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1.
Biologicals ; 40(6): 473-81, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22901944

RESUMO

During the manufacture of human plasma derivatives, a series of complementary measures are undertaken to prevent transmission of blood-borne viruses. Virus filtration using 15 nm (Planova15N) filters has successfully been implemented in manufacturing processes for various plasma derivatives primarily because virus filtration is a technique, mild for proteins, that can effectively remove even small non-lipid-enveloped viruses, such as HAV and parvovirus B19. However, the use of 15 nm filters has limitations with regard to protein capacity of the filters and the process flow, resulting in an expensive manufacturing step. Therefore, studies were performed to test whether the use of 20 nm (Planova20N) filters, having different characteristics compared to 15 nm filters, can be an alternative for the use of 15 nm filters. It is shown that 20 nm filtration can be an alternative for 15 nm filtration. However, the virus removal capacity of the 20 nm filters depends on the plasma product that is filtered. Therefore, an optimisation study must be performed with regard to process parameters such as pressure, pH and protein concentration for each plasma product. In this study, using optimised conditions, the virus removal capacity of 20 nm filters appears to be comparable or even better when compared to that of 15 nm filters.


Assuntos
Substitutos Sanguíneos , Patógenos Transmitidos pelo Sangue/isolamento & purificação , Filtração/instrumentação , Vírus/isolamento & purificação , Proteínas Inativadoras do Complemento 1/análise , Proteína Inibidora do Complemento C1 , Imunoglobulina G/análise , Protrombina/análise , Transferrina/análise
2.
Biologicals ; 35(3): 173-81, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17071103

RESUMO

We studied the efficacy of virus reduction by three process steps (polyethylene glycol 4000 (PEG) precipitation, pasteurization, and 15nm virus filtration) in the manufacturing of C1-inhibitor NF. The potential prion removing capacity in this process was estimated based on data from the literature. Virus studies were performed using hepatitis A virus (HAV) and human immunodeficiency virus (HIV) as relevant viruses and bovine viral diarrhea virus (BVDV), canine parvovirus (CPV) and pseudorabies virus (PRV) as model viruses, respectively. In the PEG precipitation step, an average reduction in infectious titer of 4.5log(10) was obtained for all five viruses tested. Pasteurization resulted in reduction of infectious virus of >6log(10) for BVDV, HIV, and PRV; for HAV the reduction factor was limited to 2.8log(10) and for CPV it was zero. Virus filtration (15nm) reduced the infectious titer of all viruses by more than 4.5log(10). The overall virus reducing capacity was >16log(10) for the LE viruses. For the NLE viruses CPV and HAV, the overall virus reducing capacities were >8.7 and >10.5log(10), respectively. Based on literature and theoretical assumptions, the prion reducing capacity of the C1-inhibitor NF process was estimated to be >9log(10).


Assuntos
Produtos Biológicos/isolamento & purificação , Proteínas Inativadoras do Complemento 1/isolamento & purificação , Serpinas/isolamento & purificação , Vírus/isolamento & purificação , Animais , Bovinos , Linhagem Celular , Precipitação Química , Proteína Inibidora do Complemento C1 , Vírus da Diarreia Viral Bovina/isolamento & purificação , Desinfecção , Cães , Contaminação de Medicamentos , Filtração , HIV/isolamento & purificação , Vírus da Hepatite A/isolamento & purificação , Herpesvirus Suídeo 1/isolamento & purificação , Humanos , Nanotecnologia , Parvovirus Canino/isolamento & purificação , Polietilenoglicóis , Segurança , Suínos
3.
Vox Sang ; 90(1): 21-32, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16359352

RESUMO

BACKGROUND AND OBJECTIVES: Producers of plasma derivatives continuously improve the viral safety of their products by, for example, introducing additional virus-reducing steps into the manufacturing process. Here we present virus-elimination studies undertaken for a number of steps employed in a new manufacturing process for liquid intravenous immunoglobulin (Nanogam) that comprises two specific virus-reducing steps: a 15-nm filtration step combined with pepsin treatment at pH 4.4 (pH 4.4/15NF); and solvent-detergent (SD) treatment. The manufacturing process also includes precipitation of Cohn fraction III and viral neutralization, which contribute to the total virus-reducing capacity of the manufacturing process. In addition, the mechanism and robustness of the virus-reducing steps were studied. MATERIALS AND METHODS: Selected process steps were studied with spiking experiments using a range of lipid enveloped (LE) and non-lipid-enveloped (NLE) viruses. The LE viruses used were bovine viral diarrhoea virus (BVDV), human immunodeficiency virus (HIV) and pseudorabies virus (PRV); the NLE viruses used were parvovirus B19 (B19), canine parvovirus (CPV) and encephalomyocarditis virus (EMC). After spiking, samples were collected and tested for residual infectivity, and the reduction factors were calculated. For B19, however, removal of B19 DNA was measured, not residual infectivity. To reveal the contribution of viral neutralization, bovine parvovirus (BPV) and hepatitis A virus (HAV) were used. RESULTS: For the pH 4.4/15NF step, complete reduction (> 6 log(10)) was demonstrated for all viruses, including B19, but not for CPV (> 3.4 but < or = 4.2 log(10)). Robustness studies of the pH 4.4/15NF step with CPV showed that pH was the dominant process parameter. SD treatment for 10 min resulted in complete inactivation (> 6 log(10)) of all LE viruses tested. Precipitation of Cohn fraction III resulted in the significant removal (3-4 log(10)) of both LE and NLE viruses. Virus-neutralization assays of final product revealed significant reduction (> or = 3 log(10)) of both BPV and HAV. CONCLUSIONS: The manufacturing process of Nanogam comprises two effective steps for the reduction of LE viruses and one for NLE viruses. In addition, the precipitation of Cohn fraction III and the presence of neutralizing antibodies contribute to the total virus-reducing capacity of Nanogam. The overall virus-reducing capacity was > 15 log(10) for LE viruses. For the NLE viruses B19, CPV and EMC, the overall virus-reducing capacities were > 10, > 7 and > 9 log(10), respectively. Including the contribution of immune neutralization, the overall virus-reducing capacity for B19 and HAV is estimated to be > 10 log(10).


Assuntos
Qualidade de Produtos para o Consumidor , Imunoglobulinas Intravenosas , Inativação de Vírus , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/virologia , Humanos , Imunoglobulinas Intravenosas/química
4.
Blood ; 95(5): 1856-61, 2000 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-10688848

RESUMO

Previously, we observed in a rat model that intravenous administration of intramuscular immunoglobulin preparations induced a long-lasting hypotension, which appeared to be associated with the presence of IgG polymers and dimers in the preparations, but unrelated to complement activation. We found evidence that this hypotensive response is mediated by platelet-activating factor (PAF) produced by macrophages. In this study, we compared the vasoactive effects of 16 intravenous immunoglobulin (IVIG) products from 10 different manufacturers, in anesthetized rats. Eight of the IVIG preparations showed no hypotensive effects (less than 15% decrease), whereas the other 8 had relatively strong effects (15%-50% decrease). The hypotensive effects correlated with the IgG dimer content of the preparations. Pretreatment of the rats with recombinant PAF acetylhydrolase completely prevented the hypotensive reaction on IVIG infusion, and administration after the onset of hypotension resulted in normalization of the blood pressure. We also observed PAF production on in vitro incubation of human neutrophils with IVIG, which could be blocked by anti-Fcgamma receptor antibodies. This indicates that induction of PAF generation may also occur in a human system. Our findings support the hypothesis that the clinical side effects of IVIG in patients may be caused by macrophage and neutrophil activation through interaction of IgG dimers with Fcgamma receptors. Because phagocyte activation may also lead to the release of other inflammatory mediators, recombinant PAF acetylhydrolase (rPAF-AH) provides a useful tool to determine whether PAF plays a role in the clinical side effects of IVIG. If so, rPAF-AH can be used for the treatment of those adverse reactions. (Blood. 2000;95:1856-1861)


Assuntos
Hipotensão/etiologia , Imunoglobulina G/toxicidade , Imunoglobulinas Intravenosas/toxicidade , Fosfolipases A/uso terapêutico , Fator de Ativação de Plaquetas/metabolismo , Receptores de IgG/fisiologia , 1-Alquil-2-acetilglicerofosfocolina Esterase , Animais , Dimerização , Estabilidade de Medicamentos , Feminino , Humanos , Hipotensão/prevenção & controle , Imunoglobulina G/farmacologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Neutrófilos/efeitos dos fármacos , Neutrófilos/metabolismo , Fosfolipases A/genética , Fosfolipases A/farmacologia , Ratos , Ratos Wistar , Receptores de IgG/antagonistas & inibidores , Proteínas Recombinantes de Fusão/farmacologia , Proteínas Recombinantes de Fusão/uso terapêutico
5.
Eur J Biochem ; 181(3): 651-5, 1989 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-2525089

RESUMO

A specific and fast method for the determination of N-acetylglucosaminyltransferase III, IV and V activity in one assay is described. The method is based on the separation by HPLC of the three transferase products formed from the common acceptor oligosaccharide substrate GlcNAc beta 1----2Man alpha 1----3(GlcNAc beta 1----2Man alpha 1---- 6)Man beta 1----4GlcNAc. Assays are not interfered with by substances that result from enzymatic or chemical breakdown of the donor substrate UDP-[14C]GlcNAc. Using this assay system N-acetylglucosaminyltransferase III, IV and V activities were estimated in Novikoff ascites tumour cells, mouse lymphoma BW 5147 cells and hen oviduct.


Assuntos
Glucosiltransferases/isolamento & purificação , N-Acetilglucosaminiltransferases , Neoplasias Experimentais/enzimologia , Oviductos/enzimologia , Animais , Linhagem Celular , Galinhas , Cromatografia Líquida de Alta Pressão/métodos , Linfoma/enzimologia , Oligossacarídeos/biossíntese , Oviductos/metabolismo , Ratos , Transferases/isolamento & purificação
6.
J Biol Chem ; 263(25): 12461-71, 1988 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-2970459

RESUMO

An N-acetylglucosaminyltransferase has been partially purified from Novikoff tumor cell ascites fluid by affinity chromatography on concanavalin A-Sepharose. The enzyme was obtained in a highly concentrated form after lyophilization. The enzyme appeared to be highly specific for acceptor oligosaccharides and glycoproteins carrying a terminal Gal beta 1----4GlcNAc beta 1----R unit. Characterization of products formed by the enzyme in vitro by methylation analysis and 1H NMR spectroscopy revealed that the enzyme catalyzed the formation of a GlcNAc beta 1----3Gal beta 1----4GlcNAc beta-R sequence. The enzyme therefore could be described as an UDP-GlcNAc:Gal beta 1----4GlcNAc beta-R beta 1----3-N-acetylglucosaminyltransferase. Acceptor specificity studies with oligosaccharides that form part of N-glycans revealed that the presence of a Gal beta 1----4GlcNAc beta 1----2(Gal beta 1----4GlcNAc beta 1----6)Man pentasaccharide in the acceptor structure is a requirement for optimal activity. Studies on the branch specificity of the enzyme showed that the branches of this pentasaccharide structure, when contained in tri- and tetraantennary oligosaccharides, are highly preferred over other branches for attachment of the 1st and 2nd mol of GlcNAc into the acceptor molecule. The enzyme also showed activity toward oligosaccharides related to blood group I- and i-active polylactosaminoglycans. In addition the enzyme together with calf thymus UDP-Gal:GlcNAc beta-R beta 1----4-galactosyltransferase was capable of catalyzing the synthesis of a series of oligomers of N-acetyllactosamine. Competition studies revealed that all acceptors were acted upon by a single enzyme species. It is concluded that the N-acetylglucosaminyltransferase functions in both the initiation and the elongation of polylactosaminoglycan chains of N-glycoproteins and possibly other glycoconjugates.


Assuntos
Amino Açúcares/metabolismo , Líquido Ascítico/enzimologia , Antígenos de Grupos Sanguíneos , Sistema do Grupo Sanguíneo I , Neoplasias Hepáticas Experimentais/enzimologia , N-Acetilglucosaminiltransferases/metabolismo , Animais , Sequência de Carboidratos , Cromatografia em Gel , Glicoproteínas/metabolismo , Cinética , Substâncias Macromoleculares , Espectroscopia de Ressonância Magnética , Metilação , Dados de Sequência Molecular , N-Acetilglucosaminiltransferases/isolamento & purificação , Oligossacarídeos/metabolismo , Ratos , Ratos Endogâmicos , Especificidade por Substrato
7.
FEBS Lett ; 222(1): 42-6, 1987 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-2958363

RESUMO

By use of a new assay method based on HPLC, GlcNAc-transferase III, IV and V activities were determined in HL-60 cells, differentiated HL-60 cells and normal myeloid cells. Differentiation along the monocytic lineage with 1 alpha,25-dihydroxyvitamin D3 resulted in increased GlcNAc-transferase IV and decreased GlcNAc-transferase III activity. Differentiation along the myeloid lineage with retinoic acid resulted in a decrease in GlcNAc-transferase III activity. Although differentiated HL-60 cells show a changed GlcNAc-transferase pattern, they do not resemble normal myeloid cells. Macrophages and granulocytes are characterized by a very low level of GlcNAc-transferase III activity whereas differentiated HL-60 cells still contain this activity. This is the first demonstration of GlcNAc-transferase IV and V activity in a human cell.


Assuntos
Diferenciação Celular , Glucosiltransferases/metabolismo , N-Acetilglucosaminiltransferases , Calcitriol/farmacologia , Configuração de Carboidratos , Sequência de Carboidratos , Diferenciação Celular/efeitos dos fármacos , Linhagem Celular , Citarabina/farmacologia , Dimetil Sulfóxido/farmacologia , Humanos , Oligossacarídeos/biossíntese , Tretinoína/farmacologia
8.
Eur J Biochem ; 166(1): 199-208, 1987 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-2954821

RESUMO

Novikoff ascites tumor cells contain a UDP-GlcNAc:beta-galactoside beta 1----6-N-acetylglucosaminyltransferase (beta 6-GlcNAc-transferase B) that acts on galactosides and N-acetylgalactosaminides in which the accepting sugar is beta 1----3 substituted by a Gal or GlcNAc residue. Characterization of enzyme products by 1H-NMR and methylation analysis indicates that an R beta 1----3(GlcNAc beta 1----6)Gal- branching point is formed such as occurs in blood-group-I-active substances. The enzyme does not show an absolute divalent cation requirement and 20 mM EDTA is not inhibitory. The activity is strongly inhibited by Triton X-100 at concentrations of greater than or equal to 0.2%. Competition studies suggest that a single enzyme acts on Gal beta 1----3Gal beta 1----4Glc, GlcNAc beta 1----3Gal beta 1----4GlcNAc and GlcNAc beta 1----3GalNAc alpha-O-benzyl (Km values 0.71, 0.83 and 0.53 mM, respectively). Gal beta----3Gal beta 1----4Glc as an acceptor substrate for beta 6-GlcNAc-transferase B does not inhibit the incorporation of GlcNAc in beta 1----6 linkage to the terminal Gal residues of asialo-alpha 1-acid glycoprotein catalyzed by a beta-galactoside beta 1----6-N-acetylglucosaminyltransferase (beta 6-GlcNAc-transferase A) previously described in Novikoff ascites tumor cells [D. H. Van den Eijnden, H. Winterwerp, P. Smeeman & W.E.C.M. Schiphorst (1983) J. Biol. Chem. 258, 3435-3437]. Neither is Triton X-100 at a concentration of 0.8% inhibitory for the activity of beta 6-GlcNAc-transferase A. This activity is absent from hog gastric mucosa microsomes, which has been described to contain high levels of beta 6-GlcNAc-transferase B. [F. Piller, J. P. Cartron, A. Maranduba, A. Veyrières, Y. Leroy & B. Fournet (1984) J. Biol. Chem. 259, 13,385-13,390]. Our results show that Novikoff tumor cells contain two beta-galactoside beta 6-GlcNAc-transferases, which differ in acceptor specificity and tolerance towards Triton X-100. A role for these enzymes in the synthesis of branched polylactosaminoglycans and of O-linked oligosaccharide core structures having blood-group I activity is proposed.


Assuntos
Glucosiltransferases/metabolismo , Neoplasias Hepáticas Experimentais/enzimologia , N-Acetilglucosaminiltransferases , Animais , Sítios de Ligação , Ligação Competitiva , Cátions Bivalentes/farmacologia , Cromatografia Líquida de Alta Pressão , Cromatografia em Camada Fina , Glucosiltransferases/antagonistas & inibidores , Concentração de Íons de Hidrogênio , Espectroscopia de Ressonância Magnética , Metilação , Octoxinol , Polietilenoglicóis/farmacologia , Ratos , Ratos Endogâmicos , Especificidade por Substrato
9.
Eur J Biochem ; 157(3): 463-74, 1986 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-2941299

RESUMO

A UDP-GlcNAc:R1-beta 1-3Gal(NAc)-R2 [GlcNAc to Gal(NAc)] beta 6-N-acetylglucosaminyltransferase activity from pig gastric mucosa microsomes catalyzes the formation of GlcNAc beta 1-3(GlcNAc beta 1-6)Gal-R from GlcNAc beta 1-3Gal-R where -R is -beta 1-3GalNAc-alpha-benzyl or -beta 1-3(GlcNAc beta 1-6)GalNAc-alpha-benzyl. This enzyme is therefore involved in the synthesis of the I antigenic determinant in mucin-type oligosaccharides. The enzyme also converts Gal beta 1-3Gal beta 1-4Glc to Gal beta 1-3(GlcNAc beta 1-6)Gal beta 1-4Glc. The enzyme was stimulated by Triton X-100 at concentrations between 0 and 0.2% and was inhibited by Triton X-100 at 0.5%. There is no requirement for Mn2+ and the enzyme activity is reduced to 65% in the presence of 10 mM EDTA. Enzyme products were purified and identified by proton NMR, methylation analysis and beta-galactosidase digestion. Competition studies suggest that this pig gastric mucosal beta 6-GlcNAc-transferase activity is due to the same enzyme that converts Gal beta 1-3GalNAc-R to mucin core 2, Gal beta 1-3(GlcNAc beta 1-6)GalNAc-R, and GlcNAc beta 1-3GalNAc-R to mucin core 4, GlcNAc beta 1-3(GlcNAc beta 1-6)GalNAc-R. Substrate specificity studies indicate that the enzyme attaches GlcNAc to either Gal or GalNAc in beta (1-6) linkage, provided these residues are substituted in beta (1-3) linkage by either GlcNAc or Gal. The insertion of a GlcNAc beta 1-3 residue into Gal beta 1-3GalNAc-R to form GlcNAc beta 1-3Gal beta 1-3GalNAc-R prevents insertion of GlcNAc into GalNAc. These studies establish several novel pathways in mucin-type oligosaccharide biosynthesis.


Assuntos
Mucosa Gástrica/enzimologia , Glucosiltransferases/metabolismo , Mucinas/biossíntese , N-Acetilglucosaminiltransferases , Oligossacarídeos/metabolismo , Animais , Ligação Competitiva , Colo/enzimologia , Cães , Ácido Edético/farmacologia , Mucosa Intestinal/enzimologia , Espectroscopia de Ressonância Magnética , Metilação , Microssomos/enzimologia , Octoxinol , Polietilenoglicóis/farmacologia , Glândula Submandibular/enzimologia , Especificidade por Substrato , Suínos
10.
Biomed Chromatogr ; 1(3): 104-8, 1986 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2976281

RESUMO

A sensitive HPLC method for the assay of UDP-GlcNAc:beta-galactoside beta 1----3-N-acetylglucosaminyltransferase activity was developed. Using lactose as an acceptor, the formation of the product GlcNAc beta 1----3Gal beta 1----4Glc can be determined without interference by substrates resulting from enzymatic and chemical breakdown of the donor substrate UDP-GlcNAc. The method is very specific since products of other transferase reactions, which potentially may be formed in the incubations in vitro, elute at positions different from that of GlcNAc beta 1----3Gal beta 1----4Glc. By use of this assay method it could be demonstrated that normal and malignant hematopoietic cells and cell-lines, with the exception of erythrocytes and reticulocytes, contain beta 1----3-N-acetylglucosaminyltransferase activity.


Assuntos
Antígenos de Grupos Sanguíneos , Medula Óssea/enzimologia , Glucosiltransferases/metabolismo , Sistema do Grupo Sanguíneo I , Isoantígenos , N-Acetilglucosaminiltransferases , Células Cultivadas , Cromatografia Líquida de Alta Pressão , Humanos
11.
Biochim Biophys Acta ; 755(1): 112-8, 1983 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-6824726

RESUMO

Rat brain mitochondrial hexokinase (ATP: D-hexose 6-phosphotransferase, EC 2.7.1.1) was solubilized by treatment of the mitochondria with glucose 6-phosphate and partly purified. The solubilized enzyme was compared with the cytosolic enzyme fraction. The solubilized and cytosolic enzymes were also compared with the enzyme bound to the mitochondrial membrane. The following observations were made. 1. There is no difference in electrophoretic mobility on cellulose-acetate between the cytosolic and the solubilized enzyme. Both fractions are hexokinase isoenzyme I. 2. There is no difference in kinetic parameters between the cytosolic or solubilized enzymes (P less than 0.001). For the cytosolic enzyme Km for glucose was 0.067 mM (S.E. = 0.024, n = 7); Km for MgATP2- was 0.42 mM (S.E. = 0.13, n = 7) and Ki,app for glucose 1,6-diphosphate was 0.084 mM (S.E. = 0.011, n = 5). For the solubilized enzyme Km for glucose was 0.071 mM (S.E. = 0.021, n = 6); Km for MgATP2- was 0.38 mM (S.E. = 0.11, n = 6) and Ki,app for glucose 1,6-diphosphate was 0.074 mM (S.E. = 0.010, n = 5). However when bound to the mitochondrial membrane, the enzyme has higher affinities for its substrates and a lower affinity for the inhibitor glucose 1,6-diphosphate. For the mitochondrial fraction Km for glucose was 0.045 mM (S.E. = 0.013, n = 7); Km for MgATP2- was 0.13 mM (S.E. = 0.02, n = 7) and Ki,app for glucose 1,6-diphosphate was 0.33 mM (S.E. = 0.03, n = 5). 3. The cytosolic and solubilized enzyme could be (re)-bound to depleted mitochondria to the same extent and with the same affinity. Limited proteolysis fully destroyed the enzyme's ability to bind to depleted mitochondria. 4. Our data support the hypothesis that soluble- and solubilizable enzyme from rat brain are one and the same enzyme, and that there is a simple equilibrium between the enzyme in these two pools.


Assuntos
Encéfalo/enzimologia , Hexoquinase/metabolismo , Mitocôndrias/enzimologia , Animais , Citosol/enzimologia , Eletroforese em Acetato de Celulose , Hexoquinase/isolamento & purificação , Isoenzimas/metabolismo , Cinética , Masculino , Ratos , Ratos Endogâmicos
12.
Comp Biochem Physiol B ; 73(4): 965-70, 1982.
Artigo em Inglês | MEDLINE | ID: mdl-6185271

RESUMO

1. The effects of oestradiol-17 beta on processes of synthesis in the pyloric caeca of female Asterias rubens were studied. 2. In vitro treatment with 2.5 X 10(-7) M oestradiol-17 beta resulted in significantly higher RNA levels. 3. In vivo treatment with oestradiol-17 beta resulted in higher lipid levels in the pyloric caeca, but RNA levels, protein levels and the incorporation of 6-[14C]orotic acid, L-leucine-[14C] and sodium 1-[14C] acetate into RNA, proteins and lipids, respectively were not affected, neither were the indices of the gonads and pyloric caeca.


Assuntos
Sistema Digestório/metabolismo , Estradiol/farmacologia , RNA/biossíntese , Estrelas-do-Mar/metabolismo , Animais , Feminino , Lipídeos/biossíntese , Biossíntese de Proteínas , Estrelas-do-Mar/efeitos dos fármacos
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