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Shiravani Z, Mirshekari K, Larki MH, Shafiee N, Haghshenas MR, Ghaderi A, Fattahi MJ. Evaluation of the genetic diversity of KIR genes in patients with endometrial cancer. J Reprod Immunol 2024; 162:104217. [PMID: 38387251 DOI: 10.1016/j.jri.2024.104217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 01/01/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
Endometrial cancer (EC) constitutes more than half of all genital cancers in women, with an increasing incidence in different countries. Natural killer cells (NK cells) are kinds of innate immune cells that are controlled by sets of receptors, such as killer cell Ig-like receptors (KIRs), which can inhibit or activate NK cells. In this study, we evaluated the diversity and genetic association of KIRs in confirmed cases of endometrial cancer compared to healthy controls. A total of 151 women with EC and 167 age/race-matched healthy controls were analyzed for KIR genes. Demographic and histopathologic data were gathered in questionnaires, and 16 KIR genes along with two variants of KIR2DS4 (KIR2DS4fl and KIR2DS4del), were genotyped by usingsequence specific primers-polymerase chain reaction (SSP-PCR) method. A comparison between cases and controls revealed that although there were not any significant differences in A haplotype associated genes and also the variants of KIR2DS4 (p >0.05), B haplotype associated genes such as KIR2DS2 and KIR2DL2 decreased significantly in EC patients in comparison with healthy controls (p=0.03 and p=0.01, respectively). Furthermore, we found that EC mostly developed in cases with the AA genotype; however, the carriers of Bx and C4T4 genotypes were less frequent in patients with EC. Our results revealed that KIR2DS2 and KIR2DL2, along with Bx and C4T4 genotypes, have a protective impact against developing endometrial cancer in Iranians.
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Affiliation(s)
- Zahra Shiravani
- Gynecology Oncology Division, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kimia Mirshekari
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marjan Hematian Larki
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nargess Shafiee
- Gynecology Oncology Division, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Haghshenas
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ghaderi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Fattahi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Surcel M, Neamtiu IA, Muresan D, Goidescu I, Staicu A, Marta MM, Nemeti G, Harsa R, Doroftei B, Capilna ME, Caracostea G. Killer Cell Immunoglobulin-like Receptor Genotypes and Reproductive Outcomes in a Group of Infertile Women: A Romanian Study. Diagnostics (Basel) 2023; 13:3048. [PMID: 37835791 PMCID: PMC10572162 DOI: 10.3390/diagnostics13193048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
A growing body of evidence suggests that endometrial immune disorders may be responsible for endometrial dysfunctions that can lead to gynecological and obstetrical pathology. The aim of this study was to explore the potential relationship between different killer cell immunoglobulin-like receptor (KIR) genotypes and reproductive outcomes. We conducted a prospective cohort study that included 104 infertile patients undergoing an in vitro fertilization procedure. All participants underwent clinical and ultrasound examination, genetic evaluation (KIR genotyping), endometrial washing fluid sampling for cytokine determination, endometrial tissue sampling for histologic assessment and hysteroscopic evaluation. Our analysis showed statistically significant lower levels of uterine cytokines TNF-α (p = 0.001) and IL-1beta (p = 0.000) in the KIR AA genotype group as compared to KIR AB and BB among study participants with chronic endometritis. The study results suggest that the KIR AA genotype population subgroups may be more susceptible to developing endometrial disorders such as chronic endometritis. The changes in the behavior of NK cells seem to be subtle and expressed as an altered regulatory pattern.
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Affiliation(s)
- Mihai Surcel
- 1st Department of Obstetrics and Gynecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400347 Cluj-Napoca, Romania; (M.S.); (D.M.); (I.G.); (A.S.); (G.N.); (G.C.)
| | - Iulia Adina Neamtiu
- Health Department, Environmental Health Center, Part of ALS, 58 Busuiocului Street, 400240 Cluj-Napoca, Romania
- Faculty of Environmental Science and Engineering, Babes-Bolyai University, 30 Fantanele Street, 400294 Cluj-Napoca, Romania
| | - Daniel Muresan
- 1st Department of Obstetrics and Gynecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400347 Cluj-Napoca, Romania; (M.S.); (D.M.); (I.G.); (A.S.); (G.N.); (G.C.)
| | - Iulian Goidescu
- 1st Department of Obstetrics and Gynecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400347 Cluj-Napoca, Romania; (M.S.); (D.M.); (I.G.); (A.S.); (G.N.); (G.C.)
| | - Adelina Staicu
- 1st Department of Obstetrics and Gynecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400347 Cluj-Napoca, Romania; (M.S.); (D.M.); (I.G.); (A.S.); (G.N.); (G.C.)
| | - Monica Mihaela Marta
- Department of Medical Education, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400347 Cluj-Napoca, Romania;
| | - Georgiana Nemeti
- 1st Department of Obstetrics and Gynecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400347 Cluj-Napoca, Romania; (M.S.); (D.M.); (I.G.); (A.S.); (G.N.); (G.C.)
| | - Radu Harsa
- In Vitro fertilization Department, “Regina Maria” Hospital, 29 Dorobantilor Street, 400117 Cluj-Napoca, Romania;
| | - Bogdan Doroftei
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania;
| | - Mihai Emil Capilna
- 1st Department of Obstetrics and Gynecology, University of Medicine, Pharmacy Science and Technology “George Emil Palade”, 38 Gheorghe Marinescu, 540142 Targu Mures, Romania;
| | - Gabriela Caracostea
- 1st Department of Obstetrics and Gynecology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400347 Cluj-Napoca, Romania; (M.S.); (D.M.); (I.G.); (A.S.); (G.N.); (G.C.)
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Hematian Larki M, Ashouri E, Barani S, Ghayumi SMA, Ghaderi A, Rajalingam R. KIR-HLA gene diversities and susceptibility to lung cancer. Sci Rep 2022; 12:17237. [PMID: 36241658 PMCID: PMC9568660 DOI: 10.1038/s41598-022-21062-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/22/2022] [Indexed: 01/06/2023] Open
Abstract
Killer-cell immunoglobulin-like receptors (KIR) are essential for acquiring natural killer (NK) cell effector function, which is modulated by a balance between the net input of signals derived from inhibitory and activating receptors through engagement by human leukocyte antigen (HLA) class I ligands. KIR and HLA loci are polygenic and polymorphic and exhibit substantial variation between individuals and populations. We attempted to investigate the contribution of KIR complex and HLA class I ligands to the genetic predisposition to lung cancer in the native population of southern Iran. We genotyped 16 KIR genes for a total of 232 patients with lung cancer and 448 healthy controls (HC), among which 85 patients and 178 HCs were taken into account for evaluating combined KIR-HLA associations. KIR2DL2 and 2DS2 were increased significantly in patients than in controls, individually (OR 1.63, and OR 1.42, respectively) and in combination with HLA-C1 ligands (OR 1.99, and OR 1.93, respectively). KIR3DS1 (OR 0.67) and 2DS1 (OR 0.69) were more likely presented in controls in the absence of their relative ligands. The incidence of CxTx subset was increased in lung cancer patients (OR 1.83), and disease risk strikingly increased by more than fivefold among genotype ID19 carriers (a CxTx genotype that carries 2DL2 in the absence of 2DS2, OR 5.92). We found that genotypes with iKIRs > aKIRs (OR 1.67) were more frequently presented in lung cancer patients. Additionally, patients with lung cancer were more likely to carry the combination of CxTx/2DS2 compared to controls (OR 2.04), and iKIRs > aKIRs genotypes in the presence of 2DL2 (OR 2.05) increased the likelihood of lung cancer development. Here we report new susceptibility factors and the contribution of KIR and HLA-I encoding genes to lung cancer risk, highlighting an array of genetic effects and disease setting which regulates NK cell responsiveness. Our results suggest that inherited KIR genes and HLA-I ligands specifying the educational state of NK cells can modify lung cancer risk.
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Affiliation(s)
- Marjan Hematian Larki
- grid.412571.40000 0000 8819 4698Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Ashouri
- grid.412571.40000 0000 8819 4698Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shaghik Barani
- grid.412571.40000 0000 8819 4698Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seiyed Mohammad Ali Ghayumi
- grid.412571.40000 0000 8819 4698Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ghaderi
- grid.412571.40000 0000 8819 4698Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Raja Rajalingam
- grid.266102.10000 0001 2297 6811Immunogenetics and Transplantation Laboratory, Department of Surgery, University of California San Francisco, San Francisco, CA USA
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Elpidio LNS, de Moraes AG, Langer IBV, do Amaral GC, Moretti ML, Garcia MT, Angerami R, Proenca-Modena JL, Bispo-dos-Santos K, Martini MC, Parise PL, Ayo CM, de Mattos LC, Brandão CC, Nogueira ML, Oliani DCMV, Spegiorin LCJF, de Lima Neto QA, Visentainer JEL. Lack of association of the KIR and HLA class I ligands with ZIKV infection in south and southeast of Brazil. Mem Inst Oswaldo Cruz 2022; 117:e210194. [PMID: 35976280 PMCID: PMC9377541 DOI: 10.1590/0074-02760210194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/25/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) is an emerging arbovirus associated with foetal malformations and neurological complications. The infection is usually associated with mild symptoms. The comparison between the allelic frequency of polymorphic genes in symptomatic infected individuals in the population can clarify the pathogenic mechanisms of ZIKV. During ZIKV infection, cytokines are produced and natural killer (NK) cells are recruited, whose activation depends on signaling pathways activated by specific receptors, such as killer cell immunoglobulin-like receptors (KIR). These molecules interact with human leukocyte antigen (HLA) class I ligands and are encoded by polymorphic genes. OBJECTIVES This study aimed to evaluate the frequency of allelic variants of the genes encoding the KIR receptors and their HLA class I ligands in 139 symptomatic ZIKV-patients and 170 controls negative for the virus, and to evaluate the role of these variants for ZIKV susceptibility. METHODS KIR and HLA class I genes were genotyped using the polymerase chain reaction-sequence specific oligonucleotide (PCR-SSO) technique. FINDINGS No significant differences in the frequency distribution of KIRs and KIR-HLA in patients compared to controls were observed. MAIN CONCLUSIONS KIR and its HLA ligands might play a minor role in ZIKV infection in the south and southeast Brazilian individuals.
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Affiliation(s)
- Laise Nayana Sala Elpidio
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Biociências e Fisiopatologia, Departamento de Análises Clínicas e Biomedicina,
Maringá, PR, Brasil
| | - Amarilis Giaretta de Moraes
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Biociências e Fisiopatologia, Departamento de Análises Clínicas e Biomedicina,
Maringá, PR, Brasil
| | | | | | - Maria Luiza Moretti
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas,
Departamento de Medicina Interna, Campinas, SP, Brasil
| | - Márcia Teixeira Garcia
- Universidade Estadual de Campinas, Divisão de Epidemiologia
Hospitalar, Hospital das Clínicas, Campinas, SP, Brasil
| | - Rodrigo Angerami
- Departamento de Vigilância em Saúde Pública de Campinas, Campinas,
SP, Brasil
| | - José Luiz Proenca-Modena
- Universidade Estadual de Campinas, Instituto de Biologia,
Departamento de Genética, Microbiologia e Imunologia, Laboratório de Vírus
Emergentes, Campinas, SP, Brasil
| | - Karina Bispo-dos-Santos
- Universidade Estadual de Campinas, Instituto de Biologia,
Departamento de Genética, Microbiologia e Imunologia, Laboratório de Vírus
Emergentes, Campinas, SP, Brasil
| | - Matheus Cavalheiro Martini
- Universidade Estadual de Campinas, Instituto de Biologia,
Departamento de Genética, Microbiologia e Imunologia, Laboratório de Vírus
Emergentes, Campinas, SP, Brasil
| | - Pierina Lorencini Parise
- Universidade Estadual de Campinas, Instituto de Biologia,
Departamento de Genética, Microbiologia e Imunologia, Laboratório de Vírus
Emergentes, Campinas, SP, Brasil
| | - Christiane Maria Ayo
- Faculdade de Medicina de São José do Rio Preto, Departamento de
Biologia Molecular, Laboratório de Imunogenética, São José do Rio Preto, SP,
Brasil
| | - Luiz Carlos de Mattos
- Faculdade de Medicina de São José do Rio Preto, Departamento de
Biologia Molecular, Laboratório de Imunogenética, São José do Rio Preto, SP,
Brasil
| | - Cinara Cássia Brandão
- Faculdade de Medicina de São José do Rio Preto, Departamento de
Biologia Molecular, Laboratório de Imunogenética, São José do Rio Preto, SP,
Brasil
| | - Maurício Lacerda Nogueira
- Faculdade de Medicina de São José do Rio Preto, Departamento de
Doenças Infecciosas e Parasitárias, Laboratório de Pesquisa em Virologia, São José
do Rio Preto, SP, Brasil
| | - Denise Cristina Mós Vaz Oliani
- Faculdade de Medicina de São José do Rio Preto, Departamento de
Ginecologia e Obstetrícia, São José do Rio Preto, SP, Brasil
| | | | - Quirino Alves de Lima Neto
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Biociências e Fisiopatologia, Departamento de Análises Clínicas e Biomedicina,
Maringá, PR, Brasil
- Universidade Estadual de Maringá, Laboratório de Imunogenética,
Maringá, PR, Brasil
| | - Jeane Eliete Laguila Visentainer
- Universidade Estadual de Maringá, Programa de Pós-Graduação em
Biociências e Fisiopatologia, Departamento de Análises Clínicas e Biomedicina,
Maringá, PR, Brasil
- Universidade Estadual de Maringá, Laboratório de Imunogenética,
Maringá, PR, Brasil
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Xie M, Li Y, Meng YZ, Xu P, Yang YG, Dong S, He J, Hu Z. Uterine Natural Killer Cells: A Rising Star in Human Pregnancy Regulation. Front Immunol 2022; 13:918550. [PMID: 35720413 PMCID: PMC9198966 DOI: 10.3389/fimmu.2022.918550] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/09/2022] [Indexed: 12/28/2022] Open
Abstract
Uterine natural killer (uNK) cells are an immune subset located in the uterus. uNK cells have distinct tissue-specific characteristics compared to their counterparts in peripheral blood and lymphoid organs. Based on their location and the pregnancy status of the host, uNK cells are classified as endometrial NK (eNK) cells or decidua NK (dNK) cells. uNK cells are important in protecting the host from pathogen invasion and contribute to a series of physiological processes that affect successful pregnancy, including uterine spiral artery remodeling, fetal development, and immunity tolerance. Abnormal alterations in uNK cell numbers and/or impaired function may cause pregnancy complications, such as recurrent miscarriage, preeclampsia, or even infertility. In this review, we introduce recent advances in human uNK cell research under normal physiological or pathological conditions, and summarize their unique influences on the process of pregnancy complications or uterine diseases. Finally, we propose the potential clinical use of uNK cells as a novel cellular immunotherapeutic approach for reproductive disorders.
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Affiliation(s)
- Min Xie
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China.,National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, The First Hospital of Jilin University, Changchun, China
| | - Yan Li
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China.,National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, The First Hospital of Jilin University, Changchun, China
| | - Yi-Zi Meng
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China.,National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, The First Hospital of Jilin University, Changchun, China
| | - Peng Xu
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China.,National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, The First Hospital of Jilin University, Changchun, China
| | - Yong-Guang Yang
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China.,National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, The First Hospital of Jilin University, Changchun, China.,International Center of Future Science, Jilin University, Changchun, China
| | - Shuai Dong
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China.,National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, The First Hospital of Jilin University, Changchun, China
| | - Jin He
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China
| | - Zheng Hu
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education, Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China.,National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, The First Hospital of Jilin University, Changchun, China
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A Brief Analysis of Tissue-Resident NK Cells in Pregnancy and Endometrial Diseases: The Importance of Pharmacologic Modulation. IMMUNO 2021. [DOI: 10.3390/immuno1030011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
NK cells are lymphocytes involved in the innate and adaptative immune response. These cells are located in peripheral blood and tissues with ample functions, from immune vigilant to tolerogenic reactions. In the endometrium, NK cell populations vary depending on age, hormones, and inflammation. When pregnancy occurs, tissue-resident NK cells and conventional NK cells are recruited to protect the fetus, a tolerogenic response. On the contrary, in the inflamed endometrium, various inflammatory cells down-regulate NK tolerance and impair embryo implantation. Therefore, NK cells’ pharmacological modulation is difficult to achieve. Several strategies have been used, from progesterone, lipid emulsions to steroids; the success has not been as expected. However, new therapeutic approaches have been proposed to decrease the endometrial inflammatory burden and increase pregnancy success based on understanding NK cell physiology.
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Mikhaleva LM, Radzinsky VE, Orazov MR, Khovanskaya TN, Sorokina AV, Mikhalev SA, Volkova SV, Shustova VB, Sinelnikov MY. Current Knowledge on Endometriosis Etiology: A Systematic Review of Literature. Int J Womens Health 2021; 13:525-537. [PMID: 34104002 PMCID: PMC8179825 DOI: 10.2147/ijwh.s306135] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/04/2021] [Indexed: 12/30/2022] Open
Abstract
Objective To review the mechanisms of endometriosis development, including those related to epigenetic mutations, cellular dysregulation, inflammatory processes, and oxidative stress. Methods A systematic literature review regarding current aspects of endometriosis etiology, genesis and development was performed using the PubMed, Google Scholar, and eLibrary databases. Keywords included endometriosis, etiology, development, genesis, associations and mechanisms. A multilingual search was performed. Results Several mechanisms underline the pathophysiological pathways for endometriosis development. Epigenetic mutations, external and internal influences, and chronic conditions have a significant impact on endometriosis development, survival and regulation. Several historically valid theories on endometriosis development were discussed, as well as updated findings. Conclusion Despite recent advances, fundamental problems in understanding endometriosis remain unresolved. The identification of unknown circulating epithelial progenitors or stem cells that are responsible for epithelial growth in both the endometrium and endometriotic foci seems to be the next step in solving these questions.
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Affiliation(s)
- Lyudmila M Mikhaleva
- Laboratory of Clinical Morphology, Research Institute of Human Morphology, Moscow, Russia
| | | | | | - Tatyana N Khovanskaya
- Laboratory of Clinical Morphology, Research Institute of Human Morphology, Moscow, Russia
| | - Anastasia V Sorokina
- Laboratory of Clinical Morphology, Research Institute of Human Morphology, Moscow, Russia
| | | | | | - Victoria B Shustova
- Laboratory of Clinical Morphology, Research Institute of Human Morphology, Moscow, Russia
| | - Mikhail Y Sinelnikov
- Laboratory of Clinical Morphology, Research Institute of Human Morphology, Moscow, Russia
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