O carcinoma epidermóide por se tratar de uma doença genética, apresenta dificuldades em relação ao seu tratamento. As vias de sinalização celular por controlarem os mecanismos responsáveis pela proliferação e sobrevivência da célula, são de extrema importância nos estudos da biologia do câncer e oncogênese. Aberrações cromossômicas que afetam a estrutura e a expressão de genes e proteínas que regulam componentes das vias de sinalização são diretamente correlacionadas com o desenvolvimento e progressão tumoral. Vários genes e proteínas vêm sendo avaliados na busca de um alvo terapêutico quimioterápico, algo pouco estudado em carcinomas epidermóides bucais. Este trabalho teve como objetivo analisar a influência do quimioterápico 17-AAG e do fator de crescimento epitelial (EGF) nos níveis das proteínas NFkB, Ciclina D1 e Cdk4 nas linhagens de carcinoma epidermóide de cabeça e pescoço (HN6 e HN31) e no queratinócito imortalizado (HaCat). Este trabalho destinou-se também a estudar uma possível inter-relação entre as proteínas Metalotioneína e NFkB e suas interações com as proteínas Ciclina D1 e Cdk4 nas linhagens celulares HN6 , HN31 e (HaCat, para uma maior compreensão de seus efeitos nas vias de sinalização celular e conseqüente progressão do câncer). Para análise a respeito da localização e os níveis das proteínas MT, NFkB, Ciclina D1 e Cdk4 foram utilizados ensaios de imunofluorescência e western blot, respectivamente.Os resultados apontaram um melhor perfil apoptótico da linhagem HN31 frente ao tratamento com 17-AAG, apresentando diminuição significante dos níveis de NFkB e Ciclina D1, além de exibir importante decréscimo nos níveis de Cdk4. A proteína MT parece não sofrer ação do NFkB. A indução de proliferação celular realizada por EGF exerceu um aumento dos níveis das proteínas NFkB e Ciclina D1, sugerindo um papel importante das vias de sinalização estimuladas por EGF (Akt, NFkB e Ciclina D1) na progressão tumoral dessas linhagens.Por fim, a ocorrência de estímulo nos níveis da proteína MT por parte do EGF, sugeriram um importante papel do EGF e da MT na resistência a apoptose nas linhagens estudadas. / Squamous cell carcinomas as a genetic diseases, presents certain difficulties in relation to their treatment. The process of cell signaling for overseeing the mechanisms responsible for cellular proliferation and survival are very important in studies of the biology of cancer and development. Chromosomal alterations affecting the structure and expression of genes and proteins that regulate the process of signaling components are directly correlated with the development and tumor progression. Several genes and proteins are being evaluated in the search for a biological marker that could help in the understanding of cancer as well as in its prognosis, and mainly in search of therapeutic target chemotherapy, something little studied in oral squamous cell carcinoma. This study aimed to examine the influence of chemotherapy 17-AAG and the epithelial growth factor (EGF) in the levels of proteins NFkB, Cyclin D1 and Cdk4 in strains of squamous cell carcinoma of the head and neck (HN6 and HN31) and immortalized in keratinocytes(HaCat). This work is also intended to explore a possible inter-relationship between the Metallothionein and NFkB proteins and their interactions with the proteins Cyclin D1 and Cdk4 in cell lines HN6, HN31 and (HaCat, to a greater understanding of its effects on pathways of cellular signaling and consequent progression of cancer. For analysis regarding the location and levels of the protein MT, NFkB, Cyclin D1 and Cdk4 were used tests of immunofluorescence and western blot. Results showed a better apoptotic profile of HN31 treated with 17-AAG, showing decrease levels of NFkB and Cyclin D1, with a important decrease in the levels of Cdk4. The metallothionin protein does not appear to suffer action of NFkB. The induction of cell proliferation conducted by EGF had increased levels of NFkB and Cyclin D1 proteins, suggesting an important role in the process of signaling stimulated by EGF (Akt, NFkB and Ciclina D1) in tumor progression of oral squamous cell carcinoma. The occurrence to stimulate the levels of metallothionein protein by the EGF, suggest an important role of EGF and MT in resistance to apoptosis in the studied cell lines.

O carcinoma epidermóide de cabeça e pescoço é responsável por 90% das neoplasias malignas, nesta região. Molecularmente, inúmeras vias de sinalização, ainda não muito bem compreendidas, são responsáveis pelo seu crescimento e invasão para tecidos vizinhos, além de metástases para órgãos distantes. Este trabalho destinou-se a avaliar o crosstalk entre as vias de sinalização do Wnt e PI3K, quando células de carcinoma epidermóide (HN6 e HN31) e queratinócitos imortalizados (HaCat), foram estimulados com 50nM Wortmannin (metabólito fúngico que mimetiza a função da PTEN) e 10ng/ml EGF (fator de crescimento epitelial). Para isto, proteínas-chave, pertencentes a estas vias, foram localizadas e quantificadas no interior celular: PTEN, ?-catenina, Akt, pAkt e Ciclina D1. As técnicas de imunofluorescência e western blot foram utilizadas, respectivamente, para observar a localização e os níveis destas proteínas, nos diferentes compartimentos celulares. Os resultados mostraram que a ativação da via do PI3K, pelo EGF, promoveu a proliferação celular, independentemente da via de sinalização do Wnt. Quando as células foram tratadas com wortmannin, houve depleção dos níveis citosólicos e totais de pAkt associada ao acúmulo citoplasmático de ciclina D1. Igualmente, não houve alteração nos níveis da proteína ?-catenina. Ademais, detectou-se a presença de PTEN nuclear em todas as linhagens estudadas. Desta forma, estas células de carcinoma epidermóide de cabeça e pescoço, apresentaram mecanismos de bloqueio e de ativação da proliferação celular, predominantemente, por atividade das proteínas PTEN (atividades citoplasmática e nuclear) e Akt, após o tratamento com wortmannin e EGF. / Head and neck squamous cell carcinoma (HNSCC) represents 90% of all head and neck malignancies. Cancer growth, invasion and metastasis are due to several signaling pathways that, unfortunately, are not completely understood. The aim of this study was the crosstalk evaluation between PI3K and Wnt signaling pathways in two different HNSCC cell lines (HN6 and HN31) and HaCat cell line (immortalized keratinocytes), treated with 50nM wortmannin and 10ng/ml EGF (epidermal growth factor). Western blot and imunofluorescence were performed in order to analyze Wnt, PTEN and PI3K signaling key target proteins: PTEN, Akt, CyclinD1 and ?-catenin. Results showed that ?-cateninindependent cellular proliferation was promoted by PI3K signaling pathway EGF-dependent activation. After wortmannin treatment, correlation between decreased phospho-Akt levels and cytosolic cyclin D1 accumulation was found. Also, all cell lines exhibited nuclear PTEN activity. Taking these results together, we conclude that the Cyclin D1 positive and negative modulations, after EGF and wortmannin treatments, were due to, respectively, Akt and PTEN proteins.

NRH quinone oxidoreductase 2 (NQO2) is regarded as a mammalian Phase I detoxifying enzyme responsible for reducing quinones to hydroquinones. NQO2 is highly expressed in different types of cancer such as breast and prostate cancer suggesting its participatory role in the progression of these diseases. A potential reason for this is that NQO2 has the ability to modulate the stability of cyclin D1 and activity of NF-ÃŽÂoB and it has been shown that inhibition of NQO2, either genetically or pharmacologically, can alter the pattern of proliferation of cancer cells. However, the biological roles of NQO2 in cancer progression are still ambiguous and need further investigation. A panel of seven ovarian cancer cell lines (OVCs) were screened for the presence and functionality of NQO2. SKOV-3 and TOV-112D cells expressing comparatively the highest and lowest levels of NQO2 were stably transduced to silence and overexpress NQO2 respectively. Pharmacological inhibition was achieved using resveratrol or a series of novel 4-aminoquinolines synthesised in-house. Cell proliferation was monitored by cell counting and clonogenic assays. Flow cytometric analysis was used to determine cell cycle distribution and levels of ROS following modulation of NQO2 function. The expression of cell cycle regulatory markers was determined by Western blot. The contributory roles of NQO2 in determining the cytotoxicity of Adriamycin (ADR) towards OVCs was investigated using MTT assay together with evaluation of P-gp expression and basal ROS levels. In the OVCs panel, NQO2 protein levels and enzymatic activity showed an excellent correlation; with activity varying 36-fold between the cell lines. The sensitivity of OVCs to CB1954 was significantly increased when combined with the NRH-like co-factor, EP0152R. This supports the notion that NQO2 mediates the toxicity of CB1954, which is further confirmed by the strong correlation between cellular NQO2 activity and the responsiveness of the OVC cell lines to CB1954. Hydrazone quinolines showed the highest inhibitiory potency against NQO2 in SKOV-3 when compared to the typical and in-house synthesised quinolines inhibitors. NQO2-overexpressing TOV-112D cells showed more aggressive growth pattern and higher capacity to form colonies than wild-type cells. This was consistently associated with an enhancement in the progression of cells through cell cycle phases and significant reduction in Rb expression. A reduction in ROS levels in NQO2-OE cells may also explain this enhancement in cell growth. Overexpressing NQO2 also resulted in destabilisation of CDK4 and cyclin D1 with significant reduction in their expression levels, and concomitant increase in p-cyclin D1 (Thr286). The involvement of NQO2 in controlling cyclin D1 turnover is also confirmed in SKOV-3 cells when genetic silencing of NQO2 was accompanied by significant reduction in p-cyclin D1 and subsequent stabilisation of cyclin D1 levels. In spite of this, no alterations in the growth pattern of SKOV-3 cells were observed highlighting the impact of cell type on the variations in cellular responses. The role of NQO2 in determining the toxicity of ADR treatment was not proved in OVC cells. This was despite that modulation of NQO2 levels caused significant changes in P-gp expression. The intracellular basal levels of ROS was found to affect the responsiveness of OVCs to ADR as demonstrated when treating SKOV-3 with resveratrol was accompanied by significant increase in ROS levels and concomitant enhancement in the cells’ response to ADR. In conclusion, NQO2 can profoundly alter the proliferation characteristics of OVCs and is a potential therapeutic target for the treatment of this disease. However, the biological functions of NQO2 and its contributory roles in particular pathways are varied among different types of cancer -in other words- are highly dependent on cancer type.

O carcinoma epidermóide de cabeça e pescoço é responsável por 90% das neoplasias malignas, nesta região. Molecularmente, inúmeras vias de sinalização, ainda não muito bem compreendidas, são responsáveis pelo seu crescimento e invasão para tecidos vizinhos, além de metástases para órgãos distantes. Este trabalho destinou-se a avaliar o crosstalk entre as vias de sinalização do Wnt e PI3K, quando células de carcinoma epidermóide (HN6 e HN31) e queratinócitos imortalizados (HaCat), foram estimulados com 50nM Wortmannin (metabólito fúngico que mimetiza a função da PTEN) e 10ng/ml EGF (fator de crescimento epitelial). Para isto, proteínas-chave, pertencentes a estas vias, foram localizadas e quantificadas no interior celular: PTEN, ?-catenina, Akt, pAkt e Ciclina D1. As técnicas de imunofluorescência e western blot foram utilizadas, respectivamente, para observar a localização e os níveis destas proteínas, nos diferentes compartimentos celulares. Os resultados mostraram que a ativação da via do PI3K, pelo EGF, promoveu a proliferação celular, independentemente da via de sinalização do Wnt. Quando as células foram tratadas com wortmannin, houve depleção dos níveis citosólicos e totais de pAkt associada ao acúmulo citoplasmático de ciclina D1. Igualmente, não houve alteração nos níveis da proteína ?-catenina. Ademais, detectou-se a presença de PTEN nuclear em todas as linhagens estudadas. Desta forma, estas células de carcinoma epidermóide de cabeça e pescoço, apresentaram mecanismos de bloqueio e de ativação da proliferação celular, predominantemente, por atividade das proteínas PTEN (atividades citoplasmática e nuclear) e Akt, após o tratamento com wortmannin e EGF. / Head and neck squamous cell carcinoma (HNSCC) represents 90% of all head and neck malignancies. Cancer growth, invasion and metastasis are due to several signaling pathways that, unfortunately, are not completely understood. The aim of this study was the crosstalk evaluation between PI3K and Wnt signaling pathways in two different HNSCC cell lines (HN6 and HN31) and HaCat cell line (immortalized keratinocytes), treated with 50nM wortmannin and 10ng/ml EGF (epidermal growth factor). Western blot and imunofluorescence were performed in order to analyze Wnt, PTEN and PI3K signaling key target proteins: PTEN, Akt, CyclinD1 and ?-catenin. Results showed that ?-cateninindependent cellular proliferation was promoted by PI3K signaling pathway EGF-dependent activation. After wortmannin treatment, correlation between decreased phospho-Akt levels and cytosolic cyclin D1 accumulation was found. Also, all cell lines exhibited nuclear PTEN activity. Taking these results together, we conclude that the Cyclin D1 positive and negative modulations, after EGF and wortmannin treatments, were due to, respectively, Akt and PTEN proteins.

O carcinoma epidermóide por se tratar de uma doença genética, apresenta dificuldades em relação ao seu tratamento. As vias de sinalização celular por controlarem os mecanismos responsáveis pela proliferação e sobrevivência da célula, são de extrema importância nos estudos da biologia do câncer e oncogênese. Aberrações cromossômicas que afetam a estrutura e a expressão de genes e proteínas que regulam componentes das vias de sinalização são diretamente correlacionadas com o desenvolvimento e progressão tumoral. Vários genes e proteínas vêm sendo avaliados na busca de um alvo terapêutico quimioterápico, algo pouco estudado em carcinomas epidermóides bucais. Este trabalho teve como objetivo analisar a influência do quimioterápico 17-AAG e do fator de crescimento epitelial (EGF) nos níveis das proteínas NFkB, Ciclina D1 e Cdk4 nas linhagens de carcinoma epidermóide de cabeça e pescoço (HN6 e HN31) e no queratinócito imortalizado (HaCat). Este trabalho destinou-se também a estudar uma possível inter-relação entre as proteínas Metalotioneína e NFkB e suas interações com as proteínas Ciclina D1 e Cdk4 nas linhagens celulares HN6 , HN31 e (HaCat, para uma maior compreensão de seus efeitos nas vias de sinalização celular e conseqüente progressão do câncer). Para análise a respeito da localização e os níveis das proteínas MT, NFkB, Ciclina D1 e Cdk4 foram utilizados ensaios de imunofluorescência e western blot, respectivamente.Os resultados apontaram um melhor perfil apoptótico da linhagem HN31 frente ao tratamento com 17-AAG, apresentando diminuição significante dos níveis de NFkB e Ciclina D1, além de exibir importante decréscimo nos níveis de Cdk4. A proteína MT parece não sofrer ação do NFkB. A indução de proliferação celular realizada por EGF exerceu um aumento dos níveis das proteínas NFkB e Ciclina D1, sugerindo um papel importante das vias de sinalização estimuladas por EGF (Akt, NFkB e Ciclina D1) na progressão tumoral dessas linhagens.Por fim, a ocorrência de estímulo nos níveis da proteína MT por parte do EGF, sugeriram um importante papel do EGF e da MT na resistência a apoptose nas linhagens estudadas. / Squamous cell carcinomas as a genetic diseases, presents certain difficulties in relation to their treatment. The process of cell signaling for overseeing the mechanisms responsible for cellular proliferation and survival are very important in studies of the biology of cancer and development. Chromosomal alterations affecting the structure and expression of genes and proteins that regulate the process of signaling components are directly correlated with the development and tumor progression. Several genes and proteins are being evaluated in the search for a biological marker that could help in the understanding of cancer as well as in its prognosis, and mainly in search of therapeutic target chemotherapy, something little studied in oral squamous cell carcinoma. This study aimed to examine the influence of chemotherapy 17-AAG and the epithelial growth factor (EGF) in the levels of proteins NFkB, Cyclin D1 and Cdk4 in strains of squamous cell carcinoma of the head and neck (HN6 and HN31) and immortalized in keratinocytes(HaCat). This work is also intended to explore a possible inter-relationship between the Metallothionein and NFkB proteins and their interactions with the proteins Cyclin D1 and Cdk4 in cell lines HN6, HN31 and (HaCat, to a greater understanding of its effects on pathways of cellular signaling and consequent progression of cancer. For analysis regarding the location and levels of the protein MT, NFkB, Cyclin D1 and Cdk4 were used tests of immunofluorescence and western blot. Results showed a better apoptotic profile of HN31 treated with 17-AAG, showing decrease levels of NFkB and Cyclin D1, with a important decrease in the levels of Cdk4. The metallothionin protein does not appear to suffer action of NFkB. The induction of cell proliferation conducted by EGF had increased levels of NFkB and Cyclin D1 proteins, suggesting an important role in the process of signaling stimulated by EGF (Akt, NFkB and Ciclina D1) in tumor progression of oral squamous cell carcinoma. The occurrence to stimulate the levels of metallothionein protein by the EGF, suggest an important role of EGF and MT in resistance to apoptosis in the studied cell lines.

Avaliamos neste estudo as expressões da ciclina D1 e da proteína p21, pela técnica de Imuno-histoquímica, para detectar a presença destas proteínas nos núcleos das células do câncer de mama localmente avançado, com o objetivo de correlacionar a concentração destas proteínas com aresposta preditiva ao tratamento quimioterápico neo-adjuvante, utilizandoo esquema docetaxel associado à epirrubicina. A avaliação foi feita previamente e após a realização da quimioterapia neo-adjuvante. A avaliação pré-quimioterápica teve a finalidade de estabelecer um papel preditivo quanto à resposta ao tratamento primário. A avaliação pós-quimioterápica teve a finalidade de explorar a relação entre a persistência da proteína com intervalo livre de doença e sobrevida global. Foram selecionados 72 casos de 162 tumores localmente avançados de mama atendidos no período de janeiro de 1998 a dezembro de 2005, tratados por quimioterapia primária no Ambulatório de Mastologiado Hospital das Clínicas de Ribeirão Preto. Conclusão: a ciclina D1 está relacionada com tumores menores, bem diferenciados e hormônio-sensíveis. Já a proteína p21 está relaciona a tumores pequenos, com estádios iniciais menores, de baixo grau histológico e hormônio-sensíveis. A expressão da ciclina D1 no tumor pré-tratamento quimioterápico não foi capaz de predizer resposta à quimioterapia neo-adjuvante. No entanto, a presença da ciclina D1 e no tumor residual e da p21tanto no tumor pré-tratamento quanto no tumor residual, sugerem melhora no intervalo livre de doença e na sobrevida global. / We evaluate in this study the expressions of the cyclin D1 and the protein p21, with the technique of Immunohistochemistry, todetect the presence of these proteins in the cells of the local advanced breast cancer. The objective was correlate the concentration of these proteins with predictive response to the neo-adjuvant chemotherapy, using docetaxel associated with epirrubicina. The evaluation was performed before and after the neo-adjuvant chemotherapy. The evaluation before the neo-adjuvant treatment had the purpose to establish a predictive value of these proteins with primary treatment response. The evaluations after neo-adjuvant treatment had the purpose to explore the relation between the persistence of these proteins with disease-free survival and overall survival. We selected 72 of 162 cases of local advanced breast cancer who had treated for primary chemotherapy in Hospital das Clínicas de Ribeirão Preto in the period of January of 1998 to December of 2005. Conclusion: Our study concluded that the cyclin D1 is related with small tumors and well differentiated and hormone-sensitive tumors. The protein p21 is relates with small tumors, initial stage tumors, low grade tumors and hormone-sensitive tumors. The expression of cyclin D1 in the tumor before the treatment failed to predict response to the neo-adjuvant chemotherapy. However, the presence of the cyclin D1 in the residual tumor andthe protein p21 before the treatment and in the residual tumors suggest improvement in the disease- free survival and overall survival.

Abstract Breast cancer is the most common cancer affecting the female population of the Western world. It is a heterogeneous disease entity that encompasses tumors with remarkably different forms of behaviour, and it is therefore vital to distinguish patients with good and poor prognoses. The classical prognostic and predictive factors for breast cancer serve as tools for clinical oncologists when planning treatment, but the growing awareness of breast cancer biology is bringing about a need for novel prognostic and predictive biomarkers. This thesis examines the prognostic significance of hypoxia response and cell cycle regulators in ductal breast cancer and in triple-negative breast cancer (negative for hormone receptors and human epidermal growth factor receptor 2), concluding that PHD2 and PHD3 are associated with a good prognosis, while the role of PHD1 is controversial, as it is associated with proliferation in ductal breast cancer but with node-negative status in triple-negative breast cancer. In our experiments HIF-1α redeemed its role as a marker of an adverse prognosis, whereas the role of HIF-2α appeared to be the opposite. Our data suggest that PHDs can have other targets than the HIF-αs, and that triple-negative breast tumors express more HIF-1α and less HIF-2α and PHD3 than those with a good prognosis. Furthermore, we identified cyclin D1 as a biomarker with independent prognostic significance in ductal breast cancer, being associated with good prognostic factors and a better outcome, whereas the opposite was seen in triple-negative breast cancer. CDK4 was associated with high proliferation in triple-negative breast cancer. In addition, high levels of p16 correlated with increased survival in breast cancer patients independently of receptor status. / Tiivistelmä Rintasyöpä on naisten yleisin syöpä läntisessä maailmassa. Rintasyöpä on heterogeeninen tautiryhmä, jossa kasvaimet vaihtelevat biologiselta käyttäytymiseltään huomattavasti. Tästä syystä on tärkeää erottaa hyvä- ja huonoennusteiset potilaat. Syöpälääkärit käyttävät klassisia ennustetekijöitä hoitopäätöksiä tehdessään, mutta lisääntynyt tieto rintasyövän biologiasta on saanut aikaan tarpeen löytää uusia ennustetekijöitä. Tässä väitöskirjatyössä tutkimme hypoksiavasteen ja solusyklin säätelijöiden ennusteellisuutta duktaalisessa rintasyövässä sekä kolmoisnegatiivisessa (ei ilmennä hormonireseptoreita eikä epidermaalikasvutekijäreseptoria) rintasyövässä. PHD2 ja PHD3:n vahva ilmentyminen liittyi parempaan ennusteeseen, mutta PHD1:n esiintymisen vaikutus oli ristiriitainen. PHD1:n ilmentyminen liittyi lisääntyneeseen solujakautumiseen duktaalisessa rintasyövässä, mutta kolmoisnegatiivisessa rintasyövässä sen esiintyminen liittyi vähentyneeseen imusolmukemetastasointiin. Tutkimuksessamme HIF-1α osoittautui huonon ennusteen merkiksi. Sitä vastoin HIF-2α:n ilmentymisen vaikutus näytti liittyvän parempaan ennusteeseen. Tuloksemme osoittavat, että PHD-entsyymeillä on mahdollisesti muitakin kohteita kuin HIF-α:t. Osoitimme myös, että HIF-1α:n ilmentyminen on yleisempää ja HIF-2α:n sekä PHD3:n ilmentyminen vähäisempää kolmoisnegatiivisessa kuin duktaalisessa rintasyövässä. Lisäksi totesimme, että sykliini D1 on itsenäinen ennustetekijä liittyen parempaan ennusteeseen duktaalisessa rintasyövässä. Huomioitavaa on kuitenkin, että kolmoisnegatiivisessa rintasyövän alaryhmässä sykliini D1:n esiintyminen oli huonon ennusteen merkki. CDK4 osoittautui voimakkaan proliferaation merkiksi kolmoisnegatiivisessa rintasyövässä. Lisäksi osoitimme, että p16:n ilmentyminen liittyy parempaan ennusteeseen sekä duktaalisessa rintasyövässä että kolmoisnegatiivisessa rintasyövässä.

A thesis on Head and neck cancer focusing on dose planning, salivary gland carcinoma and Single nucleotide polymorphism. For dose planning PET/CT (Positron emissions tomography/computed tomography) with tracer gave more precise information in comparison dose planning with CT. More primary tumours and metastases were found with the acetate tracer than with glucose tracer. Acetate PET/CT also showed larger volume of tumours attributed to lipid metabolism. In a retrospective study salivary gland cancer 5-year overall survival (OS) was 53 %. Salivary gland carcinoma consists of many histopathological groups, the two largest groups being mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ASCC). For ACC, having the best 5-year OS, it was 70 percent. Facial palsy, advanced stage disease, lymph node metastases worsened prognosis. ACC and polymorphous low grade carcinoma (PLGA) expressed c-myc and cyclin D1 to a larger extent than MEC. In squamous cell carcinoma of the head and neck we examined the occurrence of Single Nucleotide polymorphism, SNP. We found that the SNPs in male and female patients differed from each other. In male patients the SNPs were associated with immune response while in female patients the association was to SNPs concerning inflammation. This means that different pathways were engaged in cancer development for men and women. We also found that the SNPs in patients were different from those expressed in the healthy controls.

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No description available.