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Biomedical subjects

T Nguyen

Publications and source records attributed to T Nguyen.

At least 145 records · Page 8Linked to original sources

Recognition of breast cancer-associated peptides by tumor-reactive, HLA-class I restricted allogeneic cytotoxic T lymphocytes.

Strategies to identify tumor-associated antigens rely on the paradigm that tumor-associated peptides presented in the context of HLA-class I are recognized by the cellular immune system. Approaches to isolate tumor-specific cytotoxic T lymphocytes (CTL) from tumor-infiltrating lymphocytes are difficult because long-term growth of the CTL requires autologous tumor cells and lymphocytes (PBL) as feeder cells. In this study, a CTL line (BL.HBL-100 CTL) was generated from PBL from a normal healthy donor by stimulating with irradiated, HLA-class I partially matched breast cancer cell line HBL-100. Activated T lymphocytes generated expressed TCR alpha/beta+ with a predominant CD8+ population after 12 stimulations (98.54% CD8+ vs. 0.18% CD4+). These CTL lysed HLA-A1+, but not HLA-A1-, breast cancer cell lines. Moreover, HLA-A1+, non breast cancer cell lines were not recognized. The lytic activity of BL.HBL-100 CTL against HLA-A1+ breast cancer cell lines was blocked by monoclonal antibodies (MAbs) to HLA-class I and CD8, but not by anti-HLA-class II and CD4. Recognition of HLA-A1+ breast cancer cells by the CTL was dependent on peptides associated with HLA-class I since the lysis was inhibited by acid elution of HLA bound peptides. HBL-100 tumors were grown in severe combined immunodeficient (SCID) mice. Immunohistochemical staining of the HBL-100 tissue harvested from SCID mice demonstrated human breast cancer cells. HLA-class I molecules were affinity purified from the HBL-100 harvested from the SCID mice; class I bound peptides were eluted and separated by RP-HPLC. Pooled HPLC peptide fractions were tested for reconstituting antigenic epitopes recognized by the BL.HBL-100 CTL and found to reside within fraction 40. Our results show that a tumor reactive, HLA-class I restricted CTL was produced by stimulating normal PBL against an HLA-class I matched breast cancer cell line. We also provide evidence for a breast cancer-associated, HLA-class I bound peptide antigen(s) that reconstitutes the antigenic epitope(s) recognized by these CTL.

Animals↗

Adenovirus-mediated delivery of fas ligand inhibits intimal hyperplasia after balloon injury in immunologically primed animals.

BACKGROUND: Adenoviral constructs have been used for studies of injury-induced vascular hyperplasia in immunologically naive laboratory animals, but their usefulness for intra-arterial gene therapy may be limited by the prevalence of preexisting immunity to adenovirus in the patient population. Here, we explored the efficacy of adenovirus-mediated transfer of Fas ligand, a cytotoxic gene with immunomodulatory properties, in inhibiting injury-induced vascular lesion formation in both naive and immunologically primed animals. METHODS AND RESULTS: Lesion formation was evaluated in balloon-injured carotid arteries of naive and adenovirus-immunized rats that were infected with adenoviral constructs expressing Fas ligand (Ad-FasL), the cyclin-dependent kinase inhibitor p21 (Ad-p21), or beta-galactosidase (Ad-betagal). In naive rats, Ad-FasL induced apoptosis in medial vascular smooth muscle cells and inhibited intimal hyperplasia by 60% relative to Ad-betagal-treated vessels (P<0.05), whereas the cytostatic agent Ad-p21 decreased lesion size by 58% (P<0.05). In animals preimmunized with an adenoviral vector containing no transgene, Ad-FasL significantly inhibited neointima formation (73% reduction, P<0.05), but Ad-p21 failed to inhibit neointima formation relative to controls. Immunologically primed rats displayed robust T-cell infiltration in Ad-p21- and Ad-betagal-treated vessels, but T-cell infiltration was markedly attenuated in Ad-FasL-treated vessels. CONCLUSIONS: Our data demonstrate that adenovirus-mediated Fas ligand delivery can inhibit intimal hyperplasia in both immunologically primed and naive animals, whereas the efficacy of an adenovirus-mediated p21 delivery is limited to immunologically naive animals. This study documents, for the first time, the therapeutic efficacy of intravascular adenoviral gene transfer in animals with preexisting immunity to adenovirus.

Adenoviridae↗

Stereoselective and substrate-dependent inhibition of hepatic mitochondria beta-oxidation and oxidative phosphorylation by the non-steroidal anti-inflammatory drugs ibuprofen, flurbiprofen, and ketorolac.

Non-steroidal anti-inflammatory drugs (NSAIDs) cause a range of adverse effects, some of which have been associated with perturbances of lipid metabolic pathways. Previous data demonstrating stereoselective formation of the CoA thioester of R-ibuprofen in particular were suggestive of possible stereoselective effects on lipid metabolism. Our aim was to characterise the relative stereoselectivity of the effects of ibuprofen, flurbiprofen, and ketorolac (0.01-1.0 mM) on both the beta-oxidation of palmitate and oxidative phosphorylation in rat hepatic mitochondria as a means of dissecting prostaglandin related from non-prostaglandin-related events. Beta-oxidation was inhibited stereoselectively by R-ibuprofen (P = 0.015), non-stereoselectively by R- and S-flurbiprofen (P = 0.002 and P = 0.004, respectively), and was essentially unaffected by either enantiomer of ketorolac. At 0.25 mM, inhibition by R-ibuprofen and both flurbiprofen enantiomers was partially reversed by increasing CoA concentrations (0-200 microM). Mitochondrial respiration was moderately inhibited by both enantiomers of ibuprofen and flurbiprofen (P < 0.01), but only by high concentrations (> or = 1 mM) of the enantiomers of ketorolac (P < 0.01). Uncoupling of oxidative phosphorylation measured as stimulation of State 4 respiration contributed to these effects. The data support interactions involving both stereoselective CoA-dependent and non-CoA-dependent mechanisms. The plasma drug concentrations required to achieve these effects are not likely to be attained in the majority of patients, although these concentrations are achievable in the gastrointestinal tract and may contribute to the well-known spectrum of adverse effects in this organ. Some patients do experience systemic adverse events which may be mediated by these mechanisms.

Animals↗

Early cell loss after angioplasty results in a disproportionate decrease in percutaneous gene transfer to the vessel wall.

Acute cell loss has been documented following angioplasty of normal rat and rabbit arteries. Here we analyzed the effects of balloon injury intensity on early cellular loss in single- and double-injury models and how it influences the efficiency of percutaneous gene delivery to the vessel wall. Rabbits underwent bilateral iliac angioplasties (n = 52) with 2.5-mm (balloon-to-artery [B/A] ratio, 1.08 to 1.13) and 3.0-mm (B/A ratio, 1.29 to 1.34) balloons. In the single-injury model, the 3.0-mm balloon induced a 61% reduction in medial cellularity at 3 days postinjury (p < 0.001) while the 2.5-mm balloon did not produce significant cell loss. In the double-injury model, the effects were more pronounced, with 35% (p < 0.01) and 91% (p < 0.001) reductions in medial cellularity at 3 days with the 2.5- and 3.0-mm balloons, respectively, but neointimal cellularity was decreased only with the 3.0-mm balloon (37% reduction, p = 0.025). Adenovirus-mediated beta-galactosidase gene delivery with a channel balloon (n = 24) revealed that larger balloon-to-artery ratios decreased both absolute levels and relative frequencies of transgene expression in the vessel wall. In the single-injury model, gene transfer efficiency was 4.2+/-1.1 and 1.3+/-0.25% (p < 0.05) for the small and large balloons, respectively. In the double-injury model, gene transfer efficiency was 6.6+/-1.6 and 2.3+/-0.8% (p < 0.05) in the neointima and 4.1+/-1.2 and 2.6+/-1.2% (p = NS) in the media for the small and large balloon, respectively. We conclude that early cell loss is dependent on the intensity of the injury in both single- and double-injury models of balloon angioplasty, with greater frequencies of cell loss occurring in the media than in the neointima. In both models, larger balloon-to-artery ratios result in disproportionate reductions in percutaneous adenovirus-mediated gene delivery.

Adenoviridae↗

Lipophilins: human peptides homologous to rat prostatein.

Lipophilin components A, B and C are human homologues of prostatein, the major secreted protein of rat prostate. This report describes their cDNA sequences, tissue expression and chromosomal localization. Lipophilin gene products were widely expressed in normal tissues, especially in endocrine-responsive organs. The gene for lipophilin C (also called mammaglobin b) is located on chromosome 11q12-q13.1, near the mammaglobin gene, a homologue overexpressed in many breast cancers. The lipophilin B gene resides on chromosome 10q23, a region deleted in many tumors, and the lipophilin A gene is on chromosome 15q12-q13.

Amino Acid Sequence↗

Discovery of a receptor related to the galanin receptors.

We report the isolation of a cDNA clone named GPR54, which encodes a novel G protein-coupled receptor (GPCR). A PCR search of rat brain cDNA retrieved a clone partially encoding a GPCR. In a library screening this clone was used to isolate a cDNA with an open reading frame (ORF) encoding a receptor of 396 amino acids long which shared significant identities in the transmembrane regions with rat galanin receptors GalR1 (45%), GalR3 (45%) and GalR2 (44%). Northern blot and in situ hybridization analyses revealed that GPR54 is expressed in brain regions (pons, midbrain, thalamus, hypothalamus, hippocampus, amygdala, cortex, frontal cortex, and striatum) as well as peripheral regions (liver and intestine). In COS cell expression of GPR54 no specific binding was observed for 125I-galanin. A recent BLAST search with the rat GPR54 ORF nucleotide sequence recovered the human orthologue of GPR54 in a 3.5 Mb contig localized to chromosome 19p13.3.

Amino Acid Sequence↗

Discovery of three novel orphan G-protein-coupled receptors.

We have discovered three novel human genes, GPR34, GPR44, and GPR45, encoding family A G-protein-coupled receptors (GPCRs). The receptor encoded by GPR34 is most similar to the P2Y receptor subfamily, while the receptor encoded by GPR44 is most similar to chemoattractant receptors. The receptor encoded by GPR45 is the mammalian orthologue of a putative lysophosphatidic acid receptor from Xenopus laevis. Partial sequence of GPR34 was discovered during a search of the GenBank database of expressed sequence tags (ESTs). This sequence information was used both to isolate the full-length translational open reading frame from a human genomic library and to assemble a contig from additional GPR34 EST cDNAs. Northern blot and in situ hybridization analyses revealed GPR34 mRNA transcripts in several human and rat brain regions. Also, we used polymerase chain reaction (PCR) to amplify human genomic DNA using degenerate oligonucleotides designed from sequences encoding transmembrane domains 3 and 7 of opioid and somatostatin receptors. Two PCR products partially encoding novel GPCRs, named GPR44 and GPR45, were discovered and used to isolate the full-length translational open reading frames from a human genomic library. Both GPR44 and GPR45 are expressed in the central nervous system and periphery. For chromosomal localization, fluorescence in situ hybridization analysis was performed to assign GPR34 to chromosomes 4p12 and Xp11. 3, GPR44 to chromosome 11q12-q13.3, and GPR45 to chromosome 2q11. 1-q12.

Amino Acid Sequence↗

Identification and cloning of three novel human G protein-coupled receptor genes GPR52, PsiGPR53 and GPR55: GPR55 is extensively expressed in human brain.

The G protein-coupled receptor (GPCR) family share a structural motif of seven transmembrane segments with large numbers of conserved residues in those regions. Here, we report the identification and cloning of two novel human intronless GPCR genes, GPR52, GPR55 and a pseudogene PsiGPR53. GPR55 was identified from the expressed sequence tags (EST) database whereas GPR52 and pseudogene PsiGPR53 originated from the high throughput genome (HTG) database. A partial cDNA clone obtained from the IMAGE Consortium of GPR55 was used to screen a human genomic library to acquire the full length gene. GPR52 and PsiGPR53 were amplified from human genomic DNA using primers based on the HTG sequences. GPR55 and GPR52 encode receptors of 319 and 361 amino acids, respectively. GPR55 gene was mapped to chromosome 2q37, using fluorescence in situ hybridization (FISH), and its mRNA transcripts have been detected in the caudate nucleus and putamen, but not in five other brain regions. Human receptors showing the highest amino acid identity to GPR55 include P2Y5 (29%), GPR23 (30%), GPR35 (27%) and CCR4 (23%). GPR52 gene localized to chromosome 1q24 shares the highest identity with GPR21 (71%), histamine H2 (27%) and 5-HT4 (26%) human receptors. PsiGPR53 is a pseudogene mapped to chromosome 6p21 that demonstrates the highest similarity to the MRG (35%), MAS (28%) and C5a (24%) human receptor genes.

Amino Acid Sequence↗

Diurnal changes in plasma prolactin during the last one third of pregnancy in the baboon.

Previous studies in our laboratory revealed that daily plasma prolactin (Prl) levels were higher in the evening than in the morning in the pregnant baboon suggesting a diurnal variation. The goal of this study was to examine in more detail the diurnal alterations in plasma Prl levels. A tethered pregnant baboon model was utilized for these studies. Hourly venous blood samples were taken from 0700 to 2400 hr (n=10) or until 0700 hr the following day (n=5). The studies were performed at various days of pregnancy from day 135 until delivery. Plasma samples were analyzed for Prl by radioimmunoassay. A surge in plasma Prl was detected, starting around 1500 to 1600 hr and lasting for 3 to 5 hr. The surge occurred before the lights went off in the colony (1800 hr). Baseline Prl levels were higher in animals < 15 days before delivery compared to those > 15 days before delivery (P < 0.05). In contrast, no differences were found in the average peak Prl values between these two groups of animals. In summary, in the pregnant baboon during the last one-third of pregnancy plasma Prl surges, beginning around 1500 to 1600 hr and lasting for 3 to 5 hr. Less than 15 days before delivery the mean baseline Prl levels are higher compared to animals greater than 15 days before delivery.

Animals↗

Effect of a media-led education campaign on breast and cervical cancer screening among Vietnamese-American women.

BACKGROUND: Previous research has shown that breast and cervical cancer screening rates are low among Vietnamese women. METHODS: Over a 24-month period, we implemented a media-led community education campaign to promote recognition, intention, receipt, and currency of routine checkups, clinical breast examinations, mammograms, and Pap tests among Vietnamese-American women in Alameda and Santa Clara Counties in northern California. Women in Los Angeles and Orange Counties in southern California served as controls. To evaluate its impact, pretest telephone interviews were conducted of 451 randomly selected women in the intervention area and 482 women in the control area and posttest interviews with 454 and 422 women, respectively. RESULTS: At posttest, after controlling for demographic differences in the surveyed populations, the odds ratios for the intervention effect were statistically significant for having heard of a general checkup, Paptest, and clinical breast examination (CBE); planning to have a checkup, Pap test, CBE, and mammogram; and having had a checkup and Pap test. The intervention had no effect on being up to date for any of the tests. CONCLUSIONS: A media-led education intervention succeeded in increasing recognition of and intention to undertake screening tests more than receipt of or currency with the tests.

Adult↗

Use of ipsilateral greater saphenous vein as a valved transplant in management of post-thrombotic deep venous insufficiency: long-term results.

Incompetence of the deep venous valve is a common feature of post-thrombotic deep venous insufficiency. Various surgical techniques have been proposed to treat reflux. In this study we describe long-term results of a novel transposition technique using the ipsilateral greater saphenous vein. From 1984 to 1994 we used this procedure to treat 16 patients including 10 men and 6 women with a mean age of 56 years (range: 25 to 76 years). In all 16 cases the indication for surgery was incapacitating pain associated with recurring ulceration in 9 patients. From the results of using this technique we conclude that transposition using the ipsilateral greater saphenous vein is safe and effective with good mid-term results, especially for pain. For ulcers the primary success rate was 55% but this increased to 84% with proper surveillance and treatment of secondary insufficiency of the superficial venous system.

Female↗

Idiopathic polyhydramnios and perinatal outcome.

OBJECTIVE: The aim of this study was to determine whether there is any association between idiopathic polyhydramnios and adverse perinatal outcome. STUDY DESIGN: One hundred fifty-one consecutive women with singleton pregnancies complicated by idiopathic polyhydramnios (amniotic fluid index >24 cm) who were delivered at our institution during an 18-month period (December 1996-May 1998) were studied. Outcome measures studied included preterm delivery (<37 weeks' gestation), low birth weight (<2500 g), macrosomia (>4000 g), malpresentation at delivery, rate of cesarean delivery, Apgar score at 5 minutes <7, admission to the neonatal intensive care unit, and perinatal death. These findings were compared by means of the chi(2) test with those of 302 matched control subjects with normal amniotic fluid volume (<24 cm). RESULTS: Among pregnancies complicated by idiopathic polyhydramnios we did not observe any increases in preterm deliveries, low birth weight, low Apgar scores at 5 minutes, neonatal intensive care unit admissions, or perinatal mortality rate. However, idiopathic polyhydramnios was associated with significantly higher rates of malpresentation, macrosomia, and primary cesarean delivery. CONCLUSION: In contrast to previous reports that polyhydramnios related to specific causes (congenital anomalies, diabetes mellitus, isoimmunization) is associated with adverse perinatal outcomes, such as prematurity, low birth weight, and perinatal death, idiopathic polyhydramnios is not associated with higher rates of these traditional measures of poor outcome.

Apgar Score↗

Dehydroepiandrosterone (DHEA) decreases open-field spontaneous activity of Zucker rats.

The behavioral endpoint of open-field spontaneous activity was used to characterize further the central nervous system actions of dehydroepiandrosterone. DHEA, administered by intraperitoneal injection, causes a dose-dependent decrease in the spontaneous activity of lean and obese Zucker rats when exposed to a novel environment. The midpoint of DHEA's effect is around 50 mg/kg, a dose similar to that which reduces caloric intake of the rat by nearly 50%. d-Fenfluramine, a known anorectic agent, decreases spontaneous activity under the same conditions. Administration of either DHEA or d-fenfluramine leads to changes in serotonin or its metabolite, 5-hydroxyindole acetic acid, in select regions of the brain. These results emphasize that DHEA given peripherally can affect both the level of neurotransimitters and central nervous system function.

Animals↗

An economic analysis of antimicrobial prophylaxis against urinary tract infection in patients undergoing transurethral resection of the prostate.

Despite the high level of safety and low incidence of mortality associated with transurethral resection of the prostate (TURP), urinary tract infections (UTIs)-the most common complication associated with this procedure-continue to be an important source of postoperative morbidity and costs. However, there is controversy about whether antimicrobial agents should be used as UTI prophylaxis in patients undergoing TURP and, if so, which agents should be used and for what duration. This retrospective study used multivariate regression analysis to evaluate the different types and durations of antibiotic prophylaxis in 222 patients who underwent TURP at a Veterans Affairs hospital between January 1, 1995, and March 30, 1998. The primary outcome measures were total medical costs (ie, medication use, clinic office visits, and hospital care in the 4 weeks after the procedure), length of hospital stay (total days in hospital due to the procedure), and probability of UTI (incidence of infection in the 4 weeks after the procedure). Results showed that there was no difference in the length of hospital stay regardless of the regimen or duration of pre-TURP antibiotic therapy. Patients who received pre-TURP ampicillin plus ceftizoxime incurred moderately higher total medical costs than did patients who received the least costly drug, cefazolin (P = 0.10). Similarly, patients who received post-TURP quinolones incurred a significantly higher total medical cost than did patients who received co-trimoxazole (P = 0.06). We found no evidence of a relationship between use of specific parenteral or oral antibiotic prophylaxis for UTI in patients undergoing TURP and the rate of UTI in such patients. Thus there is no justification for the use of more expensive antibiotic regimens. At our institution, the preferred pre-TURP prophylactic regimen would be cefazolin, whereas co-trimoxazole would be the most cost-effective post-TURP prophylactic regimen. Because duration of post-TURP prophylaxis does not appear to influence the rate of UTI, 24 hours would seem adequate.

Anti-Bacterial Agents↗

Value of negative dobutamine stress echocardiography in predicting long-term cardiac events.

UNLABELLED: To determine the value of negative dobutamine stress echocardiography (DSE) results in predicting subsequent long-term cardiac event rates, we retrospectively reviewed all dobutamine stress echocardiograms performed at our institution over a 3-year period (1992-1994). Follow-up was accomplished through the completion of a detailed questionnaire compiled from data obtained through chart review and direct telephone contact. Information regarding death also was determined by referencing patient data with mortality data available on the World Wide Web. Event rates were determined for hard (myocardial infarction [MI] or cardiac death) and soft (hospitalization for angina and/or congestive heart failure, coronary angioplasty, or coronary bypass surgery) cardiac events occurring after the negative DSE results for up to 7 years after the test. Negative test results were defined as those showing no new or worsening wall motion abnormalities after either a normal resting echocardiogram (normal-negative [NN]) or an abnormal segmental resting echocardiogram (fixed-negative [FN]). RESULTS: Of the 346 interpretable tests, 224 were negative for inducible wall motion abnormalities, with 171 NN and 53 FN. In the NN group, the MI rate was 1.5% per patient/year, and the mortality rate was 0.13% per patient/year. In the FN group, the MI rate was 0.7% per patient/year, and the mortality rate was 0% per patient/year. CONCLUSIONS: DSE results in both NN and FN groups predict a very low subsequent hard event rate and mortality for up to 5 years after the test.

Adrenergic beta-Agonists↗

Drosophila Lissencephaly-1 functions with Bic-D and dynein in oocyte determination and nuclear positioning.

Here we show that the Drosophila homologue of Lissencephaly-1, DLis-1, acts together with Bicaudal-D (Bic-D), Egalitarian (Egl), dynein and microtubules to determine oocyte identity. DLis-1 is further required for nurse-cell-to-oocyte transport during oocyte growth, and for the positioning of the nucleus in the oocyte. Immunostaining of DLis-1 protein reveals a cortical localization that is independent of microtubules. DLis-1 may function in this position as a cortical anchor for the other nuclear-localization factors. DLis-1 and Bic-D are further required for nuclear localization in the developing nervous system, indicating that homologues of Bic-D, dynein and Egl-like proteins may also be involved in vertebrate neural migration and that their absence may cause a Miller-Dieker-like lissencephaly.

Amino Acid Sequence↗

Mouse adenovirus (MAV-1) expression in primary human endothelial cells and generation of a full-length infectious plasmid.

Using RT-PCR, we show that mouse adenovirus type I (MAV-1) is capable of infecting and expressing in various cell types, specifically human endothelial cells. The capability of MAV-1 to infect and express in human endothelial cells makes it a potentially useful alternative to the use of human adenoviruses type 2/5 (Ad2/5) in virus-based gene therapy, although presently MAV-1 can only be produced at lower titers than Ad2/5. In this report, we present methods for the purification of MAV-1 DNA and use of this DNA along with a modified bacteria-based homologous recombination protocol to generate a full-length plasmid clone of MAV-1 DNA. Using various transfection procedures, we show that this plasmid MAV-1 DNA can generate plaques of MAV-1 virus, albeit at low efficiencies (about 0. 2 p.f.u./microg DNA). Furthermore, the construction of an MAV-1 plasmid along with its capability to express in human cells justifies the full development of MAV-1 into a system of gene therapy.

Adenoviridae↗

Targeting of embryonic and postnatal autonomic and enteric neurons with a vasoactive intestinal peptide transgene.

The neuropeptide vasoactive intestinal peptide (VIP) is expressed in several distinct sites in the CNS, in cholinergic and enteric ganglia, and in a small subpopulation of neurons within sympathetic ganglia. Previous studies on the human VIP gene indicate that transcription in neural crest-derived neuroblastoma and pheochromocytoma cell lines is controlled in part by multiple regulatory elements located along 4.5 kb of upstream 5' flanking sequence. In the current studies, transgenic mice were created with a chimeric gene consisting of 16.5 kb of the mouse VIP gene fused to the beta-galactosidase reporter. In situ hybridization analysis in adult mice indicated that reporter gene expression was correctly targeted to neurons in the esophagus, stomach, small intestine, and colon. No expression was observed in the brain, including regions that contain abundant VIP-expressing cells, such as the thalamus, amygdala, cerebral cortex, hippocampus, and suprachiasmatic nucleus. Analysis of transgene expression in neonatal and embryonic day 13.5 mice revealed a near perfect correlation between VIP and beta-galactosidase gene expression in cranial cholinergic ganglia and the superior cervical ganglia, and lack of transgene expression in sensory ganglia and in nonneuronal tissue. Potential ectopic transgene expression was observed in neonates, in the cerebellar external granule layer and in a small subpopulation of neurons in the olfactory epithelium. We conclude that the 16.5 kb of VIP gene used in these studies contains sequences sufficient for directing expression specifically to VIP neurons in the PNS, and that sequences located elsewhere on the gene are required for proper CNS expression. The VIP gene sequences used here should be capable of targeting other gene products to specific populations of embryonic and adult peripheral neurons without causing significant expression in the CNS.

Aging↗