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Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| Abstract |
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production by cloned PLA-specific Th0 cells
proportionately. However, one APL, PLA-F82A, inhibited IL-4 but had no
effect on IFN-
production. This uncoupling of IL-4 from IFN-
production was also observed on immunogenic restimulation of the cloned
T cells pre-exposed to the APL/APCs. It appeared to result from lower
affinity of binding to MHC class II by the APL compared with the native
peptide. The APL also inhibited IL-4 production by polyclonal T cells.
In consequence of the change in cytokine secretion, the production of
IgG4 in vitro increased by PLA-F82A stimulation, compared with the
native peptide. Exposure of the cloned T cells to either the APL or the
native peptide, in the absence of professional APC, induced anergy such
that proliferation and production of IL-4, IL-5, and IL-13 was
abrogated on immunogenic rechallenge. Defective T cell activation
appeared to result from alterations in transmembrane signaling through
the TCR, specifically to lack of tyrosine phosphorylation of the
tyrosine kinase, ZAP-70. | Introduction |
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There has been considerable interest in immunotherapeutic intervention designed to inhibit Th2 cytokine production by allergen-specific T cells (5, 6, 7). Recently, immunotherapy using synthetic peptides, spanning dominant epitopes of the major cat and bee-sting allergenic proteins, Fel d 1 and bee venom phospholipase A2 (PLA),3 has proved successful in ameliorating allergic symptoms (8, 9). Peptides derived from PLA abrogated specific cytokine production in peripheral T cells from the majority of patients (9). We and others have previously shown that pre-exposure of cloned allergen-specific Th2 cells to native peptide, in the absence of professional APC, results in nonresponsiveness to subsequent immunogenic challenge, including abrogation of IL-4 and IL-13 production (10, 11). Reduced IL-4 and IL-13 production was correlated with altered transmembrane signaling through the TCR, specifically, ablation of p56lck and ZAP-70 tyrosine phosphorylation (10).
The interaction of CD4+ T cells with optimally presented peptide/MHC complex leads to T cell proliferation and cytokine production (reviewed in 12 . However, varying the affinity of ligand for the TCR can alter the profile of cytokine production (13, 14). Certain amino acid substitutions in the native peptide at TCR contact residues, termed altered peptide ligands (APL) (reviewed in 15 , can modify cytokine patterns of both human (16, 17) and murine T cells (18, 19). It has been shown that APL may function as partial agonists, delivering an altered signal to cells, often resulting in anergy (20, 21). Furthermore, peptides substituted at MHC class II-contact residues can divert both human (22) and murine (23, 24) Th2 to Th1 responses. An APL of myelin basic protein, modified at a MHC class II binding residue, reversed the induction of autoimmune disease by the native peptide by altering cytokine patterns of encephalitogenic T cells (25).
Therefore, we examined whether APL could alter Th2 cytokine patterns
and/or induce anergy in cloned PLA-specific Th0 cells. Furthermore, the
immunological effect of changes in specific T cell cytokine secretion
on the isotype production by B cells and the possible mechanism of
anergy induction were studied. Compared with native peptide, the ratio
of IL-4:IFN-
was significantly reduced and the IgG4 production
increased when cloned PLA-specific Th0 cells were challenged
immunogenically with an APL that had a lower affinity for MHC class II.
Pre-exposure of Th0 cells to either native peptide or APL-induced
anergy, resulting in abrogation of IL-4, IL-5, and IL-13 secretion on
immunogenic restimulation. The anergic response was correlated with
altered signaling through the TCR, namely lack of phosphorylation of
ZAP-70.
| Materials and Methods |
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rPLA was prepared as described (26). The synthetic peptides corresponding to PLA8192 (YFVGKMYFNLID) and Ala-substituted PLA8192 peptides were synthesised by Genosys Biotechnologies (Cambridge, U.K.). rIL-2 was kindly provided by Sandoz (Basel, Switzerland). mAbs to ZAP-70 (IgG2a) and phosphotyrosine (ptyr) (RC20) were purchased from Upstate Biotechnology (Lake Placid, New York) and Transduction Laboratories (Lexington, KY), respectively. Anti-CD3 mAb was produced by clone CRL 8001 obtained from American Type Culture Collection (Manassas, VA) and purified by affinity chromatography. mAb to CD3 (OKT3) was kindly donated by Dr. C. Heusser (Novartis, Basel, Switzerland). Anti-CD28 (mAb 15E8) and anti-CD2 (mAbs 4B2 and 6G4) were obtained from the Red Cross Blood Transfusion Service (Amsterdam, The Netherlands). Purified rabbit anti-mouse Ig was obtained from Dako (Zug, Switzerland). Biotin-N-hydroxysuccinimide-ester (nhs-d-Biotin) and FITC-avidin were obtained from Calbiochem (La Jolla, Ca) and Sigma (Buchs, Switzerland), respectively.
Cells
The T cell clone, BuT1.2A2, derived from a hyperimmunized
healthy individual and specific for PLA, has been reported (27).
BuT1.2A2 recognizes an epitope spanned by the amino acid sequence,
PLA8192 (27), and its cytokine profile, secreting both
IL-4 and IFN-
(28), indicates a Th0 functional phenotype. The clone
is restricted by HLA-DP (27). The cloned T cells were
resuspended in complete medium, consisting of RPMI 1640, supplemented
with 1 mM sodium pyruvate, 1% MEM nonessential amino acids and
vitamins, 2 mM L-glutamine, 100 U/ml penicillin, 100
µg/ml streptomycin (all from Life Technologies, Basel, Switzerland)
and 10% heat-inactivated FCS (Sera-Lab, Crawley Down, Sussex, U.K.).
PBMC were isolated by Ficoll (Biochrom, Berlin, Germany) density
gradient centrifugation of peripheral venous blood. Cells were washed
and resuspended in complete medium as above.
Induction of anergy in Th0 cells
Cloned T cells (12 x 106/ml) were incubated for 16 h in the presence of PLA8192 or PLA-F82A (70 µM) in 24- or 48-well culture plates (Costar, Cambridge, MA). The cells were then washed and incubated for a further 48 h before restimulation with PLA8191 in the presence of autologous, irradiated (5000 rad), EBV-transformed B cells (BuB1; APC) (27). Cloned T cells were also incubated with PLA8192 or PLA-F82A in the presence of APC (12 x 106/ml) for 5 days and then restimulated with PLA8192/APC, and proliferation and cytokine production measured.
Proliferation assays
For Ag-specific proliferation, cloned T cells (1 x 105/ml) were stimulated with PLA, antigenic peptide, or APL, in the presence of APC (1 x 105/ml), in 200 µl medium in 96-well round-bottom tissue culture plates (Becton Dickinson, Lincoln Park, NJ) in triplicate wells. Proliferation was determined after 48 h by pulsing for a further 16 h with [methyl-3H]thymidine ([3H]TdR) (DuPont/NEN, Boston, MA) (1 µCi/well, 37 kBq).
Production of IgG4 in vitro
T cell-depleted PBMC (0.5 x 105) were reconstituted with 0.5 x 105 T cell clone BuT 1.2A2, in 96-well flat-bottom plates (Costar). Cells were stimulated with increasing doses of native peptide or APL in the presence of 5 ng/ml of IL-4 (Novartis) at 37°C in a 5% CO2 atmosphere (7, 9). IgG4 was determined in supernatants after 12 days of incubation. All experiments were performed in triplicates.
Cytokine and IgG4 measurements
BuT1.2A2 (2 x 105/ml) was stimulated with
varying concentrations of PLA or peptides in the presence of autologous
EBV-transformed B cells (2 x 105/ml), and
supernatants were harvested after 24 h. Cloned T cells (1 x
106/ml) were incubated with PLA8192 or
PLA-F82A (70 µM), also in the absence of APC and
supernatants-harvested. PBMC were incubated with peptides or a
combination of mAbs to CD3 (CRL8001, 0.5 µg/ml), CD2 (0.5 µg/ml),
and CD28 (1 µg/ml), and supernatants were harvested after 5 days. The
solid phase ELISAs for IL-4, IL-5, IL-13, and IFN-
have been
described before (8, 28, 29). IL-10 was measured using a combination of
mAb JES3-9D7 and biotinylated JES3-12G8 (mAbs and IL-10 standard were
from PharMingen, San Diego, CA). The sensitivity of the IL-10
ELISA was = 50 pg/ml. IL-2 activity was detected by
[3H]TdR uptake by the CTLL-2 line (30).
IgG4 was measured in duplicates by sandwich ELISA as described (7, 9). The assays reached a sensitivity of 0.6 ng/ml of IgG4 World Health Organization 67-97 reference standard.
Affinity measurements by competition assay
The binding affinity of native peptide and APL were determined as previously described (31). PLA8192 was biotinylated and then purified by HPLC using a Nucleosol C18 column (pore size 250 Ao, 250 x 2 mm) (Mochereq-Nagel, Oensingen, Switzerland). Fractions were eluted with an acetonitrile gradient at a flow rate of 0.2 ml/min and lyophilized. Binding of biotinylated PLA8192 (25 µg/ml) to BuB1 cells in the presence or absence of varying concentrations of competitor peptides for 5 h at 37°C was detected by addition of avidin-FITC (10 µg/ml). Single color fluorescence was performed as described (29).
Immunoprecipitations
The method was as described (10), with some modifications. BuT1.2A2 was rested in complete medium without growth factors for 4 days and in 2% FCS containing medium for 24 h before experiments. T cells were exposed to PLA8192 or PLA-F82A (70 µM) for 16 h and then washed and incubated for a further 48 h. Cloned T cells (3 x 106) were then stimulated with anti-CD3 (OKT3, 10 µg/ml), cross-linked to plastic (Falcon 2051, Becton Dickinson), and mAb to CD28 (1 µg/ml) for 15 min. T cells were lysed in 0.5% Triton X-100 containing leupeptin and aprotinin (each 10 µg/ml), sodium orthovanadate (1 mM), EDTA (5 mM), and iodoacetamide (5 mM) (all from Sigma). Postnuclear lysates were precleared for 2 h each with Pansorbin (Calbiochem-Novabiochem, San Diego, CA; 10% (v/v) solution of fixed Staphylococcus aureus Cowan I, prewashed three times with PBS) and BSA-bound Sepharose-Protein A (Pharmacia, Uppsala, Sweden). Precipitations were performed overnight at 4°C with mAb to ZAP-70, and complexes captured with rabbit anti-mouse Ig bound to Protein G-Sepharose 4B (Pharmacia). Precipitates were washed with cold lysis buffer and boiled in Laemmli sample buffer before electrophoresis.
Immunoblotting
Immunoprecipitates were electrophoresed on 816% SDS-PAGE gels (Novex\/, San Diego, CA). Proteins were transferred to nitrocellulose blots and blocked with 2% BSA or 3% nonfat milk powder in 0.01 M Tris-buffered saline/0.1 M sodium chloride/0.1% Tween 20. Blots were then probed with mAb to ptyr linked to horse radish peroxidase, stripped and then probed with mAb to ZAP-70, followed by horse radish peroxidase-linked anti-mouse Ig (Transduction Laboratories). Blots were detected by the enhanced chemiluminescence system (Amersham, Little Chalfont, U.K.). Densitometry was performed using a table top scanner (UVP, OmniLab, Switzerland).
| Results |
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ratio by inhibiting IL-4
production
Peptide analogues with Ala-substitutions at each position of
PLA8192 were tested for their effects on proliferation by
the T cell clone, BuT1.2A2, in the presence of professional APC. The
reduction in the proliferative response of the clone to several
substitutions, at positions 82, 83 85, 87, and 90 indicated that these
peptides functioned either as weak or partial agonists (Fig. 1
). Substitutions at positions 84, 86,
88, and 89 rendered the clone nonresponsive in the proliferation assay,
whereas substitutions at the N- and C-terminal residues had no effect.
Partial agonists have been shown to modify cytokine production by
allergen-specific T cells (15) and therefore, cytokine production in
response to the altered peptides was investigated. Peptides that
induced no proliferative response were not included as these appear to
induce either no cytokines or in some cases IL-4 alone (17, 32). The
pattern of IL-4 and IFN-
production in response to APL, in general,
corresponded to the proliferation data (data not shown). However, for
one substitution, F82A, the proportional reduction in IL-4 was greater
than that in IFN-
secretion, and therefore, the IL-4:IFN-
ratios
were decreased compared with PLA8192. Dose-response
curves revealed that the IL-4:IFN-
ratio increased over the
concentration range for both PLA8192 and PLA-F82A (Fig. 2
, A and B). At the
lowest concentration (0.03 µM), the IL-4:IFN-
ratios were 1.3 and
0.7 for the native peptide and APL, respectively. At a higher
concentration [3 µM], the IL-4:IFN-
ratios were 1.8 and 1.1,
respectively. The reduction in IL-4:IFN-
ratio by the APL compared
with PLA8192 was however, observed over the whole
concentration range. Proliferative responses to PLA-F82A also showed
significant reductions compared with PLA8192 (Fig. 2
C), indicating that the APL was a partial rather than a
weak agonist.
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(Fig. 3
by polyclonal T
cells. Secretion of IL-4 by PBMC from three other allergic donors in
response to either peptide was not detectable. Both the native peptide
and PLA-F82A induced cytokine production by BuT1.2A2 in the absence as
well as the presence of APC (Table I
secretion, production of IL-4 in response to the APL
was only 23% of the response to PLA8192. BuT1.2A2 did
not produce any IL-2 in response to peptides.
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The immunological relevance of the changes in cytokine profile of
peptide-specific T cells by the APL, PLA-F82A, was investigated on
isotype production in T cell-depleted autologous PBMC substituted with
the PLA8192-specific T cell clone BuT1.2A2. It is known
that changes in IL-4:IFN-
ratio directly correlate with production
of IgE:IgG4 ratio (7, 28, 33). Indeed, the Th2 cytokine-suppressing APL
substantially increased the IgG4 production by B cells, compared with
the original PLA8192 peptide and an irrelevant control
peptide from a major PLA epitope in vitro. This is demonstrated in Fig. 4
.
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The reduction in IL-4 production by BuT1.2A2 in response to the
APL, PLA-F82A, indicated an altered form of TCR triggering, compared
with PLA8192. This alteration could result from variation
in the binding affinity to either the MHC class II molecule or to the
TCR. Therefore, we conducted binding experiments on the autologous
EBV-transformed B cell line to investigate this. The T cell clone,
BuT1.2A2, is restricted by HLA-DP (27), and >90% of EBV cells
expressed HLA-DP (data not shown). The biotinylated
PLA8192 bound to 40% of the B cells and the same
peptide, used as a competitor at a ratio of 8:1, reduced the number of
cells bound by 45% (Fig. 5
) and
decreased mean fluorescence values from 0.9 to 0.5. In contrast, F82A
at the same competitor ratio was unable to reduce cell binding by >8%
and mean fluorescence values were decreased from 0.9 to 0.8.
|
We have previously noted that exposure to native peptide in the
absence of professional APC induced anergy in cloned PLA-specific Th2
cells (10). The production of IL-4 and IL-13, but not IL-5, was
abrogated in response to immunogenic challenge. When BuT1.2A2 was
exposed to either PLA8192 or PLA-F82A and restimulated in
the presence of native peptide and APC, levels of all cytokines
measured, IL-4, IL-5, IL-10, IL-13, and IFN-
, were reduced compared
with untreated T cells (Fig. 6
). The APL
and native peptide were almost equally effective in inducing anergy in
the clone. There were considerable differences in the degree of
inhibition for each cytokine. Whereas the production of IL-4 was
decreased by 85% and 72% by preincubation with the native peptide or
APL, respectively, IFN-
secretion was only reduced by 25% and 26%,
respectively. As PLA-F82A had specifically inhibited IL-4 production in
the presence of APC (Fig. 2
), BuT1.2A2 was immunogenically restimulated
to determine whether anergy could be established in the presence of APC
(Fig. 7
). Pre-exposure to
PLA8192 in the presence of APC had no effect on cytokine
production and only a marginal effect on proliferation. In contrast,
pre-exposure to PLA-F82A inhibited IL-4 production by 55% on
restimulation. This effect was specific as production of IFN-
and
proliferative response were unaffected.
|
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We have previously noted abrogated lck and ZAP-70
tyrosine phosphorylation in anergic Th2 cells (10), suggesting an
alteration in signaling through the TCR. When BuT1.2A2 was exposed to
PLA81-92 or PLA-F82A in the absence of APC,
there was no evidence of ZAP-70 tyrosine phosphorylation up to 60
h after exposure (Fig. 8
and data not
shown), a result similar to that previously observed with Th2 cells. To
provide a full activating signal, control and anergic Th0 cells were
restimulated with a combination of mAbs to both CD3 and CD28. Cells
were left for 2 days after exposure to peptides before restimulation to
relate the time-course for signal transduction directly to cytokine
release. Cloned normal Th0 cells responded to anti-CD3/CD28
stimulation with a strong increase in tyrosine phosphorylation of
ZAP-70. Tyrosine-phosphorylated bands, in the 55- to 60-kDa range, were
also detected (10). In contrast, in Th0 cells pretreated with either
PLA8192 or PLA-F82A, there was no increase in ZAP-70
tyrosine phosphorylation and no associated bands observed.
|
| Discussion |
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production in comparison with the
native peptide. A decreased IL-4:IFN-
ratio in human
allergen-specific Th0 cells, responding to APL, has been described
previously (17, 22), but as a result of increased IFN-
rather than
decreased IL-4 production. Nevertheless, the functional phenotype of
polarized human Th2 cells can be skewed, leading to reduction in IL-4
production (34). This indicates plasticity in the regulation of IL-4
secretion that may allow manipulation by a variety of immunotherapeutic
means. Diminution of IL-4 production by the APL was observed in the absence as well as presence of APC, indicating that the result was not due to an inhibitory factor produced by APC, but derived from altered binding of the APL to the TCR or the MHC class II molecule. Binding studies indicated that the Phe to Ala substitution at residue 82 reduced the affinity of the peptide for the MHC class II molecule. The clone, BuT1.2A2, is restricted by HLA-DP (27), and no motifs specific for DP have as yet been described. However, the known crystal structures for DR1 and I-Ek binding peptides indicate the presence of a critical anchor residue at the N-terminal position P1 (35, 36). The Phe at position 82 may represent this residue in PLA8192, and by analogy with DR1, this large aromatic residue may be required to fit the corresponding pocket contributed by the HLA-DP molecule.
Previous studies have indicated that APL binding with lower affinity to
I-A molecules may skew both naive and cloned murine T cells toward
higher levels of IL-4 production (23, 24). However, this has not been
found in studies of peptides binding to HLA-DP or -DQ molecules
(37, 38). The evidence that IL-4 but not IFN-
production by
polyclonal T cells could also be reduced by PLA-F82A indicated that
this was not a property unique to one T cell repertoire.
We have previously reported that increasing the concentration of
allergen, and thus increasing the signal strength, increased the
IL-4:IFN-
ratio for the responses of several PLA-specific T cell
clones (28). This could also be inferred by the observation that low
concentrations of an APL preferentially induced IFN-
, whereas
10-fold higher concentrations induced both IFN-
and IL-4 production
(19). The specific signals generated by different ligand/TCR
interactions and their associated costimulatory signals, in particular
through CD28 (39, 40), may primarily determine T cell cytokine
responses. These signals are modulated by changes in affinity but not
necessarily with only one outcome.
Exposure of BuT1.2A2 to PLA8192 or PLA-F82A, in the
absence of APC, rendered the clone functionally inactive on immunogenic
restimulation. Production of all Th2 cytokines measured was abrogated
and that of IL-4 ablated. We have previously reported that IL-4
production by cloned PLA-specific Th2 cells could also be ablated (10).
This indicates that absence of costimulatory signals may alter patterns
of Th2 cytokine production by polarised as well as differentiating T
cells (reviewed in 41 . Specific inhibition of IL-4 production was
observed after exposure to the partial agonist, PLA-F82A, in the
presence of APC. Loss of proliferative capacity after exposure to a
partial agonist in the presence of APC has been reported (21), but this
is the first evidence in human T cells that an APL can partially
uncouple IL-4 from IFN-
production on immunogenic restimulation.
The effect of exposure of BuT1.2A2 to PLA8192 or PLA-F82A
in the absence of professional APC was to induce both IFN-
and Th2
cytokine production. However, secretion of IL-2 was absent. Visually,
the cells appeared highly activated, forming large clusters 68 h
after stimulation (data not shown), indicating presentation of the
peptide between the T cells. The induction of anergy may be due to lack
of IL-2 that has also been observed in murine models of anergy (41, 42). High levels of IL-10 were secreted on exposure to the peptides
that in the absence of IL-2 may also have contributed to the anergic
phenotype (43, 44).
We have previously observed that abrogation of IL-4 and IL-13
production by anergic PLA-specific Th2 cells correlated with
alterations in transmembrane signaling through the TCR (11). The
induction of anergy in cloned PLA-specific Th0 cells was associated
with similar changes. Cloned T cells, exposed to either
PLA8192 or the APL, PLA-F82A, did not
phosphorylate ZAP-70 on restimulation with mAb to CD3/CD28. Activation
of ZAP-70 is dependent on the CD4-associated tyrosine kinase,
p56lck (45) that has also been shown to
regulate the costimulatory receptor, CD28 (46). CD28 was expressed at
similar levels on both normal and anergic Th0 cells (data not shown).
Therefore, altered signaling through both the TCR and CD28 may
contribute to anergic responses of cloned PLA-specific T cells.
Although the capacity of PLA-F82A and PLA8192 to induce
anergy in Th0 cells was equivalent, it was significant that IL-4
production could be reduced by the APL in comparison with the native
peptide. This may be of advantage when considering peptide
immunotherapy in allergic patients. Some patients developed
postinjection symptoms after treatment with Fel d 1 peptides (8), and
this may be due to mediator release after Th2 cytokine production.
Recently, we have used a mixture of three major T cell
epitope-containing peptides for specific immunotherapy of bee-sting
allergic patients (9). Accordingly, it was interesting to see that the
APL-induced change in cytokine composition with suppressed IL-4,
substantially increased IgG4 in stimulated cell cultures containing the
specific T cell clone. IgE could not be generated in measurable amounts
in this system because the respective individual was not allergic. This
is in accordance with the previous finding that the production of
specific IgG4 by memory B cells depends on IFN-
, the cytokine that
suppresses IgE, and that the ratio of specific IgE:IgG4 in vitro
directly correlates with IL-4:IFN-
ratio (33, 47).
In conclusion, an APL of a dominant T cell epitope of the major bee
venom allergen has been shown to reduce IL-4 production by cloned
allergen-specific Th0 cells and to induce anergy in the cells such,
that IL-4, IL-5, and IL-13 production were abrogated on immunogenic
restimulation. The responses of anergic T cells were correlated with
alterations in transmembrane signaling through the TCR, as demonstrated
by ablated ZAP-70 tyrosine phosphorylation. Uncoupling of IL-4 from
IFN-
production changed the isotype production in favour of IgG4.
These results indicate that the application of APL, mutated at
sensitive sites, altering the secreted-T cell cytokine pattern, may
improve the efficacy in specific immunotherapy, either alone, in
combination with native peptide or as a component of a recombinant
protein.
| Footnotes |
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2 Address correspondence and reprint requests to Dr. Alexander Faith, Swiss Institute of Allergy and Asthma Research (SIAF), Obere Strasse 22, CH-7270 Davos, Switzerland. E-mail address: ![]()
3 Abbreviations used in this paper: PLA, bee venom phospholipase A2; APL, altered peptide ligand(s); ptyr, phosphotyrosine. ![]()
Received for publication February 24, 1998. Accepted for publication October 28, 1998.
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T. Kinnunen, W. W. Kwok, A. Narvanen, M. Rytkonen-Nissinen, A. Immonen, S. Saarelainen, A. Taivainen, and T. Virtanen Immunomodulatory potential of heteroclitic analogs of the dominant T-cell epitope of lipocalin allergen Bos d 2 on specific T cells Int. Immunol., December 1, 2005; 17(12): 1573 - 1581. [Abstract] [Full Text] [PDF] |
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H J Ellis, E L Pollock, W Engel, J S Fraser, S Rosen-Bronson, H Wieser, and P J Ciclitira Investigation of the putative immunodominant T cell epitopes in coeliac disease Gut, February 1, 2003; 52(2): 212 - 217. [Abstract] [Full Text] [PDF] |
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J. A. Gebe, E. J. Novak, W. W. Kwok, A. G. Farr, G. T. Nepom, and J. H. Buckner T Cell Selection and Differential Activation on Structurally Related HLA-DR4 Ligands J. Immunol., September 15, 2001; 167(6): 3250 - 3256. [Abstract] [Full Text] [PDF] |
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R. D. J. Huby, R. J. Dearman, and I. Kimber Why Are Some Proteins Allergens? Toxicol. Sci., June 1, 2000; 55(2): 235 - 246. [Abstract] [Full Text] [PDF] |
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A. Verhoef and J. R. Lamb Threshold Signaling of Human Th0 Cells in Activation and Anergy: Modulation of Effector Function by Altered TCR Ligand J. Immunol., June 1, 2000; 164(11): 6034 - 6040. [Abstract] [Full Text] [PDF] |
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