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1.
Am J Transplant ; 19(1): 62-76, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29766641

RESUMO

Cell-based therapy with CD4+ FOXP3+ regulatory T cells (Tregs) is a promising strategy to limit organ rejection and graft-vs-host disease. Ongoing clinical applications have yet to consider how human Tregs could be modified to direct their migration to specific inflammation sites and/or tissues for more targeted immunosuppression. We show here that stable, homing-receptor-tailored human Tregs can be generated from thymic Tregs isolated from pediatric thymus or adult blood. To direct migration to Th1-inflammatory sites, addition of interferon-γ and IL-12 during Treg expansion produced suppressive, epigenetically stable CXCR3+ TBET+ FOXP3+ T helper (Th)1-Tregs. CXCR3 remained expressed after injection in vivo and Th1-Tregs migrated efficiently towards CXCL10 in vitro. To induce tissue-specific migration, addition of retinoic acid (RA) during Treg expansion induced expression of the gut-homing receptors α4ß7-integrin and CCR9. FOXP3+ RA-Tregs had elevated expression of the functional markers latency-associated peptide and glycoprotein A repetitions predominant, increased suppressive capacity in vitro and migrated efficiently to healthy and inflamed intestine after injection into mice. Homing-receptor-tailored Tregs were epigenetically stable even after long-term exposure to inflammatory conditions, suppressive in vivo and characterized by Th1- or gut-homing-specific transcriptomes. Tailoring human thymic Treg homing during in vitro expansion offers a new and clinically applicable approach to improving the potency and specificity of Treg therapy.


Assuntos
Inflamação/imunologia , Intestinos/imunologia , Linfócitos T Reguladores/citologia , Linfócitos T Reguladores/imunologia , Células Th1/citologia , Animais , Adesão Celular , Movimento Celular , Proliferação de Células , Quimiocina CXCL10/metabolismo , Epigênese Genética , Feminino , Humanos , Tolerância Imunológica , Terapia de Imunossupressão , Integrinas/metabolismo , Interleucina-12/imunologia , Masculino , Camundongos , Fenótipo , Receptores CCR/metabolismo , Receptores CXCR3/metabolismo , Timo/imunologia
2.
Cell Death Dis ; 7: e2268, 2016 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-27310876

RESUMO

Calreticulin presentation on the cell surface is an important hallmark of immunogenic cell death (ICD), serving as the prophagocytic signal for macrophages. Cell adhesion is a physiologically relevant stimulus previously shown to increase calreticulin interaction with α-integrins via the juxtamembrane, cytosolic GFFKR motif. This study assessed whether integrin function can regulate surface calreticulin levels in ICD. We generated calreticulin-null T-lymphoblasts and confirmed the loss of surface calreticulin expression on cells treated with doxorubicin, an ICD inducer. Reconstituted expression with full-length calreticulin targeted to the endoplasmic reticulum (ER) successfully rescued doxorubicin-induced surface calreticulin. Reconstitution with a truncation mutant calreticulin targeted to the cytosol led to constitutively high surface calreticulin that was not further elevated by doxorubicin, suggesting calreticulin released from the stressed ER transits the cytosol before its translocation to the cell surface. When stimulated to engage integrin substrates, doxorubicin-treated wild-type T-lymphoblasts exhibited decreased surface calreticulin compared with cells under non-adherent conditions. The inhibitory effect on surface calreticulin was recapitulated for cells in suspension treated with a ß1-integrin-activating antibody, 9EG7. Similarly, cells expressing a truncated α-integrin cytosolic tail, bearing only the juxtamembrane GFFKR calreticulin-binding motif, exhibited low surface calreticulin with doxorubicin treatment under non-adherent conditions. Using partial permeabilization techniques to distinguish between cytosolic and ER staining, we found that ICD inducers promoted the accumulation of cytosolic calreticulin with negligible change in total calreticulin, suggesting that integrin-mediated inhibition of surface calreticulin was due to reduced cytosolic to surface translocation. T-lymphoblasts co-treated with an ICD inducer and 9EG7 exhibited reduced phagocytosis by macrophages when compared with treatment with only ICD inducer. This study reveals a previously uncharacterized function of integrins as negative regulators of ICD by suppressing presentation of cell surface calreticulin.


Assuntos
Calreticulina/genética , Regulação Leucêmica da Expressão Gênica , Integrina alfa3/genética , Integrina alfa4/genética , Integrina alfa5/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Linfócitos T/imunologia , Antibióticos Antineoplásicos/farmacologia , Anticorpos/farmacologia , Sequência de Bases , Calreticulina/imunologia , Linhagem Celular Tumoral , Técnicas de Cocultura , Doxorrubicina/farmacologia , Retículo Endoplasmático/efeitos dos fármacos , Retículo Endoplasmático/metabolismo , Humanos , Integrina alfa3/imunologia , Integrina alfa4/imunologia , Integrina alfa5/imunologia , Integrina beta1/genética , Integrina beta1/imunologia , Células Jurkat , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Cultura Primária de Células , Transporte Proteico , Transdução de Sinais , Linfócitos T/efeitos dos fármacos , Linfócitos T/patologia
3.
Sci Rep ; 5: 9142, 2015 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-25771919

RESUMO

Palladium doped iron rhodium is a magnetic material of significant interest for it's close to room temperature magnetostructural phase transition from antiferromagnetic (AF) to ferromagnetic (FM) ordering. Here we report on the peculiarities of the magnetization distribution in thin films of FeRh(Pd) probed by Polarized Neutron Reflectometry. Remarkably, we've found thin interfacial regions with strong magnetization that have unique thermomagnetic properties as compared to the rest of the system. These regions exist at the top and bottom interfaces of the films while the central regions behave similarly to the bulk with a clear AF-FM order transition. Further we explore the impact of an additional Pt interlayer introduced in the middle of the FeRh(Pd) film and reveal that it serves to replicate the strong interfacial magnetization found at the top and bottom interfaces. These results are of great value both in understanding the fundamental physics of such an order transition, and in considering FeRh(Pd) for magnetic media and spintronics applications.

4.
J Phys Condens Matter ; 21(30): 306004, 2009 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-21828560

RESUMO

Multilayer superlattices consisting of multiferroic Bi(2)NiMnO(6) (BNMO) and La(2)NiMnO(6) (LNMO) have been grown heteroepitaxially on pure and Nb-doped SrTiO(3) substrates using the pulsed laser deposition technique. In a series of superlattice structures grown with a fixed BNMO layer thickness of ten unit cells, we find that the c-axis lattice parameter, Curie temperature and magnetocapacitance are strongly dependent upon the number of stacked LNMO unit cells in the repeating units. The thickness-dependent magnetodielectric effect is attributed to the fluctuations in electric and magnetic dipole ordering due to the substrate and interface induced stress in the superlattice structures. An enhanced magnetodielectric effect in multilayers with LNMO thicknesses larger than six unit cells is explained based on possible canting of spin at the interfaces of LNMO and BNMO.

5.
Phys Rev Lett ; 98(10): 107202, 2007 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-17358561

RESUMO

Tunneling magnetoresistance was found to be suppressed with decreasing temperature for magnetic tunnel junctions (MTJs) oxidized under high plasma power. A strong temperature dependence of the junction resistance was observed, along with zero-bias anomalies of dynamic resistance at low temperatures. Resistance shows a logarithmic dependence on temperature, and resistance versus temperature exhibits a scaling behavior. Our experimental data can be explained in a consistent way by the Kondo effect in the MTJs with the Kondo temperature TK=20-30 K.

6.
Nat Mater ; 5(4): 298-304, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16547517

RESUMO

The search for an ideal magnetic semiconductor with tunable ferromagnetic behaviour over a wide range of doping or by electrical gating is being actively pursued as a major step towards realizing spin electronics. A magnetic semiconductor having a high Curie temperature, capable of independently controlled carrier density and magnetic doping, is crucial for developing spin-based multifunctional devices. Cr-doped In(2)O(3) is such a unique system, where the electrical and magnetic behaviour-from ferromagnetic metal-like to ferromagnetic semiconducting to paramagnetic insulator-can be controllably tuned by the defect concentration. An explicit dependence of magnetic interaction leading to ferromagnetism on the carrier density is shown. A carrier-density-dependent high Curie temperature of 850-930 K has been measured, in addition to the observation of clear magnetic domain structures in these films. Being optically transparent with the above optimal properties, Cr-doped In(2)O(3) emerges as a viable candidate for the development of spin electronics.


Assuntos
Ferro/química , Magnetismo , Óxidos/química , Ligas , Cromo/química , Compostos de Cromo/química , Cristalização , Elétrons , Índio/química , Teste de Materiais , Microscopia de Força Atômica , Microscopia Eletrônica de Transmissão , Nanoestruturas , Oxigênio/química , Pressão Parcial , Pressão , Semicondutores , Especificidade por Substrato , Propriedades de Superfície , Temperatura , Fatores de Tempo , Difração de Raios X
7.
Phys Rev Lett ; 94(3): 037006, 2005 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-15698312

RESUMO

In spite of a lack of superconductivity in bulk crystalline Bi, thin film Bi deposited on thin Ni underlayers are strong-coupled superconductors below approximately 4 K. We unambiguously demonstrate that by tuning the Ni thickness the competition between ferromagnetism and superconductivity in the Ni/Bi can be tailored. For a narrow range of Ni thicknesses, the coexistence of both a superconducting energy gap and conduction electron spin polarization are visible within the Ni side of the Ni/Bi bilayers, independent of any particular theoretical model. We believe that this represents one of the clearest observations of superconductivity and ferromagnetism coexisting.

8.
Phys Rev Lett ; 88(22): 227201, 2002 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-12059451

RESUMO

A novel, all-optical method to excite and detect spin waves in magnetic materials is presented. By exploiting the temperature dependence of the magnetic anisotropy, an ultrashort laser pulse is efficiently converted in a picosecond "anisotropy field" pulse that triggers a coherent precession of the magnetization. Recording the temporal evolution of the precessing spins by a time-delayed probe-pulse provides a quantitative method to study locally the magnetic anisotropy, as well as switching and damping phenomena in micromagnetic structures. Applications to nickel and permalloy ( Ni80Fe20) films are discussed, particularly showing the possibility to explore standing spin waves in thin films.

9.
Phys Rev Lett ; 88(10): 107201, 2002 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-11909383

RESUMO

Utilizing Co/Al(2)O(3)/Co magnetic tunnel junctions with Co electrodes of different crystalline phases, a clear relationship between electrode crystal structure and junction transport properties is presented. For junctions with one fcc(111) textured and one polycrystalline (polyphase and polydirectional) Co electrode, a strong asymmetry is observed in the magnetotransport properties, while when both electrodes are polycrystalline the magnetotransport is essentially symmetric. These observations are successfully explained within a model based on ballistic tunneling between the calculated band structures (density of states) of fcc-Co and hcp-Co.

10.
Phys Rev Lett ; 86(6): 1066-9, 2001 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-11178011

RESUMO

Large zero-bias resistance anomalies as well as a collapse of magnetoresistance were observed in Co/Al2O3/Co magnetic tunnel junctions with thin Cr interfacial layers. The tunnel magnetoresistance decays exponentially with nominal Cr interlayer thickness with a length scale of approximately 1 A more than twice as fast as for Cu interlayers. The strong suppression of magnetoresistance, as well as the zero-bias anomalies, can be understood by considering a strong spin-dependent modification of the density of states at Co/Cr interfaces. The role of the interfacial density of states is shown by the use of specially engineered structures. Similar effects are predicted and observed in junctions with Ru interfacial layers.

11.
Phys Rev Lett ; 84(13): 2933-6, 2000 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-11018979

RESUMO

Co/Al2O3/Co magnetic tunnel junctions with an interfacial Cu layer have been investigated with in situ growth characterization and ex situ magnetotransport measurements. Cu interlayers grown on Co give an approximately exponential decay of the tunneling magnetoresistance with xi approximately 0.26 nm while those grown on Al2O3 have a decay length of 0.70 nm. The difference in decay lengths can be explained by different growth morphologies, and in this way clarifies a present disagreement in the literature. For monolayer coverage of Cu, we show that the tunneling spin polarization is suppressed by at least a factor of 2 compared to Co and beyond approximately 5 ML it becomes vanishingly small.

12.
Hepatology ; 31(3): 730-6, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10706565

RESUMO

Patients with chronic hepatitis C and low serum and hepatic iron stores may have an improved response to interferon (IFN). We tested whether iron reduction before and during IFN therapy would lead to an improved sustained biochemical and virological response compared with IFN alone. Eighty-two previously untreated patients with chronic hepatitis C were randomized to either: group A IFN-alpha2b 3 MU 3 times per week for 6 months, or group B iron reduction before and during IFN-alpha2b 3 MU 3 times per week for 6 months. Group B patients had lower mean serum alanine transaminase (ALT) levels than group A patients during treatment and follow-up. Group B patients had significantly lower mean hepatitis C virus (HCV)-RNA levels at treatment weeks 4 and 12 (P <.05). Serum HCV RNA was undetectable at the end of treatment in 15 group B patients compared with 7 group A patients (P =.03); 7 group B patients and 3 group A patients had persistently undetectable serum HCV RNA 24 weeks after the end of therapy (P =.20). Paired pre- and posttreatment liver biopsies in 18 group B patients demonstrated significant improvements in 2 of the 3 inflammation scores of the Knodell histological activity index (P <. 05). No changes occurred in the paired biopsies from 15 group A patients. We conclude that iron reduction via therapeutic phlebotomy improves the end-of-treatment virological and histological response to short-term IFN therapy. Additional studies are needed to determine if iron reduction in combination with higher doses or longer duration of IFN may be of benefit.


Assuntos
Antivirais/uso terapêutico , Hepatite C Crônica/metabolismo , Interferons/uso terapêutico , Ferro/metabolismo , Adulto , Alanina Transaminase/sangue , Feminino , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/patologia , Humanos , Ferro/sangue , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , Flebotomia
13.
J Hepatol ; 31(3): 421-9, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10488699

RESUMO

BACKGROUND/AIMS: Non-alcoholic steatohepatitis (NASH) is increasingly recognized, and its pathogenesis is believed to involve increased oxidative stress. Elevated levels of serum ferritin and positive liver iron stains are often observed in patients with NASH, and the pathogenesis of liver injury due to iron is also thought to involve oxidative stress. The aim of this study was to determine whether there is an association of NASH and mutations in the HFE gene associated with hereditary hemochromatosis (HHC). METHODS: Clinical, laboratory, and histopathological data on all 57 subjects with a final diagnosis of NASH seen between August 1990 and August 1997 at our Liver Center were analyzed. Thirty-six Caucasian subjects (23 men) with NASH underwent mutational analyses of HFE gene mutations performed. The prevalence of HFE gene mutations was compared to that in 348 Caucasian normal controls. Data were analyzed by both parameteric and non-parametric methods with similar results. RESULTS: One subject (2.8%) with NASH was homozygous for the C282Y mutation and six (16.7%) were heterozygous, compared with 0%, and 11.2%, respectively, of controls. Two (5.6%) subjects with NASH were homozygous for the H63D mutation and 16 (44.4%) were heterozygous, whereas 2.9% and 26.4%, respectively, of controls had these genotypes. The prevalence of heterozygosity (61.1%) for either mutation was significantly higher in subjects with NASH than in controls (38%) (p = 0.008), and the prevalence of homozygosity or heterozygosity combined in NASH subjects (69.4%) was significantly higher than for controls (40.5%, p = 0.001). Sex (63-67% male) and age at diagnosis of NASH did not differ between those with or without HFE mutations, but men with NASH were significantly more likely than women to have the H63D mutation (15/23 vs. 3/13, p<0.05) Levels of serum ferritin, iron, transferrin saturation levels, and the degree of hepatic iron staining were significantly higher (p<0.05) in subjects with NASH who carried an HFE mutation than in those without. Differences in hepatic iron concentrations or hepatic iron indices between NASH subjects with and without HFE mutations were not significant. Those with C282Y mutations had significantly more hepatic fibrosis than those without (p<0.05). Those with HFE mutations had significantly higher levels of serum ALT (90+/-11 [mean +/- SE]) than those without (55+/-6; p = 0.02). CONCLUSION: The prevalences of the HFE gene mutations associated with hereditary hemochromatosis are increased among North American subjects with NASH.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Fígado Gorduroso/induzido quimicamente , Genes MHC Classe I , Antígenos HLA/genética , Hemocromatose/genética , Antígenos de Histocompatibilidade Classe I/genética , Ferro/efeitos adversos , Proteínas de Membrana , Adulto , Feminino , Proteína da Hemocromatose , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Prevalência , Estudos Retrospectivos
14.
Virchows Arch ; 435(1): 32-6, 1999 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10431843

RESUMO

Invariant chain (Ii) is a chaperone molecule that inhibits binding of endogenous antigens to class II molecules. High levels of Ii in cancer cells may prevent tumour antigen expression with class II and render the tumour less immunogenic. To correlate the expression of Ii and class II molecules in colon carcinomas with the density of tumour infiltrating lymphocytes (TILs), surgical specimens from a total of 48 patients with well-(WDAC), moderately (MDAC) and poorly differentiated adenocarcinomas (PDAC), adenoma with high-grade dysplasia (AdHGD) and adenomas were immunostained for Ii and class II antigen (HLA-DR). Aggregates of TILs were graded in H&E-stained sections. Normal colon epithelium was negative for Ii and HLA-DR. Invasive carcinomas showed a linear increase in the expression of Ii in the progression from low- to high-grade tumours, while there was no significant difference in HLA-DR expression across the groups. Invasive carcinomas showed a disproportionate increase in Ii over HLA-DR. Frequency of TILs showed inverse correlation with expression of Ii and tumour grade. This is the first demonstration that expression of Ii increases in the progression from low- to high-grade colon neoplasms and is most marked in the poorly differentiated carcinomas. Ii expression by carcinomas is inversely related to the frequency of TILs. The findings suggest that increased Ii renders the tumour less immunogenic and less likely to stimulate a host immune response.


Assuntos
Adenocarcinoma/imunologia , Adenoma/imunologia , Antígenos de Diferenciação de Linfócitos B/biossíntese , Neoplasias do Colo/imunologia , Antígenos de Histocompatibilidade Classe II/biossíntese , Adenocarcinoma/patologia , Adenoma/patologia , Antígenos CD/biossíntese , Antígenos de Neoplasias/biossíntese , Neoplasias do Colo/patologia , Antígenos HLA-DR/biossíntese , Humanos , Linfócitos do Interstício Tumoral/patologia
15.
Peptides ; 20(3): 343-52, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10447092

RESUMO

The effects of chronic treatment with losartan. an AT1 receptor antagonist, on the tissue content of bradykinin (BK) and des-Arg9-BK and on their pharmacological effects were examined in the carrageenan-induced paw edema model (0.5% solution, 50 microl/paw) in the rat. These effects were compared with those of angiotensin-converting enzyme inhibitors (ACEi). For this purpose, rats were chronically treated with losartan (3, 10 and 30 mg/kg/day) and enalapril or quinapril (1 mg/kg/day). Endogenous BK and des-Arg9-BK tissue contents at the site of local inflammation were measured by highly sensitive and specific enzyme immunoassays. Losartan 3 mg/kg/day for 7, 14 and 28 days had no significant effect on carrageenan-induced paw edema, but both losartan 10 and 30 mg/kg/day for 14 days significantly increased the hindpaw volume by 50% at 3 h and by 59% at 5 h. These effects, similar to those measured for ACEi, were inhibited by icatibant, a B2 kinin receptor antagonist (32.5 nmol/paw), that reduced carrageenan-induced paw edema to the level seen in vehicle-treated rats. In the same model, and contrary to ACEi, losartan 3, 10 and 30 mg/kg/day for 14 days had no significant effect on endogenous BK and des-Arg9-BK levels in the local inflammatory site or on circulating and tissue ACE activities. These results show, at least in that model, that the potentiating effects of losartan on carrageenan-induced paw edema are independent of the concentrations of endogenous kinins.


Assuntos
Angiotensina II/metabolismo , Carragenina/toxicidade , Excipientes/toxicidade , Inflamação/metabolismo , Cininas/metabolismo , Receptores de Angiotensina/metabolismo , Antagonistas de Receptores de Angiotensina , Animais , Anti-Hipertensivos/farmacologia , Relação Dose-Resposta a Droga , Edema/induzido quimicamente , Edema/metabolismo , Inflamação/induzido quimicamente , Losartan/farmacologia , Masculino , Ratos , Ratos Wistar
16.
Hepatology ; 27(6): 1661-9, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9620340

RESUMO

In some, but not all countries, porphyria cutanea tarda (PCT) has been associated with chronic infection with the hepatitis C virus (HCV). Recently, PCT has also been associated with mutations in the HFE gene that are associated with HLA-linked hereditary hemochromatosis. Until now, few studies of these associations have been reported from North America. The aims of this study were: 1) to assess the prevalence of HCV infection and HFE mutations in North American patients with PCT; 2) to compare demographic and laboratory features between those who are HCV-positive and HCV-negative; and 3) to study urinary porphyrin excretions in American HCV-positive patients without clinically manifest PCT. Clinical and laboratory data, including tests for HCV and urinary porphyrins, were collected from 70 unselected patients with typical PCT. Urinary porphyrins were also measured in 110 non-PCT patients with chronic hepatitis C. Mutational analyses of the HFE gene were performed in 26 PCT patients. Thirty-nine of 70 (56%) of the PCT patients had evidence of HCV infection. Thirty-two of 39 PCT patients with HCV were men, all of whom used alcohol. In contrast, 22 of 31 PCT patients without HCV infection were women, 12 of whom had taken estrogens. The HCV-positive group was more likely to have used illicit intravenous drugs (45% vs. 0%; P = 0.01), to have had several (>4) sex partners (48% vs. 13%; P = 0.005), and less likely to have no known risk factors for HCV infection (33% vs. 78%; P = 0.004). Total urinary porphyrin excretion was the same in the two groups, but those with HCV infection had a significantly lower percentage of uroporphyrin and higher percentages of hepta-and hexa-carboxy porphyrins in urine. Sixteen of 110 (15%) HCV-positive subjects without PCT had increased urinary porphyrins, but, unlike PCT, these were mainly coproporphyrin. Forty-two percent of PCT patients carried the C282Y mutation of HFE (15% homozygous), and another 31% carried the H63D mutation (8% homozygous). Thus, 73% of PCT patients had one of these mutations. The prevalence of HCV infection (56%) and mutations in the HFE gene (73%) are high among North American patients with PCT. Alcohol and estrogen use are important additional risk factors. All PCT patients should be tested for HCV infection and for HFE gene mutations. Although HCV infection is a trigger for PCT, preclinical PCT is rare in chronic HCV hepatitis C in the United States.


Assuntos
Antígenos HLA/genética , Hepacivirus/isolamento & purificação , Hepatite C/genética , Antígenos de Histocompatibilidade Classe I/genética , Proteínas de Membrana , Mutação , Porfiria Cutânea Tardia/genética , Adulto , Idoso , Feminino , Proteína da Hemocromatose , Hepatite C/epidemiologia , Hepatite C/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Porfiria Cutânea Tardia/epidemiologia , Porfiria Cutânea Tardia/imunologia , Porfiria Cutânea Tardia/virologia
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