1.Homer 1a overexpression alleviates nerve injury in mice with traumatic brain injury by regulating autophagy mediated by PI3K/AKT/mTOR pathway.
Yuan WANG ; Mengyang WANG ; Xiumin ZHANG ; Ming LUO
Chinese Journal of Cellular and Molecular Immunology 2025;41(1):31-37
Objective To investigate the effects and molecular mechanism of Homer protein homolog 1a (Homer 1a) overexpression on nerve injury in mice with traumatic brain injury (TBI). Methods Sixty male C57BL/6 mice were randomly divided into five groups: sham group, TBI group, empty lentivirus (Lv-NC) group, Homer 1a overexpression lentivirus (Lv-Homer 1a) group and Lv-Homer 1a + 740 Y-P group, with 12 mice in each group. The lentivirus was orthotopic injected into the cerebral cortex of mice 5 d before modeling, while 740 Y-P was injected intraperitoneally 1 d before modeling. The TBI model was established using the free-fall impact method, and the modified neurological severity scores (mNSS) of the mice was assessed 72 h post-surgery. The water content of brain tissue was quantified, and the histopathological damage and neuronal loss in brain tissue were assessed using HE staining and Nissl staining respectively. The formation of autophagosomes in brain tissue was observed by transmission electron microscopy. The protein expression levels of Homer 1a, microtubule-associated protein 1 light chain 3B (LC3B), Beclin 1, phosphatidylinositol 3-kinase (PI3K), phosphorylation PI3K(p-PI3K), protein kinase B (AKT), p-AKT, mammalian target of rapamycin (mTOR), and p-mTOR in brain tissue were detected by Western blot analysis. Results Compared to the sham group, the mice in the TBI group exhibited a significant increase in mNSS and cerebral water content. Moreover, severe brain tissue pathological damage was observed, accompanied by a substantial loss of neurons and an increase in autophagosome formation. The protein expressions of Homer 1a and Beclin 1, as well as the protein ratio of LC3B-II/LC3B-I, in brain tissues were significantly elevated, while the protein ratios of p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR were significantly reduced. Compared to the TBI group, the Lv-Homer 1a group exhibited reduced mNSS and brain water content. Additionally, there was an improvement in pathological brain tissue damage and neuron loss. Furthermore, there was an increase in autophagosome formation and expression of autophagy-related proteins, while the protein ratios of p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR were decreased. Compared to the Lv-Homer 1a group, the nerve injury in the Lv-Homer 1a+740 Y-P group was exacerbated, accompanied by a reduction in autophagosome formation and expression of autophagy-related proteins, while the PI3K/AKT/mTOR signaling pathway was activated. Conclusion Overexpression of Homer 1a effectively mitigates neurological damage in TBI mice, potentially through modulation of autophagy mediated by the PI3K/AKT/mTOR signaling pathway.
Animals
;
TOR Serine-Threonine Kinases/genetics*
;
Autophagy
;
Brain Injuries, Traumatic/pathology*
;
Male
;
Proto-Oncogene Proteins c-akt/genetics*
;
Phosphatidylinositol 3-Kinases/genetics*
;
Homer Scaffolding Proteins/metabolism*
;
Mice, Inbred C57BL
;
Signal Transduction
;
Mice
2.Multi-modal magnetic resonance imaging assessment and mechanism exploration of preterm white matter injury in neonatal rats.
Xiao-Tian GAO ; Hai-Mo ZHANG ; Xiao-Zu ZHANG ; Yi-Jing WANG ; Hui-Ning BI ; Miao YU ; Yan LI ; Xiao-Li WANG
Chinese Journal of Contemporary Pediatrics 2025;27(3):366-372
OBJECTIVES:
To evaluate preterm white matter injury (PWMI) in neonatal rats using multimodal magnetic resonance imaging (MRI) combined with histological assessments and to explore its underlying mechanisms.
METHODS:
Healthy 3-day-old Sprague-Dawley neonatal rats were randomly divided into a sham operation group and a PWMI group (n=12 in each group). A PWMI model was established in neonatal rats through hypoxia-ischemia. Laser speckle imaging was used to observe changes in cerebral oxygen saturation and blood flow at different time points post-modeling. Multimodal MRI was employed to assess the condition of white matter injury, while hematoxylin-eosin staining was utilized to observe morphological changes in the striatal area on the injured side. Immunofluorescence staining was performed to detect the proliferation and differentiation of oligodendrocyte precursor cells.
RESULTS:
At 0, 6, 12, 24, and 72 hours post-modeling, the relative blood flow and relative oxygen saturation on the injured side in the PWMI group were significantly lower than those in the sham operation group (P<0.05). At 24 hours post-modeling, T2-weighted imaging showed high signals in the white matter of the injured side in the PWMI group, with relative apparent diffusion coefficient values and Lorenz differential values being lower than those in the sham operation group (P<0.001); additionally, the arrangement of nerve cells in the PWMI group was disordered, and the number of EdU+PDGFR-α+ cells was higher than that in the sham operation group (P<0.001). At 28 days post-modeling, the relative fractional anisotropy values, the number of EdU+Olig2+ cells, and the fluorescence intensity of myelin basic protein and neurofilament protein 200 in the white matter region of the PWMI group were all lower than those in the sham operation group (P<0.001).
CONCLUSIONS
Multimodal MRI can evaluate early and long-term changes in PWMI in neonatal rat models in vivo, providing both imaging and pathological evidence for the diagnosis and treatment of PWMI in neonates. Hypoxia-ischemia inhibits the proliferation and differentiation of oligodendrocyte precursor cells in neonatal rats, leading to PWMI.
Animals
;
Rats, Sprague-Dawley
;
Magnetic Resonance Imaging/methods*
;
Rats
;
White Matter/injuries*
;
Animals, Newborn
;
Female
;
Multimodal Imaging
;
Male
;
Hypoxia-Ischemia, Brain/pathology*
3.Optical coherence tomography angiography and microvessel density quantification in penumbra after traumatic brain injury in rats.
Peng ZHONG ; Xiaodan HU ; Zhenzhou WANG
Journal of Peking University(Health Sciences) 2025;57(2):262-266
OBJECTIVE:
To observe the dynamic changes of microvascular injury and repair in the penumbra of traumatic brain injury (TBI) rats with effective cerebral perfusion microvascular imaging using optical coherence tomography angiography (OCTA).
METHODS:
Transparent closed cranial windows were placed in craniotomy rats after TBI caused by weight drop. All the rats in TBI group and control group underwent head MRI examination on the first postoperative day, and the changes of cerebral cortical microvessel density were measured by OCTA through cranial windows on d0, d2, d4, d6, and d8. On the second day after the operation, the same number of rats in the two groups were selected to complete the immunohistochemical staining of brain tissue with pimonidazole, an indicator of hypoxia.
RESULTS:
MRI T2W1 and immunohistochemical staining demonstrated that edema and hypoxia in the traumatic brain tissue extended deeply throughout the entire cortex. OCTA showed that the cortical surface veins of the rats in both groups were significantly dilated and tortuous after operation, and recovered to the postoperative day level on d8. The effective perfusion microvessel density of the rats in both groups gradually recovered after a temporary decrease, and the TBI group decreased from 39.38%±4.48% on d0 to 27.84%±6.01% on d2, which was significantly lower than that on d0, d6, and d8 (P < 0.05). The highest value was 61.71%±7.69% on d8, which was significantly higher than that on d0, d2, and d4 (P < 0.05). The control group decreased from 44.59%±7.78% on d0 to 36.69%±5.49% on d2, which was significantly lower than that on d0, d6, and d8 (P < 0.05). The highest value was 51.92%±5.96% on d8, which was significantly higher than that on d2, and d4 (P < 0.05). Comparing the two groups, the effective perfusion microvessel density in the TBI group was significantly lower than that in the control group on d2 (P=0.021), and significantly higher than that in the control group on d8 (P=0.030).
CONCLUSION
OCTA can be used as a method of imaging and measurement of effective perfusion microvessels in the injured cerebral cortex of TBI rats. After TBI, the effective perfusion microvessel density in the wound penumbra gradually recovered after decreasing, and increased significantly on d8.
Animals
;
Brain Injuries, Traumatic/physiopathology*
;
Rats
;
Tomography, Optical Coherence/methods*
;
Male
;
Rats, Sprague-Dawley
;
Microvessels/pathology*
;
Microvascular Density
;
Cerebral Cortex/blood supply*
;
Cerebrovascular Circulation
4.Buyang Huanwu Decoction Promotes Recovery after Spinal Cord Injury by Regulating cAMP/PKA/NF-κB p65 Pathway.
Si-Yuan LI ; Ting-Ting FAN ; Jian YIN ; Cai-Yun WAN ; Mei-Li LI ; Shuai-Shuai XIA ; Qiang LI ; Liang LI
Chinese journal of integrative medicine 2025;31(7):635-643
OBJECTIVE:
To investigate whether Buyang Huanwu Decoction (BYHWD) had a good curative effect on the neuroprotection of red nucleus neurons after spinal cord injury (SCI) and the possible molecular mechanism.
METHODS:
Ninety male Sprague-Dawley rats were divided into 5 groups (n=18 per group) according to a random number table, including the control, model, low- (12.78 g/kg, BL group), medium- (25.65 g/kg, BM group), and high-dose BYHWD groups (51.30 g/kg, BH group). A rubrospinal tract transection model in rats was established, and different doses of BYHWD were intragastrically administrated for 4 weeks. The forelimb locomotor function was recorded using the spontaneous vertical exploration test. Cyclic adenosine monophosphate (cAMP) level in red nucleus was detected through an enzyme-linked immunosorbent assay. The morphology and number of red nucleus neurons were observed using Nissl's staining and axonal retrograde tracing by Fluoro-Gold (FG). The expression of cAMP-dependent protein kinase A (PKA), nuclear factor kappa-B (NF-κB) p65, and brain-derived neurotrophic factor (BDNF) in red nucleus were detected using immunohistochemistry and quantitative real-time polymerase chain reaction.
RESULTS:
Compared with the control group, the utilization rate of bilateral forelimbs, unilateral right forelimbs, proportion of FG-labeled positive neurons, cAMP level, protein expressions of PKA and BDNF, and BDNF mRNA expression were significantly decreased in the model group (P<0.01), while NF-κB p65 was increased in the model group (P<0.01). Compared with the model group, the utilization rate of bilateral forelimbs and unilateral right forelimbs were significantly higher in the BL, BM and BH groups (P<0.01), the proportion of FG-labeled positive neurons, cAMP level, protein expressions of PKA and BDNF and BDNF mRNA expression in all BYHWD groups were increased (P<0.05 or P<0.01), while NF-κB p65 were decreased in all BYHWD groups (P<0.05 or P<0.01).
CONCLUSIONS
BYHWD possesses a sound neuroprotective effect on red nucleus neurons after SCI, and the efficacy was dose-related. The mechanism may be related to regulating the cAMP/PKA/NF-κ B p65 signaling pathway, finally promoting expression of BDNF.
Animals
;
Spinal Cord Injuries/pathology*
;
Drugs, Chinese Herbal/therapeutic use*
;
Rats, Sprague-Dawley
;
Male
;
Cyclic AMP/metabolism*
;
Transcription Factor RelA/metabolism*
;
Cyclic AMP-Dependent Protein Kinases/metabolism*
;
Signal Transduction/drug effects*
;
Brain-Derived Neurotrophic Factor/genetics*
;
Red Nucleus/metabolism*
;
Recovery of Function/drug effects*
;
Neurons/metabolism*
;
Rats
5.A pilot study on the effects of early use of valproate sodium on neuroinflammation after traumatic brain injury.
Zhi LIU ; Lei ZHU ; Li-Ping SHENG ; Qing-Chen HUANG ; Tong QIAN ; Bo-Xiang QI
Chinese Journal of Contemporary Pediatrics 2023;25(3):253-258
OBJECTIVES:
To study the effect of early use of sodium valproate on neuroinflammation after traumatic brain injury (TBI).
METHODS:
A total of 45 children who visited in Xuzhou Children's Hospital Affiliated to Xuzhou Medical University from August 2021 to August 2022 were enrolled in this prospective study, among whom 15 healthy children served as the healthy control group, and 30 children with TBI were divided into a sodium valproate treatment group and a conventional treatment group using a random number table (n=15 each). The children in the sodium valproate treatment group were given sodium valproate in addition to conventional treatment, and those in the conventional group were given an equal volume of 5% glucose solution in addition to conventional treatment. The serum concentrations of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3), high-mobility group box 1 (HMGB1), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) were measured in the healthy control group on the day of physical examination and in the children with TBI on days 1, 3, and 5 after admission. Glasgow Outcome Scale-Extended (GOS-E) score was evaluated for the children with TBI 2 months after discharge.
RESULTS:
Compared with the healthy control group, the children with TBI had significantly higher serum concentrations of NLRP3, HMGB1, TNF-α, and IL-1β on day 1 after admission (P<0.017). The concentration of NLRP3 on day 5 after admission was significantly higher than that on days 1 and 3 after admission in the children with TBI (P<0.017). On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of NLRP3 than the conventional treatment group (P<0.05). For the conventional treatment group, there was no significant difference in the concentration of HMGB1 on days 1, 3, and 5 after admission (P>0.017), while for the sodium valproate treatment group, the concentration of HMGB1 on day 5 after admission was significantly lower than that on days 1 and 3 after admission (P<0.017). On day 5 after admission, the sodium valproate treatment group had a significantly lower concentration of HMGB1 than the conventional treatment group (P<0.05). For the children with TBI, the concentration of TNF-α on day 1 after admission was significantly lower than that on days 3 and 5 after admission (P<0.017). On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of TNF-α than the conventional treatment group (P<0.05). The concentration of IL-1β on day 3 after admission was significantly lower than that on days 1 and 5 after admission (P<0.017) in the children with TBI. On days 3 and 5 after admission, the sodium valproate treatment group had a significantly lower concentration of IL-1β than the conventional treatment group (P<0.05). The GOS-E score was significantly higher in the sodium valproate treatment group than that in the conventional treatment group 2 months after discharge (P<0.05).
CONCLUSIONS
Early use of sodium valproate can reduce the release of neuroinflammatory factors and improve the prognosis of children with TBI.
Child
;
Humans
;
Valproic Acid/therapeutic use*
;
HMGB1 Protein
;
Pilot Projects
;
Tumor Necrosis Factor-alpha
;
Neuroinflammatory Diseases
;
NLR Family, Pyrin Domain-Containing 3 Protein
;
Prospective Studies
;
Brain Injuries, Traumatic/pathology*
6.Objective Assessment of Visual Field Defects Caused by Optic Chiasm and Its Posterior Visual Pathway Injury.
Jian XIANG ; Xu WANG ; Li-Li YU ; Kang-Jia JIN ; Ying-Kai YANG
Journal of Forensic Medicine 2023;39(4):350-359
OBJECTIVES:
To investigate the characteristics and objective assessment method of visual field defects caused by optic chiasm and its posterior visual pathway injury.
METHODS:
Typical cases of visual field defects caused by injuries to the optic chiasm, optic tracts, optic radiations, and visual cortex were selected. Visual field examinations, visual evoked potential (VEP) and multifocal visual evolved potential (mfVEP) measurements, craniocerebral CT/MRI, and retinal optical coherence tomography (OCT) were performed, respectively, and the aforementioned visual electrophysiological and neuroimaging indicators were analyzed comprehensively.
RESULTS:
The electrophysiological manifestations of visual field defects caused by optic chiasm injuries were bitemporal hemianopsia mfVEP abnormalities. The visual field defects caused by optic tract, optic radiation, and visual cortex injuries were all manifested homonymous hemianopsia mfVEP abnormalities contralateral to the lesion. Mild relative afferent pupil disorder (RAPD) and characteristic optic nerve atrophy were observed in hemianopsia patients with optic tract injuries, but not in patients with optic radiation or visual cortex injuries. Neuroimaging could provide morphological evidence of damages to the optic chiasm and its posterior visual pathway.
CONCLUSIONS
Visual field defects caused by optic chiasm, optic tract, optic radiation, and visual cortex injuries have their respective characteristics. The combined application of mfVEP and static visual field measurements, in combination with neuroimaging, can maximize the assessment of the location and degree of visual pathway damage, providing an effective scheme for the identification of such injuries.
Humans
;
Optic Chiasm/pathology*
;
Visual Pathways/pathology*
;
Visual Fields
;
Evoked Potentials, Visual
;
Random Amplified Polymorphic DNA Technique
;
Hemianopsia/complications*
;
Vision Disorders/pathology*
;
Optic Nerve Injuries/diagnostic imaging*
;
Brain Injuries, Traumatic/diagnostic imaging*
7.AD-16 Protects Against Hypoxic-Ischemic Brain Injury by Inhibiting Neuroinflammation.
Zhihua HUANG ; Zhengwei LUO ; Andrea OVCJAK ; Jiangfan WAN ; Nai-Hong CHEN ; Wenhui HU ; Hong-Shuo SUN ; Zhong-Ping FENG
Neuroscience Bulletin 2022;38(8):857-870
Neuroinflammation is a key contributor to the pathogenic cascades induced by hypoxic-ischemic (HI) insult in the neonatal brain. AD-16 is a novel anti-inflammatory compound, recently found to exert potent inhibition of the lipopolysaccharide-induced production of pro-inflammatory and neurotoxic mediators. In this study, we evaluated the effect of AD-16 on primary astrocytes and neurons under oxygen-glucose deprivation (OGD) in vitro and in mice with neonatal HI brain injury in vivo. We demonstrated that AD-16 protected against OGD-induced astrocytic and neuronal cell injury. Single dose post-treatment with AD-16 (1 mg/kg) improved the neurobehavioral outcome and reduced the infarct volume with a therapeutic window of up to 6 h. Chronic administration reduced the mortality rate and preserved whole-brain morphology following neonatal HI. The in vitro and in vivo effects suggest that AD-16 offers promising therapeutic efficacy in attenuating the progression of HI brain injury and protecting against the associated mortality and morbidity.
Animals
;
Animals, Newborn
;
Astrocytes/pathology*
;
Brain/pathology*
;
Brain Injuries/pathology*
;
Glucose
;
Hypoxia
;
Hypoxia-Ischemia, Brain/drug therapy*
;
Mice
;
Neuroinflammatory Diseases
;
Neuroprotective Agents/therapeutic use*
;
Oxygen/therapeutic use*
8.Histones of Neutrophil Extracellular Traps Induce CD11b Expression in Brain Pericytes Via Dectin-1 after Traumatic Brain Injury.
Yang-Wuyue LIU ; Jingyu ZHANG ; Wanda BI ; Mi ZHOU ; Jiabo LI ; Tiantian XIONG ; Nan YANG ; Li ZHAO ; Xing CHEN ; Yuanguo ZHOU ; Wenhui HE ; Teng YANG ; Hao WANG ; Lunshan XU ; Shuang-Shuang DAI
Neuroscience Bulletin 2022;38(10):1199-1214
The brain pericyte is a unique and indispensable part of the blood-brain barrier (BBB), and contributes to several pathological processes in traumatic brain injury (TBI). However, the cellular and molecular mechanisms by which pericytes are regulated in the damaged brain are largely unknown. Here, we show that the formation of neutrophil extracellular traps (NETs) induces the appearance of CD11b+ pericytes after TBI. These CD11b+ pericyte subsets are characterized by increased permeability and pro-inflammatory profiles compared to CD11b- pericytes. Moreover, histones from NETs by Dectin-1 facilitate CD11b induction in brain pericytes in PKC-c-Jun dependent manner, resulting in neuroinflammation and BBB dysfunction after TBI. These data indicate that neutrophil-NET-pericyte and histone-Dectin-1-CD11b are possible mechanisms for the activation and dysfunction of pericytes. Targeting NETs formation and Dectin-1 are promising means of treating TBI.
Blood-Brain Barrier/metabolism*
;
Brain/pathology*
;
Brain Injuries, Traumatic/metabolism*
;
Extracellular Traps/metabolism*
;
Histones
;
Humans
;
Lectins, C-Type
;
Pericytes/pathology*
9.Neuroprotective effects of voluntary exercise and Yisaipu after traumatic brain injury in mice.
Tian-Tian GAN ; Qi LIAO ; Ji-Hui WANG ; Zhi-Heng FAN ; Jian CAO ; Hui-Ju PAN ; Gao-Feng LOU ; Xue-Fen DONG ; Wei OUYANG
Acta Physiologica Sinica 2022;74(3):333-352
The mechanisms underlying exercise-induced neuroprotective effects after traumatic brain injury (TBI) remained elusive, and there is a lack of effective treatments for TBI. In this study, we investigated the effects of an integrative approach of exercise and Yisaipu (TNFR-IgG fusion protein, TNF inhibitor) in a mouse TBI model. Male C57BL/6J mice were randomly assigned to a sedentary group or a group that followed a voluntary exercise regimen. The effects of 6-week prophylactic preconditioning exercise (PE) alone or in combination with post-TBI Yisaipu treatment on moderate TBI associated deficits were examined. The results showed that combined treatments of PE and post-TBI Yisaipu were superior to single treatments on reducing sensorimotor and gait dysfunctions in mice. These functional improvements were accompanied by reduced systemic inflammation largely via decreased serum TNF-α, boosted autophagic flux, and mitigated lesion volume after TBI. Given these neuroprotective effects, composite approaches such as a combination of exercise and TNF inhibitor may be a promising strategy for facilitating functional recovery from TBI and are worth further investigation.
Animals
;
Brain Injuries, Traumatic/pathology*
;
Disease Models, Animal
;
Male
;
Mice
;
Mice, Inbred C57BL
;
Neuroprotective Agents/pharmacology*
;
Recovery of Function
;
Tumor Necrosis Factor Inhibitors
10.Schisandrin B Inhibits NLRP3 Inflammasome Pathway and Attenuates Early Brain Injury in Rats of Subarachnoid Hemorrhage.
Song CHEN ; Yi-Hang DING ; Song-Sheng SHI ; Xian-Kun TU
Chinese journal of integrative medicine 2022;28(7):594-602
OBJECTIVE:
To determine whether Schisandrin B (Sch B) attenuates early brain injury (EBI) in rats with subarachnoid hemorrhage (SAH).
METHODS:
Sprague-Dawley rats were divided into sham (sham operation), SAH, SAH+vehicle, and SAH+Sch B groups using a random number table. Rats underwent SAH by endovascular perforation and received Sch B (100 mg/kg) or normal saline after 2 and 12 h of SAH. SAH grading, neurological scores, brain water content, Evan's blue extravasation, and terminal transferase-mediated dUTP nick end-labeling (TUNEL) staining were carried out 24 h after SAH. Immunofluorescent staining was performed to detect the expressions of ionized calcium binding adapter molecule 1 (Iba-1) and myeloperoxidase (MPO) in the rat brain, while the expressions of B-cell lymphoma 2 (Bcl-2), Bax, Caspase-3, nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3), apoptosis-associated specklike protein containing the caspase-1 activator domain (ASC), Caspase-1, interleukin (IL)-1β, and IL-18 in the rat brains were detected by Western blot.
RESULTS:
Compared with the SAH group, Sch B significantly improved the neurological function, reduced brain water content, Evan's blue content, and apoptotic cells number in the brain of rats (P<0.05 or P<0.01). Moreover, Sch B decreased SAH-induced expressions of Iba-1 and MPO (P<0.01). SAH caused the elevated expressions of Bax, Caspase-3, NLRP3, ASC, Caspase-1, IL-1β, and IL-18 in the rat brain (P<0.01), all of which were inhibited by Sch B (P<0.01). In addition, Sch B increased the Bcl-2 expression (P<0.01).
CONCLUSION
Sch B attenuated SAH-induced EBI, which might be associated with the inhibition of neuroinflammation, neuronal apoptosis, and the NLRP3 inflammatory signaling pathway.
Animals
;
Apoptosis
;
Brain/pathology*
;
Brain Injuries/pathology*
;
Caspase 3/metabolism*
;
Cyclooctanes
;
Evans Blue
;
Inflammasomes/metabolism*
;
Interleukin-18/metabolism*
;
Lignans
;
NLR Family, Pyrin Domain-Containing 3 Protein/metabolism*
;
Polycyclic Compounds
;
Proto-Oncogene Proteins c-bcl-2/metabolism*
;
Rats
;
Rats, Sprague-Dawley
;
Subarachnoid Hemorrhage/drug therapy*
;
Water
;
bcl-2-Associated X Protein/metabolism*

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