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Li G, Liu S, Chen Y, Xu H, Qi T, Xiong A, Wang D, Yu F, Weng J, Zeng H. Teriparatide ameliorates articular cartilage degradation and aberrant subchondral bone remodeling in DMM mice. J Orthop Translat 2022; 38:241-255. [PMID: 36514714 PMCID: PMC9731868 DOI: 10.1016/j.jot.2022.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Knee osteoarthritis (KOA) is a highly prevalent musculoskeletal disorder characterized by degeneration of cartilage and abnormal remodeling of subchondral bone (SCB). Teriparatide (PTH (1-34)) is an effective anabolic drug for osteoporosis (OP) and regulates osteoprotegerin (OPG)/receptor activator of nuclear factor ligand (RANKL)/RANK signaling, which also has a therapeutic effect on KOA by ameliorating cartilage degradation and inhibiting aberrant remodeling of SCB. However, the mechanisms of PTH (1-34) in treating KOA are still uncertain and remain to be explored. Therefore, we compared the effect of PTH (1-34) on the post-traumatic KOA mouse model to explore the potential therapeutic effect and mechanisms. Methods In vivo study, eight-week-old male mice including wild-type (WT) (n = 54) and OPG-/- (n = 54) were investigated and compared. Post-traumatic KOA model was created by destabilization of medial meniscus (DMM). WT mice were randomly assigned into three groups: the sham group (WT-sham; n = 18), the DMM group (WT-DMM; n = 18), and the PTH (1-34)-treated group (WT-DMM + PTH (1-34); n = 18). Similarly, the OPG-/- mice were randomly allocated into three groups as well. The designed mice were executed at the 4th, 8th, and 12th weeks to evaluate KOA progression. To further explore the chondro-protective of PTH (1-34), the ATDC5 chondrocytes were stimulated with different concentrations of PTH (1-34) in vitro. Results Compared with the WT-sham mice, significant wear of cartilage in terms of reduced cartilage thickness and glycosaminoglycan (GAG) loss was detected in the WT-DMM mice. PTH (1-34) exhibited cartilage-protective by alleviating wear, retaining the thickness and GAG contents. Moreover, the deterioration of the SCB was alleviated and the expression of PTH1R/OPG/RANKL/RANK were found to increase after PTH (1-34) treatment. Among the OPG-/- mice, the cartilage of the DMM mice displayed typical KOA change with higher OARSI score and thinner cartilage. The damage of the cartilage was alleviated but the abnormal remodeling of SCB didn't show any response to the PTH (1-34) treatment. Compared with the WT-DMM mice, the OPG-/--DMM mice caught more aggressive KOA with thinner cartilage, sever cartilage damage, and more abnormal remodeling of SCB. Moreover, both the damaged cartilage from the WT-DMM mice and the OPG-/--DMM mice were alleviated but only the deterioration of SCB in WT-DMM mice was alleviated after the administration of PTH (1-34). In vitro study, PTH (1-34) could promote the viability of chondrocytes, enhance the synthesis of extracellular matrix (ECM) (AGC, COLII, and SOX9) at the mRNA and protein level, but inhibit the secretion of inflammatory cytokines (TNF-α and IL-6). Conclusion Both wear of the cartilage was alleviated and aberrant remodeling of the SCB was inhibited in the WT mice, but only the cartilage-protective effect was observed in the OPG-/- mice. PTH (1-34) exhibited chondro-protective effect by decelerating cartilage degeneration in vivo as well as by promoting the proliferation and enhancing ECM synthesis of chondrocytes in vitro. The current investigation implied that the rescue of the disturbed SCB is dependent on the regulation of OPG while the chondro-protective effect is independent of modulation of OPG, which provides proof for the treatment of KOA. The translational potential of this article Systemic administration of PTH (1-34) could exert a therapeutic effect on both cartilage and SCB in different mechanisms to alleviate KOA progression, which might be a novel therapy for KOA.
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Key Words
- AB, Alican blue
- ADAMTS5, ADAM Metallopeptidase with Thrombospondin Type 1 Motif 5
- AGC, Aggrecan
- AGC, aggrecan
- ANOVA, one-way analysis of variance
- ARRIVE, Animal Research: Reporting of In Vivo Experiments
- BMD, bone mineral density
- BV/TV, bone volume fraction
- CCK-8, cell counting kit-8
- CLSM, confocal laser scanning microscope
- COLII, Type II collagen
- COLX, Type X collagen
- Cartilage
- DMEM, Dulbecco's Modified Eagle's Medium
- DMM, destabilization of medical meniscus
- ECM, extracellular matrix
- EDTA, ethylene diamine tetra acetic acid
- ELISA, enzyme-linked immunosorbent assay
- EdU, 5-ethynyl-2′-deoxyuridine
- FBS, fatal bovine serum
- GAG, glycosaminoglycan
- GAPDH, glyceraldehyde-3-phosphate dehydrogenase
- HE, hematoxylin and eosin
- HPLC, High Performance Liquid Chromatography
- IL-1β, Interleukin-1β
- IL-6, Interleukin-6
- KOA, knee osteoarthritis
- Knee osteoarthritis
- MMP13, Matrix Metallopeptidase 13
- MT, masson's trichrome
- Micro-CT, microcomputer tomography
- NCBI, National Center for Biotechnology Information
- OARSI, Osteoarthritis Research Society International
- OD, optical density
- OP, osteoporosis
- OPG, osteoprotegerin
- OPG−/−, osteoprotegerin-knockout
- Osteoprotegerin (OPG)
- PBS, phosphate buffer solution
- PCR, polymerase chain reaction
- PTH (1–34), Teriparatide
- ROI, region of interest
- RT-qPCR, quantitative reverse transcription polymerase chain reaction
- S.I, subcutaneous injection
- SCB, subchondral bone
- SMI, structure model index
- SOFG, Safranin O-fast green
- SOX9, SRY-Box Transcription Factor 9
- Subchondral bone
- TB, toluidine blue O
- TNF-α, tumor necrosis factor-α
- Tb.N, trabecular number
- Tb.Th, trabecular thickness
- Teriparatide (PTH (1–34))
- WT, wild type
- nM, nMol/L
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Affiliation(s)
- Guoqing Li
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Su Liu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Yixiao Chen
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Huihui Xu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Tiantian Qi
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Ao Xiong
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Deli Wang
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
| | - Fei Yu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- Corresponding author. Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
| | - Jian Weng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- Corresponding author. Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
| | - Hui Zeng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, People's Republic of China, 518036
- Corresponding author. National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
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Xu J, Zhang Z, Huang L, Xiong J, Zhou Z, Yu H, Wu L, Liu Z, Cao K. Let-7a suppresses Ewing sarcoma CSCs' malignant phenotype via forming a positive feedback circuit with STAT3 and lin28. J Bone Oncol 2021; 31:100406. [PMID: 34917467 PMCID: PMC8645918 DOI: 10.1016/j.jbo.2021.100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022] Open
Abstract
Let-7a was repressed in the cancer stem cells of Ewing sarcoma(ES-CSCs). Increase the expression of let-7a suppress the ability of colony formation and invasion of ES-CSCs. Let-7a, STAT3 and lin28 form a positive feedback circuit in ES-CSCs. Increase the expression of let-7a suppress xenograft tumor growth of ES-CSCs.
Cancer stem cells (CSCs) have been documented to be closely related with tumor metastasis and recurrence, and the same important role were identified in Ewing Sarcoma (ES). In our previous study, we found that let-7a expression was repressed in ES. Herein, we further identified its putative effects in the CSCs of ES (ES-CSCs). The expression of let-7a was consistently suppressed in the separated side population (SP) cells, which were identified to contain the characteristics of the stem cells. Then, we increased the expression of let-7a in ES-CSCs, and found that the ability of colony formation and invasion of ES-CSCs were suppressed in vitro. The same results were found in the tumor growth of ES-CSCs’ xenograft mice in vivo. To further explore the putative mechanism involved, we also explored whether signal transducer and activator of transcription 3 (STAT3) was involved in the suppressive effects. As expected, excessive expression of let-7a could suppress the expression STAT3 in the ES-CSCs, and repressed the expression of STAT3 imitated the suppressive effects of let-7a on ES-CSCs, suppressing the ability of colony formation and invasion of ES-CSCs. Furthermore, we found lin28 was involved in the relative impacts of let-7a, as well as STAT3. Let-7a, STAT3 and lin28 might form a positive feedback circuit, which serve a pivotal role in the carcinogensis of ES-CSCs. These findings maybe provide assistance for patients with ES in the future, especially those with metastasis and recurrence, and new directions for their treatment.
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Key Words
- ABCG2, ATP-binding cassette transporter G 2
- ATCC, American Type Culture Collection
- CSCs, Cancer stem cells
- Cancer stem cells
- ES, Ewing Sarcoma
- ES-CSCs, CSCs of ES
- Ewing sarcoma
- FBS, fatal bovine serum
- Let-7a
- Lin28
- MMP2, Matrix Metallopeptidase 2
- MSCs, mesenchymal stem cells
- ORF, open reading frame
- PBS, phosphate buffer saline
- PI, propidium iodide
- SP, side populationl
- STAT3
- STAT3, signal transducer and activator of transcription 3
- iPSCs, human induced pluripotent stem cells
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Affiliation(s)
- Jiang Xu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China
| | - Zhongzu Zhang
- Department of Orthopedics, The Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, PR China
| | - Lu Huang
- Department of Children Health and Care, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi 330006, PR China
| | - Jiachao Xiong
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China
| | - Zhenhai Zhou
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China
| | - Honggui Yu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China
| | - Liang Wu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China
| | - Zhimin Liu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China
| | - Kai Cao
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, PR China
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Edamura K, Takahashi Y, Fujii A, Masuhiro Y, Narita T, Seki M, Asano K. Recombinant canine basic fibroblast growth factor-induced differentiation of canine bone marrow mesenchymal stem cells into voltage- and glutamate-responsive neuron-like cells. Regen Ther 2020; 15:121-128. [PMID: 33426210 PMCID: PMC7770349 DOI: 10.1016/j.reth.2020.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction Basic fibroblast growth factor (bFGF) is a promising cytokine in regenerative therapy for spinal cord injury. In this study, recombinant canine bFGF (rc-bFGF) was synthesized for clinical use in dogs, and the ability of rc-bFGF to differentiate canine bone marrow mesenchymal stem cells (BMSCs) into functional neurons was investigated. Methods The rc-bFGF was synthesized using a wheat germ cell-free protein synthesis system. The expression of rc-bFGF mRNA in the purification process was confirmed using a reverse transcription-polymerase chain reaction (RT-PCR). Western blotting was performed to confirm the antigenic property of the purified protein. To verify function of the purified protein, phosphorylation of extracellular signal-regulated kinase (ERK) was examined by in vitro assay using HEK293 cells. To compare the neuronal differentiation capacity of canine BMSCs in response to treatment with rc-bFGF, the cells were divided into the following four groups: control, undifferentiated, rh-bFGF, and rc-bFGF groups. After neuronal induction, the percentage of cells that had changed to a neuron-like morphology and the mRNA expression of neuronal markers were evaluated. Furthermore, to assess the function of the canine BMSCs after neuronal induction, changes in the intracellular Ca2+ concentrations after stimulation with KCl and l-glutamate were examined. Results The protein synthesized in this study was rc-bFGF and functioned as bFGF, from the results of RT-PCR, western blotting, and the expression of pERK in HEK293 cells. Canine BMSCs acquired a neuron-like morphology and expressed mRNAs of neuronal markers after neuronal induction in the rh-bFGF and the rc-bFGF groups. These results were more marked in the rc-bFGF group than in the other groups. Furthermore, an increase in intracellular Ca2+ concentrations was observed after the stimulation of KCl and l-glutamate in the rc-bFGF group, same as in the rh-bFGF group. Conclusions A functional rc-bFGF was successfully synthesized, and rc-bFGF induced the differentiation of canine BMSCs into voltage- and glutamate-responsive neuron-like cells. Our purified rc-bFGF may contribute, on its own, or in combination with canine BMSCs, to regenerative therapy for spinal cord injury in dogs. Functional rc-bFGF was successfully synthesized. rc-bFGF induced the differentiation of canine BMSCs into neuron-like cells. rc-bFGF may aid in regenerative therapy of spinal cord injury in dogs.
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Key Words
- BMSCs, bone marrow mesenchymal stem cells
- Basic fibroblast growth factor
- Bone marrow
- Differentiation
- Dog
- EDTA, ethylenediaminetetraacetic acid
- ERK, extracellular signal-regulated kinase
- FBS, fatal bovine serum
- FGFR, basic fibroblast growth factor receptor
- GUSB, β-glucuronidase
- HEK293, human embryonic kidney cells 293
- HRP, horseradish peroxidase
- Mesenchymal stem cell
- Neuron
- PBS, phosphate buffered saline
- PCR, polymerase chain reaction
- PI3K, phosphatidylinositol 3-kinase
- RT-PCR, reverse transcription-polymerase chain reaction
- bFGF, basic fibroblast growth factor
- cDNA, complementary DNA
- mRNA, messenger ribonucleic acid
- pERK, phosphorylated extracellular signal-regulated kinase
- αMEM, alpha modified eagle minimum essential medium
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Affiliation(s)
- Kazuya Edamura
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - Yusuke Takahashi
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - Airi Fujii
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - Yoshikazu Masuhiro
- Department of Applied Biological Science, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - Takanori Narita
- Laboratory of Veterinary Biochemistry, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - Mamiko Seki
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - Kazushi Asano
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
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Toubai T, Guoqing H, Rossi C, Mathewson N, Oravecz-Wilson K, Cummings E, Wu J, Sun Y, Choi S, Reddy P. Ikaros deficiency in host hematopoietic cells separates GVL from GVHD after experimental allogeneic hematopoietic cell transplantation. Oncoimmunology 2015; 4:e1016699. [PMID: 26140241 PMCID: PMC4485841 DOI: 10.1080/2162402x.2015.1016699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/02/2015] [Accepted: 02/03/2015] [Indexed: 10/25/2022] Open
Abstract
The graft-versus-leukemia (GVL) effect following allogeneic hematopoietic stem cell transplantation (allo-HCT) is critical for its curative potential. Hwever, GVL is tightly linked to graft-versus-host disease (GVHD). Among hematological malignancies, acute lymphoblastic leukemia (ALL) is the most resistant to GVL, although the reasons for this remain poorly understood. Clinical studies have identified alterations in Ikaros (Ik) transcription factor as the major marker associated with poor outcomes in ALL. We have shown that the absence of Ik in professional host-derived hematopoietic antigen-presenting cells (APCs) exacerbates GVHD. However, whether Ik expression plays a role in resistance to GVL is not known. In this study we used multiple clinically relevant murine models of allo-HCT to explore whether Ik expression in hematopoietic APCs and/or leukemic cells is critical for increasing resistance to GVL and thus inducing relapse. We found that Ik deficiency in host APCs failed to enhance GVL despite increased GVHD severity. Mechanistic studies with bone marrow (BM) chimeras and tetramer analyses demonstrated reduced tumor-specific immunodominant (gag+) antigen responses in the [B6Ik-/-→B6] group. Loss of GVL was observed when both the leukemia cells and the host APCs were deficient in Ik. We found that calreticulin (CRT) expression in host antigen-presenting dendritic cells (DCs) of Ik-/- animals was significantly lower than in wild-type animals. Rescuing CRT expression in Ik-/- DCs improved leukemic-specific cytotoxic T cell function. Together, our data demonstrate that the absence of Ikaros in host hematopoietic cells promotes resistance to GVL despite increasing GVHD and thus provides a potential mechanism for the poor outcome of Ik-/- ALL patients.
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Key Words
- 51Cr, Chromium-51
- ALL, acute lymphoblastic leukemia
- APC, allophycocyanin
- APCs, antigen-presenting cells
- Allo-HCT, allogeneic hematopoietic stem cell transplantation
- BC, blast crisis
- BLI, bioluminescence imaging
- BM, bone marrow
- BMDCs, bone marrow derived dendritic cells
- BMT, bone marrow transplantation
- CML, chronic myeloid leukemia
- CRT, calreticulin
- CTL, cytotoxic T cell
- DCs, dendritic cells
- FACS, Fluorescence-activated cell sorting
- FBS, fatal bovine serum
- FITC, fluorescein isothiocyanate
- GVHD, graft-versus-host-disease
- GVL, graft-versus-leukemia
- HCT, hematopoietic stem cell transplantation
- ICAM-1, intracellular adhesion molecule 1
- Ik DN, Ikaros dominant negative
- Ik, Ikaros
- Ikaros
- MACS, magnetic- activated cell sorting
- MBL-2, moloney-murine sarcoma virus-induced MBL-2 lymphoma cells
- MHC, major histocompatibility complex
- MLR, mixed lymphocyte reaction
- MiHAs, multiple minor histocompatibility antigens
- PBS, phosphate buffered saline
- PE, phycoerythrin
- SIRP-α, signal regulatory protein α
- TCD-BM, T cell depleted bone marrow
- TSA, tumor specific antigen
- Tregs, regulatory T cells
- UCUCA, University Committee on Use and Care of Animals
- WT, wild-type
- antigen-presenting cells
- bone marrow transplantation
- graft-versus-leukemia
- luc+, luciferase+
- mAbs, monoclonal antibodies
- mCRT, murine calreticulin
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Affiliation(s)
- Tomomi Toubai
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
| | - Hou Guoqing
- Department of Pediatrics and Communicable Diseases; University of Michigan Medical School ; Ann Arbor, MI USA
| | - Corrine Rossi
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
| | - Nathan Mathewson
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
| | - Katherine Oravecz-Wilson
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
| | - Emily Cummings
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
| | - Julia Wu
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
| | - Yaping Sun
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
| | - Sung Choi
- Department of Pediatrics and Communicable Diseases; University of Michigan Medical School ; Ann Arbor, MI USA
| | - Pavan Reddy
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center ; Ann Arbor, MI USA
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