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Center for Biomedical Research, Population Council (T.I., P.L.M.) and The Rockefeller University (P.L.M.), New York, New York 10021
Address all correspondence and requests for reprints to: Dr. Patricia L. Morris, Population Council, The Rockefeller University, 1230 York Avenue, New York, New York 10021. E-mail: p-morris{at}popcbr.rockefeller.edu.
| Abstract |
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, IL-1ß, and IL-6) expression and START-domain containing StARD1 and StARD5 proteins. IL-1ß regulates SC autocrine/paracrine activities and subsequently influences developing germ cells and spermatogenesis. This study was designed to evaluate whether IL-1ß mediates high-output inducible nitric oxide synthase (iNOS) expression and nitric oxide (NO) production in these specialized epithelial cells and characterize gonadotropin and cytokine-regulation of NO. Purified SCs were maintained in serum-free cultures and treated with FSH (100 ng1 µg/ml) or IL-1ß (10 ng/ml) in time-course studies. To determine obligatory intracellular pathways, treatments were conducted with or without activity inhibitors: COX-2 selective (NS-398, 10 µM) or JNK (SP600125, 10 µM) for 1, 3, 6, and 24 h. NOS mRNAs and proteins were evaluated by RT-PCR and Western analysis, respectively. NO and reactive oxygen species were measured by flow cytometry and ELISA. IL-1ß transiently induces intracellular NO (30 min) but not reactive oxygen species. Subsequently, iNOS mRNA and protein expression (36 h) significantly increased after IL-1ß but not FSH stimulation, and in time-dependent manner, markedly increased extracellular NO (24 h, 8-fold). No change in the constitutive endothelial NOS isoform was observed. Inhibition of JNK, but not COX-2, activity inhibits IL-1ß-induced iNOS expression and NO production. Such findings suggest that intra- and extracellular NO within the tubule may alert SCs monitoring the microenvironment to an aberrant cytokine, triggering antioxidant and antiinflammatory activities to avoid disruption of spermatogenesis. | Introduction |
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expression and secretion was shown to be major components of this response (9). Our previous studies demonstrated that SC IL-6 and its receptor are regulated by FSH, consistent with physiological regulation of environmental cytokines (10, 11). Recently, we showed in SCs that IL-1ß is a potent inducer of several ILs, cyclooxygenase-2 (prostaglandin G/H synthase, PGHS-2 or COX-2) expression and enzyme activity, and the phosphorylation of c-Jun N-terminal kinase (JNK). Activation of these signaling pathways resulted in changes in lipid binding transfer proteins levels such as steroidogenic acute regulatory protein (StAR)-1 and StARD5, and arachidonic acid use for prostaglandin production and secretion (12). Our subsequent studies showed that IL-1ß can temporally activate multiple kinases in an auto-amplifying circuit that regulates cytokine and prostaglandin expression and production (13). These IL-1ß-triggered events were not accompanied by reactive oxygen species (ROS) generation but rather by a lower basal ROS level than those in matched control (Ct) SCs, findings suggestive of an antiinflammatory response to IL-1ß (12). Studies from this laboratory and others indicate that several signal transduction pathways in the testis are activated in response to IL-1ß, and their components may interact in a cell-specific context that determines response.
JNK is activated by phosphorylation in response to numerous environmental stimuli, activated in settings of cell stress, mitogenesis, differentiation, and morphogenesis. For SCs, our studies suggest that JNK-mediated mechanisms may have relevance during Sertoli-germ cell associations and interactions. The physiological signaling molecule nitric oxide (NO) inhibits JNK by S-nitrosylation, preventing sustained activity of the kinase and stress-activated programmed cell death (14). Protein modifications by NO mediate physiological cellular and tissue responses (15). NO and S-nitrosylation of target proteins mediate IL-1ß action in steroidogenic cells such as testicular Leydig and ovarian granulosa cells (16, 17). Nitric oxide synthase (NOS) catalyzes the production of NO, a short-lived free radical with physiological or pathophysiological roles in nearly every organ system (18). There are two constitutive isoforms of NOS, neuronal NOS and endothelial (eNOS), and one high-output inducible isoform (iNOS); each are subject to phosphorylation (18). NO production by iNOS is generated after particular growth factors, cytokines, and increases in intracellular cAMP under physiological conditions and by certain cytokines such as TNF
during acute or chronic inflammation (19, 20). Increases in Sertoli NOS activity and iNOS expression are observed in response to a combination of several cytokines (interferon-
, TNF
, and IL-1
) or exposure to the potent inflammatory agent bacterial lipopolysaccharide (LPS) (21, 22). Our previous study indicates that overproduction of eNOS in transgenic mice may have additive deleterious effects on germ cells compromised by cryptorchidism (23). Round spermatid-produced factors in culture influence Sertoli iNOS mRNA expression and NO production (24). Such germ cell-to-epithelial cell interactions may represent an important mechanism for stage-specific physiological modulation of SC function during spermatogenesis.
Taken together, such findings suggest that intracellular and extracellular NO may play an active role in regulating SC function, with NO levels based on responses to distinct factors in the tubules microenvironment. Thus, it is likely that particular ILs and other cytokines, or combinations thereof, play multiple interactive roles, both hormone-dependent and independent, in the regulation and dysregulation of Sertoli function and male germ cell development. For this study, we sought to determine whether IL-1ß, gonadotropin signaling by FSH, or changes in intracellular cAMP induce SC iNOS and NO.
| Materials and Methods |
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95% pure) were maintained at a density of 1 x 107 cells per 100-mm polystyrene dish in phenol red-, serum-, and endotoxin-free DMEM/F-12 (Irvine Scientific, Santa Ana, CA) in a humidified incubator at 34 C, 5% CO2. The medium was supplemented with 2.5-µg/ml bovine insulin (Sigma, St. Louis, MO), 1 µg/ml transferrin (Calbiochem, La Jolla, CA), and 10 µg/ml bacitracin (Sigma). On d 3 ex vivo, SCs were rinsed twice with fresh serum- and phenol red-free culture medium and then treated with IL-1ß (10 ng/ml) in the absence or presence of COX-2 activity inhibitors NS-398 (10 µM) or the JNK inhibitor, SP600125 (10 µM). These experiments were conducted in a count-down manner, that is, a 24-h experimental clock began on d 3 with all matched SC harvested together at the end of the experiment on d 4 ex vivo. For the experiments reported herein, the time-specific vehicle Ct were harvested together with the experimental replicates on d 4; the vehicle Ct are represented as Ct (veh). At 1, 3, 6, and 24 h after either vehicle (Ct), IL-1ß, or addition of the inhibitor(s), whole cell extracts were isolated from each replicate for protein and total RNA analyses. Duplicate or triplicate culture dishes were used for each drug treatment and experiments were repeated at least twice. The mean (±SEM) of all the experiments was calculated for RNA analyses.
Drugs and reagents
Recombinant rat IL-1ß was purchased from R&D Systems (Minneapolis, MN). NS-398 (N-[2-(cyclohexyloxy)-4-nitrophenyl]-methanesulfonamide) was purchased from Cayman Chemical (Ann Arbor, MI). SP600125 [(N1-methyl-substituted pyrazolanthrone (N1-methyl-1, 9-pyrazoloanthrone))] and forskolin (8, 13-Epoxy-7ß-(N-metylpiperazino-
-butyryloxy)-1
, 6ß, 9
-trihydroxy-labd-14-en-11-one) were purchased from Calbiochem (San Diego, CA). FSH (ovine FSH-19) was obtained from National Hormone and Pituitary Program [University of Maryland School of Medicine, Baltimore, MD, National Institute of Diabetes and Digestive and Kidney Diseases, and Dr. Parlow (Torrance, CA)]. Recombinant IL-1ß was dissolved in 0.1% BSA in PBS as a 100-fold (10 µg/ml) stock solution. Matched aliquots of 0.1% BSA were used in Ct cultures; the final BSA concentration was 0.0001%. COX-2 and JNK inhibitors were dissolved in dimethylsulfoxide (DMSO). Forskolin and FSH were dissolved in H2O and calcium- and magnesium-free PBS, respectively (10 µM and 1 µg/ml). Subsequent dilutions, as needed, were performed in serum- and phenol red-free medium on the day of the experiment. DMSO alone was used as matched vehicle Ct in all plates as required. DMSO concentration did not exceed 0.1%. Accutase was purchased from Innovative Cell Technologies, Inc. (San Diego, CA). The fluoroprobe, 4-amino-5-methylamino-2', 7'-difluorescein (DAF-FM) diacetate was purchased from Invitrogen (Carlsbad, CA) and used per manufacturers instructions. ROS was also determined in matched SCs using methods we previously described (12).
Protein extraction and Western analysis
Whole cell homogenates were extracted for protein lysates for 15 min on ice in buffer [10 mM Tris-HCl (pH 7.8) containing 1% Nonidet P-40, 0.1% sodium dodecyl sulfate, 150 mM NaCl, 1 mM EDTA, 1 mM phenylmethylsulfonyl fluoride, 2 mM dithiothreitol, 2 mM sodium orthovanadate, 2 µg/ml aprotinin, 2 µg/ml pepstatin, and 2 µg/ml leupeptin] (chemicals were from Sigma). Cellular debris was removed by centrifugation (12,000 x g, 15 min). The proteins in the supernatant were then subjected, under reducing conditions, to SDS-PAGE using 420% Tris-glycine gels (Novex, San Diego, CA), and were electrophoretically transferred to a nitrocellulose membrane (Schleicher & Schuell, Keene, NH). The membranes were probed with antibodies, as described below. The iNOS polyclonal antibody (1:1000) was obtained from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA; sc-650). eNOS polyclonal antibody (1:1000) was obtained from BD Transduction Laboratories (Lexington, KY). Monoclonal anti-ß-actin antibody (1:2000) was purchased from Sigma. Blots were developed with the ECL Western blotting system (Amersham, Arlington Heights, IL) and exposed to x-ray film (Kodak, Rochester, NY). Densitometric analysis was performed using the PC version of NIH Image software (Scion Image; Scion Corp., Frederick, MD.) after scanning. For Western analyses, particular signal intensities in each lane were normalized with those for ß-actin on the same membranes, and data are expressed as arbitrary units relative to Ct, set as a value of one.
Total RNA extraction
Total RNA was extracted from SCs using the TRIzol reagent (Life Technologies, Inc., Grand Island, NY) according to the manufacturers instructions. RNA was measured using 260/280 UV spectrophotometry.
RT-PCR analysis
Total RNA (2 µg) was reverse-transcribed for 15 min at 42 C. Reverse transcription was performed in a 20-µl mixture containing 5 mM MgCl2, 1x PCR buffer II, 4 mM each of deoxynucleotide triphosphate, 1 U/µl ribonuclease inhibitor, and 2.5 mM random hexamers. Samples were then denatured for 5 min at 99 C. A no-template Ct was performed for each experiment, establishing the absence of genomic contamination of the samples. PCR was performed using 3 µl of each reverse transcription product as a template. The following primers were used: iNOS sense primer, 5'-GCCTCCCTCTGGAAAGA-3'; antisense primer, 5'-TCCATGCAGACAACCTT-3' (500-bp product); and S16 ribosomal gene sense primer, 5'-TCCGCTGCAGTCCGTTCAAGTCTT-3'; antisense primer, 5'-GCCAAACTTCTTGGATTCGCAGCG-3' (385-bp product). AmpliTaq DNA polymerase (PE Applied Biosystems, Foster City, CA) was used at 25 mU/µl. The PCR mixture (25 µl) contained 2 mM MgCl2, 1x PCR buffer II, and each primer at 0.2 µM. Amplification was performed in a programmable thermal controller (model PTC-100; MJ Research, Inc., Watertown, MA). The samples were first denatured at 95 C for 2 min, followed by 30 PCR cycles; the temperature profile was 95 C (30 sec), 56 C (45 sec), and 72 C (1 min). After the last cycle, additional extension incubation at 72 C (4 min) was performed. After amplification, PCR products were sequenced to verify the products.
PCR products (5 µl of each sample) were subjected to size separation by polyacrylamide gel (420% Tris/boric acid/EDTA gels, Novex). The bands were visualized by UV fluorescence after staining with ethidium bromide (1 µg/ml) for 15 min. Densitometric analysis was performed using the PC version of NIH Image software (Scion Image) after photography with a computer-assisted camera (Kodak). For each experiment, iNOS levels were normalized with S16 values and were expressed in units relative to their matched Ct, set as a value of 1. Replicates from three to five primary experiments were subsequently analyzed.
ELISA
To determine the amount of total NO produced and released, matched replicates of Sertoli culture supernatants were assayed for the stable in vivo end products of NO oxidation, i.e. the sum of nitrite (NO2) and nitrate (NO3). SCs were treated with forskolin (10 µM), FSH (1 µg/ml), and IL-1ß (10 ng/ml), IL-1ß (10 ng/ml) with NS-398 (COX-2 activity-specific inhibitor; 10 µM), or SP600125 (JNK inhibitor; 10 µM) or matched vehicle blank Ct for 1, 3, 6, and 24 h. At indicated times, cell-free supernatants were transferred to sterile microcentrifuge tubes. Two 80-µl aliquots of conditioned medium from each sample were assayed using Nitrate/Nitrite ELISA kits according to the manufacturers instructions (Cayman Chemical, Ann Arbor, MI). The total concentration of nitrate and nitrite was determined in duplicate samples of each experimental replicate by competitive binding enzyme immunoassay using the standard curve method. Fluorescence intensity was measured using a microplate reader (model MRX; Dynex Technologies, Inc., Chantilly, VA). Data were expressed as arbitrary units relative to Ct, set as a value of 1 for the duplicate samples from each individual experiment from a total of three.
NO and ROS flow cytometry analyses
The cell-permeant fluoroprobe DAF-FM passively diffuses across cellular membranes and was used to measure NO in SC after treatment with IL-1ß. ROS was measured as previously reported (12). On d 3 ex vivo, SCs were treated with IL-1ß (15 min, 30 min, 1 h, 3 h, or 6 h) or vehicle (negative Ct) at 34 C and then loaded with DAF-FM diacetate (at 5 µM final concentration) for 20 min at 34 C. SCs were rinsed once with serum-free media (2 min) to remove excess unincorporated probe and to allow complete de-esterification of the intracellular diacetates; cells were then quickly rinsed once again (1x PBS). SCs were harvested to a single cell suspension using Accutase (1.5 ml per well for 5 min at 34 C). Single SC-associated fluorescence was measured by flow cytometric analysis of 20,000 individual cell events in duplicate samples using a Becton Dickinson FACSCalibur cytometer. NO data were obtained from four to five separate SC isolations and subsequent experiments. ROS was measured by flow cytometry as previously reported (12).
Data analysis
Densitometric analyses are expressed in arbitrary units. All results are the mean ± SEM derived from the number of different experiments. Statistical analyses were performed using t test or paired t test, ANOVA. P
0.05 was considered significant.
| Results |
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IL-1ß induces intracellular NO, JNK-dependent inducible NOS expression, and extracellular NO
Flow cytometry was employed for analysis of intracellular NO at specified times after IL-1ß using matched replicates in three separate Sertoli primary cell culture experiments. IL-1ß was added for 15 min, 30 min, 1 h, 3 h, 6 h, and 24 h before DAF-FM diacetate was added for an additional 20-min period at 34 C. Intracellular NO was significantly induced by IL-1ß treatment of 30 min (P
0.01; Fig. 1
, inset). No significant changes were measured at earlier or later time points (not shown) (12). This change in intracellular NO was significant but transient and modest (1520%), findings consistent with physiological signaling and a potential protective role. Consistent with our earlier study, IL-1ß treatment resulted in reduced basal levels of intracellular ROS at 30 min relative to matched Ct (data not shown).
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0.02 and P
0.001, respectively) compared with those of matched vehicle Ct (Ctveh; no underlining).
Endogeneous NO has been shown to affect the activities of both the JNK and COX-2 enzymes, and a physiological circuit of feedback has been suggested as a Ct mechanism in response to normal microenvironmental cues. Therefore, the following pharmacological experiments were performed to determine whether SC activation by IL-1ß results in iNOS-dependent NO induction. In the presence of the specific COX-2 activity inhibitor NS-398, IL-1ß induction of extracellular NO levels was not affected (Fig. 1
; underscored lanes 2, lightly stippled bars). In the presence of the JNK activity inhibitor SP600125, IL-1ß induction of extracellular NO was significantly inhibited (Fig. 1
; underscored lanes 3; cross-hatched bars).
In comparison, neither FSH nor forskolin stimulated extracellular NO secretion, findings indicating that increases in SC cAMP do not affect steady-state NO production (Fig. 1
; unscored lanes 4 and 5, checkered and open bars, respectively). Our previous studies showed that IL-1ß significantly stimulates prostaglandin (PG) E2, F2
, and I2 production (13). Therefore, we next evaluated the effects of specific PGs directly on SC extracellular NO. No changes in extracellular NO level were observed after PG treatments (PGE2, PGF2
; 10 µM; data not shown).
Evaluation of IL-1ß effects on Sertoli iNOS expression
To determine the expression of iNOS mRNA in SC, total RNA extracted from SC treated with or without IL-1ß (10 ng/ml) was analyzed by RT-PCR. Figure 2A
depicts the time course of IL-1ß stimulation at a concentration of 10 ng/ml for 0, 1, 3, 6, and 24 h. In vehicle-Ct SCs, the levels of iNOS mRNA were low, but began to increase as early as 3 h (1.9-fold over Ct, P < 0.01) after a single addition of IL-1ß and continued for up to 24 h (Fig. 2B
). Neither FSH nor forskolin induced iNOS mRNA (data not shown).
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50% decrease, P < 0.001).
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| Discussion |
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In the mammalian testis, the process of spermatogenesis is regulated by a complex interplay of endocrine and paracrine signals. SCs provide a specialized, antiinflammatory microenvironment within the seminiferous tubules for germ cell development. We recently showed that IL-1ß is a potent inducer of several ILs and PG production in SCs, effects due to the phosphorylation of JNK, and the induction of COX-2 expression and activity. Hence, both pathways are involved in a SC cytokine regulatory loop (12). Other studies showed that either IL-1ß alone or in a combination with interferon-
and TNF
induction after LPS stimulation increase SC iNOS expression and NO release (21, 22, 27). The precise molecular signals involved in such proinflammatory mechanisms remain unknown.
The MAPKs are important intracellular signaling molecules that regulate cell function and survival in the testis. Three subfamilies of MAPKs have been identified in mammals: ERK, JNK, and p38 MAPK kinases. MAPKs are involved in the induction of high-output iNOS-NO signaling in multiple cell types. SCs express each of these kinases. Recent studies showed that IL
activates p38 MAPK but not ERK and that p38 mediates the mitogenic effects of IL-1
on proliferating rat SCs from postnatal d 8 and 9 testes (28). In differentiated, nonproliferating SCs, our studies show that IL-1ß increases time-dependent phosphorylation of JNK without affecting phosphorylation of p38 or p42/p44 ERK (12, 13). JNK phosphorylation occurs within 30 min of IL-1ß, coincident with the first detectable increase in intracellular NO. The subsequent phase of IL-1ß stimulation of NO occurs by iNOS induction. NO generation and extracellular secretion could be prevented by pretreatment with a JNK inhibitor.
JNK activates multiple transcription factors such as c-Jun, activating protein-1, activating transcription factor-2, nuclear transcription factor-
B (NF-
B), and histone modifications, initiating complex transcriptional regulation in response to extracellular stimuli (29, 30, 31, 32, 33). IL-1ß has been shown to regulate NF-
B nuclear translocation and binding to DNA. Recent studies in transformed and transfected immortalized cell lines recently demonstrated that tyrosine nitration of the NF-
B p65 subunit inactivates its activity (34). Endogeneous nitric oxide has been shown to regulate the extent of NF
B by cytokines through nitrosylation and subsequent repression of inhibitory
B kinase in transformed lung epithelial cells and Jurkat cells (35). To date, cell-specific regulation has not been clearly defined using nontransformed or nontransfected normal epithelial cells.
SCs are hormonally regulated primarily by the gonadotropin FSH mediated by ligand binding and activation of its G protein-coupled receptor and the catalytic unit of adenylate cyclase, rapid phosphorylation of cAMP regulatory binding protein, and increases in cAMP transcriptional activation of cAMP response element-containing genes (36, 37, 38, 39, 40, 41). Neither FSH nor forskolin induction of cAMP resulted in a change in iNOS expression or NO production using these methods of detection.
The presence of iNOS in the normal testis suggests that NO is generated under physiological conditions. Given the highly complex and coordinated series of events that regulate the conversion of a stem cell to a spermatozoa, transient NO production by iNOS activity could mediate rapid cytokine or growth factor regulatory signaling during spermatogenesis (42). In the seminiferous tubule, pathological levels of iNOS and NO expression follows treatment of rodents with bacterial LPS, contributing, in part, to the observed germ cell damage, sloughing, and apoptosis (43, 44). Consistent with these findings, our previous studies demonstrated that cryptorchidism-induced apoptosis of germ cells is accelerated in the testes of transgenic mice with overexpression of endothelial NO synthase and NO production (23).
Data obtained from studies with cells derived from other tissues suggest that it may be the balance between NO and ROS that determines whether NO acts in a protective or a destructive capacity (44). Using flow cytometry, we demonstrated that basal ROS is reduced after IL-1ß exposure but, when challenged, SCs can mount a robust burst of ROS in response to a known oxidative stress (12). Taken together, our studies are consistent with an antioxidant role for IL-1ß in SC by concomitant regulation of NO and ROS generation.
In summary, these studies have identified for the first time an IL-1ß-JNK-mediated regulatory mechanism for inducible NOS and NO production in the SC. Several studies in cells as diverse as pancreatic islet cells, cardiac myocytes, sperm cells, and microglia cells suggest that NO is involved in the regulation of COX-2 activity, mobilization and use of arachidonic acid, and prostaglandin production (45, 46, 47, 48). Taken together, our data indicate that NO signaling plays a role in IL-1ß regulation of autocrine and paracrine functions of the SC. Based on the findings of our experimental studies to date, a model is proposed (Fig. 5
), which illustrates potential mechanisms for the effects of IL-1ß-JNK-NO-signaling on SC activities (12, 13). Specific components of these pathways may provide novel therapeutic targets for interventional use to prevent testicular dysfunction during chronic inflammatory or oxidative stresses.
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| Acknowledgments |
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| Footnotes |
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T. Ishikawa, M.D., conducted these studies in fulfillment, in part, of his Ph.D. degree requirements as well as postdoctoral training.
Disclosure Statement: The authors have nothing to disclose.
First Published Online August 3, 2006
Abbreviations: COX, Cyclooxygenase; Ct, control; DAF-FM, 4-amino-5-methylamino-2', 7'-difluorescein; DMSO, dimethylsulfoxide; eNOS, endothelial NOS; NO, nitric oxide; NOS, nitric oxide synthase prostaglandin G/H synthase (PGHS-2 or COX-2); JNK, c-Jun N-terminal kinase; LPS, lipopolysaccharide; PG, prostaglandin; ROS, reactive oxygen species; SC, Sertoli cell; StAR, steroidogenic acute regulatory protein.
Received May 15, 2006.
Accepted for publication July 26, 2006.
| References |
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(IFN-
) receptor subunits: IFN-
enhances interferon regulatory factor-1 (IRF-1) and interleukin-1ß converting enzyme (ICE) expression. Endocrinology 139:26362644
-glutamyl transpeptidase activity in Sertoli cells. J Androl 21:855861[Abstract]
B induction by IL-1ß in epithelial and lymphoid cells. J Immunol 159:52645272[Abstract]
B. Mol Cell Proteomics 4:300309
B kinase through S-nitrosylation. Proc Natl Acad Sci USA 101:89458950This article has been cited by other articles:
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K. Birkenmeier, A. Staudt, W.-H. Schunck, I. Janke, C. Labitzke, T. Prange, C. Trimpert, T. Krieg, M. Landsberger, V. Stangl, et al. COX-2-dependent and potentially cardioprotective effects of negative inotropic substances released after ischemia Am J Physiol Heart Circ Physiol, October 1, 2007; 293(4): H2148 - H2154. [Abstract] [Full Text] [PDF] |
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