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Nasab SDS, Eniya ML, Judith A, Clasen F, Faith B, Poongulali S, Gita JB, Ashok C, Raghavi V, Vedavalli S, Lavanya C, Ranganathan K, Rajan G, Kumarasamy N, Moyes D, Ide M, Shoaie S, Kurushima Y, Jagdev D, Pun M, Johnson N, Kannian P, Challacombe S. Detection and consistency of mucosal fluid T lymphocyte phenotypes and their relationship with blood, age and gender. J Immunol Methods 2024; 532:113731. [PMID: 39059745 DOI: 10.1016/j.jim.2024.113731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
Innate and adaptive immune responses at mucosal surfaces play a role in protection against most infectious diseases. However, the relative importance either of mucosal versus systemic, or of cellular versus humoral immunity in protection against such infections remains unclear. We aimed to determine the relative percentages and reproducibility of detection of five major T lymphocyte phenotypes in stimulated whole mouth fluid (SWMF); to compare matched mucosal and blood phenotypes; to evaluate the consistency of phenotypes in SWMF over time; and to determine any associations with age or gender. Peripheral blood and SWMF samples were collected from 194 participants and sequential concomitant samples were collected from 27 of those and from 12 subjects living with HIV. CD3, CD4, CD8, Th1 and Th2 T lymphocyte phenotypes were determined by FACS. All the five T lymphocyte phenotypes were detected consistently by FACS in PBMC and SWMF with experimental replicates (N = 10; PBMC CV: 3-30%; SWMF CV: 12-36%). In longitudinal samples detection rates were reproducible in both fluids but variations were higher in SWMF (CV: 23-79.6%) than PBMC (CV: 9.7-75%). Statistically significant correlations of the percentages of all the T lymphocyte phenotypes except CD8 was seen between the two fluids. In PBMCs a negative correlation with age was found with CD3, CD4 and CD8 phenotypes, whilst a positive correlation was found in both SWMF and PBMC with the Th2 phenotype. CD3, CD4 and CD8 phenotypes in SWMF and PBMCs from an HIV-positive cohort were not significantly correlated in contrast with the HIV-negative controls. Our study provides a robust FACS protocol for the detection of the five major T lymphocyte phenotypes in SWMF which should prove useful for research with other mucosal fluids.
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Affiliation(s)
| | | | | | - Frederick Clasen
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | | | | | | | | | | | | | | | | | | | | | - David Moyes
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Mark Ide
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Saeed Shoaie
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Yuko Kurushima
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Daljit Jagdev
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Mina Pun
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Newell Johnson
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK; Griffith University Dental School, Queensland, Australia
| | | | - Stephen Challacombe
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK.
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2
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Strandmoe AL, Bremer J, Diercks GFH, Gostyński A, Ammatuna E, Pas HH, Wouthuyzen-Bakker M, Huls GA, Heeringa P, Laman JD, Horváth B. Beyond the skin: B cells in pemphigus vulgaris, tolerance and treatment. Br J Dermatol 2024; 191:164-176. [PMID: 38504438 DOI: 10.1093/bjd/ljae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 03/21/2024]
Abstract
Pemphigus vulgaris (PV) is a rare autoimmune bullous disease characterized by blistering of the skin and mucosa owing to the presence of autoantibodies against the desmosome proteins desmoglein 3 and occasionally in conjunction with desmoglein 1. Fundamental research into the pathogenesis of PV has revolutionized its treatment and outcome with rituximab, a B-cell-depleting therapy. The critical contribution of B cells to the pathogenesis of pemphigus is well accepted. However, the exact pathomechanism, mechanisms of onset, disease course and relapse remain unclear. In this narrative review, we provide an overview of the fundamental research progress that has unfolded over the past few centuries to give rise to current and emerging therapies. Furthermore, we summarize the multifaceted roles of B cells in PV, including their development, maturation and antibody activity. Finally, we explored how these various aspects of B-cell function contribute to disease pathogenesis and pave the way for innovative therapeutic interventions.
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Affiliation(s)
- Anne-Lise Strandmoe
- Departments of Medical Biology and Pathology
- Dermatology (Centre for Blistering Diseases)
| | | | - Gilles F H Diercks
- Departments of Medical Biology and Pathology
- Dermatology (Centre for Blistering Diseases)
| | - Antoni Gostyński
- Dermatology (Centre for Blistering Diseases)
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | | | | | - Marjan Wouthuyzen-Bakker
- Medical Microbiology and Infection Prevention; University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | | | | | - Jon D Laman
- Departments of Medical Biology and Pathology
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3
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van Beek N, Holtsche MM, Atefi I, Olbrich H, Schmitz MJ, Pruessmann J, Vorobyev A, Schmidt E. State-of-the-art diagnosis of autoimmune blistering diseases. Front Immunol 2024; 15:1363032. [PMID: 38903493 PMCID: PMC11187241 DOI: 10.3389/fimmu.2024.1363032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/15/2024] [Indexed: 06/22/2024] Open
Abstract
Autoimmune blistering disorders (AIBDs) are a heterogeneous group of approximately a dozen entities comprising pemphigus and pemphigoid disorders and dermatitis herpetiformis. The exact diagnosis of AIBDs is critical for both prognosis and treatment and is based on the clinical appearance combined with the detection of tissue-bound and circulating autoantibodies. While blisters and erosions on the skin and/or inspectable mucosal surfaces are typical, lesions may be highly variable with erythematous, urticarial, prurigo-like, or eczematous manifestations. While direct immunofluorescence microscopy (IFM) of a perilesional biopsy is still the diagnostic gold standard, the molecular identification of the major target antigens opened novel therapeutic avenues. At present, most AIBDs can be diagnosed by the detection of autoantigen-specific serum antibodies by enzyme-linked immunosorbent assay (ELISA) or indirect IFM when the clinical picture is known. This is achieved by easily available and highly specific and sensitive assays employing recombinant immunodominant fragments of the major target antigens, i.e., desmoglein 1 (for pemphigus foliaceus), desmoglein 3 (for pemphigus vulgaris), envoplakin (for paraneoplastic pemphigus), BP180/type XVII collagen (for bullous pemphigoid, pemphigoid gestationis, and mucous membrane pemphigoid), laminin 332 (for mucous membrane pemphigoid), laminin β4 (for anti-p200 pemphigoid), type VII collagen (for epidermolysis bullosa acquisita and mucous membrane pemphigoid), and transglutaminase 3 (for dermatitis herpetiformis). Indirect IFM on tissue substrates and in-house ELISA and immunoblot tests are required to detect autoantibodies in some AIBD patients including those with linear IgA disease. Here, a straightforward modern approach to diagnosing AIBDs is presented including diagnostic criteria according to national and international guidelines supplemented by long-term in-house expertise.
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Affiliation(s)
- Nina van Beek
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
| | - Maike M. Holtsche
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
| | - Ingeborg Atefi
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
| | - Henning Olbrich
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
| | - Marie J. Schmitz
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
| | - Jasper Pruessmann
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
| | - Artem Vorobyev
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
| | - Enno Schmidt
- Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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4
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Akeel S, Almazrooa S, Jazzar A, Mohammed Sindi A, Farsi NJ, Binmadi N, Badkok R, Aljohani M, AlFarabi S. Detection of Specific Immunoglobulins in the Saliva of Patients With Mild COVID-19. Cureus 2024; 16:e52113. [PMID: 38213933 PMCID: PMC10783611 DOI: 10.7759/cureus.52113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2024] [Indexed: 01/13/2024] Open
Abstract
Saliva has many advantages over blood as a biofluid, so using it for measuring and monitoring antibody responses in COVID-19 would be highly valuable. To assess the value of saliva-based IgG and IgM/IgA antibody testing in COVID-19, this cross-sectional pilot study evaluated the accuracy of salivary and serum IgG and IgM/IgA for detecting mild COVID-19 and their correlation. Fifty-one patients with mild COVID-19 (14-28 days post-symptom onset) were included in the study. Enzyme-linked immunosorbent assays (ELISA) were used to measure IgG and IgM/IgA responses to SARS-CoV-2 spike protein in both serum and saliva samples using a slightly modified protocol for saliva samples. Saliva-based IgG testing had 30% sensitivity and 100% specificity, with a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 50%. Saliva-based IgM/IgA testing had 13.2% sensitivity and 100% specificity, with a PPV of 100% and an NPV of 28.3%. Blood and saliva IgG values were positively correlated. Saliva currently has limited diagnostic value for COVID-19 testing, at least for mild disease. Nevertheless, the significant positive correlation between blood and saliva IgG titers indicates that saliva might be a complementary biofluid for assessing systemic antibody responses to the virus, especially if the assay is further optimized across the full disease spectrum.
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Affiliation(s)
- Sara Akeel
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Soulafa Almazrooa
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Ahoud Jazzar
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Amal Mohammed Sindi
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Nada J Farsi
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Nada Binmadi
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Reem Badkok
- Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Modi Aljohani
- Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Sarah AlFarabi
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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5
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Inhibition of UBA5 Expression and Induction of Autophagy in Breast Cancer Cells by Usenamine A. Biomolecules 2021; 11:biom11091348. [PMID: 34572561 PMCID: PMC8469757 DOI: 10.3390/biom11091348] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
Breast cancer is now the most common type of cancer worldwide, surpassing lung cancer. This issue is further worsened by the lack of effective therapies for the disease. Recent reports indicate that the inhibition of ubiquitin-like modifier-activating enzyme 5 (UBA5) can impede tumor development. However, there have been few reports regarding UBA5-inhibiting compounds. This work studied usenamine A, a natural product from the lichen Usnea longissimi that exhibits UBA5-inhibitory effects. Bioinformatics analysis was performed using public databases, and the anti-proliferative ability of usenamine A in breast cancer cells was examined through MTS and colony formation assays. Flow cytometry and western blot analysis were also conducted to examine and analyze cell cycle arrest and apoptosis. In addition, LC3B-RFP and UBA5 expression plasmids were used for the analysis of usenamine A-induced autophagy. According to the bioinformatics analysis results, UBA5 was upregulated in breast cancer. According to in vitro studies, usenamine A displayed prominent anti-proliferative activity and resulted in G2/M phase arrest in MDA-MB-231 cells. Moreover, usenamine A induced autophagy and endoplasmic reticulum stress in MDA-MB-231 cells. In conclusion, the findings support the potential of usenamine A as an agent that can attenuate the development and progression of breast cancer.
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6
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Emtenani S, Ghorbanalipoor S, Mayer-Hain S, Kridin K, Komorowski L, Probst C, Hashimoto T, Pas HH, Męcińska-Jundziłł K, Czajkowski R, Recke A, Sunderkötter C, Schneider SW, Hundt JE, Zillikens D, Schmidt E, Ludwig RJ, Hammers CM. Pathogenic Activation and Therapeutic Blockage of FcαR-Expressing Polymorphonuclear Leukocytes in IgA Pemphigus. J Invest Dermatol 2021; 141:2820-2828. [PMID: 34246620 DOI: 10.1016/j.jid.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
Pathomechanisms in IgA pemphigus are assumed to rely on Fc-dependent cellular activation by antigen-specific IgA autoantibodies; however, models for the disease and more detailed pathophysiologic data are lacking. In this study, we aimed to establish in vitro models of disease for IgA pemphigus, allowing us to study the effects of the interaction of anti-keratinocyte IgA with cell surface FcαRs. Employing multiple in vitro assays, such as a skin cryosection assay and a human skin organ culture model, in this study, we present mechanistic data for the pathogenesis of IgA pemphigus, mediated by anti-desmoglein 3 IgA autoantibodies. Our results reveal that this disease is dependent on FcαR-mediated activation of leukocytes in the epidermis. Importantly, this cell-dependent pathology can be dose-dependently abrogated by peptide-mediated inhibition of FcαR:IgA-Fc interaction, as confirmed in an additional model for IgA-dependent disease, that is, IgA vasculitis. These data suggest that IgA pemphigus can be modeled in vitro and that IgA pemphigus and IgA vasculitis are FcαR-dependent disease entities that can be specifically targeted in these experimental systems.
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Affiliation(s)
- Shirin Emtenani
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Saeedeh Ghorbanalipoor
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Sarah Mayer-Hain
- Department of Translational Dermatoinfectiology, University Hospital of Muenster, University of Muenster, Muenster, Germany; Institute of Immunology, University Hospital of Muenster, University of Muenster, Muenster, Germany
| | - Khalaf Kridin
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | | | | | - Takashi Hashimoto
- Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hendri H Pas
- Department of Dermatology, University of Groningen, Groningen, The Netherlands
| | - Kaja Męcińska-Jundziłł
- Department of Dermatology and Venerology, Faculty of Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Rafał Czajkowski
- Department of Dermatology and Venerology, Faculty of Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Andreas Recke
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Cord Sunderkötter
- Department of Translational Dermatoinfectiology, University Hospital of Muenster, University of Muenster, Muenster, Germany; Department of Dermatology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Stefan W Schneider
- Department of Dermatology and Venerology, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Jennifer E Hundt
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany
| | - Detlef Zillikens
- Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany
| | - Enno Schmidt
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany; Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany
| | - Ralf J Ludwig
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany; Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany
| | - Christoph M Hammers
- Luebeck Institute of Experimental Dermatology (LIED), University of Luebeck, Luebeck, Germany; Department of Dermatology, Allergology and Venerology, University of Luebeck, Luebeck, Germany.
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7
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Campanati A, Martina E, Diotallevi F, Radi G, Marani A, Sartini D, Emanuelli M, Kontochristopoulos G, Rigopoulos D, Gregoriou S, Offidani A. Saliva Proteomics as Fluid Signature of Inflammatory and Immune-Mediated Skin Diseases. Int J Mol Sci 2021; 22:ijms22137018. [PMID: 34209865 PMCID: PMC8267971 DOI: 10.3390/ijms22137018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/11/2022] Open
Abstract
Saliva is easy to access, non-invasive and a useful source of information useful for the diagnosis of serval inflammatory and immune-mediated diseases. Following the advent of genomic technologies and -omic research, studies based on saliva testing have rapidly increased and human salivary proteome has been partially characterized. As a proteomic protocol to analyze the whole saliva proteome is not currently available, the most common aim of the proteomic analysis is to discriminate between physiological and pathological conditions. The salivary proteome has been initially investigated in several diseases: oral squamous cell carcinoma and oral leukoplakia, chronic graft-versus-host disease, and Sjögren's syndrome. Otherwise, salivary proteomics studies in the dermatological field are still in the initial phase, thus the aim of this review is to collect the best research evidence on the role of saliva proteomics analysis in immune-mediated skin diseases to understand the direction of research in this field. The results of PRISMA analysis reported herein suggest that human saliva analysis could provide significant data for the diagnosis and prognosis of several immune-mediated and inflammatory skin diseases in the next future.
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Affiliation(s)
- Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
- Correspondence:
| | - Emanuela Martina
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Federico Diotallevi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Giulia Radi
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Andrea Marani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
| | - Davide Sartini
- Biochemistry, Department of Clinical Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (D.S.); (M.E.)
| | - Monica Emanuelli
- Biochemistry, Department of Clinical Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (D.S.); (M.E.)
| | - George Kontochristopoulos
- Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 124 62 Athens, Greece; (G.K.); (D.R.); (S.G.)
| | - Dimitris Rigopoulos
- Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 124 62 Athens, Greece; (G.K.); (D.R.); (S.G.)
| | - Stamatis Gregoriou
- Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 124 62 Athens, Greece; (G.K.); (D.R.); (S.G.)
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60100 Ancona, Italy; (E.M.); (F.D.); (G.R.); (A.M.); (A.O.)
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8
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Martina E, Campanati A, Diotallevi F, Offidani A. Saliva and Oral Diseases. J Clin Med 2020; 9:E466. [PMID: 32046271 PMCID: PMC7074457 DOI: 10.3390/jcm9020466] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 02/06/2023] Open
Abstract
Saliva is a fascinating biological fluid which has all the features of a perfect diagnostic tool. In fact, its collection is rapid, simple, and noninvasive. Thanks to several transport mechanisms and its intimate contact with crevicular fluid, saliva contains hundreds of proteins deriving from plasma. Advances in analytical techniques have opened a new era-called "salivaomics"-that investigates the salivary proteome, transcriptome, microRNAs, metabolome, and microbiome. In recent years, researchers have tried to find salivary biomarkers for oral and systemic diseases with various protocols and technologies. The review aspires to provide an overall perspective of salivary biomarkers concerning oral diseases such as lichen planus, oral cancer, blistering diseases, and psoriasis. Saliva has proved to be a promising substrate for the early detection of oral diseases and the evaluation of therapeutic response. However, the wide variation in sampling, processing, and measuring of salivary elements still represents a limit for the application in clinical practice.
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9
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Cole EF, Sami N, Feldman RJ. Updates on diagnosis and management of autoimmune blistering diseases. GIORN ITAL DERMAT V 2019; 155:46-64. [PMID: 31804056 DOI: 10.23736/s0392-0488.19.06517-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the last several decades, advances in the understanding of the pathogenesis of autoimmune blistering diseases has resulted in significant improvements in diagnosis and management. These improvements include new diagnostic assays and therapies targeted at specific disease mediators. Furthermore, the abundance of new therapies in clinic trials for autoimmune blistering diseases will translate to an enhanced therapeutic armamentarium for clinicians. The aim of this article is to review new developments in the understanding of autoimmune blistering diseases and to summarize advancements in their diagnosis and management.
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Affiliation(s)
- Emily F Cole
- Emory Autoimmune Blistering Disease Clinic, Emory Department of Dermatology, Atlanta, GA, USA
| | - Naveed Sami
- Department of Dermatology, University of Central Florida, Orlando, FL, USA -
| | - Ron J Feldman
- Emory Autoimmune Blistering Disease Clinic, Emory Department of Dermatology, Atlanta, GA, USA
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10
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Sun S, Zhong B, Li W, Jin X, Yao Y, Wang J, Liu J, Dan H, Chen Q, Zeng X. Immunological methods for the diagnosis of oral mucosal diseases. Br J Dermatol 2019; 181:23-36. [PMID: 30585301 DOI: 10.1111/bjd.17589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 02/05/2023]
Abstract
Immunological methods, which have been widely used in autoimmune blistering diseases (AIBDs) of the oral mucosa, can also be adopted as auxiliary diagnostic tools in oral lichen planus (OLP) and discoid lupus erythematosus (DLE). AIBDs, characterized by autoantibodies against structural proteins of keratinocytes or the basement membrane zone, clinically present as blisters and erosions of the oral mucosa. When atypical lesions occur, OLP or DLE may be confused with AIBDs. The improvement of diagnostic accuracy is necessary due to the significant differences in treatment and prognosis among these diseases. A variety of immunological methods are used for qualitative and quantitative detection of target antigens and autoantibodies. These methods can evaluate efficacy of treatment, monitor diseases and guide treatment decisions. In this review, we discuss the application of immunofluorescence, biochemical tests, and protein microarrays for AIBDs, OLP and DLE, as well as the differential diagnostic methods using immunological tests.
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Affiliation(s)
- S Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - B Zhong
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - W Li
- Department of Dermatovenereology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu, China
| | - X Jin
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences and College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Y Yao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Zunyi Medical University, Zunyi, China
| | - J Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - J Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - H Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Q Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - X Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
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Rare Detection of Antiviral Functions of Polyclonal IgA Isolated from Plasma and Breast Milk Compartments in Women Chronically Infected with HIV-1. J Virol 2019; 93:JVI.02084-18. [PMID: 30700599 PMCID: PMC6430545 DOI: 10.1128/jvi.02084-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/15/2019] [Indexed: 02/06/2023] Open
Abstract
The humoral response to invading mucosal pathogens comprises multiple antibody isotypes derived from systemic and mucosal compartments. To understand the contribution of each antibody isotype/source to the mucosal humoral response, parallel investigation of the specificities and functions of antibodies within and across isotypes and compartments is required. The role of IgA against HIV-1 is complex, with studies supporting a protective role as well as a role for serum IgA in blocking effector functions. Thus, we explored the fine specificity and function of IgA in both plasma and mucosal secretions important to infant HIV-1 infection, i.e., breast milk. IgA and IgG were isolated from milk and plasma from 20 HIV-1-infected lactating Malawian women. HIV-1 binding specificities, neutralization potency, inhibition of virus-epithelial cell binding, and antibody-mediated phagocytosis were measured. Fine-specificity mapping showed IgA and IgG responses to multiple HIV-1 Env epitopes, including conformational V1/V2 and linear V2, V3, and constant region 5 (C5). Env IgA was heterogeneous between the milk and systemic compartments (Env IgA, τ = 0.00 to 0.63, P = 0.0046 to 1.00). Furthermore, IgA and IgG appeared compartmentalized as there was a lack of correlation between the specificities of Env-specific IgA and IgG (in milk, τ = -0.07 to 0.26, P = 0.35 to 0.83). IgA and IgG also differed in functions: while neutralization and phagocytosis were consistently mediated by milk and plasma IgG, they were rarely detected in IgA from both milk and plasma. Understanding the ontogeny of the divergent IgG and IgA antigen specificity repertoires and their effects on antibody function will inform vaccination approaches targeted toward mucosal pathogens.IMPORTANCE Antibodies within the mucosa are part of the first line of defense against mucosal pathogens. Evaluating mucosal antibody isotypes, specificities, and antiviral functions in relationship to the systemic antibody profile can provide insights into whether the antibody response is coordinated in response to mucosal pathogens. In a natural immunity cohort of HIV-infected lactating women, we mapped the fine specificity and function of IgA in breast milk and plasma and compared these with the autologous IgG responses. Antigen specificities and functions differed between IgG and IgA, with antiviral functions (neutralization and phagocytosis) predominantly mediated by the IgG fraction in both milk and plasma. Furthermore, the specificity of milk IgA differed from that of systemic IgA. Our data suggest that milk IgA and systemic IgA should be separately examined as potential correlates of risk. Preventive vaccines may need to employ different strategies to elicit functional antiviral immunity by both antibody isotypes in the mucosa.
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12
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Autoimmune Diseases and Their Manifestations on Oral Cavity: Diagnosis and Clinical Management. J Immunol Res 2018; 2018:6061825. [PMID: 29977929 PMCID: PMC5994274 DOI: 10.1155/2018/6061825] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/15/2018] [Indexed: 02/07/2023] Open
Abstract
Oral signs are frequently the first manifestation of autoimmune diseases. For this reason, dentists play an important role in the detection of emerging autoimmune pathologies. Indeed, an early diagnosis can play a decisive role in improving the quality of treatment strategies as well as quality of life. This can be obtained thanks to specific knowledge of oral manifestations of autoimmune diseases. This review is aimed at describing oral presentations, diagnosis, and treatment strategies for systemic lupus erythematosus, Sjögren syndrome, pemphigus vulgaris, mucous membrane pemphigoid, and Behcet disease.
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Saliva as a Future Field in Psoriasis Research. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7290913. [PMID: 29888276 PMCID: PMC5985113 DOI: 10.1155/2018/7290913] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/11/2018] [Indexed: 02/06/2023]
Abstract
Psoriasis is a skin inflammatory disease characterized by an increased body of comorbidities, including parodontopathy. Despite the visibility of skin lesions, prognostic biomarkers, related to disease monitoring and therapeutic effectiveness, are still missing. Although several markers have been studied, none of them has been identified as an independent prognostic factor. This concise review aims to summarize the current knowledge and results in saliva research applied to psoriasis. Combination of different markers could improve the prognostic prediction in patients with psoriasis. Future studies are needed to implement research on salivary biomarkers and their prognostic/therapeutic effects in the management of patients with psoriasis.
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Ormond M, McParland H, Donaldson A, Andiappan M, Cook R, Escudier M, Hullah E, Higham J, McMillan R, Taylor J, Shirlaw P, Challacombe S, Setterfield J. An Oral Disease Severity Score validated for use in oral pemphigus vulgaris. Br J Dermatol 2018; 179:872-881. [DOI: 10.1111/bjd.16265] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Ormond
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - H. McParland
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - A.N.A. Donaldson
- Biostatistics and Research Methods Centre; Dental Institute; King's College London; London U.K
| | - M. Andiappan
- Biostatistics and Research Methods Centre; Dental Institute; King's College London; London U.K
| | - R.J. Cook
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - M. Escudier
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
- Mucosal and Salivary Biology Division; Dental Institute; King's College London; London U.K
| | - E. Hullah
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - J. Higham
- Birmingham Dental Hospital; Birmingham U.K
| | - R. McMillan
- Eastman Dental Hospital; UCLH/Eastman Dental Institute; University College London; London U.K
| | - J. Taylor
- University Dental Hospital; Manchester U.K
| | - P.J. Shirlaw
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
| | - S.J. Challacombe
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
- Mucosal and Salivary Biology Division; Dental Institute; King's College London; London U.K
| | - J.F. Setterfield
- Department of Oral Medicine; Dental Institute; Guy's and St Thomas’ NHS Foundation Trust and King's College London; London U.K
- Mucosal and Salivary Biology Division; Dental Institute; King's College London; London U.K
- St John's Institute of Dermatology; Guy's and St Thomas's NHS Foundation Trust; London U.K
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15
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Ahmed AR, Carrozzo M, Caux F, Cirillo N, Dmochowski M, Alonso AE, Gniadecki R, Hertl M, López-Zabalza MJ, Lotti R, Pincelli C, Pittelkow M, Schmidt E, Sinha AA, Sprecher E, Grando SA. Monopathogenic vs multipathogenic explanations of pemphigus pathophysiology. Exp Dermatol 2018; 25:839-846. [PMID: 27305362 DOI: 10.1111/exd.13106] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2016] [Indexed: 01/31/2023]
Abstract
This viewpoint highlights major, partly controversial concepts about the pathogenesis of pemphigus. The monopathogenic theory explains intra-epidermal blistering through the "desmoglein (Dsg) compensation" hypothesis, according to which an antibody-dependent disabling of Dsg 1- and/or Dsg 3-mediated cell-cell attachments of keratinocytes (KCs) is sufficient to disrupt epidermal integrity and cause blistering. The multipathogenic theory explains intra-epidermal blistering through the "multiple hit" hypothesis stating that a simultaneous and synchronized inactivation of the physiological mechanisms regulating and/or mediating intercellular adhesion of KCs is necessary to disrupt epidermal integrity. The major premise for a multipathogenic theory is that a single type of autoantibody induces only reversible changes, so that affected KCs can recover due to a self-repair. The damage, however, becomes irreversible when the salvage pathway and/or other cell functions are altered by a partnering autoantibody and/or other pathogenic factors. Future studies are needed to (i) corroborate these findings, (ii) characterize in detail patient populations with non-Dsg-specific autoantibodies, and (iii) determine the extent of the contribution of non-Dsg antibodies in disease pathophysiology.
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Affiliation(s)
- A Razzaque Ahmed
- Department of Dermatology of Tufts University and Center for Blistering Diseases, Boston, MA, USA
| | - Marco Carrozzo
- School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Frédéric Caux
- Department of Dermatology, University Paris 13, Avicenne Hospital, APHP, Bobigny, France
| | - Nicola Cirillo
- Melbourne Dental School and Oral Health CRC, The University of Melbourne, Melbourne, Vic., Australia
| | - Marian Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agustín España Alonso
- Department of Dermatology, School of Medicine, University Clinic of Navarra, University of Navarra, Navarra, Spain
| | - Robert Gniadecki
- Division of Dermatology, University of Alberta, Edmonton, AB, Canada
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | | | - Roberta Lotti
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Pincelli
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Mark Pittelkow
- Department of Dermatology, Mayo Clinic, Scottsdale, AZ, USA
| | - Enno Schmidt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Animesh A Sinha
- Department of Dermatology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Eli Sprecher
- Department of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Sergei A Grando
- Institute for Immunology and Departments of Dermatology and Biological Chemistry, University of California, Irvine, CA, USA.
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16
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Harman K, Brown D, Exton L, Groves R, Hampton P, Mohd Mustapa M, Setterfield J, Yesudian P, McHenry P, Gibbon K, Buckley D, Leslie T, Mallon E, Wakelin S, Ungureanu S, Hunasehally R, Cork M, Johnston G, Natkunarajah J, Worsnop F, Chiang N, Duarte Williamson C, Donnelly J, Saunders C, Brain A. British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017. Br J Dermatol 2017; 177:1170-1201. [DOI: 10.1111/bjd.15930] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 12/11/2022]
Affiliation(s)
- K.E. Harman
- University Hospitals Leicester Leicester Royal Infirmary Infirmary Square Leicester LE1 5WW U.K
| | - D. Brown
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital Westminster Bridge Road London SE1 7EH U.K
| | - L.S. Exton
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - R.W. Groves
- St. John's Institute of Dermatology King's College London Guy's Campus, Great Maze Pond London SE1 9RT U.K
| | - P.J. Hampton
- Royal Victoria Infirmary Queen Victoria Road Newcastle upon Tyne Tyne and Wear NE1 4LP U.K
| | - M.F. Mohd Mustapa
- British Association of Dermatologists Willan House, 4 Fitzroy Square London W1T 5HQ U.K
| | - J.F. Setterfield
- St. John's Institute of Dermatology King's College London Guy's Campus, Great Maze Pond London SE1 9RT U.K
- Mucosal & Salivary Biology Division King's College London Dental Institute Guy's Campus, Great Maze Pond London SE1 9RT U.K
| | - P.D. Yesudian
- Wrexham Maelor Hospital Croesnewydd Road Wrexham LL13 7TD U.K
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Oral Manifestations of Autoimmune and Connective Tissue Disorders. Atlas Oral Maxillofac Surg Clin North Am 2017; 25:113-126. [PMID: 28778301 DOI: 10.1016/j.cxom.2017.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Abstract
Although the surfaces of both the skin and oral mucosa are protected by squamous epithelial cells and fall within the scope of dermatologic practice, the oral cavity contains highly specialized structures and functions distinct from other skin biology and pathologic conditions and are also the purview of clinicians who care for patients with skin and mucosal diseases. We describe the distinct features of the tongue, mucosa, and salivary glands. In particular, we examine the composition and function of the saliva, with special focus on salivary biomarkers. Within the oral cavity, saliva shows great promise as a noninvasive and sensitive marker for many systemic diseases. Biomarkers are being used as diagnostic or monitoring tools for a wide variety of diseases, including systemic lupus erythematosus, Sjögren disease, Behçet disease, and autoimmune blistering disorders, as well as premalignant and malignant lesions of the mouth.
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Hashimoto T. Collaboration between dermatologists and dentists in autoimmune bullous diseases and immunoglobulin A antibodies in pemphigus. Br J Dermatol 2016; 175:15-6. [PMID: 27484268 DOI: 10.1111/bjd.14565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T Hashimoto
- Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.
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