1
|
Douda L, Hyšpler R, Mžik M, Vokurková D, Drahošová M, Řeháček V, Čermáková E, Douda T, Cyrany J, Fejfar T, Jirkovský V, Kopáčová M, Kupková B, Vašátko T, Tachecí I, Bureš J. Serum Citrulline and Ornithine: Potential Markers of Coeliac Disease Activity. ACTA MEDICA (HRADEC KRALOVE) 2023; 65:75-82. [PMID: 36735884 DOI: 10.14712/18059694.2022.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION To date, there is not generally accepted and universal indicator of activity, and functional integrity of the small intestine in patients with coeliac disease. The aim of our study was to investigate whether serum concentrations of the non-essential amino acids citrulline and ornithine might have this function. METHODS We examined serum citrulline and ornithine concentrations in a subgroup of patients with proven coeliac disease and healthy controls (blood donors). RESULTS A total of 94 patients with coeliac disease (29 men, mean age 53 ± 18 years; 65 women, mean age 44 ± 14 years) and 35 healthy controls (blood donors) in whom coeliac disease was serologically excluded (10 men, mean age 51 ± 14 years; 25 women, mean age 46 ± 12 years) were included in the study. Significantly lower concentrations of serum ornithine were found in patients with coeliac disease (mean 65 ± 3 μmol/L; median 63 μmol/L, IQR 34 μmol/L, p < 0.001). No statistically nor clinically significant differences were found in the citrulline concentrations between the study and control group. CONCLUSIONS Serum ornithine (but not citrulline) may be useful for assessing the functional status of the small intestine in uncomplicated coeliac disease. Further studies involving more detailed analysis of dietary and metabolic changes in patients will be needed to reach definitive conclusions.
Collapse
Affiliation(s)
- Ladislav Douda
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Radomír Hyšpler
- Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Martin Mžik
- Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Doris Vokurková
- Department of Clinical Immunology and Allergology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Marcela Drahošová
- Department of Clinical Immunology and Allergology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Vít Řeháček
- Transfusion Department, University Hospital Hradec Králové, Czech Republic
| | - Eva Čermáková
- Department of Medical Biophysic, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
| | - Tomáš Douda
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Jiří Cyrany
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Tomáš Fejfar
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Václav Jirkovský
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Marcela Kopáčová
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Blanka Kupková
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Tomáš Vašátko
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Ilja Tachecí
- 2nd Department of Internal Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic.
| | - Jan Bureš
- Biomedical Research Centre, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| |
Collapse
|
2
|
Zhou H, Yang Y, Wang L, Ye S, Liu J, Gong P, Qian Y, Zeng H, Chen X. Integrated multi-omic data reveal the potential molecular mechanisms of the nutrition and flavor in Liancheng white duck meat. Front Genet 2022; 13:939585. [PMID: 36046229 PMCID: PMC9421069 DOI: 10.3389/fgene.2022.939585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/14/2022] [Indexed: 12/01/2022] Open
Abstract
The Liancheng white (LW) duck is one of the most valued Chinese indigenous poultry breeds. Its meat is rich in nutrients and has distinct flavors, but the molecular mechanisms behind them are unknown. To address this issue, we measured and compared multi-omic data (genome, transcriptome, and metabolome) of breast meat from LW ducks and the Mianyang Shelduck (MS) ducks. We found that the LW duck has distinct breed-specific genetic features, including numerous mutant genes with differential expressions associated with amino acid metabolism and transport activities. The metabolome driven by genetic materials was also seen to differ between the two breeds. For example, several amino acids that are beneficial for human health, such as L-Arginine, L-Ornithine, and L-lysine, were found in considerably higher concentrations in LW muscle than in MS duck muscle (p < 0.05). SLC7A6, a mutant gene, was substantially upregulated in the LW group (p < 0.05), which may lead to excessive L-arginine and L-ornithine accumulation in LW duck meat through transport regulation. Further, guanosine monophosphate (GMP), an umami-tasting molecule, was considerably higher in LW muscle (p < 0.05), while L-Aspartic acid was significantly abundant in MS duck meat (p < 0.05), showing that the LW duck has a different umami formation. Overall, this study contributed to our understanding of the molecular mechanisms driving the enriched nutrients and distinct umami of LW duck meat, which will provide a useful reference for duck breeding.
Collapse
Affiliation(s)
- Hao Zhou
- Insitute of Animal Husbandry and Veterinary, Wuhan Academy of Agricultural Science, Wuhan, China
- Department of Animal Science, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Yang
- Insitute of Animal Husbandry and Veterinary, Wuhan Academy of Agricultural Science, Wuhan, China
| | - Lixia Wang
- Insitute of Animal Husbandry and Veterinary, Wuhan Academy of Agricultural Science, Wuhan, China
| | - Shengqiang Ye
- Insitute of Animal Husbandry and Veterinary, Wuhan Academy of Agricultural Science, Wuhan, China
| | - Jiajia Liu
- Department of Animal Science, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, China
| | - Ping Gong
- Insitute of Animal Husbandry and Veterinary, Wuhan Academy of Agricultural Science, Wuhan, China
| | - Yunguo Qian
- Insitute of Animal Husbandry and Veterinary, Wuhan Academy of Agricultural Science, Wuhan, China
| | - Huijun Zeng
- Wuhan Institute for Food and Cosmetic Control, Wuhan, China
- Key Laboratory of Edible Oil Quality and Safety for State Market Regulation, Wuhan, China
- *Correspondence: Huijun Zeng, ; Xing Chen,
| | - Xing Chen
- Insitute of Animal Husbandry and Veterinary, Wuhan Academy of Agricultural Science, Wuhan, China
- *Correspondence: Huijun Zeng, ; Xing Chen,
| |
Collapse
|
3
|
Effects of CB2 Receptor Modulation on Macrophage Polarization in Pediatric Celiac Disease. Biomedicines 2022; 10:biomedicines10040874. [PMID: 35453624 PMCID: PMC9029516 DOI: 10.3390/biomedicines10040874] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 01/27/2023] Open
Abstract
Celiac Disease (CD) represents an autoimmune disorder triggered by the exposure to gluten in genetically susceptible individuals. Recent studies suggest the involvement of macrophages in CD pathogenesis. Macrophages are immune cells, present as pro-inflammatory classically activated macrophages (M1) or as anti-inflammatory alternatively activated macrophages (M2). The Cannabinoid Receptor 2 (CB2) has important anti-inflammatory and immunoregulatory properties. We previously demonstrated that a common CB2 functional variant, Q63R, causing CB2 reduced function, is associated with several inflammatory and autoimmune diseases The first aim of this study was to investigate the phenotype of macrophages isolated from peripheral blood of CD patients and CB2 expression. The second aim was to evaluate the effects of CB2 pharmacological modulation on CD macrophage polarization. Moreover, by an in vitro model of “immunocompetent gut” we investigated the role of CD macrophages in inducing intestinal barrier damage and the possibility to restore its functionality modulating their polarization. We found an increased expression of M1 macrophages and a CB2 reduced expression. We also demonstrated CD M1 macrophages in inducing the typical mucosal barrier damage of CD. CB2 stimulation switches macrophage polarization towards the anti-inflammatory M2 phenotype thus reducing inflammation but also limiting the epithelial dysfunction. Therefore, we suggest CB2 receptor as a possible novel therapeutic target for CD by regulating macrophages polarization and by preventing mucosal barrier damage.
Collapse
|
4
|
Rotoli BM, Visigalli R, Ferrari F, Ranieri M, Tamma G, Dall’Asta V, Barilli A. Desmopressin Stimulates Nitric Oxide Production in Human Lung Microvascular Endothelial Cells. Biomolecules 2022; 12:biom12030389. [PMID: 35327581 PMCID: PMC8945551 DOI: 10.3390/biom12030389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 01/10/2023] Open
Abstract
Desmopressin (dDAVP) is the best characterized analogue of vasopressin, the endocrine regulator of water balance endowed with potent vasoconstrictive effects. Despite the use of dDAVP in clinical practice, ranging from the treatment of nephrogenic diabetes insipidus to bleeding disorders, much remains to be understood about the impact of the drug on endothelial phenotype. The aim of this study was, thus, to evaluate the effects of desmopressin on the viability and function of human pulmonary microvascular endothelial cells (HLMVECs). The results obtained demonstrate that the vasopressor had no cytotoxic effect on the endothelium; similarly, no sign of endothelial activation was induced by dDAVP, indicated by the lack of effect on the expression of inflammatory cytokines and adhesion molecules. Conversely, the drug significantly stimulated the production of nitric oxide (NO) and the expression of the inducible isoform of nitric oxide synthase, NOS2/iNOS. Since the intracellular level of cAMP also increased, we can hypothesize that NO release is consequent to the activation of the vasopressin receptor 2 (V2R)/guanylate cyclase (Gs)/cAMP axis. Given the multifaceted role of NOS2-deriving NO for many physio-pathological conditions, the meanings of these findings in HLMVECs appears intriguing and deserves to be further addressed.
Collapse
Affiliation(s)
- Bianca Maria Rotoli
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (B.M.R.); (R.V.); (F.F.); (V.D.)
| | - Rossana Visigalli
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (B.M.R.); (R.V.); (F.F.); (V.D.)
| | - Francesca Ferrari
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (B.M.R.); (R.V.); (F.F.); (V.D.)
| | - Marianna Ranieri
- Department of Bioscience, Biotechnology and Biopharmaceutics, University of Bari, 70125 Bari, Italy; (M.R.); (G.T.)
| | - Grazia Tamma
- Department of Bioscience, Biotechnology and Biopharmaceutics, University of Bari, 70125 Bari, Italy; (M.R.); (G.T.)
| | - Valeria Dall’Asta
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (B.M.R.); (R.V.); (F.F.); (V.D.)
| | - Amelia Barilli
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (B.M.R.); (R.V.); (F.F.); (V.D.)
- Correspondence:
| |
Collapse
|
5
|
Barilli A, Visigalli R, Ferrari F, Borsani G, Dall'Asta V, Rotoli BM. Flagellin From Pseudomonas Aeruginosa Stimulates ATB 0,+ Transporter for Arginine and Neutral Amino Acids in Human Airway Epithelial Cells. Front Immunol 2021; 12:641563. [PMID: 33841424 PMCID: PMC8029981 DOI: 10.3389/fimmu.2021.641563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/08/2021] [Indexed: 01/08/2023] Open
Abstract
At present, the central role played by arginine in the modulation of the inflammatory cellular responses is well-recognized, and many pro-inflammatory stimuli are known to modulate the expression and activity of its transmembrane transporters. In this regard, we have addressed the effects of bacterial flagellin from Pseudomonas aeruginosa (FLA-PA) on the uptake of the amino acid in human epithelial respiratory cells. Among the arginine transporters, only ATB0,+, y+L, and y+ were operative in bronchial epithelial Calu-3 cells under control conditions; however, only the expression and activity of ATB0,+ were stimulated upon incubation with flagellin, whereas those of systems y+L and y+ were not stimulated. As a result, this induction, in turn, led to an increase in the intracellular content of arginine without making any change to its metabolic pathway. In addition, flagellin upregulated the amount of other amino acids substrates of ATB0,+, in particular, all the essential amino acids, such as valine, isoleucine, and leucine, along with the non-essential glutamine. At the molecular level, these effects were directly referable to the stimulation of a toll-like receptor-5 (TLR5) signaling pathway and to the induction of nuclear factor-κB (NF-κB) transcription factor. An induction of ATB0,+ expression has been observed also in EpiAirway™, a model of primary human normal tracheal-bronchial epithelial cells that mimics the in vitro pseudostratified columnar epithelium of the airways. In this tissue model, the incubation with flagellin is associated with the upregulation of messenger RNAs (mRNAs) for the chemokine IL-8 and for the cytokines IL-6 and interleukin-1β (IL-1β); as for the latter, a marked secretion in the extracellular medium was also observed due to the concomitant activation of caspase-1. The overall findings indicate that, in human respiratory epithelium, flagellin promotes cellular responses associating the increase of intracellular amino acids through ATB0,+ with the activation of the inflammasome. Given the role of the ATB0,+ transporter as a delivery system for bronchodilators in human airway epithelial cells, its induction under inflammatory conditions gains particular relevance in the field of respiratory pharmacology.
Collapse
Affiliation(s)
- Amelia Barilli
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rossana Visigalli
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Ferrari
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Borsani
- Section of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Valeria Dall'Asta
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Bianca Maria Rotoli
- Laboratory of General Pathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
6
|
Arranz E, De Prado Á, Fiz-López A, Arribas E, Garrote JA, Bernardo D. Human intestinal dendritic cell and macrophage subsets in coeliac disease. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2020; 358:85-104. [PMID: 33707058 DOI: 10.1016/bs.ircmb.2020.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Dendritic cells (DC) and macrophages (Mϕ) constitute the most abundant antigen presenting cells in the human intestinal mucosa. In resting conditions, they are essential to maintain the mechanisms of immune tolerance toward food antigens and commensals, at the time that they keep the capacity to initiate and maintain antigen-specific pro-inflammatory immune responses toward invading pathogens. Nevertheless, this delicate equilibrium between immunity and tolerance is not perfect, like in coeliac disease (CD), where DC and Mϕ drive the development of antigen-specific immune responses toward dietary gluten peptides. In this review, we provide therefore a comprehensive discussion about CD pathogenesis, the human intestinal immune system and the biology of intestinal DC and Mϕ both in resting conditions and in CD. Last, but not least, we discuss about all the remaining issues pending to be studied regarding DC and Mϕ contribution toward CD pathogenesis. This may allow the identification of unique and specific factors which may be useful in the clinical practice, as well as identify new therapeutic targets in order to reestablish the loss intestinal homeostasis in CD.
Collapse
Affiliation(s)
- Eduardo Arranz
- Mucosal Immunology Lab. Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, Valladolid, Spain
| | - Ángel De Prado
- Mucosal Immunology Lab. Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, Valladolid, Spain
| | - Aida Fiz-López
- Mucosal Immunology Lab. Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, Valladolid, Spain
| | - Elisa Arribas
- Mucosal Immunology Lab. Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, Valladolid, Spain
| | - José A Garrote
- Mucosal Immunology Lab. Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, Valladolid, Spain; Servicio de Análisis Clínicos, Hospital Universitario Río Hortega, Valladolid, Spain
| | - David Bernardo
- Mucosal Immunology Lab. Instituto de Biología y Genética Molecular (IBGM), Universidad de Valladolid-CSIC, Valladolid, Spain.
| |
Collapse
|
7
|
Kateh Shamshiri M, Jaafari MR, Badiee A. Preparation of liposomes containing IFN-gamma and their potentials in cancer immunotherapy: In vitro and in vivo studies in a colon cancer mouse model. Life Sci 2020; 264:118605. [PMID: 33096119 DOI: 10.1016/j.lfs.2020.118605] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to prepare non-PEGylated (HSPC/DSPG/Chol, LIPF1) and PEGylated (HSPC/DSPG/Chol/mPEG2000-DSPE, LIPF2) liposomal formulations containing Interferon-gamma (IFN-γ) and evaluation their effects on macrophages and their antitumor properties. The results showed that the size of liposomal formulations LIP-F1 and LIP-F2 was 120 and 135 nm, respectively. The encapsulation efficiencies of LIP-F1 and LIP-F2 were 52.79% and 49.2%, respectively. Nitric Oxide Synthase (INOS) and arginase assays showed an increase in nitric oxide (NO) level and a reduction in arginase level after the treatment of M2 phenotype macrophage cell line with IFN-γ liposomes. The biodistribution study illustrated the amplitude of iodinated-IFN-γ liposomal formulations in the tumor site, the circulation time and tumor accumulation of LIP-F2 was significantly more than LIPF1. As a result, PEGylated liposomes containing IFN-γ induced significant antitumor responses due to the increased delivery of the cargo to the immune cells and induction of antitumor immune responses.
Collapse
Affiliation(s)
- Maryam Kateh Shamshiri
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mahmoud Reza Jaafari
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Badiee
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
8
|
Gaiani F, Rotoli BM, Ferrari F, Barilli A, Visigalli R, Carra MC, de'Angelis GL, de'Angelis N, Dall'Asta V. Monocytes from infliximab-resistant patients with Crohn's disease exhibit a disordered cytokine profile. Sci Rep 2020; 10:12238. [PMID: 32699266 PMCID: PMC7376177 DOI: 10.1038/s41598-020-68993-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/03/2020] [Indexed: 01/09/2023] Open
Abstract
Crohn's disease (CD) is a chronic inflammatory disorder characterized by immune response dysregulation. Tumor necrosis factor-α (TNFα) is a key cytokine in the pathogenesis of CD, as indicated by the efficacy of anti-TNF-α therapy with infliximab (IFX). However, approximately 30-40% of CD patients fail to respond to IFX with still unclear underlying mechanisms. This study compares the inflammatory phenotype of monocytes from CD patients, who respond or non-respond to IFX. Under basal conditions, the mRNA for the cytokines TNFα, IL-23, IL-1β and the chemokines CXCL8/IL-8, CCL5/RANTES and CCL2/MCP-1 was up-regulated in monocytes from non-responders than responders. The expression of the same cytokines and CCL2/MCP-1 was higher in non-responders also upon LPS treatment. Moreover, higher secretion of TNFα, IL-1β, IFNγ and IL-2 proteins occurred in the supernatants of LPS-treated non-responders cells. Resistance to IFX in CD may result from a transcriptional dysregulation of circulating monocytes, leading to hyperactivation of pro-inflammatory pathways. Monocytes' cytokine profile may thus represent a predictive marker of response to IFX. Monocytes were isolated from blood samples of 19 CD patients (11 responders, 8 non-responders) and incubated with or without LPS. Cytokine profiles were assessed by RT-qPCR and, in the supernatants, by ELISA assay.
Collapse
Affiliation(s)
- Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Bianca Maria Rotoli
- Unit of General Pathology, Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Francesca Ferrari
- Unit of General Pathology, Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Amelia Barilli
- Unit of General Pathology, Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Rossana Visigalli
- Unit of General Pathology, Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Maria Clotilde Carra
- Rothschild Hospital, AP-HP, Université de Paris, 5 rue Santerre, 75012, Paris, France
| | - Gian Luigi de'Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Nicola de'Angelis
- Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, Université Paris Est-UPEC, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Valeria Dall'Asta
- Unit of General Pathology, Department of Medicine and Surgery, University of Parma, Via Volturno 39, 43125, Parma, Italy
| |
Collapse
|
9
|
Ma WT, Gao F, Gu K, Chen DK. The Role of Monocytes and Macrophages in Autoimmune Diseases: A Comprehensive Review. Front Immunol 2019; 10:1140. [PMID: 31178867 PMCID: PMC6543461 DOI: 10.3389/fimmu.2019.01140] [Citation(s) in RCA: 205] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/07/2019] [Indexed: 12/19/2022] Open
Abstract
Monocytes (Mo) and macrophages (Mϕ) are key components of the innate immune system and are involved in regulation of the initiation, development, and resolution of many inflammatory disorders. In addition, these cells also play important immunoregulatory and tissue-repairing roles to decrease immune reactions and promote tissue regeneration. Several lines of evidence have suggested a causal link between the presence or activation of these cells and the development of autoimmune diseases. In addition, Mo or Mϕ infiltration in diseased tissues is a hallmark of several autoimmune diseases. However, the detailed contributions of these cells, whether they actually initiate disease or perpetuate disease progression, and whether their phenotype and functional alteration are merely epiphenomena are still unclear in many autoimmune diseases. Additionally, little is known about their heterogeneous populations in different autoimmune diseases. Elucidating the relevance of Mo and Mϕ in autoimmune diseases and the associated mechanisms could lead to the identification of more effective therapeutic strategies in the future.
Collapse
Affiliation(s)
- Wen-Tao Ma
- Veterinary Immunology Laboratory, College of Veterinary Medicine, Northwest A&F University, Yangling, China.,School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Fei Gao
- Veterinary Immunology Laboratory, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Kui Gu
- Veterinary Immunology Laboratory, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - De-Kun Chen
- Veterinary Immunology Laboratory, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| |
Collapse
|
10
|
Orlando A, Linsalata M, Bianco G, Notarnicola M, D'Attoma B, Scavo MP, Tafaro A, Russo F. Lactobacillus rhamnosus GG Protects the Epithelial Barrier of Wistar Rats from the Pepsin-Trypsin-Digested Gliadin (PTG)-Induced Enteropathy. Nutrients 2018; 10:nu10111698. [PMID: 30405050 PMCID: PMC6265991 DOI: 10.3390/nu10111698] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/25/2018] [Accepted: 10/24/2018] [Indexed: 02/07/2023] Open
Abstract
Celiac disease (CD) is a chronic immune-mediated disorder, characterized by enhanced paracellular permeability across the intestinal epithelium. The complex system of intercellular junctions, including tight junctions (TJs) and adherens junctions (AJs), seals together the epithelial cells to form a continuous layer. The improvements in barrier integrity have been related to modifications in intercellular junction protein expression. Polyamines (spermidine, spermine, and putrescine) actively participate in the modulation of the AJ expression. Both in vitro and in vivo studies have demonstrated that also probiotics can promote the integrity and the function of the intestinal barrier. On these bases, the present work investigated the protective effects exerted by Lactobacillus rhamnosus GG (L.GG) against the pepsin-trypsin-digested gliadin (PTG)-induced enteropathy in jejunal tissue samples of Wistar rats. In particular, the probiotic effects have been evaluated on the intestinal mucosal architecture, polyamine metabolism and intercellular junction protein expression (ZO-1, Occludin, Claudin-1, β-catenin and E-cadherin). The results from this study indicate that L.GG protects the intestinal mucosa of rats from PTG-induced damage, by preventing the reduction of the expression of the intercellular junction proteins. Consequently, a role for L.GG in the therapeutic management of the gluten-related disorders in humans could be hypothesized.
Collapse
Affiliation(s)
- Antonella Orlando
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| | - Michele Linsalata
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| | - Giusy Bianco
- Animal Facility, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| | - Maria Notarnicola
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| | - Benedetta D'Attoma
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| | - Maria Principia Scavo
- National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| | - Angela Tafaro
- Animal Facility, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| | - Francesco Russo
- Laboratory of Nutritional Pathophysiology, National Institute of Gastroenterology "S. de Bellis" Research Hospital, 70013 Castellana Grotte (Ba), Italy.
| |
Collapse
|
11
|
Arroba AI, Campos-Caro A, Aguilar-Diosdado M, Valverde ÁM. IGF-1, Inflammation and Retinal Degeneration: A Close Network. Front Aging Neurosci 2018; 10:203. [PMID: 30026694 PMCID: PMC6041402 DOI: 10.3389/fnagi.2018.00203] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/14/2018] [Indexed: 01/10/2023] Open
Abstract
Retinal degenerative diseases are a group of heterogeneous diseases that include age-related macular degeneration (AMD), retinitis pigmentosa (RP), and diabetic retinopathy (DR). The progressive degeneration of the retinal neurons results in a severe deterioration of the visual function. Neuroinflammation is an early hallmark of many neurodegenerative disorders of the retina including AMD, RP and DR. Microglial cells, key components of the retinal immune defense system, are activated in retinal degenerative diseases. In the microglia the interplay between the proinflammatory/classically activated or antiinflammatory/alternatively activated phenotypes is a complex dynamic process that occurs during the course of disease due to the different environmental signals related to pathophysiological conditions. In this regard, an adequate transition from the proinflammatory to the anti-inflammatory response is necessary to counteract retinal neurodegeneration and its subsequent damage that leads to the loss of visual function. Insulin like-growth factor-1 (IGF-1) has been considered as a pleiotropic factor in the retina under health or disease conditions and several effects of IGF-1 in retinal immune modulation have been described. In this review, we provide recent insights of inflammation as a common feature of retinal diseases (AMD, RP and RD) highlighting the role of microglia, exosomes and IGF-1 in this process.
Collapse
Affiliation(s)
- Ana I Arroba
- Alberto Sols Biomedical Research Institute (IIBm) (CSIC/UAM), Madrid, Spain.,Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERdem), ISCIII, Madrid, Spain.,Research Unit, Instituto de Investigación e Innovación en Ciencias Biomédicas de la Provincia de Cádiz (INiBICA), University Hospital "Puerta del Mar", Cádiz, Spain
| | - Antonio Campos-Caro
- Research Unit, Instituto de Investigación e Innovación en Ciencias Biomédicas de la Provincia de Cádiz (INiBICA), University Hospital "Puerta del Mar", Cádiz, Spain
| | - Manuel Aguilar-Diosdado
- Research Unit, Instituto de Investigación e Innovación en Ciencias Biomédicas de la Provincia de Cádiz (INiBICA), University Hospital "Puerta del Mar", Cádiz, Spain.,Department of Endocrinology and Metabolism, Instituto de Investigación e Innovación en Ciencias Biomédicas de la Provincia de Cádiz (INiBICA), University Hospital "Puerta del Mar", Cádiz, Spain
| | - Ángela M Valverde
- Alberto Sols Biomedical Research Institute (IIBm) (CSIC/UAM), Madrid, Spain.,Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERdem), ISCIII, Madrid, Spain
| |
Collapse
|
12
|
Barilli A, Gaiani F, Prandi B, Cirlini M, Ingoglia F, Visigalli R, Rotoli BM, de'Angelis N, Sforza S, de'Angelis GL, Dall'Asta V. Gluten peptides drive healthy and celiac monocytes toward an M2-like polarization. J Nutr Biochem 2017; 54:11-17. [PMID: 29216605 DOI: 10.1016/j.jnutbio.2017.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 10/20/2017] [Accepted: 10/26/2017] [Indexed: 01/16/2023]
Abstract
Celiac disease (CD) is an immune-mediated enteropathy triggered by ingested gluten in genetically susceptible individuals and sustained by both adaptive and innate immune responses. Recent studies in murine macrophages demonstrated that the activation of arginase (ARG) metabolic pathway by gluten peptides contributes to the modulation of intestinal permeability in vitro. Here we characterize the effects of gluten on arginine metabolism and cell polarization in human monocytes from both healthy and CD subjects; both a simplified enzymatic digestion of gliadin and a physiological digestion of whole wheat have been tested. Results indicate that gluten digests induce the onset of an M2-like phenotype in activated macrophages; more precisely, both isoforms of arginase, ARG1 and ARG2, are induced likely due to the inhibition of mTOR and the consequent induction of C/EBPβ transcription factor. These effects are independent from the origin of gluten as well as from the digestive protocol employed; moreover, no statistical difference can be evidenced between healthy and CD patients, excluding a diverse predisposition of CD monocytes to gluten-triggered polarization with respect to healthy immune cells. Overall, the present findings sustain a role for arginase pathway in the immune response elicited by human monocytes toward ingested gluten that, hence, deserves particular attention when addressing the pathogenesis of CD.
Collapse
Affiliation(s)
- Amelia Barilli
- Unit of General Pathology, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Via Volturno 39, 43125 Parma, Italy
| | - Federica Gaiani
- Unit of Gastroenterology and Digestive Endoscopy of Parma, University Hospital of Parma, via Gramsci 14, 43126 Parma, Italy
| | - Barbara Prandi
- Department of Food Science, University of Parma, Parco Area delle Scienze 17A, 43124 Parma, Italy
| | - Martina Cirlini
- Department of Food Science, University of Parma, Parco Area delle Scienze 17A, 43124 Parma, Italy
| | - Filippo Ingoglia
- Unit of General Pathology, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Via Volturno 39, 43125 Parma, Italy
| | - Rossana Visigalli
- Unit of General Pathology, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Via Volturno 39, 43125 Parma, Italy
| | - Bianca Maria Rotoli
- Unit of General Pathology, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Via Volturno 39, 43125 Parma, Italy
| | - Nicola de'Angelis
- Department of HPB Surgery and Liver Transplantation, Henri-Mondor Hospital, Université Paris Est-UPEC, Créteil, France
| | - Stefano Sforza
- Department of Food Science, University of Parma, Parco Area delle Scienze 17A, 43124 Parma, Italy
| | - Gian Luigi de'Angelis
- Unit of Gastroenterology and Digestive Endoscopy of Parma, University Hospital of Parma, via Gramsci 14, 43126 Parma, Italy
| | - Valeria Dall'Asta
- Unit of General Pathology, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Via Volturno 39, 43125 Parma, Italy.
| |
Collapse
|
13
|
Changes in paracellular permeability induced by Pepsin-Trypsin digested Gliadin (PTG): Role of polyamines in the Lactobacillus rhamnosus GG protective action. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.06.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
|
14
|
Wu W, Zhang M, Sun C, Brennan M, Li H, Wang G, Lai F, Wu H. Enzymatic preparation of immunomodulatory hydrolysates from defatted wheat germ (Triticum Vulgare) globulin. Int J Food Sci Technol 2016. [DOI: 10.1111/ijfs.13238] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Wenjia Wu
- School of Food Science and Engineering; South China University of Technology; Wushan Road 381 Guangzhou 510641 China
| | - Mengmeng Zhang
- School of Food Science and Engineering; South China University of Technology; Wushan Road 381 Guangzhou 510641 China
| | - Chongzhen Sun
- School of Food Science and Engineering; South China University of Technology; Wushan Road 381 Guangzhou 510641 China
| | - Margaret Brennan
- Department of Wine, Food and Molecular Biosciences; Faculty of Agriculture and Life Sciences; Lincoln University; Lincoln 7647 Christchurch 85084 New Zealand
| | - Huixian Li
- School of Food Science and Engineering; South China University of Technology; Wushan Road 381 Guangzhou 510641 China
| | - Guang Wang
- School of Food Science and Engineering; South China University of Technology; Wushan Road 381 Guangzhou 510641 China
| | - Furao Lai
- School of Food Science and Engineering; South China University of Technology; Wushan Road 381 Guangzhou 510641 China
| | - Hui Wu
- School of Food Science and Engineering; South China University of Technology; Wushan Road 381 Guangzhou 510641 China
| |
Collapse
|
15
|
Wen L, Chen Y, Zhang L, Yu H, Xu Z, You H, Cheng Y. Rice protein hydrolysates (RPHs) inhibit the LPS-stimulated inflammatory response and phagocytosis in RAW264.7 macrophages by regulating the NF-κB signaling pathway. RSC Adv 2016. [DOI: 10.1039/c6ra08927e] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Different RPH components inhibit LPS-induced NO and TNF-α production. RPHs-C-7-3 inhibits the expression of pro-inflammatory expression. RPHs-C-7-3 suppresses the LPS-stimulated phagocytic ability. RPHs-C-7-3 regulates the nuclear translocation of p65.
Collapse
Affiliation(s)
- Li Wen
- Department of Food and Biological Engineering
- College of Chemical and Biological Engineering
- Changsha University of Science and Technology
- Changsha 410114
- China
| | - Yuehua Chen
- Department of Food and Biological Engineering
- College of Chemical and Biological Engineering
- Changsha University of Science and Technology
- Changsha 410114
- China
| | - Li Zhang
- Key Laboratory of Nuclear Medicine
- Ministry of Health
- Jiangsu Key Laboratory of Molecular Nuclear Medicine
- Jiangsu Institute of Nuclear Medicine
- Wuxi 214063
| | - Huixin Yu
- Key Laboratory of Nuclear Medicine
- Ministry of Health
- Jiangsu Key Laboratory of Molecular Nuclear Medicine
- Jiangsu Institute of Nuclear Medicine
- Wuxi 214063
| | - Zhou Xu
- Department of Food and Biological Engineering
- College of Chemical and Biological Engineering
- Changsha University of Science and Technology
- Changsha 410114
- China
| | - Haixi You
- Department of Food and Biological Engineering
- College of Chemical and Biological Engineering
- Changsha University of Science and Technology
- Changsha 410114
- China
| | - Yunhui Cheng
- Department of Food and Biological Engineering
- College of Chemical and Biological Engineering
- Changsha University of Science and Technology
- Changsha 410114
- China
| |
Collapse
|
16
|
Barilli A, Rotoli BM, Visigalli R, Ingoglia F, Cirlini M, Prandi B, Dall'Asta V. Gliadin-mediated production of polyamines by RAW264.7 macrophages modulates intestinal epithelial permeability in vitro. Biochim Biophys Acta Mol Basis Dis 2015; 1852:1779-86. [PMID: 26047680 DOI: 10.1016/j.bbadis.2015.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/28/2015] [Accepted: 06/01/2015] [Indexed: 01/22/2023]
Abstract
Celiac disease (CD) is an immune-mediated enteropathy sustained by dietary gluten in susceptible individuals, and characterized by a complex interplay between adaptive and innate responses against gluten peptides (PTG). In a recent contribution we have demonstrated that the treatment with PTG induces the expression and activity of arginase in both murine macrophages and human monocytes from healthy subjects, thus suggesting a role for arginine and its metabolites in gluten-triggered response of these cells. Here we further explore this field, by addressing the effects of PTG on polyamine synthesis and release in murine RAW264.7 macrophages, and how they affect epithelial permeability of Caco-2 monolayers. Results obtained show a massive production and release of putrescine by macrophages upon incubation with gluten peptides; this, in turn, causes a decrease in TEER in epithelial cells, indicating that PTG-driven secretion of polyamines by macrophages has a role in the modulation of intestinal permeability in vitro. At a molecular level, putrescine production appears referable to the activation of C/EBPβ transcription factor, which is known to be responsible for arginase induction in activated macrophages and is a crucial mediator of inflammation. Whether these pathways are stimulated also in vivo deserves to be further investigated, as well as their role in gluten-driven cellular and intestinal defects typical of CD patients.
Collapse
Affiliation(s)
- Amelia Barilli
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, SBiBiT, Università degli Studi di Parma, Via Volturno 39, 43125 Parma, Italy
| | - Bianca Maria Rotoli
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, SBiBiT, Università degli Studi di Parma, Via Volturno 39, 43125 Parma, Italy
| | - Rossana Visigalli
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, SBiBiT, Università degli Studi di Parma, Via Volturno 39, 43125 Parma, Italy
| | - Filippo Ingoglia
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, SBiBiT, Università degli Studi di Parma, Via Volturno 39, 43125 Parma, Italy
| | - Martina Cirlini
- Dipartimento di Scienze degli Alimenti, Università degli Studi di Parma, Parco Area delle Scienze 49/A, 43124 Parma, Italy
| | - Barbara Prandi
- Dipartimento di Scienze degli Alimenti, Università degli Studi di Parma, Parco Area delle Scienze 49/A, 43124 Parma, Italy
| | - Valeria Dall'Asta
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali, SBiBiT, Università degli Studi di Parma, Via Volturno 39, 43125 Parma, Italy.
| |
Collapse
|
17
|
Rath M, Müller I, Kropf P, Closs EI, Munder M. Metabolism via Arginase or Nitric Oxide Synthase: Two Competing Arginine Pathways in Macrophages. Front Immunol 2014; 5:532. [PMID: 25386178 PMCID: PMC4209874 DOI: 10.3389/fimmu.2014.00532] [Citation(s) in RCA: 809] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/09/2014] [Indexed: 12/23/2022] Open
Abstract
Macrophages play a major role in the immune system, both as antimicrobial effector cells and as immunoregulatory cells, which induce, suppress or modulate adaptive immune responses. These key aspects of macrophage biology are fundamentally driven by the phenotype of macrophage arginine metabolism that is prevalent in an evolving or ongoing immune response. M1 macrophages express the enzyme nitric oxide synthase, which metabolizes arginine to nitric oxide (NO) and citrulline. NO can be metabolized to further downstream reactive nitrogen species, while citrulline might be reused for efficient NO synthesis via the citrulline–NO cycle. M2 macrophages are characterized by expression of the enzyme arginase, which hydrolyzes arginine to ornithine and urea. The arginase pathway limits arginine availability for NO synthesis and ornithine itself can further feed into the important downstream pathways of polyamine and proline syntheses, which are important for cellular proliferation and tissue repair. M1 versus M2 polarization leads to opposing outcomes of inflammatory reactions, but depending on the context, M1 and M2 macrophages can be both pro- and anti-inflammatory. Notably, M1/M2 macrophage polarization can be driven by microbial infection or innate danger signals without any influence of adaptive immune cells, secondarily driving the T helper (Th)1/Th2 polarization of the evolving adaptive immune response. Since both arginine metabolic pathways cross-inhibit each other on the level of the respective arginine break-down products and Th1 and Th2 lymphocytes can drive or amplify macrophage M1/M2 dichotomy via cytokine activation, this forms the basis of a self-sustaining M1/M2 polarization of the whole immune response. Understanding the arginine metabolism of M1/M2 macrophage phenotypes is therefore central to find new possibilities to manipulate immune responses in infection, autoimmune diseases, chronic inflammatory conditions, and cancer.
Collapse
Affiliation(s)
- Meera Rath
- Department of Pharmacology, Institute of Medical Sciences, Faculty of Medical Sciences, Siksha 'O' Anusandhan University , Bhubaneshwar , India
| | - Ingrid Müller
- Section of Immunology, Department of Medicine, Imperial College London , London , UK
| | - Pascale Kropf
- Section of Immunology, Department of Medicine, Imperial College London , London , UK
| | - Ellen I Closs
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University , Mainz , Germany
| | - Markus Munder
- Third Department of Medicine (Hematology, Oncology, and Pneumology), University Medical Center, Johannes Gutenberg University , Mainz , Germany ; Research Center for Immunotherapy, University Medical Center, Johannes Gutenberg University , Mainz , Germany
| |
Collapse
|