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*
Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892;
Department of Oncology and Neuroscience, Medical School, University "Gabriele DAnnunzio," Chieti, Italy; and
Neurologische Klinik, Universitätsklinikum Carl-Gustav-Carus der Technischen Universität Dresden, Dresden, Germany
| Abstract |
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| Introduction |
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Since human T cells upon antigenic priming down-regulate the high-m.w. CD45RA isoform and reciprocally up-regulate the low-m.w. form CD45RO, these molecules have been proposed as markers for naive (CD45RA+/RO-) and memory (CD45RA-/RO+) T cells (17, 18). The following well-established observations corroborate this notion: 1) CD45RO+ cells are reduced under conditions of limited antigenic exposure, such as in human cord blood or in neonatal mice; 2) CD45RO+ cells are almost absent in the spleens of mice bred in a germfree environment; 3) increased proportions of CD45RO+ T cells are found in the peripheral blood of aging or immunized humans and animals; and 4) CD4+CD45RO+ T cells predominantly give rise to the human response to recall Ags such as tetanus toxoid (TT) in immunized subjects (19). More recent data, however, demonstrated that changes in CD45R isoforms are reversible in the rat (20, 21). Since evidence of such reversion in humans is so far only indirect (22), CD45RA vs CD45RO expression has been widely accepted and used to identify and select human naive and memory CD4+ T cells, respectively. A concomitant expression of both CD45RA and CD45RO has been associated with the phenotype of effector T cells, but the relationship of this cell population with that of naive and memory cells is not fully understood (8, 23). Thus, we studied human myelin Ag-specific responses from CD4+ T cell populations identified by clear expression of either the CD45RA or CD45RO isoform postulating they represent resting naive and memory T cells, and excluded double-positive cells which may either represent a transitional or an effector state.
To better understand the origin, the functional characteristics, and the specificity of CD4+ MBP-specific T cells derived from the peripheral blood of MS patients and controls, we asked 1) whether autoreactive T cells can originate both from the putatively naive (CD45RA+/RO-) and memory (CD45RA-/RO+) CD4+ subsets; 2) whether effector autoreactive cells raised from these subsets express different T helper phenotypes; and 3) whether the MBP-reactive T cell repertoires originating from the two subsets differ with respect to frequency, epitope recognition, and antigenic affinity.
| Materials and Methods |
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Donors were typed for HLA class II using standardized molecular typing methods by the Department of Transfusion Medicine, National Institutes of Health. To include well-characterized backgrounds in terms of HLA-restricted T cell response to MBP, we selected patients with haplotypes including DRB1*1501, *1502, or *0401. Age, gender, and HLA-DR haplotype of the subjects were as follows: MS patients MS1, 31-year-old female, DRB1*1501,04*; MS2, 31-year-old female, DRB1*1501,04*; MS3, 24-year-old female, DRB1*0403,1501; MS4, 44-year-old female, DRB1*0401,1301; MS5, 39-year-old-female, DRB1*1501; MS6, 32-year-old-female, DRB1*1502, 0701; and MS7, 38-year-old male, DRB1*0401,1501 and healthy donors: HD1, 33-year-old female, DRB1*0401,07*; HD2, 56-year-old female, DRB1*0401,1302; and HD3, 30-year-old male, DRB1*0301,1101. The study was approved by the Institute Clinical Research Subpanel, and informed consent was obtained from each patient.
Ags
Human MBP was prepared according to the method of Deibler et al. (24). A single batch of MBP of known purity and in vitro immunogenicity was used throughout the entire study. MBP peptides were synthesized on a Beckman 990 peptide synthesizer (Beckman Coulter, Fullerton, CA) using Merrifields solid-phase synthesis methodology according to published sequences (5). The superantigens (SAgs) staphylococcal enteroxin A, staphylococccal enteroxin B, staphylococcal enteroxin C-1, -2, -3, staphylococcal enteroxin D, staphylococcal enteroxin E, and toxic shock syndrome toxin-1 were obtained from Toxin Technologies (Sarasota, FL). TT was purchased from Pasteur Merieux Connaught (North York, Ontario, Canada).
Purification of CD4+ T cell subsets
PBMC were obtained from leukoapheresis buffy coats by density
gradient centrifugation (Organon Teknika, Durham, NC). T cell subsets
were isolated from 12 x 108 freshly
obtained PBMC via high-affinity negative selection using human
CD4+/45RO- or
CD4+/45RA- subset column
kits (R&D Systems, Minneapolis, MN), essentially according to the
manufacturers protocol. Our improvements included thorough
resuspension of the cell pellet by gently passing the cells six times
through a 16-gauge needle before loading and keeping a steady cell
elution flow by carefully maintaining a 2-ml wash buffer volume in the
column reservoir. Cryopreserved cells proved unsuitable for the
separation procedure due to reduced viability and an increased tendency
for aggregation. Therefore, only data obtained from subset separations
of freshly collected PBMC were included in this study. Composition of
the PBMC and purity of the separated T cell subsets were routinely
checked by flow cytometry using a FACScan- and CellQuest software
(Becton Dickinson, Mountain View, CA) after staining with
fluorochrome-labeled anti- CD3, CD4, CD8, CD45RA, and CD45RO mAb as
described below. The mean purity of all separations as determined by
FACS staining with mAb specific for CD45RA and CD45RO was
95% for
each subset. Double-positive
(CD45RA+/RO+)
"effector" cells, variably present in the PBMC (9 and
our observation), were selected out. Cell viability was always >98%
by trypan blue staining exclusion. The yield of purified cells
recovered from all cells loaded into the column ranged from 25 to 45%,
in accordance to the manufacturers specifications. To assess whether
cell loss biased the phenotypic characteristics of T cell subsets, we
performed FACS analysis of cell surface markers including, in addition
to CD45 isoforms, costimulation receptors (CD28), cell adhesion
molecules (CD11a, CD49d, and CD62L) and activation markers (CD25 and
CD69). The expression of these molecules on the isolated
CD45RA+ or RO+ subset
reflected the expected phenotypes of naive and memory T cells and
matched the profiles found on the corresponding subset analyzed by
electronic gating in whole PBMC (data not shown). These experiments
also confirmed that the negative selection strategy avoided functional
alterations consequent to engagement of CD45 molecules, yielding
unaltered cells.
Generation and characterization of Ag-specific T cell clones
T cell clones (TCC) specific for MBP were established from
purified T cell subsets using a modification of the split-well method
(2). From each donor, purified
CD45RA+/RO- and CD45
RA-/RO+
CD4+ T cells (2.5 x
104/well) were seeded into 96-well plates (Nunc,
Roskilde, Denmark) along with autologous irradiated PBMC (3000 rad,
1.5 x 105/well) as APC and stimulated with
30 µg/ml MBP or 10 µg/ml MBP peptide. Wells containing specific
proliferating T cells (stimulation index >2 with a
cpm>1000) were periodically (1015 days)
restimulated with Ag and APC and expanded in medium containing 5 ng/ml
of human rIL-2 (generously provided by Prof. Sebald, Biozentrum,
Würzburg, Germany). Clonality of T cell cultures was assessed by
PCR-assisted TCR Vß gene usage analysis as described elsewhere
(5).
Concentrations of the soluble factors IFN-
, TNF-
, IL-4, IL-10,
and GM-CSF were measured by ELISA using CytoSets (BioSource, Camarillo,
CA) according to an optimized standard protocol. Aliquots of cell
culture supernatant (50 µl) were harvested 48 h after Ag
stimulation and stored at -80°C until analysis. Supernatants were
diluted 1:5 with assay buffer and used in a total assay volume of 75
µl/well. For each TCC tested, we measured cytokine secretion upon the
following conditions: no Ag, 10 and 100 µg/ml MBP, 10 and 100 µg/ml
specific MBP peptide. All measurements were performed in duplicate
wells, and the specificity of proliferation was ascertained in every
instance.
Antigenic peptide specificities of the MBP-reactive TCC were defined by using a panel of 16 overlapping 19-mers in standard proliferation assays. Epitopes within the immunodominant region of MBP(111129) were further mapped using a set of 16 peptides truncated at the amino (112 to 119129) and carboxyl (111121 to 128) termini at equimolar concentrations (5). The overall functional Ag affinity was estimated by determining the Ag concentration required to induce 50% of the maximum proliferation (EC50). This was accomplished in dose-response proliferation assays covering Ag concentrations between 10-5 and 102 µg/ml.
The expression of cell surface markers of MBP-specific TCC was assessed by three-color flow cytometry staining. Taking into account that the expression of several lymphocyte surface molecules including CD45 isoforms varies during cell cycle progression (25), we performed FACS staining always on resting TCC at the end of each restimulation cycle (day 12), thus avoiding to introduce a bias. To monitor a possible variation of cell surface molecules after repeated antigenic contact, analysis included TCC which underwent a number of restimulations ranging from three to nine cycles. For FACS staining, 1 x 105 T cells/well were plated in 96-well plates and washed twice with 200 µl cold staining buffer (PBS 1% FCS-0.1% (w/v) sodium azide). The following mAb combinations were added at saturating concentrations: 1) IgG1 FITC, IgG1 PE, IgG1 Cy-Chrome; 2) CD45RA FITC (clone HI100), CD45RO PE (clone UCHL1), and CD4 Cy-Chrome; 3) CD28 FITC, CD62L PE, and CD4 Cy-Chrome; 4) CD29 FITC, CD54 PE, and CD 4 Cy-Chrome; 5) CD25 FITC, CD40 ligand (CD40L) PE, and CD4 Cy-Chrome; 6) HLA-DR FITC, CD2 PE, and CD4 Cy-Chrome; 7) CD11a FITC, CD95 PE, and CD4 Cy-Chrome; 8) CD49d FITC, CD27 PE, and CD4 Cy-Chrome; 9) CD80 FITC, CD86 PE, and CD4 Cy-Chrome; 10) CD30 FITC, CD58 PE, and CD4 Cy-Chrome; 11) CD26 FITC, CD44 PE, and CD4 Cy-Chrome; 12) CD134 FITC, CD152(CTLA-4) PE, and CD4 Cy-Chrome; and 13) unstained cells. Abs were purchased from Becton Dickinson (CD2 PE, CD69 PE, and HLA-DR PE), Exalpha (Boston, MA; IgG1 FITC, IgG1 PE), Immunotech (Westbrook, ME; CD11a FITC, CD25 FITC, and CD49d FITC), and PharMingen (San Diego, CA). After 30 min incubation on ice in the dark, cells were washed twice, resuspended in 200 µl staining buffer, and transferred to 5-ml tubes for FACS scanning. Of each stained sample, 5000 events were acquired in a forward scatter/sideward scatter lymphocyte gate. Cell surface marker expression was analyzed on the CD4+ lymphocyte population.
Statistical methods
Given the difficulty in obtaining large numbers of purified T cells to set up full limiting dilution experiments, we chose culture conditions aimed to obtain MBP-specific T cell lines arising from a single precursor cell per well. Such expectation was confirmed by the clonal profiles of TCR usage of the T cell lines (data not shown). This allowed us to estimate T cell precursor frequency of MBP-responding cells by dividing the number of responding wells by the number of wells seeded, multiplied by the number of cells per well.
Variance was measured by calculating SD. Differences between groups were evaluated by the unpaired t test. For data not normally distributed, the Mann-Whitney U rank sum test was applied. Statistical calculations were performed using SigmaStat software (Jandel Scientific, San Rafael, CA).
| Results |
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To estimate the frequency of autoantigen-specific T cells in the naive and memory resting CD4+ T cell population, we obtained highly purified CD45RA+/RO- and CD45RA-/RO+ cell subsets by negative selection. To assess the maximum proliferative capacity of the isolated subsets in response to potent stimuli, we compared the primary response to SAg (staphylococcal enteroxin A, staphylococcal enteroxin B, SEC1SEC3, staphylococcal enteroxin D, staphylococcal enteroxin E, and toxic shock syndrome toxin-1) at concentrations ranging from 10-2 to 102 ng/ml in dose-response proliferation assays. Cells from both subsets proliferated comparably well, indicating that universal T cell stimuli elicit similar responses both in naive and memory T lymphocytes. In contrast, the short-term reaction to TT in primary proliferation assays clearly resided in the CD45RO+ subset, as expected from a response to a recall Ag in immunized subjects. However, although a vigorous primary proliferation to TT (assayed after 3 days) could be detected only in the CD45RO+ subset, short-term TT-specific cell lines could be raised after rechallenge with the Ag from the CD45RA+ subset as well (data not shown).
We next dissected the T cell response of the subsets to MBP using
purified T cell subsets and APCs. Interestingly, it was the
CD45RA+ T cell population that originated
predominant responses to MBP, both in MS patients and in healthy
controls (Table I
). The estimated
precursor frequency of MBP-reactive T cells in the
CD45RA+ subset was significantly higher than in
the CD45RO+ subset of MS patients, (6.10 ±
3.41 x 10-6 vs 2.59 ± 2.13 x
10-6; p = 0.040). Although this
was true also for healthy donors (7.24 ± 1.79 x
10-6 vs 2.67 ± 1.33 x
10-6), the small number of subjects available
for analysis does not allow us to compare their precursor frequency of
MBP-reactive cells with that of MS patients.
|
To assess the Ag-fine specificities of TCC originating from either
subset, we tested MBP-reactive TCC in proliferation assays using a
panel of 16 overlapping MBP peptides. As summarized in Fig. 1
, the overall specificities corresponded
well to the pattern of immunodominant MBP epitopes previously
identified by others and by us (3, 4, 5, 26, 27, 28). However, a
clear skewing in the specificities of TCC derived from either subset
emerged. Most important, 13 of 14 TCC recognizing the immunodominant
epitope MBP(8199) originated from the
CD45RA+ subset. T cells responding to other
immunodominant regions of MBP, such as MBP(6179) in the
central region of the protein and MBP(141159) toward the
carboxyl terminus, resided as well in the naive pool (nine naive vs 1
memory TCC and seven vs none, respectively). Strikingly, when
considering individual patients, the MBP epitopes recognized by TCC
from either subset excluded each other almost completely (Table II
). Even in the case of naive- and
memory- derived TCC from a given subject responding to the same peptide
MBP (111129) (patient MS4), further epitope mapping with truncated
peptides delineated different nested epitopes, probably recognized by
distinct TCC. Consistent with this finding, in this patient naive
subset-derived MBP(116124)-specific TCC
MS4-RA2 and -RA11 and memory-derived
MBP(115125)-specific TCC MS4-RO1, -RO3 and
-RO7 expressed different TCR Vß genes, i.e., TCRBV3 and
TCRBV2, respectively.
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To define the T helper subtype of MBP-specific T cells emerging
from the CD45RA+ and
CD45RO+ subsets of MS patients, we measured the
secretion of pro (IFN-
, TNF-
)- and anti-inflammatory
cytokines (IL-4, IL-10) in culture supernatants of 41 TCC raised from 4
subjects , as well as the APC-activating factor GM-CSF. The
conventional types of T helper cells (Th1, Th2, and Th0) emerged from
both the naive and the memory subsets (Table III
). By using the IFN-
to IL-4
quotient as a marker of Th1- vs Th2-type cells, we failed to detect
clear-cut systematic differences in the cytokine secretion of TCC
derived from the naive and memory subsets (Fig. 2
). Although the small number of memory
subset-derived TCC available for analysis precludes a definitive
statement on their phenotype, naive subset-originating TCC were
predominantly Th1 or Th0, similar to observations on PBMC-derived TCC
specific for immunodominant MBP epitopes (5, 29).
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To estimate the functional avidity for the Ag of naive vs memory
subset-derived MBP-specific T cells, we determined the
EC50 of 35 representative, well-characterized TCC
(25 naive and 10 memory derived). CD45RA+
subset-derived TCC had significantly lower EC50
than CD45RO+ subset-derived TCC (0.50 vs 6.25
µg/ml, median; p < 0.001, Fig. 3
). Since the EC50
measure does not represent the receptor/ligand affinity in
physicochemical terms, but rather a functional equivalent of complex
interactions involving a number of molecules, we examined the
expression of the most important cofactors involved in cell
proliferation in these TCC. Among molecules regulating signaling and
homing of naive and memory T cells, we analyzed CD45RA, CD45RO, CD62L
(L-selectin), and CD27. Cell adhesion molecules under examination
included CD54 (ICAM-1), CD11a (LFA-1), CD2 (LFA-2), CD58(LFA-3), CD29
(ß1 integrin chain), CD49d (VLA-4), and CD44 (Pgp-1). We
also assessed the expression of molecules involved in Ag presentation,
costimulation, and T cell-B cell interactions such as HLA-DR, CD28,
CD80 (B7-1), CD86 (B7-2), CD152 (CTLA-4), and CD40L. Activation,
proliferation and apoptosis markers included CD25 (IL-2R
-chain),
CD26, CD30, CD69, CD134, and CD95 (Fas). Significant differences
between naive and memory subset-derived TCC are summarized in Fig. 4
. Interestingly, even after repeated in
vitro Ag stimulation of the TCC, consistent differences in their CD45R
isoform expression were still clearly detectable. The proportion of
CD28+ cells was greater in memory-derived TCC
(p = 0.003). CD29 expression was also strongly
associated with memory-derived TCC, both in terms of percent positive
cells (p < 0.001) and staining intensity
(p < 0.001). We observed a more prominent CD27
down-regulation (p = 0.018) and a larger
proportion of CD134+ cells
(p = 0.026) in the memory-derived TCC group.
Trends not reaching statistical significance included a larger number
of TCC expressing CD62Lhigh in the naive
subset-derived group and a greater proportion of
CD40L+ cells in the memory-derived TCC (data not
shown). The percentages of CD2-, CD11a-, CD49d-, CD58-, CD26-, and
CD44-positive cells neared 100% in almost all TCC, with comparable
fluorescence intensities. Similarly, >95% of all TCC tested were
CD54+. As expected from in vitro-stimulated T
cells, both naive and memory TCC included >80% of cells with
significant HLA-DR surface expression. Although there were only few
(<10%) CD152+ cells in each TCC, variable
proportions of CD25-, CD30-, CD80-, and CD86-positive cells were
observed, however, without systematic differences. Finally, there were
no significant differences in the surface expression of the
apoptosis-mediating molecule CD95 (Fas) on TCC derived from the
CD45RA+ or CD45RO+
subsets.
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| Discussion |
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This notion is first supported by the
2-fold higher frequency of
MBP-reactive T cells in the naive
CD45RA+/RO- subset that
did not depend on a biased viability, proliferative potential, or
coreceptor/adhesion molecule density of the progenitor T cell
population. In fact, viability and response to potent stimuli like SAg
did not differ in the naive and memory cell subsets. Levels of
expression of IL-2R, adhesion molecules, and ligands for costimulation
were lower in the purified CD45RA+ subset, thus
penalizing rather than favoring its proliferation potential
(11). Our results are in contrast to recent data reporting
a higher frequency of MBP-specific T cells in memory
CD45RO+ subsets from MS patients
(30). The different experimental setting might account for
this discrepancy. Burns et al. (30) generated MBP-specific T cell lines
from seeding PBMC populations depleted of cells expressing CD45RA or
CD45RO. Since not only lymphocytes, but also dendritic cells and
monocytes express CD45R isoforms (Refs. 3, 32 and our
observation), isoform depletion may affect Ag presentation by accessory
cells, which is crucial for the activation of naive T lymphocytes
(6, 11, 33). Different from that study, we compared the
precursor frequency in the two subsets using exact numbers of isolated
CD45RA+ and CD45RO+ T cells
and delivering antigenic presentation by means of unmanipulated
PBMC.
The second major finding of our study is that the human T cell response to immunodominant MBP epitopes mainly resides in the CD45RA+/RO- naive subset. This observation is in line with results obtained in experimental models of autoimmunity. Encephalitogenic T cells with specificity for the immunodominant regions of MBP could be selected in vitro from PBL and spleen cells of nonimmunized healthy Lewis rats (34). Similarly, the T cell repertoire of naive healthy rats harbored diabetogenic T cells (35). In addition, CD45RB high cells have autoaggressive potential toward several other target organs (36, 37). Unlike the case in inbred animal strains, however, MBP-reactive cells from either the naive or memory CD4+ T subsets of MS patients did not show the strong bias toward a Th1 phenotype which is characteristic for disease-mediating effector cells in experimental models of autoimmune diseases, but were phenotypically more diverse.
Although a prevalent T cell reactivity to MBP from the naive subset in MS patients could also be seen as a lack of involvement of this autoantigen in the pathogenesis of the disease, the detection of proinflammatory and activated MBP-specific T cells in MS patients by different functional assays argues against this possibility (38, 39, 40). Moreover, the increased frequency of MBP-specific T cells which can be raised in the absence of CD28/B7-mediated costimulation in MS patients (41, 42) has suggested the presence of myelin-reactive activated/memory cells. However, MBP-specific responses in those studies were not examined with respect to their origin in the CD45RA+ vs CD45RO+ compartments. The CD45RA+ T cell response to recall Ag increases 3- to 5-fold in the presence of anti-CD28 Ab (43), but it remains to be determined to which extent this population contributes to the overall response of PBMC in the absence of costimulation.
The differences we found in the human CD45RA+ and CD45RO+ MBP-specific T cell repertoires offer important clues to speculate on the possible mechanisms of regulation and maintenance of the autoreactive effector T cell pool. In this context, particularly significant are the more efficient recognition of antigenic epitopes by naive subset-derived TCC and the absence, in each individual subject, of resting memory T cells responding to epitopes recognized by the naive repertoire. Given the lower density of coreceptors like CD28 and CD29 observed on naive subset-derived cells, their Ag-specific responses at 10-fold lower concentrations appear to be significant and indicate that a greater functional avidity of TCR-MHC-peptide interactions outweighed poorer costimulation. The absence within each individual of memory T cells responding to epitopes recognized by the naive repertoire is difficult to reconcile with the hypothesis that primed MBP-specific cells might revert to a canonical naive phenotype, as shown in other systems (44). Rather, the lack of MBP epitopes shared by the naive and memory subsets in MS patients suggests that naive T cells specific for the immunodominant regions of MBP do not evolve beyond effector stage into resting long-term memory cells with CD45RA-/RO+ phenotype after priming and activation in vivo.
We propose that in MS, upon effective Ag priming probably due to a potent cross-reacting stimulus (45), sufficient TCR affinity, and adequate costimulation, naive CD45RA+ T cells become activated and proliferate in secondary lymphoid organs, acquiring a double-positive (CD45RA+/RO+) effector cell phenotype. These activated cells can reach the brain vascular endothelium via the peripheral blood and cross the blood-brain barrier. Their recognition of immunodominant epitopes of myelin Ag may elicit proinflammatory T cell functions and initiate a demyelinating attack. To limit the autoimmune process and restore self-tolerance, high-affinity MBP-primed T cells need to be neutralized by peripheral mechanisms, including clonal deletion and high-dose anergy (46, 47). This concept is supported by the recent observation of a strong T cell response to an immunodominant epitope in MBP-deficient (shiverer) mice, and the inactivation of the high-avidity MBP-specific repertoire in congenic MBP-expressing (C3H) mice (48). According to a recently proposed model (23), memory CD45RO+ cells, which we found to recognize subdominant MBP epitopes with low affinity, may have differentiated directly from the naive pool as a result of partial activation, bypassing the proliferative/effector stage. These cells could survive in the peripheral blood as a result of cross-reactive stimulation, facilitated by their high density of adhesion molecules and receptors for costimulation (46, 49).
Our interpretation implies that effector CD4+ cells mediating demyelination in MS are generated de novo from the CD45RA+ T cell pool and differentiate either into short-lived effector or long-term memory cells. Defining how naive cells can be recruited into an inflammatory focus leading to organ-specific immune attack warrants further studies. The detection of prevalent, immunodominant autoantigen-specific responses from the CD45RA+/RO- CD4+ T cell compartment points to this subset as the main reservoir of self-reactive cells, continuously available to trigger human autoimmune processes upon the appropriate stimuli.
| Acknowledgments |
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| Footnotes |
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2 Abbreviations used in this paper: MS, multiple sclerosis; EAE, experimental allergic encephalomyelitis; MBP, myelin basic protein; SAg, superantigen; TCC, T cell clone; TT, tetanus toxoid; CD40L, CD40 ligand. ![]()
Received for publication July 13, 1999. Accepted for publication March 1, 2000.
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4 and VLA-ß1 discriminates multiple subsets of CD4+ CD45R0+ "memory" T cells. J. Immunol. 149:4082.[Abstract]
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