The raccoon is a seasonal breeder with a mating season in the winter. In a previous study, adult male raccoons exhibited active spermatogenesis with high plasma testosterone concentrations, in the winter mating season. Maintenance of spermatogenesis generally requires high testosterone, which is produced by steroidogenic enzymes. However, even in the summer non-mating season, some males produce spermatozoa actively despite low plasma testosterone concentrations. To identify the factors that regulate testosterone production and contribute to differences in spermatogenetic activity in the summer non-mating season, morphological, histological and endocrinological changes in the testes of wild male raccoons should be known. In this study, to assess changes in the biosynthesis, metabolism and reactivity of testosterone, the localization and immunohistochemical staining intensity of four steroidogenic enzymes (P450scc, P450c17, 3βHSD, P450arom) and the androgen receptor (AR) were investigated using immunohistochemical methods. P450scc and P450c17 were detected in testicular tissue throughout the year. Seasonal changes in testosterone concentration were correlated with 3βHSD expression, suggesting that 3βHSD may be important in regulating the seasonality of testosterone production in raccoon testes. Immunostaining of P450arom and AR was detected in testicular tissues that exhibited active spermatogenesis in the summer, while staining was scarce in aspermatogenic testes. This suggests that spermatogenesis in the raccoon testis might be maintained by some mechanism that regulates P450arom expression in synthesizing estradiol and AR expression in controlling reactivity to testosterone.
The raccoon is a seasonal breeder with a mating season in the winter. In a previous study, adult male raccoons exhibited active spermatogenesis with high plasma testosterone concentrations, in the winter mating season. Maintenance of spermatogenesis generally requires high testosterone, which is produced by steroidogenic enzymes. However, even in the summer non-mating season, some males produce spermatozoa actively despite low plasma testosterone concentrations. To identify the factors that regulate testosterone production and contribute to differences in spermatogenetic activity in the summer non-mating season, morphological, histological and endocrinological changes in the testes of wild male raccoons should be known. In this study, to assess changes in the biosynthesis, metabolism and reactivity of testosterone, the localization and immunohistochemical staining intensity of four steroidogenic enzymes (P450scc, P450c17, 3βHSD, P450arom) and the androgen receptor (AR) were investigated using immunohistochemical methods. P450scc and P450c17 were detected in testicular tissue throughout the year. Seasonal changes in testosterone concentration were correlated with 3βHSD expression, suggesting that 3βHSD may be important in regulating the seasonality of testosterone production in raccoon testes. Immunostaining of P450arom and AR was detected in testicular tissues that exhibited active spermatogenesis in the summer, while staining was scarce in aspermatogenic testes. This suggests that spermatogenesis in the raccoon testis might be maintained by some mechanism that regulates P450arom expression in synthesizing estradiol and AR expression in controlling reactivity to testosterone.
Many mammalian species breed seasonally for effective reproduction. Seasonal changes in the
gonads are generally controlled by the hypothalamic-pituitary-gonadal axis and directly
regulated by sex steroid hormones. In many seasonal breeding mammals, males exhibit a seasonal
cycle in testicular activity, with spermatogenesis and testicular steroidogenesis limited to a
specific period of the year. Active spermatogenesis along with high testosterone
concentrations have been detected in the mating season, and, in contrast, inactive
spermatogenesis along with low testosterone concentrations have been detected in the
non-mating season in many seasonal breeding males, such as Hokkaido sika deer (Cervus
nippon yesoensis) [1], American black bears
(Ursus americanus) [2] and Hokkaido
brown bears (U. arctos yesoensis) [3].The raccoon (Procyon lotor) is a long-day seasonal breeder [4], with mating in the winter, from January to March, in
Hokkaido, Japan [5]. We previously found that adult male
raccoons exhibited active spermatogenesis with high plasma testosterone concentrations in the
winter mating season, as in other seasonal breeding mammals [6]. Steroidogenesis is accomplished by several steroidogenic enzymes. The
immunolocalization of steroidogenic enzymes in testicular tissue has been determined in many
mammals, and both localization and expression intensity have been observed to change
seasonally in several seasonal breeders, such as raccoon dogs (Nyctereutes
procyonoides) [7], Japanese black bears
(U. thibetanus japonicus) [8] and
ground squirrels (Citellus dauricus Brandt) [9]. The immunolocalization and the seasonal changes vary among species and have not
yet been reported in raccoons. In particular, the relationship between testicular function and
the role of steroidogenic enzymes remains unknown. To reveal factors that regulate
testosterone production, expression sites and seasonal changes in steroidogenic enzymes should
be investigated.In a previous study, some male raccoons were found to produce spermatozoa actively despite
low plasma testosterone concentrations in the summer non-mating season [6]. Maintenance of spermatogenesis generally requires high testosterone
production from Leydig cells. In raccoons, there may be other mechanisms for maintaining
spermatogenesis that are not coincident with peripheral testosterone concentration changes.
There are at least two possible proximate factors. First, testosterone concentrations in local
sites in testicular tissue may be independent of peripheral testosterone concentrations and
relatively high in testes with active spermatogenesis. Second, metabolism and reactivity
against testosterone in testicular tissue may vary among individuals in the summer season.Testosterone influences spermatogenesis by binding to a specific nuclear receptor, the
androgen receptor (AR). Detecting the types of cells that express the AR may assist
identification of the cells that control spermatogenesis via a direct influence of
testosterone. Additionally, seasonal changes in AR expression in testicular tissue have been
reported in several seasonal mammals, such as bank voles (Clethrionomys
glareolus) [10] and big fruit-eating bats
(Artibeus lituratus) [11]. Thus,
clarifying the localization and expression changes in steroidogenic enzymes and the AR can
help in understanding the mechanisms that regulate spermatogenesis and testicular
steroidogenesis in the raccoon testes.In the present study, to assess changes in the biosynthesis, metabolism and reactivity of
testosterone, the localization and immunohistochemical staining intensity of steroidogenic
enzymes and AR were investigated according to season and spermatogenesis activity in wild
raccoons. The goals of this study were to identify factors related to seasonal changes in
testosterone production and differences in spermatogenetic activity in the summer non-mating
season.
Materials and Methods
Sample collection
We collected carcasses of adult male raccoons that were euthanized for pest control in
west-central Hokkaido from 2010 to 2013. In total, 15 raccoons were used in this study.
Five were collected between February and early April, and 10 were collected in July; these
10 samples were divided into two groups according to spermatogenetic activity. Raccoon
carcasses were weighed, and body length was measured; blood was obtained by cardiac
puncture, and the testes were removed. Blood was placed in a 5 ml tube and centrifuged
(1,050 g, 10 min). The plasma was removed and stored at –30 C until
assayed. The testes were brought to the laboratory on ice within 1 h after euthanasia. The
left testes were weighed, measured and immediately fixed for about half a day in 4%
paraformaldehyde solution at 4 C for histological examination. The right testes were kept
at –80 C until assayed.All procedures were performed with methods approved by the Animal Care and Use Committee
of Hokkaido University (approval no. JU13054).
Histological and immunohistochemical analyses
Testicular tissues were dehydrated through an ethanol series, embedded in paraffin wax,
sectioned at 4 µm and stained with hematoxylin and eosin. From four fields of each testis
section under a microscope, ten seminiferous tubules were chosen randomly. The
“spermatogenetic score” (SS) was evaluated as the mean value of each seminiferous tubule
chosen according to the most advanced spermatogenetic cells present [6]: 1 = spermatogonia, 2 = no cells beyond primary spermatocytes, 3 =
some cells beyond secondary spermatocytes, 4 = round spermatids and 5 = elongated
spermatids and/or spermatozoa. The presence of spermatozoa in the cauda epididymis was
also checked.For immunohistochemical analyses, testicular tissue was cut into 5×5-mm pieces and
mounted on the same glass slide. To detect the immunohistochemical sites and expression
intensity of AR and the four steroidogenic enzymes—cholesterol side-chain cleavage
cytochrome P450 (P450scc), 17-α hydroxylase cytochrome P450 (P450c17), 3 β‑hydroxysteroid
dehydrogenase (3βHSD) and aromatase cytochrome P450 (P450arom)—sections of testicular
tissue were immunostained. The primary antibody references are summarized in Table 1. The sections were activated in immunostimulatory with DakoCytomation Target
Retrieval Solution (S3307, DakoCytomation, Carpinteria, CA, USA) at 105 C for 15 min and
were then incubated with methanol containing 3% H2O2 at room
temperature for 30 min. All sections were treated using a Vectastain ABC kit (Vector
Laboratories, Burlingame, CA, USA) according to the manufacturer’s protocol.
Immunoreactivity was visualized with DAB solution (3,3’-diaminobenzidine
tetrahydrochloride, 0.01 g, Tris buffer 50 ml, 20% H2O2 10 µl).
Negative controls were treated with each normal serum or 0.01 M PBS instead of the primary
antibody. The immunostaining intensity was evaluated when staining was detected strongly
(++), detected (+) or scarce/absent (–).
Table 1.
Characteristics and dilutions of primary antibodies
Plasma testosterone concentrations (Plasma T) were measured by applying a competitive
enzyme immunoassay [12], which was performed using
blood samples. Testosterone-3-CMO-HRP (FKA101, Cosmo Bio, Tokyo, Japan) was diluted
600,000-fold with assay buffer. Testosterone standard (Cayman, Ann Arbor, MI, USA) was
diluted in assay buffer. Anti-testosterone serum (first antibody, FKA102-E, Cosmo Bio) was
diluted 1,200,000-fold with assay buffer. Anti-rabbit γ-globulin serum (Seikagaku, Tokyo,
Japan) was used as the secondary antibody. The minimum detectable level of testosterone
was 4.9 pg/well, and the intra-assay coefficient of variation was 3.15%.
High-performance liquid chromatography-electrospray-ionization tandem mass
spectrometry (HPLC/ESI-MS/MS)
Testosterone concentrations in testis tissue (Tissue T) were measured by applying
HPLC/ESI-MS/MS [13], which was performed using
tissue samples. For steroid extraction, testicular tissues were homogenized in 3 ml
phosphate buffer (0.01 M, pH 7.5). Homogenate aliquots were extracted three times with 5
ml diethyl ether, and then after centrifugation (1,100 g, 10 min, 4 C),
the supernatant was evaporated at 47 C under a gentle stream of N2 gas. The
residue was reconstituted in 200 µl of acetonitrile:water (50:50, v/v) and centrifuged
(15,000 g, 15 min, 4 C).Tissue T was measured using HPLC/ESI-MS/MS (HPLC with a Shimadzu LC-20 series HPLC
system; ESI-MS/MS with an LCMS-8030). Extracted samples (50 µl) were injected onto a
Hypersil GOLD column (Thermo Scientific, Tewksbury, MA, USA) with a temperature at 45 C.
The flow rate was 0.3 ml/min. Mobile phase A was 0.1% formic acidwater, and mobile phase
B was methanol. The gradient conditions were set as B concentration of 50% for 0–2 min,
50–95% for 2–5 min, 95% for 5–6.5 min and 50% for 6.5–8 min. The parent/product ion pairs
of m/z 289.2 to 97.2 (positive ion mode) were used for analysis. Mass
spectrometer parameters were optimized for the strongest product ion signal intensities;
the optimized Q1 PreBias, collision energy and Q3 PreBias were –14, –30 and –19 V,
respectively. Other mass spectrometry parameters were as follows: nebulizing gas flow of 3
l/min, dry gas flow of 15 l/min and electro ionspray voltage of 4,500 V at an ion source
temperature of 350 C.
Statistical analysis
Results were analyzed using a one-way ANOVA and Scheffe’s F test for
pair-wise comparisons between each pair of groups with Microsoft Excel 2003. SS was not
subjected to a statistical analysis because the samples from July were allocated to two
groups based on the SS. All values are presented as means ± SEM.
Results
Anatomical and histological evaluations
The 15 male adult raccoons were classified into three groups according to the season and
level of spermatogenesis. Group WIN contained samples from the winter (n = 5). Samples
from the summer in which we observed spermatozoa in the cauda epididymis with active
spermatogenesis (SS > 4) in the seminiferous tubules were classified into group SUM+ (n
= 5). Samples from the summer in which we observed inactive spermatogenesis (SS ≤ 4) in
the seminiferous tubules without spermatozoa in the cauda epididymis were classified into
group SUM– (n = 5).There was no significant difference in body length or body mass among the three groups (P
= 0.64 and 0.95, respectively; Fig. 1). Testes weights in WIN were significantly heavier than those in SUM– (P < 0.01;
Fig. 1).
Fig. 1.
Differences in body length (BL; cm), body mass (BM; kg), testis weight (TW; g),
spermatogenetic score (SS), plasma testosterone concentration (Plasma T; ng/ml) and
testis tissue testosterone concentration (Tissue T; ng/100 mg testis tissue) among
the WIN, SUM+ and SUM– groups. *P < 0.05; **P < 0.01. The SS was not subjected
to statistical analysis. All values are presented as means ± SEM.
Differences in body length (BL; cm), body mass (BM; kg), testis weight (TW; g),
spermatogenetic score (SS), plasma testosterone concentration (Plasma T; ng/ml) and
testis tissue testosterone concentration (Tissue T; ng/100 mg testis tissue) among
the WIN, SUM+ and SUM– groups. *P < 0.05; **P < 0.01. The SS was not subjected
to statistical analysis. All values are presented as means ± SEM.
Testosterone concentrations in plasma and testicular tissue
Regarding Plasma T, although there was no significant difference between any pair of two
groups by Scheffe’s F test, variability among the three groups was
detected by ANOVA (P < 0.05), and the WIN value (7.57 ± 3.42 ng/ml) was higher than
those of other two groups (0.76 ± 0.13 ng/ml in SUM+ and 0.62 ± 0.13 ng/ml in SUM–; Fig. 1). Regarding Tissue T, although only three
fresh testes samples were collected in the winter, the WIN value (16.8 ± 6.17 ng/100 mg
tissue) was significantly higher those of the other two groups (3.18 ± 2.13 ng/100 mg
tissue in SUM+, P < 0.05, and 0.86 ± 0.10 ng/100 mg tissue in SUM–, P
< 0.01; Fig. 1). There was no significant
difference between the SUM+ and SUM– values.
Immunohistochemical localization and expression differences in enzymes and AR
Immunolocalization of the four steroidogenic enzymes was observed using the winter
samples. Immunostaining for P450scc and P450c17 was present only in the cytoplasm of
Leydig cells. 3βHSD was detected in the cytoplasm of Leydig cells and the cytoplasm in
parts of Sertoli cells. Immunostaining for P450arom was detected in the cytoplasm of
Leydig cells and parts of the cytoplasm in Sertoli cells and spermatids (Fig. 2). AR was detected in nuclei of Leydig cells and Sertoli cells. No immunostaining
was detected in control sections (NC in Fig. 3).
Immunostaining for some of the enzymes became scarce or was absent in summer samples.
Differences in immunohistochemical localization among groups are shown in Fig. 3, and immunostaining intensity is shown in
Table 2. All immunopositive positions in summer samples were also detected in winter
samples, in other words, there was no immunopositive site that was detected only in
summer. P450scc was detected strongly in all groups. P450c17 was detected in all groups
and strongly, especially in WIN and SUM+. Immunostaining of 3βHSD was detected strongly in
WIN, and the intensity in SUM+ was weaker, especially in Leydig cells. Immunostaining in
the cytoplasm of Sertoli cells also became weaker; however, it was still observed in some
SUM+ samples. In SUM–, 3βHSD was detected in two samples, and no immunohistochemical
reaction was observed in three samples. P450arom was detected in WIN and SUM+ but was weak
in SUM–. Immunostaining of AR was strong in WIN and SUM+ samples and relatively weak in
SUM– samples, while the intensities varied in two samples, and no immunohistochemical
reaction was observed in three samples.
Fig. 2.
Immunohistochemical localization of four steroidogenic enzymes (A, P450scc; B,
P450c17; C, 3βHSD; D, P450arom) in raccoon testes in the winter mating season. L,
Leydig cells; S, Sertoli cells; Sp, Spermatids. Bar=50 µm.
Fig. 3.
Immunohistochemical staining of four steroidogenic enzymes (A, P450scc; B,
P450c17; C, 3βHSD; D, P450arom) and (E): androgen receptor in representative samples
of raccoon testes among the WIN, SUM+ and SUM– groups. NC, negative control; IT,
interstitial tissue; ST, seminiferous tubules. Bar=100 µm.
Table 2.
Immunostaining intensity of four steroidogenic enzymes and androgen receptor
(AR) in raccoon testes among three groups
Sample group
Immunostaining intensity
P450scc
P450c17
3βHSD
P450arom
AR
WIN
++
++
++
+
++
SUM+
++
++
+
+
++
SUM–
++
+
– / + *1
–
– / + *1
Four steroidogenic enzymes were cholesterol side-chain cleavage cytochrome P450
(P450scc), 3β-hydroxysteroid dehydrogenase (3βHSD), 17α-hydroxylase cytochrome P450
(P450c17) and aromatase cytochrome P450 (P450arom). The intensity was evaluated when
immunostaining detected (+), detected strongly (++), scarce or not (–).
*1: Samples were classified as + and 3 samples were classified as
–.
Immunohistochemical localization of four steroidogenic enzymes (A, P450scc; B,
P450c17; C, 3βHSD; D, P450arom) in raccoon testes in the winter mating season. L,
Leydig cells; S, Sertoli cells; Sp, Spermatids. Bar=50 µm.Immunohistochemical staining of four steroidogenic enzymes (A, P450scc; B,
P450c17; C, 3βHSD; D, P450arom) and (E): androgen receptor in representative samples
of raccoon testes among the WIN, SUM+ and SUM– groups. NC, negative control; IT,
interstitial tissue; ST, seminiferous tubules. Bar=100 µm.Four steroidogenic enzymes were cholesterol side-chain cleavage cytochrome P450
(P450scc), 3β-hydroxysteroid dehydrogenase (3βHSD), 17α-hydroxylase cytochrome P450
(P450c17) and aromatase cytochrome P450 (P450arom). The intensity was evaluated when
immunostaining detected (+), detected strongly (++), scarce or not (–).
*1: Samples were classified as + and 3 samples were classified as
–.
Discussion
In testes collected during the winter mating season, active spermatogenesis was observed
with high testosterone concentrations in both plasma and testicular tissue. In the summer
non-mating season, some raccoons exhibited active spermatogenesis, producing spermatozoa,
despite low testosterone concentrations, the levels of which were the same as in other
summer samples showing inactive spermatogenesis. These results are similar to our previous
reports [6]. Changes in testosterone concentration in
testicular tissue correlated with peripheral changes. Thus, the first possibility, that the
local testosterone concentration in testicular tissue may be a proximate factor for
maintaining spermatogenesis over the summer, would seem to be eliminated. Between the two
groups in the summer, which were divided according to spermatogenetic activity, there was no
difference in body length or body mass. Thus, the level of spermatogenetic activity was
apparently independent from the raccoon’s nutritional condition or body development.Spermatogenesis is generally regulated by sex steroid hormones, and steroidogenesis is the
result of the actions of steroidogenic enzymes [14].
The presence of these steroidogenic enzymes in testicular tissues has been reported in
mammals, and in this present study, P450scc, P450c17, 3βHSD and P450arom were detected
immunohistochemically in raccoon testes. All four enzymes were located in the cytoplasm of
Leydig cells. Androgen synthesis has been detected generally in Leydig cells in many
mammalian species [15, 16]; thus, Leydig cells are likely to also be a major site of
steroidogenesis in raccoon testes. However, 3βHSD was also located in Sertoli cells in this
study. Although the biosynthesis of androgens in the testes had been considered to occur
only in Leydig cells [17], some evidence indicates
that Sertoli cells possess 3βHSD and can metabolize steroids [18]. Immunoreactivity for 3βHSD in Sertoli cells was also reported in
cynomolgus monkey (Macaca fascicularis) testes [19]. The results of the present study suggest that Sertoli cells, as well
as Leydig cells, play a role in producing androgens in raccoon testes. Estradiol is thought
to be also essential for male reproduction, for stimulating sperm maturation [20] and for absorbing rete testis fluid to concentrate
sperm in semen [21]. P450arom has been detected in
Leydig cells, Sertoli cells and germ cells in some animals, such as Japanese black bears
[8, 22],
Hokkaido brown bears [23], raccoon dogs [7], laboratorymice [24] and laboratory rats [25]. Also, in
raccoon testes, various cells, including Leydig cells, Sertoli cells and spermatids, are
considered to be sources of estradiols.Seasonal changes in steroidogenic enzyme expression in testicular tissue have been reported
in some seasonal breeding animals, and the key enzyme associated with changes in the
seasonal secretion of testosterone varies by species: P450c17 in bank voles [26] and American grey squirrels (Sciurus
carolinensis) [27] and P450scc and P450c17
in DLS rams [28]. Seasonal changes in 3βHSD
expression were demonstrated in raccoon dogs [7],
Japanese black bears [22] and Colorado mule deer
(Odocoileus hemionus) [29] by
immunohistological evaluation and in raccoon dogs [30] by gene expression analyses. In the present study, P450scc and P450c17 were
detected in all individuals throughout the seasons. Between WIN and SUM+, an intensity
difference was observed only in 3βHSD. These results suggest that 3βHSD may play a key role
in regulating testosterone production in Leydig cells in raccoon testes, as in the other
mammals mentioned. Decreasing testosterone over the summer might be related to decreases in
Leydig cell number or size changes [22, 31] and decreased testes weight, in addition to 3βHSD
expression changes. Also, changes in luteinizing hormone (LH) secretion, which controls
these factors [32], are thought to be part of another
regulatory system.When SUM– samples were compared with SUM+ samples, the testosterone concentrations in both
plasma and tissue were not significantly different. However, P450arom expression decreased
markedly and immunoreactivity was scarce in the SUM– group. Estradiol is also considered to
be important for testicular development and spermatogenesis [33]. Synthesis of estradiol by P450arom occurs in various tissues and cells in
mammals, such as adipose tissue, bone, the ovary, the placenta and the testis [14]. In raccoons, expression of P450arom in other tissues
has not been noted, but in local testicular tissue, differences in the intensity of
expression were observed, along with spermatogenetic activity, in the summer season. Thus,
P450arom expression in raccoon testicular tissue might contribute to keeping spermatogenesis
active during the summer non-mating season.AR was detected strongly in Leydig cells and parts of Sertoli cells in SUM+, whereas it was
detected weakly in both cells in inactive testes in SUM–. AR expression in Sertoli cells,
which play a central role in nursing germ cells, decreased along with aspermatogenesis in
summer. Thus, spermatogenesis in the raccoon testis may be maintained by reactivity to
testosterone in Sertoli cells. AR expression in Sertoli cells has been reported to increase
with stimulation of follicle-stimulating hormone (FSH) secretion [34, 35]. In further research, such
upstream regulatory factors should be investigated.The results in this study suggested that P450arom and AR were involved in maintenance of
spermatogenesis in summer. However, there is a possibility that spermatogenetic activity was
reduced promptly after the winter mating season and then was restarted by P450arom and AR
expression in SUM+. In our previous study [6], we
conducted histological observation of a testis repeatedly using one captive male and found
that it took almost 4 months to restart spermatogenesis after the SS decline in summer. In
addition, considering that all wild males showed active spermatogenesis until May in spring
[6], spermatogenesis in SUM+ in the present study
was thought to be maintained from the winter mating season, not reactivated after the
aspermatogenetic period. The results for Plasma T and Tissue T suggested that a high
testosterone concentration was not necessarily required for active spermatogenesis. In
summer, even if the testosterone level was lower than in winter, spermatogenetic activity
may be kept with the actions of testosterone on AR and of estradiol synthesized by
P450arom.In summary, the present study showed that morphological, histological and endocrinological
differences in testes of wild male raccoons occurred with the seasons and spermatogenetic
activity. Four steroidogenic enzymes and the AR were immunolocalized in raccoon testicular
tissue, and changes in immunohistochemical staining intensity were evaluated according to
season and spermatogenesis. Seasonal changes in testosterone concentration correlated with
3βHSD expression, and spermatogenetic activity correlated with P450arom and AR expression.
Maintaining spermatogenetic activity in the summer was related to metabolism and reactivity
against testosterone, not with local testosterone concentrations in testicular tissue.
Further investigations should examine how the differential effects of pituitary
gonadotropins, such as FSH and LH, their receptors and estradiol expression affect
spermatogenesis to clarify the details of the mechanism of the regulation of spermatogenesis
in the raccoon testis.
Authors: H Nitta; D Bunick; R A Hess; L Janulis; S C Newton; C F Millette; Y Osawa; Y Shizuta; K Toda; J M Bahr Journal: Endocrinology Date: 1993-03 Impact factor: 4.736
Authors: Leonardo Catalano-Iniesta; Virginia Sánchez-Robledo; Maria Carmen Iglesias-Osma; Maria José García-Barrado; Marta Carretero-Hernández; Enrique J Blanco; Teresa Vicente-García; Deborah Jane Burks; José Carretero Journal: J Anat Date: 2018-11-25 Impact factor: 2.610