Proteomic Profiling of Cranial (Superior) Cervical Ganglia Reveals Beta-Amyloid and Ubiquitin Proteasome System Perturbations in an Equine Multiple System Neuropathy[S]
Equine grass sickness (EGS) is an acute, predominantly fatal, multiple system neuropathy of grazing horses with reported incidence rates of ∼2%. An apparently identical disease occurs in multiple species, including but not limited to cats, dogs, and rabbits. Although the precise etiology remains unc...
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creator | McGorum, Bruce C. Pirie, R. Scott Eaton, Samantha L. Keen, John A. Cumyn, Elizabeth M. Arnott, Danielle M. Chen, Wenzhang Lamont, Douglas J. Graham, Laura C. Llavero Hurtado, Maica Pemberton, Alan Wishart, Thomas M. |
description | Equine grass sickness (EGS) is an acute, predominantly fatal, multiple system neuropathy of grazing horses with reported incidence rates of ∼2%. An apparently identical disease occurs in multiple species, including but not limited to cats, dogs, and rabbits. Although the precise etiology remains unclear, ultrastructural findings have suggested that the primary lesion lies in the glycoprotein biosynthetic pathway of specific neuronal populations. The goal of this study was therefore to identify the molecular processes underpinning neurodegeneration in EGS. Here, we use a bottom-up approach beginning with the application of modern proteomic tools to the analysis of cranial (superior) cervical ganglion (CCG, a consistently affected tissue) from EGS-affected patients and appropriate control cases postmortem. In what appears to be the proteomic application of modern proteomic tools to equine neuronal tissues and/or to an inherent neurodegenerative disease of large animals (not a model of human disease), we identified 2,311 proteins in CCG extracts, with 320 proteins increased and 186 decreased by greater than 20% relative to controls. Further examination of selected proteomic candidates by quantitative fluorescent Western blotting (QFWB) and subcellular expression profiling by immunohistochemistry highlighted a previously unreported dysregulation in proteins commonly associated with protein misfolding/aggregation responses seen in a myriad of human neurodegenerative conditions, including but not limited to amyloid precursor protein (APP), microtubule associated protein (Tau), and multiple components of the ubiquitin proteasome system (UPS). Differentially expressed proteins eligible for in silico pathway analysis clustered predominantly into the following biofunctions: (1) diseases and disorders, including; neurological disease and skeletal and muscular disorders and (2) molecular and cellular functions, including cellular assembly and organization, cell-to-cell signaling and interaction (including epinephrine, dopamine, and adrenergic signaling and receptor function), and small molecule biochemistry. Interestingly, while the biofunctions identified in this study may represent pathways underpinning EGS-induced neurodegeneration, this is also the first demonstration of potential molecular conservation (including previously unreported dysregulation of the UPS and APP) spanning the degenerative cascades from an apparently unrelated condition of large animals, to s |
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Scott ; Eaton, Samantha L. ; Keen, John A. ; Cumyn, Elizabeth M. ; Arnott, Danielle M. ; Chen, Wenzhang ; Lamont, Douglas J. ; Graham, Laura C. ; Llavero Hurtado, Maica ; Pemberton, Alan ; Wishart, Thomas M.</creator><creatorcontrib>McGorum, Bruce C. ; Pirie, R. Scott ; Eaton, Samantha L. ; Keen, John A. ; Cumyn, Elizabeth M. ; Arnott, Danielle M. ; Chen, Wenzhang ; Lamont, Douglas J. ; Graham, Laura C. ; Llavero Hurtado, Maica ; Pemberton, Alan ; Wishart, Thomas M.</creatorcontrib><description>Equine grass sickness (EGS) is an acute, predominantly fatal, multiple system neuropathy of grazing horses with reported incidence rates of ∼2%. An apparently identical disease occurs in multiple species, including but not limited to cats, dogs, and rabbits. Although the precise etiology remains unclear, ultrastructural findings have suggested that the primary lesion lies in the glycoprotein biosynthetic pathway of specific neuronal populations. The goal of this study was therefore to identify the molecular processes underpinning neurodegeneration in EGS. Here, we use a bottom-up approach beginning with the application of modern proteomic tools to the analysis of cranial (superior) cervical ganglion (CCG, a consistently affected tissue) from EGS-affected patients and appropriate control cases postmortem. In what appears to be the proteomic application of modern proteomic tools to equine neuronal tissues and/or to an inherent neurodegenerative disease of large animals (not a model of human disease), we identified 2,311 proteins in CCG extracts, with 320 proteins increased and 186 decreased by greater than 20% relative to controls. Further examination of selected proteomic candidates by quantitative fluorescent Western blotting (QFWB) and subcellular expression profiling by immunohistochemistry highlighted a previously unreported dysregulation in proteins commonly associated with protein misfolding/aggregation responses seen in a myriad of human neurodegenerative conditions, including but not limited to amyloid precursor protein (APP), microtubule associated protein (Tau), and multiple components of the ubiquitin proteasome system (UPS). Differentially expressed proteins eligible for in silico pathway analysis clustered predominantly into the following biofunctions: (1) diseases and disorders, including; neurological disease and skeletal and muscular disorders and (2) molecular and cellular functions, including cellular assembly and organization, cell-to-cell signaling and interaction (including epinephrine, dopamine, and adrenergic signaling and receptor function), and small molecule biochemistry. Interestingly, while the biofunctions identified in this study may represent pathways underpinning EGS-induced neurodegeneration, this is also the first demonstration of potential molecular conservation (including previously unreported dysregulation of the UPS and APP) spanning the degenerative cascades from an apparently unrelated condition of large animals, to small animal models with altered neuronal vulnerability, and human neurological conditions. Importantly, this study highlights the feasibility and benefits of applying modern proteomic techniques to veterinary investigations of neurodegenerative processes in diseases of large animals.</description><identifier>ISSN: 1535-9476</identifier><identifier>EISSN: 1535-9484</identifier><identifier>DOI: 10.1074/mcp.M115.054635</identifier><identifier>PMID: 26364976</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Amyloid beta-Protein Precursor - genetics ; Amyloid beta-Protein Precursor - metabolism ; Animals ; Female ; Ganglia, Sensory - chemistry ; Ganglia, Sensory - metabolism ; Ganglia, Sensory - pathology ; Gene Expression Profiling ; Gene Expression Regulation ; Gene Ontology ; Horse Diseases - diagnosis ; Horse Diseases - genetics ; Horse Diseases - metabolism ; Horse Diseases - pathology ; Horses ; Male ; Molecular Sequence Annotation ; Neurodegenerative Diseases - diagnosis ; Neurodegenerative Diseases - genetics ; Neurodegenerative Diseases - metabolism ; Neurodegenerative Diseases - pathology ; Proteasome Endopeptidase Complex - metabolism ; Proteomics ; Proteostasis Deficiencies - diagnosis ; Proteostasis Deficiencies - genetics ; Proteostasis Deficiencies - metabolism ; Proteostasis Deficiencies - pathology ; tau Proteins - genetics ; tau Proteins - metabolism ; Ubiquitin - genetics ; Ubiquitin - metabolism</subject><ispartof>Molecular & cellular proteomics, 2015-11, Vol.14 (11), p.3072-3086</ispartof><rights>2015 © 2015 ASBMB. Currently published by Elsevier Inc; originally published by American Society for Biochemistry and Molecular Biology.</rights><rights>2015 by The American Society for Biochemistry and Molecular Biology, Inc.</rights><rights>2015 by The American Society for Biochemistry and Molecular Biology, Inc. 2015 The American Society for Biochemistry and Molecular Biology, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-f554a03d7adf0fe387796db6e795171ce0bed19cd7d2db05ffdcd35b8d1ca7493</citedby><cites>FETCH-LOGICAL-c476t-f554a03d7adf0fe387796db6e795171ce0bed19cd7d2db05ffdcd35b8d1ca7493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638047/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638047/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26364976$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McGorum, Bruce C.</creatorcontrib><creatorcontrib>Pirie, R. Scott</creatorcontrib><creatorcontrib>Eaton, Samantha L.</creatorcontrib><creatorcontrib>Keen, John A.</creatorcontrib><creatorcontrib>Cumyn, Elizabeth M.</creatorcontrib><creatorcontrib>Arnott, Danielle M.</creatorcontrib><creatorcontrib>Chen, Wenzhang</creatorcontrib><creatorcontrib>Lamont, Douglas J.</creatorcontrib><creatorcontrib>Graham, Laura C.</creatorcontrib><creatorcontrib>Llavero Hurtado, Maica</creatorcontrib><creatorcontrib>Pemberton, Alan</creatorcontrib><creatorcontrib>Wishart, Thomas M.</creatorcontrib><title>Proteomic Profiling of Cranial (Superior) Cervical Ganglia Reveals Beta-Amyloid and Ubiquitin Proteasome System Perturbations in an Equine Multiple System Neuropathy[S]</title><title>Molecular & cellular proteomics</title><addtitle>Mol Cell Proteomics</addtitle><description>Equine grass sickness (EGS) is an acute, predominantly fatal, multiple system neuropathy of grazing horses with reported incidence rates of ∼2%. An apparently identical disease occurs in multiple species, including but not limited to cats, dogs, and rabbits. Although the precise etiology remains unclear, ultrastructural findings have suggested that the primary lesion lies in the glycoprotein biosynthetic pathway of specific neuronal populations. The goal of this study was therefore to identify the molecular processes underpinning neurodegeneration in EGS. Here, we use a bottom-up approach beginning with the application of modern proteomic tools to the analysis of cranial (superior) cervical ganglion (CCG, a consistently affected tissue) from EGS-affected patients and appropriate control cases postmortem. In what appears to be the proteomic application of modern proteomic tools to equine neuronal tissues and/or to an inherent neurodegenerative disease of large animals (not a model of human disease), we identified 2,311 proteins in CCG extracts, with 320 proteins increased and 186 decreased by greater than 20% relative to controls. Further examination of selected proteomic candidates by quantitative fluorescent Western blotting (QFWB) and subcellular expression profiling by immunohistochemistry highlighted a previously unreported dysregulation in proteins commonly associated with protein misfolding/aggregation responses seen in a myriad of human neurodegenerative conditions, including but not limited to amyloid precursor protein (APP), microtubule associated protein (Tau), and multiple components of the ubiquitin proteasome system (UPS). Differentially expressed proteins eligible for in silico pathway analysis clustered predominantly into the following biofunctions: (1) diseases and disorders, including; neurological disease and skeletal and muscular disorders and (2) molecular and cellular functions, including cellular assembly and organization, cell-to-cell signaling and interaction (including epinephrine, dopamine, and adrenergic signaling and receptor function), and small molecule biochemistry. Interestingly, while the biofunctions identified in this study may represent pathways underpinning EGS-induced neurodegeneration, this is also the first demonstration of potential molecular conservation (including previously unreported dysregulation of the UPS and APP) spanning the degenerative cascades from an apparently unrelated condition of large animals, to small animal models with altered neuronal vulnerability, and human neurological conditions. Importantly, this study highlights the feasibility and benefits of applying modern proteomic techniques to veterinary investigations of neurodegenerative processes in diseases of large animals.</description><subject>Amyloid beta-Protein Precursor - genetics</subject><subject>Amyloid beta-Protein Precursor - metabolism</subject><subject>Animals</subject><subject>Female</subject><subject>Ganglia, Sensory - chemistry</subject><subject>Ganglia, Sensory - metabolism</subject><subject>Ganglia, Sensory - pathology</subject><subject>Gene Expression Profiling</subject><subject>Gene Expression Regulation</subject><subject>Gene Ontology</subject><subject>Horse Diseases - diagnosis</subject><subject>Horse Diseases - genetics</subject><subject>Horse Diseases - metabolism</subject><subject>Horse Diseases - pathology</subject><subject>Horses</subject><subject>Male</subject><subject>Molecular Sequence Annotation</subject><subject>Neurodegenerative Diseases - diagnosis</subject><subject>Neurodegenerative Diseases - genetics</subject><subject>Neurodegenerative Diseases - metabolism</subject><subject>Neurodegenerative Diseases - pathology</subject><subject>Proteasome Endopeptidase Complex - metabolism</subject><subject>Proteomics</subject><subject>Proteostasis Deficiencies - diagnosis</subject><subject>Proteostasis Deficiencies - genetics</subject><subject>Proteostasis Deficiencies - metabolism</subject><subject>Proteostasis Deficiencies - pathology</subject><subject>tau Proteins - genetics</subject><subject>tau Proteins - metabolism</subject><subject>Ubiquitin - genetics</subject><subject>Ubiquitin - metabolism</subject><issn>1535-9476</issn><issn>1535-9484</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFksFu1DAQhiMEoqVw5oZ8LIfd2hs7Ti5IZVUKUgsVS08IWY492Q5K7NR2Vto34jHxsmUFB8TJI_ubfzwzf1G8ZHTOqORngxnn14yJORW8KsWj4piJUswaXvPHh1hWR8WzGL9TuqBMiqfF0aIqK97I6rj4cRN8Aj-gITnqsEe3Jr4jy6Ad6p6crqYRAvrwmiwhbNDku0vt1j1q8hk2oPtI3kLSs_Nh23u0RDtLblu8nzChI7_UdfQDkNU2JhjIDYQ0hVYn9C6SjGhHLjLtgFxPfcKxP6AfYQp-1Olu-3X17XnxpMvF4MXDeVLcvrv4snw_u_p0-WF5fjUzuc8064TgmpZWatvRDspayqaybQWyEUwyA7QFyxpjpV3Yloqus8aWoq0tM1rypjwp3ux1x6kdwBpwKehejQEHHbbKa1R_vzi8U2u_UXn-NeUyC5w-CAR_P0FMasBooO-1Az9FxWpaV6yhlP8flYumFIyzHXq2R03wMQboDj9iVO2soLIV1M4Kam-FnPHqz0YO_O_dZ6DZA5DHuUEIKhoEZ8BiAJOU9fhP8Z_zP8hK</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>McGorum, Bruce C.</creator><creator>Pirie, R. Scott</creator><creator>Eaton, Samantha L.</creator><creator>Keen, John A.</creator><creator>Cumyn, Elizabeth M.</creator><creator>Arnott, Danielle M.</creator><creator>Chen, Wenzhang</creator><creator>Lamont, Douglas J.</creator><creator>Graham, Laura C.</creator><creator>Llavero Hurtado, Maica</creator><creator>Pemberton, Alan</creator><creator>Wishart, Thomas M.</creator><general>Elsevier Inc</general><general>The American Society for Biochemistry and Molecular Biology</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>5PM</scope></search><sort><creationdate>20151101</creationdate><title>Proteomic Profiling of Cranial (Superior) Cervical Ganglia Reveals Beta-Amyloid and Ubiquitin Proteasome System Perturbations in an Equine Multiple System Neuropathy[S]</title><author>McGorum, Bruce C. ; Pirie, R. Scott ; Eaton, Samantha L. ; Keen, John A. ; Cumyn, Elizabeth M. ; Arnott, Danielle M. ; Chen, Wenzhang ; Lamont, Douglas J. ; Graham, Laura C. ; Llavero Hurtado, Maica ; Pemberton, Alan ; Wishart, Thomas M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-f554a03d7adf0fe387796db6e795171ce0bed19cd7d2db05ffdcd35b8d1ca7493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Amyloid beta-Protein Precursor - genetics</topic><topic>Amyloid beta-Protein Precursor - metabolism</topic><topic>Animals</topic><topic>Female</topic><topic>Ganglia, Sensory - chemistry</topic><topic>Ganglia, Sensory - metabolism</topic><topic>Ganglia, Sensory - pathology</topic><topic>Gene Expression Profiling</topic><topic>Gene Expression Regulation</topic><topic>Gene Ontology</topic><topic>Horse Diseases - diagnosis</topic><topic>Horse Diseases - genetics</topic><topic>Horse Diseases - metabolism</topic><topic>Horse Diseases - pathology</topic><topic>Horses</topic><topic>Male</topic><topic>Molecular Sequence Annotation</topic><topic>Neurodegenerative Diseases - diagnosis</topic><topic>Neurodegenerative Diseases - genetics</topic><topic>Neurodegenerative Diseases - metabolism</topic><topic>Neurodegenerative Diseases - pathology</topic><topic>Proteasome Endopeptidase Complex - metabolism</topic><topic>Proteomics</topic><topic>Proteostasis Deficiencies - diagnosis</topic><topic>Proteostasis Deficiencies - genetics</topic><topic>Proteostasis Deficiencies - metabolism</topic><topic>Proteostasis Deficiencies - pathology</topic><topic>tau Proteins - genetics</topic><topic>tau Proteins - metabolism</topic><topic>Ubiquitin - genetics</topic><topic>Ubiquitin - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McGorum, Bruce C.</creatorcontrib><creatorcontrib>Pirie, R. Scott</creatorcontrib><creatorcontrib>Eaton, Samantha L.</creatorcontrib><creatorcontrib>Keen, John A.</creatorcontrib><creatorcontrib>Cumyn, Elizabeth M.</creatorcontrib><creatorcontrib>Arnott, Danielle M.</creatorcontrib><creatorcontrib>Chen, Wenzhang</creatorcontrib><creatorcontrib>Lamont, Douglas J.</creatorcontrib><creatorcontrib>Graham, Laura C.</creatorcontrib><creatorcontrib>Llavero Hurtado, Maica</creatorcontrib><creatorcontrib>Pemberton, Alan</creatorcontrib><creatorcontrib>Wishart, Thomas M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Molecular & cellular proteomics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McGorum, Bruce C.</au><au>Pirie, R. Scott</au><au>Eaton, Samantha L.</au><au>Keen, John A.</au><au>Cumyn, Elizabeth M.</au><au>Arnott, Danielle M.</au><au>Chen, Wenzhang</au><au>Lamont, Douglas J.</au><au>Graham, Laura C.</au><au>Llavero Hurtado, Maica</au><au>Pemberton, Alan</au><au>Wishart, Thomas M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proteomic Profiling of Cranial (Superior) Cervical Ganglia Reveals Beta-Amyloid and Ubiquitin Proteasome System Perturbations in an Equine Multiple System Neuropathy[S]</atitle><jtitle>Molecular & cellular proteomics</jtitle><addtitle>Mol Cell Proteomics</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>14</volume><issue>11</issue><spage>3072</spage><epage>3086</epage><pages>3072-3086</pages><issn>1535-9476</issn><eissn>1535-9484</eissn><abstract>Equine grass sickness (EGS) is an acute, predominantly fatal, multiple system neuropathy of grazing horses with reported incidence rates of ∼2%. An apparently identical disease occurs in multiple species, including but not limited to cats, dogs, and rabbits. Although the precise etiology remains unclear, ultrastructural findings have suggested that the primary lesion lies in the glycoprotein biosynthetic pathway of specific neuronal populations. The goal of this study was therefore to identify the molecular processes underpinning neurodegeneration in EGS. Here, we use a bottom-up approach beginning with the application of modern proteomic tools to the analysis of cranial (superior) cervical ganglion (CCG, a consistently affected tissue) from EGS-affected patients and appropriate control cases postmortem. In what appears to be the proteomic application of modern proteomic tools to equine neuronal tissues and/or to an inherent neurodegenerative disease of large animals (not a model of human disease), we identified 2,311 proteins in CCG extracts, with 320 proteins increased and 186 decreased by greater than 20% relative to controls. Further examination of selected proteomic candidates by quantitative fluorescent Western blotting (QFWB) and subcellular expression profiling by immunohistochemistry highlighted a previously unreported dysregulation in proteins commonly associated with protein misfolding/aggregation responses seen in a myriad of human neurodegenerative conditions, including but not limited to amyloid precursor protein (APP), microtubule associated protein (Tau), and multiple components of the ubiquitin proteasome system (UPS). Differentially expressed proteins eligible for in silico pathway analysis clustered predominantly into the following biofunctions: (1) diseases and disorders, including; neurological disease and skeletal and muscular disorders and (2) molecular and cellular functions, including cellular assembly and organization, cell-to-cell signaling and interaction (including epinephrine, dopamine, and adrenergic signaling and receptor function), and small molecule biochemistry. Interestingly, while the biofunctions identified in this study may represent pathways underpinning EGS-induced neurodegeneration, this is also the first demonstration of potential molecular conservation (including previously unreported dysregulation of the UPS and APP) spanning the degenerative cascades from an apparently unrelated condition of large animals, to small animal models with altered neuronal vulnerability, and human neurological conditions. Importantly, this study highlights the feasibility and benefits of applying modern proteomic techniques to veterinary investigations of neurodegenerative processes in diseases of large animals.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26364976</pmid><doi>10.1074/mcp.M115.054635</doi><tpages>15</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Amyloid beta-Protein Precursor - genetics Amyloid beta-Protein Precursor - metabolism Animals Female Ganglia, Sensory - chemistry Ganglia, Sensory - metabolism Ganglia, Sensory - pathology Gene Expression Profiling Gene Expression Regulation Gene Ontology Horse Diseases - diagnosis Horse Diseases - genetics Horse Diseases - metabolism Horse Diseases - pathology Horses Male Molecular Sequence Annotation Neurodegenerative Diseases - diagnosis Neurodegenerative Diseases - genetics Neurodegenerative Diseases - metabolism Neurodegenerative Diseases - pathology Proteasome Endopeptidase Complex - metabolism Proteomics Proteostasis Deficiencies - diagnosis Proteostasis Deficiencies - genetics Proteostasis Deficiencies - metabolism Proteostasis Deficiencies - pathology tau Proteins - genetics tau Proteins - metabolism Ubiquitin - genetics Ubiquitin - metabolism |
title | Proteomic Profiling of Cranial (Superior) Cervical Ganglia Reveals Beta-Amyloid and Ubiquitin Proteasome System Perturbations in an Equine Multiple System Neuropathy[S] |
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