Recombinant Rat Aquaporin-9 (Aqp9)

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Description

Hepatic Glycerol Metabolism

  • AQP9 facilitates glycerol uptake into hepatocytes during fasting, critical for gluconeogenesis and triglyceride synthesis. Knockout (AQP9⁻/⁻) mice exhibit hyperglycerolemia (plasma glycerol ↑ 300%) and hypertriglyceridemia .

  • Insulin downregulates hepatic AQP9 expression via promoter elements, linking it to metabolic disorders like diabetes .

Liver Regeneration

  • AQP9⁻/⁻ mice show delayed liver regeneration post-hepatectomy (70–90% liver resection), with:

    • Reduced hepatocyte proliferation (↓ Ki67, cyclin D1, PCNA) .

    • Elevated oxidative stress (↑ H₂O₂) and glycogen depletion .

    • Rescue via AQP3 or AQP9 reintroduction via AAV vectors, confirming glycerol/H₂O₂ transport roles .

Reproductive System

  • AQP9 co-localizes with CFTR and NHERF1 in epididymis/vas deferens epithelia. cAMP-activated CFTR enhances AQP9-mediated glycerol permeability, essential for sperm maturation .

Metabolic Dysregulation

  • AQP9⁻/⁻ obese (Lepr^db) mice exhibit exacerbated hyperglycerolemia and impaired fasting glucose homeostasis .

  • Hepatic AQP9 downregulation reduces steatosis in oleic acid-treated hepatocytes, suggesting therapeutic potential in non-alcoholic fatty liver disease (NAFLD) .

Oxidative Stress and Disease

  • AQP9 mediates H₂O₂ efflux in hepatocytes. Its absence exacerbates oxidative injury during liver regeneration .

  • Permeability to arsenite implicates AQP9 in arsenic detoxification and chemotherapy resistance in leukemia .

Experimental Models and Tools

  • Recombinant Expression: Rat AQP9 has been expressed in LO2 hepatocytes using pEGFP-N1 vectors, with confirmed functionality via glycerol transport assays .

  • Crystallography: 2D crystals of recombinant AQP9 in OG detergent enabled structural analysis, though full atomic resolution remains elusive .

Clinical and Therapeutic Prospects

ApplicationMechanismEvidence
Liver regenerationGlycerol/H₂O₂ transportAAV-AQP9 rescues AQP9⁻/⁻ mice
Metabolic syndromeHepatic glycerol modulationAQP9 ↓ in diabetic models
Cancer therapyArsenite transportExpressed in leukemia cells

Product Specs

Form
Lyophilized powder
Note: We prioritize shipping the format currently in stock. However, if you require a specific format, please indicate your preference during order placement. We will accommodate your request whenever possible.
Lead Time
Delivery time may vary depending on the purchase method and location. Please contact your local distributor for specific delivery timeframes.
Note: All our proteins are shipped with standard blue ice packs. If you require dry ice shipping, please inform us in advance, as additional charges will apply.
Notes
Repeated freezing and thawing is not recommended. Store working aliquots at 4°C for up to one week.
Reconstitution
We recommend centrifuging the vial briefly before opening to ensure the contents settle to the bottom. Reconstitute the protein in deionized sterile water to a concentration of 0.1-1.0 mg/mL. We suggest adding 5-50% glycerol (final concentration) and aliquoting for long-term storage at -20°C/-80°C. Our standard glycerol concentration is 50% and serves as a reference point.
Shelf Life
Shelf life depends on various factors such as storage conditions, buffer composition, temperature, and the inherent stability of the protein.
Generally, the shelf life of liquid form is 6 months at -20°C/-80°C. Lyophilized form has a shelf life of 12 months at -20°C/-80°C.
Storage Condition
Store at -20°C/-80°C upon receipt. Aliquoting is necessary for multiple uses. Avoid repeated freeze-thaw cycles.
Tag Info
Tag type will be determined during the manufacturing process.
The specific tag type will be decided during production. If you have a preferred tag type, please inform us, and we will prioritize its development.
Synonyms
Aqp9; Aquaporin-9; AQP-9; Aquaglyceroporin-9
Buffer Before Lyophilization
Tris/PBS-based buffer, 6% Trehalose.
Datasheet
Please contact us to get it.
Expression Region
1-295
Protein Length
Full length protein
Species
Rattus norvegicus (Rat)
Target Names
Aqp9
Target Protein Sequence
MPSEKDGAKKSLMQRLALKSRIAKETLSEFLGTFIMIVLGCSSIAQAVLSRERFGGIITINIGFASAVVMALYVTFGISGGHINPAVSFAMCAFGRMEWFKFPFYVGAQFLGAFVGAATVFGIYYDGLMAFAGGKLLVVGENATAFIFATYPAPFISTPGAFVDQVVSTMFLLLIVFAMFDSRNLGVPRGLEPVVIGLLIIVLSCSLGLNSGCAMNPARDLSPRLFTALAGWGFEVFTVGNNFWWIPVVGPMIGAFLGGLIYILFIQMHHSKLDPDMKAEPSENNLEKHELSVIM
Uniprot No.

Target Background

Function
Aquaporin-9 (AQP9) functions as a water channel with broad specificity. It is also permeable to glycerol and urea. AQP9 facilitates the passage of a wide range of small, uncharged solutes, including carbamides, polyols, purines, and pyrimidines.
Gene References Into Functions
  1. Upregulation of AQP9 may be involved in gluconeogenesis and co-regulated by the JNK and p38 MAPK pathway in both Type 1 and 2 diabetes mellitus. PMID: 29523003
  2. AQP9 expression gradually increases following optic nerve crushing, reaching a peak on day 14. PMID: 25479407
  3. Dynamic changes in AQP9 expression, potentially mediated by the p38 MAPK signaling pathway, may contribute to the development of cerebral edema after brain ischemia. PMID: 25903824
  4. Studies suggest that AQP9 plays a role in viral tropism and the pathogenesis of Herpes simplex encephalitis. PMID: 25604497
  5. Aquaporin-9 is expressed in rat Sertoli cells and interacts with the cystic fibrosis transmembrane conductance regulator. PMID: 25270793
  6. AQP9 is primarily localized in the membrane structures of hepatocytes and appears to be primarily responsive to glucagon induction. [aquaporin-9, AQP9] PMID: 16857339
  7. Expression of AQP9 is upregulated in a glaucoma model, and its immunoreactivity co-localizes with AQP4 and GFAP in the optic nerve region. PMID: 23464865
  8. Loss of AQP9 negatively affects the survival of retinal ganglion cells. PMID: 23506846
  9. AQP9 has a potential role in the pathogenesis of hepatic steatosis. PMID: 23415870
  10. AQP9 expression increases in the brains of injured rats and correlates with brain edema and the number of injured neurons in cortical layers II/III and V/VI, striatum, and hippocampal regions CA1/CA3. Inhibition of AQP9 improves neurobehavioral outcome. PMID: 23040263
  11. Xenopus oocytes microinjected with either AQP7 or AQP9 cRNA (cloned from mouse adipocyte and rat liver, respectively) exhibit a 10-fold increase in arsenite permeability, indicating that both aquaglyceroporins recognize and transport arsenite. PMID: 11972053
  12. The sexual dimorphism in hepatic AQP9 regulation may be attributed to estradiol-17 beta suppressing the expression of hepatic AQP9. PMID: 22114114
  13. AQP9 immunolabeling of the retinal pigment epithelium (RPE) was elevated in retinal slices from diabetic rats compared to control rats. PMID: 21851171
  14. Enhanced AQP9 expression is observed in LPS-induced brain edema. PMID: 19399395
  15. Considering AQP9's role in transporting metabolites from astrocytes to neurons, its reduced expression at specific sites may be implicated in the pathogenesis of glaucomatous optic neuropathy. PMID: 20357197
  16. Expression of AQP9 in the developing rat epididymis is downregulated by neonatal DES, GNRHa, EE, and flutamide. The effects mediated by estrogens can be prevented by testosterone administration. PMID: 19948840
  17. AQP-9 is localized to the microvilli of the principal cells of the testis, with the most intense reaction observed in the initial segment and cauda regions, as well as the clear cells of the cauda region. PMID: 12002438
  18. Expression of aquaporin 9 is modulated by androgens in the adult rat epididymis. PMID: 12021052
  19. AQP9 functions as a membrane channel in hepatocytes for glycerol and urea at physiological pH. PMID: 12594337
  20. Steroid hormones regulate AQP9 expression at the mRNA and protein level, and other ovarian signals are involved in the expression of AQP5 and -8. PMID: 15647391
  21. Catecholaminergic, putatively dopaminergic, amacrine cells of the retina express aquaporin-9. PMID: 16446030
  22. AQP9 is involved in energy balance as a glycerol-lactate channel and appears to regulate cell volume in retinal ganglion neurons. This water channel may play a crucial role in retinal ganglion pathology. PMID: 17337204
  23. The expression of AQP9 in glioma has been investigated. PMID: 17525633
  24. In brainstem slices, insulin induces a decrease in AQP9 protein levels 6 hours after application, suggesting that brain AQP9 is also regulated by insulin. This indicates that brain AQP9 is affected by insulin concentration in a diabetic model. PMID: 18053968
  25. Evidence suggests that extrahepatic cholestasis leads to downregulation of AQP9 in the hepatocyte basolateral plasma membrane, and dysregulated aquaporin channels contribute to bile flow dysfunction in cholestatic hepatocytes. PMID: 18669624
  26. Data provides conclusive evidence for the presence of tetrameric AQP9 in the brain and its expression in neurons. PMID: 19115411

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Database Links
Protein Families
MIP/aquaporin (TC 1.A.8) family
Subcellular Location
Cell membrane; Multi-pass membrane protein.
Tissue Specificity
Detected in testis and liver. Detected in immature spermatocytes and in interstitial Leydig cells.

Q&A

What is the structural organization of Aquaporin-9?

Aquaporin-9 belongs to the aquaglyceroporin subfamily of water channel proteins and forms homotetrameric transmembrane structures. Each monomer functions independently to transport glycerol and water across plasma membranes following osmotic gradients. The tetrameric organization is characteristic of all members of the aquaporin family, as confirmed through single particle analysis of recombinant rat AQP9. Projection mapping at 7 Å resolution reveals a tetrameric structure similar to GlpF (glycerol facilitator), with each square-like monomer forming a distinct pore . This structural arrangement is critical for understanding how AQP9 accommodates various solutes of different sizes and chemical properties.

How does rat AQP9 differ functionally from other aquaporins?

Rat AQP9 exhibits broader substrate specificity compared to conventional aquaporins. While classical aquaporins primarily transport water, AQP9 mediates the passage of a wide variety of non-charged solutes including water, glycerol, urea, carbamides, polyols, purines, and pyrimidines . This transport occurs in a phloretin- and mercury-sensitive manner. Notably, AQP9 excludes amino acids, cyclic sugars, Na+, K+, Cl-, and deprotonated monocarboxylates . The structural basis for this broader specificity likely involves substitutions in the pore-lining residues, particularly at the hydrophobic edge of the tripathic pore, as compared to the glycerol facilitator GlpF . This unique permeability profile makes AQP9 physiologically significant in metabolic pathways involving glycerol transport and utilization.

What are the primary tissue expression patterns of rat AQP9?

While AQP9 is expressed in multiple organs, it is most abundantly expressed in the liver . In hepatocytes, AQP9 is specifically localized at the sinusoidal plasma membrane facing the portal vein, strategically positioning it for metabolic functions . This localization makes it the primary route for glycerol uptake in hepatocytes, supporting hepatic gluconeogenesis . Beyond the liver, AQP9 may also play roles in brain function, particularly in astrocyte-to-neuron lactate shuttle mechanisms, providing neurons with energy due to its permeability to lactate . Understanding these tissue-specific expression patterns is essential for interpreting AQP9's physiological roles and potential implications in disease states.

What are the optimal conditions for producing functional recombinant rat AQP9?

Production of functional recombinant rat AQP9 requires careful consideration of expression systems and purification protocols. Based on available research, mammalian expression systems such as HEK293 cells have been successfully used to express recombinant aquaporins with proper folding and post-translational modifications . For structural studies, recombinant rat AQP9 has been successfully reconstituted into two-dimensional crystals for projection mapping .

The recommended protocol involves:

  • Cloning the rat AQP9 gene into an appropriate expression vector (such as pEGFP-N1 for fusion protein studies)

  • Transfection into mammalian cells (HEK293) or alternative expression systems

  • Membrane protein extraction using mild detergents that preserve protein structure

  • Affinity purification utilizing tags such as His or Myc-DYKDDDDK

  • Assessment of purity via SDS-PAGE (aim for >80% purity)

  • Functional verification through glycerol or water transport assays

Maintaining the tetrameric structure throughout purification is crucial for preserving activity, as monomeric AQP9 may not exhibit the same transport properties as the assembled tetramer.

What methodologies are most effective for analyzing AQP9 channel function in experimental settings?

Multiple complementary approaches can effectively characterize AQP9 channel functionality:

MethodologyApplicationAdvantagesConsiderations
Stopped-flow spectroscopyWater/glycerol permeability measurementsQuantitative kinetic dataRequires specialized equipment
Liposome reconstitutionIsolated channel functionControlled environmentMay not reflect in vivo complexity
Cell swelling assaysFunctional analysis in cellular contextMore physiologicalBackground from endogenous channels
Radioactive solute uptakeSubstrate specificity determinationHigh sensitivityHandling radioactive materials
FRET-based assaysReal-time transport dynamicsDirect visualizationComplex setup and interpretation

For definitive characterization, researchers should employ multiple methods to cross-validate findings. When investigating specific transport properties, the phloretin sensitivity of AQP9 can be exploited as a control, as it selectively inhibits this channel . Additionally, site-directed mutagenesis of key pore-lining residues can provide valuable insights into structure-function relationships, particularly when comparing to the known structure of related aquaglyceroporins like GlpF .

How can structural changes in AQP9 be effectively analyzed following site-directed mutagenesis?

Analysis of structural alterations following site-directed mutagenesis requires a multi-faceted approach:

When targeting mutations, particular attention should be paid to the pore-lining residues that differ between AQP9 and other aquaporins, especially those located at the hydrophobic edge of the tripathic pore, as these regions likely contribute to AQP9's broader substrate specificity . Comparing experimental data with computational predictions can provide deeper insights into the structural determinants of channel function.

What is the role of AQP9 in non-alcoholic fatty liver disease (NAFLD) pathogenesis?

AQP9 plays a significant role in NAFLD development through its function as a glycerol channel in hepatocytes. Research indicates that AQP9 regulation is directly linked to hepatic fat accumulation, a hallmark of NAFLD . In oleic acid-induced NAFLD cell models, downregulation of AQP9 prevents steatosis, suggesting its potential as a therapeutic target .

The mechanistic relationship appears to involve:

  • AQP9-mediated glycerol uptake into hepatocytes

  • Increased substrate availability for triglyceride synthesis

  • Accumulation of excess triglycerides in hepatocytes (steatosis)

  • Progression of steatosis to more severe forms of liver disease

Experimental approaches to study this relationship have utilized both overexpression (pEGFP-N1-AQP9) and knockdown (pGenesil-1-AQP9-shRNA) strategies in cell models . These approaches allow researchers to directly manipulate AQP9 expression and observe consequent effects on lipid accumulation, offering valuable insights into potential therapeutic strategies for NAFLD through AQP9 modulation.

How does AQP9 contribute to arsenic detoxification pathways?

AQP9 demonstrates permeability to arsenite, which contributes significantly to liver-mediated arsenic excretion and provides partial protection against arsenic toxicity . This unique property makes AQP9 an important player in detoxification pathways.

The mechanism appears to involve:

  • AQP9-facilitated uptake of arsenite by hepatocytes

  • Hepatic biotransformation of arsenite

  • Biliary excretion of arsenic metabolites

  • Reduction of systemic arsenic toxicity

Researchers investigating this pathway should consider using:

  • AQP9 knockout or knockdown models to assess changes in arsenic sensitivity

  • Site-directed mutagenesis to identify specific residues involved in arsenite transport

  • Comparative analysis of arsenic handling in tissues with varying AQP9 expression levels

  • Correlation studies between AQP9 polymorphisms and arsenic sensitivity in populations

Understanding this mechanism may have important implications for managing arsenic exposure in vulnerable populations and could potentially inform therapeutic approaches for arsenic poisoning.

What is known about the regulatory mechanisms controlling AQP9 expression in different physiological states?

AQP9 expression undergoes dynamic regulation in response to various physiological and pathological stimuli. Several regulatory mechanisms have been identified:

  • Metabolic regulation: Fasting and insulin resistance increase hepatic AQP9 expression to facilitate glycerol uptake for gluconeogenesis during periods of glucose scarcity

  • Transcriptional control: Several transcription factors including peroxisome proliferator-activated receptors (PPARs) and hepatocyte nuclear factors (HNFs) bind to the AQP9 promoter region

  • Post-transcriptional regulation: microRNAs may regulate AQP9 mRNA stability and translation

  • Post-translational modifications: Phosphorylation events can alter AQP9 trafficking and membrane insertion

For research in this area, consideration of physiological context is crucial, as AQP9 regulation differs between fed/fasted states, healthy/diseased conditions, and across different tissues. Experimental designs should account for these variables by carefully controlling nutritional status and selecting appropriate time points for analysis.

What are the advantages and limitations of current immunodetection methods for rat AQP9?

Various immunodetection methods are available for rat AQP9 research, each with distinct advantages and limitations:

Detection MethodAdvantagesLimitationsSensitivity
Western blottingQuantification of expression levels, size verificationCannot determine cellular localizationModerate
ImmunohistochemistryTissue and cellular localizationChallenges with membrane protein fixationModerate
ELISAHigh-throughput quantificationNo spatial informationHigh (0.421ng/mL)
ImmunofluorescenceSubcellular localization, co-localization studiesPhoto-bleaching, autofluorescenceModerate
Flow cytometrySingle-cell analysis, quantitativeRequires cell isolationHigh

When selecting antibodies, chicken polyclonal antibodies against rat AQP9 have proven effective for ELISA applications . For maximal specificity, antibodies targeting unique epitopes in rat AQP9 should be chosen, particularly when working with samples that may express multiple aquaporin isoforms. The detection range for commercial ELISA kits is typically 0.78-50ng/ml with a sensitivity of 0.421ng/mL , making them suitable for detecting physiological levels of AQP9 in most experimental settings.

How can functional transport assays be optimized for rat AQP9 in different experimental systems?

Optimizing functional transport assays for rat AQP9 requires careful consideration of experimental design:

  • Xenopus oocyte expression system:

    • Inject 5-10ng cRNA encoding rat AQP9

    • Allow 2-3 days for expression

    • Perform swelling assays in hypotonic solutions containing different substrates

    • Measure rates of volume change using video microscopy

  • Cell culture systems:

    • Transfect cells with rat AQP9 expression vectors (e.g., pEGFP-N1-AQP9)

    • Verify expression through Western blot or fluorescence (if using GFP fusion)

    • Conduct transport assays using:
      a. Radiolabeled substrates to measure uptake kinetics
      b. Fluorescent substrates with real-time imaging
      c. Cell volume measurements for water permeability

  • Liposome reconstitution:

    • Purify recombinant rat AQP9 (>80% purity)

    • Reconstitute into liposomes at protein:lipid ratios of 1:50 to 1:200

    • Perform stopped-flow light scattering to measure permeability

Key optimization parameters include temperature (typically 25°C for kinetic measurements), pH (physiological range 7.2-7.4), and inclusion of specific inhibitors (phloretin) as controls. When comparing different substrates, equalizing for molecular size and concentration is essential for accurate kinetic comparisons.

What are the best approaches for generating stable rat AQP9 expression models?

Generating stable expression models for rat AQP9 requires selecting appropriate systems based on research objectives:

  • Stable mammalian cell lines:

    • Clone rat AQP9 into vectors with strong promoters and selection markers

    • Transfect target cells (HEK293 are commonly used)

    • Select with appropriate antibiotics for 2-3 weeks

    • Isolate and characterize single-cell clones for expression levels

    • Verify functional activity through transport assays

  • Viral transduction systems:

    • Package rat AQP9 into lentiviral or adenoviral vectors

    • Transduce target cells at optimal MOI (typically 1-10)

    • Select for stable integration if using lentivirus

    • Advantage: Can achieve high efficiency in difficult-to-transfect cells

  • Inducible expression systems:

    • Use Tet-On/Tet-Off or similar inducible promoters

    • Allows controlled expression timing and levels

    • Beneficial for studying dose-dependent effects

  • In vivo models:

    • Consider transgenic approaches for tissue-specific expression

    • Adeno-associated virus (AAV) delivery for targeted expression

For each system, expression verification should include both protein detection (Western blot, immunofluorescence) and functional assessment (transport assays). When using fluorescent protein fusions like EGFP-AQP9 , researchers should verify that the tag doesn't interfere with channel assembly or function through comparative studies with untagged protein.

How can researchers troubleshoot issues with recombinant rat AQP9 expression and purification?

Common challenges in recombinant rat AQP9 work and their solutions include:

  • Low expression levels:

    • Optimize codon usage for expression system

    • Test different promoters (CMV, EF1α for mammalian systems)

    • Consider fusion tags that enhance expression (SUMO, MBP)

    • Lower cultivation temperature (28-30°C for mammalian cells)

  • Protein aggregation:

    • Screen multiple detergents (DDM, LMNG, OG) for extraction

    • Add glycerol (10-15%) to stabilize the tetramer

    • Include cholesterol or specific lipids during purification

    • Use gentle purification methods avoiding harsh elution conditions

  • Loss of functional activity:

    • Verify tetrameric assembly by native PAGE or size exclusion chromatography

    • Maintain critical lipids throughout purification

    • Avoid freeze-thaw cycles (prepare single-use aliquots)

    • Test function immediately after purification

  • Purity issues:

    • Implement two-step purification strategies

    • Consider on-column detergent exchange

    • Use size exclusion as a final polishing step

    • Target >80% purity as assessed by SDS-PAGE

If pursuing structural studies, reconstitution into two-dimensional crystals has been successful for rat AQP9 projection mapping . The successful approach involved careful optimization of lipid composition, protein-to-lipid ratio, and crystallization conditions.

What are the key considerations when interpreting conflicting data on AQP9 substrate specificity?

When faced with conflicting data regarding AQP9 substrate specificity, researchers should systematically evaluate:

  • Expression system differences:

    • Different expression hosts may produce proteins with varying post-translational modifications

    • Membrane composition can affect channel function

    • Expression levels influence transport measurements

  • Assay methodology variations:

    • Direct transport measurements vs. indirect (swelling) assays

    • Concentration ranges tested (saturation effects)

    • Assay conditions (pH, temperature, presence of inhibitors)

  • Species-specific differences:

    • Rat vs. human AQP9 may have subtle functional differences

    • Amino acid variations in the pore region can alter specificity

  • Protein integrity considerations:

    • Full-length vs. truncated constructs

    • Native vs. tagged proteins (tags may interfere with function)

    • Monomeric vs. properly assembled tetramers

To resolve discrepancies, researchers should:

  • Directly compare methodologies using identical protein samples

  • Perform site-directed mutagenesis of key residues in the pore region

  • Conduct parallel assays with multiple substrates under identical conditions

  • Consider computational modeling to predict interaction energetics

Remember that the broad specificity of AQP9 makes it permeable to water, urea, glycerol, and various other non-charged solutes including carbamides, polyols, purines, and pyrimidines, while excluding amino acids, cyclic sugars, and ions .

How should researchers design experiments to distinguish between direct and indirect effects of AQP9 on cellular processes?

Distinguishing direct from indirect effects of AQP9 requires careful experimental design:

  • Use multiple complementary approaches:

    • Loss-of-function: knockdown/knockout (e.g., pGenesil-1-AQP9-shRNA)

    • Gain-of-function: overexpression (e.g., pEGFP-N1-AQP9)

    • Pharmacological: specific inhibitors (phloretin with appropriate controls)

    • Rescue experiments with wild-type and mutant constructs

  • Include appropriate controls:

    • Non-targeting shRNA/empty vector controls

    • Channel-dead mutants (for separating transport vs. structural roles)

    • Related aquaporins with different substrate profiles

  • Implement time-course studies:

    • Immediate effects (minutes to hours) more likely represent direct consequences

    • Delayed effects (hours to days) may indicate secondary adaptations

    • Use inducible expression systems to precisely control timing

  • Employ metabolic flux analysis:

    • Trace labeled substrates (e.g., ³H-glycerol) to follow metabolic fates

    • Compare flux distributions between AQP9-expressing and control cells

    • Identify metabolic bottlenecks downstream of substrate transport

  • Utilize systems biology approaches:

    • Transcriptomics to identify compensatory responses

    • Metabolomics to detect global metabolic shifts

    • Network analysis to distinguish primary from secondary effects

In the context of NAFLD research, for example, both overexpression and knockdown approaches have been used to establish the direct relationship between AQP9 expression and hepatic lipid accumulation . These complementary approaches provide stronger evidence than either approach alone.

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