The Journal of Immunology, 1999, 163: 3524-3529.
Copyright © 1999 by The American Association of Immunologists
Up-Regulation of CCR2 Chemokine Receptor Expression and Increased Susceptibility to the Multitropic HIV Strain 89.6 in Monocytes Exposed to Glucocorticoid Hormones1
Giselle Penton-Rol2,*,
Manuela Cota2,
,
Nadia Polentarutti*,
Walter Luini*,
Sergio Bernasconi*,
Alessandro Borsatti*,
Antonio Sica*,
Gregory J. LaRosa
,
Silvano Sozzani*,
Guido Poli
and
Alberto Mantovani3,*,§
*
Department of Immunology and Cell Biology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy;
AIDS Immunopathogenesis Unit, Ospedale S. Raffaele, Milan, Italy;
Receptor Pharmacology, LeukoSite, Inc., Cambridge, MA 02142; and
§
Section of Pathology and Immunology, Department of Biotechnology, University of Brescia, Brescia, Italy
 |
Abstract
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Glucocorticoid hormones (GC) are potent antiinflammatory agents
widely used in the treatment of diverse human diseases. The present
study was aimed at assessing the effect of GC on chemokine receptor
expression in human monocytes. Dexamethasone (Dex) up-regulated mRNA
expression of the monocyte chemotactic protein (MCP-1, CCL2) chemokine
receptor CCR2. The effect was selective in that other chemokine
receptors were not substantially affected. Stimulation by Dex was
observed after 4 h of exposure at concentrations of
10-7 to 10-5 M. Steroids devoid of GC
activity were inactive, and the GC receptor antagonist, RU486,
inhibited stimulation. Dex did not affect the rate of nuclear
transcription, but augmented the CCR2 mRNA half-life. Augmentation of
CCR2 expression by Dex was associated with increased chemotaxis.
Finally, Dex treatment induced productive replication of the HIV strain
89.6, which utilizes CCR2 as entry coreceptor, in freshly isolated
monocytes. Together with previous findings, these results indicate that
at least certain pro- and antiinflammatory molecules have reciprocal
and divergent effects on expression of a major monocyte
chemoattractant, MCP-1, and of its receptor (CCR2). Augmentation of
monocyte CCR2 expression may underlie unexplained in vivo effects of GC
as well as some of their actions on HIV
infection.
 |
Introduction
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Chemokines
are a growing superfamily of low m.w. chemotactic proteins that can be
divided into four branches according to the position of the first
cysteine pair (C-X-C, C-C, and C-X3-C) or the lack of two of the four
cysteines (C) (1, 2, 3, 4, 5). C-X-C chemokines, of which IL-8 is
the prototype, are mainly active on neutrophils, T, and B lymphocytes.
C-C chemokines have a wider spectrum of action being active on
monocytes, granulocytes, T, and B lymphocytes, NK cells, and dendritic
cells (1, 2, 3, 4, 6). Lymphotactin, the only C chemokine so far
described, is active on T lymphocytes and NK cells (7, 8).
Chemokines are produced by multiple cell types, including
monocytes/macrophages, endothelial cells, mesothelial cells,
fibroblasts, keratinocytes, and lymphocytes, and bind to seven
transmembrane domain G protein-coupled receptors (1, 2, 3, 9, 10). Five receptors for C-X-C chemokines (CXCR15) and eight
for C-C chemokines (CCR18) were recently cloned. These receptors show
a promiscuous pattern of ligand recognition and are differentially
expressed and regulated in leukocytes (10, 11, 12, 13, 14, 15, 16, 17, 18, 19).
Regulation of chemokine receptor expression has been studied less
extensively than agonist production. IL-2 was recently shown to augment
expression of CCR2 in T cells, NK cells, and monocytes (14, 15, 19). Recently, we found that LPS, a prototypic proinflammatory
molecule, which induces monocyte chemotactic protein-1
(MCP-1)4 production in
mononuclear phagocytes (20), causes a rapid, drastic, and
selective down-regulation of CCR2 mRNA and surface expression in human
monocytes (15). Similar results were obtained with other
proinflammatory molecules (15, 21). It was therefore of
interest to investigate whether and how antiinflammatory agents affect
C-C chemokine receptor expression in human monocytes. In this regard,
we recently reported that the anti-inflammatory cytokine IL-10
enhances expression of certain CC chemokine receptors in monocytes
(22).
Glucocorticoid hormones (GC) are prototypic
antiinflammatory/immunosuppressive agents widely used in the treatment
of diverse human diseases. They exert complex effects on
immunocompetent cells, including induction of the type II "decoy"
receptor, which represents a unique pathway of negative regulation of
the IL-1 system (23, 24). They inhibit production of
chemokines in a variety of cell types (25, 26, 27, 28, 29, 30), including
monocytes, and cause alterations in monocyte trafficking, some which
are poorly understood (31, 32, 33, 34).
The present study was aimed at assessing whether and how GC affect CC
chemokine receptor expression in human monocytes. Perhaps unexpectedly,
GC selectively up-regulated CCR2 receptor expression by stabilizing
mRNA transcripts. Thus, GC have divergent effects on agonist
(MCP-1) production and receptor expression in monocytes. These
observations provide an explanation for some of the in vivo effects of
GC, as well as for some of their actions in HIV infection. More in
general, they add to an emerging picture of prototypic pro- and
antiinflammatory agents having reciprocal and divergent effects on
expression in mononuclear phagocytes of a major monocyte attractant,
MCP-1, and of its receptor, CCR2.
 |
Materials and Methods
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Cells
Human monocytes were separated from peripheral blood of human
healthy donors by Percoll gradient centrifugation (20, 21). Briefly, whole blood was fractionated by Ficoll gradient
centrifugation (Seromed-Biochem KG, Berlin, Germany) and monocytes
collected from the ring, layered on top of 46% Percoll (Pharmacia,
Uppsala, Sweden) after a centrifugation at 2000 rpm for 30 min at room
temperature. Monocytes (>98% pure, as assessed by morphology) were
resuspended at 5 x 106 cells/ml in RPMI
1640 (Seromed) with 10% FCS (HyClone, Logan, UT). All reagents
contained <0.125 EU/ml of endotoxin, as checked by Limulus
amebocyte lysate assay (Microbiological Associates, Rockville, MD).
THP-1 cell line was obtained from the American Type Culture Collection
( Manassas, VA) and cultivated in RPMI 1640 medium containing 10% FCS
with 2 mM glutamine. MonoMac 6 cell line (gift of Dr. L. Ziegler
Heitbrock, Radiologische Klinik, Universitat Müncher, Munich,
Germany) was cultured in RPMI 1640 with 20% FCS, 2 mM glutamine, 1 mM
sodium pyruvate (Seromed), 1 mM oxaloacetic acid (Sigma, St. Louis,
MO), and 1x nonessential amino acids (Seromed).
Stimulation conditions and reagents
Monocytes, THP-1, and MonoMac 6 cell lines were incubated in
endotoxin-free RPMI 1640 with 10% FCS at 5 x
106 cells/ml, with or without stimuli for the
indicated times at 37°C in the presence of 5%
CO2. Dexamethasone (Dex; Merck, Rahway, NJ) was
used at 10-7 M, unless otherwise specified. Actinomycin D
(Act D; Sigma) was used at 1 µg/ml.
5,6-Dichloro-1-ß-D-ribofuranosylbenzimidazole (DRB;
Sigma) was used at 20 µg/ml. Cycloheximide (Sigma) was used at 10
µg/ml. Cortexolone (17-hydroxy-11-deoxycorticosterone; Sigma) and
progesterone (Sigma) were used at 10-5 M and
10-7 M, respectively; RU486 (Roussel Uclaf,
Romainville, France) at 10-6 M, as previously
described (24). For phenotype analysis, indirect
immunofluorescence was performed with the human anti-CCR2 Ab
132.1D9 (G. LaRosa, data not shown) and PE-labeled goat anti-mouse
Ig (Jackson ImmunoResearch West Grove, PA) using a FACStar (Becton
Dickinson, Mountain View, CA)
Northern blot and run off analyses
Total RNA was isolated by the guanidium isothiocyanate method,
as previously reported (35). A total of 10 µg of total
RNA was analyzed by electrophoresis through 1% agarose/formaldehyde
gels, followed by Northern blot transfer to Gene Screen Plus membranes
(New England Nuclear, Boston, MA). Probes were labeled by the Megaprime
DNA labeling system (Amersham, Little Chalfont, U.K.) with
[
-32P]dCTP of 3000 Ci/mmol sp. act.
(Amersham). CCR2-B cDNA was obtained by PCR amplification of the
reported sequences (19, 36), and the CCR1, CCR4, and CCR5
cDNAs were obtained from Dr. T. Wells (Glaxo Wellcome Research and
Development S.A., Geneva, Switzerland).
Nuclear run-off experiments were performed essentially as described
(35) using nuclei from 2030 x
106 cells isolated after 4 h of
stimulation.
Migration assay
Cell migration was evaluated using a chemotaxis microchamber
technique (37). Then, 27 µl of chemoattractant solution
or control medium (RPMI 1640 with 1% FCS) was added to the lower wells
of a chemotaxis chamber (Neuroprobe, Pleasanton, CA). A polycarbonate
filter (5-µm pore size; Neuroprobe) was layered onto the wells and
covered with a silicon gasket and with the top plate. A total of 50
µl of the cell suspension (1.5 x 106/ml
monocytes in PBMC) was seeded in the upper chamber. The chamber was
incubated at 37°C in air with 5% CO2 for 90
min. At the end of the incubation, filters were removed and stained
with Diff-Quik (Baxter, Rome, Italy), and five high-power oil-immersion
fields were counted.
HIV infection
Percoll-derived monocytes were resuspended in DMEM
(BioWhittaker, Verviers, Belgium) supplemented with 10% FCS (HyClone
Europe, Oud-Beijerland, The Netherlands) and 5% AB human serum, and
seeded in 24-well plates (Falcon; Becton Dickinson Labware, Lincoln
Park, NY) at 0.5 x 106 cell/ml. Monocytes
were either left untreated or were treated with Dex
(10-7 M) 30 min before infection with the 89.6
HIV strain (kind gift of Prof. Ronald G. Collman, University of
Pennsylvania, Philadelphia, PA) at the fixed concentration of
105 cpm of RT activity per 0.5 x
106 cells. Fifty percent of culture media was
replaced with fresh media twice a week. Aliquots of culture
supernatants were harvested at the indicated times points and stored at
-80°C until simultaneously tested for RT activity contents.
HIV-RT activity assay
HIV replication was monitored as
Mg2+-dependent RT activity released into the
supernatants was measured as previously described (22, 38).
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Results
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Selective up-regulation of CCR2 by Dex
CCR1, CCR2, and CCR5 mRNAs were present at high levels in
untreated human monocytes (Fig. 1
),
whereas the CCR4 transcript was less expressed under the same
experimental conditions, with considerable donor-to-donor
variation. In a series of 10 experiments with 10 donors, Dex
(10-7 M for 4 h) caused a median
30-fold increase in CCR2 transcript levels (range 6- to
80-fold), as assessed by densitometry. CCR1, CCR4, and CCR5, as well as
CXCR2 and CXCR4, were not substantially affected under the same
conditions (Fig. 1
, and data not shown). Therefore, subsequent analysis
focused on CCR2.

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FIGURE 1. Selective induction of CCR2 by Dex. The effect of Dex on the CCR1,
CCR2, CCR4, and CCR5 mRNA expression was examined by Northern blot
analysis. The lower part of the figures shows the ethidium
bromide-stained membranes. Results presented are representative of 10,
4, 4, and 2 donors for CCR2, CCR1, CCR5, and CCR4, respectively.
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The effect of Dex was dose-dependent, with augmentation at
concentrations between 10-7 and
10-5 M (Fig. 2
A, representative of two
donors). Peak induction of CCR2 mRNA occurred at 4 h and decreased
between 8 and 20 h of stimulation (Fig. 2
B, two
donors). To establish whether the increase in CCR2 mRNA was specific
for Dex, we stimulated monocytes with different types of steroids (Fig. 2
C, two donors). Cortexolone and progesterone were inactive,
while Dex was able to augment CCR2. We also treated monocytes with
RU486, a GC-receptor antagonist, (Fig. 2
D, two donors), and
we found that RU486 blocked by 75% the increase induced by Dex. Thus,
the action of Dex on CCR2 mRNA is mediated by GC receptors.

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FIGURE 2. Characterization of Dex-stimulation of CCR2 expression in monocytes.
Cells were incubated with increasing concentrations of Dex for 4 h
(A) or with 10-7 M Dex for 220 h
(B). C, lanes 1 and
2 are untreated and Dex-treated monocytes, respectively.
Cells were also treated with cortexolone (lane 3) and
progesterone (lane 4). D, lanes
1 and 2 represent untreated and Dex-treated
monocytes, respectively; lane 3, cells were incubated
with RU486; lane 4, RU486 plus Dex. For each panel, the
lower part shows the ethidium bromide-stained membranes.
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To assess whether the effect of Dex was related to cellular
differentiation, we evaluated the CCR2 mRNA expression in
monocyte-derived macrophages after 5 days of culture, THP-1 and MonoMac
6 cell lines (Fig. 3
). Also in these
cells, Dex up-regulated CCR2 transcripts, though with lower efficiency
compared with fresh monocytes. For monocyte-derived macrophages the
increase was 5-fold (two donors), for the MonoMac 6 cell line it was
2-fold (two experiments), and for the THP-1 cell line it was only 25%
(two experiments).

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FIGURE 3. Effect of Dex on CCR2 expression in macrophages and monocytic cell
lines. Monocyte-derived macrophages after 5 days of culture, THP-1 cell
line and MonoMac-6 cell line (MM-6) were treated with 10-7
M Dex for 4 h, and CCR2 mRNA expression was examined. The lower
part of the figure shows the ethidium bromide-stained membranes.
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Mechanism of action
The mechanisms involved in Dex augmentation of CCR2 steady state
transcripts in monocytes were studied. We evaluated its effects on both
mRNA stability and gene transcription. Act D (1 µg/ml) and DRB (20
µg/ml) were added to human monocytes in the presence or absence of
10-7 M Dex, and total RNA was extracted at
different times as indicated (Fig. 4
). In
the presence of Act D, the estimated half-life of the transcript was
about 1.5 h, in agreement with recent results (15, 39). Treatment with Act D plus Dex increased the CCR2 mRNA
half-life to 2.3 h (Fig. 4
A). Similar increases were
observed when DRB was used instead of Act D (Fig. 4
B). To
explore the effects of Dex on gene transcription, we performed a
nuclear run-off analysis (Fig. 4
C). Dex did not result in
variations of the transcriptional rate of the CCR2 gene, but, in
contrast, it reduced MCP-1 gene transcription, as expected.

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FIGURE 4. Mechanism of Dex augmentation of CCR2 steady state mRNA levels.
Stability of CCR2 transcript: monocytes were incubated with or without
Dex at 10-7 M for 4 h. Then, Act D (A)
or DRB (B) was added for the indicated times and cells
examined for CCR2 transcripts. The lower part of the figure shows the
ethidium bromide-stained membranes and densitometric analysis.
C, Nuclear run-off analysis of the CCR2 and MCP-1 genes.
ß-Actin was used as control.
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Up-regulation of CCR2 surface expression and chemotactic
responsiveness
To assess whether the up-regulation that we observed at the mRNA
level correlated with protein expression, monocytes were exposed to Dex
(10-7 M) for 8 h, and surface CCR2 was
examined by flow cytometry. As shown in Fig. 5
, Dex augmented surface expression of
CCR2 The mean channel of fluorescence was 340 and 396 for control and
Dex-treated cells, respectively, with 46 and 70% of positive cells,
respectively (Fig. 5
). In an effort to assess the functional relevance
of CCR2 up-regulation, monocytes were incubated with Dex
(10-7 M) for 10 h, washed, and cultured for
an additional 2 h before examining their chemotactic
responsiveness (Fig. 6
, representative of
two experiments). This experimental protocol was designed to avoid any
confounding direct influence of Dex on the locomotory capacity of
monocytes, which has been the object of conflicting results (40, 41). As shown in Fig. 6
A, Dex pretreated monocytes
showed stronger responsiveness to MCP-1, better evident at suboptimal
agonist concentrations. As expected on the basis of the lack of
substantial effects on CCR5 (Fig. 1
), the responsiveness to the CCR5
agonist macrophage-inflammatory protein-1ß was little or not affected
by Dex (Fig. 6
B). In one experiment (data not shown),
binding of radiolabeled MCP-1 was also increased in Dex-treated
monocytes.

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FIGURE 5. Up-regulation of CCR2 surface expression by Dex. Monocytes were exposed
to Dex (10-7 M) for 8 h, and surface CCR2 was
examined by flow cytometry. The mean channel of fluorescence was 340
and 396 for control and Dex-treated cells, respectively, with 46 and
70% of positive cells, respectively.
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FIGURE 6. Effect of Dex on the chemotactic responsiveness of monocytes. Monocytes
(3 x 106/ml) were exposed to 10-7 M Dex
for 10 h, washed, and cultured for an additional 2 h before
assessment of chemotaxis.
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Dex enhances the replication of a CCR2-using HIV strain in
monocytes
Freshly purified monocytes were infected with the 89.6 strain of
HIV, known to utilize CCR2b as well as other chemokine receptors in
order to enter CD4+ cells (42). As
expected, no replication was observed in monocytes that were left
untreated, whereas a sustained production of HIV was consistently
detected in cultures of different donors that were stimulated with Dex
(Fig. 7
). Consistent with the observed pattern of
modulation of chemokine receptor, Dex did not enhance the replication
of the CCR5-dependent BaL strain of HIV-1 (data not shown).

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FIGURE 7. Dex enhances 89.6 HIV-1 replication in monocytes. Freshly isolated
monocytes from three independent donors were infected by the CCR2-using
89.6 strain, as described. No substantial replication was observed in
control cultures, whereas glucocorticoids stimulated virus replication;
results are means of duplicate cultures. This pattern was observed in a
total of five of six monocyte cultures established from independent
donors. In contrast, Dex did not enhance the replication of the
CCR5-dependent HIV-1 BaL strain.
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 |
Discussion
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The results presented here show that Dex up-regulates expression
of CCR2 in human monocytes. A similar effect, though less marked, was
observed with monocyte-derived macrophages and two myelomonocytic cell
lines. The action of Dex was selective in that other C-C and C-X-C
chemokine receptors (CXCR2 and CXCR4) expressed in monocytes were
unaffected. Dex mediated CCR2 up-regulation by interacting with GC
receptors and prolonging the half-life of CCR2 transcripts.
GC are potent immunosuppressive/antiinflammatory molecules
(32, 33, 34, 43) whose mode of action has not been fully
defined. GC inhibit expression of a variety of cytokines
(44), including chemokines (26, 27, 28, 29, 30, 31). GC also
affect cytokine receptor expression, though frequently do they do so in
concert with other agents (45, 46).
The type II IL-1 decoy receptor is up-regulated by GC in monocytes and
PMN, which release this molecule in increased amounts (24, 47). GC-augmented IL-1 decoy receptor expression and release may
contribute to the antiinflammatory activity of these molecules.
Interestingly, as for CCR2, this effect was mediated by stabilization
of receptor transcripts (24, 47). The 3'-untranslated
region of the mRNAs of several rhodopsin family members, contains
AU-rich elements, which correlate with highly regulated short- lived
mRNAs (48, 49)
GC have profound effects on the number of circulating monocytes and on
their recruitment at sites of inflammation and tumor growth
(32, 33, 34, 50). GC cause profound monocytopenia, which, at
least initially in humans, is caused by redistribution of circulating
monocytes (32, 34, 51). It is tempting to speculate that
up-regulation of CCR2 may render circulating monocytes more sensitive
to tissue-derived chemoattractants (MCP-1, -2, and -3) and thus
contribute to this unexplained in vivo action of GC. In the same
perspective, acute stress augments Ag-specific cell-mediated immunity,
at least in part via GC (52). Again, up-regulation of CCR2
in monocytes and possibly in T and NK cells, could underlie this
phenomenon, which may represent a means to mobilize defenses under
extreme acute conditions. Under conditions of chronic exposure to
elevated GC, we speculate that inhibition of cytokine and chemokine
production prevails and results in inhibition of recruitment. Finally,
sustained up-regulation of CCR2 may play a role in the rebound of
inflammatory reactions and symptoms that often follow chronic GC
therapy.
Chemokine receptors, including CCR2-B, act as fusion coreceptors for
HIV (42, 53). Elevated levels of GC are found in the blood
and saliva of HIV-infected patients (54). GC have complex
actions on HIV infection in in vitro system (38, 55, 56, 57).
In particular, GC have been shown to enhance HIV replication during
viral isolation from activated PBMC of HIV-positive individuals
(57). In addition, Dex and related molecules enhanced the
transcriptional activation of HIV in latently infected U1 cells
costimulated with TNF-
(38, 56). Monocytes, unlike
tissue macrophages, are not efficient targets for HIV replication in
vitro infection in vitro (22, 58) and in vivo
(59). However, they express both CD4 and some chemokine
receptors, potentially acting as entry coreceptor for HIV. The results
presented here show that GC can substantially enhance the levels of HIV
replication in mononuclear phagocytes infected by CCR2-using viral
strain, such as 89.6 (42), but not by a more common
CCR5-dependent virus BaL. By an analogous mechanism, we have recently
shown that another antiinflammatory molecule, IL-10, could enhance the
replication of HIV-1 BaL via selective up-regulation of CCR5
(22).
Thus, GC are potent inhibitors of chemokine production
(26, 27, 28, 29, 30, 31), MCP-1 in particular (31), yet they
up-regulate the CCR2 receptor. This dual action of GC mirrors the
effects of at least some proinflammatory molecules (15).
LPS and other proinflammatory signals, potent inducers of MCP-1 and
MCP-3 in mononuclear phagocytes (20), were found to
selectively destabilize CCR2 mRNA in monocytes (15, 21, 60). Hence, major pro- and antiinflammatory molecules have
reciprocal and opposing effects on agonist production and CCR2 receptor
expression in mononuclear phagocytes. These opposing and reciprocal
influences may serve to attenuate the major net pro- or
antiinflammatory action of these molecules. These results also suggest
that regulation of CCR2 receptor mRNA stability may represent an
interesting novel target for therapeutic intervention.
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Acknowledgments
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We thank Dr. P. Allavena and Prof. S. Garattini for
invaluable discussions and critical review of the paper.
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Footnotes
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1 This work was supported by Project AIDS from Istituto Superiore di Sanità and by 40% fund from Ministero dellUniversitá e della Ricerca Scientifica e Technologica (MURST; Italy). The generous contribution of the Italian Association for Cancer Research (Milan, Italy) is gratefully acknowledged. This work was conducted under a research contract with Consorzio Autoimmunità Tardiva (Pomezia, Italy) within the "Programma Nazionale Farmaci-seconda fase" of MURST. 
2 G.P.-R. and M.C. contributed equally to this work. 
3 Address correspondence and reprint requests to Dr. Alberto Mantovani, Istituto di Ricerche Farmacologiche, "Maria Negri," Via Eritrea, 62, 20157 Milan, Italy. E-mail address: 
4 Abbreviations used in this paper: MCP-1, monocyte chemotactic protein-1; GC, glucocorticoid hormones; Act D, actinomycin D; DRB, 5,6-dichloro-1-ß-D-ribofuranosylbenzimidazole; Dex, dexamethasone. 
Received for publication December 21, 1998.
Accepted for publication July 2, 1999.
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