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81.
Genetic markers previously reported to occur at significantly different frequencies in isolates of Escherichia coli O157:H7 obtained from cattle and from clinically affected humans concordantly delineate at least five genetic groups. Isolates in three of these groups consistently carry one or more markers rarely found among clinical isolates.Escherichia coli serotype O157:H7 is an important zoonotic pathogen that may cause diarrhea, bloody diarrhea, and hemolytic-uremic syndrome (3, 10, 14). E. coli O157 is transmitted to humans by direct contact with the animal reservoir (which includes cattle and other ruminant animals) or indirectly by ingestion of contaminated food or water (3, 10). Genetic analyses of bovine isolates of E. coli O157 from diverse geographic origins have provided evidence for the global dissemination of genotypes and also for significant regional differences in the relative prevalence of some genotypes (5, 8, 18, 19).Several research groups have identified genetic markers that occur at different relative frequencies among E. coli O157 isolates from human clinical cases and from cattle. One group initially used octamer-based genomic scanning to identify two lineages of U.S. origin E. coli O157 (7), of which lineage I was composed mostly (36/44) of clinical isolates and lineage II was composed mostly (25/32) of cattle isolates. Subsequently, a simpler multiplex PCR-based assay (Table (Table1),1), the lineage-specific polymorphism assay (LSPA), was developed to indentify these lineages (19). Six LSPA loci with alleles characteristic of lineage I, lineage II, or neither lineage I nor lineage II are, respectively, classified with the digit 1, 2, or 3, and these digits are concatenated to an LSPA code: 111111 indicates lineage I, and 211111 indicates a genetically intermediate group termed lineage I/II (20), whereas all other genotype variations are considered to belong to lineage II. More recently, a typing assay based on Shiga toxin-encoding bacteriophage insertion (SBI) sites grouped 91 of 92 clinical E. coli O157 isolates from the northwestern United States into three clusters, of which clusters 1 and 3 predominated (>90%) (16). SBI consists of six PCRs (Table (Table1)1) that amplify the Stx toxin genes and the insertion site junctions of the Stx1- and Stx2-encoding bacteriophages of E. coli O157. In a subsequent study, the predominance (92.6%) of clusters 1 and 3 was confirmed in 190 additional human (clinical) isolates (1). In contrast, many (48.8%) E. coli O157 isolates from cattle in the northwestern United States and western Canada demonstrated SBI patterns rarely found among human (clinical) isolates (1).

TABLE 1.

Oligonucleotides used in this study
TestTargetTypeSequence (5′→3′)aReference(s)
LSPAFold-sfmAPrimerVIC-TACGTAGGTCGAAGGG18, 20
Z5935PrimerCCAGATTTACAACGCC
yhcGPrimerFAM-GTGTTCCCGGTATTTG
rbsBPrimerCTCACTGGCGTAACCT
rtcBPrimerVIC-CTCTGCAAAAAACTTACGCC
arp-iclRPrimerCAGGTGGTTGATCAGCG
PrimerFAM-AGTTTAATGTTCTTGCCAGCC
PrimerATTCACCGCTTTTTCGCC
PrimerVIC-GCGCCAGATCGATAAAGTAAG
PrimerGCCGTTGTAAACGTGATAAAG
PrimerFAM-GCTCAATCTCATAATGCAGCC
PrimerCACGTATTACCGATGACCG
SBIstx1PrimerCGCTTTGCTGATTTTTCACA16
PrimerGTAACATCGCTCTTGCCACA
stx2PrimerGTTCCGGAATGCAAATCAGT
PrimerCGGCGTCATCGTATACACAG
L yehV-phagePrimerCACCGGAAGGACAATTCATC
R yehV-phagePrimerAACAGATGTGTGGTGAGTGTCTG
L wrbA-phagePrimerAAGTGGCGTTGCTTTGTGAT
R wrbA-phagePrimerGATGCACAATAGGCACTACGC
PrimerCCGACCTTTGTACGGATGTAA
PrimerCGAATCGCTACGGAATAGAGA
PrimerAGGAAGGTACGCATTTGACC
PrimerATCGTTCGCAAGAATCACAA
Q933Q933FPrimerCGGAGGGGATTGTTGAAGGC9
Q21stx2aRPrimerCCGAAGAAAAACCCAGTAACAG
Q21FPrimerGAAATCCTCAATGCCTCGTTG
stx2aRPrimerCCGAAGAAAAACCCAGTAACAG
TirtirFPrimerTGGCGGCGTCTGAGATAAC2
tirRPrimerGAGTATCGAGCGGACCATGATC
tirAProbeVIC-ACTGAATGATGGATTTG-MGBNFQ
tirTProbeFAM-CTGAATGAAGGATTTG-MGBNFQ
Open in a separate windowaVIC, proprietary reporter dye, Applied Biosystems; FAM, 6-carboxyfluorescein; MGBNFQ, molecular-groove-binding nonfluorescent quencher.Additional individual markers reported to occur at differing frequencies among clinical and reservoir isolates include the presence or absence of stx2-Q junction alleles (e.g., Q933 and Q21 alleles in 90% and 15.2% of 66 human isolates versus 44% and 64.8% of 91 bovine isolates, respectively) (9) and the nonsynonymous single nucleotide polymorphism (SNP) 255T→A in tir, a key virulence gene of E. coli O157:H7 (<1% of 108 human isolates versus 44% of 77 bovine isolates had the A allele) (2).The goal of this study was to evaluate the concordance of these various markers reported to occur at different frequencies among isolates from asymptomatic cattle and from human patients. A convenience set of 145 E. coli O157 isolates obtained from cattle, aggregated from two isolate sets chosen to maximize the diversity of geographic and temporal origins within our isolate bank and whose provenance and SBI types were described previously, was used for this study (1, 5, 18). Briefly, these isolates were non-sorbitol-fermenting, beta-glucuronidase-negative E. coli O157 isolates from cattle on 130 different premises in five countries and 14 U.S. states, isolated in 12 different years ranging from 1991 through 2004. The isolates from outside North America included isolates from Australia (n = 7, obtained in 1993 to 2003), Japan (n = 17, obtained in 1996 to 1997), and Scotland (n = 11, obtained in 1999). LSPA was applied to this set by using previously described primer sequences (19), although capillary rather than gel electrophoresis was used (Table (Table1;1; DNA analyzer 3730, LIZ 600 size standard; Applied Biosystems, Foster City, CA). Data were analyzed with GeneMarker software (SoftGenetics, LLC, State College, PA). Q-stx2 alleles Q933 and Q21 were detected by PCR, and the tir polymorphism was detected by real-time PCR as described previously (2, 9).Comparison of typing results produced by the LSPA, SBI, Q-stx2, and tir methods showed considerable overall agreement. Cross-classification of the LSPA and SBI results (Table (Table2)2) showed particularly strong agreement in assignment to the two human disease-associated genotypes (LSPA 111111 and 211111; SBI 1 and 3; chi square = 268, 20 df, P < 0.001; Cramer''s V statistic = 0.681). Q-stx2 typing identified the Q933 allele in 117 isolates, including 59 of 60 LSPA/SBI human disease-associated genotypes. The Q21 allele was detected in 67 isolates but was not strongly associated with either human disease or cattle-associated genotypes overall (data not shown). The tir nucleotide 255A allele was detected in 39 isolates, only 1 of which had an LSPA/SBI human disease-associated genotype.

TABLE 2.

Cross-tabulation of genotypes identified by the SBI and LSPA methods among 145 isolates of bovine E. coli O157:H7 isolates of diverse temporal and geographic origins
LSPA typeNo. of isolates typed by SBI as:
Total
1356Othera
111111044021056
21111116021827
21311100113216
222213105107
222222002507
221213204006
Otherb21202126
Total2145342421145
Open in a separate windowaSBI also identified five isolates of genotype 7; four isolates of genotype 10; three isolates of genotype 16; two isolates each of genotypes 11, 14, and 15; and single isolates of genotypes 4, 12, and 13 (1).bLSPA also identified three isolates each of genotypes 222113 and 222313; two isolates each of genotypes 212111, 222212, 223213, 231111, 231233, and 232233; and single isolates of genotypes 111211, 212113, 222223, 223212, 223313, and 232233 (20).While these cross-comparisons supported a significant degree of concordance between the results of the various typing systems, the data analysis was complicated by the differing numbers of genotypes determined by the different systems, and in particular by the classification by LSPA and SBI of numerous isolates into a number of sparsely populated genotypes (Table (Table2).2). More generally, it seemed likely that the best classification of the isolates would result from a consideration of all of the data generated. Therefore, we used Markov chain Monte Carlo (MCMC) model-based clustering, implemented in the structure software package, version 2.2 (6), to investigate the population structure using as input data the 15 locus-specific test results (i.e., the six loci each from the LSPA and SBI genotyping panels together with the Q933, Q21, and tir loci) (see Table S1 in the supplemental material). The model assumes K populations, each of which is characterized by allele frequencies at multiple unlinked or weakly linked loci. Within each population, the loci are assumed to be at linkage equilibrium. It was not possible to test the validity of these assumptions for the isolate set modeled here, and it is likely that at least some degree of linkage disequilibrium is present within E. coli O157:H7 populations (12). We utilized this model both to determine the most likely number of populations (K) within the isolate set and to assign individual isolates to the best-fitting population(s). K = 1 would imply a lack of genetic substructure within the isolate set, while any K of >1 would assume the presence of the corresponding number of subgroups with distinct sets of allele frequencies. Initial assignments of group membership for each isolate were based on the location (North America, Scotland, Japan, or Australia) of the cattle from which the E. coli O157 isolates were obtained, due to the potential for genetic divergence of geographically separated populations.K values of 1 to 10 were initially evaluated with 10 model runs each, with each run consisting of a 20,000-step burn-in followed by a 50,000-step parameter estimation. Comparison of the estimated logarithmic posterior probabilities [ln P(X|K), where X is the data] of these runs revealed that K values of <4 or >7 were highly unlikely. Additional runs (25 runs, each consisting of 100,000 steps for burn-in, followed by 100,000 steps for parameter estimation), were then performed in order to model each K value from 4 through 7. The results of these models demonstrated nearly equal maximum relative posterior probabilities for K = 5 and K = 6.We selected K = 5 models for assigning isolates to specific clusters, based on (i) the parsimony principle (K = 5 being a less complex population structure than K = 6), (ii) the precision of the posterior probabilities (K = 5 models had consistently lower variances than K = 6 models), (iii) the lack of sensitivity of the model-derived posterior probabilities to the prior population assignments used to initialize the model (posterior probabilities of models initialized or not initialized with each isolate''s country of origin increasingly diverged in values as K increased from 6), and (iv) the admixture determinations for individual isolates (as K increased from 6, an increasing proportion of the study isolates shared characteristics of two or more clusters). Cluster assignments from six independent, randomly selected K = 5 model runs were compared for concordance: using a criterion of a 0.5 or higher probability to assign isolates to their best-fit clusters, all cluster assignments from the six selected runs were perfectly concordant, with 140 to 142 isolates assigned to specific clusters, leaving only 3 to 5 isolates (depending on the run) with no cluster assignable at a 0.5 or higher probability (see Fig. S1 in the supplemental material). However, it is possible that the uncertainty of these ancestry assignments was underestimated or that the assignments were biased as a result of possible violation of the assumptions of linkage equilibrium within populations (6).The concordant assignments of 142 isolates to five genetic clusters (designated A to E) were then used as the basis for individual evaluation of the different genetic typing systems by comparing each genotyping test or system for agreement with the model-derived cluster assignments. These comparisons revealed associations between genetic markers typical of human infection (for example, SBI type 1 and LSPA type 211111 in cluster A and SBI type 3 and LSPA type 111111 in cluster B), whereas isolates in clusters C to E each contained one or more markers rarely found in clinical isolates (Fig. (Fig.1).1). All markers/marker systems were strongly nonindependently distributed among the model-derived clusters (χ2 = 84 to 338; 4 to 16 df, Cramer''s V = 0.662 to 0.937; P < 0.001 for each system). Not surprisingly, some isolates were assigned to clusters C to E by the model based on the complete data set despite carrying one or more markers typical of clinical isolates. For example, LSPA type 211111 was frequent among isolates assigned to both clusters A (17 of 19) and D (9 of 15), suggesting that this LSPA genotype may be polyphyletic. Clusters A and B cumulatively contained 73 of the 142 classified isolates (51%). We previously reported that the proportions of isolates with SBI genotypes typical of clinical isolates in different countries was weakly correlated to the respective national incidences of E. coli O157:H7-associated hemolytic-uremic syndrome (18). The structure version 2.2-derived cluster assignments reported here also differed by isolate provenance (Fig. (Fig.2;2; χ2 = 30.0, 4 df, P < 0.001; Cramer''s V = 0.262). While the number of international source isolates examined here is clearly insufficient to support strong inferences, the data indicate the possibilities of (i) the unique occurrence of cluster C in North America, (ii) a relatively high frequency of cluster A and a low frequency of cluster E in Scotland, and (iii) a relatively low frequency of cluster A in Japan and Australia. As the genetic markers of cluster A have been associated with increased virulence (11), further research on the association of the distribution of E. coli O157:H7 genotypes and the national incidence and severity of E. coli O157:H7-associated disease may be merited.Open in a separate windowFIG. 1.MCMC model-based genetic cluster assignments (A to E) and their association with (a) SBI typing, (b) LSPA typing, (c) Q933 typing, (d) Q21 typing, and (e) tir typing. Clusters A to E included 19, 54, 14, 15, and 40 isolates, respectively.Open in a separate windowFIG. 2.MCMC model-based genetic cluster assignments and their association with regions of origin. Each isolate is depicted as a single vertical bar colored to represent its genetic cluster admixture (orange, cluster A; blue, cluster B; yellow, cluster C; green, cluster D; pink, cluster E). The isolates are sorted by cluster and location of isolation. The locations are North America (n = 108), Scotland (Sc; n = 10), Japan (Jp; n = 17), and Australia (Au; n = 7). This image was generated by using the DISTRUCT 1.1 software (15).Multiple-correspondence analysis (MCA) and hierarchical clustering were used in a second approach to explore the relationships between the isolates defined by the same set of genetic markers by using the methods of Murtagh (13). The application of MCA provided an opportunity to test whether the clusters identified by the MCMC models were supported by this very different analytical method. MCA identifies a lower-dimensional subspace that approximately represents the diversity within a multivariate data set. In initial MCA models using the full data set, uncommon LSPA and SBI types (specifically, those each comprising less than 5% of the isolate set) exhibited a strong tendency to cocluster, and therefore these unusual types were pooled to produce four LSPA categories. MCA of this reduced data set (SBI [1, 3, 5, 6, or other], LSPA [111111, 211111, 213111, or other], Q933 [positive or negative], Q21 [positive or negative], and Tir [255T or 255A]) identified four dimensions (factors) that cumulatively accounted for >80% of the variation within the data set and retained 69 to 93% of the quality of representation of each marker (13) (see Table S2 in the supplemental material). The coordinates of the projections of each marker onto these four dimensions were extracted from the model and hierarchically clustered by using minimum-variance methods, weighting each marker by its mass (marginal total) (13) (Fig. (Fig.3),3), resulting in five clusters very similar (and named accordingly) to those produced by the MCMC model illustrated in Fig. Fig.11.Open in a separate windowFIG. 3.MCA with hierarchical clustering of E. coli O157:H7 genotyping data, weighted to reflect the contributions of individual factors to the total inertia (n = 138 isolates with no missing data, Ward''s minimum-variance method).In summary, these results clearly demonstrate that the several individual genetic tests or multiple test marker systems previously reported to occur at different frequencies among isolates from cattle and humans identify largely concordant genotypes of E. coli O157. The distribution of these markers among this international collection of isolates strongly indicated the existence of five (or more) genetic groups of E. coli O157, only two of which (clusters A and B) predominantly carry markers previously associated with clinical isolates. It is nearly certain that additional genetic groups or subgroups of E. coli O157 exist in nature, since delineation of these five groups is based on the sampling of only a tiny proportion of the genome: For example, in a recent study, 96 SNPs differentiated clinical E. coli O157 isolates into nine discrete clades (11). The Stx content and the relative frequencies of the two numerically predominant clades of clinical isolates identified in reference 11, clades 2 and 8, are consistent with those of clusters B and A, respectively, as described here.The concordance of the multiple genetic markers, each with alleles differentially associated with human disease, supports the hypothesis of the existence of discrete genotypes of E. coli O157 that differ in their virulence for humans. This diversity is consistent with a source-sink ecological model characterized by broad genetic diversity in the reservoir (source) bovine populations that includes at least five genetic clusters, of which only two carry genetic markers typical of clinical isolates (17). In this ecological model, human infections represent a “sink” characterized by relatively short-duration infections unlikely to be persistently transmitted (R0 < 1.0). The source-sink model implies that various E. coli O157 genotypes diverged in the bovine reservoir through genetic drift and/or through bovine fitness-based selection, during which some genotypes evolved into accidental human pathogens. Based on this model, we predict that the genomic DNA sequences of E. coli O157 genotypes largely restricted to the bovine reservoir will reveal more genetic diversity than is apparent from the clinical isolate sequences now available, and SNP data supporting this prediction have already appeared (4). Investigation of the presence and expression of virulence factors by diverse bovine E. coli O157 genotypes may be required to reveal the mechanism(s) underlying their differential association with human disease.   相似文献   
82.
One of the mechanisms for generation of tolerance involves immature dendritic cells (DCs) and a subpopulation of regulatory CD4+ CD25+ T lymphocytes (T REG). The purpose of this work was to analyze how Cyclosporine A (CsA), a widely used immunosuppressive drug, may affect T REG proliferation. Purified and activated murine DCs obtained from bone marrow precursors differentiated with rGMCSF were co-cultured with purified CFSE-labeled T REG from OTII mice, and their phenotype and proliferation analyzed by flow cytometry. Our data indicate that DCs differentiated in the presence of CsA show an altered phenotype, with a lower expression of MHC-II and a lower activating capacity. Additionally, these CsA-treated DCs show decreased production of IL-2 and IL-12 and increased IL-10 secretion when stimulated with LPS, indicating an effect on the polarization of the immune response. Interestingly, CsA-treated DCs show an anti-tolerogenic effect since they reduce the proliferation of T REG cells from 72 to 47%. Further inhibition to a 24% of T REG proliferation was obtained as a direct effect of CsA on T REG. In conclusion, the anti-tolerogenic effect of CsA should be considered in the planning of immunosuppression in the context of clinical transplantation.  相似文献   
83.
Most pockets in the human leukocyte antigen-group DR (HLA-DR) groove are shaped by clusters of polymorphic residues and, thus, have distinct chemical and size characteristics in different HLA-DR alleles. Each HLA-DR pocket can be characterized by "pocket profiles," a quantitative representation of the interaction of all natural amino acid residues with a given pocket. In this report we demonstrate that pocket profiles are nearly independent of the remaining HLA-DR cleft. A small database of profiles was sufficient to generate a large number of HLA-DR matrices, representing the majority of human HLA-DR peptide-binding specificity. These virtual matrices were incorporated in software (TEPITOPE) capable of predicting promiscuous HLA class II ligands. This software, in combination with DNA microarray technology, has provided a new tool for the generation of comprehensive databases of candidate promiscuous T-cell epitopes in human disease tissues. First, DNA microarrays are used to reveal genes that are specifically expressed or upregulated in disease tissues. Second, the prediction software enables the scanning of these genes for promiscuous HLA-DR binding sites. In an example, we demonstrate that starting from nearly 20,000 genes, a database of candidate colon cancer-specific and promiscuous T-cell epitopes could be fully populated within a matter of days. Our approach has implications for the development of epitope-based vaccines.  相似文献   
84.
The peripheral benzodiazepine receptor (PBR) has been implicated in several mitochondrial functions but the exact physiological role of this receptor is still under debate. Since the mitochondria have been attributed a central role in cell death, we have determined the effects of various PBR agonists and antagonists on the apoptosis of the human lymphoblastoid cell line U937. On this cell type, the PBR agonist Ro5-4864 was found to strongly protect the cells against apoptosis induced by TNFalpha. The antiapoptotic effect of PBR agonists was due to a selective interaction with the PBR as demonstrated by: (1) a close correlation between the antiapoptotic activity of various PBR agonists and their respective affinity for the PBR determined on the same cells, (2) a lack of effect of central benzodiazepine receptors agonists such as clonazepam on cell survival, (3) the lack of an antiapoptotic activity of Ro5-4864 on wild-type Jurkat cells (lacking the PBR receptor) and the reappearance of this effect on PBR-transfected Jurkat cells, and (4) the blockade of the antiapoptotic effect of PBR agonists by a selective PBR antagonist. The present results therefore indicate that PBR agonists are potent antiapoptotic compounds and show that this effect might represent a major function for this enigmatic receptor.  相似文献   
85.
86.
VEGFR-3 is essential for vascular development and maintenance of lymphatic vessel's integrity. Little is known about its cooperative effect with other receptors of the same family. Contrary to VEGFR-2, stimulation of VEGFR-3 by VEGF-C and -D failed to enhance its phosphorylation either in HEK293T or in PAE cells. These ligands were unable to induce angiogenesis of PAEC expressing VEGFR-3 alone. In the presence of VEGFR-2, VEGF-C and -D induced heterodimerization of VEGFR-3 with VEGFR-2. This heterodimerization was associated with enhanced VEGFR-3 phosphorylation and subsequent cellular responses as evidenced by the formation of capillary-like structures in PAE cells and proliferation of primary human endothelial cells expressing both receptors. Taken together, these results show for the first time that VEGFR-3 needs to be associated to VEGFR-2 to induce ligand-dependent cellular responses.  相似文献   
87.
Glaucoma is a leading cause of blindness worldwide. The disease is characterized by a degeneration of the optic nerve, which is usually associated with elevated intraocular pressure. The common form of adult-onset primary open-angle glaucoma is inherited as a complex trait, whereas the rarer early-onset juvenile open-angle glaucoma (JOAG) exhibits autosomal dominant inheritance. Of all cases of JOAG, approximately 10%-20% are caused by mutations in the myocilin gene. We have identified 25 pedigrees that are affected with typical JOAG and that demonstrate autosomal dominant inheritance. We sequenced the myocilin gene in probands from each family and found mutations in 8% of this population. To identify novel genes responsible for JOAG, we used families that did not have myocilin mutations for a genomewide screen. Markers located on chromosomes 9q22 and 20p12 showed evidence for linkage, identifying two novel loci for early-onset open-angle glaucoma.  相似文献   
88.
Down syndrome is the most common autosomal aberration among liveborns, characterised by several clinical features and metabolic disturbances. Aminoacid pathways abnormalities and defective oxidative balance are the most common metabolic problems in Down Syndrome. To evaluate the biochemical responses of children with Down Syndrome to a nutritional regimen supplemented with aminoacids, vitamins and polyunsaturated fatty acids, we submitted 86 subjects divided in two groups (0-6 and 6-12 years) to the dosage of plasma levels of aminoacids, antioxidant enzymes activities and reactive oxygen species, before and after 12 months of such nutritional supplementation and in relation to normal controls. The results obtained showed a tendency towards the values of normal subjects with statistically significant differences. Although other studies must be performed to confirm and define such report, our experience supports the usefulness of a nutritional supplementation with aminoacids, vitamins and polyunsaturated fatty acids, also considering the absence of side effects.  相似文献   
89.
To confirm that Mycobacterium tuberculosis chaperonin 10 (Cpn10) is secreted outside the live bacillus, infected macrophages were examined by electron microscopy. This revealed that the mycobacterial protein accumulates both in the wall of the bacterium and in the matrix of the phagosomes in which ingested mycobacteria survive within infected macrophages. To understand the structural implications underlying this secretion, a structural study of M. tuberculosis Cpn10 was performed under conditions that are generally believed to mimic the membrane environment. It was found that in buffer-organic solvent mixtures, the mycobacterial protein forms two main species, namely, a partially helical monomer that prevails in dilute solutions at room temperature and a dimer that folds into a beta-sheet-dominated structure and prevails in either concentrated protein solutions at room temperature or in dilute solutions at low temperature. A partially helical monomer was also found and was completely associated with negatively charged detergents in a micelle-bound state. Remarkably, zwitterionic lipids had no effect on the protein structure. By using N- and C-truncated forms of the protein, the C- and N-terminal sequences were identified as possessing an amphiphilic helical character and as selectively associating with acidic detergent micelles. When the study was extended to other chaperonins, it was found that human Cpn10 is also monomeric and partially helical in dilute organic solvent-buffer mixtures. In contrast, Escherichia coli Cpn10 is mostly dimeric and predominately beta-sheet in both dilute and concentrated solutions. Interestingly, human Cpn10 also crosses biological membranes, whereas the E. coli homologue is strictly cytosolic. These results suggest that dissociation to partially helical monomers and interaction with acidic lipids may be two important steps in the mechanism of secretion of M. tuberculosis Cpn10 to the external environment.  相似文献   
90.
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