Published online before print
March 13, 2001, 10.1101/gr.GR-1610R
Vol. 11, Issue 4, 531-539, April 2001
Identification and Functional Analysis of Mutations in the Hypocretin (Orexin) Genes of Narcoleptic Canines
Marcel
Hungs,1,3
Jun
Fan,2,3
Ling
Lin,1
Xiaoyan
Lin,1
Richard A.
Maki,2 and
Emmanuel
Mignot1,4
1 Stanford Center for Narcolepsy, Stanford University
Medical Center, Department of Psychiatry and Behavioral Sciences, Palo
Alto, California 94304-5485, USA; 2 Neurocrine Biosciences,
San Diego, California 92121, USA
 |
ABSTRACT |
Narcolepsy is a sleep disorder affecting animals and humans. Exon
skipping mutations of the Hypocretin/Orexin-receptor-2
(Hcrtr2) gene were identified as the cause of narcolepsy in
Dobermans and Labradors. Preprohypocretin (Hcrt) knockout mice
have symptoms similar to human and canine narcolepsy. In this study, 11 sporadic cases of canine narcolepsy and two additional multiplex
families were investigated for possible Hcrt and
Hcrtr2 mutations. Sporadic cases have been shown to have more
variable disease onset, increased disease severity, and undetectable
Hypocretin-1 levels in cerebrospinal fluid. The canine Hcrt
locus was isolated and characterized for this project. Only one novel
mutation was identified in these two loci. This alteration results in a
single amino acid substitution (E54K) in the N-terminal region of the
Hcrtr2 receptor and autosomal recessive transmission in a Dachshund
family. Functional analysis of previously-described exon-skipping
mutations and of the E54K substitution were also performed using
HEK-293 cell lines transfected with wild-type and mutated constructs.
Results indicate a truncated Hcrtr2 protein, an absence of proper
membrane localization, and undetectable binding and signal transduction
for exon-skipping mutated constructs. In contrast, the E54K abnormality
was associated with proper membrane localization, loss of ligand
binding, and dramatically diminished calcium mobilization on activation
of the receptor. These results are consistent with a loss of function for all three mutations. The absence of mutation in sporadic cases also
indicates genetic heterogeneity in canine narcolepsy, as reported
previously in humans.
 |
INTRODUCTION |
Narcolepsy is a neurological sleep disorder affecting humans and
animals (Baker et al. 1982 ; Mignot et al. 1992 ;
Aldrich 1998 ). It is characterized by excessive daytime sleepiness and
symptoms of abnormal rapid-eye-movement (REM) sleep (cataplexy,
hypnagogic hallucinations, and sleep paralysis). Cataplexy is a sudden
loss of muscle tone triggered by emotions that share some physiological similarities with REM sleep atonia. This symptom is the most valuable clinical feature used to diagnose narcolepsy in humans and animals (Nishino and Mignot 1997 ; Anic-Labat et al. 1999 ).
Canine and human narcolepsy are strikingly similar at the clinical and
genetic epidemiological level. Most cases of human and canine
narcolepsy are sporadic in nature (Baker et al. 1982 ; Mignot et al.
1992 ; Mignot 1998 ). Familial clustering suggestive of highly penetrant
narcolepsy genes is observed occasionally in both human and canines.
Human narcolepsy is tightly associated with HLA-DQB1*0602 and has been
suggested to be autoimmune in nature (Mignot et al. 1995 , 2001 ). In
contrast, canine narcolepsy is not associated with specific dog
leukocyte antigen (DLA) -DQ alleles (Wagner et al. 2000 ), but the
involvement of other major histocompatibility complex (MHC) loci
remains to be investigated.
Recent studies have implicated Hypocretin (also called Orexin)
abnormalities in both human and canine narcolepsy (Lin et al. 1999 ;
Nishino et al. 2000 ; Peyron et al. 2000 ; Thannickal et al. 2000 ; Ripley
et al. 2001 ). In Dobermans and Labradors, familial canine narcolepsy is
caused by exon-skipping mutations of the Hcrtr2 (Lin et al.
1999 ). Sporadic human narcolepsy-cataplexy is associated with
dramatically decreased Hcrt transcript and peptides in brain
and CSF (Nishino et al. 2000 ; Peyron et al. 2000 ; Thannickal et al.
2000 ). This result parallels recent findings indicating undetectable
CSF Hcrt-1 levels in two sporadic canine narcolepsy cases but not in
Hcrtr2-mutated canines (Nishino et al. 2000 ; Ripley et al. 2001 ).
The majority of familial and sporadic cases of human narcolepsy lack
Hcrt system gene mutations. In a recent study including 74 patients of various HLA and family history status, only one mutation
was observed in the signal peptide of the Hcrt locus in a
child with early onset and severe narcolepsy-cataplexy (Peyron et al.
2000 ). Mutations in the two Hypocretin receptor genes, Hcrtr1
and Hcrtr2, were not observed. In this study, we characterized the dog Hcrt locus and sequenced the Hcrt and
Hcrtr2 loci in sporadic and familial cases of dog narcolepsy
to identify potential mutations.
 |
RESULTS |
Isolation and Characterization of the Canine Hcrt and
Hcrtr2 Loci
A total of 16 bacterial artificial chromosome (BAC) clones covering
the Hcrtr2 locus and its immediate vicinity were isolated (Fig. 1A). Seven canine
Hcrt-positive BAC clones covering ~200 kb (Fig.
1B) were isolated by library screening as described in the Methods
section. The canine Hcrtr2 locus has been previously described
(Lin et al. 1999 ), but approximate exon locations are now reported
(Fig. 1A). A sequence of 1961 bp encompassing the newly isolated canine
Hcrt gene including exon 1, exon 2, intron, and flanking
sequences has been submitted to GenBank (accession no. AF285110). The
locus is organized similarly to the human locus (Sakurai et al. 1998 ).
Exon 2 encompasses the full sequence of both the Hcrt-1 and Hcrt-2
peptides. The predicted mature amino acid sequence of canine Hcrt-1 is
identical to human, rat, pig ,and mouse sequences, while canine Hcrt-2
differs from the human sequence by one amino acid (S71P; Fig.
2). We also isolated and mapped three novel
microsatellite polymorphic markers in the vicinity of Hcrt.

View larger version (19K):
[in this window]
[in a new window]
|
Figure 1
Canine BAC clone contigs encompassing the Hcrtr2 locus
(A) and Hcrt (B). Approximate exon locations
are indicated by dark boxes with associated exon numbers. Sequence tag
sites (STS) for which locations were not strictly constrained were
spaced at roughly equidistant intervals between constrained markers.
Polymorphic microsatellite markers are indicated with dotted lines.
Note the large distance between exons 1 and 2 as well as between exons
4 and 5. The crossover reported in Figure 3 occurred between 6-28-2 and
exon 5.
|
|

View larger version (21K):
[in this window]
[in a new window]
|
Figure 2
Deduced amino acid sequence of the canine preprohypocretin peptide and
mature Hcrt-1 and Hcrt-2 peptides (black boxes). Sequences for other
known species (human, rat, pig, and mouse) are indicated for
comparative purposes. Variable residues are marked in black-underlined
letters. Please note that while Hcrt-1 is identical in all species,
canine and pig Hcrt-2 are identical but Hcrt-2 differs in other
species.
|
|
Mutation Screening of Hcrt and Hcrtr2 in
Canine Narcolepsy
The seven exons of Hcrtr2 and two exons of Hcrt
were screened by sequencing PCR products encompassing the exons and a
minimum of 50 bp of flanking sequence on both sides. Seven
Hcrtr2 and three Hcrt polymorphisms were observed in
17 narcoleptic dogs, 28 unrelated controls, and 15 related asymptomatic
dogs. All polymorphisms but one were benign, being observed in both
asymptomatic and narcoleptic animals. Most of these polymorphisms were
common in controls and unrelated narcoleptic animals across several
breeds. Allele frequencies in unrelated control Poodles (10 animals,
P), Dachshunds (9, Da), Dobermans (7, Do), and Labradors (2, L) were
Hcrtr2 Exon 1 26G C (P: 0.50, Da: 0.33, Do: 0.78, L:
0.75); Hcrtr2 Exon 1 202TCG deletion (P: 0.50, Da: 0.17, Do: 0.71, L: 0.00); Hcrtr2 Exon 2 15T C (P: 0.50, Da:
0.89, Do: 0.36, L: 0.00); Hcrtr2 Exon 2 111A G (P: 0.50, Da: 0.12, Do: 0.57, L: 1.00); Hcrtr2 Exon 5 +61C T (P:
1.00, Da: 0.89, Do: 1.00, L: 0.50); Hcrtr2 Exon 6 64A G (P: 0.55, Da: 0.39, Do: 0.71, L: 0.75); Hcrt
Exon 2 57G T (P: 0.00, Da: 0.00, Do: 0.00, L: 0.25). Two
Hcrt polymorphisms were observed only in the multiplex family
of poodles (Hcrt exon 1 75 C A; Hcrt exon 2 +67 G A; A30T [Alanine Threonine]) and were found not to
segregate with disease susceptibility.
A Novel Hcrtr2 Mutation Causing Autosomal Recessive
Narcolepsy in a Dachshund Pedigree
A highly penetrant Hcrtr2 mutation was observed in a
Dachshund family. This mutation of Exon 1 (461G A) results in a
Glutamic acid (E) to Lysine (K) change at position 54 of the Hcrtr2
protein (E54K). The mutation is located at the level of the last amino acid of the N-terminal region of the receptor, immediately preceding the first transmembrane domain of the receptor. All three narcoleptic dogs born in the litter are homozygous for the substitution. The DNA
change was not found in any other sporadic or familial narcoleptic canine or in healthy control dogs (144 chromosomes).
Segregation Studies in Familial Narcolepsy
All available Hcrtr2 and Hcrt microsatellite
markers and single-nucleotide polymorphisms were used to examine
cosegregation with narcolepsy in multiplex family pedigrees. Results
for Hcrtr2 and familial Doberman and Labrador narcolepsy have
been reported previously (Lin et al. 1999 ). Of special interest was the
observation of a crossover in the disease locus (Hcrtr2) in a
member of the Dachshund family (Fritz; Fig.
3). The detailed mapping of the Hcrtr2 gene revealed that this crossover occurred between
6-28-2 and exon 5 (Fig. 1A). Interestingly, narcolepsy in the Poodle pedigree did not cosegregate with Hcrtr2 or Hcrt
markers (data not shown), indicating that another locus is most likely
implicated. The exon 2 A30T amino acid substitution observed only in
the Poodle family was a benign polymorphism located in the signal
peptide region of Hcrt, with the unaffected father being
homozygous for the substitution and all the offspring, whether affected
or not, being heterozygous for this change. This hydrophobic to neutral substitution is located in a variable region of the signal peptide across species (Fig. 2).

View larger version (17K):
[in this window]
[in a new window]
|
Figure 3
Mapping of an informative Hcrtr2 gene crossover observed in a
litter of Dachshund with a recessive Hcrtr2 mutation causing
narcolepsy. Six microsatellite markers located in the vicinity of
Hcrtr2 were used (Lin et al. 1999 , and Fig. 1A). Alleles are
arbitrarily numbered by size and displayed in parenthesis. Five
sequenced variants (four single nucleotides polymorphisms and a 3-bp
deletion in exon 1) described in the Results section were also used.
Note that the informative crossover occurred between marker 6-28-2 and
exon 5 (Fig. 1A). The disease-causing mutation is the third
polymorphism indicated in bold (exon 1, G/A).
|
|
Functional Analysis of the Mutated Hcrtr2 Receptors
The functional effects of the two previously described exon-skipping
Hcrtr2 mutations (Labradors and Dobermans) and of E54K were
examined using Western blot analysis, expression of GFP tagged receptors, radioreceptor binding, and calcium flux studies in human
embryonic kidney (HEK) 293 cells. Western blot analysis of mutated and
wild-type expressed proteins indicated truncated Hcrtr2 in mutated
Dobermans (55 kD) and Labradors (65 kD) but not in wild-type or E54K
mutated proteins (78 kD; data not shown). These results are in
agreement with a predicted frame shift for these two corresponding
exon-skipping mutations (Lin et al. 1999 ). In-frame GFP tags were added
to the cDNA sequence of wild-type and mutant alleles to examine
cellular localization in HEK-293 (see Methods). Fluorescence microscopy
indicated that wild-type and E54K-substituted Hcrtr2 receptors were
mostly expressed on the cell membrane, lining the shape of the cells
(Fig. 4A,B). In contrast, exon-skipping
mutated Hcrtr2 proteins were predominantly located
intracytoplasmically, staining HEK cells (Fig. 4C,D) similar to control
cells in which the GFP constructs were expressed (data not shown).

View larger version (59K):
[in this window]
[in a new window]
|
Figure 4
Localization of GFP-tagged mutated Hcrtr2 constructs in HEK-293 cells.
Wild-type (A) and E54K (B) mutated constructs are
expressed in the membrane, lining the surface of the cells. Truncated
Hcrtr2 receptors of Doberman (C) and Labrador (D)
mutants are cytoplasmically located.
|
|
Radioreceptor binding studies were also performed in all
Hcrtr2-transfected cells (with and without GFP tags), using
[125I] Hcrt-1. Saturation studies in wild-type receptors
indicated a Kd of 0.9 nM for Hcrt-1. Further studies indicated no
specific binding for all mutated receptors, even in E54K
Hcrtr2-transfected cells known to express the receptor on its surface
(Fig. 5). Lack of specific binding was
demonstrated for this mutation even at saturating levels of
radiolabeled ligand (4 nM). We also evaluated functional effects of the
transfected receptor by measuring Ca2+ influx in response to
Hcrt-1 and Hcrt-2 application (0.25 nM-1 µM). Calcium response to
Hcrt-1 in wild-type receptors is shown in Figure
6. As expected, no response was observed in
cell lines transfected with the truncated Hcrtr2 mutated proteins of
narcoleptic Dobermans and Labradors, even when up to 1 µM of Hcrt-1
and Hcrt-2 were added (data not shown). The response of the substituted
E54K Hcrtr2 receptor was more intriguing. A 1000-fold reduced response was observed, with a 1-µM concentration of Hcrt-1 weakly activating Calcium influx at levels similar to 0.25 nM in wild-type receptors (Fig. 6). Results were identical whether or not the constructs were
associated with a C-terminal GFP tag (data not shown).

View larger version (15K):
[in this window]
[in a new window]
|
Figure 5
Radioreceptor-binding studies of wild-type (square symbol) and E54K
(round symbol) mutated receptors using [125I] Hcrt-1.
HEK-293 cells transfected with wild-type and mutated Hcrtr2 constructs
with and without GFP were used (for technical details, see text). Note
that wild -type receptors express saturable binding with an approximate
Kd of 0.9 nM, while E54K does not bind the ligand at concentrations up
to 4 nM. Data obtained with other mutated constructs are not shown, but
the cells do not display any specific binding.
|
|

View larger version (27K):
[in this window]
[in a new window]
|
Figure 6
Ca2+ influx after application of Hcrt-1 using wild type
(A) and E54K (B) receptors (for technical details,
see Methods). Ionomycin induces similar calcium influx in control and
mutated receptors. Control receptors are activated at a higher level
and by significantly lower Hcrt-1 concentrations (A) than the
mutated E54K receptor. Similar results were obtained with Hcrt-2
(data not shown). Truncated mutants (Labrador and Doberman) did not
react to Hcrt stimulation (see text).
|
|
 |
DISCUSSION |
In this study, we systematically screened the Hcrt and
Hcrtr2 loci in sporadic and familial cases of canine
narcolepsy and identified only a single novel point mutation in the
Hcrtr2 gene in a narcoleptic Dachshund multiplex family. The
mutation, a 461G A substitution in exon 1, causes an amino acid
change from Glutamic acid to Lysine (E54K) in the N-terminal part of
the G-protein coupled receptor (GPCR). Functional analysis studies were
performed for E54K and two previously-identified exon-skipping
mutations. Results indicate a loss of function consistent with
autosomal recessive transmission in these pedigrees and in vitro
mutation data reported for other GPCR systems (Novotny et al. 1994 ; van Eyll et al. 1996 ; Pearce et al. 1996 ). Many naturally-occurring activating and deactivating mutations have been identified in various
GPCR in a number of diseases (Spiegel 1998 ).
Functional studies in two exon-skipping mutations reported previosly in
Labradors and Dobermans indicate a truncated receptor protein that is
not even localized on the cytoplasmic membrane. The location of the
skipping mutation predicts a 247 and a 330 amino acid protein in
narcoleptic Dobermans and Labradors (as opposed to 444 for the wild
type protein). Whereas the Doberman mutation is associated with a
protein carrying only four of seven transmembrane domains and thus was
rather unlikely to localize on the cell surface, the Labrador mutation
is only truncated past the sixth transmembrane domain and could
theoretically be normally translocated to the cell surface. Previous
studies using other GPCR receptors have shown that truncated receptors
may or may not be localized to the membrane or even bind their
respective ligand (Schöneberg et al. 1995 ; Ho and MacKenzie 1999 ;
Ling et al. 1999 ). The lack of membrane localization for the two Hcrtr2 mutants suggest that undetermined sequences in the last extracellular loop, the seventh transmembrane domain, and the C-terminal region of
Hcrtr2 are necessary for proper cellular transport of the receptor.
Functional analysis of the E54K N-terminal substitution was more
intriguing. The mutated receptor localizes to the membrane but does not
bind Hypocretin at physiological concentrations (up to 4 nM).
Interestingly, however, Ca2+ mobilization studies indicate
that the receptor may still be activated by abnormally high ligand
concentrations (>1 µM) suggesting a very reduced but not absent
affinity for Hcrt-1. This result parallels in vitro functional studies
reported for similar mutations in other GPCR receptors. The N-terminal
extracellular domain of GPCRs is critically important for agonist
binding and resulting receptor activation (Couvineau et al. 1995 ; van
Eyll et al. 1996 ; de Lucca et al. 1997 ). Single amino acid
substitutions in the N-terminal region of the Glucagon-like peptide 1 receptor and/or human vasoactive intestinal peptide 1 receptors impair
ligand binding and cAMP intracellular activation (van Eyll et al. 1996 ; Gaudin et al. 1998 ). Other N-terminal substitutions can produce constitutive receptor activation, dominant diseases, and gain of
function, for example, in sporadic hypoparathyroidism (de Lucca et al.
1997 ). Of importance is the fact that our substitution replaces a
negatively charged Glutamic acid with a positively charged Lysine. The
E54 residue is present for both Hcrtr1 and Hcrtr2 receptors in dogs,
humans, pigs, and rats, suggesting a functionally important residue for
Hypocretin binding (Sakurai et al. 1998 ; Lin et al. 1999 ). Changes in
the charge distribution of the ligand-binding site of the N-terminal
extracellular domain of GPCR often reduce or increase affinity of GPCRs
for their ligand (Pearce et al. 1996 ; van Eyll et al. 1996 ).
The E54K mutation is the first example of a single amino acid
substitution in the Hcrtr2 gene causing autosomal recessive canine narcolepsy. We conclude that the E54K and the two exon-skipping mutated Hcrtr2 lead to a complete loss of function consistent with
autosomal recessive transmission. Interestingly, no other Hypocretin
gene mutations were observed in 11 sporadic cases of narcolepsy or in
one additional multiplex family of Poodles. This result parallels data
observed in humans that indicate no hypocretin mutations in most cases
(Peyron et al. 2000 ). In this recent study, a large number of familial
and sporadic cases of human narcolepsy were screened for the
Hcrt, Hcrtr1, and Hcrtr2 loci. Only one single mutation, a signal peptide alteration in the Hcrt locus producing dominant, severe, and early onset narcolepsy-cataplexy, was
observed, indicating genetic heterogeneity. No Hcrtr2
mutations were reported in this study.
The lack of reported receptor mutations in familial human cases
contrasts with the three reported Hcrtr2 mutations observed in
canine narcolepsy. This finding could be explained by canine inbreeding
in the face of recessive mutations, species-specific differences in
mutation rates among loci, and/or differences in phenotype expression
between animals and humans. In this vein, Hcrtr2-receptor-mutated mice have recently been shown to
exhibit cataplexy and to have disturbed sleep patterns but may have a less severely affected phenotype than Hcrt knockout mice
(Chemelli et al. 1999 , 2000 ). This observation parallels data in
canines indicating that Hcrtr2-mutated familial cases are
generally less affected than are sporadic cases (Baker et al. 1982 ),
now known to have undetectable Hcrtr-1 CSF levels (Ripley et al. 2001 ). In contrast, Hcrtr-1-receptor knockout mice do not display
cataplexy but have a milder degree of sleep fragmentation, suggesting a more minor but possibly significant role for Hcrtr-1 in the expression of the narcolepsy phenotype (Kisanuki et al. 2000 ). In this context, the lack of Hypocretin receptor mutations in human narcolepsy might
also be explained by a milder phenotype for these alterations in humans
versus other mammals.
The lack of mutations observed in most human and canine cases does not
necessarily mean that Hypocretin system plays an insignificant role in
most cases of narcolepsy. Deficient Hcrt neurotransmission is involved
in most sporadic cases, with undetectable Hcrt-1 CSF levels and a
dramatic loss of Hypocretin mRNA and peptides reported in human brains
and in two sporadic cases of canine narcolepsy (Nishino et al. 2000 ;
Peyron et al. 2000 ; Thannickal et al. 2000 ; Ripley et al. 2001 ). In
human narcolepsy, the disorder is HLA-DQ associated (Mignot et al.
2001 ), and an autoimmune destruction of Hypocretin-containing cells has
been postulated but not established for these cases. The absence of
Hcrt mutations in sporadic cases of canine narcolepsy,
together with undetectable CSF levels, may suggest similar
pathophysiological mechanisms in sporadic canine narcolepsy cases. In
contrast to human narcolepsy, however, canine narcolepsy is not
associated with DLA-DQ (Wagner et al. 2000 ). This result could be
explained by a different role of various MHC heterodimers in disease
susceptibility across animal species. Additional neuropathological and
genetic screening studies in human, mouse, and canine narcolepsy will
in time answer these important questions.
 |
METHODS |
Canine Patients and Controls
A total of 78 dogs (17 with narcolepsy) were investigated in this
study. All affected dogs had cataplexy (the pathognomonic feature of
narcolepsy) when emotionally excited with food or playing. Most cases
were initially diagnosed by veterinarians familiar with narcolepsy, and
the diagnosis was confirmed with clinical interviews by one of the
authors (E. M.). Three sporadic cases and most Doberman and Labrador
familial cases were donated to the Center for Narcolepsy and had their
diagnoses verified. Sporadic cases were typically more severely
affected when compared to familial cases, had undetectable CSF
Hypocretin-1 levels when tested (n = 2; Ripley et al. 2001 ),
and had a later and more variable age of onset, as previously described
(Baker et al. 1982 ). Familial cases included three affected Dachshunds
in a multiplex family of six and three affected Poodles in a family of
13 Poodles. Ten affected Dobermans and 10 affected Labradors with
previously-reported Hcrtr2 mutations were also investigated.
These dogs have been shown to have normal CSF Hypocretin-1 levels
(Nishino et al. 2000 ). Eleven sporadic cases (seven Poodles, three
Dachshunds, and one Labrador) and 28 healthy dogs (10 Poodles, nine
Dachshunds, seven Labradors, and two Dobermans) were also included.
Canine BAC Library Screening
The isolation of the Hcrtr2 loci was previously described
in Lin et al. (1999) . Attempts to screen the canine BAC library with
human and rodent Hcrt probes were unsuccessful. Partial canine cDNA sequences were obtained using degenerate consensus PCR primers derived from rodent and human sequences. Total RNA was extracted from
the cortex of two canines, one wild-type and one sporadic narcoleptic
Dachshund, using RNeasy Maxi (QIAGEN). mRNA was purified from total RNA
using Oligotex mRNA Midi Kits (QIAGEN). cDNA was synthesized using
SuperScript II RT Kit (GIBCO BRL) and amplified using preproF:23
(5'CCCT GAGCKCCAGRCACCATGAA3') and preproR(Sal1):18 (5'CGCGTCGACGAGAMWCGTCTTTATTGCC3'). These primers were designed in the Hcrt gene according to known human, mouse, and rat cDNA sequences. PCR conditions were 95°C for 2 min and 35 cycles of 94°C for 1 min, 56°C for 1 min, and 72°C for 1 min and a final extension of 72°C for 5 min. cDNA sequences were analyzed on an ABI
PRISM 377 DNA sequencer (Perkin Elmer). Probes designed using canine
cDNA exon 1 and exon 2 sequences were found to be inappropriate for
library screening. Exon 1 and exon 2 primers were thus designed to
amplify and sequence intronic regions of the Hcrt locus
using canine genomic DNA. F1 (5'AGAGCACTATAAACCCCAGACC3';
5' end of exon 1 Hcrt) and dppR4
(5'AGTCTTYTGRCGACAGCAGTCG3'; first part of exon 2 Hcrt) were used to generate a 1079-bp PCR product, containing exon 1, the intron region between exon 1 and 2 and the first part of
exon 2. PCR conditions were one cycle of 95°C (2 min); 10 cycles of
94°C (1 min), 57°C (1 min), 72°C (1 min); followed by 30 cycles of 94°C (1 min), 55°C (1 min), 72°C (1 min); and ending
with one cycle of 72°C (5 min). This fragment was sequenced and used
as a probe to screen our previously described Canine Genomic BAC Library (Li et al. 1999 ).
Isolation and Testing of Polymorphic Markers
Six previously described polymorphic markers (13-14-2, 5-19-6, 6-28-6, 6-28-2, 530-5, and 530-3) located in the vicinity of the canine
Hcrtr2 gene were used in this study (Lin et al. 1999 ). Hcrt dinucleotide microsatellite markers were generated using Hcrt-positive BAC clones as described in Lin et al. (1999) .
Briefly, BAC clones were triple-digested with DraI,
SspI, and EcoRV, and the fragments were ligated to
pBluescript vector (Stratagene). The resulting transformation was
plated on LB/Agar plates covered with a Duralose-UV membrane
(Stratagene). The membrane was duplicated and hybridized with
[ -32P] dATP radiolabeled (CA)15, (GAAA)8, (GAAT)8,
and/or (GATA)8 oligonucleotides. Positives clones were cultured,
extracted, and sequenced with T3 and T7 primers on an ABI 377 DNA
sequencer. The program Primers
(http://www-genome.wi.mit.edu/cgi-bin/primer/primer3_www.cgi) was used
to design flanking primers on all sequence traces containing a repeat
sequence >10 compound repeats. Amplification and detection of the
fragment length polymorphism was performed as described in Lin et al.
(1997) .
Hcrtr2 and Hcrt Contig Building and Sequencing
Characterization of the canine Hcrtr2 locus was partially
described in Lin et al. (1999) . A similar approach was used to
characterize the canine Hcrt locus. Direct BAC sequencing of
the positive clones was performed to determine end sequences and to
complete the characterization of exons, intron, and of at least 275-bp
flanking boundaries. Sequence tag sequences (STS) primers were designed
to amplify ~200 bp in the end of each BAC clone. Insert size was
determined using NotI digestion followed by pulsed field gel
electrophoresis in 1% agarose with CHEF-DR-II system (Bio-Rad), as
described previously (Li et al. 1999 ). STS primer amplification, typing
of polymorphic markers, sizing, and hybridization with selected
Hcrt and Hcrtr2 probes were used to organize the
contigs for each respective loci.
Mutation Screening of the Hcrtr2 and Hcrt
Loci in Narcoleptic Canines
Primers designed in the flanking 5' and 3' intron regions
of Hcrtr2 (seven exons; Lin et al. 1999 ) and Hcrt
(two exons) were used to amplify and sequence these loci. PCR primers
and conditions are Hcrtr2, exon 1: EXON1F
(5'ACCTCTTTGTTT GCCTCCCAG3') and EXON1R (5'GTGGGCTTCTGCTCTC CCTCT3'): 95°C (2 min); 30 cycles of
94°C (1 min), 55°C (1 min), 72°C (1 min); and 72°C (5 min).
Hcrtr2 Exon 2: 2INF (5'AGGGTCCCTTTTATAAAGGCAC3') and
2INR (5'GT GATCCTGGAGGCTCAAG ATC3'): 95°C (2 min); 30 cycles of 94°C (1 min), 56°C (1 min), 72°C (1 min); and
72°C (5 min). Hcrtr2 Exon 3: 3INF
(5'GAATCCAATTATCTGTGCAACC3') and 3INR
(5'GCAGAGCTATTCAGTGAAATGG3'): 95°C (2 min), 30 cycles of
94°C (1 min), 56°C (1 min), 72°C (1 min); and 72°C (5 min). Hcrtr2 Exon 4: 4INF (5'ATATTGGGGGAG GAACAGAAGG3')
and 4INR (5'GAAGGCTTGACTGTG GATAGCC 3'): 95°C (2 min); 30 cycles of 94°C (1 min), 56°C (1 min), 72°C (1 min); and
72°C (5 min). Hcrtr2 Exon 5: 5INF
(5'AAGTATCCAGAACACTGTCCTTCC3') and EXSHCR-2R
(5'GAAGGCTTGACTGTGGATAGCC3'): 95°C (2 min); 10 cycles of
94°C (1 min), 57°C (1 min), 72°C (1 min); 30 cycles of 94°C (1 min), 55°C (1 min), 72°C (1 min); and 72°C (5 min).
Hcrtr2 Exon 6: 6INF (5'GACTTCATTTGGCCTTTGATT TAC3')
and 6INR (5'ACATTTGAAAACTCACCACTG AGA3'): 95°C (2 min); 10 cycles of 94°C (1 min), 57°C (1 min), 72°C (1 min); 30 cycles
of 94°C (1 min), 55°C (1 min), 72°C (1 min); and 72°C (5 min). Hcrtr2 Exon 6/intron between Exon 6 and Exon 7/5'
end of exon 7: 6EXF (5'GAGACCGTATATGCCTG GTTTACAT3') and 7EXR
(5'TTTTGATACGTTGTCGAA ATT GCT3'): 95°C for 2 min; 5 cycles of 94°C (1 min), 58°C (1 min), 72°C (1 min); 30 cycles of
94°C (1 min), 55°C (1 min), 72°C (1 min); and 72°C (5 min).
Hcrtr2 Exon 7: 7INF (5'AAGAGTCTAGCAAGCTTCCCGTAA3') and
7INR (5'GCAAACAATCTGCAGGTAAGAGAT3'): 95°C (2 min); 30 cycles
of 94°C (1 min), 57°C (1 min), 72°C (1 min); and 72°C (5 min). Hcrt Exon 1: Ex1pp01 (5'CTTGGCGGCCAT TCTTTG3') and EMR2 (5'GGCAGAGACACCTCAGCTT TCT3'): 95°C (2 min); 30 cycles of 94°C (1 min), 55°C (1 min), 72°C (1 min); and
72°C (5 min). Hcrt Exon 2:ppdogintronF1
(5'CCAGAAAAGAGGAGTTCACTGC3') and 3'013 (5'GTCTC CGTACCACGGGGCCTC3'): 95°C (2 min); 10 cycles of
94°C (1 min), 68.9°C (1 min), 72°C (1 min); 25 cycles of
94°C (1 min), 55°C (1 min), 72°C (1 min); and 72°C (5 min).
PCR products were purified using the Qiaquick Kit (QIAGEN),
amplified using the BigDye sequencing mix (PE Biosystems), column purified (Edge Biosystems), and sequenced in both directions on an ABI
PRISM 377 DNA Sequencer (Perkin Elmer). Sequence alignments and trace
comparisons were performed using Sequencher 3.11 (Gene
Codes). cDNA-genomic DNA comparisons were performed using BLAST (http://www.ncbi.nlm.nih.gov/BLAST/). Polymorphism and mutation positions are reported with respect to the first base pair
of each screened exon. Allele frequencies are reported for each sample
of unrelated control animals of each breed when appropriate.
Control and Mutated Hcrtr2 Constructs
Total RNA was isolated from cerebral cortex of a narcoleptic
Doberman, Doberman wild type, narcoleptic Labrador, and Labrador wild
type, using the RNeasy Mini Kit (QIAGEN). First-strand cDNA was made
with a cDNA synthesis kit (Life Technologies). To clone the Hypocretin
receptors from wild-type dogs and dogs with narcolepsy, PCR primers
were generated corresponding to the 5' end of the coding sequence
(5'-aaggttaggatccgagccgga ctcgagcccgtgatgtcc-3') and the 3'
end of the coding sequence (5'-aaccttaag
ctttccctgtcatatgaat gaatgttcta-3') of the Hypocretin 2 receptor.
PCR amplification was performed using the following conditions: 95°C
(2 min); 35 cycles of 95°C (40 sec), 63°C (40 sec), 72°C (2 min); and 72°C (5 min). The PCR-amplified material was fractionated
by agarose gel electrophoresis, and a fragment of ~1.3 kb was
isolated, amplified, and cloned into the expression vector pCDNA3.1( )
(Invitrogen). The Hypocretin 2 receptor from a Dachshund that has
narcolepsy was generated by mutating the wild-type receptor based on
the genomic sequence of the Hypocretin 2 receptor found in Dachshunds with narcolepsy. All of the above constructions were confirmed by
sequencing using an Applied Biosystems 377 automated sequencer (Perkin
Elmer). The three mutated and the wild-type Hcrtr2 constructs without a stop codon were also subcloned into pEGFP-N3 (Clontech), which contains the gene for GFP, and the subsequent translated protein,
which contains a GFP tag at the C terminus.
Expression of Control and Mutated Alleles in HEK-293
Stable cell lines expressing dog Hcrtr2 were created by
transfecting the constructions into HEK-293 cells using Effectene (QIAGEN). Cells were cultured in Dulbecco's modified Eagle's medium (GIBCO BRL) supplemented with 10% fetal bovine serum, 2 mM glutamine, 1 mM pyruvate, 10 mM Hepes, 50 U penicillin, and 50 µg/mL
streptomycin. G418 (200 µg/mL) was added after 2 d to the media as a
selection agent and cultures grown for 4 wk. GFP-tagged
receptor-expressing cell lines were observed under inverted
fluorescence microscopy (Nikon Eclipse TE300). Fluorescence images were
captured with a Spot Digital Camera (Diagnostic Instruments) with
standard FITC filter sets, using a 20× objective lens and analyzed by
Image Pro Analysis Software (Media Cybernetics).
Radioreceptor-Binding Studies and Measurements of intracellular
Ca2+ in Transfected Cell Lines
Receptor binding assays were performed using [125I]
Hypocretin-1 (NEN) in Dulbecco's modified medium with 0.1% BSA. Cold
Hypocretin-1 and Hypocretin-2 peptide, (human sequence) were
synthesized at Neurocrine Biosciences. HEK-293 cells were released
using 10 mM EDTA (10 mM) and washed twice with Dulbecco's modified
medium. In each tube, approximately one million cells were added to 1 mL of Binding buffer (Dulbecco's modified medium containing 0.1% BSA)
and 30 pM of [125I] Hcrt-1. To determine nonspecific
binding in each case, 1 µM of cold Hcrt-1 was added. For the
saturation binding experiment, 5-0.01 nM [125I] Hcrt-1
(with twofold series dilution) were added to each tube with 1 µM cold
Hcrt-1 (nonspecific) or without cold Hcrt-1 (total binding) in
triplicate. The binding mixture was incubated for 40 min at room
temperature. Cells were centrifuged at 3000 rpm for 5 min, and cell
pellets were counted for bound [125I] Hcrt-1 in a counter (Packard). Binding studies were analyzed using
PRIZM (GraphPad Software).
Calcium release on activation of the Hypocretin receptors expressed in
HEK-293 was examined. HEK-293 cells expressing either the wild-type or
mutant Hcrtr2 receptors were plated onto 60-mm dishes. After the cells
grew to confluency, the cells were washed with Dulbecco's modified
medium containing 10% fetal bovine serum and 3 µM Indo-1 (Molecular
probe) and pluronic acid (0.01%) and incubated at 37°C for 40 min.
The cells were then released from the dish by the addition of 10 mM
EDTA, washed twice with PBS, and then suspended in Hanks buffer
containing 1 mM MgCl2, 5 mM Glucose, 20 mM Hepes. The PTI
Fluorescence System hardware and Felix software (PTI) were
used to analyze intracellular Ca2+ mobilization in response
to various concentrations of human Hcrt-1 and Hcrt-2.
Western Blot Analysis of Translated Products
SDS loading buffer containing 100 mM DTT was added to whole-cell
lysis or membranes, and the samples were run on an 8%-16% SDS-polyacrylamide gel. Proteins were transferred onto a PDV membrane, blocked with 5% nonfat milk in TBST, incubated with anti-GFP anti body
(Zymed) and then horseradish peroxidase conjugated goat anti-mouse IgG
(Fc specific; Sigma), and detected with ECL system (Amersham Life Sciences).
 |
ACKNOWLEDGMENTS |
This work was supported by National Institutes of Health (NS23724,
NS33797, and HL59601) (E.M.), Deutsche Forschungsgemeinschaft (HU
827/2-1) (M.H.), and Neurocrine Biosciences (J.F., R.A.M). We thank
Anna Voros for her excellent technical support; Seiji Nishino, Robin
Li, Hiroshi Kadotani, Juliette Faraco, Will Rogers, Mario
Pedrazzoli, and Michele Okun for their experimental, technical, and
scientific contributions to this work; and Claudia Gumbiner for editing
the manuscript.
The publication costs of this article were defrayed in part by payment
of page charges. This article must therefore be hereby marked
"advertisement" in accordance with 18 USC section 1734 solely to
indicate this fact.
 |
FOOTNOTES |
3
These authors contributed equally to this work.
4
Corresponding author.
E-MAIL mignot{at}stanford.edu; FAX (650) 498-7761.
Article published on-line before print: Genome Res.,
10.1101/gr.161001.
Article and publication are at www.genome.org/cgi/doi/10.1101/gr.161001.
 |
REFERENCES |
-
Aldrich, M.S.
1998.
Diagnostic aspects of narcolepsy.
Neurology
50:
S2-S7.
-
Anic-Labat, S.,
Guilleminault, C.,
Kraemer, H.C.,
Meehan, J.,
Arrigoni, J., and
Mignot, E.
1999.
Validation of a cataplexy questionnaire in 983 sleep-disorders patients.
Sleep
22:
77-87.
-
Baker, T.L.,
Foutz, A.S.,
McNerney, V.,
Mitler, M.M., and
Dement, W.C.
1982.
Canine model of narcolepsy: Genetic and developmental determinants.
Exp. Neurol.
75:
729-742.
-
Chemelli, R.M.,
Willie, J.T.,
Sinton, C.M.,
Elmquist, J.K.,
Scammell, T.,
Lee, C.,
Richardson, J.A.,
Williams, S.C.,
Xiong, Y.,
Kisanuki, Y.
1999.
Narcolepsy in orexin knockout mice: Molecular genetics of sleep regulation.
Cell
98:
437-511.
-
Chemelli, R.M.,
Sinton, C.M., and
Yanagisawa, M.
2000.
Polysomnographic characterization of Orexin-2 receptor knockout mice.
Sleep
23: (Suppl.):
296-297.
-
Couvineau, A.,
Gaudin, P.,
Maoret, J.J.,
Rouyer-Fessard, C.,
Nicole, P., and
Laburthe, M.
1995.
Highly conserved Aspartate 68, Tryptophane 73 and Glycine 109 in the N-terminal extracellular domain of the human VIP receptor are essential for its ability to bind VIP.
Biochem. Biophys. Res. Commun.
206:
246-252.
-
de Lucca, F.,
Ray, K.,
Mancilla, E.E.,
Fan, G.F.,
Winer, K.K.,
Gore, P.,
Spiegel, A.M., and
Baron, J.
1997.
Sporadic hypoparathyroidism caused by de novo gain of function mutations of the Ca2+-sensing receptor.
J. Clin. Endocrino. Metab.
82:
2710-2715.
-
Gaudin, P.,
Maoret, J.J.,
Couvineau, A.,
Rouyer-Fessard, C., and
Laburthe, M.
1998.
Constitutive activation of the human vasoactive intestinal peptide 1 receptor, a member of the new class II family of G protein-coupled receptors.
J. Biol. Chem.
273:
4990-4996.
-
Ho, G. and
MacKenzie, R.G.
1999.
Functional characterization of mutations in melanocortin-4 receptor associated with human obesity.
J. Biol. Chem.
274:
35816-35822.
-
Kisanuki, Y.Y.,
Chemelli, R.M.,
Sinton, C.M.,
Williams, S.C.,
Richardson, J.A.,
Hammer, R.E., and
Yanagisawa, M.
2000.
The role of orexin receptor Type-1 (OX1R) in the regulation of sleep.
Sleep
23: (Suppl.):
91.
-
Li, R.,
Mignot, E.,
Faraco, J.,
Kadotani, H.,
Cantanese, J.,
Zhao, B.,
Lin, X.,
Hinton, L.,
Ostrander, E.,
Patterson, D., and
de Jong, P.
1999.
Construction and characterization of an eightfold redundant dog genomic bacterial artificial chromosome library.
Genomics
58:
9-17.
-
Lin, L.,
Jin, L.,
Kimura, A.,
Carrington, M., and
Mignot, E.
1997.
DQ microsatellite association studies in three ethnic groups.
Tissue Antigens
50:
507-520.
-
Lin, L.,
Faraco, J.,
Li, R.,
Kadotani, H.,
Rogers, W.,
Lin, X.,
Qiu, X.,
de Jong, P.J.,
Nishino, S., and
Mignot, E.
1999.
The sleep disorder canine narcolepsy is caused by a mutation in the Hcrt (orexin) receptor 2 gene.
Cell
98:
365-376.
-
Ling, K.,
Wang, P.,
Zhao, J.,
Wu, Y.L.,
Cheng, Z.J.,
Wu, G.X.,
Hu, W.,
Ma, L., and
Pei, G.
1999.
Five-transmembrane domains appear sufficient for a G protein-coupled receptor: Functional five-transmembrane domain chemokine receptors.
Proc. Natl. Acad. Sci.
96:
7922-7927.
-
Mignot, E.
1998.
Genetic and familial aspects of narcolepsy.
Neurology
50:
S16-S22.
-
Mignot, E.,
Guilleminault, C.,
Dement, W.C., and
Grumet, F.C.
1992.
Genetically determined animal models of narcolepsy, a disorder of REM sleep.
In Genetically definied animal models of neurobehavioral dysfunction (ed. P. Driscoll), pp. 89-110. Birhäuser, Boston.
-
Mignot, E.,
Tafti, M.,
Dement, W.C., and
Grumet, F.C.
1995.
Narcolepsy and Immunity.
Adv. Neuroimmunol.
5:
23-37.
-
Mignot, E., Lin, L., Rogers, W., Honda, Y., Qiu, X., Lin, X., Okun, M.,
Hohjoh, H., Miki, T., Hsu, S.H., et al. 2001. Complex HLA-DR and DQ
interactions confer risk for narcolepsy-cataplexy in three ethnic
groups. Am. J. Hum. Genet. (in press).
-
Nishino, S. and
Mignot, E.
1997.
Pharmacological aspects of human and canine narcolepsy.
Prog. Neurobiol.
52:
27-78.
-
Nishino, S.,
Ripley, B.,
Overeem, S.,
Lammers, G.J., and
Mignot, E.
2000.
Hypocretin (orexin) deficiency in human narcolepsy.
Lancet
355:
39-40.
-
Novotny, E.A.,
Bednar, D.L.,
Connolly, M.A.,
Connor, J.R., and
Stormann, T.M.
1994.
Mutation of aspartate residues in the third extracellular loop of the rat b2 Bradikinin receptor decrease affinity for bradykinin.
Biochem. Biophys. Res. Comm.
201:
523-530.
-
Pearce, S.H.S.,
Bai, M.,
Quinn, S.J,
Kifor, O.,
Brown, E.M., and
Thakker, R.V.
1996.
Functional characterization of calcium-sensing receptor mutations expressed in human embryonic kidney cells.
J. Clin. Investig.
98:
1860-1866.
-
Peyron, C.,
Faraco, J.,
Rogers, W.,
Ripley, B.,
Overeem, S.,
Charnay, Y.,
Nevsimalova, S.,
Aldrich, M.,
Reynolds, D.,
Albin, R.
2000.
A mutation in early onset narcolepsy and a generalized absence of Hypocretin peptides in human narcoleptic brains.
Nat. Med.
6:
991-997.
-
Ripley, B., Fujiki, N., Okura, M., Mignot, E., and Nishino, S. 2001. Hypocretin levels in sporadic and familial cases of canine narcolepsy.
Neurobiol. Dis. (in press).
-
Sakurai, T.,
Amemiya, A.,
Ishii, M.,
Matsuzaki, I.,
Chemelli, R.M.,
Tanaka, H.,
Williams, S.C.,
Richardson, J.A.,
Kozlowski, G.P.,
Wilson, S.
1998.
Orexins and orexin receptors: A family of hypothalamic neuropeptides and G protein-coupled receptors that regulate feeding behavior.
Cell
92:
573-585.
-
Schöneberg, T.,
Liu, J., and
Wess, J.
1995.
Plasma membrane localization and functional rescue of truncated forms of a G protein-coupled receptor.
J. Biol. Chem.
270:
18000-18006.
-
Spiegel, A.M.
1998.
G proteins, receptors and disease. Humana, Totawa, NJ.
-
Thannickal, T.C.,
Moore, R.Y.,
Nienhuis, R.,
Ramanathan, L.,
Gulyani, S.,
Aldrich, M.,
Cornford, M., and
Siegel, J.M.
2000.
Reduced number of Hypocretin neurons in human narcolepsy.
Neuron
27:
469-474.
-
Van Eyll, B.,
Göke, B.,
Wilmen, A., and
Göke, R.
1996.
Exchange of W39 by A within the N-terminal extracellualr domain of the GLP-1 receptor results in a loss of receptor function.
Peptides
17:
565-570.
-
Wagner, J.L.,
Storb, R.,
Storer, B., and
Mignot, E.
2000.
DLA-DQB1 alleles and bone marrow transplantation experiments in narcoleptic dogs.
Tissue Antigens
56:
223-231.
Received August 16, 2000; accepted in revised form January 25, 2001.
11:531-539 ©2001 by Cold Spring Harbor Laboratory Press ISSN 1088-9051/01 $5.00

CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this?
This article has been cited by other articles:

|
 |

|
 |
 
M. Tonokura, K. Fujita, and S. Nishino
Review of pathophysiology and clinical management of narcolepsy in dogs
Vet Rec.,
September 15, 2007;
161(11):
375 - 380.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. Takakusaki, K. Takahashi, K. Saitoh, H. Harada, T. Okumura, Y. Kayama, and Y. Koyama
Orexinergic projections to the cat midbrain mediate alternation of emotional behavioural states from locomotion to cataplexy
J. Physiol.,
November 1, 2005;
568(3):
1003 - 1020.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Aguirre-Hernandez and D. R. Sargan
Evaluation of Candidate Genes in the Absence of Positional Information: A Poor Bet on a Blind Dog!
J. Hered.,
September 1, 2005;
96(5):
475 - 484.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. T. Beuckmann, C. M. Sinton, S. C. Williams, J. A. Richardson, R. E. Hammer, T. Sakurai, and M. Yanagisawa
Expression of a Poly-Glutamine-Ataxin-3 Transgene in Orexin Neurons Induces Narcolepsy-Cataplexy in the Rat
J. Neurosci.,
May 5, 2004;
24(18):
4469 - 4477.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. Ammoun, T. Holmqvist, R. Shariatmadari, H. B. Oonk, M. Detheux, M. Parmentier, K. E. O. Akerman, and J. P. Kukkonen
Distinct Recognition of OX1 and OX2 Receptors by Orexin Peptides
J. Pharmacol. Exp. Ther.,
May 1, 2003;
305(2):
507 - 514.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. P. Kukkonen, T. Holmqvist, S. Ammoun, and K. E. O. Akerman
Functions of the orexinergic/hypocretinergic system
Am J Physiol Cell Physiol,
December 1, 2002;
283(6):
C1567 - C1591.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
B. Ripley, S. Overeem, N. Fujiki, S. Nevsimalova, M. Uchino, J. Yesavage, D. Di Monte, K. Dohi, A. Melberg, G. J. Lammers, et al.
CSF hypocretin/orexin levels in narcolepsy and other neurological conditions
Neurology,
December 26, 2001;
57(12):
2253 - 2258.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Hungs, L. Lin, M. Okun, and E. Mignot
Polymorphisms in the vicinity of the hypocretin/orexin are not associated with human narcolepsy
Neurology,
November 27, 2001;
57(10):
1893 - 1895.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. S. Kilduff
Sleepy Dogs Don't Lie: A Genetic Disorder Informative About Sleep
Genome Res.,
April 1, 2001;
11(4):
509 - 511.
[Full Text]
|
 |
|
|