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LPS-challenged TNFα production, prostaglandin secretion, and TNFα/TNFRs expression in the endometrium of domestic cats in estrus or diestrus, and in cats with pyometra or receiving medroxyprogesterone acetate. Mediators Inflamm 2014; 2014:689280. [PMID: 25028529 PMCID: PMC4083830 DOI: 10.1155/2014/689280] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/20/2014] [Indexed: 11/18/2022] Open
Abstract
Progesterone (P4) derivatives which are commonly used to block the cyclicity of domestic cats disturb the endocrine balance in the endometrium. The aims of this study were (i) to examine whether lipopolysaccharide (LPS) is responsible for enhancement of tumor necrosis factor-α (TNFα) secretion by the feline endometrial epithelial and stromal cells in vitro, (ii) to know whether immunolocalization of TNFα/TNFR1 and TNFR2 differs in cats at estrus or diestrus, receiving medroxyprogesterone acetate and suffering from pyometra, and (iii) to determine if TNFα-challenged prostaglandin secretion is stopped by prostaglandin synthases inhibitors. A total of 37 domestic adult cats in estrus or diestrus, receiving octane medroxyprogesterone or having clinical symptoms of pyometra, were enrolled in this study. The results obtained showed a distinct increase in LPS-challenged TNFα secretion in endometrial epithelial, but not stromal cells. TNFα augmented PG secretion was blocked by phospholipase A2 (PLA2) and cyclooxygeanase-2 (COX-2), but not by mitogen-activated protein kinase (MAPK) inhibitor. TNFα/TNFR1 and 2 protein expressions were limited mostly to the surface and glandular epithelium. TNFα/TNFRs protein was upregulated in the inflammatory uterus and hence may be involved in development of pathologic changes in the endometrial glands in cats receiving exogenous P4 as a hormonal contraceptive.
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In vivo intra-luteal implants of prostaglandin (PG) E1 or E2 (PGE1, PGE2) prevent luteolysis in cows. I. Luteal weight, circulating progesterone, mRNA for luteal luteinizing hormone (LH) receptor, and occupied and unoccupied luteal receptors for LH. Prostaglandins Other Lipid Mediat 2011; 95:35-44. [DOI: 10.1016/j.prostaglandins.2011.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Revised: 04/21/2011] [Accepted: 05/04/2011] [Indexed: 11/22/2022]
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Skarzynski DJ, Piotrowska KK, Bah MM, Korzekwa A, Woclawek-Potocka I, Sawai K, Okuda K. Effects of exogenous tumour necrosis factor-alpha on the secretory function of the bovine reproductive tract depend on tumour necrosis factor-alpha concentrations. Reprod Domest Anim 2008; 44:371-9. [PMID: 18564315 DOI: 10.1111/j.1439-0531.2007.01016.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of study was to correlate tumour necrosis factor-alpha (TNF) infused doses used with the TNF concentrations achieved and with the secretory function of both the ovary and the uterus in cows. We evaluated the concentrations of progesterone (P4), prostaglandin (PG)F(2alpha), PGE(2) nitric oxide (NO) and TNF in the jugular vein and vena cava caudalis as parameters of exogenous TNF action on the female reproductive tract. Aortae abdominalis of cows (n = 18) were infused with saline or two doses of TNF (luteolytic--1 microg or luteotrophic--10 microg). In the peripheral blood, 1 microg TNF concentrations achieved within the range of 30-45 pg/ml, and 10 microg TNF provoked a sharp increase in achieved concentrations at a range of 250-450 pg/mL). The TNF concentrations achieved in vena cava caudalis were five to six times higher than that in peripheral blood (p < 0.001). One microgram TNF increased PGF(2alpha) and NO (p < 0.001) and decreased P4 (p < 0.05). The higher TNF dose stimulated P4 and PGE(2) (p < 0.01). TNF infusion at luteolytic dose achieved its concentrations at the physiological range previously observed in cows. Luteotrophic TNF dose achieved the concentrations in vena cava caudalis that are much higher than physiological level and were previously noted in pathological circumstances (i.e. mastitis, metritis).
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Affiliation(s)
- D J Skarzynski
- Department of Reproductive Immunology, Institute of Animal Reproduction and Food Research, PAS, Tuwima-St 10, Olsztyn 10-747, Poland.
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Skarzynski DJ, Woclawek-Potocka I, Korzekwa A, Bah MM, Piotrowska K, Barszczewska B, Okuda K. Infusion of exogenous tumor necrosis factor dose dependently alters the length of the luteal phase in cattle: differential responses to treatment with indomethacin and L-NAME, a nitric oxide synthase inhibitor. Biol Reprod 2006; 76:619-27. [PMID: 17192516 DOI: 10.1095/biolreprod.106.053280] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
We examined whether prostaglandins (PGs) and nitric oxide (NO) mediate tumor necrosis factor (TNF) actions in the estrus cycle. On Day 14 of the cycle, the following solutions were infused into the aorta abdominalis of a total of 51 heifers (Experiments 1 and 2): saline; 1 or 10 microg of TNF; 480 mg indomethacin (INDO), an inhibitor of prostaglandin H synthase; 800 mg L-NAME, an inhibitor of NO synthase; and TNF (1 or 10 microg) in combination with INDO or L-NAME. TNF at 1 microg infused directly into aorta abdominalis increased the level of PGF(2alpha) and decreased the level of progesterone (P4) in the peripheral blood and shortened the estrus cycle. The high TNF dose stimulated P4 and PGE(2) and prolonged the corpus luteum (CL) lifespan. INDO blocked the effects of both TNF doses on the CL lifespan and hormone output. L-NAME completely blocked the effects of the luteolytic TNF dose, whereas the effects of the luteotropic TNF dose were not inhibited. In Experiment 3 (Day 14), saline or different TNF doses were infused into the jugular vein (n = 9) or into the uterine lumen (n = 18). The CL lifespans of the different groups were not different when TNF was infused into the jugular vein. Although high TNF doses (1 and 10 microg) infused into the uterine lumen prolonged the CL lifespan, low doses (0.01 and 0.1 microg) induced premature luteolysis. We suggest that the actions of exogenous TNF on the CL lifespan depend on PG synthesis stimulated by TNF in the uterus. TNF at low concentrations initiates a positive cascade between uterine PGF(2alpha) and various luteolytic factors, including NO, to complete premature luteolysis. PGE(2) is a good candidate mediator of the luteotropic actions of exogenous TNF action.
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Affiliation(s)
- Dariusz J Skarzynski
- Department of Reproductive Immunology, Institute of Animal Reproduction and Food Research, PAS, Olsztyn 10-747, Poland.
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Kowalewski MP, Schuler G, Taubert A, Engel E, Hoffmann B. Expression of cyclooxygenase 1 and 2 in the canine corpus luteum during diestrus. Theriogenology 2006; 66:1423-30. [PMID: 16481032 DOI: 10.1016/j.theriogenology.2006.01.039] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the dog, unlike most other domestic animal species, corpus luteum (CL) life span is not affected by hysterectomy. Only in pregnant dogs, during the immediate prepartum decline of progesterone, does PGF2alpha clearly seem to act as an endogenous luteolytic agent. Whether endogenous PGF2alpha plays a role in the slow regression of the corpora lutea of the nonpregnant cycle is not known. To test for possible paracrine/autocrine effects of locally produced PGF2alpha, luteal expression of the key rate-limiting enzymes in prostaglandin biosynthesis, i.e. cyclooxygenase 1 and 2 (Cox1 and Cox2), was examined in dogs during diestrus, including the periods of CL formation, as well as early and late CL regression. Corpora lutea were collected by ovariohysterectomy from nonpregnant bitches 5, 15, 25, 35, 45 and 65 days after ovulation. On the mRNA-level, expression of Cox1 and Cox2 was tested by qualitative and quantitative, Real Time (Taq Man) RT-PCR; on the protein level, expression of Cox2 was studied by immunohistochemistry. The mRNA for Cox1 and Cox2 were detected at all stages of diestrus. Expression of Cox1 was lowest on Day 5 (ovulation = Day 0) and higher and nearly constant thereafter. Expression of Cox2-mRNA was distinctly cycle related and highest on Day 5; it decreased by Day 15 and remained constantly low until Day 65. Immunohistochemistry localized expression of Cox2 in the cytoplasm of luteal cells. Staining was restricted to Days 5 and 15, with stronger signals on Day 5. These data suggested that increased expression of Cox2 is associated with luteal growth and development and not luteal regression. Furthermore, the expression of Cox1 more likely reflected activity of a housekeeping gene.
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Affiliation(s)
- Mariusz Pawel Kowalewski
- Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals, Justus-Liebig-University Giessen, Frankfurter Strasse 106, D-35392 Giessen, Germany.
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Engel E, Klein R, Baumgärtner W, Hoffmann B. Investigations on the expression of cytokines in the canine corpus luteum in relation to dioestrus. Anim Reprod Sci 2005; 87:163-76. [PMID: 15885449 DOI: 10.1016/j.anireprosci.2004.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2004] [Revised: 09/07/2004] [Accepted: 10/01/2004] [Indexed: 10/26/2022]
Abstract
Control of luteal regression in the dog is still poorly understood. Unlike other domestic animal species, luteolysis is not prevented by hysterectomy. Indications that PGF(2alpha) may act as an endogenous luteolytic agent have been found only in pregnant animals during the prepartal decline of progesterone. Evidence from several species indicates that the immune system plays an important role in corpus luteum (Cl) function, possibly by the release of cytokines from immigrant immune cells. Hence, in the present experiment we attempted to examine the expression of cytokines in the canine Cl during the course of dioestrus (formation and regression of the Cl), using RT-PCR. Groups of 4-5 bitches were ovario-hysterectomised on days 5, 15, 25, 35, 45 and 60-80 after ovulation. Canine-specific primers for IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, TNFalpha, IFNgamma and TGFbeta1 were used. Positive and negative controls were included in all tests. Adequate expression was confirmed by sequencing selective samples of positive PCR products. The expression of mRNA for IL-8, IL-10, IL-12, TNF-alpha and TGF-beta1 was detected in all samples at each stage of dioestrus, without any obvious variations indicating a likely modulatory function of these cytokines in differentiation, maintenance or regression of the canine Cl. All tests for the expression of mRNA for IL-4, IL-1beta and IL-2 were negative. More negative than positive results were obtained when testing for the expression of mRNA for IL-6 and IFN-gamma, leading to the conclusion that expression of these two cytokines is at a low level, and no conclusion can be drawn as to their involvement in control of Cl function.
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Affiliation(s)
- Eva Engel
- Clinic for Obstetrics, Gynaekology und Andrology of Large and Small Animals, Justus-Liebig-University Giessen, Frankfurter Strasse 106, 35392 Giessen, Germany
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Sakumoto R, Okuda K. Possible actions of tumor necrosis factor-alpha in ovarian function. J Reprod Dev 2004; 50:39-46. [PMID: 15007200 DOI: 10.1262/jrd.50.39] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Tumor necrosis factor-alpha (TNFalpha) is a multifunctional cytokine that was first described as a tumoricidal factor produced by activated macrophages. Extensive research over the last two decades has suggested that TNFalpha has physiologically diverse actions in ovarian function in a variety of species. TNFalpha and its specific receptors are present in the ovaries of many species. Furthermore, TNFalpha plays multiple and probably important roles in corpus luteum (CL) function as well as ovarian cell function throughout the estrous cycle. This review focuses on recent studies documenting TNFalpha in ovarian follicles and CL in several mammals. In addition, possible roles of TNFalpha in ovarian function throughout the estrous cycle and in the gestation period are discussed.
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Affiliation(s)
- Ryosuke Sakumoto
- Department of Physiology and Genetic Regulation, National Institute of Agrobiological Sciences, Ibaraki 305-8602, Japan.
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Hoffmann B, Büsges F, Engel E, Kowalewski MP, Papa P. Regulation of Corpus Luteum-function in the Bitch. Reprod Domest Anim 2004; 39:232-40. [PMID: 15225276 DOI: 10.1111/j.1439-0531.2004.00508.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Functional lifespan of the corpus luteum (CL) in non-pregnant dogs exceeds that of pregnant animals and may last for more than 80 days. Prolactin and LH act luteotropic, however, luteolytic mechanisms are poorly understood. Other than in life stock there is no uterine luteolysine and it was postulated that local paracrine/autocrine mechanisms might play a major role. In following this hypothesis the present investigations have clearly demonstrated that up-regulation of prostaglandin synthesis in the CL as indicated by the expression of cyclo-oxygenase II occurs with its formation and not regression, pointing towards a luteotropic rather than luteolytic action. Throughout dioestrus luteal and other cells of the CL express the oestrogen (ERalpha) and progesterone receptor (PR). While ERalpha expression was not cycle-related, PR concentrations were high in the early and late-luteal phase and a regulatory role of both steroids on CL-function is assumed. As in other species also in the dog the immune system seems to participate in the mechanisms regulating CL-function as an increased presence of lymphocytes within the CL could be detected at the beginning [CD4- CD8-, major histocompatibility complex (MHC)II-antigen expressing cells] and during the latter half of dioestrus (CD8- and MHCII-antigen expressing cells). Thus, leucocyte-derived cytokines may be important and the expression of the mRNA for interleukin (IL)8, IL10, IL12, tumour necrosis factor (TNF)alpha and transforming growth factor (TGF) beta1 was observed throughout dioestrus. Electron microscopy confirmed the slow process of luteolysis; first distinct signs of degeneration were seen on day 60, accompanied by some apoptotic events. From these data it is concluded that luteal regression as monitored by the gradual decrease of systemic progesterone concentrations in the dog is not an actively regulated but rather a permissive process. Immune-mediated events may play a key role. Changes in the vascular supply, as indicated by the expression of endoglin, seem to be of lower importance.
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Affiliation(s)
- B Hoffmann
- Klinik für Geburtshilfe, Gynäkologie und Andrologie der Gross-und Kleintiere mit Tierärztlicher Ambulanz, Frankfurter Strasse 106, 35390 Giessen, Germany.
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9
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Zhang B, Yan L, Tsang PCW, Moses MA. Matrix metalloproteinase-2 (MMP-2) expression and regulation by tumor necrosis factor alpha (TNF?) in the bovine corpus luteum. Mol Reprod Dev 2004; 70:122-32. [PMID: 15570615 DOI: 10.1002/mrd.20196] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Angiogenesis and tissue remodeling events in the corpus luteum (CL) are mediated by matrix metalloproteinases (MMPs). We have recently reported the cloning of bovine membrane-type 1 metalloproteinase (MT1-MMP) and have shown that active MT1-MMP is correlated to MMP-2 activity in the CL during the estrous cycle. Given the important role that MMP-2 plays in neovascularization, we became interested in understanding the role of this enzyme in the CL, a system in which angiogenesis is exquisitely regulated in the course of its lifespan. The aims of the present study were to clone bovine MMP-2 cDNA, to investigate its temporal and spatial expression in three stages of CL during the estrous cycle and to study its regulation by TNFalpha, a key cytokine regulator of CL physiology. Bovine MMP-2 cDNA was isolated from a UNI-ZAP II bovine capillary endothelial cell cDNA library and sequenced. This gene encoded a protein of 662 amino acids. Luteal tissues were collected from non-lactating dairy cows on days 4, 10, and 16 of the estrous cycle. Northern and Western blotting revealed that the levels of MMP-2 mRNA (3.1 kb) and immunoreactive pro-MMP-2 protein (68 kDa) did not differ (P > 0.05) in any age of CL examined. In addition to large luteal cells, MMP2 was localized to endothelial cells in all ages of CL by immunohistochemistry. Studies using in vitro luteal cell cultures showed that MMP-2 mRNA, protein expression and activity was upregulated by TNFalpha in a dose- and time-dependent manner. The present study suggests that MMP-2 is predominantly produced by large luteal cells and endothelial cells, and that it plays an essential role in luteal remodeling and angiogenesis. These data also suggest that cytokines such as TNFalpha may modulate these processes by regulating MMP-2 expression.
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MESH Headings
- Animals
- Cattle
- Cells, Cultured
- Cloning, Molecular
- Corpus Luteum/chemistry
- Corpus Luteum/metabolism
- Endothelium, Vascular/chemistry
- Endothelium, Vascular/metabolism
- Estrous Cycle/physiology
- Female
- Gene Expression/drug effects
- Gene Expression Regulation, Enzymologic
- Matrix Metalloproteinase 2/analysis
- Matrix Metalloproteinase 2/genetics
- Matrix Metalloproteinase 2/metabolism
- Neovascularization, Physiologic/genetics
- Neovascularization, Physiologic/physiology
- RNA, Messenger/analysis
- RNA, Messenger/metabolism
- Sequence Analysis, DNA
- Tumor Necrosis Factor-alpha/pharmacology
- Tumor Necrosis Factor-alpha/physiology
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Affiliation(s)
- Bo Zhang
- Vascular Biology Program, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
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Okuda K, Sakumoto R. Multiple roles of TNF super family members in corpus luteum function. Reprod Biol Endocrinol 2003; 1:95. [PMID: 14613529 PMCID: PMC280732 DOI: 10.1186/1477-7827-1-95] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2003] [Accepted: 11/10/2003] [Indexed: 01/12/2023] Open
Abstract
The main function of the corpus luteum (CL) is the production of progesterone. Adequate luteal progesterone is crucial for determining the physiological duration of the estrous cycle and for achieving a successful pregnancy. The CL is regulated not only by hypophyseal gonadotropin, but also by a number of cytokines that are locally produced. Tumor necrosis factor-alpha (TNF) and its specific receptors (TNFR) are present in the CL of many species. TNF plays multiple and likely important roles in CL function throughout the estrous cycle. TNF appears to have luteotropic and luteolytic roles in the CLs. In contrast, Fas ligand (Fas L), another member of TNF super family (TNF-SF), is primarily recognized for its apoptotic actions. Presumably, Fas L binds its cognate receptor (Fas) to induce structural luteolysis. This review is designed to focus on recent studies documenting the expression of TNF and Fas L, their receptors, and intracellular signaling mechanisms in the CL.
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Affiliation(s)
- Kiyoshi Okuda
- Laboratory of Reproductive Endocrinology, Faculty of Agriculture, Okayama University, Okayama 700-8530, Japan
| | - Ryosuke Sakumoto
- Laboratory of Reproductive Endocrinology, Faculty of Agriculture, Okayama University, Okayama 700-8530, Japan
- Department of Physiology and Genetic Regulation, National Institute of Agrobiological Sciences, Ibaraki 305-8602, Japan
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Hayashi K, Acosta TJ, Berisha B, Kobayashi SI, Ohtani M, Schams D, Miyamoto A. Changes in prostaglandin secretion by the regressing bovine corpus luteum. Prostaglandins Other Lipid Mediat 2003; 70:339-49. [PMID: 12611498 DOI: 10.1016/s0090-6980(02)00148-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Secretion of prostaglandins (PGs) by the regressing corpus luteum (CL) was investigated in the cow. Six cows were implanted with microcapillary dialysis membranes of a microdialysis system (MDS) into the CL during Days 8-9 (Day 0 = estrus), and a prostaglandin (PG) F2alpha analogue (Estrumate) was injected intramuscularly (i.m.) to induce luteolysis. Acute increases in intraluteal release of PGF2alpha and PGE2 were observed during the first 4 h, followed by decreases over the next 8 h. Intraluteal release of both PGs gradually increased again during the period 48-72 h. Concentrations of PGF2alpha in ovarian venous plasma (OVP) were 4-13 times higher than those of jugular venous plasma (JVP) (P < 0.001) during the period of the experiment, and increased from 24 h after treatment with Estrumate (P < 0.05). Cyclooxygenase (COX)-2 mRNA expression increased (P < 0.05) at 2 and 24 h after treatment with Estrumate. The results indicated that local release of PGF2alpha and PGE2, and COX-2 mRNA expression were increased by Estrumate in the regressing CL at the later stages of luteolysis. Thus, luteal secretion of PGs may be involved in the local mechanism for structural rather than functional luteolysis.
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Affiliation(s)
- Kanako Hayashi
- Department of Animal Science, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan
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Bakri Y, Mannioui A, Ylisastigui L, Sanchez F, Gluckman JC, Benjouad A. CD40-activated macrophages become highly susceptible to X4 strains of human immunodeficiency virus type 1. AIDS Res Hum Retroviruses 2002; 18:103-13. [PMID: 11839143 DOI: 10.1089/08892220252779647] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Activating cells of the immune system may stimulate human immunodeficiency virus type 1 (HIV-1) replication and contribute to select pathogenic variants in vivo. Here, we examined the possible effect of a major pathway of immune activation, CD40 interaction with its ligand (CD40L), on the susceptibility of monocyte-derived macrophages (MDMs) to various HIV-1 strains. Stimulation of MDMs with CD40L led to reduced replication of R5 HIV-1(Ba-L), whereas this strongly enhanced the replication of X4 HIV-1(Lai) as well as of X4 primary isolates, and this was associated with strong cytopathic effects. The replication of X4 strains was inhibited by stromal cell-derived factor 1, an indication of the restricted usage of CXCR4 as virus coreceptor in this case. CD40L induced the activation of mitogen-activated protein kinases ERK1/ERK2 and stimulated MDMs to secrete RANTES (regulated on activation, normal T cell expressed and secreted), macrophage inflammatory protein 1alpha (MIP-1alpha), MIP-1beta, interleukin 6 (IL-6), IL-1beta, and tumor necrosis factor alpha. From this data, it may be hypothesized that activated macrophages represent a favorable environment for the replication of classically T lymphocyte-tropic X4 variants and, thus, may contribute significantly to the selection of such variants at late stages of clinical HIV-1 infection.
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Affiliation(s)
- Youssef Bakri
- Institut National de la Santé et de la Recherche Médicale EPI-0013, Institut Universitaire d'Hématologie, Hôpital Saint-Louis, 75571 Paris Cedex 12, France.
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Affiliation(s)
- Jennifer R Wood
- Center for Research on Reproduction and Women's Health, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA
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