína Adaptadora de Sinalização NOD2/fisiologia , Nódulos Linfáticos Agregados/metabolismo , Animais , Células CACO-2 , Permeabilidade da Membrana Celular , Humanos , Mucosa Intestinal/patologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fosforilação , Junções Íntimas
3.
J Crohns Colitis ; 10(12): 1428-1436, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27147452

RESUMO

BACKGROUND AND AIMS: Crohn's disease [CD] is a complex disorder characterised by an inappropriate immune response, impaired barrier function and microbial dysbiosis. Mutations in nucleotide oligomeriation domain 2 [NOD2] are CD risk factors. Increase of intestinal permeability, CD4+ T cell infiltration, and bacterial dysbiosis are also seen in Nod2-knockout [Nod2 KO] mice. However, the specificity and relationship between these Nod2-associated abnormalities remain largely unexplored. METHODS: Wild-type [WT], Nod1-knockout [Nod1 KO] and Nod2 KO mice were analysed in parallel. Microbial composition was defined by 454-pyrosequencing of bacterial 16S rRNA genes. Mucin and antimicrobial peptide expression was assessed by RT-PCR. Cell populations from Peyer's patches were determined by flow cytometry. Ussing chambers were used to measure intestinal permeability and bacterial translocation. Finally, to explore the impact of colonisation with mother's microbiota at birth, analyses were also performed in Nod2 KO and WT mice born from WT surrogate mothers after embryo transfer. RESULTS: Nod2 KO mice exhibited colonic bacterial dysbiosis different from WT and Nod1 KO mice. Altered expression of antimicrobial peptides and mucins in ileum and colon was associated with the microbial composition. Bacterial composition of Nod2 KO and WT mice obtained by embryo transfer was similar to that observed in Nod2 KO mice, arguing for a dominant effect of Nod2 KO-associated dysbiosis. In contrast, increased levels of CD4+ T cells and gut barrier defects across Peyer's patches were specific to Nod2 deficiency and independent of Microbial dysbiosis. CONCLUSIONS: Nod2 deficiency is associated with a specific dominant dysbiosis which does not drive mucosal tissue and immune alterations.


Assuntos
Disbiose/fisiopatologia , Microbioma Gastrointestinal/fisiologia , Mucosa Intestinal/fisiopatologia , Proteína Adaptadora de Sinalização NOD2/deficiência , Animais , Peptídeos Catiônicos Antimicrobianos/metabolismo , Feminino , Microbioma Gastrointestinal/genética , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Mucinas/metabolismo , Proteína Adaptadora de Sinalização NOD2/fisiologia , Nódulos Linfáticos Agregados/fisiopatologia , RNA Ribossômico 16S/genética , Reação em Cadeia da Polimerase em Tempo Real
4.
Inflamm Bowel Dis ; 22(4): 763-73, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26963567

RESUMO

BACKGROUND: NOD2 mutations are associated with Crohn's disease (CD). Both CD (in human) and Nod2 deficiency (in mice) are characterized by increased mucosal CD4 T-cells, an altered permeability and a microbial dysbiosis. However, the respective roles of the gut epithelial and immune compartments on the phenotype are not known. METHODS: Microbial composition, epithelial peptide secretion, intestinal permeability, and immune cell composition of Peyer patches were studied in Nod2 knock-out mice transplanted with wild-type bone marrow cells and vice versa. RESULTS: The nonhematopoietic cells control the microbiota composition and epithelial secretion of mucins and antimicrobial peptides. These parameters are correlated with recurrent associations between bacterial species and luminal products. In contrast, Nod2 in the hematopoietic compartment regulates the epithelial permeability and the gut-associated lymphoid tissue independently of the bacterial composition. CONCLUSIONS: The immune system and the gut permeability in one hand and the microbial and epithelial peptide compositions in the other hand are separate couples of interdependent parameters, both controlled by Nod2 in either the hematopoietic or nonhematopoietic lineages.


Assuntos
Disbiose/microbiologia , Microbioma Gastrointestinal , Células-Tronco Hematopoéticas/microbiologia , Homeostase/fisiologia , Mucosa Intestinal/microbiologia , Proteína Adaptadora de Sinalização NOD2/fisiologia , Animais , Disbiose/metabolismo , Disbiose/patologia , Células-Tronco Hematopoéticas/metabolismo , Mucosa Intestinal/metabolismo , Camundongos , Camundongos Knockout
5.
Inflamm Bowel Dis ; 21(3): 543-55, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25659087

RESUMO

BACKGROUND: Ileal Crohn's disease is related to NOD2 mutations and to a gut barrier dysfunction. Pseudomonas fluorescens has also been associated with ileal Crohn's disease. The aim of this study was to determine the impact of P. fluorescens on the paracellular permeability in ileum and Peyer's patches. METHODS: To explore this question, in vivo and ex vivo experiments were performed in wild-type, Nod2, Nod2, and IL-1R mice together with in vitro analyses using the Caco-2 (epithelial) and the THP-1 (monocyte) human cell lines. RESULTS: Pseudomonas fluorescens increased the paracellular permeability of the intestinal mucosa through the secretion of IL-1ß by the immune cell populations and the activation of myosin light chain kinase in the epithelial cells. Induction of the IL-1ß pathway required the expression of Nod2 in the hematopoietic compartment, and muramyl dipeptide (a Nod2 ligand) had an inhibitory effect. CONCLUSIONS: Pseudomonas fluorescens thus alters the homeostasis of the epithelial barrier function by a mechanism similar to that previously observed for Yersinia pseudotuberculosis. This work further documents a putative role of psychrotrophic bacteria in Crohn's disease.


Assuntos
Células-Tronco Hematopoéticas/metabolismo , Mucosa Intestinal/metabolismo , Macrófagos/metabolismo , Proteína Adaptadora de Sinalização NOD2/fisiologia , Pseudomonas fluorescens/fisiologia , Receptores de Interleucina-1/fisiologia , Animais , Western Blotting , Células CACO-2 , Permeabilidade da Membrana Celular , Células Cultivadas , Células-Tronco Hematopoéticas/citologia , Células-Tronco Hematopoéticas/microbiologia , Humanos , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Mucosa Intestinal/citologia , Mucosa Intestinal/microbiologia , Macrófagos/citologia , Macrófagos/microbiologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteína Adaptadora de Sinalização NOD2/genética , Proteína Adaptadora de Sinalização NOD2/metabolismo , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais
6.
J Clin Invest ; 122(6): 2239-51, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22565313

RESUMO

Intestinal barrier function requires intricate cooperation between intestinal epithelial cells and immune cells. Enteropathogens are able to invade the intestinal lymphoid tissue known as Peyer's patches (PPs) and disrupt the integrity of the intestinal barrier. However, the underlying molecular mechanisms of this process are poorly understood. In mice infected with Yersinia pseudotuberculosis, we found that PP barrier dysfunction is dependent on the Yersinia virulence plasmid and the expression of TLR-2 by hematopoietic cells, but not by intestinal epithelial cells. Upon TLR-2 stimulation, Y. pseudotuberculosis-infected monocytes activated caspase-1 and produced IL-1ß. In turn, IL-1ß increased NF-κB and myosin light chain kinase activation in intestinal epithelial cells, thus disrupting the intestinal barrier by opening the tight junctions. Therefore, Y. pseudotuberculosis subverts intestinal barrier function by altering the interplay between immune and epithelial cells during infection.


Assuntos
Células-Tronco Hematopoéticas/imunologia , Mucosa Intestinal/imunologia , Nódulos Linfáticos Agregados/imunologia , Transdução de Sinais/imunologia , Receptor 2 Toll-Like/imunologia , Infecções por Yersinia pseudotuberculosis/imunologia , Yersinia pseudotuberculosis/imunologia , Animais , Células CACO-2 , Caspase 1/genética , Caspase 1/imunologia , Ativação Enzimática/genética , Ativação Enzimática/imunologia , Células-Tronco Hematopoéticas/microbiologia , Células-Tronco Hematopoéticas/patologia , Humanos , Interleucina-1beta/genética , Interleucina-1beta/imunologia , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia , Camundongos , Camundongos Knockout , Monócitos/imunologia , Monócitos/microbiologia , Monócitos/patologia , Quinase de Cadeia Leve de Miosina/genética , Quinase de Cadeia Leve de Miosina/imunologia , NF-kappa B/genética , NF-kappa B/imunologia , Nódulos Linfáticos Agregados/microbiologia , Nódulos Linfáticos Agregados/patologia , Transdução de Sinais/genética , Receptor 2 Toll-Like/genética , Yersinia pseudotuberculosis/genética , Infecções por Yersinia pseudotuberculosis/genética , Infecções por Yersinia pseudotuberculosis/patologia
7.
Cell Host Microbe ; 11(4): 337-51, 2012 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-22520462

RESUMO

Yersinia pseudotuberculosis is an enteropathogenic bacteria that disrupts the intestinal barrier and invades its host through gut-associated lymphoid tissue and Peyer's patches (PP). We show that the Y. pseudotuberculosis effector YopJ induces intestinal barrier dysfunction by subverting signaling of the innate immune receptor Nod2, a phenotype that can be reversed by pretreating with the Nod2 ligand muramyl-dipeptide. YopJ, but not the catalytically inactive mutant YopJ(C172A), acetylates critical sites in the activation loops of the RICK and TAK1 kinases, which are central mediators of Nod2 signaling, and decreases the affinity of Nod2 for RICK. Concomitantly, Nod2 interacts with and activates caspase-1, resulting in increased levels of IL-1ß. Finally, IL-1ß within PP plays an essential role in inducing intestinal barrier dysfunction. Thus, YopJ alters intestinal permeability and promotes the dissemination of Yersinia as well as commensal bacteria by exploiting the mucosal inflammatory response.


Assuntos
Proteínas de Bactérias/metabolismo , Caspase 1/metabolismo , Intestinos/enzimologia , MAP Quinase Quinase Quinases/metabolismo , Proteína Adaptadora de Sinalização NOD2/metabolismo , Proteína Serina-Treonina Quinase 2 de Interação com Receptor/metabolismo , Infecções por Yersinia pseudotuberculosis/enzimologia , Yersinia pseudotuberculosis/metabolismo , Animais , Proteínas de Bactérias/genética , Caspase 1/genética , Linhagem Celular , Feminino , Humanos , Mucosa Intestinal/metabolismo , Intestinos/microbiologia , MAP Quinase Quinase Quinases/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Proteína Adaptadora de Sinalização NOD2/genética , Proteína Serina-Treonina Quinase 2 de Interação com Receptor/genética , Transdução de Sinais , Yersinia pseudotuberculosis/genética , Infecções por Yersinia pseudotuberculosis/genética , Infecções por Yersinia pseudotuberculosis/metabolismo , Infecções por Yersinia pseudotuberculosis/microbiologia
9.
Gut ; 59(2): 207-17, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19837677

RESUMO

Nucleotide oligomerisation domain 2 (NOD2) mutations are associated with susceptibility to Crohn's disease and graft-versus-host disease, two human disorders related with dysfunctions of Peyer's patches (PPs). In Nod2(-/-) mice transcellular permeability and bacterial translocation are increased in PPs. In this study, we show that both anti-CD4(+) and anti-interferon gamma (anti-IFNgamma) monoclonal antibodies abrogate this phenotype and reduce the expression of tumour necrosis factor (TNF) receptor 2 and the long isoform of myosin light chain kinase, thus demonstrating that immune T cells influence the epithelial functions. In turn, intraperitoneal injection of ML-7 (a myosin light chain kinase inhibitor) normalises the values of CD4(+) T cells, IFNgamma and TNFalpha. This reciprocal cross-talk is under the control of the gut microflora as shown by the normalisation of all parameters after antibiotic treatment. Toll-like receptor 2 (TLR2) and TLR4 expression were increased in Nod2(-/-) mice under basal conditions and TLR2 and TLR4 agonists induced an increased transcellular permeability in Nod2(+/+) mice. Muramyldipeptide (a Nod2 agonist) or ML-7 was able to reverse this phenomenon. It thus appears that Nod2 modulates the cross-talk between CD4(+) T cells and the epithelium recovering PP and that it downregulates the pro-inflammatory effect driven by the ileal microflora, likely by inhibiting the TLR pathways.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Absorção Intestinal/imunologia , Proteína Adaptadora de Sinalização NOD2/imunologia , Nódulos Linfáticos Agregados/imunologia , Nódulos Linfáticos Agregados/microbiologia , Animais , Antibacterianos/farmacologia , Translocação Bacteriana , Linfócitos T CD4-Positivos/efeitos dos fármacos , Cultura em Câmaras de Difusão , Íleo/microbiologia , Interferon gama/imunologia , Mucosa Intestinal/imunologia , Mucosa Intestinal/fisiopatologia , Camundongos , Camundongos Endogâmicos C57BL , Permeabilidade , Nódulos Linfáticos Agregados/fisiopatologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Receptor 2 Toll-Like/agonistas , Receptor 2 Toll-Like/fisiologia , Receptor 4 Toll-Like/agonistas , Receptor 4 Toll-Like/fisiologia
10.
PLoS One ; 3(7): e2769, 2008 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-18648508

RESUMO

Nucleotide oligomerisation domain 2 (NOD2) is a component of the innate immunity known to be involved in the homeostasis of Peyer patches (PPs) in mice. However, little is known about its role during gut infection in vivo. Yersinia pseudotuberculosis is an enteropathogen causing gastroenteritis, adenolymphitis and septicaemia which is able to invade its host through PPs. We investigated the role of Nod2 during Y. pseudotuberculosis infection. Death was delayed in Nod2 deleted and Crohn's disease associated Nod2 mutated mice orogastrically inoculated with Y. pseudotuberculosis. In PPs, the local immune response was characterized by a higher KC level and a more intense infiltration by neutrophils and macrophages. The apoptotic and bacterial cell counts were decreased. Finally, Nod2 deleted mice had a lower systemic bacterial dissemination and less damage of the haematopoeitic organs. This resistance phenotype was lost in case of intraperitoneal infection. We concluded that Nod2 contributes to the susceptibility to Y. pseudotuberculosis in mice.


Assuntos
Predisposição Genética para Doença , Proteína Adaptadora de Sinalização NOD2/genética , Proteína Adaptadora de Sinalização NOD2/fisiologia , Nódulos Linfáticos Agregados/microbiologia , Infecções por Yersinia pseudotuberculosis/genética , Infecções por Yersinia pseudotuberculosis/microbiologia , Yersinia pseudotuberculosis/genética , Animais , Apoptose , Células da Medula Óssea/metabolismo , Suscetibilidade a Doenças , Deleção de Genes , Homeostase , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Fenótipo
11.
PLoS One ; 2(6): e523, 2007 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-17565376

RESUMO

BACKGROUND: CARD15/NOD2 mutations are associated with susceptibility to Crohn's Disease (CD) and Graft Versus Host Disease (GVHD). CD and GVHD are suspected to be related with the dysfunction of Peyer's patches (PP) and isolated lymphoid follicles (LFs). Using a new mouse model invalidated for Card15/Nod2 (KO), we thus analysed the impact of the gene in these lymphoid formations together with the development of experimental colitis. METHODOLOGY/PRINCIPAL FINDINGS: At weeks 4, 12 and 52, the numbers of PPs and LFs were higher in KO mice while no difference was observed at birth. At weeks 4 and 12, the size and cellular composition of PPs were analysed by flow cytometry and immunohistochemistry. PPs of KO mice were larger with an increased proportion of M cells and CD4(+) T-cells. KO mice were also characterised by higher concentrations of TNFalpha, IFNgamma, IL12 and IL4 measured by ELISA. In contrast, little differences were found in the PP-free ileum and the spleen of KO mice. By using chamber experiments, we found that this PP phenotype is associated with an increased of both paracellular permeability and yeast/bacterial translocation. Finally, KO mice were more susceptible to the colitis induced by TNBS. CONCLUSIONS: Card15/Nod2 deficiency induces an abnormal development and function of the PPs characterised by an exaggerated immune response and an increased permeability. These observations provide a comprehensive link between the molecular defect and the Human CARD15/NOD2 associated disorders: CD and GVHD.


Assuntos
Colite/patologia , Proteína Adaptadora de Sinalização NOD2/fisiologia , Nódulos Linfáticos Agregados/metabolismo , Nódulos Linfáticos Agregados/patologia , Animais , Western Blotting , Colite/induzido quimicamente , Colite/metabolismo , Ensaio de Imunoadsorção Enzimática , Feminino , Citometria de Fluxo , Homeostase , Técnicas Imunoenzimáticas , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fenótipo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Baço/citologia , Baço/metabolismo
12.
Bioconjug Chem ; 13(3): 654-62, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12009958

RESUMO

Radiolabeled peptides are emerging tools for diagnosis and therapy of tumors overexpressing receptors. However, binding to receptors expressed by nontumor tissues may cause toxicity. The objective of this study was to specifically enhance the binding affinity of labeled peptides to tumor cells, as opposed to receptor-positive nontumor cells, to ensure targeting selectivity. This was achieved by the simultaneous binding of hapten-bearing peptides to their receptor and to a tumor-associated antigen, mediated by a bispecific antibody directed to the tumor antigen and to the hapten. Binding of labeled neurotensin analogues bearing the DTPA(indium) hapten (NT-DTPA(111In)) to human colorectal carcinoma cells (HT29), which express the neurotensin receptor (NTR1) and carcinoembryonic antigen (CEA), was studied in the presence of a bispecific antibody (BsmAb) directed to CEA and to DTPA(indium). In vitro dual binding of NT-DTPA in the presence of BsmAb was about 6.5-fold higher than monovalent binding to NTR1 and 3.5-fold higher than the sum of the monovalent bindings to NTR1 or to CEA, suggesting cooperativity. Increased binding under bivalent conditions translated into increased internalization. In vivo pretargeting with BsmAb enhanced tumor uptake and tumor retention. Hapten bearing peptides binding simultaneously an overexpressed cell-surface receptor and a tumor antigen show increased selectivity to target tumor cells as compared to cells only expressing the cell surface receptor. Better resistance to enzymatic degradation and optimized administration protocols should further enhance in vivo targeting selectivity and may allow the development of radiopharmaceuticals labeled with isotopes suitable for radiotherapy such as 131I or 90Y.


Assuntos
Anticorpos Biespecíficos/imunologia , Especificidade de Anticorpos , Antígenos de Neoplasias/imunologia , Neoplasias/diagnóstico por imagem , Radioimunodetecção , Radioimunoterapia , Receptores de Neurotensina/metabolismo , Animais , Antígeno Carcinoembrionário/metabolismo , Simulação por Computador , Feminino , Haptenos/metabolismo , Haptenos/uso terapêutico , Humanos , Radioisótopos de Índio/farmacocinética , Cinética , Camundongos , Camundongos Nus , Neoplasias/radioterapia , Ácido Pentético/química , Ácido Pentético/farmacocinética , Fragmentos de Peptídeos/imunologia , Fragmentos de Peptídeos/uso terapêutico , Distribuição Tecidual , Células Tumorais Cultivadas
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