JP4544865B2 - 統合失調症の診断および治療のための標的、方法、ならびに試薬 - Google Patents
統合失調症の診断および治療のための標的、方法、ならびに試薬 Download PDFInfo
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Description
この出願は、米国仮出願第60/367,944号(2002年3月26日出願)と、発明者としてGerber、Karayiorgou、Miyakawa、およびTonegawaが記されている「統合失調症および他の精神疾患の診断および治療ならびに関連試薬およびそれを用いる方法」が名称である米国仮出願(2003年3月7日出願、未だ一連番号付与されず)とに対して、優先権を主張する。これらの出願の内容を本明細書で援用する。
米国政府は、本発明の開発に利用される助成金による支援を提供してくれた。特に、国立衛生研究所によって与えられたP50−MH58880および国立衛生研究所によって与えられたR01−MH61399は、この発明の開発を支援した。米国政府は、本発明において何らかの権利を有するものと思われる。
本発明は、統合失調症および関連症状の診断および治療のための標的を同定することに関する。本発明は、カルシニュリン突然変異マウスが統合失調症を思わせる表現型を持つこと、またカルシニュリン・サブユニット遺伝子の位置とカルシニュリン・シグナル伝達で働くポリペプチドをコードする数多くの他の遺伝子の位置とが統合失調症感受性の遺伝子座と一致するという観察を包含する。これらの発見は、カルシニュリン(本明細書ではCaNまたはCNと略す)と、統合失調症および/または関連症状の病因でのカルシニュリン・シグナル伝達経路の構成要素とに関係する。
(定義)
「アゴニスト(agonist)」という用語は、ポリペプチドまたは核酸の効果の持続時間を増加または延長する分子をいう。アゴニストとして、タンパク質、核酸、炭水化物、脂質、小分子、イオン、またはポリペプチドあるいは核酸の効果を調節するなんらかの他の分子を挙げることができる。アゴニストは、ポリペプチドまたは核酸に結合することによって効果を発揮する分子である直接アゴニスト、もしくはポリペプチドまたは核酸に結合する以外のメカニズム(例えば、ポリペプチドまたは核酸の発現または安定性を変えることによって、ポリペプチドまたは核酸の標的の発現または活性を変えることによって、ポリペプチドまたは核酸が関与する経路の中間体と相互作用することによって、等)を介して効果を発揮する間接アゴニストであってもよい。
I.概要
カルシニュリンは、Ca2+によって媒介されるシグナル伝達で重要な役割を果たすカルシウム依存性タンパク質ホスファターゼである。哺乳類の脳抽出物中ではじめて同定されたことから、例えば、カルシニュリンはリンパ球活性化、神経細胞および筋の分化、軸索突起生成、脊椎動物心臓弁の形態発生を含む種々の生物学的応答に関係している。また、学習および記憶に加えて、カルシニュリンが軸索誘導において重要な役割を持つことも示されている(Chang,H.,et al.(1995)Nature 376,686−690;Xeng,H.,et al.,Cell,Vol 107,617−629,1991)。種々のカルシニュリン・サブユニットおよびイソ型(以下を見よ)に加えて、多くの他の分子が、カルシニュリン活性に役割を持っている。これらの分子として、例えば、カルシニュリン存在量および/または活性(間接的または直接的な物理的相互作用を介して)を調節するタンパク質、サブユニット等が挙げられる。カルシニュリンをコードする遺伝子のゲノム位置およびカルシニュリン・シグナル伝達に関与する多くの分子が同定されている。
カルシニュリンとダイナミン1との複合体が、クラスリン媒介エンドサイトーシスの調節に関与することが示されている(Lai,M.M.,et al.,J Biol Chem 274,25963−6,1999)。このプロセスは、シナプス小胞のエンドサイトーシス(Lai,et al.1999)およびAMPA受容体(Haucke,V.(2000)Nat Neurosci 3,1230−2)にかかわってきた。したがって、変化したカルシニュリン活性は、クリティカルなシナプスのエンドサイトーシスの事象とそれに伴う異常シナプスの機能の異常カルシウム依存性調節に帰着するかもしれない。
カルシニュリンは、中枢神経系で高発現されるカルシウム依存性セリン/スレオニン・タンパク質ホスファターゼである(Klee,C.B.,Ren,H.& Wang,X.(1998)J Biol Chem 273,13367−70;Shibasaki,F.,Hallin,U.& Uchino,H.(2002)J Biochem(Tokyo)131,1−15;Rusnak,F.and Mertz,P.,Physiological Reviews(2000)80(4):1483−1522 カルシニュリンは、調節サブユニット、CNB、および触媒サブユニットCNAから構成されたヘテロ二量体からなる。3つの異なるCNAアイソ型があり、異なる遺伝子によってコードされたCNAα、CNAβ、およびCNAγ他と呼ばれる。Ca2+/カルモジュリン複合体に対するCNAサブユニットの結合は、活性に必要と思われる。CNBサブユニットは、カルモジュリンと構造的に関連しており、また完全CN活性に必要である。概してミリストイル化されているCNBは、概ねCa2+非存在下でCNAと結合したままであり、Ca2+がBサブユニットに結合した場合、ホスファターゼ活性が増加する。
統合失調症の原因は知られていないが、かなりの遺伝的要素を含むことが示されている。メンデル性遺伝パターンを示し、かつ単一遺伝子での突然変異が原因の嚢胞性線維症および鎌状赤血球貧血等の障害とは異なり、統合失調症は、多遺伝子性障害であると考えられ、この際多くの異なる遺伝子での突然変異または変異は、異なる程度および異なる組み合わせで、疾患の発生に寄与することが可能である。複数の遺伝子からの寄与は、任意の所定の患者に関与し、それらの遺伝子でのその突然変異または変異は、浸透度の変動する程度を示すので、個体が統合失調症病因に寄与することが可能な突然変異または変異を有する場合であっても、該個体が臨床上の疾患を発症しない可能性があるようだ。これらの特色により、統合失調症の遺伝的基礎を決定的に確定することが難しくなる。
A.診断方法。本発明は、統合失調症または統合失調症感受性の診断用の様々な方法を提供する。具体的には、本発明は、(i)統合失調症または統合失調症感受性について試験すべき被験体から得た試料を提供するステップと、(ii)カルシニュリン・サブユニットまたはカルシニュリン相互作用分子をコードする遺伝子のコーディングまたは非コーディング部位中の多形性現象の多形性変異体を検出する、あるいは試料中のカルシニュリン・サブユニットまたはカルシニュリン相互作用分子をコードする遺伝子のコーディングまたは非コーディング部位に結合するゲノム領域中の多形性現象の多形性変異体を検出するステップとを含む統合失調症または統合失調症感受性を診断するための方法を提供する。「統合失調症感受性」とは、被験体が統合失調症を発症していることを必ずしも意味しないが、統計学的な意味で、集団の平均的なメンバーと比べて被験体が統合失調症を発症する可能性が高いことが理解される。本明細書で使用されるように、被験体が、単独でまたは1つ以上の他の遺伝的決定因子と組み合わさって被験体のいくつかまたは全てで統合失調症を発症するリスクの増加に寄与する1つ以上の遺伝的決定因子(例えば多形性変異体または対立遺伝子)を有する場合、「統合失調症感受性」は存在することが可能である。被験体が任意の該遺伝的決定因子(すなわち、適当な遺伝的バックグラウンドで、統合失調症を発症するリスクを増加させる遺伝的決定因子)を有するかどうかを確認することは、本明細書で使用されるように、統合失調症感受性を診断するという概念に含まれる。このような決定因子は、例えば遺伝的カウンセリングの目的のために有用である。したがって、統合失調症感受性に関する診断情報を提供することは、遺伝的カウンセリングで有用な情報を提供することを含み、このような情報の提供は、本発明により組み込まれる。
上記に記載されるように多形性現象の存在を初めに確立する方法と同様に、シーケンシングによって、被験体中の多形性現象または多形性変異体の検出(遺伝子タイピング)を実行することが可能である。しかし、いったん多形性現象の存在を確立したら、様々なより効率的な方法を使用することが可能である。そのような方法の多くは、2つ以上の多形性変異体間での識別を容易にするオリゴヌクレオチド・プローブまたはプライマーの設計に基づいている。
本発明の特定の実施形態に従えば、複数の多形性変異体(例えば、複数の多形性部位にある多形性変異体)の存在を平行してまたは実質的に同時に検出することができる方法を使用することが好ましい。オリゴヌクレオチド・アレイは、そうするための1つの好適な手段を表す。反応(例えば、増幅、ハイブリダイゼーション)が個別の容器中、例えばマルチウエル・プレートの個別のウエルまたは他の容器内で実行される方法を含む他の方法を、本発明の特定の実施形態にしたがって、複数の多形性変異体(例えば複数の多形性部位にある多形性変異体)の存在を平行してまたは実質的に同時に検出するように実行することが可能である。
材料と方法
動物および実験設計。前脳特異的カルシニューリン・ノックアウト・マウス(CN変異体)の作製に関しては、他の場所で詳細に述べた[36]。試行開始時に生後11週間であった雄マウスを用いて、すべての行動試験を行った。マウスは、12時間の明暗サイクルがある(午前7時に照明をつける)部屋で個別に飼育し、食物および水へのアクセスを任意(ad libitum)とした。行動試験は、午前9時および午後5時の間に行った。動物の世話および取扱いに関するすべての処置を、MITおよびNIHのガイドラインにしたがって行った。
本発明の発明者らは、コンディショナル・ジーン・ターゲッティング(conditional gene targeting)技法を用い、カルシニューリン活性が成体マウスの前脳で特異的に破壊されたマウス(本明細書において、CNノックアウト・マウスと呼ぶ)を作製した[36]。具体的には、成体マウス前脳の興奮性ニューロン中でfCNB1遺伝子をノックアウトした。fCNB1遺伝子は、脳カルシニューリンの唯一の既知な調節サブユニットであるCNB1をコードする。インサイチュウ(in situ)ハイブリダイゼーション分析に基づき、fCNB1遺伝子が、海馬、新皮質、およびへん桃核の選択された細胞形のみで、欠失していることを確認した。一方、線条体、小脳、および他の皮質下の領域でのfCNB1発現は、すべての齢数で正常に見えた。fCNB1を発現している細胞の低減は、5週齢における海馬CA1および大脳皮質で最初に検出可能であった。上記の欠失パターンは約2.5月齢で明白になり、少なくとも、調べられた最後の時点である5月齢まで変わりがなかった。CNノックアウト・マウスは、巨視的に正常に見え、知覚障害または運動障害の明白な徴候はなかった。ヘマトキシリンによる脳切片の染色では、巨視的な構造的異常が見られなかった。CNノックアウト・マウスに関して行われた追加検討の詳細、およびさらなる記載については、[36]を参照するとよい。
目標探索試験の順化フェーズ(すなわち、試行1および試行2)でCN変異体はコントロールより長い間、フィールドの周辺領域にいた(図の1Aの上側のパネル; p<0.05)。きわだったことに、フィールドに目標を導入した後(すなわち、試行3、試行4、および試行5)、CN変異体はフィールドの中心領域で、より多くの時間を過ごした。これは目標に対する探索行動の増加を示すものである(p<0.01)。CN変異体が目標の近くで費やした時間も、コントロールのそれよりかなり長かった(図1A下部パネル、p=0.0088)。認識指数に関しては、1時間の試行(すなわち、試行4)、または24時間の試行(すなわち、試行5)のいずれでも、CN変異体とコントロールとに有意差がみられなかった(データは示されていない)。
遺伝子座決定分析。カルシニューリン・サブユニット遺伝子およびカルシニューリン関連遺伝子の染色体位置を決定するため、ヒト・ドラフト配列のマップ・ビューアー機能/サイト(http://www.ncbi.nlm.nih.gov/cg− i−bin/Entrez/hum_srch?chr=hum_chr.inf&query)を、「カルシニューリン」などのクエリー用語(query term)を用いて探索し、それらの遺伝子の正確な染色体位置を検索した。それらの遺伝子の染色体位置を記述する用語(例えば、chromosome 8、または8q)を、「schizophrenia」という用語に結合し、それらの個々の組合せを、Entrez Pubmedデータベース(http://www.ncbi.nlm.nih.gov/Entrez/)を捜すのに用いることによって、それらの染色体にある統合失調症感受性遺伝子座を記述する刊行物を検索した。それら統合失調症遺伝子座の染色体位置を、該遺伝子の遺伝子座と比較し、一致度(coincidence)の検出を行った。より詳細な分析のため、ヒト・ゲノム・ブラウザ(Human Genome Browser)(http://genome.ucsc.edu/cgi−bin/hgGate−wav)、またはヒトEnsemblサイト(http://www.ensembl.org/Homo_sapiens/)を用い、所与の領域の疾患感受性(a given region of susceptibility)に関する最重要マーカーの位置と、正確な遺伝子位置とを比べた。
カルシニューリンおよびカルシニューリン結合タンパク質をコードする遺伝子の位置。CN変異体で観察された行動異常、および実施例1に記載された行動異常は、統合失調症発病機序におけるカルシニューリン機能不全の関与を集合的に示した。統合失調症病因に、カルシニューリン遺伝子の変異が寄与しうるかを調査するため、4つのカルシニューリン・サブユニット遺伝子、すなわちPPP3R1、PPP3CA、PPP3CC、およびPPP3CB、ならびに2つのカルシニューリン結合タンパク質、すなわちCABIN 1およびCABIN 2をコードする遺伝子の染色体位置を、以前に同定された統合失調症感受性遺伝子座と比較した。これらの5つの遺伝子の染色体位置は、以前にマッピングされた(mapped)統合失調症遺伝子座と一致していると認められた(表1)。
材料と方法
患者試料。この研究で使用した合衆国患者試料および南アフリカ患者試料に関しては、以前に記述されている[1,2]。成人分裂症患者(AS)試料に関する詳細な情報は、Sobin,C.,Blundell,M.L.,Conry,A.,Weiller,F.,Gavigan,C.,Haiman,C.,およびKarayiorgou,M.(2001)Psychiatry Res.101,101−113.に提供されている。南アフリカ試料は、本発明の発明者らによるアフリカ人出自統合失調症患者の進行中の収集の一部であり、他の場所で詳細に記述されるだろう(M.K.,M.Torrington,C.S.,B.R.,S.C.H.,M.L.B.,H.Pretorius,S.Lay,J.A.G.,およびJ.L.R.,の未発表研究)両試料の発端者(proband)は、統合失調症、または分裂情動性型障害(schizoaffective disorder)に関するDiagnostic and Statistical Manual of Mental Disorders, 4th Ed.(DSM−IV)(American Psychiatric Association.(1994)Diagnostic and Statistical Manual(Am.Psychiatric Assoc.,Washington,D.C.))の寿命評価基準を満たした。特別に訓練された臨床医により、Diagnostic Interview for Genetic Studies (DIGS)(Numberger,J.I.,et al.1994)Arch.Gen. Psychiatry 51,849−859)を用いて参加者をインタビューした。COS試料に関する詳細な情報は、Usiskin,S.I.,ら(1999)J.Am.Acad.Child Adolesc.Psychiatry 38, 1536−1543,およびNicolson,R.,ら(2000)Am.J.Psychiatry 157,794−800に提供されている。すべてのCOS発端者は、統合失調症の変更されていない評価基準を満たし、彼らの13回目の誕生日以前に精神病性の徴候を開始し、精神病の平均発病年齢は10.1才(±1.8年)であった。実験計画書(protocol)および同意書(concent form)は、すべての参加部署における施設内審査委員会(Institutional Review Bord)(IRB)によって承認された。National Institute of Mental Health(NIMH)試料は、NIMH Human Genetics Inititative dataset(http://zork.wustl.edu/nimh)から入手した。
統合失調症感受性に寄与する可能性のある6つの遺伝子(カルシニューリン・サブユニット、またはカルシニューリン・シグナル伝達に関連する他のタンパク質をコードする遺伝子)の潜在的な機能的多形性現象、および関連性研究に用いる可能性のある多形性現象を同定するため、12人の独立している統合失調症患者から単離されたゲノムDNA中にあるこれらの遺伝子のコード領域、非コード・エキソン領域、およびいくらかのプロモーター領域の配列を決定した。選択された遺伝子は、PPP3R1、PPP3CA、PPP3CB、PPP3CC、CAMLG、およびFKBP5であった。ここに提示されるデータは、これらの遺伝子のうち、最初の3つの遺伝子の分析に関する。
材料と方法
関連解析。単一SNP、および複数のSNPのハプロタイプ伝達は、Transmitプログラムを用い、伝達不平衡試験(Transmission Disequilibrium Test)によって分析した[3]。記載されたP値は、transmitプログラムによって計算された全体的な有意水準(global significance level)を表し、http://www−gene.cimr.cam.ac.uk/clayton/software/transmit.txtで説明されている。P値は、transmitプログラムのTDT分析から得られた全体的カイ2乗値(global chi square)から計算した。
統合失調症発病機序におけるカルシニューリン・サブユニットおよびカルシニューリン相互作用タンパク質をコードする遺伝子の関与をさらに調査するため、本発明の発明者らは、表1に記載された候補遺伝子と、多数の罹患家族(affected family)を含んだ標本における疾病との関連を体系的に試験している。現在、これらの遺伝子のうち、PPP3R1、PPP3CA、および3PPP3CCの3遺伝子に関して初期関連解析を行ってきている。この研究には、本発明の発明者らが直接配列決定法で同定した多型現象のいくつかを利用し、NCBIまたはセレラ・データベースから得られた追加の1塩基多形(SNP)を補足した。利用された多形性現象は、表3に記載されている。遺伝子型決定反応に用いられたプライマーの配列を補遺3に記載し、これらの多形性現象の配列を補遺4に提供する。
本発明の発明者らがPPP3CCと統合失調症感受性との間の関連を発見したことは、統合失調症発病機序にカルシニューリン・シグナル伝達の変調が関与していることを支持する有力な証拠を提供する。上で記載したように、これらの結果は、さらに拡張され、表1に記載した追加遺伝子の統合失調症との遺伝的関連の調査、および既に分析された遺伝子の分析にさらなる集団標本を追加する拡大が行われるだろう。上に記載した系統的研究を拡張することによって、カルシニューリン・シグナル伝達に関与する追加遺伝子座の統合失調症感受性との関連が決定されるだろう。
材料と方法
cDNAのPCR。成人全ヒト脳cDNA、胎児全ヒト脳cDNA、およびヒト精巣cDNAは、クローンテック(Clontech (Palo Alto, Calif.))から購入したmarathon−ready cDNAからなった。成人脳の諸領域パネルは、オリジーン(Origene (Rockville, Md.).)から購入した。
PPP3CCは、最初、マウスでの初期特徴付けに基づいて、睾丸特異的カルシニューリン触媒サブユニットの遺伝子とされた。PPP3CCがヒト脳で発現されるかを決定するため、本発明の発明者らは、まず、PPP3CC特異的プライマーを用いて、ヒト全成人脳、および全胎児脳からのcDNAのPCR増幅を行った。図7Aに示されるように、異なった2プライマーペアをもちいたPCR反応によって、PPP3CCがヒト成人および胎児脳で発現されることを示した。
Claims (29)
- 統合失調症または統合失調症感受性の治療に有用な候補化合物をスクリーニングする方法であって、該方法は、
(a)リン酸化カルシニュリン基質およびカルシニュリンを含む生物学的系を提供するステップと、
(b)該生物学的系を化合物と接触させるステップと、
(c)該カルシニュリン基質の脱リン酸化の程度または速度を、コントロールと比較して、該化合物が、カルシニュリンホスファターゼ活性の賦活剤であるかどうかを決定するステップと、
(d)該化合物が、ステップ(c)の結果に基づいて、統合失調症または統合失調症感受性の治療に有用な候補化合物であるかどうかを決定するステップと
を含む、方法。 - 前記コントロールが、前記化合物の非存在下で、前記カルシニュリン基質の脱リン酸化の程度または速度を示す、請求項1に記載の方法。
- ステップ(d)が、前記カルシニュリン基質の脱リン酸化の程度または速度が前記コントロールと比較して増大する場合に、前記化合物を、カルシニュリンホスファターゼ活性の賦活剤と同定するステップを含む、請求項1または2に記載の方法。
- ステップ(d)が、前記化合物が、カルシニュリンホスファターゼ活性の賦活剤である場合に、該化合物を、統合失調症または統合失調症感受性の治療に有用な候補化合物と同定するステップを含む、請求項1〜3のいずれか一項に記載の方法。
- 前記生物学的系が細胞または細胞群である請求項1〜4のいずれか一項に記載の方法。
- 前記細胞または細胞群が、カルシニュリンを内在的に発現する、請求項5に記載の方法。
- 前記細胞または細胞群が、さらにカルシニュリン基質を内在的に発現する、請求項6に記載の方法。
- 前記生物学的系が、特定のカルシニュリンサブユニットを含む、請求項1〜7のいずれか一項に記載の方法。
- 前記生物学的系がCNAγを含み、かつCNAαとCNAβとを欠如している請求項1〜8のいずれか一項に記載の方法。
- 前記生物学的系がカルシニュリン阻害剤をさらに含む請求項1〜9のいずれか一項に記載の方法。
- 前記化合物が、小分子、天然産物、ペプチド、または核酸である、請求項1〜10のいずれか一項に記載の方法。
- 前記化合物が、小分子である、請求項11に記載の方法。
- 前記カルシニュリン基質の脱リン酸化の程度または速度が、イムノブロッティング、免疫組織化学法、ELISA、ラジオイムノアッセイ、または、タンパク質チップにより決定される、請求項1〜12のいずれか一項に記載の方法。
- 前記方法が、ハイスループット形式で行われる、請求項1〜13のいずれか一項に記載の方法。
- 前記方法が、動物モデルにおいて、統合失調症を治療するための前記候補化合物の能力を試験するステップをさらに含む、請求項1〜14のいずれか一項に記載の方法。
- 前記動物モデルが、統合失調症を示唆する一つ以上の表現型を示す、請求項15に記載の方法。
- 前記動物モデルが、カルシニュリンノックアウトマウスである、請求項16に記載の方法。
- 前記カルシニュリンノックアウトマウスが、成体マウス前脳におけるCNB1コンディショナルノックアウトマウスである、請求項17に記載の方法。
- 統合失調症を治療するための化合物を同定する方法であって、
(a)候補化合物が投与されている非ヒト被験体を提供するステップであって、該候補化合物は、カルシニュリンの活性または発現を変調し、該非ヒト被験体は、該候補化合物の非存在下で、統合失調症を示唆する一つ以上の表現型を示す、ステップと、
(b)該被験体における統合失調症を示唆する一つ以上の表現型の重症度または発生率が、コントロールと比較して低減される場合に、該候補化合物を、統合失調症の治療のための化合物と同定するステップと
を含む、方法。 - 前記コントロールが、前記候補化合物が投与されていないコントロール非ヒト被験体において、統合失調症を示唆する一つ以上の表現型の重症度または発生率を示す、請求項19に記載の方法。
- 前記候補化合物が、小分子、天然産物、ペプチド、または核酸である、請求項19または20に記載の方法。
- 前記候補化合物が、小分子である、請求項21に記載の方法。
- 前記候補化合物が、カルシニュリンまたはカルシニュリン相互作用分子の活性または発現を変調する、請求項19〜22のいずれか一項に記載の方法。
- 前記候補化合物が、カルシニュリン基質の脱リン酸化を変調する、請求項23に記載の方法。
- 前記候補化合物が、カルシニュリンサブユニットに結合する、請求項23に記載の方法。
- 前記非ヒト被験体が、カルシニュリンノックアウトマウスである、請求項19〜25のいずれか一項に記載の方法。
- 前記カルシニュリンノックアウトマウスが、成体マウス前脳におけるCNB1コンディショナルノックアウトマウスである、請求項26に記載の方法。
- 前記カルシニュリンノックアウトマウスが、ヘテロ接合カルシニュリンノックアウトマウスある、請求項26に記載の方法。
- 前記非ヒト被験体が、CNAγ低次形態であり、ここで、該CNAγ低次形態が、野生型より少ないレベルであるが、CNAγ遺伝子の完全な欠失に起因するよりは多いレベルで、CNAγを発現する非ヒト被験体として定義される、請求項19〜25のいずれか一項に記載の方法。
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EP2270197A2 (en) | 2011-01-05 |
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US20110288027A1 (en) | 2011-11-24 |
EP2270197A3 (en) | 2011-02-16 |
JP2006507795A (ja) | 2006-03-09 |
US7935500B2 (en) | 2011-05-03 |
EP1578354A4 (en) | 2008-04-09 |
AU2003233451A1 (en) | 2003-10-13 |
US20040014095A1 (en) | 2004-01-22 |
CA2481238A1 (en) | 2003-10-09 |
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US20110172158A1 (en) | 2011-07-14 |
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