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Component of T Cell Responses to Salmonella typhimurium1
National Institute of Immunology, New Delhi, India
| Abstract |
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from CD4 T cells. Mechanisms
linking intracellular pathogen recognition with induction of
IFN-
-producing T cells are still poorly understood. We show in this
study that IL-12 is not required for commitment to the
IFN-
-producing T cell response in infection with Salmonella
typhimurium, but is needed for its maintenance. The
IL-12-independent signals required for commitment depend on events
during the first hour of infection and are related to Ag presentation.
Even transient attenuation of Ag presentation early during infection
specifically abrogates the IFN-
component of the resulting CD4 T
cell response. The IL-12 needed for maintenance is also better induced
by live rather than dead bacteria in vivo, and this difference is due
to specific suppression of IL-12 induction by dead bacteria. Presence
of exogenous IL-4 down-modulates IL-12 production by macrophages
activated in vitro. Furthermore, macrophages from IL-4-null mice
secrete high levels of both IL-12 and IL-18 in response to stimulation
in vivo even with dead bacteria, but this does not lead to induction of
IFN-
-secreting T cells in response to immunization with dead
S. typhimurium. Early IL-4 is contributed by triggering
of CD4 NK T cells by dead, but not live, bacteria. Thus, Ag
presentation-related IL-12-independent events and IL-4-sensitive
IL-12-dependent events play crucial complementary roles in the
generation of the IFN-
-committed CD4 T cell component of the immune
response in Salmonella infection. | Introduction |
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(1, 2, 3). Commitment of responding CD4 T cells to production
of cytokines such as IFN-
, IL-4, IL-5, IL-10, and others can be
controlled by Ag-nonspecific signals such as CD80/CD86, IL-12/IL-18,
IL-6, IL-4, or IFN-
(2, 4, 5, 6), as well as by
peptide-MHC class II (MHCII) complex availability (7, 8).
Pathogenic products can modulate many of these signals, and induce
secretion of cytokines both from APCs (9) and from NK
lineage cells (10, 11, 12). FIPs such as
Salmonella, Mycobacterium, Leishmania,
or Listeria use a variety of strategies to find safe niches
inside phagocytic cells (13, 14, 15), which may influence Ag
processing and presentation. However, it is unclear which pathways are
actually used in regulating cytokine balance commitment in response to
a given infecting pathogen so as to trigger the most optimal effector T
cell cytokine profile for achieving clearance of infection.
We have used the FIP Salmonella typhimurium (Stm), a natural
mouse pathogen, to examine how triggering of IFN-
-making T
(IFN-
-T) cells against FIPs is regulated. We have shown earlier that
immunization of mice with live Stm activates an IFN-
-T cell response
(16), even when an auxotrophic mutant, Stm-aroA, which
cannot multiply in vivo, is used (17), whereas injection
of dead Stm triggers an equivalent magnitude of T cell responses that
cannot, however, secrete IFN-
. We have now further analyzed signals
required for inducing IFN-
-T cell responses to live Stm, and we
demonstrate in this study that while IL-12-independent signals required
for commitment of the T cell response to IFN-
are mediated through
MHCII-restricted Ag presentation, the IL-12 induction needed for
maintenance of the IFN-
-T cell response is controlled by
presentation to NK T cells, illustrating the complex role Ag
presentation plays in qualitative regulation of the T cell response to
infection.
| Materials and Methods |
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Mouse strains from The Jackson Laboratory (Bar Harbor, ME) or as
a gift from L. van Kaer (Vanderbilt University, Nashville, TN), and
maintained in the Small Animal Facility of the National Institute of
Immunology (New Delhi, India) were used with the approval of the
Institutional Animal Ethics Committee (two to five mice per group). For
engineered mutant mouse strains, syngeneic mice served as wild-type
(WT) controls. A metabolic mutant strain of Stm, Stm-aroA, was used for
immunization either live or after heat killing in a boiling waterbath
(17) at
1 x 106 Stm-aroA
i.p. per mouse. Parenteral gentamicin (GM) and tetracycline (TC) (1 mg
each/mouse/day) treatment was initiated at various times to kill both
extracellular and intracellular Stm, and was continued daily until
euthanasia. Parenteral chloroquine (CQ) was given as a single dose (0.5
mg/mouse) at the times indicated.
Measurement of CFUs of intracellular Stm
Stm-infected mice were given GM (1 mg/mouse/day) at indicated times, and euthanized 48 h later. Splenic cells were isolated, washed, and lysed in 1% taurocholate in PBS, and dilutions were plated on Luria Bertani agar plates for overnight incubation at 37°C for CFU enumeration.
Lymphocyte proliferation assays
Splenic cells from immunized mice were cultured in the presence of titrated amounts of sonicated Stm extract (Stm sonicate) in Clicks medium (Irvine Scientific, Irvine, CA) containing 10% FBS (Biological Industries, Rehovot, Israel), glutamine, and antibiotics. After 4 days of incubation, cultures were pulsed with 0.5 µCi [3H]thymidine (New England Nuclear, Boston, MA), harvested, and counted (Betaplate; LKB-Pharmacia, Turku, Finland). Counts from triplicate cultures are expressed as mean ± SEM.
Cytokine estimation
For cytokine estimation in T cell activation assays, culture supernatants (CS) were harvested at 60 h. For estimating cytokine induction from macrophages ex vivo, plastic-adherent peritoneal cells from mice given dead or live Stm-aroA i.p. 24 h earlier were cultured in titrating numbers for 24 h, and CS collected. For triggering cytokine secretion from peritoneal cells in vitro, live or dead Stm were added to wells with titrating cell numbers in presence or absence of rIL-4 (10 ng/ml; R&D Systems, Minneapolis, MN), where appropriate, and CS collected at 48 h. Cytokines were measured using commercial enzyme immunoassay systems (R&D Systems), with recombinant cytokine standards run in parallel for quantitation.
Flow cytometry
For measuring phagocytosis, FITC-labeled live or dead Stm-aroA were used. The viability of labeled live Stm-aroA was 90%. Peritoneal cells from mice receiving equal numbers of live or dead fluorescein-labeled Stm-aroA 15240 min earlier were harvested and analyzed for cell-associated bacteria by flow cytometry (Bryte; Bio-Rad, Hemel Hampstead, U.K.). For detecting intracellular IL-4 in NK T cells, spleen cells from mice given live or dead Stm 24 h previously were stained for CD4 and NK1.1 in two separate colors, and then permeabilized and stained for IL-4, according to manufacturers instructions (BD PharMingen, San Diego, CA), before being subjected to flow cytometry (LSR; BD Biosciences, San Jose, CA). Flow cytometric data were analyzed with FlowJo software (Treestar, San Jose, CA).
Statistical analysis
Wherever appropriate, Students t test was applied to calculate significance.
| Results |
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-T cell responses in vivo
When we immunized C57BL/6 mice with either live or dead Stm-aroA
i.p., the proliferative responses (Fig. 1
A) of their splenic cells to
Stm Ags in vitro at day 7 postimmunization (p.i.) were similar, as were
the levels of IL-10 induced in CS (Fig. 1
C). However, high
IFN-
levels were seen in CS from live Stm-immune cells, while
practically no IFN-
was seen in CS from dead Stm-immune cells (Fig. 1
B). The ratio of IFN-
:IL-10 levels in T cell CS from
live Stm-immune mice was significantly different from those from dead
Stm-immune mice (p < 0.01). Spleen cells from
unimmunized mice did not respond to Stm sonicate in vitro (data not
shown). If MHCII-null (MHCII-/-) mice were
similarly immunized with live Stm-aroA, their spleen cells did not
generate IFN-
responses (Fig. 1
D), while TAP-1-null mice
generated excellent responses (Fig. 1
E), demonstrating that
the response being read out was mediated by MHCII-restricted T
cells.
|
induction in
T cells (18), we measured IL-12 and IL-18 levels secreted
by peritoneal macrophages from mice given live or dead Stm in vivo.
Macrophages from mice given live Stm secreted higher levels of both
IL-12 and IL-18 than those from mice given dead Stm (Fig. 1
in the T cell responses triggered.
IL-12-null mice can generate an IFN-
-T cell response but cannot
maintain it
To examine the role of IL-12 in anti-Stm T cell responses, we
immunized WT or IL-12p40-null mice with live or dead Stm-aroA. Anti-Stm
proliferative responses of splenic cells in vitro were similar between
the two groups at both 3 and 7 days p.i. (Fig. 2
, A and B), as
were the levels of IL-10 induced (Fig. 2
, C and
D). In WT mice, live Stm immunization led to induction of
detectable IFN-
levels even at 3 days p.i. (Fig. 2
E), and
these IFN-
levels increased significantly (p <
0.05) at 7 days p.i. (Fig. 2
F), while no such induction was
seen in T cells from dead Stm-immune mice. Interestingly, live
Stm-mediated induction of IFN-
-T cells was almost unaffected at 3
days p.i. in IL-12p40-null mice (Fig. 2
E). However, the
levels of IFN-
induced did not go up further at 7 days p.i. in
IL-12-null mice, unlike in WT mice (Fig. 2
F). These data
showed that even in the absence of IL-12, live Stm immunization could
induce commitment to an IFN-
-T cell response, but its maintenance
required IL-12.
|
-T cell commitment in response to live Stm
involves Ag presentation
We next examined the possible role of Ag presentation-related
events in the induction of IFN-
-T cell responses to Stm. The H-2 M
(human HLA-DM) molecule catalyzes peptide loading onto MHCII in
endolysosomal compartments (19). We immunized WT or H-2
M
-null mice with live or heat-killed Stm-aroA. Seven days p.i.,
proliferative responses of spleen cells were comparable in all groups
(Fig. 3
A). However, H-2 M-null
mice generated no IFN-
-T cells in response to live Stm (Fig. 3
B). We confirmed that the proliferative responses being
detected were from CD4 T cells by adding anti-CD4 mAb to the recall
cultures, which blocked the proliferative responses (Fig. 3
C). Although H-2 M-null mice could not generate any IFN-
component in their T cell responses to live Stm, their macrophages
secreted unchanged levels of IL-12 in response to live Stm (Fig. 3
D), suggesting that IL-12-independent events relevant for
IFN-
commitment of CD4 T cells against live Stm involve Ag
presentation.
|
-T cell responses depends on early events
during Stm infection
To extrapolate from H-2 M-null mice to normal WT mice, it was
necessary to compromise Ag presentation transiently during Stm
immunization in WT mice. For this, we first established the time window
over which Stm had to be alive in vivo to induce IFN-
-T cell
responses. GM + TC treatment to kill Stm in vivo was either initiated
just before live Stm injection, or 30 min later. One week p.i., the
magnitude of splenic cell proliferative responses was comparable in all
groups of immunized mice (Fig. 4
A). However, if antibiotic
treatment was initiated along with live Stm injection, IFN-
-T cell
induction was prevented, while treatment begun 30 min after bacterial
injection allowed efficient commitment to IFN-
-T cell pathways (Fig. 4
B). Thus, live Stm are needed for only a short period after
infection for induction of T cells committed to making IFN-
.
|
Early events mediating commitment to IFN-
-T cell responses to
live Stm are sensitive to chloroquine
To block Ag presentation transiently during this critical early
time window, we used a single dose of CQ, a lysosomotropic agent known
to block MHCII-restricted presentation (21). CQ was given
in a single dose either along with live Stm, or 2 h later. GM + TC
treatment was initiated 1 h postinfection. CQ treatment at either
time point had no effect on the magnitude of proliferative spleen cell
responses triggered (Fig. 5
A).
If CQ treatment was initiated at 2 h postinfection, normal
IFN-
-T cell responses were triggered (Fig. 5
B),
establishing that CQ did not abrogate anti-Stm T cell responses.
However, if CQ was given along with live Stm, T cell commitment to
IFN-
was inhibited by 10- to 30-fold (Fig. 5
B).
Macrophages from live Stm-immunized mice given CQ secreted levels of
IL-12 indistinguishable from mice given live Stm alone (Fig. 5
C), showing that the CQ-inhibitable early event responsible
for triggering IFN-
-T cells was IL-12 independent.
|
We also examined the control of induction of IL-12 by live, but
not dead Stm in vivo. When live or dead Stm were used to stimulate
macrophages in vitro, equivalent levels of IL-12 were generated (Fig. 6
A), consistent with previous
reports (22). Also, when peritoneal macrophages were
harvested 24 h after injection of live or dead Stm and cultured in
vitro for a further 24-h period, and cytokines secreted by them were
measured, it was evident that, while macrophages from mice given live
Stm showed higher levels of IL-12 and IL-18 as compared with cells from
dead Stm-immune mice (Fig. 6
, B and C), the
levels of IL-1
, TNF-
, and IL-10 secreted were not different (Fig. 6
, D, E, and F), suggesting that
induction of IL-12 and IL-18 by dead Stm is specifically suppressed
in vivo.
|
We tested whether IL-4, claimed to be an inhibitor of IL-12
induction (23), could suppress IL-12 induction. The
addition of rIL-4 into macrophage cultures stimulated with Stm
efficiently suppressed IL-12 induction in vitro (Fig. 7
A). We therefore tested
whether IL-4 played a role in the induction of IL-12 in vivo. IL-4-null
or WT mice were given either live or dead Stm, and IL-12 and IL-18
secreted by their peritoneal macrophages were estimated. Although live
Stm triggered equivalent levels of IL-12 and IL-18 from both IL-4-null
and WT mice, dead Stm could evoke a similar induction of IL-12 and
IL-18 in IL-4-null mice, but not in WT mice (Fig. 7
, B and
C), suggesting that in WT mice administration of dead Stm
specifically induced IL-4-mediated suppression of IL-12 and IL-18
production.
|
-T cell responses in WT and IL-4-null
mice. Although anti-Stm proliferative responses of immune T cells
from all groups were comparable (Fig. 7
, while dead Stm did not (Fig. 7
, despite triggering high levels of
IL-12 and IL-18. Suppression of IL-12 induction in vivo in mice given dead Stm is mediated by nonclassical MHC class I-restricted NK T cells
Because the IL-4-mediated suppression of IL-12 in vivo in response
to dead Stm was an early event mediated in the first 24 h after
injection, we looked at the most likely candidate component of the
innate immune system capable of secreting IL-4 early after exposure,
the NK T cells. Spleen cells from mice receiving either live or dead
Stm 24 h before euthanasia were stained for CD4 (Fig. 8
A), NK1.1 (Fig. 8
B), and intracellular IL-4 (Fig. 8
D). NK T cells
from dead Stm-immunized mice showed substantial increase in size (Fig. 8
C) as well as induction of intracellular IL-4 (Fig. 8
D), while cells from live Stm-immunized mice did not,
showing that dead Stm triggered NK T cells better than live Stm could.
NK T cells from IL-4-null mice given live or dead Stm showed no
staining for IL-4 (data not shown), confirming the specificity of
detection.
|
2-microglobulin
(
2m)-null mice in comparison with WT mice,
because TAP-1-null mice have normal CD1-restricted NK T cells, while
2m-null mice lack them (24, 25).
All three strains showed similar induction of IL-12 levels in response
to live Stm (Fig. 8
2m-null mice (Fig. 8| Discussion |
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-T cells for protective immunity. However,
the mechanisms by which detection of the intracellular nature of FIP
infection is connected to induction of IFN-
-T cell responses are not
yet clear. Our data in this study suggest that rapid ingress of live
Stm into APCs and associated early Ag presentation-related events
culminate in specific commitment to IFN-
-T cell responses in an
IL-12-independent fashion. The induction of IL-12 is crucially needed
for maintaining immune response to live Stm, and is ensured by the
absence of its IL-4-mediated suppression that is normally seen in
response to dead Stm via activation of NK T cells.
All proliferative and IFN-
responses we have reported in this work
require MHCII and are inhibited by anti-CD4 mAb in culture,
ensuring that selective induction of IFN-
in responding
MHCII-restricted CD4 T cells is being measured. We have also estimated
a non-IFN-
cytokine in all these experiments, and the levels of
IL-10 induced follow the proliferative responses in magnitude, again
confirming that the modulatory effects observed are specific to IFN-
induction. We have also observed that immunization with dead Stm
induces greater levels of IL-13, a Th2 cytokine, than immunization with
live Stm does (data not shown), confirming the radical cytokine profile
shift observed between the two modes of immunization.
It has been reported that IL-12 induces IFN-
responses in activated
T cells (2, 3) and IL-12p40-null mice are susceptible to
FIP infections (18, 23). However, we show in this work
that live Stm induce a IFN-
-T cell response quite well in
IL-12p40-null mice early after immunization. Thus, IL-12 is not
essential for selective commitment to IFN-
in live Stm-induced T
cell responses. In support of other reports (26, 27), our
results also show that the absence of IL-12 does cause lack of
maintenance of IFN-
-T cell response, so that at 7 days p.i., cells
from immunized IL-12-null mice make relatively little IFN-
in their
responses. By day 20, there is no detectable IFN-
-T cell response in
live Stm-immune IL-12-null mice (data not shown). We find normal IL-18
levels in IL-12-null mice receiving live Stm (data not shown). Thus,
IL-12 is not necessary to induce IFN-
-T cell responses, but is
essential (and nonreplaceable by IL-18) for maintaining them.
We have examined Ag-nonspecific signals reported to be involved in
IFN-
-T cell commitment, and have not observed any differences in
induction of the cell surface molecules CD40, CD80, CD86, ICAM-1, or
LFA-1 by flow cytometry, or in mRNA levels of TGF-
, ligand for
chemokine receptor CCR4, or ligand for chemokine receptor CXCR3 by
real-time quantitative RT-PCR (Taqman) analysis, in APCs from mice
recently given live or killed Stm (data not shown). No differential
modulation of Ag-nonspecific signals by live vs killed Stm can
therefore be invoked to explain the induction of IFN-
-T cell
responses by live Stm.
In contrast, our data do show that Ag presentation-related events play
a crucial role in IFN-
-T cell induction by live Stm. APCs from H-2
M-null mice show defective presentation of many Ags on MHCII, although
they present exogenous peptides well, but these mice can still generate
CD4 T cell responses to some immunogens (28). The Stm
sonicate used in this study for recall responses contains sufficient
degraded peptidic moieties to be well presented without processing by
fixed APCs (data not shown), ensuring its efficient presentation by H-2
M-null APCs during recall assays. In H-2 M-null mice, live Stm did not
generate any IFN-
-T cell response, although the magnitude of T cell
priming was unaffected, as indicated by proliferative responses and
induction of IL-10 (data not shown), suggesting a role for Ag
presentation in the IFN-
-T cell response induced by live Stm.
However, it remained possible that the known changes found in the
positively selected TCR repertoires of H-2 M-null mice (19, 28) may have contributed to the phenomenon observed,
necessitating transient inhibition of Ag processing in WT
mice.
The antibiotic treatment-based data show that Stm are required to be
live only for the first 30 min in vivo for the eventual induction of
IFN-
-T cell responses. This time window correlates with the more
rapid entry of live than killed Stm into APCs. FIPs such as Stm
efficiently enter phagocytes (20) and persist in early
endosomal compartments by redirecting their intracellular transport
pathways (29). Parasitophorous vacuoles can contain H-2 M
(30), and peptide-MHC complexes can be formed efficiently
in phagosomes (31). We (8) and others
(7, 32) have shown that increased efficiency of Ag
presentation can enhance the IFN-
-T cell responses, raising this
possibility in the present case as well. Furthermore, recent evidence
suggests that Ag presentation for as short a period as 2 h may be
enough to induce commitment in responding T cells (33),
providing one possible explanation for the data we report in this
work.
Such an explanation is supported by our findings using CQ, a known
inhibitor of endolysosomal acidification that inhibits presentation of
Stm Ags to Stm-immune T cells in vitro (data not shown). The dose of CQ
used is within the clinical range, and CQ did not show any toxicity
against Stm (data not shown). The use of a single dose of CQ to block
Ag presentation on MHCII transiently in vivo did not change the
magnitude of the T cell responses. However, CQ treatment inhibited the
IFN-
-T cell response to live Stm only if treatment was initiated
along with immunization, and not if it was started 2 h after
immunization. The data with CQ treatment and H-2 M-null mice together
suggest strongly that, rather than any repertoire restriction in H-2
M-null mice, early Ag presentation-related events associated with
presence of live Stm are likely to be essential, despite being
themselves transient, for mediating long-range commitment of responding
T cells to IFN-
. Early events may mediate identification of the FIP
nature of an incoming infection so that responding T cells may commit
themselves quickly to IFN-
-T cell pathway, and it is surprising and
significant that these early events may function through differential
Ag presentation.
The ability of H-2 M-null mice or CQ-treated WT mice to produce IL-12
in vivo is not compromised, despite inefficient commitment to IFN-
-T
cell responses against live Stm. High levels of IL-12 and IL-18 by
themselves, as found in IL-4-null mice receiving dead Stm, are not
sufficient to trigger IFN-
-T cell responses. Thus, IL-12 appears to
have little influence on the IFN-
-T cell commitment during Stm
infection. It must be noted that these findings may be Stm specific,
since IL-12 is a major crucial factor for preferential IFN-
-T cell
responses during infection by Leishmania
(34).
On the other hand, IL-12 is clearly essential for the maintenance of
the IFN-
-T cell response against live Stm, which is initially
triggered in IL-12-independent fashion. Our data show that live and
dead Stm trigger IL-12 and IL-18 differentially, while they induce
equivalent levels of other APC-derived cytokines such as IL-1
,
TNF-
, or IL-10. This indicates the possibility that there may be
specific suppression of IL-12 induction in response to dead Stm. This
was also supported by the IL-4-mediated inhibition of IL-12 production
in vitro, and by the ability of macrophages from IL-4-null mice given
dead Stm to secrete high levels of IL-12 and IL-18.
The role of early IL-4 in naive CD4 T cell commitment has been extensively studied. Although most reports favor for a role of IL-4 in polarizing T cells to Th2 pathway (1, 2, 3), some reports indicate a role for IL-4 even in Th1 responses when used for DC maturation and priming along with CpG DNA (35). Our data show that IL-4 suppresses IL-12 and IL-18 induction from macrophages, and the disparity between our results and those previously reported (35) may be due either to the different cell types and/or receptors studied and/or the mouse strain used (36).
Because the IL-12 induction responses being read out are within 2448
h of immunization, it is likely that elements of the innate immune
system are the source of the regulatory IL-4 triggered by dead, but not
live Stm. NK T cells are known to respond rapidly to microbial
infection and secrete cytokines, including IL-4 (10, 12).
Our data show that dead Stm, but not live Stm, activate NK T cells and
induce IL-4 in them, providing strong support for their role in
regulating IL-12 induction by dead, but not live Stm. CD1-mediated Ag
presentation plays a prominent role in activating NK T cells in
situations such as mycobacterial infections (11), although
their ability to recognize Stm Ags is as yet unexplored. CD1-mediated
Ag presentation is TAP independent (24), but CD1
expression is
2m dependent (25).
Therefore, the finding that
2m, but not TAP-1,
is essential for suppression of IL-12 in dead Stm-injected mice
provides an indication that preferential CD1-mediated presentation of
dead Stm and not live Stm may be responsible for the differential
induction of IL-12 observed. Thus, the induction of IL-12, the cytokine
essential for maintenance of the IFN-
-T cell response, also appears
to be regulated by early Ag presentation-related events, albeit through
an entirely separate MHC-TCR interaction.
The model for explaining the generation of IFN-
-T cell responses
against live Stm, but not dead Stm, thus has two elements. In the
first, IL-12-independent phase of commitment, Ag-presentation-related
early stimuli provided by live, but not dead Stm would lead to
IFN-
-T cell commitment. Simultaneously, dead Stm would be presented
to NK T cells, leading to induction of IL-4 and suppression of IL-12.
Presentation of live Stm to NK T cells would be prevented, thus leaving
IL-12 induction unaffected, thereby ensuring that the IFN-
-T cell
response triggered in the first phase is maintained well. The major
factors determining the immune response outcome in favor of IFN-
following Stm infection thus appear to be associated with the
presentation of Stm Ags by priming APCs, on classical MHCII for the
IL-12-independent events responsible for commitment to IFN-
, and on
nonclassical MHC for the regulation of IL-12, which is essential for
maintenance of the IFN-
response. Thus, Ag presentation appears to
be complexly and crucially involved in the early immune sensing of live
Stm as an FIP.
| Acknowledgments |
|---|
| Footnotes |
|---|
2 Address correspondence and reprint requests to Dr. Vineeta Bal, National Institute of Immunology, Aruna Asaf Ali Road, New Delhi 110067, India. E-mail address: vineeta{at}nii.res.in ![]()
3 Abbreviations used in this paper: FIP, facultative intracellular parasite;
2m,
2-microglobulin; CQ, chloroquine; CS, culture supernatant; GM, gentamycin; IFN-
-T, IFN-
-making T; p.i., postimmunization; Stm, Salmonella typhimurium; TC, tetracycline; WT, wild type. ![]()
Received for publication January 14, 2002. Accepted for publication June 26, 2002.
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-dominant versus an interleukin-4-dominant immune response. Int. Immunol. 5:1431.
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production and type 1 cytokine responses. Immunity 4:471.[Medline]
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