Abstract
Reproductive toxicity encompasses harmful effects of various agents on all aspects and stages of the reproductive cycle, including infertility and the induction of adverse effects in the embryo/fetus. In developing a model for reproductive toxicity screening, it is important to define the stage of the human reproductive cycle that this specific model is going to recreate in vitro and to identify molecular targets that are critical for this stage of development. In this review, we focus our discussion on modeling pre-implantation embryotoxicity. The rationale for this is that despite advances on both clinical and biological levels, many unresolved infertility cases may be due to our lack of knowledge regarding environmental influences on this short, but critical stage of development. Data from in vitro fertilization practice suggest that the early-dividing embryo is very sensitive to numerous factors present in its microenvironment. In vivo, as the embryo travels down the oviduct, physical or chemical insults can directly damage the embryo and/or prevent implantation, and cause infertility. Multiple lines of evidence point to the differences between mouse and human pre-implantation development and between mouse and human embryonic stem cells (hESCs). In light of these data we present the case that hESCs and their derivatives are better suited as in vitro models for human pre-implantation development than their mouse counterparts. We then describe some of the most promising hESC-based systems that are used today to model certain aspects of development in the human pre-implantation embryo and that have the potential to be used for embryo toxicity screening tests in the near future. Described systems model two major events during differentiation of the human pre-implantation embryo: differentiation of the trophectoderm and segregation of the inner cell mass into epiblast and hypoblast. The first event is replicated in vitro by triggering either direct or indirect (through embryoid body stage) differentiation into trophectoderm. The second event can be modeled using the recently described system of high-throughput generation of embryoid bodies that recapitulate segregation of inner cell mass. We conclude by discussing the potential of these existing models in toxicology studies and the possibilities for their improvement in the future.
Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest
Bibliography
- 1 The Teratology Society: Teratology Primer. The Teratology Society, Reston, USA (2005).Google Scholar
- 2 Miller RK, Peters PW, Schaefer CE: General commentary on drug therapy and drug risks in pregnancy. In: Drugs During Pregnancy and Lactation (2nd Edition). Schaefer CE, Peters PW, Miller RK (Eds). Academic Press, New York, USA (2007).Google Scholar
- 3 Lutwak-Mann C: Drugs and the blastocyst. In: Fetal Pharmacology. Boreus L (Ed.). Plenum Press, New York, USA 569–605 (1973).Google Scholar
- 4 Fabro S: Passage of drugs and other chemicals into the uterine fluids and pre-implantation blastocyst. In: Fetal Pharmacology. Boreus L (Ed.). Plenum Press, New York, USA 443–459 (1973).Google Scholar
- 5 Miller RK, D Mattison, Filler R, Rice J: Reproductive and Developmental Toxicology. In: Drug Therapy During Pregnancy. Eskes TEAK, Finster M (Eds). Butterworth & Co, London, UK (1985).Google Scholar
- 6 Fille R, Lew KJ: Developmental onset of mixed-function oxidase activity in pre-implantation mouse embryos. Proc. Natl Acad. Sci. USA78,6991–6995 (1981).Crossref, Medline, Google Scholar
- 7 Vogel R: In vitro approach to fertility research: genotoxicity tests on primordial germ cells and embryonic stem cells. Reprod. Toxicol.7(Suppl. 1),69–73 (1993).Crossref, Medline, Google Scholar
- 8 Scholz G, Pohl I, Genschow E, Klemm M, Spielmann H: Embryotoxicity screening using embryonic stem cells in vitro: correlation to in vivo teratogenicity. Cells Tissues Organs165,203–211 (1999).Crossref, Medline, CAS, Google Scholar
- 9 Spielmann H, Bochkov NP, Costa L et al. : 13th Meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC): alternative testing methodologies for organ toxicity. Environ. Health Perspect.106(Suppl. 2),427–439 (1998).Medline, CAS, Google Scholar
- 10 Mummery CL, Slager HG, van Inzen W, Freund E, van den Eijnden-Van Raaij AJ: Regulation of growth and differentiation in early development: of mice and models. Reprod. Toxicol.7(Suppl. 1),145–154 (1993).Crossref, Medline, CAS, Google Scholar
- 11 Rohwedel J, Guan K, Hegert C, Wobus AM: Embryonic stem cells as an in vitro model for mutagenicity, cytotoxicity and embryotoxicity studies: present state and future prospects. Toxicol. In vitro15,741–753 (2001).▪▪ Comprehensive overview of current and potential uses of human embryonic stem cells (hESCs) in toxicological studies.Crossref, Medline, CAS, Google Scholar
- 12 Gorba T, Allsopp TE: Pharmacological potential of embryonic stem cells. Pharmacol. Res.47,269–278 (2003).Crossref, Medline, CAS, Google Scholar
- 13 Pellizzer C, Adler S, Corvi R, Hartung T, Bremer S: Monitoring of teratogenic effects in vitro by analysing a selected gene expression pattern. Toxicol. In Vitro18,325–335 (2004).Crossref, Medline, CAS, Google Scholar
- 14 Genschow E, Spielmann H, Scholz G et al. : Validation of the embryonic stem cell test in the international ECVAM validation study on three in vitro embryotoxicity tests. Altern. Lab. Anim.32,209–244 (2004).Crossref, Medline, CAS, Google Scholar
- 15 Seiler A, Visan A, Buesen R, Genschow E, Spielmann H: Improvement of an in vitro stem cell assay for developmental toxicity: the use of molecular endpoints in the embryonic stem cell test. Reprod. Toxicol.18,231–240 (2004).▪▪ Introduces molecular end points into embryotoxicity testing.Crossref, Medline, CAS, Google Scholar
- 16 Genschow E, Scholz G, Brown N et al. : Development of prediction models for three in vitro embryotoxicity tests in an ECVAM validation study. In Vitro Mol. Toxicol.13,51–66 (2000).Medline, CAS, Google Scholar
- 17 zur Nieden NI, Kempka G, Ahr HJ: Molecular multiple endpoint embryonic stem cell test – a possible approach to test for the teratogenic potential of compounds. Toxicol. Appl. Pharmacol.194,257–269 (2004).▪▪ Provides a comprehensive discussion on the need for molecular end points in embryotoxicity testing.Crossref, Medline, CAS, Google Scholar
- 18 Chung Y, Klimanskaya I, Becker S et al. : Human embryonic stem cell lines generated without embryo destruction. Cell Stem Cell2(2),113–117 (2008).Crossref, Medline, CAS, Google Scholar
- 19 Ilic D, Giritharan G, Zdravkovic T et al. : Derivation of human embryonic stem cell lines from biopsied blastomeres on human feeders with a minimal exposure to xenomaterials. Stem Cells Dev. (2009) (Epub ahead of print).Medline, Google Scholar
- 20 Jaenisch R, Bird A: Epigenetic regulation of gene expression: how the genome integrates intrinsic and environmental signals. Nat. Genet.33(Suppl.),245–254 (2003).Crossref, Medline, CAS, Google Scholar
- 21 Wolffe AP, Matzke MA: Epigenetics: regulation through repression. Science286,481–286 (1999).Crossref, Medline, CAS, Google Scholar
- 22 Wachsman JT: DNA methylation and the association between genetic and epigenetic changes: relation to carcinogenesis. Mutat. Res.375(1),1–8 (1997).Crossref, Medline, CAS, Google Scholar
- 23 Dean W, Lucifero D, Santos F: DNA methylation in mammalian development and disease. Birth Defects Res. C Embryo Today75,98–111 (2005).Crossref, Medline, CAS, Google Scholar
- 24 Haaf T: Methylation dynamics in the early mammalian embryo: implications of genome reprogramming defects for development. Curr. Top. Microbiol. Immunol.310,13–22 (2006).▪▪ Excellent review regarding the role of DNA methylation in development.Crossref, Medline, CAS, Google Scholar
- 25 Reik W, Dean W, Walter J: Epigenetic reprogramming in mammalian development. Science293,1089–1093 (2001).Crossref, Medline, CAS, Google Scholar
- 26 Mayer W, Niveleau A, Walter J, Fundele R, Haaf T: Demethylation of the zygotic paternal genome. Nature403,501–502 (2000).Crossref, Medline, CAS, Google Scholar
- 27 Oswald J, Engemann S, Lane N et al.: Active demethylation of the paternal genome in the mouse zygote. Curr. Biol.10,475–478 (2000).Crossref, Medline, CAS, Google Scholar
- 28 Fulka H, Mrazek M, Tepla O, Fulka Jr J: DNA methylation pattern in human zygotes and developing embryos. Reproduction128,703–708 (2004).Crossref, Medline, CAS, Google Scholar
- 29 Dean W, Santos F, Stojkovic M et al. : Conservation of methylation reprogramming in mammalian development: aberrant reprogramming in cloned embryos. Proc. Natl Acad. Sci. USA98,13734–13738 (2001).Crossref, Medline, CAS, Google Scholar
- 30 Sinkkonen L, Hugenschmidt T, Berninger P et al. : MicroRNAs control de novo DNA methylation through regulation of transcriptional repressors in mouse embryonic stem cells. Nat. Struct. Mol. Biol.15,259–267 (2008).Crossref, Medline, CAS, Google Scholar
- 31 Cui XS, Shen XH, Kim NH: Dicer1 expression in pre-implantation mouse embryos: involvement of Oct3/4 transcription at the blastocyst stage. Biochem. Biophys. Res. Commun.352,231–356 (2007).Crossref, Medline, CAS, Google Scholar
- 32 Tang F, Hajkova P, Barton SC et al. : 220-plex microRNA expression profile of a single cell. Nat. Protoc.1,1154–1159 (2006).Crossref, Medline, CAS, Google Scholar
- 33 Jaroudi S, SenGupta S: DNA repair in mammalian embryos. Mutat. Res.635,53–77 (2007).▪▪ Excellent review regarding the role of DNA repair in early embryogenesis.Crossref, Medline, CAS, Google Scholar
- 34 Gjorret JO, Knijn HM, Dieleman SJ, Avery B, Larsson LI, Maddox-Hyttel P: Chronology of apoptosis in bovine embryos produced in vivo and in vitro. Biol. Reprod.69,1193–1200 (2003).Crossref, Medline, CAS, Google Scholar
- 35 Kawamura K, Sato N, Fukuda J et al. : Survivin acts as an antiapoptotic factor during the development of mouse pre-implantation embryos. Dev. Biol.256,331–341 (2003).Crossref, Medline, CAS, Google Scholar
- 36 Brison DR: Apoptosis in mammalian pre-implantation embryos: regulation by survival factors. Hum. Fertil. (Camb.)3,36–47 (2000).Crossref, Medline, Google Scholar
- 37 Aladjem MI, Spike BT, Rodewald LW et al. : ES cells do not activate p53-dependent stress responses and undergo p53-independent apoptosis in response to DNA damage. Curr. Biol.8,145–155 (1998).Crossref, Medline, CAS, Google Scholar
- 38 Hardy K: Apoptosis in the human embryo. Rev. Reprod.4,125–134 (1999).Crossref, Medline, CAS, Google Scholar
- 39 Zheng P, Schramm RD, Latham KE: Developmental regulation and in vitro culture effects on expression of DNA repair and cell cycle checkpoint control genes in rhesus monkey oocytes and embryos. Biol. Reprod.72,1359–1369 (2005).Crossref, Medline, CAS, Google Scholar
- 40 Jurisicova A, Latham KE, Casper RF, Varmuza SL: Expression and regulation of genes associated with cell death during murine pre-implantation embryo development. Mol. Reprod. Dev.51,243–253 (1998).Crossref, Medline, CAS, Google Scholar
- 41 Larsen E, Gran C, Saether BE, Seeberg E, Klungland A: Proliferation failure and gamma radiation sensitivity of Fen1 null mutant mice at the blastocyst stage. Mol. Cell Biol.23,5346–5353 (2003).Crossref, Medline, CAS, Google Scholar
- 42 Brown EJ, Baltimore D: ATR disruption leads to chromosomal fragmentation and early embryonic lethality. Genes Dev.14,397–402 (2000).Medline, CAS, Google Scholar
- 43 Sharan SK, Morimatsu M, Albrecht U et al. : Embryonic lethality and radiation hypersensitivity mediated by Rad51 in mice lacking Brca2. Nature386,804–810 (1997).Crossref, Medline, CAS, Google Scholar
- 44 Suzuki A, de la Pompa JL, Hakem R et al. : Brca2 is required for embryonic cellular proliferation in the mouse. Genes Dev.11,1242–1252 (1997).Crossref, Medline, CAS, Google Scholar
- 45 Connor F, Bertwistle D, Mee PJ et al. : Tumorigenesis and a DNA repair defect in mice with a truncating Brca2 mutation. Nat. Genet.17,423–430 (1997).Crossref, Medline, CAS, Google Scholar
- 46 Patel KJ, Yu VP, Lee H et al.: Involvement of Brca2 in DNA repair. Mol. Cell1,347–357 (1998).Crossref, Medline, CAS, Google Scholar
- 47 Barlow C, Hirotsune S, Paylor R et al. : Atm-deficient mice: a paradigm of ataxia telangiectasia. Cell86,159–171 (1996).Crossref, Medline, CAS, Google Scholar
- 48 Xu Y, Ashley T, Brainerd EE, Bronson RT, Meyn MS, Baltimore D: Targeted disruption of ATM leads to growth retardation, chromosomal fragmentation during meiosis, immune defects, and thymic lymphoma. Genes Dev.10,2411–2422 (1996).Crossref, Medline, CAS, Google Scholar
- 49 Xu Y, Baltimore D: Dual roles of ATM in the cellular response to radiation and in cell growth control. Genes Dev.10,2401–2410 (1996).Crossref, Medline, CAS, Google Scholar
- 50 Wells D, Bermudez MG, Steuerwald N et al. : Expression of genes regulating chromosome segregation, the cell cycle and apoptosis during human pre-implantation development. Hum. Reprod.20,1339–1348 (2005).Crossref, Medline, CAS, Google Scholar
- 51 Kopecny V, Flechon JE, Camous S, Fulka Jr J: Nucleologenesis and the onset of transcription in the eight-cell bovine embryo: fine-structural autoradiographic study. Mol. Reprod. Dev.1,79–90 (1989).Crossref, Medline, CAS, Google Scholar
- 52 Tesarik J, Kopecny V, Plachot M, Mandelbaum J: Early morphological signs of embryonic genome expression in human pre-implantation development as revealed by quantitative electron microscopy. Dev. Biol.128,15–20 (1988).Crossref, Medline, CAS, Google Scholar
- 53 Schultz RM: Regulation of zygotic gene activation in the mouse. Bioessays15,531–538 (1993).Crossref, Medline, CAS, Google Scholar
- 54 Schultz RM: The molecular foundations of the maternal to zygotic transition in the pre-implantation embryo. Hum. Reprod. Update8,323–331 (2002).Crossref, Medline, CAS, Google Scholar
- 55 Miller MS, Juchau MR, Guengerich FP, Nebert DW, Raucy JL: Drug metabolic enzymes in developmental toxicology. Fundam. Appl. Toxicol.34,165–175 (1996).Crossref, Medline, CAS, Google Scholar
- 56 Choudhary D, Jansson I, Schenkman JB, Sarfarazi M, Stoilov I: Comparative expression profiling of 40 mouse cytochrome P450 genes in embryonic and adult tissues. Arch. Biochem. Biophys.414,91–100 (2003).Crossref, Medline, CAS, Google Scholar
- 57 Choudhary D, Jansson I, Stoilov I, Sarfarazi M, Schenkman JB: Expression patterns of mouse and human CYP orthologs (families 1–4) during development and in different adult tissues. Arch. Biochem. Biophys.436,50–61 (2005).Crossref, Medline, CAS, Google Scholar
- 58 Martignoni M, Groothuis GM, de Kanter R: Species differences between mouse, rat, dog, monkey and human CYP-mediated drug metabolism, inhibition and induction. Expert Opin. Drug Metab. Toxicol.2,875–894 (2006).▪▪ Addresses, in a comprehensive way, the variability in CYP-mediated metabolism: induction, inhibition and polymorphisms.Crossref, Medline, CAS, Google Scholar
- 59 McCarroll SA, Murphy CT, Zou S et al.: Comparing genomic expression patterns across species identifies shared transcriptional profile in aging. Nat. Genet.36(2),197–204 (2004).Crossref, Medline, CAS, Google Scholar
- 60 Stuart JM, Segal E, Koller D, Kim SK: A gene-coexpression network for global discovery of conserved genetic modules. Science302(5643),249–255 (2003).Crossref, Medline, CAS, Google Scholar
- 61 Sun Y, Li H, Liu Y et al. : Cross-species transcriptional profiles establish a functional portrait of embryonic stem cells. Genomics89(1),22–35 (2007).▪▪ Discusses expression-pattern analysis of key regulatory networks in ESCs.Crossref, Medline, CAS, Google Scholar
- 62 Rao M: Conserved and divergent paths that regulate self-renewal in mouse and human embryonic stem cells. Dev. Biol.275,269–286 (2004).▪▪ Discusses expression-pattern analysis of key regulatory networks in ESCs.Crossref, Medline, CAS, Google Scholar
- 63 Ginis I, Luo Y, Miura T et al. : Differences between human and mouse embryonic stem cells. Dev. Biol.269,360–380 (2004).Crossref, Medline, CAS, Google Scholar
- 64 Brandenberger R, Wei H, Zhang S et al. : Transcriptome characterization elucidates signaling networks that control human ES cell growth and differentiation. Nat. Biotechnol.22,707–716 (2004).Crossref, Medline, Google Scholar
- 65 Wang Y, Keys DN, Au-Young JK, Chen C: MicroRNAs in embryonic stem cells. J. Cell Physiol.218,251–255 (2009).Crossref, Medline, CAS, Google Scholar
- 66 Chen C, Ridzon D, Lee CT, Blake J, Sun Y, Strauss WM: Defining embryonic stem cell identity using differentiation-related microRNAs and their potential targets. Mamm. Genome18,316–327 (2007).Crossref, Medline, CAS, Google Scholar
- 67 Houbaviy HB, Murray MF, Sharp PA: Embryonic stem cell-specific microRNAs. Dev. Cell5,351–358 (2003).Crossref, Medline, CAS, Google Scholar
- 68 Suh MR, Lee Y, Kim JY et al. : Human embryonic stem cells express a unique set of microRNAs. Dev. Biol.270,488–498 (2004).Crossref, Medline, CAS, Google Scholar
- 69 Mineno J, Okamoto S, Ando T et al. : The expression profile of microRNAs in mouse embryos. Nucleic Acids Res.34,1765–1771 (2006).Crossref, Medline, CAS, Google Scholar
- 70 Landgraf P, Rusu M, Sheridan R et al. : A mammalian microRNA expression atlas based on small RNA library sequencing. Cell129,1401–1414 (2007).Crossref, Medline, CAS, Google Scholar
- 71 Laurent LC, Chen J, Ulitsky I et al. : Comprehensive microRNA profiling reveals a unique human embryonic stem cell signature dominated by a single seed sequence. Stem Cells26,1506–1516 (2008).Crossref, Medline, CAS, Google Scholar
- 72 Morin RD, O’Connor MD, Griffith M et al. : Application of massively parallel sequencing to microRNA profiling and discovery in human embryonic stem cells. Genome Res.18,610–621 (2008).Crossref, Medline, CAS, Google Scholar
- 73 Genbacev O, Bass KE, Joslin RJ, Fisher SJ: Maternal smoking inhibits early human cytotrophoblast differentiation. Reprod. Toxicol.9(3),245–255 (1995).Crossref, Medline, CAS, Google Scholar
- 74 Genbacev O, Joslin R, Damsky CH, Polliotti BM, Fisher SJ: Hypoxia alters early gestation human cytotrophoblast differentiation/invasion in vitro and models the placental defects that occur in preeclampsia. J. Clin. Invest.97(2),540–550 (1996).Crossref, Medline, CAS, Google Scholar
- 75 Genbacev O, Zhou Y, Ludlow JW, Fisher SJ: Regulation of human placental development by oxygen tension. Science277(5332),1669–1672 (1997).Crossref, Medline, CAS, Google Scholar
- 76 Genbacev O, Krtolica A, Kaelin W, Fisher SJ: Human cytotrophoblast expression of the von Hippel–Lindau protein is downregulated during uterine invasion in situ and upregulated by hypoxia in vitro. Dev. Biol.233(2),526–536 (2001).Crossref, Medline, CAS, Google Scholar
- 77 Shiverick KT, Slikker W Jr, Rogerson SJ, Miller RK: Drugs and the placenta – a workshop report. Placenta24(Suppl. A),S55–S59 (2003).Crossref, Medline, Google Scholar
- 78 Myllynen P, Pasanen M, Pelkonen O: Human placenta: a human organ for developmental toxicology research and biomonitoring. Placenta26(5),361–371 (2005).Crossref, Medline, CAS, Google Scholar
- 79 Zdravkovic T, Genbacev O, McMaster MT, Fisher SJ: The adverse effects of maternal smoking on the human placenta: a review. Placenta26(Suppl. A),S81–S86 (2005).Crossref, Medline, Google Scholar
- 80 Tanaka S, Kunath T, Hadjantonakis AK, Nagy A, Rossant J: Promotion of trophoblast stem cell proliferation by FGF4. Science282(5396),2072–2075 (1998).Crossref, Medline, CAS, Google Scholar
- 81 Henderson JK, Draper JS, Baillie HS et al. : Pre-implantation human embryos and embryonic stem cells show comparable expression of stage-specific embryonic antigens. Stem Cells20(4),329–337 (2002).Crossref, Medline, CAS, Google Scholar
- 82 Hay DC, Sutherland L, Clark J, Burdon T: Oct-4 knockdown induces similar patterns of endoderm and trophoblast differentiation markers in human and mouse embryonic stem cells. Stem Cells22,225–235 (2004).Crossref, Medline, CAS, Google Scholar
- 83 Matin MM, Walsh JR, Gokhale PJ et al. : Specific knockdown of Oct4 and β2-microglobulin expression by RNA interference in human embryonic stem cells and embryonic carcinoma cells. Stem Cells22,659–668 (2004).Crossref, Medline, CAS, Google Scholar
- 84 Hyslop L, Stojkovic M, Armstrong L et al. : Downregulation of NANOG induces differentiation of human embryonic stem cells to extraembryonic lineages. Stem Cells23,1035–1043 (2005).Crossref, Medline, CAS, Google Scholar
- 85 Xu RH, Chen X, Li DS et al. : BMP4 initiates human embryonic stem cell differentiation to trophoblast. Nat. Biotechnol.20,1261–1264 (2002).Crossref, Medline, CAS, Google Scholar
- 86 Schulz LC, Ezashi T, Das P, Westfall SD, Livingston KA, Roberts RM: Human embryonic stem cells as models for trophoblast differentiation. Placenta29(Suppl. A),S10–S16 (2008).Crossref, Medline, Google Scholar
- 87 Wu Z, Zhang W, Chen G et al. : Combinatorial signals of activin/nodal and bone morphogenic protein regulate the early lineage segregation of human embryonic stem cells. J. Biol. Chem.283,24991–25002 (2008).Crossref, Medline, CAS, Google Scholar
- 88 Gerami-Naini B, Dovzhenko OV, Durning M, Wegner FH, Thomson JA, Golos TG: Trophoblast differentiation in embryoid bodies derived from human embryonic stem cells. Endocrinology145,1517–1524 (2004).Crossref, Medline, CAS, Google Scholar
- 89 Harun R, Ruban L, Matin M et al. : Cytotrophoblast stem cell lines derived from human embryonic stem cells and their capacity to mimic invasive implantation events. Hum. Reprod.21,1349–1358 (2006).▪ First successful differentiation of hESCs into trophectoderm line.Crossref, Medline, CAS, Google Scholar
- 90 Ungrin MD, Joshi C, Nica A, Bauwens C, Zandstra PW: Reproducible, ultra high-throughput formation of multicellular organization from single cell suspension-derived human embryonic stem cell aggregates. PLoS ONE3,e1565 (2008).▪▪ Description of a high-throughput method for generation of a homogeneous population of embryoid bodies from hESCs.Crossref, Medline, Google Scholar
- 91 Niebruegge S, Nehring A, Bar H, Schroeder M, Zweigerdt R, Lehmann J: Cardiomyocyte production in mass suspension culture: embryonic stem cells as a source for great amounts of functional cardiomyocytes. Tissue Eng. Part A14,1591–1601 (2008).Crossref, Medline, CAS, Google Scholar
- 92 Yirme G, Amit M, Laevsky I, Osenberg S, Itskovitz-Eldor J: Establishing a dynamic process for the formation, propagation, and differentiation of human embryoid bodies. Stem Cells Dev.17,1227–1241 (2008).Crossref, Medline, CAS, Google Scholar
- 101 miRBase. http://microrna.sanger.ac.ukGoogle Scholar

