(1)cell signaling

Upload: daryll-anne-lagtapon

Post on 02-Apr-2018

221 views

Category:

Documents


0 download

TRANSCRIPT

  • 7/27/2019 (1)Cell Signaling

    1/31

    "Receptor-ligand interactions

    - cell signaling, adhesion,

    motility, cell migration"

    Patricia Zuk, PhD

    Research Director

    Regenerative Bioengineering and Repair(REBAR) Lab

    Department of Surgery

    David Geffen School of Medicine at UCLA

  • 7/27/2019 (1)Cell Signaling

    2/31

    No cell lives in isolation

    survival depends on an elaborateintercellular communication network that

    coordinates growth, differentiation andmetabolism

    cells adjacent to one another frequentlycommunicate through cell-cell contact

    other forms of communication coverlarger distances = extracellular signalingmolecules

  • 7/27/2019 (1)Cell Signaling

    3/31

    Extracellular Signalling

    signaling molecules are released by signaling cells

    the signal is called the ligand

    the ligand binds to its specific receptoron a target cell

    this ligand-receptor interaction induces a conformational orshape-change in the receptor

    produces a specific response - called the cellular response

    can include a vast array of compounds

    e.g. small amino acid derivatives, small peptides,proteins

  • 7/27/2019 (1)Cell Signaling

    4/31

    Cell-to-cell communication by extracellular signaling usuallyinvolves six steps

    (1) synthesis of the signaling molecule by the signaling cell

    (2) release of the signaling molecule by the signaling cell

    (3) transport of the signal to the target cell

    (4) detection of the signal by a specific receptor protein receptor-ligand specificity

    (5) a change in cellular metabolism, function, or development =cel lu lar respon se

    triggered by the receptor-ligand complex specific to the ligand-receptor complex

    (6) removal of the signal, which usually terminates the cellularresponse degredation of ligand

  • 7/27/2019 (1)Cell Signaling

    5/31

    Signaling molecules operate over various distances in animals

    -extracellular signaling can occur over:

    1. large distanc es or endocr ine sign al ing signaling molecules are called

    hormones

    - act on target cells distant from their site of synthesis

    -usually carried through the bloodstream2. sho rt distances or paracr ine signal ing affects target cells within proximity

    to the cell that synthesized the molecule

    -usually mediated by neurotransmitters and some growth

    factors

  • 7/27/2019 (1)Cell Signaling

    6/31

    Signaling molecules operate over various distances in animals

    -extracellular signaling can occur over:

    3. no d istance or autocr ine sign al ing the signal feeds-back and affects

    itself

    -action of many growth factors

    -these compounds generally act on themselves toregulate proliferation

    -seen frequently in tumor cells

    -many compounds can act through two or even three types of cell signaling

    e.g. growth factors (e.g. EGF) paracrine and autocrine and endocrine

    -epinephrine endocrine and paracrine

  • 7/27/2019 (1)Cell Signaling

    7/31

    Circulating & Local Hormones

    Circulat ing

    hormones

    act on distant targets travel in blood endocrine hormones

    Local ho rmones

    paracrine hormones &autocrine hormones

  • 7/27/2019 (1)Cell Signaling

    8/31

    Hormones

    two types

    lipid soluble water soluble

  • 7/27/2019 (1)Cell Signaling

    9/31

    Lipid-Soluble Hormones

    -lipid-soluble hormones can easily

    enter a cell by diffusing through the

    plasma membrane

    -PROBLEM: how do they travel in the

    water-based blood??-SOLUTION: they are carried by

    carrier-proteins

    -these hormones then enter their

    target cell where they result in a

    specific cellular effect or response

  • 7/27/2019 (1)Cell Signaling

    10/31

    Water-soluble Hormones

    -water soluble hormones can easily travel within the blood

    -PROBLEM: how do they enter a cell and result in a cellular response??

    -SOLUTION: binding to specific cell-surface receptors

    -this binding activates the receptor and results in a series of cellular events called

    the second messenger system

  • 7/27/2019 (1)Cell Signaling

    11/31

    Lipid-soluble Hormones

    Steroids lipids derived from cholesterol in SER different functional groups attached tocore of structure provide uniqueness interact with specific intracellular

    receptors (within the cell) to turnspecific genes on or off

    effective for hours or days

    Thyro id hormones tyrosine ring plus attached iodines arelipid-soluble

    activate enzymes involved in thecatabolism of fats and glucose

    help set our basal metabolic rate Retinoids

    vitamin A derivatives have dramatic effects on proliferationand differentiation plus cellular death(i.e. apoptosis)

  • 7/27/2019 (1)Cell Signaling

    12/31

    Water-soluble Hormones

    Am ino acid der ivat ives,

    small pept ides andprotein hormones modified amino acids or

    amino acids put together serotonin, melatonin,

    histamine, epinephrine

    larger peptide hormones insulin and glucagon

    Eicosanoids

    derived from arachidonicacid(fatty acid) prostaglandins or

    leukotrienes

    prostaglandins despite beinglipidphilic bind to cell

    surface receptors

  • 7/27/2019 (1)Cell Signaling

    13/31

    Action of Lipid-Soluble Hormones

    Hormone diffusesthrough phospholipid

    bilayer & into cell

    Binds to receptor

    turning on/off specific

    genes

    New mRNA is formed

    & directs synthesis ofnew proteins

    New protein alters

    cells activity

  • 7/27/2019 (1)Cell Signaling

    14/31

    Action of Water-Soluble Hormones

    Can not diffuse through plasma

    membrane Hormone receptors are integral

    membrane proteins

    act as first messenger Receptor protein activates G-protein in

    membrane G-protein activates adenylate cyclase to

    convert ATP to cAMP in the cytosol

    Cyclic AMP is the 2nd messenger

    Activates kinases in the cytosol to

    speed up/slow down physiological

    responses

    Phosphodiesterase inactivates cAMP

    quickly

    Cell response is turned off unless

    new hormone molecules arrive

  • 7/27/2019 (1)Cell Signaling

    15/31

    Cell-surface receptors belong to four major classes

    GPCRsare involved in a range of signaling pathways, includinglight detection, odorant detection, and detection of certainhormones and neurotransmitters

    Many different mammalian cell-surface receptors includingGPCRs are coupled to a trimeric signal-transducing G protein

    made of an alpha, beta and gamm asubunit complex

    Ligand binding activates the receptor, which activates the Gprotein, which activates an effector enzym eto generate an

    in t racel lu lar second messenger e.g. adenyly l c yclaseconverts ATP to cAMP

    depending on regulation at the effector enzyme this pathwaycan be either activated or inhibited

    by the type of G protein activated by the hormone-receptorcomplex

    Gsproteins result in stimulation of the effector enzyme Giproteins result in inhibition of the effector enzyme

    adenyly l cy clase (AC)

  • 7/27/2019 (1)Cell Signaling

    16/31

    Four classes of cell-surface

    receptors

    -ligand binding changes the confirmation of the receptor so that specific ions flow

    through it

    -the resultant ion movement alters the electric potential across the plasmamembrane

    -found in high numbers on neuronal plasma membranes

    e.g. ligand-gated channels for sodium and potassium

    -also found on the plasma membrane of muscle cells

    -binding of acetylcholine results in ion movement and

    eventual contraction of muscle

  • 7/27/2019 (1)Cell Signaling

    17/31

    -lack intrinsic catalytic activity

    -binding of the ligand results in the formation of a receptor dimer (2 receptors)

    -this dimer than activates a class of protein called tyros ine kinases

    -this activation results in the phosphorylation of downstream targets by

    these tyrosine kinases (stick phosphate groups onto tyrosines withinthe target protein)

    -receptors for cytokines such as XXXX, interferons (XXXXXXX)

  • 7/27/2019 (1)Cell Signaling

    18/31

    -also called receptor tyros ine kinases OR ligand-tr iggered protein kinases

    -similar to tyrosine-linked receptors - ligand binding results in formation of a dimer

    -BUT: they differ from tyrosine-linked receptorsintr ins ic catalyt ic act iv i ty-means that ligand binding activates it and the activated receptor acts as a

    kinase

    -recognize soluble or membrane bound peptide/protein hormones that act as

    growth factors

    e.g. NGF, PDGF, insulin

    -binding of the ligand stimulates the receptors tyrosine kinase activity,-results in phosphorylation of multiple amino acid residues within its target

    such as serine and threonine residues

    -this phosphorylation activates downstream targets

    -its targets are generally other protein kinaseswhich phosphorylate their

    own downstream targets (other kinases??)

    Signal

    transductionCascade

  • 7/27/2019 (1)Cell Signaling

    19/31

    Signal transduction cascades

    -the successivephosphorylation/activation ofmultiple kinases results in acascade ofphosphorylation/activation

    -this cascade is frequently called as ignal-t ransdu ct ion cascade

    -this cascade eventually leads to aspecific cellular response

    e.g. changes in cellphysiology and/or patterns ofgene expression

    -RTK pathways are involved inregulation of cell proliferation anddifferentiation, promotion of cellsurvival, and

    modulation of cellular metabolism

    Signal

    KINASE #2

    KINASE #3

    TARGET

    EFFECT

    KINASE #1

    p

    p

    p

    p

  • 7/27/2019 (1)Cell Signaling

    20/31

    Second messengers

    produced by the activation of GPCRs and RTKs

    Hormone stimulation of Gs protein-coupled receptors leads to activationof adenyly l cyc laseand synthesis of the second messenger cAMP most commonly studied second messenger cAMP does not function in signal pathways initiated by RTKs cAMP and other second messengers activate specific protein kinases (cAMP-

    dependent protein kinases or PKAs)

    cAMP has a wide variety of effects depending on the cell type and thedownstream PKAs and other kinases in adipocytes, increased cAMP activates a PKA that stimulates production of fatty

    acids in ovarian cells another PKA will respond to cAMP by increase estrogen synthesis

    second messenger systems allow for ampl i f icat ionof an extracellularsignal

    one epinephine molecule can bind one GPCR this can result in the synthesis ofmultiple cAMP molecules which can go on to activate and amplified number ofPKAs

    a blood level as low as 10 -10M epinephrine can raise blood glucose levels by 50%

  • 7/27/2019 (1)Cell Signaling

    21/31

    Second messengers

    other second messengers include: IP3 and DAG breakdown products of phosphotidylinositol

    (PI) produced upon activation of multiple hormone receptor types

    (GPCRs and RTKs) calcium IP3 production results in the opening of calcium-channels on the plasma membrane of the ER release ofcalcium a rise in calcium in pancreatic beta cells triggers the exocytosis

    of insulin a rise in intracellular calcium also triggers contraction of

    muscle cells much study has been done on the binding of calcium to a

    protein called calmodul inand the effect of this complex ongene expression

  • 7/27/2019 (1)Cell Signaling

    22/31

    MAP kinase pathways

    best characterized signal transduction pathway activation of RTKs by growth factors, hormones etc.. result in activation of an adaptor protein called Ras GTPase ras induces a kinase signal cascade that starts with a kinase called rac

    and culminates in activation of a MAP kinase (MAPK) in between are a series of kinases that are part of the cascade MAPK activation results in translocation into the nucleus and

    phosphorylate many different proteins, including transcription factors thatregulate gene expression

  • 7/27/2019 (1)Cell Signaling

    23/31

    MAPK kinase paths

    StressCytokines

    StressHormonesCytokines

    MitogensHormones

    cdc42/rac

    MEKKs

    JNKK 1/2

    JNK 1/2

    elk

    jun

    ATFMAPKAP-2

    HSP27

    MEK 3/6

    MEKKs

    p38MAPK

    ATF

    elk

    cdc42/rac then activates one of three MAPK paths:

    Activation ofras/MEK/ERK path: proliferation &

    differentiation

    p38MAPK: stress response & apoptosis (MAPKAP-

    2, HSP27)

    Stress, cytokines, hormones & mitogens signal

    through cdc42/rac

    raf-1

    MEK 1/2

    ERK 1/2

    elk

    RSK

    ras

    grb2

    sos

    fos

    JNK: stress response & proliferation (jun)

    transcription

    factors (nucleus)

    MAPK kinase

  • 7/27/2019 (1)Cell Signaling

    24/31

    Common signaling pathways are initiated by differentreceptors in a class

    The effects of activation of GPCRsand RTKs is more complicated thana simple step-by-step cascade

    Stimulation of either GPCRs orRTKs often leads to production ofmultiple second messengers, andboth types of receptors promote orinhibit production of many of thesame second messengers

    in addition, RTKs can promote asignal transduction cascade thateventually acts on the same targetas the GPCR

    therefore the same cellular

    response may be induced bymultiple signaling pathways bydistinct mechanisms

    Interaction of different signalingpathways permits fine-tuning ofcellular activities

  • 7/27/2019 (1)Cell Signaling

    25/31

    Integrating Cells into Tissues:

    Cell-Cell Adhesion and Communication

    -a key event in the evolution of multicellularity is the ability for cells to adhere to one

    another and be able to communicate with each other

    -evolved a series ofcel l-adhesion moleculesorCAMsthat allow interaction with

    each other and with the surrounding extracellular matrix (ECM)

    -this results in coordinated functioning of tissues

    -HOW??

    -these interactions result in the activation of specific signal transduction

    cascades eventually resulting in the desired cellular effect

    -therefore the physical interaction of CAMs with the ECM can turn pathways on oroff cellular effect

    e.g. cellular interactions with the adhesion protein b1-integrin can result in

    activation of the MAPK cascade

  • 7/27/2019 (1)Cell Signaling

    26/31

    -various classes of CAMs found on cells

    1. cadherins cell-cell adhesion

    -calcium dependent

    e.g, E-cadherin, P-cadherin

    2. Ig superfamily of CAMs cell-cell adhesion

    e.g. N-CAM, V-CAM

    -calcium-independent

    -some are found enriched on specific cell types N-CAM

    3. Integri ns major cell-matrix adhesion molecule

    e.g. a1 integrin, b1 integrin

  • 7/27/2019 (1)Cell Signaling

    27/31

    Cell-Cell adhesion: Cadherin-containing junctions

    1. Adherens junction

    2. Desmosome

    -cadherins are a family of calcium-dependent

    CAMs

    -major molecules of cell-cell adhesion (homophilic)

    -over 40 different are knowne.g. E or epithelial cadherin

    N or neural cadherin

    -tissues have specialized junctions made of cadherins

    1. adher ens j un ct io n continuous band of

    cadherins found in epithelial cells

    -connects cells tightly and interact

    with the actin portion of the cytoskeleton2. desm osomes also found in high #s in

    epithelial tissues

    -cells attach via cadherins connect

    to protein plaques that attach to the

    plasma membrane and to intermediate

    filaments within the cytoskeleton

  • 7/27/2019 (1)Cell Signaling

    28/31

    Cell Matrix

    three components to the ECM

    insoluble col lagens structural framework of the ECM,provides strength and resiliency

    proteoglycans cushions cells adhesive matr ix proteins bind these components to

    receptors on the cell surface

    different combinations result in unique ECM compositionswhich can directly affect the activity of the cells

    the interaction of ECM components with specific CAMs (i.e.ECM receptors) can turn certain signaling paths ON or OFF

    also the ECM is capable of sequestering growth factors andhormones by binding them and making them unavailable toturn cellular signaling on or off

  • 7/27/2019 (1)Cell Signaling

    29/31

    Cell-matrix interactions: integrins

    integrins allow connection between the extracellular matrix with the cytoskeleton of the cell also can mediate cell-cell interactions (weak)

    made of an alpha and a beta subunit 17 types ofa chains, 8 types ofb chains

    these ab complexes act as receptors to specific matrix components e.g. a1b1 collagen and laminin a5 b1 - fibronectin

    cells will express multiple integrin types

    attachment can be regulated by up- or down-regulated expression of these integrins integrins can also form very specific adhesive junctions

    foca l adhesions(FN to actin) complex of more than 20 proteins can increase and decrease based on physical stress

    hemidesmosomes(intermediate filaments to collagens and laminins) epithelial cells

    activation of these integrins can promote cell signaling

    e.g. formation and activation of focal adhesions triggers a cascade initaited by aFocal Adhesion Kinase (FAK) modulates cell growth and motility

  • 7/27/2019 (1)Cell Signaling

    30/31

    Cell-Cell Communication: Gap Junctions

    -almost all cells have specialized junctions

    that allow the free passage of materials(e.g. signaling molecules) back and forth

    -these junctions = gap junc t ions

    -made of a channel protein called connexon

    -connexons interact to form channels between

    two cells

    -one important compound small enough totraverse this junction is the second messenger

    cAMP

    -also allows passage of calcium ions and other

    ions crucial to signaling (sodium, phosphate)

    -these gaps are not free-swinging gates

    -they actually open and close inresponse to ion concentrations

    thereby restricting the flow of too

    many ions

    -they also exclude materials based

    on size

  • 7/27/2019 (1)Cell Signaling

    31/31

    Cell-Cell and Cell-Matrix interactions can activatesignal transduction cascades J Biomed Sci. 2006 Feb 23; Crosstalk between hepatocyte growth factor and integrin

    signaling pathways.Chan PC, Chen SY, Chen CH, Chen HC

    J Neurochem. 2006 Jan;96(1):148-59Fibronectin promotes brain capillary endothelial cell survival and proliferation throughalpha5beta1 and alphavbeta3 integrins via MAP kinase signalling. Wang J, Milner R.

    Immunopharmacol Immunotoxicol. 2005;27(3):371-93.Interleukin-3, -5, and granulocyte macrophage colony-stimulating factor induce adhesionand chemotaxis of human eosinophils via p38 mitogen-activated protein kinase andnuclear factor kappaB. Ip WK, Wong CK, Wang CB, Tian YP, Lam CW.

    Cell Commun Adhes. 2004 Sep-Dec;11(5-6):137-53.ERK signaling pathways regulate the osteogenic differentiation of human mesenchymalstem cells on collagen I and vitronectin. Salasznyk RM, Klees RF, Hughlock MK, PlopperGE.

    Microsc Microanal. 2005 Jun;11(3):200-8.Cross talk between cell-cell and cell-matrix adhesion signaling pathways during heartorganogenesis: implications for cardiac birth defects.Linask KK, Manisastry S, Han M.

    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chan+PC%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chen+SY%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chen+CH%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chen+HC%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/utils/lofref.fcgi?PrId=3046&uid=16269008&db=pubmed&url=http://dx.doi.org/10.1111/j.1471-4159.2005.03521.xhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Wang+J%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Milner+R%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/utils/lofref.fcgi?PrId=3396&uid=16237950&db=pubmed&url=http://taylorandfrancis.metapress.com/openurl.asp?genre=article&issn=0892-3973&volume=27&issue=3&spage=371http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Ip+WK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Wong+CK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Wang+CB%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Tian+YP%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Lam+CW%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Salasznyk+RM%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Klees+RF%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Hughlock+MK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Plopper+GE%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Plopper+GE%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Linask+KK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Manisastry+S%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Han+M%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Han+M%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Manisastry+S%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Linask+KK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Plopper+GE%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Plopper+GE%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Hughlock+MK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Klees+RF%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Salasznyk+RM%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Lam+CW%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Tian+YP%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Wang+CB%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Wong+CK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Ip+WK%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/utils/lofref.fcgi?PrId=3396&uid=16237950&db=pubmed&url=http://taylorandfrancis.metapress.com/openurl.asp?genre=article&issn=0892-3973&volume=27&issue=3&spage=371http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Milner+R%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Wang+J%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/utils/lofref.fcgi?PrId=3046&uid=16269008&db=pubmed&url=http://dx.doi.org/10.1111/j.1471-4159.2005.03521.xhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chen+HC%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chen+CH%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chen+SY%22%5BAuthor%5Dhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Chan+PC%22%5BAuthor%5D