The JI
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     
 


This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Julien, S.
Right arrow Articles by Pasquali, J.-L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Julien, S.
Right arrow Articles by Pasquali, J.-L.
Right arrowPubmed/NCBI databases
*Substance via MeSH
The Journal of Immunology, 2002, 169: 4198-4204.
Copyright © 2002 by The American Association of Immunologists

B Cell Positive Selection by Soluble Self-Antigen1

Sylvie Julien, Pauline Soulas, Jean-Claude Garaud, Thierry Martin and Jean-Louis Pasquali2

Laboratoire d’Immunopathologie, Institut d’Hématologie et d’Immunologie, Strasbourg, France


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
It is well established that autoreactive B cells undergo negative selection. This stands in paradox with the high frequency of so-called natural autoreactive B cells producing low affinity polyreactive autoantibodies with recurrent specificities, suggesting that these B cells are selected on the basis of their autoreactivity. We previously described two transgenic mouse lines (with and without IgD) producing a human natural autoantibody (nAAb) that binds ssDNA and human Fc{gamma}. In the absence of human IgG, nAAb-transgenic B cells develop normally. By crossing these mice with animals expressing knockin chimeric IgG with the human Fc{gamma}, we now show that the constitutive expression of chimeric IgG promotes the increase of nAAb-expressing B cells. This positive selection is critically dependent on the presence of IgD, occurs in the spleen, and concerns all mature B cell subsets, with a relative preferential enrichment of marginal zone B cells. These data support the view that soluble self-Ags can result in positive clonal selection.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
It is generally accepted that most autoreactive B cells are eliminated from the normal repertoire. Various mechanisms have been described relying on data mainly from Ig transgenic (Tg)3 mouse models (1, 2, 3). In the bone marrow, tolerance mechanisms operate mostly at the immature/transitional stages of B cell development (4). They include clonal deletion, receptor editing, and anergy, which may be just a state of delayed deletion (5). Autoreactive B cells that escape tolerization in the bone marrow are eliminated on peripheral encounter with the autoantigen (6, 7). In addition, experimental models have shown that physiological concentrations of naturally occurring self-Ags may effectively silence conventional B cells even when the affinity for autoantigen is moderate to low (8, 9). However, natural autoreactive B cells constitute an important part of the naive B cell repertoire in normal adults, and autoantibodies referred to as natural autoantibodies constitute a large fraction of serum IgM, indicating that many of these cells are not anergic (10). Natural autoantibodies (nAAbs) are usually polyreactive and bind with low affinity to a limited set of self-Ags (11). This observation, added to structure-function relationship studies of H chain complementarity-determining region 3 (12, 13), has suggested for a long time that nAAbs might be positively selected. Recent work has supported the view that this apparent paradox to the clonal tolerance theory may reside in the B-1 cell population (14).

Generally speaking, the idea of positive selection of B cells has left many groups skeptical for a long time, not only because of a lack of direct proof, but also because the model was initially proposed by analogy with T cell development and, even though some level of Ag receptor engagement by interaction with self-Ag has an obvious role in the establishment of a functional T cell repertoire, the biological function of a similar phenomenon in B cell ontogeny remains mysterious.

At present, the concept of positive selection of B cells is based on the following findings. A functional B cell receptor (BCR) is required for the emigration of immature B cells from the bone marrow to the spleen, and only a small fraction of them enters the long-lived pool (15, 16). The survival of follicular (FO) B cells in the periphery is also dependent on the expression of the BCR (17). Syk-deficient mice have a developmental block at the immature to mature B cell transition in the periphery, suggesting that a survival signal delivered in a receptor-specific fashion is mandatory at this stage (18). However, it is not clear whether these data reflect the necessity of a certain level of constitutive signaling through the BCR, as recently suggested (19), or whether endogenous Ags mediate the selection of the "chosen few" (20). Although the initial findings that the VH gene repertoires expressed in bone marrow pre-B cells (21) or in fetal liver (22) are more limited than that found in mature B cells could be explained by negative selection, a recent report by Shlomchik, Janeway, and coworkers (23) demonstrated a significant skewing of the VL repertoires in H chain-only Tg mice occurring at the immature to mature B cell transition and hardly attributable to pure negative selection. Recent studies of mutants that directly or indirectly perturb BCR signaling capacity concur to support a strength of signal model, in which there is a range of BCR-mediated signals less intense than those responsible for negative selection or full activation and differentiation, but necessary for complete B cell maturation (24, 25 , and references cited therein). In this model, the strength of the signal may also determine in which subset the newly generated B cell will reside. Experiments showing that B cells expressing a transgenic H chain derived from a neonatal mouse are positively selected in the marginal zone (MZ) repertoire also support this model (26).

Therefore, there is mounting indirect evidence that self-Ags drive the development of naive B cells, but Hardy’s (14) murine model, dealing with a monoreactive autoantibody directed against a membrane (mb)-bound Ag, is, to date, the only direct proof of such a positive selection of B cells. However, as mentioned earlier, nAAbs are mostly polyreactive, and mainly react with conserved soluble self-Ags such as ssDNA, IgG, thyroglobulin, or cytokines (10, 11). Precisely because of the polyreactivity profile of these nAAbs, demonstrating the role of a given autoantigen by its elimination is difficult, or even impossible. For this reason, we have generated Tg mice that express a prototypical human nAAb that reacts with different self-Ags, including ssDNA and human IgG (rheumatoid factor (RF) activity), but not with murine IgG. We have previously shown that, in the absence of constitutive expression of human IgG, these nAAb-producing B cells develop normally on a nonautoimmune background, without being anergic (27). Indeed, it was not possible, in these mice, to determine the role, if any, of ssDNA in the maturation of the Tg B cells. By crossing these animals with genetically modified mice constitutively expressing another soluble self-Ag (chimeric IgG1 with human {gamma}-chain C regions), we now observe a clear increase of the nAAb-producing B cells.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Mice

Transgenic mouse lines and conventional inbred C57BL/6 (The Jackson Laboratory, Bar Harbor, ME) were housed under standard conditions in the Institute’s animal facility. The RF transgenic mice expressing H and L chain genes encoding the chimeric murine-human nAAb bearing the G6 VH Id and the 17109 V{kappa} Id have been previously described (27). Briefly, founder lines were maintained by backcross mating with the C57BL/6 strain. H + L Tg mice were obtained by crossing H chain Tg mice with the L chain Tg mice. Double Tg mice (H + L) (nAAbµ{kappa} or nAAbµ{delta}{kappa}) were identified by PCR assay of tail DNA. These double Tg mice were bred to human IgG1 knockin mice (cIgG; a gift from W. Mueller and K. Rajewsky, Institute for Genetics, University of Cologne, Cologne, Germany) to generate mice that carry both the chimeric RF and the human IgG1 transgenes (nAAbµ{kappa} x cIgG and nAAbµ{delta}{kappa} x cIgG mice). Positive progeny of transgenic matings were identified by PCR assay of tail DNA for the detection of the RF transgene and by ELISA for the determination of humanized IgG1 (28).

Serum ELISA

Quantifications of IgMtot, IgMa, and IgMa/17109 were performed as described (27).

Flow cytometry analysis

Cells were prepared from bone marrow, spleen, and peritoneum, then stained as described (27). Cell phenotype was determined using the following reagents: anti-mouse B220 FITC, anti-mouse IgMa FITC, anti-mouse CD19 FITC, anti-mouse CD21 FITC, anti-mouse IgMa biotin, anti-mouse IgMb biotin, anti-mouse IgDa biotin, anti-mouse CD19 biotin, anti-mouse CD23 biotin, anti-mouse CD43 biotin, anti-mouse CD11b (Mac-1) biotin, anti-mouse CD86 (B7.2) biotin, anti-mouse CD44 PE, anti-mouse CD5 PE (all from BD PharMingen, San Diego, CA), 17109 biotin (provided by D. A. Carson, University of California, San Diego, CA), and G6 biotin (provided by R. Jefferis, University of Birmingham, Birmingham, U.K.).

Immunohistochemistry

Tissue samples were laid on a piece of cardboard in a drop of Tissue-Tek medium (Euromedex, Souffelweyersheim, France) and snap frozen in melting isopentane. Sections (8 µm thick) were cut in a cryostat and triple stained with fluorescein (dichlorotriazinyl amino fluorescein)-conjugated Affinipure F(ab')2 goat anti-human IgG (Jackson ImmunoResearch Laboratories, West Grove, PA), PE anti-mouse IgMa (PharMingen), and biotin 17109, followed by Cy-5 streptavidin (Amersham Pharmacia Biotech, Piscataway, NJ).

In vitro B cell activation and proliferation assays

Spleen cells were cultured, as described (27), in presence of one of the following reagents: LPS from Salmonella typhosa (Difco Laboratories, Detroit, MI), F(ab')2 goat anti-mouse IgM (Jackson ImmunoResearch), or monomeric human IgG (mhIgG). After 12 h of culture at 37°C, the phenotype of the cells was determined by two-color fluorescence analysis. For proliferation assays, splenocytes were labeled with CFSE (Molecular Probes, Eugene, OR), before the culture with LPS or anti-IgM or mhIgG. Suspensions of 107 cells/ml in 0.1% PBS/BSA were incubated with CFSE at a final concentration of 10 µM for 10 min at 37°C, then cells were washed and resuspended in the culture medium. After 4 days of culture, cells were analyzed by flow cytometry.

5-Bromo-2'deoxyuridine (BrdU) assay and cell cycle analysis

BrdU (Sigma-Aldrich, St. Louis, MO) was administered to mice in the drinking water at a concentration of 1 mg/ml for 1–4 days. The method used to detect BrdU in B cell DNA has been described in detail elsewhere (16). Briefly, spleen and bone marrow cells (1 x 106) were labeled with anti-mouse CD23 PE and anti-mouse IgMa biotin, then stained with streptavidin Cy-5 (Jackson ImmunoResearch). After washing with PBS, cells were resuspended in 0.5 ml ice-cold 0.15 M NaCl, then 1.2 ml ice-cold 95% ethanol was slowly added while gently vortex mixing the cells. Cells were incubated on ice for 30 min, then washed with PBS. One milliliter of PBS 1%, paraformaldehyde 0.01%, and Tween 20 was then added, and cells were incubated for 30 min at room temperature. Cells were pelleted by centrifugation (4000 rpm for 5 min, 4°C), then incubated for 10 min at room temperature with 1 ml 0.15 M saline that contained 4.2 mM MgCl2 (pH 5) and 50 Kunitz U/ml DNase I (Sigma-Aldrich). Samples were then washed with PBS, stained with anti-BrdU FITC (Caltag Laboratories, Burlingame, CA; 30 min, room temperature), washed with PBS, and analyzed by flow cytometry, as above. Gates for BrdU incorporation were set between two clearly separate populations, the negative population corresponding to that obtained in control mice not fed BrdU.

For cell cycle analysis, splenic cells were first stained with FITC- and Cy-5-labeled Abs directed against surface markers. Cells were then fixed with 70% ethanol. Propidium iodide (PI; 10 µg/ml) was added after a 30-min treatment with RNase.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
To study the contribution of autoantigens to the development of natural autoreactive B cells, we have generated two sets of Tg mice (µ{kappa} only and µ{delta}{kappa}) that express a nAAb with V regions of human origin (previously described in Ref. 27). The original Ab is a human nAAb reacting with low affinity with ssDNA as well as with soluble autoantigens, including thyroglobulin and human IgG (this nAAb is a prototype of natural G6+/17109+ RF (12)). We previously showed that grafting mouse C regions does not alter the nAAb reactivity toward the different Ags (27).

Soluble chimeric IgG (cIgG) induces an increase of autoreactive B cells in IgM/IgD, but not in IgM-only, Tg mice

By crossing double Tg mice nAAb µ{kappa} and nAAb µ{delta}{kappa} with cIgG knockin mice expressing the human {gamma}-chain C region (28), we generated animals that carry both the chimeric nAAb and the cIgG transgenes {kappa} x cIgG and µ{delta}{kappa} x cIgG mice). These animals were analyzed at 6–8 wk of age. They had nAAb B cells and cIgG-producing B cells that secreted variable amounts of cIgG in their serum (see below). In these animals, as judged by triple immunofluorescence analysis with anti-IgMa, 17109, and anti-human IgG, cIgG were produced by a small proportion of IgManegative/17109negative B cells, which were present in the spleens (close to 2%), excluding a cis effect (not shown).

Fig. 1Go shows clearly that, in µ{kappa} x cIgG and µ{delta}{kappa} x cIgG mice, the vast majority of splenic B220+ B cells coexpress the Tg H and L chains, respectively, µa+ and 17109+. Similar results were obtained in the bone marrow (data not shown). Thus, the transgene-encoded H and L chains exclude endogenous gene rearrangements and support B cell development. Staining with anti-IgMa (Tg) and anti-IgMb reveals that almost all of the IgM-expressing B cells in Tg mice use the transgene-encoded H chain. Only 3.5% of the splenocytes and 2% of the bone marrow cells express endogenous IgMb H chains in µ{kappa} x cIgG mice compared with 3% (spleen) and 1.5% (bone marrow) in µ{delta}{kappa} x cIgG mice (Table IGo).



View larger version (62K):
[in this window]
[in a new window]
 
FIGURE 1. Flow cytometry analysis of the phenotype of nAAb µ{delta}{kappa} x cIgG spleen cells. Tg and Tg- spleen cells were double stained with Abs, as indicated in Materials and Methods. Plots were gated on viable (PI-) lymphoid cells. Tgµ chains were indifferently detected by anti-IgMa or G6 anti-idiotype. The percentages of cells in the quadrants are given. Data are representative of groups of eight mice.

 

View this table:
[in this window]
[in a new window]
 
Table I. Characteristics of the different transgenic animalsa

 
A quantitative analysis reveals important differences in the B cell compartments in these mice. As shown in Table IGo and Fig. 2Go, the percentages and absolute numbers of nAAb B cells are significantly increased in µ{delta}{kappa} x cIgG mice (58%, 35.106 in spleen; 36% in bone marrow) compared with µ{kappa} x cIgG mice (35%, 17.106 in spleen; 27% in bone marrow), and compared with control nAAb Tg animals µ{delta}{kappa} (34%, 8.106 in spleen; 20% in bone marrow) and µ{kappa} (30%, 10.106 in spleen; 24% in bone marrow). Both the absolute numbers and the proportions of mature splenic B cells (CD23+) are increased; they are also more abundant in the bone marrow, where they probably represent recirculating B cells from the periphery. We also observe an increase of nAAb Tg B cells in the peritoneal cavity of µ{delta}{kappa}-cIgG mice, but this increase is not associated with a significant rise of CD5+ or CD11b/Mac-1+ cells. Thus, the analysis of the four Tg lines strongly supports the notion of a positive selection of the nAAb B cells, which requires both the introduction of the new soluble self-Ag and the presence of the mb IgD.



View larger version (29K):
[in this window]
[in a new window]
 
FIGURE 2. Absolute numbers of nAAb Tg splenic B cells, with or without cIgG. Each symbol represents one mouse.

 
Positive selection is dependent on BCR specificity, but not correlated with the level of Ag expression

To make sure that the specificity of the Tg BCR for its ligand (cIgG) is indeed involved in the observed phenomenon and mediates the selection signal, we analyzed µ{delta} H chain-only Tg mice crossed with cIgG mice (µ{delta} x cIgG), a condition that allows natural pairing of the transgenic H chains with endogenous L chains. The results, indicated in Table IGo and Fig. 2Go, show a lack of increase of IgMa+ B cells, despite the presence of both the cIgG and the {delta}-chain in these mice. This comparison, added to the µ{kappa} x cIgG analysis, also argues against the possible influence of the genetic background of the cIgG knockin animals on the observed results.

As indicated in Table IGo, the levels of cIgG present in the serum of the cIgG Tg mice are quite variable, ranging from as few as 5 to 200 µg/ml (compared with 20–150 µg/ml in cIgG non-Tg mice), with the highest mean concentration in µ{delta}{kappa} animals. However, within the observed range of cIgG, there is no statistical correlation between the level of soluble self-Ag and the nAAb B cell increase.

Is the nAAb B cell development driven into a particular B cell subset?

Considering the possible influence of the BCR specificity on the generation of the different peripheral B cell subsets, we analyzed the phenotypic characteristics of the selected nAAb splenic B cells and compared them with nonselected B cells originating from nAAb Tg mice without cIgG, and from non-Tg control littermates. IgMa+-gated cells (or IgMb+-gated cells in control animals) were stained with anti-CD23 and anti- CD21 reagents (Fig. 3Go). It is clear that all the B cell subsets (6) are enlarged in µ{delta}{kappa} x cIgG compared with µ{delta}{kappa} mice: the absolute numbers of CD23highCD21positive (mature recirculating/B-2 cells) are increased, as well as the numbers of CD23negativeCD21low/negative (immature or transitional T1 B cells), CD23negativeCD21high (MZ B cells), and CD23positiveCD21high (transitional T2 B cells). However, it is interesting to note that the most important increase concerns the MZ B cells (11% vs 0.5%).



View larger version (34K):
[in this window]
[in a new window]
 
FIGURE 3. Phenotype of the splenic B cell populations of nAAb µ{delta}{kappa} x cIgG mice. Three-color FACS analysis, gated on viable (PI-) lymphoid cells, after staining with anti-CD21, anti-CD23, and IgMa. Plots are gated on IgMa+ cells (or IgMb+ in control animals). The percentages of splenocytes in the gates are given (absolute numbers in parentheses). The results are representative of the analysis of three mice.

 
Positive selection operates in periphery at the T1 and T2 steps of differentiation

In the spleen, transitional cells represent recent immigrants from the bone marrow (Hardy’s fraction E). In normal mice, they are short-lived with a life span of 3–4 days. Subsequently, they are either incorporated in the mature long-lived compartment or eliminated (16, 29, 30). To investigate the significance of the increased cell numbers in the spleen of µ{delta}{kappa} x cIgG mice, we used the BrdU-labeling technique. Mice were analyzed 1, 2, 3, and 4 days after the beginning of BrdU administration. In the bone marrow, the labeling rates of CD23negative Tg cells are lower than in control non-Tg animals, but comparable between µ{delta}{kappa} x cIgG and µ{delta}{kappa} animals, confirming that the presence of cIgG does not significantly influence the early steps of B cell development (Fig. 4Goa). In the spleens, the fraction of CD23negative Tg-labeled cells reaches a maximum of 25 ± 5% and of 10 ± 1.5% in µ{delta}{kappa} x cIgG and µ{delta}{kappa} mice, respectively, after 4 days of continuous treatment (Fig. 4Gob). The percentages of CD23negative-labeled cells remain constant thereafter (not shown), suggesting that they have comparable life spans in both types of Tg animals. Splenic B cells that are labeled after such a short BrdU pulse represent the balance of: 1) newly generated B cells that have just migrated from the bone marrow; 2) cycling splenic B cells that have incorporated BrdU in the spleen; and 3) labeled cells that died during the BrdU treatment (6). Because immature B cell numbers and labeling rates are comparable in the bone marrow, the increase of labeled cells in the spleens of µ{delta}{kappa} x cIgG can be attributed either to a better recruitment of labeled transgenic B cells just after leaving the bone marrow, or to an increased splenic B cell proliferation, or to a reduction in the proportion of labeled cells that died during the BrdU incorporation time.



View larger version (18K):
[in this window]
[in a new window]
 
FIGURE 4. Kinetics of BrdU labeling of B lymphocytes of nAAb µ{delta}{kappa} x cIgG mice in bone marrow (a) and in spleen (b). B cell populations were identified on the basis of the surface staining IgMa (or IgMb in control animals) vs CD23. The BrdU content of the cells was determined by flow cytometry. Each point represents the mean ± SE of values originating from three separate experiments.

 
To distinguish between these possibilities, we studied the cell cycle status of the different B cell subsets. Transitional T1 cells are the most immature cells and develop into T2 cells that generate the mature B cell pool (6). Surface staining with anti-IgMa and anti-CD23 Abs identified the different populations, and DNA content was measured with PI (Fig. 5Go). The results show that the great majority of mature and T1 cells are in the G0-G1 phase of the cell cycle, whereas 20–25% of the T2 cells from µ{delta}{kappa} mice and 30–35% of the T2 cells from µ{delta}{kappa} x cIgG animals are in the G2-M phase, confirming that T2 B cells are a population of cycling cells (6). These results are similar when identifying B cell subsets with anti-IgMa and anti-CD21 Abs (not shown). The slight increase in the fraction of T2 (CD23+) cells in G2-M cannot account by itself for the augmentation of the BrdU-labeled cells (that are mostly CD23-) as well as for the increases of the T1 and mature B cells in µ{delta}{kappa} x cIgG mice. Thus, we are left with a complex picture suggesting that self-IgG: 1) increase the recruitment rate into the T1 compartment of immature Tg B cells that have left the bone marrow; 2) increase the recruitment rate of the T1 cells into the T2 pool, where the cells have a slight proliferating advantage; and 3) increase the recruitment of T2 cells into the long-lived compartment of mature cells.



View larger version (41K):
[in this window]
[in a new window]
 
FIGURE 5. Cell cycle status of B cell subsets of nAAb µ{delta}{kappa} x cIgG and µ{delta}{kappa} mice. Spleen cells were stained with Abs to IgMa and CD23. PI was used to label DNA. For cell cycle, cells were gated in T1 + MZ, T2, and M, as indicated, and DNA content was measured in these subpopulations. Percentages of T2, M, and T1 + MZ B cells in the G2-M phase of the cell cycle are given.

 
The positively selected B cells are not anergic

Different data argue against spontaneous activation of nAAb-expressing B cells in µ{delta}{kappa} x cIgG mice. First, the Tg IgMa+/17109+ Abs are poorly secreted in these animals: despite the overrepresentation of nAAb B cells, their contribution to the total secreted IgM is weak (5–10% of the total secreted IgM), and quite similar in presence or in absence of cIgG. Second, as determined by immunohistology (not shown), nAAb B cells are strictly localized in the B cell zones and are never detected within the germinal centers of secondary follicles or within the T cell zones, which could have indicated Ag-driven activation. And third, the Tg nAAb B cells are not phenotypically in vivo activated, as judged by unchanged basal expression of CD86, CD44, CD80, and CD69 on CD23- and CD23+ Tg B cells (data not shown).

We have previously shown that nAAb Tg B cells originating from mice lacking the cIgG self-Ag were ignorant to human IgG stimulation in vitro, but were activatable by both anti-IgM and LPS (27). The introduction of the new self-Ag in these mice does not modify the reactivity profile of the nAAb B cells when stimulating by LPS, anti-IgM, monomeric, and aggregated human IgG both in terms of the levels of expression of activation markers CD86, CD44, and MHC class II (Fig. 6Goa), and in terms of proliferation (CFSE labeling) (Fig. 6Gob). In addition, LPS stimulation at 72 h results in secretion of Tg-IgM from µ{delta}{kappa} x cIgG mice (913 ± 110 ng/ml, vs 107 ± 21 ng/ml before stimulation). Thus, these data indicate that BCR-dependent and BCR-independent pathways of B cell activation are functional in the positively selected B cells.



View larger version (32K):
[in this window]
[in a new window]
 
FIGURE 6. Effects of in vitro LPS, anti-IgM, mhIgG, and aggregated human IgG (aghIgG) stimulations on the levels of activation markers (a) and on the proliferation rate (b) of nAAb µ{delta}{kappa} x cIgG splenocytes. a, Spleen cells from nAAb µ{delta}{kappa} x cIgG, nAAb µ{delta}{kappa}, and Tg- mice were cultured for 12 h in the presence of LPS at 10 µg/ml, anti-mouse IgM at 10 µg/ml, mhIgG at 1000 µg/ml, aghIgG at 1000 µg/ml (thick line), or medium alone (dotted line), then stained with anti-CD19 and anti-CD86, anti-MHCII, or anti-CD44, and analyzed by flow cytometry. Histograms show CD86 staining of CD19+ cells gated on viable (PI-) lymphoid cells. Similar results were obtained with MHCII and CD44 staining. b, Spleen cells from nAAb µ{delta}{kappa} x cIgG, nAAb µ{delta}{kappa}, and Tg- mice were labeled with CFSE and cultured for 4 days in the presence of LPS at 10 µg/ml, anti-mouse IgM at 10 µg/ml, mhIgG at 1000 µg/ml, or medium alone (NS, no stimulation), then stained with anti-CD19, and analyzed by flow cytometry. Histograms show CFSE staining of CD19+ cells gated on viable (PI-) lymphoid cells. Division is characterized by sequential halving of CFSE fluorescence. These results are representative of three independent experiments, and similar results were obtained with nAAb µ{kappa} x cIgG and µ{kappa} spleen cells.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
During the late steps of B lymphocyte development, the expression of a BCR is an absolute requirement for the recruitment and the maintenance of newly generated B cells in the mature long-lived pool (15, 16, 17). Not only is the BCR itself mandatory, but the BCR signaling pathway is also necessary, because many mutations affecting this pathway are known to interfere with B cell maturation (15, 18, 31, 32, 33, 34). Besides the indirect arguments mentioned earlier, the direct evidence that a self-Ag can be involved in B cell development comes from Hayakawa et al. (14). They elegantly showed that natural autoreactive B cells recognizing mb-bound Thy-1 are positively selected into the B-1 compartment. In the presence of the autoantigen, autoreactive B cells accumulate in the peritoneal cavity and secrete anti-Thy-1 nAAb in the serum. In this study, we extend these data to other mature B cell subsets (FO and MZ) and show that a soluble autoantigen can induce positive selection. Our data also suggest that the autoantigens bound by a polyreactive nAAb are not equivalent in their capacity to drive B cell maturation, which is consistent with the signal strength theory. In normal mice, the signal strength mostly depends on both the structure of the ligand, which regulates the extent of cross-linking, and the affinity of the BCR. Although we cannot directly evaluate the contribution of the other autoantigens recognized by the nAAb, including ssDNA, the presence of self-IgG clearly increases the mature B cell compartment, significantly modifies its composition, but, on the contrary to mb-bound Thy-1 Ag, does not induce nAAb secretion. This additional effect of IgG supports the view that endogenous Ags may cooperate to positively select B cells and could explain why natural IgM are frequently polyreactive.

To our surprise, soluble self-Ag induced positive selection of all mature nAAb B cell compartments. Our nAAb being a prototype of Abs usually produced by CD5+ B-1 cells, the results emphasize our current ignorance of all the molecular actors in B subpopulation commitment. Although transgenic animals with BCRs characteristic of CD5+ B-1 cells were shown to mainly develop into this cell subset (35, 36), our results indicate that this is not always true. Other parameters seem to influence the B cell decision, the most influential probably being the signal strength. Using Ig Tg mice, Lam and Rajewsky (35) demonstrated that when surface expression of a B1-canonical receptor is reduced through the expression of a second H chain, B cell development proceeds toward the B2 compartment. This suggests that, within the range of signals compatible with B cell positive selection, the strongest ones would lead to differentiation to the B-1 compartment. Also, Pillai and colleagues (25) recently showed that Btk is epistatic to Aiolos; in the absence of Aiolos, BCR signaling is enhanced and B cells accumulate as mature FO cells, whereas MZ B cells are absent. Conversely, in CD21/Cr2 null mice, there is a decrease in the absolute numbers of FO B cells, but a significant increase of MZ B cells (25). Together, these data support the idea that the intensity of the signal might determine the mature B cell subset in which the transitional cell will differentiate.

Another surprise comes from the contribution of mb IgD in the selection process. According to Watanabe et al. (37) and Kouskoff et al. (38), a possible explanation could be a lower density of the BCR on the surface of Tg B cells from µ{kappa} x cIgG due to the lack of IgD. However, both types of Tg mice express similar amounts of BCR, based on anti-{kappa}-chain staining and on the identity of the titration curves for binding of IgG (27). We previously observed that nAAb Tg mice expressing mb IgD and IgM have in proportion an increased mature B cell pool compared with Tg mice expressing only mb IgM (27). Similar findings were reported by others, supporting a role for mb IgD in B cell maturation (39). The reasons remain unclear because mb IgD and IgM apparently signal equally (40, 41, 42). However, this result suggests that B cells undergo positive selection mainly at a stage when they express mb IgD. In fact, our data show that self-Ag positively regulates B cell development at different steps between immature and mature stages. The effect on T1 cells, which classically do not yet express mb IgD, is probably responsible for the slight positive selection observed in µ{kappa} x cIgG mice.

Finally, our results raise two questions of importance: are all mature B cells naturally self-reactive and naturally selected on this basis? And what could be the significance of B cell positive selection? Clearly, natural autoreactive B cells are most probably selected by low affinity interactions with soluble or mb-bound autoantigens. Recently, it was suggested, on the basis of preliminary experiments, that all B cells are submitted to such a selection via BCR V region cross-recognition (43). Our results show that other conserved self-Ags are also able to select B cells. In contrast, the reduced numbers of mature B cells in germfree animals also suggest a role for xenoantigens in B cell ontogeny (6).

This leads to the last issue, namely the intriguing biological significance of B cell positive selection. Several lines of evidence, including recent data on {alpha}{beta} NKT and on {gamma}{delta} T cell specificities (44), suggest that, from a phylogenetic point of view, the immune system has evolved to components that are less and less dependent on self recognition for their development and functions. In this view, B cell positive selection might be a mere trace of the evolution of adaptive immunity. In contrast, natural Abs, after having been regarded as byproducts of B cell development, are now thought to play an important role in the early defense against bacteria and viruses (45, 46, 47). Positive selection of natural Abs could confer a biological advantage because the selecting Ags may give them the potential to cross-react with generic molecular patterns such as surface carbohydrates or nucleic acids of pathogens. In that case, positive selection of FO B cells would logically confer an analogous advantage. In addition to antigenic specificity, B cell positive selection also seems to determine in which subset the BCR-selected clones reside. This may be important to direct B cells with given specificities in strategically located sites (47). Although in our model differentiation into the MZ pool is only partial, it is interesting to note that a proposed role for natural RF B cells may be to function as universal APC for Ags trapped as immune complexes (48). This could be particularly useful and efficient to initiate secondary immune responses when the concentration of Ag is low. Because MZ B cells can develop more potent APC properties than naive FO B cells (49), preferential differentiation of natural RF B cells into the MZ pool may indeed confer a biological advantage.


    Acknowledgments
 
We thank M. Lemeur for transgenic mice, K. Rajewsky for the vectors and the human IgG1 knockin mice, D. Carson for gift of Abs, C. Benoist and D. Mathis for their critical reading of the manuscript, and E. Lozay for technical assistance.


    Footnotes
 
1 This work was supported by the Institut National de la Santé et de la Recherche Médicale (INSERM CRI 9702). S.J. was supported by the Association de Recherche sur la Polyarthrite. Back

2 Address correspondence and reprint requests to Dr. Jean-Louis Pasquali, Laboratoire d’Immunopathologie, Institut d’Hématologie et d’Immunologie, 1 place de l’hôpital, 67091 Strasbourg Cedex, France. E-mail address: Jean-Louis.Pasquali{at}hemato-ulp.u-strasbg.fr Back

3 Abbreviations used in this paper: Tg, transgenic; BCR, B cell receptor; BrdU, 5-bromo-2'deoxyuridine; cIgG, chimeric IgG; FO, follicular; mb, membrane; mhIgG, monomeric human IgG; MZ, marginal zone; nAAb, natural autoantibody; PI, propidium iodide; RF, rheumatoid factor. Back

Received for publication May 17, 2002. Accepted for publication August 9, 2002.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

  1. Goodnow, C. C.. 1996. Balancing immunity and tolerance: deleting and tuning lymphocyte repertoires. Proc. Natl. Acad. Sci. USA 93:2264.[Abstract/Free Full Text]
  2. Murakami, M., T. Honjo. 1997. Transgenic mouse models for B-cell dominant autoimmune diseases. Curr. Opin. Immunol. 9:846.[Medline]
  3. Nemazee, D., M. Weigert. 2000. Revising B cell receptors. J. Exp. Med. 191:1813.[Abstract/Free Full Text]
  4. Carsetti, R., G. Kohler, M. C. Lamers. 1995. Transitional B cells are the target of negative selection in the B cell compartment. J. Exp. Med. 181:2129.[Abstract/Free Full Text]
  5. Fulcher, D. A., A. Basten. 1994. Reduced life span of anergic self-reactive B cells in a double-transgenic model. J. Exp. Med. 179:125.[Abstract/Free Full Text]
  6. Loder, F., B. Mutschler, R. J. Ray, C. J. Paige, P. Sideras, R. Torres, M. C. Lamers, R. Carsetti. 1999. B cell development in the spleen takes place in discrete steps and is determined by the quality of B cell receptor-derived signals. J. Exp. Med. 190:75.[Abstract/Free Full Text]
  7. Russell, D. M., Z. Dembic, G. Morahan, J. F. Miller, K. Burki, D. Nemazee. 1991. Peripheral deletion of self-reactive B cells. Nature 354:308.[Medline]
  8. Hartley, S. B., C. C. Goodnow. 1994. Censoring of self-reactive B cells with a range of receptor affinities in transgenic mice expressing heavy chains for a lysozyme-specific antibody. Int. Immunol. 6:1417.[Abstract/Free Full Text]
  9. Rojas, M., C. Hulbert, J. W. Thomas. 2001. Anergy and not clonal ignorance determines the fate of B cells that recognize a physiological autoantigen. J. Immunol. 166:3194.[Abstract/Free Full Text]
  10. Coutinho, A., M. D. Kazatchkine, S. Avrameas. 1995. Natural autoantibodies. Curr. Opin. Immunol. 7:812.[Medline]
  11. Mouthon, L., A. Nobrega, N. Nicolas, S. V. Kaveri, C. Barreau, A. Coutinho, M. D. Kazatchkine. 1995. Invariance and restriction toward a limited set of self-antigens characterize neonatal IgM antibody repertoires and prevail in autoreactive repertoires of healthy adults. Proc. Natl. Acad. Sci. USA 92:3839.[Abstract/Free Full Text]
  12. Martin, T., S. F. Duffy, D. A. Carson, T. J. Kipps. 1992. Evidence for somatic selection of natural autoantibodies. J. Exp. Med. 175:983.[Abstract/Free Full Text]
  13. Martin, T., R. Crouzier, J. C. Weber, T. J. Kipps, J. L. Pasquali. 1994. Structure-function studies on a polyreactive (natural) autoantibody: polyreactivity is dependent on somatically generated sequences in the third complementarity-determining region of the antibody heavy chain. J. Immunol. 152:5988.[Abstract]
  14. Hayakawa, K., M. Asano, S. A. Shinton, M. Gui, D. Allman, C. L. Stewart, J. Silver, R. R. Hardy. 1999. Positive selection of natural autoreactive B cells. Science 285:113.[Abstract/Free Full Text]
  15. Torres, R. M., H. Flaswinkel, M. Reth, K. Rajewsky. 1996. Aberrant B cell development and immune response in mice with a compromised BCR complex. Science 272:1802.[Abstract]
  16. Allman, D. M., S. E. Ferguson, V. M. Lentz, M. P. Cancro. 1993. Peripheral B cell maturation. II. Heat-stable antigenhi splenic B cells are an immature developmental intermediate in the production of long-lived marrow-derived B cells. J. Immunol. 151:4431.[Abstract]
  17. Lam, K. P., R. Kuhn, K. Rajewsky. 1997. In vivo ablation of surface immunoglobulin on mature B cells by inducible gene targeting results in rapid cell death. Cell 90:1073.[Medline]
  18. Turner, M., A. Gulbranson-Judge, M. E. Quinn, A. E. Walters, I. C. MacLennan, V. L. Tybulewicz. 1997. Syk tyrosine kinase is required for the positive selection of immature B cells into the recirculating B cell pool. J. Exp. Med. 186:2013.[Abstract/Free Full Text]
  19. Bannish, G., E. M. Fuentes-Panana, J. C. Cambier, W. S. Pear, J. G. Monroe. 2001. Ligand-independent signaling functions for the B lymphocyte antigen receptor and their role in positive selection during B lymphopoiesis. J. Exp. Med. 194:1583.[Abstract/Free Full Text]
  20. Pillai, S.. 1999. The chosen few? Positive selection and the generation of naive B lymphocytes. Immunity 10:493.[Medline]
  21. Gu, H., D. Tarlinton, W. Muller, K. Rajewsky, I. Forster. 1991. Most peripheral B cells in mice are ligand selected. J. Exp. Med. 173:1357.[Abstract/Free Full Text]
  22. Malynn, B. A., G. D. Yancopoulos, J. E. Barth, C. A. Bona, F. W. Alt. 1990. Biased expression of JH-proximal VH genes occurs in the newly generated repertoire of neonatal and adult mice. J. Exp. Med. 171:843.[Abstract/Free Full Text]
  23. Levine, M. H., A. M. Haberman, D. B. Sant’Angelo, L. G. Hannum, M. P. Cancro, C. A. Janeway, Jr, M. J. Shlomchik. 2000. A B-cell receptor-specific selection step governs immature to mature B cell differentiation. Proc. Natl. Acad. Sci. USA 97:2743.[Abstract/Free Full Text]
  24. Cyster, J. G., J. I. Healy, K. Kishihara, T. W. Mak, M. L. Thomas, C. C. Goodnow. 1996. Regulation of B-lymphocyte negative and positive selection by tyrosine phosphatase CD45. Nature 381:325.[Medline]
  25. Cariappa, A., M. Tang, C. Parng, E. Nebelitskiy, M. Carroll, K. Georgopoulos, S. Pillai. 2001. The follicular versus marginal zone B lymphocyte cell fate decision is regulated by Aiolos, Btk, and CD21. Immunity 14:603.[Medline]
  26. Martin, F., J. F. Kearney. 2000. Positive selection from newly formed to marginal zone B cells depends on the rate of clonal production, CD19, and btk.V. Immunity 12:39.[Medline]
  27. Koenig-Marrony, S., P. Soulas, S. Julien, A. M. Knapp, J. C. Garaud, T. Martin, J. L. Pasquali. 2001. Natural autoreactive B cells in transgenic mice reproduce an apparent paradox to the clonal tolerance theory. J. Immunol. 166:1463.[Abstract/Free Full Text]
  28. Zou, Y. R., W. Muller, H. Gu, K. Rajewsky. 1994. Cre-loxP-mediated gene replacement: a mouse strain producing humanized antibodies. Curr. Biol. 4:1099.[Medline]
  29. Osmond, D. G.. 1991. Proliferation kinetics and the life span of B cells in central and peripheral lymphoid organs. Curr. Opin. Immunol. 3:179.[Medline]
  30. Rolink, A. G., C. Schaniel, J. Andersson, F. Melchers. 2001. Selection events operating at various stages in B cell development. Curr. Opin. Immunol. 13:202.[Medline]
  31. Benatar, T., R. Carsetti, C. Furlonger, N. Kamalia, T. Mak, C. J. Paige. 1996. Immunoglobulin-mediated signal transduction in B cells from CD45-deficient mice. J. Exp. Med. 183:329.[Abstract/Free Full Text]
  32. Satterthwaite, A. B., Z. Li, O. N. Witte. 1998. Btk function in B cell development and response. Semin. Immunol. 10:309.[Medline]
  33. Tarakhovsky, A., M. Turner, S. Schaal, P. J. Mee, L. P. Duddy, K. Rajewsky, V. L. Tybulewicz. 1995. Defective antigen receptor-mediated proliferation of B and T cells in the absence of Vav. Nature 374:467.[Medline]
  34. Zhang, R., F. W. Alt, L. Davidson, S. H. Orkin, W. Swat. 1995. Defective signalling through the T- and B-cell antigen receptors in lymphoid cells lacking the vav proto-oncogene. Nature 374:470.[Medline]
  35. Lam, K. P., K. Rajewsky. 1999. B cell antigen receptor specificity and surface density together determine B-1 versus B-2 cell development. J. Exp. Med. 190:471.[Abstract/Free Full Text]
  36. Arnold, L. W., C. A. Pennell, S. K. McCray, S. H. Clarke. 1994. Development of B-1 cells: segregation of phosphatidylcholine-specific B cells to the B-1 population occurs after immunoglobulin gene expression. J. Exp. Med. 179:1585.[Abstract/Free Full Text]
  37. Watanabe, N., S. Nisitani, K. Ikuta, M. Suzuki, T. Chiba, T. Honjo. 1999. Expression levels of B cell surface immunoglobulin regulate efficiency of allelic exclusion and size of autoreactive B-1 cell compartment. J. Exp. Med. 190:461.[Abstract/Free Full Text]
  38. Kouskoff, V., G. Lacaud, K. Pape, M. Retter, D. Nemazee. 2000. B cell receptor expression level determines the fate of developing B lymphocytes: receptor editing versus selection. Proc. Natl. Acad. Sci. USA 97:7435.[Abstract/Free Full Text]
  39. Brink, R., D. A. Fulcher, C. C. Goodnow, A. Basten. 1994. Differential regulation of early and late stages of B lymphocyte development by the µ and {delta} membrane heavy chains of Ig. Int. Immunol. 6:1905.[Abstract/Free Full Text]
  40. Nitschke, L., M. H. Kosco, G. Kohler, M. C. Lamers. 1993. Immunoglobulin D-deficient mice can mount normal immune responses to thymus-independent and -dependent antigens. Proc. Natl. Acad. Sci. USA 90:1887.[Abstract/Free Full Text]
  41. Brink, R., C. C. Goodnow, J. Crosbie, E. Adams, J. Eris, D. Y. Mason, S. B. Hartley, A. Basten. 1992. Immunoglobulin M and D antigen receptors are both capable of mediating B lymphocyte activation, deletion, or anergy after interaction with specific antigen. J. Exp. Med. 176:991.[Abstract/Free Full Text]
  42. Norvell, A., J. G. Monroe. 1996. Acquisition of surface IgD fails to protect from tolerance-induction: both surface IgM- and surface IgD-mediated signals induce apoptosis of immature murine B lymphocytes. J. Immunol. 156:1328.[Abstract]
  43. Janeway, C. A., Jr. 2001. How the immune system works to protect the host from infection: a personal view. Proc. Natl. Acad. Sci. USA 98:7461.[Free Full Text]
  44. Matsuda, J. L., M. Kronenberg. 2001. Presentation of self and microbial lipids by CD1 molecules. Curr. Opin. Immunol. 13:19.[Medline]
  45. Ochsenbein, A. F., T. Fehr, C. Lutz, M. Suter, F. Brombacher, H. Hengartner, R. M. Zinkernagel. 1999. Control of early viral and bacterial distribution and disease by natural antibodies. Science 286:2156.[Abstract/Free Full Text]
  46. Baumgarth, N., O. C. Herman, G. C. Jager, L. E. Brown, L. A. Herzenberg, J. Chen. 2000. B-1 and B-2 cell-derived immunoglobulin M antibodies are nonredundant components of the protective response to influenza virus infection. J. Exp. Med. 192:271.[Abstract/Free Full Text]
  47. Martin, F., J. F. Kearney. 2001. B1 cells: similarities and differences with other B cell subsets. Curr. Opin. Immunol. 13:195.[Medline]
  48. Carson, D. A., P. P. Chen, T. J. Kipps. 1991. New roles for rheumatoid factor. J. Clin. Invest. 87:379.
  49. Oliver, A. M., F. Martin, J. F. Kearney. 1999. IgMhighCD21high lymphocytes enriched in the splenic marginal zone generate effector cells more rapidly than the bulk of follicular B cells. J. Immunol. 162:7198.[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
J. Immunol.Home page
J. Yamagami, S. Kacir, K. Ishii, A. S. Payne, D. L. Siegel, and J. R. Stanley
Antibodies to the Desmoglein 1 Precursor Proprotein but Not to the Mature Cell Surface Protein Cloned from Individuals without Pemphigus
J. Immunol., November 1, 2009; 183(9): 5615 - 5621.
[Abstract] [Full Text] [PDF]


Home page
J. Virol.Home page
A. Woods, F. Monneaux, P. Soulas-Sprauel, S. Muller, T. Martin, A.-S. Korganow, and J.-L. Pasquali
Influenza Virus-Induced Type I Interferon Leads to Polyclonal B-Cell Activation but Does Not Break Down B-Cell Tolerance
J. Virol., November 15, 2007; 81(22): 12525 - 12534.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
Y. Liu, L. Li, K. R. Kumar, C. Xie, S. Lightfoot, X. J. Zhou, J. F. Kearney, M. Weigert, and C. Mohan
Lupus Susceptibility Genes May Breach Tolerance to DNA by Impairing Receptor Editing of Nuclear Antigen-Reactive B Cells
J. Immunol., July 15, 2007; 179(2): 1340 - 1352.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
E. M. Fuentes-Panana, G. Bannish, F. G. Karnell, J. F. Treml, and J. G. Monroe
Analysis of the Individual Contributions of Ig{alpha} (CD79a)- and Igbeta (CD79b)-Mediated Tonic Signaling for Bone Marrow B Cell Development and Peripheral B Cell Maturation
J. Immunol., December 1, 2006; 177(11): 7913 - 7922.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
Q. Tian, M. Beardall, Y. Xu, J. Li, D. C. Parker, N. Casanova, A. C. Bakke, and C. Chen
B Cells Expressing a Natural Polyreactive Autoantibody Have a Distinct Phenotype and Are Overrepresented in Immunoglobulin Heavy Chain Transgenic Mice
J. Immunol., August 15, 2006; 177(4): 2412 - 2422.
[Abstract] [Full Text] [PDF]


Home page
JEMHome page
M. Tsuiji, S. Yurasov, K. Velinzon, S. Thomas, M. C. Nussenzweig, and H. Wardemann
A checkpoint for autoreactivity in human IgM+ memory B cell development
J. Exp. Med., February 21, 2006; 203(2): 393 - 400.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
J. E. Wither, C. Loh, G. Lajoie, S. Heinrichs, Y.-C. Cai, G. Bonventi, and R. MacLeod
Colocalization of Expansion of the Splenic Marginal Zone Population with Abnormal B Cell Activation and Autoantibody Production in B6 Mice with an Introgressed New Zealand Black Chromosome 13 Interval
J. Immunol., October 1, 2005; 175(7): 4309 - 4319.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
M. Carbonari, E. Caprini, T. Tedesco, F. Mazzetta, V. Tocco, M. Casato, G. Russo, and M. Fiorilli
Hepatitis C Virus Drives the Unconstrained Monoclonal Expansion of VH1-69-Expressing Memory B Cells in Type II Cryoglobulinemia: A Model of Infection-Driven Lymphomagenesis
J. Immunol., May 15, 2005; 174(10): 6532 - 6539.
[Abstract] [Full Text] [PDF]


Home page
J. Immunol.Home page
N. Kanayama, M. Cascalho, and H. Ohmori
Analysis of Marginal Zone B Cell Development in the Mouse with Limited B Cell Diversity: Role of the Antigen Receptor Signals in the Recruitment of B Cells to the Marginal Zone
J. Immunol., February 1, 2005; 174(3): 1438 - 1445.
[Abstract] [Full Text] [PDF]


Home page
JEMHome page
K.-J. Rhee, P. J. Jasper, P. Sethupathi, M. Shanmugam, D. Lanning, and K. L. Knight
Positive selection of the peripheral B cell repertoire in gut-associated lymphoid tissues
J. Exp. Med., January 3, 2005; 201(1): 55 - 62.
[Abstract] [Full Text] [PDF]


This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Julien, S.
Right arrow Articles by Pasquali, J.-L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Julien, S.
Right arrow Articles by Pasquali, J.-L.
Right arrowPubmed/NCBI databases
*Substance via MeSH


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS