P15538 (C11B1_HUMAN) Reviewed, UniProtKB/Swiss-Prot

Names and origin

Protein names

Recommended name:
Cytochrome P450 11B1, mitochondrial

Alternative name(s):
CYPXIB1
Cytochrome P-450c11
Short name=Cytochrome P450C11
Steroid 11-beta-hydroxylase
EC=1.14.15.4

Gene names

Name:	CYP11B1
Synonyms:	S11BH

Organism

Homo sapiens (Human) [Reference proteome]

Taxonomic identifier

9606 [NCBI]

Taxonomic lineage

cellular organisms › Eukaryota › Opisthokonta › Metazoa › Eumetazoa › Bilateria › Deuterostomia › Chordata › Craniata › Vertebrata › Gnathostomata › Teleostomi › Euteleostomi › Sarcopterygii › Tetrapoda › Amniota › Mammalia › Theria › Eutheria › Euarchontoglires › Primates › Haplorrhini › Simiiformes › Catarrhini › Hominoidea › Hominidae › Homininae › Homo

Protein attributes

Sequence length	503 AA.
Sequence status	Complete.
Sequence processing	The displayed sequence is further processed into a mature form.
Protein existence	Evidence at protein level

General annotation (Comments)

Function	Has steroid 11-beta-hydroxylase activity. In addition to this activity, the 18 or 19-hydroxylation of steroids and the aromatization of androstendione to estrone have also been ascribed to cytochrome P450 XIB.
Catalytic activity	A steroid + reduced adrenal ferredoxin + O2 = an 11-beta-hydroxysteroid + oxidized adrenal ferredoxin + H2O.
Cofactor	Heme group By similarity.
Subcellular location	Mitochondrion membrane.
Involvement in disease	Adrenal hyperplasia 4 (AH4) [MIM:202010]: A form of congenital adrenal hyperplasia, a common recessive disease due to defective synthesis of cortisol. Congenital adrenal hyperplasia is characterized by androgen excess leading to ambiguous genitalia in affected females, rapid somatic growth during childhood in both sexes with premature closure of the epiphyses and short adult stature. Four clinical types: 'salt wasting' (SW, the most severe type), 'simple virilizing' (SV, less severely affected patients), with normal aldosterone biosynthesis, 'non-classic form' or late-onset (NC or LOAH)and 'cryptic' (asymptomatic). Note: The disease is caused by mutations affecting the gene represented in this entry. Ref.10 Ref.11 Ref.16 Ref.17 Ref.18 Familial hyperaldosteronism 1 (FH1) [MIM:103900]: A disorder characterized by hypertension, variable hyperaldosteronism, and abnormal adrenal steroid production, including 18-oxocortisol and 18-hydroxycortisol. There is significant phenotypic heterogeneity, and some individuals never develop hypertension. Note: The disease is caused by mutations affecting the gene represented in this entry. The molecular defect causing hyperaldosteronism familial 1 is an anti-Lepore-type fusion of the CYP11B1 and CYP11B2 genes. The hybrid gene has the promoting part of CYP11B1, ACTH-sensitive, and the coding part of CYP11B2.
Sequence similarities	Belongs to the cytochrome P450 family.

Ontologies

Keywords
Biological process	Lipid metabolism Steroid metabolism Steroidogenesis
Cellular component	Membrane Mitochondrion
Coding sequence diversity	Alternative splicing Polymorphism
Disease	Congenital adrenal hyperplasia Disease mutation
Domain	Transit peptide
Ligand	Heme Iron Metal-binding
Molecular function	Monooxygenase Oxidoreductase
Technical term	Complete proteome Direct protein sequencing Reference proteome
Gene Ontology (GO)
Biological_process	aldosterone biosynthetic process Inferred from mutant phenotype PubMed 19342457. Source: UniProtKB cellular response to hormone stimulus Inferred from expression pattern PubMed 19342457. Source: UniProtKB cellular response to potassium ion Inferred from expression pattern PubMed 19342457. Source: UniProtKB cortisol biosynthetic process Inferred from mutant phenotype PubMed 19342457. Source: UniProtKB glucose homeostasis Traceable author statement PubMed 16114325. Source: BHF-UCL immune response Traceable author statement PubMed 12452430. Source: BHF-UCL regulation of blood pressure Inferred from mutant phenotype Ref.10. Source: BHF-UCL response to stress Traceable author statement PubMed 12452430. Source: BHF-UCL xenobiotic metabolic process Traceable author statement. Source: Reactome
Cellular_component	mitochondrial inner membrane Traceable author statement PubMed 15026188. Source: BHF-UCL
Molecular_function	electron carrier activity Inferred from electronic annotation. Source: InterPro heme binding Inferred by curator PubMed 2256920. Source: BHF-UCL iron ion binding Inferred from electronic annotation. Source: InterPro steroid 11-beta-monooxygenase activity Inferred from direct assay PubMed 2256920PubMed 8506298. Source: BHF-UCL
Complete GO annotation...

Alternative products

This entry describes 2 isoforms produced by alternative splicing. [Align] [Select]

Isoform 1 (identifier: P15538-1)

This isoform has been chosen as the 'canonical' sequence. All positional information in this entry refers to it. This is also the sequence that appears in the downloadable versions of the entry.

Isoform 2 (identifier: P15538-2)

The sequence of this isoform differs from the canonical sequence as follows:
     401-466: Missing.

Note: No experimental confirmation available.

Sequence annotation (Features)

	Feature key	Position(s)	Length	Description	Graphical view	Feature identifier
Molecule processing
	Transit peptide	1 – 24	24	Mitochondrion
	Chain	25 – 503	479	Cytochrome P450 11B1, mitochondrial		PRO_0000003596
Sites
	Metal binding	450	1	Iron (heme axial ligand) By similarity
Natural variations
	Alternative sequence	401 – 466	66	Missing in isoform 2.		VSP_043308
	Natural variant	10	1	C → Y. Ref.13 Corresponds to variant rs6405 [ dbSNP | Ensembl ].		VAR_014145
	Natural variant	42	1	P → S in AH4; non-classic. Ref.11		VAR_001260
	Natural variant	43	1	R → Q. Ref.2 Ref.13 Ref.15 Corresponds to variant rs4534 [ dbSNP | Ensembl ].		VAR_014146
	Natural variant	63	1	D → H. Corresponds to variant rs5282 [ dbSNP | Ensembl ].		VAR_014638
	Natural variant	94	1	P → L in AH4. Ref.16		VAR_065666
	Natural variant	133	1	N → H in AH4; non-classic. Ref.11		VAR_001261
	Natural variant	160	1	M → I. Ref.15 Corresponds to variant rs5287 [ dbSNP | Ensembl ].		VAR_014147
	Natural variant	173	1	K → R. Corresponds to variant rs4539 [ dbSNP | Ensembl ].		VAR_014639
	Natural variant	248	1	T → I. Corresponds to variant rs34620645 [ dbSNP | Ensembl ].		VAR_048462
	Natural variant	257	1	F → L. Corresponds to variant rs5288 [ dbSNP | Ensembl ].		VAR_014640
	Natural variant	281	1	S → N. Corresponds to variant rs5291 [ dbSNP | Ensembl ].		VAR_014641
	Natural variant	293	1	L → V. Ref.15 Corresponds to variant rs5292 [ dbSNP | Ensembl ].		VAR_014148
	Natural variant	318	1	T → M in AH4.		VAR_001262
	Natural variant	318	1	T → R in AH4. Ref.16		VAR_065667
	Natural variant	319	1	T → M in AH4; non-classic. Ref.11		VAR_001263
	Natural variant	348	1	A → T. Ref.13 Corresponds to variant rs6407 [ dbSNP | Ensembl ].		VAR_014149
	Natural variant	374	1	R → Q in AH4.		VAR_001264
	Natural variant	379	1	G → V in AH4. Ref.17		VAR_065196
	Natural variant	386	1	A → V. Ref.2 Ref.8 Ref.13 Corresponds to variant rs4541 [ dbSNP | Ensembl ].		VAR_014150
	Natural variant	404	1	R → H. Corresponds to variant rs4998896 [ dbSNP | Ensembl ].		VAR_048463
	Natural variant	439	1	Y → H. Corresponds to variant rs5294 [ dbSNP | Ensembl ].		VAR_014642
	Natural variant	448	1	R → H in AH4. Ref.10 Ref.16 Corresponds to variant rs28934586 [ dbSNP | Ensembl ].		VAR_001265
	Natural variant	454	1	R → C in AH4. Ref.18		VAR_065197
	Natural variant	494	1	F → C. Ref.1 Ref.12		VAR_008687

Sequences

	Sequence		Length	Mass (Da)
	Isoform 1 [UniParc]. Last modified November 25, 2008. Version 5. Checksum: 0B36D82513960EE9	FASTA	503	57,573
	10 20 30 40 50 60 MALRAKAEVC MAVPWLSLQR AQALGTRAAR VPRTVLPFEA MPRRPGNRWL RLLQIWREQG 70 80 90 100 110 120 YEDLHLEVHQ TFQELGPIFR YDLGGAGMVC VMLPEDVEKL QQVDSLHPHR MSLEPWVAYR 130 140 150 160 170 180 QHRGHKCGVF LLNGPEWRFN RLRLNPEVLS PNAVQRFLPM VDAVARDFSQ ALKKKVLQNA 190 200 210 220 230 240 RGSLTLDVQP SIFHYTIEAS NLALFGERLG LVGHSPSSAS LNFLHALEVM FKSTVQLMFM 250 260 270 280 290 300 PRSLSRWTSP KVWKEHFEAW DCIFQYGDNC IQKIYQELAF SRPQQYTSIV AELLLNAELS 310 320 330 340 350 360 PDAIKANSME LTAGSVDTTV FPLLMTLFEL ARNPNVQQAL RQESLAAAAS ISEHPQKATT 370 380 390 400 410 420 ELPLLRAALK ETLRLYPVGL FLERVASSDL VLQNYHIPAG TLVRVFLYSL GRNPALFPRP 430 440 450 460 470 480 ERYNPQRWLD IRGSGRNFYH VPFGFGMRQC LGRRLAEAEM LLLLHHVLKH LQVETLTQED 490 500 IKMVYSFILR PSMFPLLTFR AIN
	Isoform 2 [UniParc]. Checksum: F85180BFB83C9B5A	FASTA	437	49,750
	10 20 30 40 50 60 MALRAKAEVC MAVPWLSLQR AQALGTRAAR VPRTVLPFEA MPRRPGNRWL RLLQIWREQG 70 80 90 100 110 120 YEDLHLEVHQ TFQELGPIFR YDLGGAGMVC VMLPEDVEKL QQVDSLHPHR MSLEPWVAYR 130 140 150 160 170 180 QHRGHKCGVF LLNGPEWRFN RLRLNPEVLS PNAVQRFLPM VDAVARDFSQ ALKKKVLQNA 190 200 210 220 230 240 RGSLTLDVQP SIFHYTIEAS NLALFGERLG LVGHSPSSAS LNFLHALEVM FKSTVQLMFM 250 260 270 280 290 300 PRSLSRWTSP KVWKEHFEAW DCIFQYGDNC IQKIYQELAF SRPQQYTSIV AELLLNAELS 310 320 330 340 350 360 PDAIKANSME LTAGSVDTTV FPLLMTLFEL ARNPNVQQAL RQESLAAAAS ISEHPQKATT 370 380 390 400 410 420 ELPLLRAALK ETLRLYPVGL FLERVASSDL VLQNYHIPAG VLKHLQVETL TQEDIKMVYS 430 FILRPSMFPL LTFRAIN

References

	« Hide 'large scale' referencesShow 'large scale' references »
[1]	"Characterization of two genes encoding human steroid 11 beta-hydroxylase (P-450(11) beta)." Mornet E., Dupont J., Vitek A., White P.C. J. Biol. Chem. 264:20961-20967(1989) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [GENOMIC DNA], VARIANT CYS-494.
[2]	"Cloning of cDNA and genomic DNA for human cytochrome P-45011 beta." Kawamoto T., Mitsuuchi Y., Toda K., Miyahara K., Yokoyama Y., Nakao K., Hosoda K., Yamamoto Y., Imura H., Shizuta Y. FEBS Lett. 269:345-349(1990) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [MRNA] (ISOFORM 1), PARTIAL PROTEIN SEQUENCE, VARIANTS GLN-43 AND VAL-386.
[3]	NHLBI resequencing and genotyping service (RS&G) Submitted (DEC-2007) to the EMBL/GenBank/DDBJ databases Cited for: NUCLEOTIDE SEQUENCE [GENOMIC DNA].
[4]	"DNA sequence and analysis of human chromosome 8." Nusbaum C., Mikkelsen T.S., Zody M.C., Asakawa S., Taudien S., Garber M., Kodira C.D., Schueler M.G., Shimizu A., Whittaker C.A., Chang J.L., Cuomo C.A., Dewar K., FitzGerald M.G., Yang X., Allen N.R., Anderson S., Asakawa T. , Blechschmidt K., Bloom T., Borowsky M.L., Butler J., Cook A., Corum B., DeArellano K., DeCaprio D., Dooley K.T., Dorris L. III, Engels R., Gloeckner G., Hafez N., Hagopian D.S., Hall J.L., Ishikawa S.K., Jaffe D.B., Kamat A., Kudoh J., Lehmann R., Lokitsang T., Macdonald P., Major J.E., Matthews C.D., Mauceli E., Menzel U., Mihalev A.H., Minoshima S., Murayama Y., Naylor J.W., Nicol R., Nguyen C., O'Leary S.B., O'Neill K., Parker S.C.J., Polley A., Raymond C.K., Reichwald K., Rodriguez J., Sasaki T., Schilhabel M., Siddiqui R., Smith C.L., Sneddon T.P., Talamas J.A., Tenzin P., Topham K., Venkataraman V., Wen G., Yamazaki S., Young S.K., Zeng Q., Zimmer A.R., Rosenthal A., Birren B.W., Platzer M., Shimizu N., Lander E.S. Nature 439:331-335(2006) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [LARGE SCALE GENOMIC DNA].
[5]	Mural R.J., Istrail S., Sutton G.G., Florea L., Halpern A.L., Mobarry C.M., Lippert R., Walenz B., Shatkay H., Dew I., Miller J.R., Flanigan M.J., Edwards N.J., Bolanos R., Fasulo D., Halldorsson B.V., Hannenhalli S., Turner R. , Yooseph S., Lu F., Nusskern D.R., Shue B.C., Zheng X.H., Zhong F., Delcher A.L., Huson D.H., Kravitz S.A., Mouchard L., Reinert K., Remington K.A., Clark A.G., Waterman M.S., Eichler E.E., Adams M.D., Hunkapiller M.W., Myers E.W., Venter J.C. Submitted (SEP-2005) to the EMBL/GenBank/DDBJ databases Cited for: NUCLEOTIDE SEQUENCE [LARGE SCALE GENOMIC DNA].
[6]	"The status, quality, and expansion of the NIH full-length cDNA project: the Mammalian Gene Collection (MGC)." The MGC Project Team Genome Res. 14:2121-2127(2004) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [LARGE SCALE MRNA] (ISOFORMS 1 AND 2).
[7]	"A nonsense mutation (TGG [Trp116]-->TAG [Stop]) in CYP11B1 causes steroid 11 beta-hydroxylase deficiency." Naiki Y., Kawamoto T., Mitsuuchi Y., Miyahara K., Toda K., Orii T., Imura H., Shizuta Y. J. Clin. Endocrinol. Metab. 77:1677-1682(1993) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [GENOMIC DNA] OF 1-132. Tissue: Peripheral blood.
[8]	"Cloning of cDNA encoding steroid 11 beta-hydroxylase (P450c11)." Chua S.C., Szabo P., Vitek A., Grzeschik K.H., John M., White P.C. Proc. Natl. Acad. Sci. U.S.A. 84:7193-7197(1987) [PubMed] [Europe PMC] [Abstract] Cited for: PRELIMINARY NUCLEOTIDE SEQUENCE [MRNA] OF 216-466, VARIANT VAL-386.
[9]	"Role of steroid 11 beta-hydroxylase and steroid 18-hydroxylase in the biosynthesis of glucocorticoids and mineralocorticoids in humans." Kawamoto T., Mitsuuchi Y., Toda K., Yokoyama Y., Miyahara K., Miura S., Ohnishi T., Icikawa Y., Nakao K., Imura H., Ulick S., Shuzuta Y. Proc. Natl. Acad. Sci. U.S.A. 89:1458-1462(1992) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [GENOMIC DNA] OF 1-30.
[10]	"A mutation in CYP11B1 (Arg-448-->His) associated with steroid 11 beta-hydroxylase deficiency in Jews of Moroccan origin." White P.C., Dupont J., New M.I., Leiberman E., Hochberg Z., Roesler A. J. Clin. Invest. 87:1664-1667(1991) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANT AH4 HIS-448.
[11]	"CYP11B1 mutations causing non-classic adrenal hyperplasia due to 11 beta-hydroxylase deficiency." Joehrer K., Geley S., Strasser-Wozak E.M.C., Azziz R., Wollmann H.A., Schmitt K., Kofler R., White P.C. Hum. Mol. Genet. 6:1829-1834(1997) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANTS AH4 SER-42; HIS-133 AND MET-319.
[12]	"The C494F variant in the CYP11B1 gene is a sequence polymorphism in the Spanish population." Loidi L., Quinteiro C., Barros F., Dominguez F., Barreiro J., Pombo M. J. Clin. Endocrinol. Metab. 84:4749-4749(1999) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANT CYS-494.
[13]	"Characterization of single-nucleotide polymorphisms in coding regions of human genes." Cargill M., Altshuler D., Ireland J., Sklar P., Ardlie K., Patil N., Shaw N., Lane C.R., Lim E.P., Kalyanaraman N., Nemesh J., Ziaugra L., Friedland L., Rolfe A., Warrington J., Lipshutz R., Daley G.Q., Lander E.S. Nat. Genet. 22:231-238(1999) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANTS TYR-10; GLN-43; THR-348 AND VAL-386.
[14]	Erratum Cargill M., Altshuler D., Ireland J., Sklar P., Ardlie K., Patil N., Shaw N., Lane C.R., Lim E.P., Kalyanaraman N., Nemesh J., Ziaugra L., Friedland L., Rolfe A., Warrington J., Lipshutz R., Daley G.Q., Lander E.S. Nat. Genet. 23:373-373(1999)
[15]	"Patterns of single-nucleotide polymorphisms in candidate genes for blood-pressure homeostasis." Halushka M.K., Fan J.-B., Bentley K., Hsie L., Shen N., Weder A., Cooper R., Lipshutz R., Chakravarti A. Nat. Genet. 22:239-247(1999) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANTS GLN-43; ILE-160 AND VAL-293.
[16]	"21-Hydroxylase and 11beta-hydroxylase mutations in Romanian patients with classic congenital adrenal hyperplasia." Grigorescu Sido A., Weber M.M., Grigorescu Sido P., Clausmeyer S., Heinrich U., Schulze E. J. Clin. Endocrinol. Metab. 90:5769-5773(2005) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANTS AH4 LEU-94; ARG-318 AND HIS-448.
[17]	"Only two mutations detected in 15 Tunisian patients with 11beta-hydroxylase deficiency: the p.Q356X and the novel p.G379V." Kharrat M., Trabelsi S., Chaabouni M., Maazoul F., Kraoua L., Ben Jemaa L., Gandoura N., Barsaoui S., Morel Y., M'rad R., Chaabouni H. Clin. Genet. 78:398-401(2010) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANT AH4 VAL-379.
[18]	"Novel homozygous p.R454C mutation in the CYP11B1 gene leads to 11beta-hydroxylase deficiency in a Chinese patient." Wu C., Zhou Q., Wan L., Ni L., Zheng C., Qian Y., Jin J. Fertil. Steril. 95:1122-1122(2011) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANT AH4 CYS-454.
+	Additional computationally mapped references.

Web resources

GeneReviews

Cross-references

Sequence databases
EMBL GenBank DDBJ	M32879, M32863, M32878 Genomic DNA. Translation: AAA52149.1. X55764 mRNA. Translation: CAA39290.1. D16153 Genomic DNA. Translation: BAB71992.1. D16155 Genomic DNA. Translation: BAA03717.1. EU332839 Genomic DNA. Translation: ABY87528.1. AC083841 Genomic DNA. No translation available. CH471162 Genomic DNA. Translation: EAW82293.1. BC096286 mRNA. Translation: AAH96286.1. BC096287 mRNA. Translation: AAH96287.1. M24667 mRNA. Translation: AAA52148.1. Sequence problems. D10169 Genomic DNA. Translation: BAA01039.1.
IPI	IPI00291348.
PIR	S11338.
RefSeq	NP_000488.3. NM_000497.3. NP_001021384.1. NM_001026213.1.
UniGene	Hs.184927.
3D structure databases
ProteinModelPortal	P15538.
ModBase	Search...
Protein-protein interaction databases
STRING	9606.ENSP00000292427.
PTM databases
PhosphoSite	P15538.
Polymorphism databases
DMDM	215274267.
Proteomic databases
PaxDb	P15538.
PRIDE	P15538.
Protocols and materials databases
StructuralBiologyKnowledgebase	Search...
Genome annotation databases
Ensembl	ENST00000292427; ENSP00000292427; ENSG00000160882. ENST00000517471; ENSP00000428043; ENSG00000160882.
GeneID	1584.
KEGG	hsa:1584.
UCSC	uc003yxi.3. human.
Organism-specific databases
CTD	1584.
GeneCards	GC08M143950.
HGNC	HGNC:2591. CYP11B1.
HPA	HPA049171.
MIM	103900. phenotype. 202010. phenotype. 610613. gene.
neXtProt	NX_P15538.
Orphanet	90795. Congenital adrenal hyperplasia due to 11-beta-hydroxylase deficiency. 403. Familial hyperaldosteronism type 1.
PharmGKB	PA133.
GenAtlas	Search...
Phylogenomic databases
eggNOG	COG2124.
HOGENOM	HOG000013161.
HOVERGEN	HBG051098.
KO	K00497.
PhylomeDB	P15538.
Enzyme and pathway databases
BioCyc	MetaCyc:HS08547-MONOMER.
BRENDA	1.14.15.4. 2681.
Reactome	REACT_111217. Metabolism. REACT_15493. Steroid hormones.
Gene expression databases
ArrayExpress	P15538.
Bgee	P15538.
CleanEx	HS_CYP11B1.
Genevestigator	P15538.
GermOnline	ENSG00000160882. Homo sapiens.
Family and domain databases
Gene3D	1.10.630.10. 1 hit.
InterPro	IPR001128. Cyt_P450. IPR017972. Cyt_P450_CS. IPR002399. Cyt_P450_mitochondrial. [Graphical view]
Pfam	PF00067. p450. 1 hit. [Graphical view]
PRINTS	PR00408. MITP450. PR00385. P450.
SUPFAM	SSF48264. Cytochrome_P450. 1 hit.
PROSITE	PS00086. CYTOCHROME_P450. 1 hit. [Graphical view]
ProtoNet	Search...
Other
BindingDB	P15538.
ChEMBL	CHEMBL1908.
DrugBank	DB00648. Mitotane.
GenomeRNAi	1584.
NextBio	6509.
SOURCE	Search...

Entry information

Entry name

C11B1_HUMAN

Accession

Primary (citable) accession number: P15538
Secondary accession number(s): Q14095 , Q4VAQ8, Q4VAQ9, Q9UML2

Entry history

Integrated into UniProtKB/Swiss-Prot:	April 1, 1990
Last sequence update:	November 25, 2008
Last modified:	May 1, 2013
This is version 149 of the entry and version 5 of the sequence. [Complete history]

Entry status

Reviewed (UniProtKB/Swiss-Prot)

Annotation program

Chordata Protein Annotation Program

Disclaimer

Any medical or genetic information present in this entry is provided for research, educational and informational purposes only. It is not in any way intended to be used as a substitute for professional medical advice, diagnosis, treatment or care.