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in the Opossum Monodelphis domestica1 ,2
Department of Biology, University of New Mexico, Albuquerque, NM 87131
| Abstract |
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chains in the South American opossum, Monodelphis
domestica, were analyzed at the expressed cDNA and genomic
organization level, the first described for a nonplacental mammal. The
V
segment repertoire in the opossum was found to be comprised of at
least three diverse V
families. Each of these families appears to be
related to distinct V
families present in placental mammals,
suggesting the divergence of these genes before the separation of
metatherians and eutherians more than 100 million years ago. Based on
framework and constant region sequences from full-length cDNAs and
intron sequences from genomic clones, it appears that there are
multiple functional J
-C
pairs in the opossum locus. The opossum
J
-C
sequences are phylogenetically clustered, suggesting that
these gene duplications are more recent and species specific. Sequence
analysis of a large set of functional, expressed V
-J
recombinations is consistent with an unbiased, highly diverse
light
chain repertoire in the adult opossum. Overall, the complexity of the
Ig
locus appears to be greater than that found in the Ig heavy chain
locus in the opossum, and light chains are therefore likely to
contribute significantly to Ig diversity in this
species. | Introduction |
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and
, are encoded at separate, unlinked loci. The use of
the two IgL types can vary between species, some having a bias or
preferential use of one over the other (reviewed in 1 . Mice and
rabbits, for example, use predominantly Ig
, whereas horses, sheep,
and cattle use primarily Ig
(1, 2, 3, 4, 5, 6). The use of one IgL type over
another correlates, in general, with the overall complexity of the loci
in most species. Humans, for example, have a significant amount of V
and V
diversity and use both extensively, 60% Ig
:40% Ig
(2, 7, 8, 9). Mice, on the other hand, have only three functional V
segments but a large number of available V
and have a 95% Ig
:5%
Ig
ratio (7, 9). The contributions that IgL make to Ab diversity can
also vary greatly between species. Humans appear to have a significant
amount of light chain diversity (7, 10). In contrast, the
repertoire of cattle is restricted to a recurrent V
-J
rearrangement, even though they appear to have multiple functional V
and J
segments in their germline (5). Perhaps the most extreme case
of limited contribution by light chains occurs in the camelids (camels
and llamas), which produce a form of IgG lacking light chains entirely
(11). Our knowledge of the structure, diversity, and evolution of the mammalian IgL genes is based on studies of only one of the three major orders of mammals, the eutherians or "placental" mammals. To date there has been no reported IgL gene structure from either of the other two mammalian orders, the prototherians (egg laying monotremes, e.g., the platypus) or the metatherians (marsupials). The relationship of these three mammalian lineages has been a subject of continued debate over much of this century with most investigators placing the metatherians and the eutherians together as sister taxa, with the prototherians diverging earliest (12). However, more recent analysis of mitochondrial DNA supports the idea that prototherians and metatherians are sister taxa, with the eutherians splitting off first (12, 13). Possible times for the divergence of these groups range from less than 120 million years ago, during the Cretaceous Period, to possibly greater than 170 million years ago, during the Jurassic Period (14, 15). A more extensive analysis of metatherian and prototherian immunobiology provides a comparison between very distantly related mammalian species and should yield important knowledge into the evolution of mammalian immune systems.
In addition to their importance to mammalian evolution, marsupials also provide an opportunity to study mammals that are born comparatively less developed than mice or humans. Developmental immaturity combined with the lack of a placenta, which supports the transfer of maternal Ig, in most marsupial species creates unique immunological problems for metatherians (16). The opossum, Monodelphis domestica, has been established over the last decade as an important laboratory-bred marsupial for studies of many areas of comparative and biomedical research (17, 18). M. domestica are native to South America and are a member of the family Didelphidae, which contains the largest number of species within the marsupials, and Monodelphis is the most species-rich genus of the family (19). The Didelphidae are also thought to have diverged earliest from the rest of the metatheria and may contain some of the oldest extant mammalian species (20, 21).
We have begun characterizing the Ig genes of M. domestica,
and we previously reported that the IgH repertoire was derived from two
related group III type VH families (22). To extend this
analysis to opossum IgL, we have cloned and characterized
Ig
-containing cDNAs and have found the presence of at least three
highly divergent V
families, the absence of bias in the V
-J
combinations, and evidence that the duplicated J
-C
pair
arrangements found in placental mammals is conserved in the opossum. It
appears that the genetic complexity of the M. domestica
Ig
locus is greater than that for the IgH locus, suggesting that
light chains contribute significantly to the diversity of the Ig
repertoire in this species.
| Materials and Methods |
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sequences
A degenerate oligonucleotide (5'-CCNGGYTTYTGYTGRTACCA)
complementary to the coding strand for the amino acid sequence WYQQKPG
conserved in framework region 2 (FR2) of light chain V segments (also
see 23 was used to amplify opossum VL fragments by
anchored PCR. The target for PCR was a commercially available M.
domestica spleen cDNA library constructed using the
ZAPII
cloning vector (Stratagene, La Jolla, CA). The degenerate FR2
oligonucleotide was used in PCR as a reverse primer in combination with
the T3 universal sequencing primer specific for a site flanking the
cloning site in
ZAPII. Successful amplification was achieved using 2
mM MgCl2 and 55°C annealing temperature and
Taq polymerase (Perkin-Elmer, Foster City, CA). For this
study, all PCR products were cloned for sequencing or for use as probes
using the pCR2.1 vector (Invitrogen, Carlsbad, CA) following the
manufacturers recommended protocol. An oligonucleotide primer
complementary to the 5' region of M. domestica C
(5'-ACCATAGGCCATGACCATGG) was paired in PCR with the T3 primer to
amplify V
region segments in an unbiased manner. The spleen cDNA
library described above was used as target with the conditions of 3.0
mM MgCl2 and 55°C annealing temperature.
In experiments to confirm the germline J
-C
pair arrangement,
oligonucleotides for each known M. domestica J
segment
(J
I, 5'-GTGTTCGGCAGTGGGACCAG; J
II, 5'-GTGTTCGGTGGTGGGACCAA;
J
III, 5'-GTGTTCGGTGCTGGGACCAA; J
IV, 5'-GTGTTCGGCCGTGGGACCAG;
J
V, 5'-GTGTTTGGCGGTGGGACCAA; J
VI, 5'-GTGTTCGGCGGTGGGACCAG)
were paired with the C
primer described above to amplify genomic
fragments. Amplifications were performed using PCR with 2 mM
MgCl2 and a 60°C annealing temperature.
Blot hybridizations
All genomic M. domestica DNA used were extracted from spleen tissue using standard protocols. For Southern blot analysis, genomic DNA were cut with various restriction endonucleases following the manufacturers recommended conditions (see figure legends). Digested DNA were electrophoresed through 1% agarose (FMC Bioproducts, Rockland, ME) and transferred to reinforced nitrocellulose for probing (Micron Separations, Westborough, MA). Phage plaque lifts for cDNA library screening were also made using reinforced nitrocellulose. All probes used in this study were prepared as DNA inserts excised from plasmids and labeled with [32P]dCTP by the random primer method (Prime-it Kit, Stratagene). Hybridizations were done at 42°C in 50% formamide, 5x Denhardts solution, 5x SSC, 50 mM NaPO4 (pH 6.5), 0.1% SDS, 5 mM EDTA, and 250 mg/ml sheared salmon sperm DNA. Final wash conditions were 65°C and 0.2x SSC.
Sequencing and analysis
DNA sequencing reactions were performed using the ThermoSequenase sequencing kit (Amersham, Arlington Heights, IL), and the reactions were analyzed using an automated DNA sequencer (Perkin-Elmer ABI Prism 377 DNA sequencer). All DNA sequences reported were derived by completely sequencing both strands of each clone. Sequences were analyzed using the Sequencher 3.0 program (Gene Codes, Ann Arbor, MI), and alignments were constructed using the CLUSTAL W program (24). All phylogenetic trees shown are reconstructed from nucleotide alignments. To align the nucleotide sequences, first the amino acid translations were aligned using CLUSTAL W with minor manual corrections, then nucleotide sequences were aligned and gapped manually based on the protein alignments to retain codon positions. Based on these nucleotide alignments, trees were reconstructed using the neighbor-joining method of Saitou and Nei (25).
| Results |
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cDNAs
To isolate clones containing opossum Ig
sequences, fragments of
V
segments were first amplified from a spleen cDNA by anchored PCR
using a FR2-specific degenerate primer and then, cloned and sequenced.
Four unique clones were found to be homologous to the leader, FR1, and
complementarity determining region 1 (CDR1) of known mammalian V
segments (not shown). The clones varied from 175 to 184
nucleotides in length and shared from 52% to 74% nucleotide
similarity to mammalian V
, but less than 40% similarity to any
mammalian V
sequences (not shown). Two of the PCR-generated clones
were from different V
families, based on less than 50% similarity,
and were used independently to screen a cDNA phage library constructed
from M. domestica spleen RNA. Three clones were identified
using each probe, and all six clones were found to contain full length
light chain cDNAs containing variable and constant
regions (Fig. 1
).
|
families in M.
domestica
The six full length cDNA sequences shown in Fig. 1
are grouped by
nucleotide similarity in the V region. The presence of at least two
V
families, which have been designated opossum V
1 (clones 2c, 3c,
and 4c) and V
2 (clones 7c, 10c, and 12c), is apparent in the
opossum Ig
repertoire. The separation of these sequences into two
V
families is based on a typically >87% similarity among sequences
in the same family and <56% similarity between the families.
To rapidly screen for the presence of additional V
families, an
oligonucleotide primer complementary to coding sequence near the 5' end
of the C
region was paired with a primer specific for the T3
promoter sequence flanking the cloning site in the phage vector used to
construct the cDNA library. This approach amplifies V domain sequences,
using the spleen cDNA library as target, without bias for V
or J
sequences. The sequence of the C
primer was complementary to
nucleotides 422441 in the C
region shown in Fig. 1
, which is a
sequence common to all 6 C
regions found so far. A total of 40
unique V
-J
rearrangements were amplified from the cDNA library
and then, cloned and sequenced. Of these new sequences, the majority
(36 total) clearly grouped with the V
1 family, while 2 grouped with
the known V
2 family (sequences 46p and 62p in Fig. 2
). The remaining 2 clones (sequences 18p
and 25p in Fig. 2
) shared 97% nucleotide similarity to each other, but
<65% similarity to any V
1 or V
2 sequences, and defined a third
V
family, opossum V
3. One clone (51p in Fig. 2
) was grouped as a
V
1 member but clearly contains a FR3 from the V
2 family. Whether
this clone contains a bona fide germline V segment that may have
undergone gene conversion or recombination, or is an artifact of
template jumping during PCR, remains to be determined.
|
2 and
V
3 families when compared with the V
1 members. The V
2 and
V
3 segments are one codon shorter than V
1 in CDR1 and four and
three codons shorter in CDR2, respectively. In addition, the CDR3
regions created by the V
-J
junction are also consistently shorter
in those clones that contain rearrangements involving V
2 and V
3
family members. The length of the CDR3 does not appear to correlate
with a bias in V
-J
combinations. Based on FR4 sequences, we
estimate there to be at least six functional J
segments in the
M. domestica Ig
locus (indicated by the Roman numerals
next to the FR4 sequences in Fig. 2
segments can be
found in rearrangements that contain a V
1 and long CDR3 regions,
while four of six J
segments can be found in rearrangements that
contain a V
2 or V
3 with comparatively shorter CDR3 regions. In
summary, there appears to be no relationship between the combination of
particular J
with specific V
segments, and the length of the CDR3
region does not associate with particular J
segments.
To estimate the number of V
gene segments present in the M.
domestica genome, Southern blot hybridizations were performed
using representative clones from each of the three families as probes
(Fig. 3
). A V
1 probe hybridized to an
average of 20 restriction fragments in the M. domestica
genome (Fig. 3
A). This same blot was stripped and
rehybridized with probes specific for the V
2 (Fig. 3
B)
and V
3 (Fig. 3
C) families, which revealed 8 and 4 genomic
fragments, respectively.
|
-C
pairs in M.
domestica
An alignment of the nucleotide (Fig. 2
) or amino acid sequence
encoded (Fig. 4
) by the six full-length
cDNAs revealed three distinct pairs of sequences based on FR4 and C
regions. Unlike the order of the clones presented in Fig. 2
, the six
sequences in Fig. 4
are grouped based on similar FR4 regions (amino
acid positions 105116) to illustrate the paired relationships. The
FR4 regions of cDNA clones 2c and 7c are nearly identical, and there is
significant similarity in the FR4 regions of clones 3c and 12c, as well
as 4c and 10c. Comparison of the six C
sequences reveals identical
paired patterns of similarity; in other words, cDNA clones with similar
FR4 sequences share similar C
sequences. The most likely explanation
for this pattern is the presence of multiple functional J
segments, each with its own C
downstream.
|
-C
pairs in the opossum
genome, primers were designed to be unique for each of the six known
FR4 regions (J
) and paired with the C
primer for PCR using
genomic DNA as a target. PCR amplification with each FR4 primer paired
with the C
primer yielded products
1.8 kb long, which were cloned
and partially sequenced. Sequences internal to the primers confirmed
that the amplified fragments contained an intron with predicted splice
sites flanked by J
and C
segments, and each clone had a unique
restriction map (Fig. 5
-C
pairs in the
opossum genome. A Southern blot of M. domestica genomic DNA
probed for C
revealed typically six to eight fragments (Fig. 6
segments based on FR4 sequences and the presence
of J
-C
pairs.
|
|
families and C
regions
Pairwise comparisons of the opossum sequences with V
sequences
from placental mammals revealed greater similarity between the opossum
V
families and V
sequences from other species than that found
between opossum V
families. To illustrate these relationships, a
phylogenetic tree was constructed using opossum V
aligned to
representative V
sequences from other mammals. Fig. 7
A shows a tree based on
nucleotide alignment of the FR regions of the 3 opossum V
families
and the 10 human V
families. Also included in the alignment were
sequences from mice, rabbits, and two artiodactyl species, cattle and
sheep. There was no difference in the tree topology when CDR sequences
were included in the alignments (not shown). The overall topology of
the tree, or relationship among the mammalian V
sequences, is in
general agreement with that reported in more extensive analysis of
vertebrate VL sequences (26, 27). Mouse V
2 was excluded
from the alignment because it is highly similar to mouse V
1. The
rabbit and artiodactyl sequences cluster on their own branches, whereas
the 2 mouse sequences and 10 human V
families are more dispersed
around the tree. The opossum V
families also intersperse with the
sequences from mice and humans. This result suggests that the gene
duplication events that produced these families predate the
evolutionary separation of mammals.
|
sequences from the cDNA clones in Fig. 1
regions from
other species revealed a strikingly different pattern of evolution at
the C end of the opossum Ig
compared with the V end (Fig. 7
, the duplication events appear to
have occurred after speciation. The C
regions of the opossum all
cluster at the end of a long branch and, likewise, the duplicated C
regions of mouse, human, and rabbit all cluster on their own branches.
Two avian C
sequences were included for comparison. Mouse C
4 was
excluded because it is a pseudogene and highly similar to C
1.
Several relationships support the validity of this tree, including the
intraspecies clustering of C
sequences previously noted (see 26 , and the common branch that the mouse surrogate light chain C
5
shares with C
1; C
5 is thought to be derived from C
1 (28). | Discussion |
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light chain repertoire of the opossum is derived
from at least 3 ancient V families, which total
30 gene segments.
These V segments appear to randomly recombine with available J
segments, giving a potential combinatorial diversity for opossum
comparable to that described in humans. The first important conclusion
from our results is that
has been retained in the metatherian
lineage. This is not unexpected given that both
- and
-like
sequences have been described in all vertebrate groups, including
sharks (23, 33, 34, 35, 36, 37, 38, 39).
Evolution of mammalian V
Phylogenetic analysis of V
and V
sequences from several
vertebrates revealed the presence of multiple V
groups, but only a
single V
cluster, hence V
has been referred to as being
"polyphyletic" compared with the V
(26, 27). In addition,
phylogenetic analysis of V
sequences by Hayzer (26), Sitnikova and
Su (27), and Zezza et al. (36) all generally agree that human and mouse
V
families intersperse with genes from other vertebrates, while
sequences from other species generally remain clustered with their
phylogenetic origin (i.e., all rabbit V
clustered within a single
group, all avian V
clustered within a single group, etc.).
Reconstruction of a phylogenetic tree that includes the opossum V
sequences, shown here, reveals the interspersion of marsupial and
placental mammal sequences. Although convergent evolution of
metatherian and eutherian V
gene segments could account for this
interspersion, the most likely explanation is the separation of the
three V
lineages before the divergence of metatherians and
eutherians, which probably occurred more than 100 million years ago and
may have been as long ago as 175 million years (14, 15).
Mammalian VH sequences do not show a similar evolutionary
interspersion between marsupials and placental mammals. There are two
VH families in M. domestica, and both cluster on
the same branch within the mammalian group III lineage (22).
VH sequences from two other marsupial species, one a
complete sequence from the North American opossum Didelphis
virginiana, the other a partial sequence from the Australian
brushtail possum Trichosurus vulpecula, also cluster with
the M. domestica VH sequences on a common
marsupial branch (Ref. 22 and our unpublished observations).
Opossum V
gene segments, in contrast, retained a wider germline
diversity, perhaps to compensate for less diversity in the heavy chain.
Evolution of mammalian C
The gene duplication event that separated the mouse JC
1-JC
3
pair from the JC
2-JC
4 pair was reported to be very old, on the
order of 240 million years ago, based on nonsynonomous substitution
rates (40). Our analysis of mammalian C
also supports gene
duplications in mice that are more ancient than those found in
most mammals, as indicated by the long branch lengths for mouse C
in
Fig. 7
B. However, these duplications, like those in all
mammals, not only occurred after the separation of metatherians and
eutherians, probably much less than 200 million years ago, but occurred
after the separation of the species themselves. The mammalian Ig
and
Ig
loci have followed distinct patterns of evolution in their gene
organization. The Ig
loci, in general, contain duplicated J-C units,
whereas the Ig
loci have a single C segment downstream from
duplicated J segments (7, 8, 9). This pattern of multiple tandem J-C
duplications in the
locus in placental mammals is clearly conserved
in the opossum and, therefore, conserved across mammalian orders that
may be separated by as many as 175 million years. In contrast, the
avian Ig
, represented by chickens and ducks, contains only a single
J
and C
region (37, 38, 39), and the
-like genes in cartilaginous
and boney fishes are organized in duplicated units of
[VL-JL-CL] (33, 34, 35). A light
chain related to mammalian
has been identified in an amphibian and
found to contain more than one of each JL and
CL segment, although the organization of these genes
has not been reported (23). It is interesting that while the tendency
to undergo J-C duplications in
is conserved across mammalian
orders, the duplications themselves appear species specific and not
conserved. In other words, the mammalian
locus appears to
consistently evolve by duplicating the J and C segments as a unit,
although the duplications present in modern mammals likely occurred
after the separation of the species. The presence of paralogous
J
-C
pairs within a species without orthologous relationships
between species was reported by Hayzer (26) in a more extensive analyis
of eutherian C
sequences. It is curious as to why the
locus in
mammals would continue to independently evolve as
(V)n-(J-C)n, while parallel evolution in the
locus proceeded as (V)n-(J)n-C. We have
recently identified variable and constant region sequences from the
opossum that are clearly the homologues of Ig
(G.H.R. and R.D.M.,
unpublished observations), but the complexity and organization of
in the opossum remains to be determined. It will be interesting in the
future to compare how the
locus has evolved in metatherians as
well.
Structure of the opossum Ig
locus and the
repertoire
The preferential use of one light chain isotype over another, as
seen in many mammals, appears to correlate with the overall complexity,
or number, of available VL segments, although sheep and
horses may indicate that there are exceptions (3, 4). Humans have
similar numbers of available V
and V
segments and use both light
chain types nearly equally (60:40,
:
). Mice have a strong bias
for Ig
and nearly 50-fold more V segments in their Ig
locus than
Ig
(7, 9). Conversely, sheep have 10-fold more V segments in their
Ig
locus than Ig
, and a 20:1 bias for Ig
expression (1, 6).
The opossum, M. domestica, has
30 V
segments that are
divided among 3 evolutionarily diverse families. We would expect,
although we have not yet shown, that
should contribute
significantly to the expressed Ig diversity in this marsupial. When the
expressed V
repertoire was sampled, V
segments from the V
1
family far outnumbered the other 2 families in V-J rearrangements
cloned. Although we cannot rule out the possibility that this may
reflect some bias in V-J recombination or selection for B cells
expressing V
1, it is consistent with and easily explained by the
number of V
segments in each family. Based on Southern blot
analysis, V
1 appears to have twice as many segments as V
2 and
five times as many as V
3. While it remains to be determined what
percentage of the germline V segments in each family are functional,
the frequency at which a V
segment is expressed likely reflects its
representation in the genome, rather than a bias or preferential use.
A curious aspect of the structure of the opossum V
domains is the
coincident length variation of all three CDRs. Members of the V
2 and
V
3 families encode shorter CDR1 and CDR2 regions, or conversely,
V
1 members encode longer CDR1 and CDR2. The V-J rearrangements
generated using V
2 and V
3 segments contain shorter CDR3 regions
as well. V
family-specific CDR length is also apparent in the
alignment of human V
(29). Three of the human V
families (V
4,
-5, and -9) have significantly longer CDR2 regions. In the
opossum, the longer CDR3 found in rearrangements using V
1 does not
correlate with FR4 sequence. Furthermore, in the seven rearrangements
that contain a V
2 or V
3 isolated so far, four of the six putative
J segments are present. These results support a lack of bias in the
V
-J
recombinations and suggest that it is not the choice of J
segment that creates the length variation of the CDR3 depending on
whether V
1 vs V
2 or V
3 are being rearranged. The alternative
explanation is that the length of the regions in the germline V
2 or
V
3, which contribute to the CDR3, are shorter. We are presently
cloning the germline V
segments to see if V
2 and V
3 members
contain a shorter CDR3. It is also possible that during V-J
recombinations involving a V
2 or V
3 there is additional
nucleotide trimming at the junction to create shorter CDR3s or,
conversely, more N region additions made by terminal deoxynucleotidyl
transferase when a V
1 member is recombined. Shorter CDRs translate
into shorter Ag binding loops in those Abs that contain a V
2 or
V
3. Lack of N region additions and shorter CDR3 regions have been
shown to increase Ag receptor cross-reactivity or Ag promiscuity in Ig
and TCR (41, 42). It is possible that in the opossum Ig repertoire the
Abs that contain a V
2 or V
3 have a broader specificity, although
this remains to be experimentally determined.
PCR amplification with primers specific for opossum J
and C
segments from genomic DNA produced six unique J-C introns. Attempts to
produce completely inbred lines of M. domestica have been
unsuccessful to date, and we cannot presently determine whether or not
the opossums we are using are homozygous or heterozygous at the Ig
locus (43). Therefore, given that we were able to clone at least six
unique J-C introns, there may be as few as three functional Ig
(J-C)
pairs in the opossum genome. Nonetheless, this provides the opossum
with multiple functional J
segments to use in V-J recombination.
Interestingly, in cattle, although multiple J-C pairs exist, the
light chain repertoire appears to be dominated by a single V-J
recombination (5). As pointed out earlier, there was no apparent bias
in the V
-J
recombinations in the opossum spleen cDNA library.
In summary, the
repertoire of the opossum is more heterogeneous
than that of many placental mammals, such as the artiodactyls, and
contains more available germline segments than rodents. The kinds of
gene duplications that have occurred at the
locus in placental
mammals have also occurred independently in the marsupial lineage.
Given the apparent combination of any V with any J, we would predict
that the overall organization of the Ig
locus is probably similar to
that found in humans with an array of V segments upstream of an array
of J-C pairs.
| Footnotes |
|---|
2 All sequences reported have been deposited in the GenBank/EMBL database and assigned accession numbers AF049746AF049790. ![]()
3 Address correspondence and reprint requests to Dr. R. D. Miller, Department of Biology, University of New Mexico, Albuquerque, NM 87131-0001. ![]()
4 Abbreviations used in this paper: IgH, Ig heavy chain; IgL, Ig light chain; FR, framework region; CDR, complementarity determining region. ![]()
Received for publication July 6, 1998. Accepted for publication August 26, 1998.
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M. L. Baker, K. Belov, and R. D. Miller Unusually Similar Patterns of Antibody V Segment Diversity in Distantly Related Marsupials J. Immunol., May 1, 2005; 174(9): 5665 - 5671. [Abstract] [Full Text] [PDF] |
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J. Johansson, M. Aveskogh, B. Munday, and L. Hellman Heavy Chain V Region Diversity in the Duck-Billed Platypus (Ornithorhynchus anatinus): Long and Highly Variable Complementarity-Determining Region 3 Compensates for Limited Germline Diversity J. Immunol., May 15, 2002; 168(10): 5155 - 5162. [Abstract] [Full Text] [PDF] |
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