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Gulati P, Falck-Pedersen E, Siskind GW. Regulation of antibody secretion by hybridoma cells. II. Mechanism of idiotype-induced suppression of antibody secretion by hybridoma cells. Cell Immunol 1989; 123:276-82. [PMID: 2529040 DOI: 10.1016/0008-8749(89)90288-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We have previously reported that antibody secretion by B.22 hybridoma cells can be suppressed in an MHC-restricted manner, by idiotype-specific T cells. It was shown that T cells of both helper and suppressor phenotypes are involved, and that the suppression is mediated by soluble factors. In the present paper, we have characterized the effects of T-cell-mediated suppression at the level of B.22 antibody mRNA expression and stability. Nuclear run-on analysis comparing suppressed and control B.22 cells indicates no change in the transcription rates of heavy and light chains. Northern blot analysis demonstrates that steady-state levels of heavy and light chain mRNAs are also unchanged. Thus, the suppression of antibody secretion by B.22 cells probably occurs at the levels of translation or secretion.
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Affiliation(s)
- P Gulati
- Department of Medicine, Cornell University Medical College, New York, New York 10021
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Adelman NE, Watling D, McDevitt HO. In vivo effects of antibodies to immune response gene products. II. Suppression of humoral immune responses with monoclonal anti-I-A is due to suppressor cells. Int Rev Immunol 1988; 3:333-44. [PMID: 2854550 DOI: 10.3109/08830188809051201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- N E Adelman
- Department of Medical Microbiology, Stanford University School of Medicine, California 94305
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Flood PM, Friedman A, Freedman J, Horvat B, Reuter P, Ptak W. The role of contrasuppression in tumor regression. Immunol Res 1988; 7:12-22. [PMID: 2897407 DOI: 10.1007/bf02918150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- P M Flood
- Department of Pathology, Yale University School of Medicine, New Haven, Conn
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Zalman MA, Meruelo D. Analysis of H-2-linked immune responses involved in resistance to AKR tumor growth. Immunogenetics 1986; 24:51-62. [PMID: 2874112 DOI: 10.1007/bf00372298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
H-2-associated immune response gene(s) govern resistance to growth of a spontaneous AKR lymphoma, BW5147. The antigenic specificities recognized by the anti-BW5147 humoral response have been characterized and include: Thy-1, a T-cell differentiation antigen; gp70, a retroviral envelope protein; and several previously uncharacterized proteins, including a 78 000 molecular mass protein, p78, which is restricted to expression on BW5147 cells and five phosphoproteins with molecular masses of 33 000, 29 000, 23 000, 17 000, and 16 000. Only mice which are able to respond to Thy-1, p78, and the phosphoproteins can survive an inoculation of BW5147. Thus, resistance to BW5147 is complex and involves multiple antigens with possible roles in tumor rejection.
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Abstract
The data discussed here touch upon several issues in the evolving story of T cell contrasuppression, the underlying theme being that of heterogeneity. First, there is the issue of function. We are considering here only those cells that affect the function of secretory differentiation. We have evidence that different contrasuppressor cells exist for clone growth, but have not yet studied them in the same depth as those for secretory differentiation. Second, there is the important issue of target cells. In this article by Green and Gershon it is pointed out that there is clear evidence that contrasuppressor effects can work by protecting helper cells from suppressor cell effects in vitro. On the other hand, direct additional inhibition of the suppressor cells themselves has not been excluded. The latter point is also true in our system. However, we must suppose for the sake of simplicity in many of our experiments that if suppressors are not the target of the contrasuppressor effects then the B cells themselves probably are. This is because the tumor cells engage in a spontaneous rate of growth and differentiation in the absence of help or suppression. When T cell-dependent, specifically triggered effects reduce this spontaneous behavior, then a suppressive effect must have been delivered directly to the B cells. This is a simplifying assumption which is attractive, but since the experiments are carried out in vivo and thus may be affected by some factors that we have not yet recognized, we are not confident on its "intuitive" appeal. A third issue revolves around triggering specificity. One of our contrasuppressors exhibits the phenomenon of carrier crossreactivity (CRCS) and is thus behaving in accord with expectations aroused by Green and Gershon in this review. The other cell is apparently quite carrier specific (SCS). The meaning of this is not at all clear, but its potential significance may somehow be related to a sort of "mirror image" relationship of the two cells. Thus, for example, in other experiments not discussed here, we have noted that the CRCS binds to 315 protein-coated plates, but as noted here counteracts a suppressive effect which is generated by cells which do not adhere to these plates. In contrast to SCS does not bind to 315 plates and yet, as noted here, appears to counteract a suppressor effect generated by cells which do adhere to 315 plates.(ABSTRACT TRUNCATED AT 400 WORDS)
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Adelman NE, Watling DL, McDevitt HO. Treatment of (NZB x NZW)F1 disease with anti-I-A monoclonal antibodies. J Exp Med 1983; 158:1350-5. [PMID: 6578293 PMCID: PMC2187363 DOI: 10.1084/jem.158.4.1350] [Citation(s) in RCA: 176] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
(NZB x NZW)F1 mice spontaneously develop an autoimmune syndrome characterized by a fatal immune complex glomerulonephritis. Administration of monoclonal antibodies specific for an I region gene product (I-Az) of the H-2 haplotype associated with susceptibility to glomerulonephritis in these animals produced a remission in female mice with established renal disease. The results demonstrated that anti-I-A therapy stabilized the level of proteinuria and increased the 1-yr survival rate from 10% to greater than 90% in treated animals relative to control mice. These findings may ultimately have therapeutic potential for the treatment of systemic lupus erythematosus.
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Abstract
The data presented in this paper show that the population of cells that adoptively transfer contact hypersensitivity are Lyt-1+ 2-, I-J- and nonadherent to V. villosa lectin. However, the adoptive transfer of immunity by this population of cells is successful only when the recipient has been treated in such a way as to impair the host immunosuppression mechanism. This population cannot, on its own, transfer immunity to adult, untreated naive recipients unless an additional population of immunoregulatory cells is present. This immunoregulatory population does not itself adoptively transfer immunity. This latter population is differentiated from the immune cells in that they are Lyt-1+ 2-, I-J+ and are adherent to V. villosa lectin. Both populations are required to adoptively transfer immunity to adult untreated naive recipients.
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Kruisbeek AM, Fultz MJ, Sharrow SO, Singer A, Mond JJ. Early development of the T cell repertoire. In vivo treatment of neonatal mice with anti-Ia antibodies interferes with differentiation of I-restricted T cells but not K/D-restricted T cells. J Exp Med 1983; 157:1932-46. [PMID: 6222135 PMCID: PMC2187039 DOI: 10.1084/jem.157.6.1932] [Citation(s) in RCA: 69] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Monoclonal antibodies to I-Ak were injected into neonatal H-2k mice for a period of 3 wk. The spleens of such mice are devoid of Ia-positive cells. Allo- and trinitrophenyl (TNP)-self-specific cytotoxic T lymphocyte (CTL) responses in such anti-I-A-treated mice were almost completely abrogated at the end of the 2-3 wk in vivo treatment period. Development of suppressor cells, carry-over of blocking antibodies, lack of responder accessory cells, or defective CTL function were not responsible for the observed defect. As concanavalin A supernatant could restore the defect, it is more likely that the defect is due to the absence of competent Ia-specific T helper cells. In addition, anti-I-A-treated mice exhibit reduced I-A antigen expression in the thymus and defective Ia-bearing accessory cell function in the spleen. It is postulated that, for development of Ia-specific T cells to occur, precursor T cells need to interact with Ia-encoded products in the thymus, and anti-Ia treatment interferes with this process. Finally, the mechanism of this interference was shown to be due to actual removal or functional inactivation of those I-A-positive elements responsible for the education of I-A-recognizing T cells, since in (H-2b X H-2k)F1 mice, treatment with anti-I-Ak antibodies results in abrogation of CTL responses to TNP in association with both parental haplotypes, while in the thymus of these mice expression of both I-Ak and I-Ab was reduced.
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Waldor MK, Sriram S, McDevitt HO, Steinman L. In vivo therapy with monoclonal anti-I-A antibody suppresses immune responses to acetylcholine receptor. Proc Natl Acad Sci U S A 1983; 80:2713-7. [PMID: 6405386 PMCID: PMC393898 DOI: 10.1073/pnas.80.9.2713] [Citation(s) in RCA: 115] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
A monoclonal antibody to I-A gene products of the immune response gene complex attenuates both humoral and cellular responses to acetylcholine receptor and appears to suppress clinical manifestations of experimental autoimmune myasthenia gravis. This demonstrates that use of antibodies against immune response gene products that are associated with susceptibility to disease may be feasible for therapy in autoimmune conditions such as myasthenia gravis.
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Green DR, Gershon RK. Contrasuppression, class I antigens, and cancer immunity. HAEMATOLOGY AND BLOOD TRANSFUSION 1983; 28:479-85. [PMID: 6602750 DOI: 10.1007/978-3-642-68761-7_94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Takaoki M, Sy MS, Tominaga A, Lowy A, Tsurufuji M, Finberg R, Benacerraf B, Greene MI. I-J-restricted interactions in the generation of azobenzenearsonate-specific suppressor T cells. J Exp Med 1982; 156:1325-34. [PMID: 6215456 PMCID: PMC2186844 DOI: 10.1084/jem.156.5.1325] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The genetic restrictions of the activation of third-order suppressor cells (Ts3) were studied in mice, using two different types of anti-azobenzenearsonate (ABA)-immune responses, namely delayed-type hypersensitivity (DTH) and cytotoxic T lymphocyte (CTL) generation. Ts2 cells were induced in several different strains of mice by injecting monoclonal T hybridoma molecules or first-order suppressor factors (TsF1) originating in A/J (H-2a, Igh-1e) mice and then testing the TsF2 molecules derived from these Ts2 in A/J and A.By (H-2b, Igh-1e) or (A/J X A.By)F1 (H-2a/b, Igh-1e) and (C57Bl/6 X A/J)F1 (H-2b/a, Igh-1e) mice. It was shown that the activity of TsF2 was restricted to the I-J of the strain in which Ts2 was induced. By genetic analysis, restriction was shown to be due to the requirement of H-2 identity between ABA-coupled cells used for Ts3 activation and the strain of the TsF2 origin. Moreover, by using H-2-congenic ABA-coupled cells, we were also able to precisely map and demonstrate that ABA-coupled cells I-J identical to TsF2 induced in various strains were necessary for effective suppression to occur. This selective activation of Ts3 suggested the existence of I-J-related antigen presentation for suppression as the counterpart of I-A or I-A-I-E-restricted antigen presentation for positive immune responses.
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Drebin JA, Perry LL, Carter R, Greene MI. Regulation of the immune response to antigens on the malignant cell surface. SPRINGER SEMINARS IN IMMUNOPATHOLOGY 1982; 5:175-92. [PMID: 6293112 DOI: 10.1007/bf00199795] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
MESH Headings
- Animals
- Antigens, Neoplasm/genetics
- Antigens, Neoplasm/immunology
- Antigens, Surface/genetics
- Antigens, Surface/immunology
- Antilymphocyte Serum/pharmacology
- Antilymphocyte Serum/therapeutic use
- Cell Transformation, Neoplastic/immunology
- Cell Transformation, Viral
- Histocompatibility Antigens Class II/immunology
- Humans
- Immunity, Cellular
- Immunologic Memory
- Lymphocyte Activation/radiation effects
- Lymphokines/metabolism
- Mice
- Neoplasms, Experimental/immunology
- Neoplasms, Experimental/therapy
- Neoplasms, Radiation-Induced/immunology
- Phenotype
- Polyomavirus/immunology
- Suppressor Factors, Immunologic
- T-Lymphocytes/classification
- T-Lymphocytes/immunology
- T-Lymphocytes/radiation effects
- T-Lymphocytes, Regulatory/immunology
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Bromberg JS, Tominaga A, Takaoki M, Greene MI. I-J subregion and suppressor signals. SURVEY OF IMMUNOLOGIC RESEARCH 1982; 1:67-75. [PMID: 6227066 DOI: 10.1007/bf02918242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Yamauchi K, Taniguchi M, Green D, Gershon RK. The use of a monoclonal i-j-specific antibody to distinguish cells in the feedback suppression circuit from those in the contrasuppressor circuit. Immunogenetics 1982; 16:551-8. [PMID: 6190738 DOI: 10.1007/bf00372023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
A monoclonal anti-I-Jb serum designated D-7 reacts in high titer with three different T-cell subsets and one cell-free product involved in generating contrasuppressive activity, but has no activity against I-J T-cell subsets (or their cell-free mediators) involved in feedback suppression. These results give evidence for heterogeneity in the I-J subregion. They also indicate that the serological markers on I-J+ cells may define the functional activity of the regulatory circuits they belong to. Clearly, they do not separate the role that the cells play within a particular immunoregulatory circuit, i.e., inducer, transducer, or effector cells.
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Argov S, Cochran AJ, Kärre K, Klein GO, Klein G. Incidence and type of tumors induced in C57BL bg/bg mice and +/bg littermates by oral administration of DMBA. Int J Cancer 1981; 28:739-46. [PMID: 6800966 DOI: 10.1002/ijc.2910280613] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
As an attempt to study the effect of the beige (bg) mutation on chemical carcinogenesis, 65 C57Bl/bg/bg mice and 83 +/bg littermate controls received DMBA in five weekly intragastric doses. The incidence of tumors of different histological types was monitored through observation periods ranging between 165 and 500 days. By 165 days after the first DMBA feeding, 18% of the +/bg and 31% of the bg/bg mice had developed tumors. The beige mice had a higher incidence of epithelial and non-epithelial tumors arising in cutaneous or subcutaneous sites than the controls. The total incidence of lymphomas was similar in the two groups. However, lymphomas appeared somewhat earlier in beige than in control mice. Altogether 33 +/bg and 27 bg/bg mice were followed for 500 days. By this time, 73% of the +/bg and 78% of the bg/bg mice had developed tumors. The beige group showed a higher incidence of non-thymic lymphomas than the controls. In contrast, the incidence of thymic lymphoma, cutaneous epithelial tumors and bile-duct adenomas was similar in the two groups or higher in +/bg that in bg/bg mice. The results suggest that the bg mutation causes a certain defect in a mechanism that may prevent or delay the onset of non-thymic lymphomas and of epithelial and non-epithelial cutaneous tumors in DMBA-treated mice. The differences between the two groups were smaller than those previously reported in relation to the increased susceptibility of beige mice to certain transplanted tumors, attributed to the known defect in natural killer (NK) activity in the beige mice. The reduced differential in the DMBA system may be due to the partial reduction of NK activity, induced by the carcinogen, as reported previously (Ehrlich et al., 1980) and confirmed in the present study.
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Yamauchi K, Murphy D, Cantor H, Gershon RK. Analysis of antigen-specific, Ig-restricted cell-free material made by I-J+ Ly-1 cells (Ly-1 TsiF) that induces Ly-2+ cells to express suppressive activity. Eur J Immunol 1981; 11:905-12. [PMID: 6173228 DOI: 10.1002/eji.1830111110] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
A set of T cells defined by a unique profile of cell surface alloantigens (phenotype Ly-1+2-; Qa-1+; I-J+) produces biologically active cell-free material(s) (Ly-1 TsiF) which induces another T cell set (cell surface phenotype Ly-1,2+; I-J/; Qa-1+) to participate in the suppression of primary immune responses to heterologous erythrocytes. The suppression is specific for the inducing antigen, and the Ly-1 TsiF binds antigen in a specific way. The activity of Ly-1 TsiF can be removed by anti-I-J immunosorbents and will not be expressed if the functional producer and acceptor cells do not share gene products that are encoded in or are tightly linked to the VH portion of the Ig complex. There is no requirement for the Ly-1 TsiF and its acceptor cell(s) to share major histocompatibility complex gene products. Thus, for optimal induction of antigen-specific suppression by cell-gree materials from Ly-1 T cells, three necessary conditions must be met: (a) antigen recognition by Ly-1 TsiF; (b) the expression of I-J gene products and (c) identify of VH-linked Ig locus gene products (or other products influenced by those genes) on both the inducer molecule and its acceptor cell. The role of the Ig-linked restriction is particularly intriguing, and its possible meaning is considered in detail.
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Rosenbaum JT, Adelman NE, McDevitt HO. In vivo effects of antibodies to immune response gene products. I. Haplotype-specific suppression of humoral immune responses with a monoclonal anti-I-A. J Exp Med 1981; 154:1694-702. [PMID: 6795305 PMCID: PMC2186506 DOI: 10.1084/jem.154.5.1694] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Immune response (Ir) gene products control immunologic function at several critical sites. We administered in vivo a monoclonal antibody reactive with I-Ak to F1 mice with the genotype H-2k/b. These treated mnice made a markedly reduced antibody response to antigen (H,G)-A--L, under the control of I-Ak, but not to antigen (T,G)-A--L, under the control of I-Ab. This relative specificity was lost if the antigen was given in complete Freund's adjuvant rather than aqueous solution. The monoclonal antibody reduced the antibody titer in an ongoing, secondary response as well. Several potential mechanisms can be postulated for this effect. This haplotypic specificity might ultimately be relevant to human disease.
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Steinman L, Rosenbaum JT, Sriram S, McDevitt HO. In vivo effects of antibodies to immune response gene products: prevention of experimental allergic encephalitis. Proc Natl Acad Sci U S A 1981; 78:7111-4. [PMID: 6947275 PMCID: PMC349205 DOI: 10.1073/pnas.78.11.7111] [Citation(s) in RCA: 159] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Prevention of experimental allergic encephalitis in SJL/J [H-2s] mice was achieved with in vivo administration of antibody reactive with I-As gene products prior to immunization with spinal cord antigen. No protection was evident in animals that received antisera specific for I-Js gene products. Administration of antibody to I-As beginning 5 days after immunization with spinal cord antigen delayed, but did not prevent, the onset of experimental allergic encephalitis.
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Bromberg JS, Benacerraf B, Greene MI. Mechanisms of regulation of cell-mediated immunity. VII. Suppressor T cells induced by suboptimal doses of antigen plus an I-J-specific allogeneic effect. J Exp Med 1981; 153:437-49. [PMID: 6165798 PMCID: PMC2186088 DOI: 10.1084/jem.153.2.437] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Intravenous injection of 0.01 mM 2,4,6-trinitrobenzene sulfonic acid-derivatized syngeneic lymphoid cells generates a Thy-1-positive, antigen-specific suppressor cell for contact sensitivity which requires an I-J allogeneic effect to become fully activated. It is necessary and sufficient for all allogeneic effect to be directed solely against the suppressor cell, and once activated, the cell can suppress in an H-2-unrestricted fashion. The results are discussed in the framework of entry into the suppressor pathway, the allogeneic effect as a reflection of normal physiologic processes, and the importance of I-J as a receptor and signal among cells in the suppressor pathway.
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Eardley DD, Murphy DB, Kemp JD, Shen FW, Cantor H, Gershon RK. Ly-1 inducer and Ly-1,2 acceptor T cells in the feedback suppression circuit bear an I-J-subregion controlled determinant. Immunogenetics 1980; 11:549-57. [PMID: 6086090 DOI: 10.1007/bf01567824] [Citation(s) in RCA: 40] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
An I-J-subregion controlled determinant is expressed on Ly-1 inducer and Ly-1,2 acceptor T cells in the feedback suppression circuit. Ly-1 T cells absorb the I-J antibody reactive with the Ly-1,2 acceptor T cell, suggesting that both inducer and acceptor T cells have the same I-J determinant. Since less than 10 percent of Ly-1 or Ly-1,2 T cells are killed by anti-I-J plus complement treatment, the I-J determinant demarcates functionally distinct subsets of both the Ly-1 and Ly-1,2 T-cell sets. This I-J determinant is not expressed on a detectable number of Ly-1 helper T cells which induce B lymphocytes to produce anti-sheep red cell antibody in tissue culture.
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Affiliation(s)
- D D Eardley
- Laboratory of Cellular Immunology, Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Connecticut 06510
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Meruelo D, Edidin M. The biological function of the major histocompatibility complex: hypotheses. CONTEMPORARY TOPICS IN IMMUNOBIOLOGY 1980; 9:231-53. [PMID: 6244914 DOI: 10.1007/978-1-4615-9131-3_9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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