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J. Biol. Chem., Vol. 277, Issue 41, 38709-38713, October 11, 2002
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From the Division of Pulmonary Biology, Cincinnati
Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
Received for publication, June 21, 2002, and in revised form, August 2, 2002
Surfactant protein D (SP-D)
gene-targeted mice develop severe pulmonary disease associated with
emphysema, pulmonary lipidosis, and foamy macrophage infiltrations. To
determine the potential reversibility of these abnormalities,
transgenic mice were developed in which SP-D was
conditionally replaced in the respiratory epithelium of
SP-D Surfactant protein D
(SP-D)1 is a 43-kDa
member of the collectin family of mammalian lectins (for review,
see Refs. 1 and 2). SP-D is synthesized in many organs including the
lung where it is expressed primarily in type II epithelial cells in
alveoli and in non-ciliated bronchiolar cells in conducting airways
(3). Studies in SP-D gene targeted animals demonstrated its
unexpected role in surfactant phospholipid homeostasis.
SP-D Animal Husbandry--
Mice used in the experimental procedures
were handled in accordance with approved protocols through the
Institutional Animal Care and Use Committee at Cincinnati Children's
Hospital. All mice had been maintained in containment facilities. At
the time of study, all mice appeared healthy and without evidence of
infection. Sentinel mice in the colony were serologically negative for
common murine pathogens.
Generation of Transgenic Mice--
The 1.3-kb cDNA encoding
recombinant rat SP-D (rSP-D), a generous gift from Dr. E. C. Crouch, Washington University, was inserted into the
NotI site of (tetO)7-CMV
plasmid (9). Restriction enzyme digestion and 5' end sequencing
confirmed the orientation of the insert. The transgene was
microinjected into fertilized FVB/N oocytes by the Cincinnati
Children's Hospital Transgenic Core facility. Founders were identified
by two sets of transgene-specific PCR using upstream primer 5'-ATA GGA
CCC CAA GGC AAA CCAG-3' and downstream primer 5'-TGT TCT GTCT-TGT ACC
TCT AGG-3' in rSP-D and upstream primer 5'-CAC CGG GAC CGA TCC AGC-3'
in cytomegalovirus (CMV) promoter and downstream
primer 5'-CAC CCC CCA GAA TAG AAT GAC AC-3' in bovine growth hormone
polymerase A. SP-D genotypes were determined as described previously
(14). Transgenic animals were crossed with CCSP-rtTA mice
(9, 15) and SP-D Western Blot Analysis--
Mice were weighed, anesthetized by
intraperitoneal injection of pentobarbital, and exsanguinated by
severing the distal aorta. Bronchoalveolar lavage was performed five
times with 1 ml of normal saline, and the collected volume was measured
(10). Bronchoalveolar lavage fluid (BALF) (25 µl) from each mouse was
dried and reconstituted in 15 µl of Laemmli sample buffer (Bio-Rad)
containing Saturated Phosphatidylcholine (SatPC)--
BALF was performed as
described above, and after lavage, lung tissue was homogenized in
saline. SatPC in BALF and lung homogenates was measured in mice
(8-10 weeks old) from each genotype (12, 13). Differences between
genotypes and treatments were evaluated by analysis of variance Fisher
analysis. Differences of p < 0.05 were considered significant.
Lung Morphology--
Mouse lungs (12 weeks old) were fixed at 25 cm of water pressure with 4% paraformaldehyde in phosphate-buffered
saline and processed into paraffin blocks. Five-µm sections from each
lobe were stained with hematoxylin and eosin. Immunostaining of
transgenic rSP-D was performed in lung tissue using an
avidin-biotin-peroxidase technique (Vectastain Elite ABC kit, Vector
Laboratories, Burlingame, CA). Immunostaining was completely blocked by
co-incubation with purified mouse SP-D.
Conditional Expression of Recombinant SP-D in Vivo--
SP-D
mRNA and protein were undetectable in
SP-D SP-D Reverses Lipid Abnormalities but Not Emphysema--
Pulmonary
abnormalities were established in SP-D Development of Pulmonary Abnormalities after Reversal of
Complementation--
To assess the timing and extent of reversibility
of the effects of SP-D, triple transgenic mice were maintained on
doxycycline until adulthood and then removed from doxycycline. SP-D
content in BALF decreased rapidly, being undetectable 3 days after
removal from doxycycline as assessed by Western blot analysis (Fig.
2B). As assessed by immunohistochemistry, the intensity and
extent of SP-D staining decreased rapidly, although residual SP-D
staining was detected in rare subsets of cells 2 weeks after removal
from doxycycline (Fig. 4G). In the presence of doxycycline,
SP-D staining was detected in alveolar type II cells in the alveolar
parenchyma and in subsets of Clara cells lining the conducting airways
(Fig. 4F). Foamy alveolar macrophages, typical of SP-D
deficiency, were observed within 2 weeks after removal from doxycycline
(Fig. 4C). Four weeks after removal from doxycycline,
extensive infiltration by enlarged alveolar macrophages and airspace
abnormalities consistent with emphysema were observed throughout the
lungs (Fig. 4D). Surprisingly, after removal from
doxycycline for up to 4 weeks, SatPC remained at levels typical of wild
type mice (Fig. 5).
In the present study, rat recombinant SP-D was expressed at
physiological levels. Conditional expression of recombinant rat SP-D
completely corrected pulmonary abnormalities in
SP-D The finding that replacement of SP-D corrected phospholipid and
alveolar macrophage abnormalities but did not correct emphysema is of
considerable clinical interest. Emphysema can be caused by both
developmental and inflammatory processes, leading to the loss of lung
parenchyma reflected by airspace enlargement. D. Massaro and G. D. Massaro (16) recently summarized findings in rodent models wherein
emphysema was partially reversible. In the present study, replacement
of SP-D for 1-3 months did not correct established emphysema in the
SP-D It has been unclear whether alveolar macrophage infiltration and
emphysema in SP-D The sites and level of expression of rSP-D in the present studies were
virtually identical to those of the endogenous mouse and human
SP-D protein (3, 19), the transgene being expressed in type II
epithelial cells and bronchiolar epithelial cells in the lung. As
demonstrated previously by Fisher et al. (20), rat
recombinant SP-D fully corrected pulmonary abnormalities in the
SP-D *
This work was supported by National Institutes of Health
Grants PPG HL61646 and HL33865 (to J. A. W.), Grant HL63329 (to
M. I.), and Grant SCOR HL56387 (to J. A. W. and T. R. K.).The costs of publication of this
article were defrayed in part by the
payment of page charges. The article
must therefore be hereby marked
"advertisement" in
accordance with 18 U.S.C. Section
1734 solely to indicate this fact.
Published, JBC Papers in Press, August 5, 2002, DOI 10.1074/jbc.M206200200
The abbreviations used are:
SP-D, surfactant protein D;
CCSP, Clara cell secretory protein;
rtTA, reverse
tetracycline transactivator;
BALF, bronchoalveolar lavage fluid;
satPC, saturated phosphatidylcholine;
r, rat;
m, mouse.
Reversibility of Pulmonary Abnormalities by Conditional
Replacement of Surfactant Protein D (SP-D) in Vivo*
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ABSTRACT
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ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
/
mice. SP-D was not detected in the
absence of doxycycline. Treatment with doxycycline after birth restored
pulmonary SP-D concentrations and corrected pulmonary pathology at
adulthood. When SP-D was replaced in adult
SP-D
/
mice, alveolar SP-D was restored
within 3 days, pulmonary lipid abnormalities were corrected, but
emphysema persisted. In corrected adult
SP-D
/
mice, loss of SP-D caused focal
emphysema and pulmonary inflammation but did not cause phospholipid
abnormalities characteristic of SP-D
/
mice.
Thus, abnormalities in surfactant phospholipid homeostasis and alveolar
macrophage abnormalities were readily corrected by restoration of SP-D.
However, once established, emphysema was not reversed by SP-D.
SP-D-dependent processes regulating surfactant lipid
homeostasis were disassociated from those mediating emphysema.
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INTRODUCTION
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ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
/
mice developed increased tissue and
alveolar phospholipid pool sizes that were established soon after birth
(4, 5). Abnormalities in alveolar macrophage morphology and emphysema
were also apparent before 1 month of age and increased with age (6).
Increased oxidant production, activation of NF
B, and enhanced
metalloproteinase expression by alveolar macrophages were observed,
perhaps contributing to the alveolar remodeling seen in
SP-D
/
mice (6, 7). In addition to
abnormalities in lung structure and phospholipid metabolism,
SP-D
/
mice were highly susceptible to
pulmonary infections by respiratory synctial and influenza A viruses.
SP-D
/
mice failed to clear either virus
effectively and developed exaggerated inflammatory responses following
infection (8). Since SP-D-dependent abnormalities in lipid
metabolism were established immediately following birth and continued
postnatally, it has been unclear whether SP-D is required during lung
morphogenesis or whether there is an ongoing requirement for SP-D for
regulation of pulmonary surfactant metabolism in the adult lung. To
further clarify the role of SP-D in pulmonary homeostasis, recombinant
SP-D was conditionally expressed in respiratory epithelial cells under
control of the Clara cell secretory protein (CCSP) promoter
in SP-D
/
gene targeted mice in
vivo. Abnormalities in surfactant lipid homeostasis and monocytic
infiltrates were reversed by expression of SP-D in adult
SP-D
/
mice. Reversal of complementation in
adult SP-D
/
mice caused emphysema and
alveolar infiltrates but did not perturb phospholipid homeostasis.
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MATERIALS AND METHODS
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ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
/
mice (4) to
generate triple transgenic mice (CCSP-rtTA +, (tetO)7-rSP-D +,
mSP-D
/
). Triple transgenic mice were treated
with doxycycline containing food pellets (25 mg/g; Harlan Tekland,
Madison, WI) to induce the expression of rSP-D protein (Fig.
1). Several (tetO)7-rSP-D transgenic mouse lines were generated. Founder line 10 expressed rSP-D
at levels similar to those in wild type mice after treatment with
doxycycline and was therefore utilized for this study.

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Fig. 1.
Schematic representation
for generation of triple transgenic mice. CCSP-rtTA
transgenic mice were mated with (tetO)7-rSP-D transgenic
mice to generate double transgenic mice (CCSP-rtTA +,
(tetO)7-rSP-D +). Double transgenic
mice were mated with SP-D
/
mice to generate
heterozygous (CCSP-rtTA +,
(tetO)7-rSP-D +,
mSP-D+/
) mice. Heterozygous double transgenic
mice were mated to generate triple transgenic mice
(CCSP-rtTA +,
(tetO)7-rSP-D +,
mSP-D
/
) for study. bGH, bovine
growth hormone.
-mercaptoethanol. Proteins were resolved on
10-20% SDS-Tris-glycine-polyacrylamide gels (NOVEX, San Diego, CA)
and transferred to nitrocellulose membranes. Blots were blocked with
5% nonfat milk and incubated overnight at room temperature with rabbit
anti-mouse SP-D antiserum diluted 1:5,000 in Tris-buffered saline with
0.1% Tween. Blots were washed with Tris-buffered saline/Tween and
incubated with peroxidase-conjugated goat anti-rabbit IgG antibody
(Calbiochem). After washing, blots were developed with a
chemiluminescence detection system (Amersham Biosciences). Generally,
at least two to four mice from each genotype were analyzed, and
representative results are shown. The rabbit anti-SP-D antibody was
generated against purified mouse SP-D and affinity absorbed against
lung homogenates from SP-D
/
mice (11).
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RESULTS
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ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
/
mice or in triple transgenic
(CCSP-rtTA, (tetO)7-rSP-D,
SP-D
/
) mice in the absence of doxycycline
(Fig. 2A, lane 1).
Administration of doxycycline to adult mice for 2 weeks resulted in
production of physiologic levels of the rat SP-D in lungs of triple
transgenic mice (Fig. 2A, compare lanes 5 and
6). Thus, in triple transgenic (CCSP-rtTA,
(tetO)7-rSP-D,
SP-D
/
) mice, the only detectable SP-D was
derived from the rat SP-D transgene. When maintained on doxycycline
from birth, airspace size, alveolar macrophage morphology, and
pulmonary SatPC pool sizes were not different from control
SP-D+/+ mice (Figs.
3 and Fig. 4B). In contrast,
in the absence of doxycycline, pulmonary abnormalities
characteristic of
SP-D
/
mice were readily apparent in the
triple transgenic mice (Fig. 3 and Fig. 4A). In the absence
of doxycycline, the severity of emphysema, macrophage abnormalities,
and lipid accumulations was not distinguishable from that in
SP-D
/
mice. Thus, continuous expression of
rSP-D from birth completely corrected abnormalities in lung morphology
and surfactant phospholipid metabolism in
SP-D
/
mice.

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Fig. 2.
Conditional expression of rSP-D protein
in vivo. In A, adult mice were treated
for 2 weeks with doxycycline (Dox). BALF (25 µl) from
SP-D+/+, SP-D
/
,
double, or triple transgenic mice was analyzed by Western blot after
SDS-PAGE under reducing conditions. Blots were developed with rabbit
anti-mouse SP-D, and the reaction was detected with
peroxidase-conjugated goat anti-rabbit IgG. B, reversibility
of rSP-D expression. Mice were treated with doxycycline at 6 weeks of age for 3, 7, or 14 days or treated with doxycycline from
embryonic day 3 until 6 weeks of age and then removed from doxycycline
for 3, 7, or 14 days. BALF (25 µl) was analyzed by SDS-PAGE under
reducing conditions. Western blot was used to detect SP-D
protein.

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Fig. 3.
Expression of rSP-D corrects surfactant
phospholipid homeostasis in SP-D
/
lung. Mice were
treated with doxycycline (Dox) from postnatal day 3 to 8 weeks of age. SatPC in BALF, tissue, and total (BALF + tissue) was compared with those from mice without doxycycline
treatment. Values are mean ± S.E. Open bars represent
SP-D+/+ mice, solid bars represent
SP-D
/
mice, and shaded bars
represent triple transgenic mice. SatPC levels were increased in the
absence of SP-D as compared with SP-D+/+ mice
(*, p < 0.001). SatPC levels decreased in triple
transgenic mice after treatment with doxycycline (*, p < 0.001) by analysis of variance Fisher analysis. WT, wild
type.

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Fig. 4.
Emphysema and alveolar
macrophage abnormalities after removal from doxycycline. Lung
tissues were collected from triple transgenic mice (12 weeks of age)
without doxycycline (Dox) treatment (A and
E), on continuous doxycycline treatment for 12 weeks
(B and F), removed from doxycycline for 2 weeks
after 10 weeks of treatment (C and G), or removed
from doxycycline for 4 weeks after 8 weeks of treatment (D
and H). Lung morphology is shown after staining with
hematoxylin-eosin (A-D). Immunohistochemistry was performed
with rabbit anti-mouse SP-D (E-H). Thick arrows
point to foamy macrophages. Arrowheads point to staining in
bronchiolar cells, and thin arrows point to staining in Type
II cells.
/
mice
by maintaining the triple transgenic mice without doxycycline until 2 months of age, at which time SP-D remained undetectable. Increased SatPC, foamy macrophage infiltrates, and emphysema characteristic of
SP-D deficiency were observed. Pulmonary phospholipid content was
decreased within 3 days and normalized 7-14 days after treatment with
doxycycline (Fig. 5). Again, rSP-D was
undetectable in the absence of doxycycline and was rapidly induced,
reaching physiologic levels 3 days after administration of doxycycline
(Fig. 2B). Abnormalities in alveolar macrophage morphology
were also readily reversed by restoration of SP-D in the adult mice
(Fig. 6C). To further assess the reversibility of airspace remodeling, triple transgenic mice that
were maintained without doxycycline until 2 months of age were treated
with doxycycline for 1-3 months. Although alveolar macrophage infiltrates and increased phospholipid pool sizes were corrected, airspace abnormalities persisted, demonstrating that emphysema was not reversed by replacement of SP-D in the adult SP-D
/
mice (Fig. 6, C and
D).

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Fig. 5.
Time course of the regulation of lipid
homeostasis after doxycycline. Mice were treated with doxycycline
(Dox) at 6 weeks of age for 3, 7, or 14 days
(n = 5, mean ± S.E.) or maintained on doxycycline
from embryonic day 3 to 6 weeks of age and then removed from
doxycycline for 3, 7, 14, or 28 days (n = 3).
Open bars represent SP-D+/+ mice,
solid bars represent SP-D
/
mice,
and shaded bars represent triple transgenic mice. SatPC
levels were reduced in mice treated with doxycycline for 7 days or 14 days (*, p < 0.005). SatPC was not different in
corrected SP-D
/
mice removed from
doxycycline for 3-28 days as compared with those treated with
doxycycline. WT, wild type.

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Fig. 6.
Correction of macrophage and neutrophil
infiltration but not emphysema by SP-D. Lung tissues were
collected from SP-D
/
mice (A),
wild type mice (B), and triple transgenic mice treated with
doxycycline from 7 weeks of age for 6 weeks (C) or for 13 weeks (D). Lung morphology is shown after staining with
hematoxylin-eosin. Thick arrows point to enlarged, foamy
macrophages. The thin arrow points to neutrophil
infiltration. * indicates enlarged alveolar space.
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DISCUSSION
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ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
/
mice when expressed from birth. In
adult SP-D
/
mice, extinction of the
transgene expression resulted in a rapid decrease in alveolar SP-D,
consistent with the known clearance rate of SP-D (14) and the
pharmacodynamics of doxycycline on which reversal of transgene
expression was dependent (15). In complemented adult
SP-D
/
mice treated with doxycycline from
birth, removal from doxycycline resulted in decreased tissue SP-D,
reappearance of abnormal alveolar macrophage infiltrates, and airspace
remodeling that were detected within 7-14 days. In contrast, SatPC was
not reversed by loss of SP-D in adult mice. Thus,
SP-D-dependent lung remodeling was neither dependent on
lipid accumulation nor on processes that affect lung morphogenesis.
Although surfactant pool size and alveolar macrophage abnormalities in
SP-D
/
mice were readily reversed by
restoration of SP-D, emphysema persisted, demonstrating that
irreversible changes in lung parenchyma had occurred in the absence of
SP-D. Lack of SP-D results in rapid onset of alveolar macrophage
activation and initiation of tissue remodeling in adult animals. Thus,
SP-D is required for maintenance of pulmonary homeostasis in the mature
and developing mouse lung.
/
mice. Such findings are consistent
with clinical observations demonstrating that various forms of
pulmonary hypoplasia and emphysema do not resolve. Therefore, despite
the rapid correction of lipid surfactant and macrophage abnormalities
by expression of SP-D, emphysema persisted. This conditional system
will be of use in identifying agents that may enhance alveolarization.
/
mice are secondary to
lipid accumulation or are mediated by distinct pathological mechanisms.
In the present study, macrophage infiltrates and remodeling were
observed after removal of the corrected mice from doxycycline. In sharp
contrast, lung SatPC remained at normal wild type levels after
prolonged removal from doxycycline and absence of SP-D. Thus, these
experiments dissociate abnormalities in surfactant homeostasis from the
airway remodeling. A similar dissociation of these two processes was
observed in studies in which the SP-D mutant protein
(Rr-SP-Dser-15/ser-20) caused a dose-dependent
inhibitory effect on SP-D function, producing airspace but not lipid
abnormalities in SP-D+/+ mice (17). Likewise,
expression of a chimeric protein consisting of the neck and
carbohydrate recognition domain of conglutinin linked to the
SP-D amino-terminal and collagenous domain corrected surfactant
phospholipid homeostasis but did not improve emphysema or macrophage
activation in the SP-D
/
mice (18). Taken
together, both structural and temporal requirements for the correction
of pulmonary surfactant abnormalities are distinct from those mediating
alveolar macrophage activation and tissue remodeling, suggesting that
these two processes are mediated by distinct mechanisms in
vivo. Furthermore, the finding that surfactant SatPC remained
normalized in adult mice despite a prolonged absence of SP-D suggests
that SP-D plays a critical role in establishing SatPC concentrations
during postnatal development. Since lung SatPC pools are markedly
higher in neonatal mice than in adults (6, 14), SP-D appears to be
required for the establishment of the low SatPC pool size
characteristic of mature mice. Once normal SatPC concentrations were
established in the complemented SP-D
/
mice,
loss of SP-D in adulthood did not cause the abnormal accumulation of
surfactant lipid. Therefore, SP-D is not required for maintenance of
steady state SatPC pools in adult mice.
/
mice and did not cause observable
pulmonary abnormalities in wild type mice. Thus, the effects of SP-D
deficiency on lung physiology are not related to the effects of SP-D in
other organs but are dependent on local pulmonary requirements for
SP-D. In the present study, the rat CCSP promoter was
utilized to express the transgene. Although CCSP is normally expressed
only in conducting airways in the mouse, this rat CCSP
promoter element expresses transgenes in both bronchiolar and alveolar
epithelial cells, sites consistent with the known expression pattern of
SP-D in the mouse (21). The sites and extent of expression of SP-D
observed in the present study are also consistent with previous studies
with the CCSP-rtTA mice from this laboratory (15). The lack
of detectable expression in the absence of doxycycline has made the
CCSP-rtTA activator line highly useful for conditional
expression of genes in vivo (9, 15). The time course of SP-D
expression following administration or removal from doxycycline is
consistent with previous studies in which luciferase activity was used
to monitor of gene expression in SP-C-rtTA and
CCSP-rtTA transgenic mice. Gene expression was induced
within 6-12 h following addition of doxycycline to drinking water or
food, and activity was generally decreased within 12-24 h after
removal of doxycycline (15). Thus, the rapid loss of SP-D protein from
BALF following removal of doxycycline is consistent with the known
pharmacodynamics of doxycycline, the stability of rtTA, and the
half-life of SP-D protein in the lung, the latter being approximately
8 h in the mouse (14). The distinct temporal differences for
reversibility of macrophage abnormalities, as compared with surfactant
phospholipid concentrations, suggest that these aspects of pulmonary
homeostasis are influenced by distinct pathways.
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FOOTNOTES
To whom correspondence should be addressed: Cincinnati Children's
Hospital Medical Center, Divisions of Neonatology and Pulmonary Biology, 3333 Burnet Ave., Cincinnati, OH 45229-3039. Tel.:
513-636-4830; Fax: 513-636-7868; E-mail:
jeff.whitsett@chmcc.org.
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ABBREVIATIONS
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REFERENCES
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
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Stripp, B. R.,
Sawaya, P. L.,
Luse, D. S.,
Wikenheiser, K. A.,
Wert, S. E.,
Huffman, J. A.,
Lattier, D. L.,
Singh, G.,
Katyal, S. L.,
and Whitsett, J. A.
(1992)
J. Biol. Chem.
267,
14703-14712
Copyright © 2002 by The American Society for Biochemistry and Molecular Biology, Inc.
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