Brain, Vol. 123, No. 6, 1092-1101,
June 2000
© 2000 Oxford University Press
Differential adhesion molecule requirements for immune surveillance and inflammatory recruitment
1 Section of Immunobiology, 2 Howard Hughes Medical Institute and 3 Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
Correspondence to:
Dr Michael D. Carrithers, Section of Immunobiology, Yale University School of Medicine, PO Box 208011, 310 Cedar Street, New Haven, CT 06520-8011, USA
| Abstract |
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Activated CD4 Th1 lymphocytes can enter the brain in the absence of an inflammatory focus. However, the molecular mediators that regulate this early migration of lymphocytes into the brain have remained unclear. We hypothesized that the entry of these `pioneer' lymphocytes into the brain is regulated by a set of molecular events that are distinct from those used once inflammation has been established. Using cells fluorescently labelled with the lipophilic dye DiI, myelin basic protein (MBP)-specific CD4 lymphocytes that expressed low or high levels of very late antigen-4 (VLA-4) and non-antigen-specific activated splenocytes homed to mouse brain in similar quantities 2 h after adoptive transfer. However, antigen specificity and VLA-4 expression were required for more robust recruitment by 24h. Immunocytochemistry revealed endothelial and microenvironmental upregulation of vascular cell adhesion molecule (VCAM), intercellular cell adhesion molecule 1 (ICAM-1), MHC class II and interferon-
48 h after transfer of MBP-specific cells. In contrast, expression of meningeal and choroid plexus-associated P selectin was upregulated 2 h after adoptive transfer, but not at 48 h. Monoclonal antibody to P selectin, but not to VLA-4, inhibited early migration of high VLA-4-expressing MBP-specific lymphocytes. These results suggest that early migration occurs independent of the lymphocyte integrin VLA-4 and endothelial VCAM, but does require increased surface expression of endothelial P selectin. brain; T lymphocytes; EAE/multiple sclerosis; homing; adhesion molecules
EAE = experimental autoimmune encephalomyelitis; EHAA = Eagle's Hanks' amino acid; ICAM = intercellular adhesion molecule; IFN-
= interferon-
; LFA-1 = lymphocyte function-associated antigen-1; MBP = myelin basic protein; MHC = major histocompatibility complex; MMP = matrix metalloproteinase; PSGL-1 = P selectin glycoprotein ligand-1; VCAM = vascular cell adhesion molecule; VLA-4 = very late antigen 4
| Introduction |
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The bloodbrain barrier consists of endothelial tight junctions that permit stringent regulation of molecular transport and cell migration (Brightman and Reese, 1969
Although the classic concepts of the bloodbrain barrier have been useful in understanding the unique immune status of the brain, they have also hindered investigations of the normal immune surveillance of the CNS. It was thought for many years that immune cells do not enter this microenvironment in the absence of an inflammatory focus. However, the work of Hickey and colleagues clearly demonstrated that activated, but not naïve, lymphocytes can enter the CNS to perform immune surveillance under normal conditions (Hickey et al., 1991
), as had been hypothesized previously (Wekerle, 1986). The steps necessary for entry have remained unclear, in part because the best-studied endothelial adhesion molecules, such as VCAM and ICAM-1, do not appear to be involved in this immune surveillance pathway (Hickey et al., 1997
). As this migratory pathway is important not only in the immune surveillance of non-lymphoid organs but also in the initiation of tissue-specific inflammatory disease, the identity of the molecular steps responsible has relevance to the treatment of multiple sclerosis and the defence of the brain against non-inflammatory infections.
Lymphocyte migration is a multistep molecular process that requires at least four steps: an initial low-affinity contact associated with the rolling of lymphocytes on the endothelial cell surface; activation through chemokine G protein-linked receptors; activation-dependent arrest mediated by higher-affinity adhesion; and diapedesis into the extracellular matrix (Springer, 1994
; Butcher and Picker, 1996
). Interference with any of these steps will terminate transmigration, and the cell will return to the circulation. In general, binding of a lymphocyte carbohydrate ligand such as P selectin glycoprotein ligand-1 (PSGL-1) to selectins such as P and E selectin on the endothelial cell mediates the initial low-affinity contact; the higher-affinity interactions necessary for arrest and diapedesis require the binding of the
4ß1 integrin very late antigen 4 (VLA-4) to VCAM or of the
Lß2 integrin lymphocyte function-associated antigen (LFA-1) to intercellular adhesion molecules (ICAM-1, -2 and -3).
We hypothesized that the entry of these `pioneer' lymphocytes into the brain is regulated by a set of molecular events that are distinct from those used once inflammation has been established. For example, previous work in this laboratory demonstrated that VLA-4 was required for the recruitment of autoreactive CD4 T lymphocytes into the brain in the mouse model of human multiple sclerosis, experimental autoimmune encephalomyelitis (EAE) (Baron et al., 1993
). However, since the endothelial counterligand VCAM is not expressed on the resting brain endothelium, a VLA-4VCAM interaction is probably not relevant to early migratory steps. In contrast, P selectin does not appear to be necessary for the recruitment of inflammatory cells in EAE (Engelhardt et al., 1997
), but can be expressed on the resting brain endothelium or rapidly induced on the endothelial surface in response to an acute immune stimulus. Here, using fluorescence-labelled T lymphocytes activated in vitro, our goal was to demonstrate that VLA-4, a molecule important for subsequent recruitment into the CNS, does not mediate pioneer lymphocyte migration into the brain, but that P selectin, an endothelial ligand not necessary for subsequent cellular recruitment in EAE, does facilitate entry into the CNS within the first few hours after adoptive transfer.
| Material and methods |
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Mice
Female (SJLxPL/J)F1 and PL/J mice (68 weeks of age) were purchased from The Jackson Laboratory. PL/J.MBP mice were bred in our facility at the Howard Hughes Medical Institute, Section of Immunobiology, Yale University School of Medicine. Animal experiments were performed in accordance with the guidelines of the Yale Animal Care and Use Center and national authorities. Metofane inhalant anaesthesia was used for all procedures described.
Monoclonal antibodies
The following biotinylated monoclonal antibodies (rat anti-mouse) for immunocytochemistry were obtained from PharMingen, San Diego, Calif., USA: 429 (anti-VCAM); 3E2 (anti-ICAM-1); XMG1.2 [anti-interferon-
(IFN-
)]; 10E9.6 (anti-CD4); and RB40.34 (anti-P selectin). Antibodies purified in our own hybridoma facility included R12 (anti-VLA-4), C363.29B (anti-CD3) and biotinylated Y3JP (anti-I-Au).
T-cell clones and lines
The Th1 clone C19lo, which expresses a T-cell receptor specific for Ac111 of myelin basic protein (MBP), was derived after immunization of PL/J mice as described previously (Baron et al., 1993
). These clones express high levels of CD4, LFA-1 and Vß8.2 and have a Th1 cytokine profile, but have low levels of VLA-4 and do not cause EAE when adoptively transferred to susceptible mice. Clones were stimulated every 14 days with 3x106 irradiated syngeneic splenocytes per well of a six-well plate, 5 µg/ml Ac111 peptide of MBP, and 5 U/ml rIL-2. Cells were maintained in Click's Eagle's Hanks' amino acid (EHAA) medium with 5% foetal calf serum.
T-cell lines expressing the same T-cell receptor were generated from PL/J.MBP transgenic mice (Hardardottir et al., 1995
). Spleens were removed and stimulated with 5 µg/ml Ac111 peptide and 5 U/ml recombinant IL-2. After 7 days in culture, the cells were restimulated and used 4 days later for adoptive transfer. These cells were almost entirely CD4+ cells that expressed the clonotypic T-cell receptor specific for MBP and expressed high surface levels of VLA-4 and cause EAE when adoptively transferred (Dittel et al., 1999
).
Fluorescence microscopy
Cells were washed in Click's EHAA medium and resuspended at a concentration of 1x107 cells/ml. The fluorescent lipophilic dye DiI (Molecular Probes, Eugene, Oreg., USA) was added from a x1000 stock solution in 100% ethanol to a final concentration of 7.5 µg/ml. Cells were incubated at 37°C in the dark for 30 min and were then washed extensively in Click's EHAA with 5% serum followed by phosphate-buffered saline. Labelled cells were injected intravenously (1x107 cells in 200 µl phosphate-buffered saline per animal). At the times indicated, mice were perfused and the tissue was fixed (paraformaldehyde lysine periodate) and prepared for frozen sectioning. For brain tissue, eight sections (7 µm thickness) from three brain regions were counted manually, giving a total of 24 sections per animal. The total brain surface area examined for each mouse was ~800 mm2 and was similar in all treatment groups. For pancreatic tissue, a total of eight sections were counted per animal. The total pancreatic surface area examined for each mouse was ~200 mm2 and was similar in all treatment groups. Counted sections were separated by at least 20 µm to avoid counting the same cell twice. Approximately 2160 brain sections were analysed by fluorescence microscopy. Serial sections were used for immunocytochemistry. Cell density was expressed as the number of cells per unit calculated tissue volume. To detect differences between treatment groups and controls, interassay variance due to differences in labelling efficiency, perfusion and sectioning techniques was corrected by assigning matched controls, both untreated and isotype antibody-treated, to treatment animals for a given experiment and then expressing the data as a percentage of control migration. The density of cells in untreated mice was defined as 100%, and statistical differences were compared between isotype-treated animals and the treatment group. Differences between groups were compared using Student's t-test. P < 0.01 was considered significant.
Immunocytochemistry
Brain sections were stained according to standard protocols using bovine serum albumin (BSA) as preincubation blocker and Triton X-100 as solubilizer. Biotinylated antibodies were diluted in BSA and Triton X-100 solution and added to the sections for 2 h. Sections were washed and incubated with streptavidinalkaline phosphatase (Zymed, South, San Francisco, Calif., USA). Sections were then washed, developed with alkaline phosphatase substrate Fast Red and counterstained with haematoxylin.
| Results |
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Migration of activated, DiI-labelled antigen-specific CD4 lymphocytes and antigen-non-specific splenocytes into the brain and pancreas
Within 2 h after adoptive transfer, MBP-specific, DiI-labelled C19lo cells, which express low levels of VLA-4, could be visualized within perivascular brain regions, tissue parenchyma and in the meningeal space (Fig. 1A, C and D
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When the number of cells in the sections was quantitated, as shown in Fig. 3A
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Adhesion molecule, MHC class II and IFN-
expression after adoptive transfer of C19lo cells or activated splenocytesIn order to demonstrate that the C19lo cells can have a physiological effect and mediate the activation of the brain endothelium and immune microenvironment, we performed immunohistochemistry 4, 24, 48, 72, 96 and 168 h after adoptive transfer. As expected, endothelial VCAM and ICAM expression began to increase at 24h, peaked at 48 h and began to decline at 96 h after adoptive transfer (Fig. 5AD
staining was present at the same time points (Fig. 5G and H
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Anti-P selectin monoclonal antibody, but not anti-VLA-4, inhibits early migration
Our next goal was to attempt to block early migration with inhibitors of known adhesion events. To detect differences of a small number of cells between treatment groups and controls, we reasoned that interassay variance due to differences in labelling efficiency, perfusion and sectioning techniques could be corrected by assigning matched controls, both untreated and isotype antibody-treated, to treatment animals for a given experiment and then expressing the data as a percentage of control migration. The density of cells in untreated mice was defined as 100%, and statistical differences were compared between isotype-treated animals and the treatment group.
In these experiments, using the high VLA-4-expressing, MBP-specific T-cell lines, we examined the roles of P selectin and
4 integrin in pioneer T-lymphocyte migration 2 h after adoptive transfer. We hypothesized that P selectin, which appeared to be induced very rapidly on the endothelial surface after adoptive transfer, would impair early migration, while blocking
4 integrin would not. The monoclonal antibody to VLA-4 (rat monoclonal antibody R12) has been shown previously to inhibit recruitment of lymphocytes to the CNS in EAE (Baron et al., 1993
). The monoclonal antibodies used are summarized in Table 1
, and the data are shown in Table 2
. Control migration was 33 ± 6 cells/mm3 (mean ± standard error of the mean). As shown, anti-VLA-4 at a dose of 250 µg per animal (~10 µg/g mouse weight) had little effect on migration at this time point, whereas anti-P selectin (rat monoclonal antibody RB40.34) at 125 µg per recipient (~5 µg/g mouse weight) inhibited migration to 49% of the control value. The differences between the anti-P selectin group and the isotype control were statistically significant (P < 0.01).
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| Discussion |
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We have demonstrated in an in vivo model that endothelial P selectin but not lymphocyte VLA-4 facilitates migration of pioneer Th1 CD4 lymphocytes into the brain. Although previous studies have demonstrated that ICAM-1 and VCAM do not appear to be involved in CNS homing in the absence of an inflammatory focus (Irani and Griffin, 1996
Our quantitative results for the initial step of pioneer T-lymphocyte migration into the brain and the pancreas at 2 h were independent of cell type or specificity, whereas subsequent antigen-dependent recruitment by 24 h was very similar to the results of Hickey and colleagues (Hickey et al., 1991
) if their data are converted to cells/mm3. For example, for all cell types tested in our experiments, ~1040 cells were observed per mm3; based on section thickness, the range in the study of Hickey and colleagues was ~2050 cells/mm3. Furthermore, although Hickey and colleagues were able to demonstrate trends in the number of cells entering the tissue at various time points, the standard errors were relatively large and they were unable to detect statistical differences between time points. Despite the fact that that counting fluorescent cells proved easier than staining and counting CD4+ cells in the CNS, refinement of the technique was required to correct these problems. For this reason, we used isotype antibody-matched controls to permit statistical comparison between treatment groups that contained a relatively small number of observations.
Similar endothelial and immune activation has been shown previously to correlate with leucocyte entry into the CNS (Cannella et al., 1990
, 1991
). Another study also demonstrated that MHC class II upregulation on brain astrocytes is hyperinducible by IFN-
in rodent strains susceptible to EAE (Massa et al., 1987
). Whether early P selectin expression or later VCAM or ICAM-1 endothelial expression is also hyperinducible is unclear. Further work would be clinically relevant because of genetic studies in EAE which suggest that endothelial factors may be involved in the pathogenesis of EAE and human multiple sclerosis (Teuscher et al., 1999
).
The present results demonstrating the surface expression of P selectin during early migration but not at 48 h after adoptive transfer are also consistent with previous studies. In most endothelial cells, P selectin is stored in WeibelPalade bodies and can be transported rapidly to the cell membrane surface after early inflammatory signals such as thrombin and histamine (Wagner et al., 1982
; Hattori et al., 1989
). On CNS endothelium, constitutive expression of P selectin is very low or absent (Engelhardt et al., 1997
), but expression can be induced by cytokine stimulation (Barkalow et al., 1996
). Although brain endothelium appears to contain WeibelPalade bodies, these bodies do not appear to contain P selectin. However, cytokines can mediate the upregulation of the surface expression of P selectin on brain endothelium through transcriptional upregulation (Barkalow et al., 1996
). Based on our working model of pioneer T-lymphocyte migration into the brain, we hypothesize that P selectin is expressed constitutively, but at very low levels, on brain endothelium and can be upregulated in a cytokine-dependent fashion after adoptive transfer of activated Th1 lymphocytes. This speculation is supported by a recent study that demonstrated that membrane-bound or membrane-associated cytokines, particularly TNF-
(tumour necrosis factor
) from activated lymphocytes can mediate rapid endothelial activation within a few hours (Lou et al., 1996
). In addition, a previous study showed that P selectin did not appear to be necessary for the recruitment of encephalitogenic cells in EAE and may be downregulated on brain endothelium during active disease (Engelhardt et al., 1997
).
We cannot discount the possibility that anti-P selectin treatment predominantly inhibited brain-epithelial migration of lymphocytes into the cerebrospinal fluid through the choroid plexus rather than migration across the brain endothelium (Steffen et al., 1996
). A previous study demonstrated that, in cytokine-induced meningitis in mice, P selectin facilitates early migration of neutrophils and mononuclear cells into the cerebrospinal fluid (Tang et al., 1996
). However, on the basis of our qualitative results there does not appear to be a clear reduction in the number of cells in the choroidmeningeal regions as opposed to the parenchymalperivascular regions. Further studies are required to determine the differences in migration into these two unique compartments.
On the basis of on these preliminary results, we have formulated the following working model. Initial attachment and rolling of activated pioneer T lymphocytes to the brain endothelium occurs via P selectin, which is either constitutively expressed at low levels or is rapidly induced throughout the endothelium by activated T cells. After this attachment, a chemokine receptor-dependent step occurs that can activate lymphocyte integrins. Firm adhesion does not appear to be mediated by VLA-4 but may be mediated by the binding of LFA-1 to a member of the ICAM family. Subsequent migration and antigen presentation within the perivascular space causes endothelial and microenvironmental activation, which leads to higher-affinity VLA-4-dependent recruitment within 24 h. Further elucidation of these steps is necessary to fully understand homing to the brain by lymphocyte subsets during immune surveillance and in disease states. One may expect, for example, that disease-causing Th1 CD4 cells use a different molecular pathway than Th2 lymphocytes. After activation, Th1 cells, but not Th2, cells express the enzyme
(1,3)fucosyl transferase VII, which is required for the fucosylation of PSGL-1 and for subsequent binding to P and E selectin (Maly et al., 1996
; Austrup et al., 1997; Borges et al., 1997
). This functional difference permits Th1 cells to home specifically to inflamed skin (Austrup et al., 1997; Borges et al., 1997
).
This model also suggests that therapies for multiple sclerosis designed to inhibit T-lymphocyte migration into the brain should target multiple molecules at different time points during lesion development if they are to achieve optimal efficacy. For example, in addition to their numerous other biological effects, ß-interferons may be effective in the treatment of individuals with relapsingremitting and secondary progressive disease because of their inhibitory effect on gelatinase B, a matrix metalloproteinase (MMP-9) (Leppert et al., 1996
; Stuve et al., 1996
). Gelatinase B is expressed by activated T lymphocytes and is required for the migration of cells across the perivascular basement membrane and into tissue parenchyma. MMPs and other proteases may be responsible for the breakdown of the bloodbrain barrier in acute multiple sclerosis lesions, which can be demonstrated by gadolinium enhancement of MRI images. It is not surprising, therefore, that inhibition of MMP activity by ß-IFNs results in a marked decrease in the number of new enhancing lesions in multiple sclerosis patients (Stone et al., 1995
). Similarly, a recent short-term study of an anti-VLA-4 monoclonal antibody (Antegren, natalizumab) also demonstrated a reduction in new active and enhancing lesions during the first 12 weeks of follow-up (Tubridy et al., 1999
). As VLA-4 ligation by VCAM can initiate MMP activation in T lymphocytes to facilitate migration (Romanic and Madri, 1994
), both MMP inhibitors and blockers of VLA-4 are probably acting during the recruitment phase of a developing multiple sclerosis lesion. In other words, these agents seem to be most efficacious at a time point in pathogenesis after pioneer T lymphocyte entry but before breakdown of the bloodbrain barrier severe enough to be visualized by gadolinium enhancement on MRI. Although inhibition of early lymphocyte entry would not be useful for the treatment of acute clinical multiple sclerosis exacerbations, it may be of benefit in combination therapy with an IFN-ß or natalizumab to prevent clinical relapses. Clearly, additional laboratory studies are required to identify mediators of early migration that can be blocked without interfering with immune surveillance of other tissues. The greatest challenge will be to design rational combination treatments that can be tested with sufficient statistical power in clinical trials.
| Acknowledgments |
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We wish to thank B. Dittel, D. Graesser, J. Madri, P. Preston-Hurlburt and S. Wong for helpful discussions, G. Losyev for the preparation of monoclonal antibodies, C. Annicelli for animal care and L. Carrithers for assistance with the graphics. This work was supported by the Howard Hughes Medical Institute and National Institutes of Health grants AI/AR 36529 (to C.A.J.) and KO8 NS 0212401 (to M.D.C.). M.D.C. was previously an Advanced Postdoctoral Fellow of the National Multiple Sclerosis Society (FA1237-A-1).
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Received September 28, 1999. Revised January 3, 2000. Accepted January 24, 2000.
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P. Kivisakk, D. J. Mahad, M. K. Callahan, C. Trebst, B. Tucky, T. Wei, L. Wu, E. S. Baekkevold, H. Lassmann, S. M. Staugaitis, et al. Human cerebrospinal fluid central memory CD4+ T cells: Evidence for trafficking through choroid plexus and meninges via P-selectin PNAS, July 8, 2003; 100(14): 8389 - 8394. [Abstract] [Full Text] [PDF] |
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L. Battistini, L. Piccio, B. Rossi, S. Bach, S. Galgani, C. Gasperini, L. Ottoboni, D. Ciabini, M. D. Caramia, G. Bernardi, et al. CD8+ T cells from patients with acute multiple sclerosis display selective increase of adhesiveness in brain venules: a critical role for P-selectin glycoprotein ligand-1 Blood, June 15, 2003; 101(12): 4775 - 4782. [Abstract] [Full Text] [PDF] |
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C. M. Denkinger, M. Denkinger, J. J. Kort, C. Metz, and T. G. Forsthuber In Vivo Blockade of Macrophage Migration Inhibitory Factor Ameliorates Acute Experimental Autoimmune Encephalomyelitis by Impairing the Homing of Encephalitogenic T Cells to the Central Nervous System J. Immunol., February 1, 2003; 170(3): 1274 - 1282. [Abstract] [Full Text] [PDF] |
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L.-Y. Kwok, H. Miletic, S. Lutjen, S. Soltek, M. Deckert, and D. Schluter Protective Immunosurveillance of the Central Nervous System by Listeria-Specific CD4 and CD8 T Cells in Systemic Listeriosis in the Absence of Intracerebral Listeria J. Immunol., August 15, 2002; 169(4): 2010 - 2019. [Abstract] [Full Text] [PDF] |
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S. M. Kerfoot and P. Kubes Overlapping Roles of P-Selectin and {alpha}4 Integrin to Recruit Leukocytes to the Central Nervous System in Experimental Autoimmune Encephalomyelitis J. Immunol., July 15, 2002; 169(2): 1000 - 1006. [Abstract] [Full Text] [PDF] |
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A. C. Issekutz and T. B. Issekutz The Role of E-Selectin, P-Selectin, and Very Late Activation Antigen-4 in T Lymphocyte Migration to Dermal Inflammation J. Immunol., February 15, 2002; 168(4): 1934 - 1939. [Abstract] [Full Text] [PDF] |
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L. Piccio, B. Rossi, E. Scarpini, C. Laudanna, C. Giagulli, A. C. Issekutz, D. Vestweber, E. C. Butcher, and G. Constantin Molecular Mechanisms Involved in Lymphocyte Recruitment in Inflamed Brain Microvessels: Critical Roles for P-Selectin Glycoprotein Ligand-1 and Heterotrimeric Gi-Linked Receptors J. Immunol., February 15, 2002; 168(4): 1940 - 1949. [Abstract] [Full Text] [PDF] |
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W. F. Hickey P selectin, pioneer cells and the path to inflammation Brain, June 1, 2000; 123(6): 1073 - 1074. [Full Text] [PDF] |
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