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Erschienen in: Inflammation 4-6/2005

01.12.2005

Human Conjunctival Epithelial Cells Lack Lipopolysaccharide Responsiveness Due to Deficient Expression of MD2 but Respond After Interferon-γ Priming or Soluble MD2 Supplementation

verfasst von: Jaya Talreja, Kavitha Dileepan, Sanjeev Puri, Mohammad H. Kabir, David M. Segal, Daniel J. Stechschulte, Kottarappat N. Dileepan

Erschienen in: Inflammation | Ausgabe 4-6/2005

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Abstract

Inflammatory responses to Gram-positive and Gram-negative bacterial cell wall components are initiated by Toll-like receptor 2 (TLR2) and TLR4, respectively. Therefore, the existence of functionally active TLR2 and TLR4 in human conjunctival epithelial cells (HCEC) are critical for the effective host defense against bacterial infections in the eye. We examined the ability of HCEC to respond to TLR4 ligand, lipopolysaccharide (LPS), or TLR2 ligands, lipoteichoic acid (LTA) and peptidoglycan (PGN) using the Chang conjunctival epithelial cell line and the primary conjunctival epithelial cell line (IOBA-NHC) as in vitro models. Incubation of Chang cells with LPS (1 to 1,000 ng/ ml) failed to stimulate IL-6 production where as stimulation with LTA or PGN resulted in marked increases in IL-6 production. Semi-quantitative RT–PCR and immunofluorescence analyses showed that Chang cells express TLR2 and TLR4 mRNA and proteins. However, these cells expressed little or no mRNA encoding MD2, an accessory molecule required for TLR4 signaling. Incubation of Chang epithelial cells with interferon-γ (IFNγ), but not TNF-α, stimulated MD2 mRNA expression and restored LPS responsiveness. In addition, when Chang cell cultures were supplemented with soluble MD2, LPS was able to stimulate IL-6 production. The lack of LPS response, deficient expression of MD2, and induction of MD2 expression and LPS response after IFNγ priming, were also evident in IOBA-NHC cells. These results demonstrate that HCEC lack LPS responsiveness due to deficient expression of MD2 and that the response can be restored by IFN-γ priming or MD2 supplementation.
Literatur
1.
Zurück zum Zitat Chung, C. W., and E. J. Cohen. 2000. Eye-disorders: bacterial conjunctivitis. West J Med. 173:202–205.PubMedCrossRef Chung, C. W., and E. J. Cohen. 2000. Eye-disorders: bacterial conjunctivitis. West J Med. 173:202–205.PubMedCrossRef
2.
Zurück zum Zitat Aswad M. I., T. John, M. Barza, K. Kenyon, and J. Baum. 1990. Bacterial adherence to extend wear soft contact lenses. Ophthalmol. 97:296–302. Aswad M. I., T. John, M. Barza, K. Kenyon, and J. Baum. 1990. Bacterial adherence to extend wear soft contact lenses. Ophthalmol. 97:296–302.
3.
Zurück zum Zitat Doyle A., B. Beigi, A. Early, A. Blake, P. Eustace, and R. Hone. 1995. Adherence of bacteria to intraocular lenses: a prospective study. Br. J. Ophthalmol. 79:347–349.PubMed Doyle A., B. Beigi, A. Early, A. Blake, P. Eustace, and R. Hone. 1995. Adherence of bacteria to intraocular lenses: a prospective study. Br. J. Ophthalmol. 79:347–349.PubMed
4.
Zurück zum Zitat Takeda K., T. Kaisho, and S. Akira. 2003. Toll-like receptors. Annu. Rev. Immunol. 21:335–376.PubMedCrossRef Takeda K., T. Kaisho, and S. Akira. 2003. Toll-like receptors. Annu. Rev. Immunol. 21:335–376.PubMedCrossRef
5.
Zurück zum Zitat Aderem A., and R. J. Ulevitch. 2000. Toll-like receptors in the induction of the innate immune response. Nature. 406:782–787.PubMedCrossRef Aderem A., and R. J. Ulevitch. 2000. Toll-like receptors in the induction of the innate immune response. Nature. 406:782–787.PubMedCrossRef
6.
Zurück zum Zitat Krutzik S. R., P. A. Sieling, and R.L. Modlin. 2001. The role of Toll-like receptors in host defense against microbial infection. Curr. Opin. Immunol. 13:104–108.PubMedCrossRef Krutzik S. R., P. A. Sieling, and R.L. Modlin. 2001. The role of Toll-like receptors in host defense against microbial infection. Curr. Opin. Immunol. 13:104–108.PubMedCrossRef
7.
Zurück zum Zitat Medzhitov R., P. Preston-Hurlburt, and C. A. Janeway. 1997. A human homologue of the drosophila Toll protein signals activation of adaptive immunity. Nature. 388:394–397.PubMedCrossRef Medzhitov R., P. Preston-Hurlburt, and C. A. Janeway. 1997. A human homologue of the drosophila Toll protein signals activation of adaptive immunity. Nature. 388:394–397.PubMedCrossRef
8.
Zurück zum Zitat Hoshino K., O. Takeuchi, T. Kawai, H. Sanjo, T. Ogawa, Y. Takeda, K. Takeda, and S. Akira. 1999. Toll-like receptor-4 deficient mice are hyporesponsive to lipopolysaccharide. Evidence for TLR4 as the lps gene product. J. Immunol. 162:3749–3752.PubMed Hoshino K., O. Takeuchi, T. Kawai, H. Sanjo, T. Ogawa, Y. Takeda, K. Takeda, and S. Akira. 1999. Toll-like receptor-4 deficient mice are hyporesponsive to lipopolysaccharide. Evidence for TLR4 as the lps gene product. J. Immunol. 162:3749–3752.PubMed
9.
Zurück zum Zitat Takeuchi O., K. Hoshino, T. Kawai, H. Sanjo, H. Takeda, T. Ogawa, K. Takeda, and S. Akira. 1999. Differential roles of TLR2 and TLR4 in recognition of Gram-negative and Gram-positive bacterial cell wall components. Immunity. 11:443–451.PubMedCrossRef Takeuchi O., K. Hoshino, T. Kawai, H. Sanjo, H. Takeda, T. Ogawa, K. Takeda, and S. Akira. 1999. Differential roles of TLR2 and TLR4 in recognition of Gram-negative and Gram-positive bacterial cell wall components. Immunity. 11:443–451.PubMedCrossRef
10.
Zurück zum Zitat Lehner M. D., S. Morath, K. S. Michelsen, R. R. Schumann, and T. Hartung. 2001. Induction of cross-tolerance by lipopolysaccharide and highly purified lipoteichoic acid via different Toll-like receptors independent of paracrine mediators. J. Immunol. 166:5161–5167.PubMed Lehner M. D., S. Morath, K. S. Michelsen, R. R. Schumann, and T. Hartung. 2001. Induction of cross-tolerance by lipopolysaccharide and highly purified lipoteichoic acid via different Toll-like receptors independent of paracrine mediators. J. Immunol. 166:5161–5167.PubMed
11.
Zurück zum Zitat Miyake K. 2003. Innate recognition of lipopolysaccharide by CD14 and toll-like receptor 4-MD-2: Unique roles for MD-2. Int Immunopharmacol. 3:119–128.PubMedCrossRef Miyake K. 2003. Innate recognition of lipopolysaccharide by CD14 and toll-like receptor 4-MD-2: Unique roles for MD-2. Int Immunopharmacol. 3:119–128.PubMedCrossRef
12.
Zurück zum Zitat Nagai Y., S. Akashi, M. Nagafuku, M. Ogata, Y. Iwakura, S. Akira, T. Kitamura, A. Kosugi, M. Kimoto, and K. Miyake. 2002. Essential role of MD-2 in LPS responsiveness and TLR-4 distribution. Nat Immunol. 3:667–672.PubMed Nagai Y., S. Akashi, M. Nagafuku, M. Ogata, Y. Iwakura, S. Akira, T. Kitamura, A. Kosugi, M. Kimoto, and K. Miyake. 2002. Essential role of MD-2 in LPS responsiveness and TLR-4 distribution. Nat Immunol. 3:667–672.PubMed
13.
Zurück zum Zitat Shimazu R., S. Akashi, H. Ogata, Y. Nagai, K. Fukudome, K. Miyake, and M. Kimoto. 1999. MD-2, a molecule that confers lipopolysaccharide responsiveness on Toll-like receptor 4. J. Exp. Med. 189:1777–1782.PubMedCrossRef Shimazu R., S. Akashi, H. Ogata, Y. Nagai, K. Fukudome, K. Miyake, and M. Kimoto. 1999. MD-2, a molecule that confers lipopolysaccharide responsiveness on Toll-like receptor 4. J. Exp. Med. 189:1777–1782.PubMedCrossRef
14.
Zurück zum Zitat Visintin A., A. Mazzoni, J.A. Spitzer, and D. M. Segal. 2001. Secreted MD2 is a large polymeric protein that efficiently confers lipopolysaccharide sensitivity to Toll-like receptor 4. Proc. Natl. Acad. Sci. USA 98:12156–12161.PubMedCrossRef Visintin A., A. Mazzoni, J.A. Spitzer, and D. M. Segal. 2001. Secreted MD2 is a large polymeric protein that efficiently confers lipopolysaccharide sensitivity to Toll-like receptor 4. Proc. Natl. Acad. Sci. USA 98:12156–12161.PubMedCrossRef
15.
Zurück zum Zitat Schromm A. B., E. Lien, E. Henneke, J. C. Chow, A. Yoshimura, H. Heine, E. Latz, B. G. Monks, D. A. Schwartz, K. Miyake, and D. T. Golenbock. 2001. Molecular genetic analysis of an endotoxin nonresponder mutant cell line: a point mutation in a conserved region of MD2 abolishes endotoxin-induced signaling. J. Exp. Med. 194:79–88.PubMedCrossRef Schromm A. B., E. Lien, E. Henneke, J. C. Chow, A. Yoshimura, H. Heine, E. Latz, B. G. Monks, D. A. Schwartz, K. Miyake, and D. T. Golenbock. 2001. Molecular genetic analysis of an endotoxin nonresponder mutant cell line: a point mutation in a conserved region of MD2 abolishes endotoxin-induced signaling. J. Exp. Med. 194:79–88.PubMedCrossRef
16.
Zurück zum Zitat Mullen G. E., M. N. Kennedy, A. Visintin, A. Mazzoni, C. A. Leifer, D. R. Davies, and D. M. Segal. 2003. The role of disulfide bonds in the assembly and function of MD-2. Proc. Natl. Acad. Sci. USA 100:3919–3924.PubMedCrossRef Mullen G. E., M. N. Kennedy, A. Visintin, A. Mazzoni, C. A. Leifer, D. R. Davies, and D. M. Segal. 2003. The role of disulfide bonds in the assembly and function of MD-2. Proc. Natl. Acad. Sci. USA 100:3919–3924.PubMedCrossRef
17.
Zurück zum Zitat Chang J. H., P. McCluskey, and D. Wakefield. 2004. Expression of toll-like receptor 4 and its associated lipopolysaccharide receptor complex by resident antigen-presenting cells in the human uvea. Invest Ophthalmol. Vis. Sci. 45:1871–1878.PubMedCrossRef Chang J. H., P. McCluskey, and D. Wakefield. 2004. Expression of toll-like receptor 4 and its associated lipopolysaccharide receptor complex by resident antigen-presenting cells in the human uvea. Invest Ophthalmol. Vis. Sci. 45:1871–1878.PubMedCrossRef
18.
Zurück zum Zitat Diebold Y., M. Calonge, A. Enriquez de Salamanca, S. Callejo, R. M. Corrales, V. Saez, K. Siemasko, and M. E. Stem. 2003. Characterization of a spontaneously immortalized cell line (IOBA–NHC) from normal human conjunctiva. Invest Opthamol. Vis. Sci. 44:4263–4274.CrossRef Diebold Y., M. Calonge, A. Enriquez de Salamanca, S. Callejo, R. M. Corrales, V. Saez, K. Siemasko, and M. E. Stem. 2003. Characterization of a spontaneously immortalized cell line (IOBA–NHC) from normal human conjunctiva. Invest Opthamol. Vis. Sci. 44:4263–4274.CrossRef
19.
Zurück zum Zitat Talreja J., M. H. Kabir, M. B. Filla, D. J. Stechschulte, and K. N. Dileepan. 2004. Histamine induces Toll-like receptor 2 and 4 expression in endothelial cells and enhances sensitivity to Gram-positive and Gram-negative bacterial cell wall components. Immonol. 113:224–233.CrossRef Talreja J., M. H. Kabir, M. B. Filla, D. J. Stechschulte, and K. N. Dileepan. 2004. Histamine induces Toll-like receptor 2 and 4 expression in endothelial cells and enhances sensitivity to Gram-positive and Gram-negative bacterial cell wall components. Immonol. 113:224–233.CrossRef
20.
Zurück zum Zitat Kennedy M. N., G. E. Mullen, C. A. Leifer, C. W. Lee, A. Mazzoni, K. N. Dileepan, and D.M. Segal. 2004. A complex of soluble MD2 and lipopolysaccharide serves as an activating ligand for Toll-like receptor 4. J. Biol. Chem. 279:34698–34704.PubMedCrossRef Kennedy M. N., G. E. Mullen, C. A. Leifer, C. W. Lee, A. Mazzoni, K. N. Dileepan, and D.M. Segal. 2004. A complex of soluble MD2 and lipopolysaccharide serves as an activating ligand for Toll-like receptor 4. J. Biol. Chem. 279:34698–34704.PubMedCrossRef
21.
Zurück zum Zitat Pace J. L., S. W. Russell, R. D. Schreiber, A. Altman, and A. Katz 1983. Macrophage activation: priming activity from a T-cell hybridoma is attributable to interferon-gamma. Proc. Natl. Acad. Sci. USA 80:3782–3786.PubMedCrossRef Pace J. L., S. W. Russell, R. D. Schreiber, A. Altman, and A. Katz 1983. Macrophage activation: priming activity from a T-cell hybridoma is attributable to interferon-gamma. Proc. Natl. Acad. Sci. USA 80:3782–3786.PubMedCrossRef
22.
Zurück zum Zitat Dileepan K. N., J. C. Page, Y. Li, and D. J. Stechschulte. 1995. Direct activation of murine peritoneal macrophages for nitric oxide production and tumor cell killing by interferon-gamma. J. Interferon. Cytokine. Res. 15:387–394.PubMedCrossRef Dileepan K. N., J. C. Page, Y. Li, and D. J. Stechschulte. 1995. Direct activation of murine peritoneal macrophages for nitric oxide production and tumor cell killing by interferon-gamma. J. Interferon. Cytokine. Res. 15:387–394.PubMedCrossRef
23.
Zurück zum Zitat Abreu M. T., E. T. Arnold, L. S. Thomas, R. Gonsky, Y. Zhou, B. Hu, and M. Arditi. 2002. TLR4 and MD-2 expression is regulated by immune-mediated signals in human intestinal epithelial cells. J. Biol. Chem. 277:20431–2037.PubMedCrossRef Abreu M. T., E. T. Arnold, L. S. Thomas, R. Gonsky, Y. Zhou, B. Hu, and M. Arditi. 2002. TLR4 and MD-2 expression is regulated by immune-mediated signals in human intestinal epithelial cells. J. Biol. Chem. 277:20431–2037.PubMedCrossRef
24.
Zurück zum Zitat Li Y., Y. Chi, D. J. Stechschulte, and K. N. Dileepan. 2001. Histamine-induced production of IL-6 and IL-8 by human coronary artery endothelial cells is enhanced by endotoxin and TNF-α. Microvasc Res. 61:253–262.PubMedCrossRef Li Y., Y. Chi, D. J. Stechschulte, and K. N. Dileepan. 2001. Histamine-induced production of IL-6 and IL-8 by human coronary artery endothelial cells is enhanced by endotoxin and TNF-α. Microvasc Res. 61:253–262.PubMedCrossRef
25.
Zurück zum Zitat De Saint Jean M., M. Baudouin, M. Di Nolfo, S. Roman, P. Lozato, J. M. Warnet, and F. Brigole. 2004. Comparison of morphological and functional characteristics of primary-cultured human conjunctival epithelium and of Wong–Kilbourne derivative of Chang conjunctival cell line. Exp. Eye. Res. 78:257–274.PubMedCrossRef De Saint Jean M., M. Baudouin, M. Di Nolfo, S. Roman, P. Lozato, J. M. Warnet, and F. Brigole. 2004. Comparison of morphological and functional characteristics of primary-cultured human conjunctival epithelium and of Wong–Kilbourne derivative of Chang conjunctival cell line. Exp. Eye. Res. 78:257–274.PubMedCrossRef
26.
Zurück zum Zitat Kumar A., J. Zhang, and F. S. Yu. 2004. Innate immune response of corneal epithelial cells to Staphylococcus aureus infection: role of peptidoglycan in stimulating proinflammatory cytokine secretion. Invest. Ophthalmol. Vis. Sci. 45:3513–3522.PubMedCrossRef Kumar A., J. Zhang, and F. S. Yu. 2004. Innate immune response of corneal epithelial cells to Staphylococcus aureus infection: role of peptidoglycan in stimulating proinflammatory cytokine secretion. Invest. Ophthalmol. Vis. Sci. 45:3513–3522.PubMedCrossRef
27.
Zurück zum Zitat Srinivasan B. D., F. A. Jakobiec, T. Iwamoto. 1982. In: Conjunctiva, F. A. Jokobiec, ed. Ocular anatomy, embryology and teratology. Harper and Row, Philadelphia, pp. 733–777. Srinivasan B. D., F. A. Jakobiec, T. Iwamoto. 1982. In: Conjunctiva, F. A. Jokobiec, ed. Ocular anatomy, embryology and teratology. Harper and Row, Philadelphia, pp. 733–777.
28.
Zurück zum Zitat Naik S., E. J. Kelly, L. Meijer, S. Pettersson, and I. R. Sanderson. 2001. Absence of Toll-like receptor 4 explains endotoxin hyporesponsiveness in human intestinal epithelium. J. Pediatr. Gastroenterol. Nutr. 32:449–453.PubMedCrossRef Naik S., E. J. Kelly, L. Meijer, S. Pettersson, and I. R. Sanderson. 2001. Absence of Toll-like receptor 4 explains endotoxin hyporesponsiveness in human intestinal epithelium. J. Pediatr. Gastroenterol. Nutr. 32:449–453.PubMedCrossRef
29.
Zurück zum Zitat Abreu M. T., P. Vora, E. Faure, L. S. Thomas, E. T. Arnold, and M. Arditi. 2001. Decreased expression of Toll-like receptor-4 and MD-2 correlates with intestinal epithelial cell protection against dysregulated proinflammatory gene expression in response to bacterial lipopolysaccharide. J. Immunol. 167:1609–1617.PubMed Abreu M. T., P. Vora, E. Faure, L. S. Thomas, E. T. Arnold, and M. Arditi. 2001. Decreased expression of Toll-like receptor-4 and MD-2 correlates with intestinal epithelial cell protection against dysregulated proinflammatory gene expression in response to bacterial lipopolysaccharide. J. Immunol. 167:1609–1617.PubMed
30.
Zurück zum Zitat Fusunyan R. D., N. N. Nanthakumar, M. E. Baldeon, and W. A. Walker. 2001. Evidence for an innate immune response in the immature human intestine: toll-like receptors on fetal enterocytes. Pediatr. Res. 49:589–593.PubMed Fusunyan R. D., N. N. Nanthakumar, M. E. Baldeon, and W. A. Walker. 2001. Evidence for an innate immune response in the immature human intestine: toll-like receptors on fetal enterocytes. Pediatr. Res. 49:589–593.PubMed
31.
Zurück zum Zitat Backhed F., M. Soderhall, P. Ekman, S. Normak, and A. Richter-Dahlfors. 2001. Induction of innate immune responses by Escherichia coli and purified lipopolysaccharide correlate with organ- and cell-specific expression of Toll-like receptors within the human urinary tract. Cell Microbiol. 3:153–158.PubMedCrossRef Backhed F., M. Soderhall, P. Ekman, S. Normak, and A. Richter-Dahlfors. 2001. Induction of innate immune responses by Escherichia coli and purified lipopolysaccharide correlate with organ- and cell-specific expression of Toll-like receptors within the human urinary tract. Cell Microbiol. 3:153–158.PubMedCrossRef
32.
Zurück zum Zitat Kawai T., O. Adachi, T. Ogawa, K. Takeda, and S. Akira. 1999. Unresponsiveness of MyD88-deficient mice to endotoxin. Immunity. 11:115–122.PubMedCrossRef Kawai T., O. Adachi, T. Ogawa, K. Takeda, and S. Akira. 1999. Unresponsiveness of MyD88-deficient mice to endotoxin. Immunity. 11:115–122.PubMedCrossRef
33.
Zurück zum Zitat Dileepan K. N., R. B. Lorsbach, and D. J. Stechschulte. 1993. Mast cell granules inhibit macrophage-mediated lysis of mastocytoma cells (P815) and nitric oxide production. J. Leukoc. Biol. 53:446–453.PubMed Dileepan K. N., R. B. Lorsbach, and D. J. Stechschulte. 1993. Mast cell granules inhibit macrophage-mediated lysis of mastocytoma cells (P815) and nitric oxide production. J. Leukoc. Biol. 53:446–453.PubMed
34.
Zurück zum Zitat Sen G. C., and P. Lengyel. 1992. The interferon system. A bird’s eye view of its biochemistry. J. Biol. Chem. 267:5017–5020.PubMed Sen G. C., and P. Lengyel. 1992. The interferon system. A bird’s eye view of its biochemistry. J. Biol. Chem. 267:5017–5020.PubMed
35.
Zurück zum Zitat Uehara A., S. Sugawara, and H. Takada. 2002. Priming of human oral epithelial cells by interferon-γ to secrete cytokines in response to lipopolysaccharides, lipoteichoic acids and peptidoglycans. J. Med. Micobiol. 51:624–634. Uehara A., S. Sugawara, and H. Takada. 2002. Priming of human oral epithelial cells by interferon-γ to secrete cytokines in response to lipopolysaccharides, lipoteichoic acids and peptidoglycans. J. Med. Micobiol. 51:624–634.
36.
Zurück zum Zitat Wolfs T., W.A. Buurman, A. Schadewijk, B. D. Vries, M. Daemen, P. S. Hiemstra, and C. V. Veer. 2002. In vivo expression of Toll-like receptor 2 and 4 by renal epithelial cells: IFNγ and TNFα mediated up-regulation during inflammation. J. Immunol. 168:1286–1293.PubMed Wolfs T., W.A. Buurman, A. Schadewijk, B. D. Vries, M. Daemen, P. S. Hiemstra, and C. V. Veer. 2002. In vivo expression of Toll-like receptor 2 and 4 by renal epithelial cells: IFNγ and TNFα mediated up-regulation during inflammation. J. Immunol. 168:1286–1293.PubMed
37.
Zurück zum Zitat Rehli M., A. Poltorak, L. Schwarzfischer, S. W. Krause, R. Andreesen, and B. Beutler. 2000. PU.1 and interferon consensus sequence-binding protein regulate the myeloid expression of the human Toll-like receptor 4 gene. J. Biol. Chem. 275:9773–9781.PubMedCrossRef Rehli M., A. Poltorak, L. Schwarzfischer, S. W. Krause, R. Andreesen, and B. Beutler. 2000. PU.1 and interferon consensus sequence-binding protein regulate the myeloid expression of the human Toll-like receptor 4 gene. J. Biol. Chem. 275:9773–9781.PubMedCrossRef
38.
Zurück zum Zitat Latz E., A. Visintin, E. Lien, K. A. Fitzgerald, B. G. Monks, E. A. Kurt-Jones, D. T. Golenbock, and T. Espevik. 2002. Lipopolysaccharide rapidly traffics to and from the Golgi apparatus with the Toll-like receptor 4-MD-2-CD14 complex in a process that is distinct from the initiation of signal transduction. J. Biol. Chem. 277:47834–47843.PubMedCrossRef Latz E., A. Visintin, E. Lien, K. A. Fitzgerald, B. G. Monks, E. A. Kurt-Jones, D. T. Golenbock, and T. Espevik. 2002. Lipopolysaccharide rapidly traffics to and from the Golgi apparatus with the Toll-like receptor 4-MD-2-CD14 complex in a process that is distinct from the initiation of signal transduction. J. Biol. Chem. 277:47834–47843.PubMedCrossRef
Metadaten
Titel
Human Conjunctival Epithelial Cells Lack Lipopolysaccharide Responsiveness Due to Deficient Expression of MD2 but Respond After Interferon-γ Priming or Soluble MD2 Supplementation
verfasst von
Jaya Talreja
Kavitha Dileepan
Sanjeev Puri
Mohammad H. Kabir
David M. Segal
Daniel J. Stechschulte
Kottarappat N. Dileepan
Publikationsdatum
01.12.2005
Erschienen in
Inflammation / Ausgabe 4-6/2005
Print ISSN: 0360-3997
Elektronische ISSN: 1573-2576
DOI
https://doi.org/10.1007/s10753-006-9014-y

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