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Blood, 1 August 2005, Vol. 106, No. 3, pp. 978-987. Prepublished online as a Blood First Edition Paper on April 19, 2005; DOI 10.1182/blood-2004-07-2656.
IMMUNOBIOLOGY TLR3-induced activation of mast cells modulates CD8+ T-cell recruitmentFrom the Department of Immunology and Cell Biology, Research Center Borstel, Borstel, Germany; Department of Dermatology, University of Mainz, Mainz, Germany; and Department of Dermatology and Allergy, University Hospital Charité, Humboldt University Berlin, Berlin, Germany.
Mast cells play an important role in host defense against various pathogens, but their role in viral infection has not been clarified in detail. dsRNA, synthesized by various types of viruses and mimicked by polyinosinic-polycytidylic acid (poly(I:C)) is recognized by Toll-like receptor 3 (TLR3). In this study, we demonstrate that poly(I:C) injection in vivo potently stimulates peritoneal mast cells to up-regulate a number of different costimulatory molecules. Therefore, we examined the expression and the functional significance of TLR3 activation in mast cells. Mast cells express TLR3 on the cell surface and intracellularly. After stimulation of mast cells with poly(I:C) and Newcastle disease virus (NDV), TLR3 is phosphorylated and the expression of key antiviral response cytokines (interferon , ISG15) and chemokines (IP10, RANTES) is upregulated. Interestingly, mast cells activated via TLR3-poly(I:C) potently stimulate CD8+ T-cell recruitment. Indeed, mast-celldeficient mice (KitW/KitW-v) given an intraperitoneal injection of poly(I:C) show a decreased CD8+ T-cell recruitment, whereas granulocytes normally migrate to the peritoneal cavity. Mast-cell reconstitution of KitW/KitW-v mice normalizes the CD8+ T-cell influx. Thus, mast cells stimulated through engagement of TLR3 are potent regulators of CD8+ T-cell activities in vitro and in vivo.
The magnitude and quality of innate immune response is essential for appropriate adaptive response. The activation of naive CD8+ T cells, the main effector cells in the course of viral infections, their clonal expansion, development of effector cells, and maintenance and expansion of memory CD8+ T cells after antigen reappearance are precisely regulated and dependent on an adequate context of costimulation and cytokine/chemokine environment, provided by cells responding to "first defense line" signals of innate immunity.1-4 Mast cells (MCs), pivotal effector cells in immunoglobulin (Ig) Eassociated disorders, have recently been recognized as important elements in innate immune defenses.5 Strategically located at host/environment interfaces like the skin, airways, and gastrointestinal and urogenital tracts,6,7 MCs are equipped with a large variety of receptors to detect signs of infections including Toll-like receptors (TLRs), CD48, and complement receptors.8 MCs activated via these receptors secrete a large number of proinflammatory products including granule-associated preformed mediators (histamine, serotonin, proteases, proteoglycans), lipid mediators (leukotrienes B4 and C4 and prostaglandins), as well as cytokines, chemokines, and growth factors.9
In contrast to the well-established crucial role of MCs in induction of host defense responses to bacteria and parasites, the function of MCs in antiviral immune responses remains to be characterized in detail. Recently, a number of reports have shown the functional interplay between MCs and T cells in allergic, infectious, and autoimmune processes, for example, MCs and T cells colocalizing in inflamed tissues, as in the lungs of patients with asthma and in animal models of allergic asthma.10,11 It has also been reported that tumor necrosis factor
TLRs play an important role in innate immunity recognizing specific, nonself, conserved components shared by different pathogens. Different TLRs are involved in the specific recognition of various microbes.16,17 Human and mouse MCs have been shown to be activated by bacterial peptidoglycan and lipopolysaccharide (LPS) via TLR2 and TLR4, respectively, producing a number of cytokines such as interleukin 5 (IL-5), IL-6, IL-10, IL-13, and TNF-
On binding of viral dsRNA or its synthetic counterpart polyinosinic-polycytidylic acid (poly(I:C)), TLR3 activates a signaling pathway, leading to the activation of interferon regulatory factor 3 (IRF3).22,23 This results in transactivation of primary genes, such as interferon
Materials Recombinant IL-3 was purchased from PeproTech (London, United Kingdom). Poly(I:C), phorbol myristate acetate (PMA), and ionomycin were from Sigma (St Louis, MO). LPS, kindly provided by H. Brade (Research Center Borstel, Borstel, Germany) was derived from Salmonella enterica serovar Friedenau and prepared by the hot phenol-water procedure, repeated ultracentrifugation, and electrodialysis.25 Poly(I:C) was tested for endotoxin activity by the Coamatic Chromo-LAL kit (Hemochrom Diagnostica, Essen, Germany) with a resolution limit of 0.005 EU (endotoxin units)/mL. This was equal to 0.732 EU/mL corresponding to 50 pg/mL per 10 µg/mL poly(I:C). Stimulation of bone marrowderived cultured mast cells (BMMCs) with 50 pg/mL LPS does not lead to chemokine production at all. Furthermore, treatment of poly(I:C) with RNAse A (Boehringer Mannheim, Mannheim, Germany) abolished poly(I:C)induced chemokine production. Antibodies against IRF3 (FL-425), TLR3 (Q-18), and Myc (9E10) were purchased from Santa Cruz Biotechnology (Santa Cruz, CA). Mouse antiphosphotyrosine (antip-Tyr) antibody (RC20) was from BD Transduction Laboratories (Heidelberg, Germany). Goat antimouse, goat antirabbit, and rabbit antigoat horseradish peroxidase conjugates (Amersham Pharmacia Biotech, Buckinghamshire, United Kingdom) were used as secondary antibodies. Animals and reconstitution experiments C57BL/6 mice were purchased from Harlan Winkelman (Borchen, Germany). Genetically MC-deficient WBB6F1-KitW/KitW-v (KitW/KitW-v and congenic wild-type WBB6F1-Kit+/+ (Kit+/+) mice were bred at the Department of Dermatology, Mainz, Germany. OTI and OTII TCR transgenic mice were bred in the Animal Care Facility of the Research Center Borstel. All mice were housed in specific pathogen-free facilities. Sex- and age-matched (6-8 weeks of age) mice were used for experiments, performed according to institutional guidelines. Poly(I:C) (10 µgin200 µL phosphate-buffered saline [PBS]) was injected intraperitoneally and controls were injected with PBS only. Reconstitution experiments were performed as described.26 Briefly, 8-week-old KitW/KitW-v mice were reconstituted with 3 x 106 BMMCs injected intraperitoneally, challenged with poly(I:C), and analyzed 6 weeks after reconstitution. Cell isolation Peritoneal cells from C57BL/6 mice were isolated by peritoneal lavage with 10 mL cold 0.9% NaCl solution. For some experiments, peritoneal mast cells (PMCs) were enriched by centrifugation using a Percoll gradient (MC purity, 60%-80%) as described.27 Peripheral and mesenterial LNs were excised and single-cell suspensions were prepared by homogenization in PBS. Generation of BMMCs
The BMMCs were generated by cultivation of bone marrow cells from C57BL/6 mice in the presence of recombinant murine IL-3. Cells were maintained in complete medium consisting of 10% heat-inactivated fetal calf serum (Biochrom, Berlin, Germany), 50 µM Infection with NDV NDV was kindly provided by R. Zawatzky (DKFZ, Heidelberg, Germany). BMMCs and PMCs were infected with 0.5 hemagglutinating units (HA)/mL and 2.4 HA/mL NDV in complete medium. It was demonstrated that in these concentrations NDV strongly activates human blood monocytes30 and murine dendritic cells.31 Evaluation of cytokine concentrations To analyze cytokine production, BMMCs (2 x 106/mL) were stimulated with poly(I:C) or infected with NDV for 48 hours at 37°C and 5% CO2. Supernatants were collected and cytokines and chemokines were measured by specific enzyme-linked immunosorbent assays (ELISAs) using specific antibodies and standard proteins from R&D Systems (Wiesbaden-Nordenstadt, Germany). Flow cytometry
Cells were washed twice in FACS buffer (2% newborn calf serum, 0.1% NaN3, 2 mM EDTA [ethylenediaminetetraacetic acid] in PBS) and stained with phycoerythrin (PE), allophycocyanin (APC), or FITC-conjugated antibodies. To detect Fc Degranulation assay
Release of histamine-containing granules in vitro was quantified by measuring Chemotaxis assays Chemotaxis of granulocytes or CD4+ and CD8+ cells was measured by assessing migration through a polycarbonate filter of 5-µm pore size in 24-well transwell chambers (Corning Life Sciences, Schipol-Rijk, Netherlands) with the use of complete IMDM. BMMCs (3.3 x 106 cells/mL) were loaded into the lower chambers and incubated with or without poly(I:C) (10 µg/mL) and 1 ng/mL IL-3 for different periods of time. Complete IMDM with or without poly(I:C) was used to determine the spontaneous migration. Then, 3 x 106 bone marrow cells freshly isolated from C57BL/6 mice or 4 x 106 LN cells from OTI or OTII TCR transgenic mice were added into the upper chamber in a volume of 200 µL and incubated at 37°C and 5% CO2 for indicated time intervals. After incubation, the total cell number in the lower chamber was determined microscopically by staining with trypan blue (Biochrom), and the percentages of granulocytes (Gr1+ and CD11b+ double-positive cells), CD4+ cells, and CD8+ cells were determined by staining with specific antibodies and subsequent FACS analysis. Chemotactic indices were determined by dividing absolute migrated cell numbers in probes by absolute migrated cell numbers in controls with medium only. Poly(I:C) alone did not induce chemotaxis in any of the cell populations tested. Western blotting and immunoprecipitation assays
Cells (1 x 106) were lysed for 15 minutes on ice in 1% ODGP cell-extraction buffer: 20 mM Tris (tris(hydroxymethyl)aminomethane)HCl buffer, pH 8.0, 15 mM NaCl, 2 mM EDTA, 10 mM sodium fluoride, 1 µg/mL pepstatin A, 1 µg/mL leupeptin, 10 mM phenylmethylsulfonyl fluoride (PMSF), and 100 µM sodium vanadate (all reagents from Sigma). The detergent-insoluble materials were removed by centrifugation for 15 minutes at 18 890 g at 4°C. Nuclear extracts from 5 x 106 cells were prepared according to the method of Schreiber et al.33 Protein concentrations were determined using a BSA protein assay kit (Bio-Rad, Munich, Germany), and 50 µg protein was analyzed by electrophoresis in 10% sodium dodecyl sulfatepolyacrylamide gel electrophoresis (SDS-PAGE). For immunoprecipitation, 500 µg protein was incubated overnight at 4°C with 5 µg/mL antibodies. Immunocomplexes were captured on protein A/G-agarose (Bio-Rad) with gentle mixing for 1 hour at 4°C. Samples were resuspended in SDS-PAGE sample buffer (62.5 mM Tris-HCL, pH 8.0, 1% glycerol, 2% SDS, 5% Reverse transcriptionPCR
RNA was extracted from cells using Trizol reagent (Gibco-Invitrogen, Karlsruhe, Germany). cDNA was synthesized from 5 µg total RNA using random oligonucleotides as primers and SuperScriptII kit (Gibco-Invitrogen). cDNA was amplified by polymerase chain reaction (PCR) in a reaction mixture (20 µL) containing 2 µL 10-fold PCR buffer with 1.5 mM MgCl2, 250 µM of each dNTPs, 200 nM 5' and 3' primers, and 1 U Taq DNA polymerase ("Amplitaq," Applied Biosciences, Warrington, United Kingdom). The following primers were used: mTLR3 (392 bp) sense 5'-CCGCCCTCTTCGTAACTTGACC-3', antisense 5'-GCGGCCCGAAAACATCCTT-3'; murine IFN-inducible protein 10 (mIP10; 188 bp) sense 5'-GATGACGGGCCAGTGAGAATG-3', antisense 5'-GGAGCCCTTTTAGACCTTTTT-3'; mRANTES (murine regulated on activation, normal T-cell expressed and secreted; 202 bp) sense 5'-CTGCCCTCACCATCATCCTCACTG-3', antisense 5'-CACACTTGGCGGTTCCTTC-3'; mIFN Statistical analysis All experiments were performed in at least 3 independent assays, which yielded highly comparable results. Data are summarized as mean plus or minus SEM. Statistical analysis of the results was performed by Student t test for unpaired samples. P values below .05 were considered statistically significant.
Poly(I:C) activates PMCs in vivo
We were interested whether MCs can sense and react to viral products in vivo. Therefore, we injected C57BL/6 mice intraperitoneally with 10 µg poly(I:C) dsRNA, a synthetic mimetic of viral RNA recognized by the TLR3. Peritoneal-cell suspensions were obtained 24 hours thereafter, and MCs, defined as c-Kit, Fc
Murine MCs express TLR3 To investigate whether murine MCs express innate immune receptors, well known to detect dsRNA, we examined BMMCs and PMCs for TLR3 expression. BMMCs express and up-regulate the TLR3 message after stimulation with 10 µg/mL poly(I:C) for 1 hour as assessed by reverse transcription (RT)PCR (Figure 2A). Western blotting confirmed the constitutive expression of TLR3 by BMMCs (Figure 2B) and FACS analyses detected TLR3 on the surface and in the cytoplasm of both BMMCs and PMCs (Figure 2C-F), confirming that BMMCs and PMCs express TLR3.
Poly(I:C) stimulation induces signal transduction and transactivation of a set of primary genes in BMMCs
On dsRNA stimulation, TLR3 undergoes tyrosine phosphorylation.35,36 Furthermore, the transcriptional up-regulation of several primary genes, primarily IFN-
Mast cells release MIP-1 , KC, and RANTES, but do not degranulate, after activation via TLR3
Induction of primary response genes by poly(I:C) prompted us to analyze the cytokine and chemokine secretion by BMMCs stimulated with poly(I:C) in vitro. For this purpose, we stimulated BMMCs with 10 µg/mL poly(I:C) and analyzed the cytokine and chemokine production in their supernatants 48 hours later. As shown in Figure 4, poly(I:C) induces a strong production of macrophage inflammatory protein 1
In response to Fc MCs are activated following NDV infection Because MCs are activated by the recombinant dsRNA, poly(I:C), we further investigated whether similar effects could be induced by natural dsRNA viruses. For this purpose we infected BMMCs with NDV and investigated the TLR3 engagement, transcriptional activation of primary response genes, surface receptor expression, and chemokine production.
As shown in Figure 5A, NDV infection induces tyrosine phosphorylation of the TLR3 similarly to the poly(I:C) stimulation. Transcription of primary response genes is induced in a dose-dependent manner (Figure 5B). Interestingly, virus infection leads to a down-regulation of c-Kit expression (Figure 5C) as well. Furthermore, NDV-infected BMMCs are potent releasers of MIP-1
Even if we cannot exclude the involvement of other TLRs41-43 or virus-specific receptor-mediated pathways,44,45 these results demonstrate that NDV treatment activates MCs using the TLR3 signaling pathway and modulates their chemokine production and surface receptor expression. MCs contribute to CD8+ T-cell recruitment after poly(I:C) injection in vivo The chemokines we found to be produced in response to poly(I:C) or virus-infected MCs are known to be importantly involved in the recruitment of granulocytes and T cells to sites of antiviral host responses. Thus, we investigated whether the recruitment of such cells is MC dependent after intraperitoneal injections of poly(I:C) in C57BL/6 mice. Notably, injection of 10 µg poly(I:C) was followed by a rapid and pronounced intraperitoneal influx of granulocytes, which peaked 3 hours after injection. Afterward the number of granulocytes started to continuously drop, reaching normal levels at 48 hours after injection (Figure 6A). In contrast, intraperitoneal CD4+ and CD8+ T-cell populations diminished during the first 3 hours (Figure 6B-C), recovered, and reached normal levels 48 hours after injection. To test whether MCs contribute to granulocyte recruitment or specifically modulate T-cell numbers in response to poly(I:C), we investigated genetically MC-deficient KitW/KitW-v mice46 and normal Kit+/+ mice for granulocyte and T-cell numbers at time 0 and 3 and 48 hours after poly(I:C) injection. KitW/KitW-v and Kit+/+ mice showed comparable and nonsignificant different numbers of T cells (CD4+: 1.30 ± 0.23 x 105 versus 1.82 ± 0.64 x 105; CD8+: 0.43 ± 0.10 x 105 versus 0.47 ± 0.13 x 105 in Kit+/+ and KitW/KitW-v mice [n = 4-7], respectively) and basically no granulocytes (data not shown) before treatment. After 3 hours, as shown in Figure 6D, KitW/KitW-v and Kit+/+ mice injected with poly(I:C) exhibited similar numbers of granulocytes, indicating that the absence of MCs does not significantly influence the early recruitment of granulocytes. On the other hand, 48 hours after poly(I:C) injection, KitW/KitW-v mice showed a slightly reduced number of CD4+ T cells as well as a significantly reduced numbers of CD8+ T cells compared with controls (Figure 6E-F). In fact, MC-deficient mice treated with poly(I:C) exhibited a 48% reduction in the CD8+ T-cell compartment compared with Kit+/+ mice (P < .05 at 48 hours). Reconstitution of KitW/KitW-v mice with BMMCs restores the intraperitoneal CD8+ T-cell compartment but exerts no significant effect on CD4+ T cells (Figure 6E-F), thus demonstrating that the recruitment of CD8+ T cells 48 hours after poly(I:C) injection, but not the granulocyte influx 3 hours after poly(I:C) injection, is strongly modulated by MCs.
MCs activated by poly(I:C) are chemotactic for CD8+ T cells To understand whether the CD8+ T-cell chemotaxis shown in vivo is directly mediated by MCs, transwell double-chamber migration assays were performed. BMMCs stimulated with poly(I:C) induced a moderately increased migration of CD4+ T cells, that is, LN cells derived from MHC class IIrestricted T-cell receptor transgenic (OTII) mice, compared to untreated BMMCs (Figure 7A). However, this difference was not statistically significant (CD4-chemotactic index: 2.7 ± 0.3 versus 1.7 ± 0.2 [P = .08] of poly(I:C) and unstimulated BMMCs, respectively). In contrast, chemotaxis induced by poly(I: C)stimulated BMMCs in CD8+ T cells, that is, LN cells derived from MHC class Irestricted T-cell receptor transgenic mice (OTI mice), was found to be significantly increased compared to chemotactic responses elicited by unstimulated BMMCs (Figure 7B; 3.9 ± 0.2 versus 2.0 ± 0.3 for poly(I:C) stimulated versus unstimulated BMMCs, respectively; P < .01). The chemotactic responses of granulocytes to untreated or 48-hour poly(I:C)stimulated BMMCs were similar (Figure 7C). Taken together, these data confirm that CD8+ T cells are selectively recruited by MCs activated via TLR3 receptors in vitro, whereas granulocyte chemotaxis is constitutively induced by MCs and is independent of TLR3 activation.
In this paper, we demonstrate that murine peritoneal as well as in vitrogenerated BMMCs express TLR3, a member of the evolutionary conserved TLR family responsible for recognition of pathogen-associated molecular patterns.15 Both MC populations investigated express intracellular and membrane TLR3. Responses to the synthetic TLR3 ligand poly(I:C) involve the TLR3 downstream signaling cascade, resulting in the transcription of primary response genes, that is, IFN , ISG15, and IP10, the production and release of RANTES, MIP-1 , and KC, and up-regulation of MCH class II molecules, costimulatory molecules, and complement receptors. Furthermore, NDV-stimulated BMMCs phosphorylate TLR3, activate a set of primary TLR3-response genes, and release MIP-1 as well as KC. Most importantly, we found that poly(I:C)/TLR3-activated MCs elicit strong chemotactic responses in CD8+ T cells in vitro and that CD8+ T-cell recruitment to sites of poly(I:C) challenge is significantly impaired in the absence of MCs in vivo.
TLR3, one of the most important TLRs in the detection of viral infections,24,47 has been shown to be present on the surface or in the cytoplasm of dendritic cells,48,49 macrophages,50 epithelial cells,51,52 fibroblasts,53 and, most recently, natural killer (NK) cells.54,55 MCs have been shown to express TLR1 and TLR2, and TRL4-TLR9.16,19,38,56 In addition, expression of functional TLR3, TLR7, and TLR9 have recently been demonstrated on skin MCs,57 suggesting that MCs may detect viruses by mechanisms other than TLR3. TLR7-TLR9 are also described as receptors involved in viral recognition. For example, IFN- production induced by herpes simplex virus 1 (HSV-1) and HSV-2, dsRNA viruses, is abrogated in the absence of TLR9.41,58 TLR9 and TLR3 both are required for an effective response to mouse cytomegalovirus (CMV) infection, and mice homozygous for a missense mutation in the Tlr9 allele show impaired lymphocytic choriomeningitis virus (LCMV) infectioninduced secretion of type I interferons and NK-cell activation.42 Otherwise, ssRNA viruses could be recognized by TLR7, and an infection with vesicular somatitis virus (VSV) in vivo induces IFN- production in a MyD88-dependent manner.43 So far, it is unknown, whether MCs could respond to viral RNA by other TLRs in a TLR3-independent manner and how the TLR3-dependent MC response is regulated by downstream adaptor proteins MyD88 (myloid differentiation factor 88) and TRIF (Toll/IL-1R domain-containing adapter inducing IFN- ). On the other hand, activation of MCs via TLR3 could occur and be relevant not only in antiviral immunity but also contribute to the recognition of endogenous danger signals. Heterologous mRNA, released from or associated with necrotic cells or generated by in vivo transcription,59 or siRNA, delivered extracellularly, stimulates TLR3 activation.60 These observations indicate that TLR3-dependent antiviral functions of MCs could be extended to a number of other processes, for example, clearing up inflammation sites or influencing the onset of autoimmune diseases.
Stimulation of MCs with poly(I:C), mimicking the natural TLR3 ligand dsRNA, is followed by rapid phosphorylation of TLR3 and results in 3 distinct responses, all of which could importantly contribute to a protective immunity against viral infections: (1) the production of IFN-
Our finding that BMMCs induce IFN-
Here we show that expression of costimulatory molecules by MCs is up-regulated by poly(I:C) and NDV, indicating that MCs could shape adaptive antiviral CD4+ and CD8+ T-cell responses. Up-regulation of costimulatory molecules in response to bacteria and bacterial products is a general feature of antigen-presenting cells, including macrophages and dendritic cells, and strongly regulates the adaptive immune response.31,64 MCs can express MHC class I and II molecules, present antigen to T cells,65-67 and express CD28,68 CD80 and CD86,69 CD40L, and intercellular adhesion molecule 1 (ICAM-1).6 Expression of CD28 by BMMCs could be modulated by LPS.68 Complement receptors on MCs are important links between innate and adaptive immunity and can mediate the MC activation as well.70 Interestingly, the expression of c-Kit, the receptor for stem-cell factor, was found to be down-regulated after poly(I:C) injection in vivo and infection with NDV in vitro, indicating potential direct or indirect regulation of c-Kit expression by TLR3-dependent signals. At least 3 mechanisms for regulating the c-Kit expression on the cell surface are describedinternalization after ligand binding,71,72 down-regulation by TH2 cytokines such as IL-10 and IL-4,73 and shedding from the membrane, for example, by tumor necrosis factor
The cytokines and chemokines produced by MCs are known to profoundly alter the nature and the strength of the innate immune response. Our observations indicate that TLR3-stimulated MCs secrete a unique profile of chemokines independently of classical MC degranulation. These chemokines could determine the kinetics and extent of T-cell recruitment as well. Expression of chemokine receptors and migratory behavior is different for naive, activated, and memory T cells.75 CCR5 receptors for chemokines RANTES, MIP-1 MCs play an important role in host defense responses against bacterial and parasitic pathogens, but their contribution to antiviral immunity is largely unknown. Increasing evidence indicates that MCs can be infected by viruses and respond to viral signals.85,86 For example, dengue virus and HIV have been shown to infect MCs and to induce MC cytokine and chemokine production in vitro.85,87,88 In addition, encephalomyocarditis virus infection reportedly results in MC chymase and tryptase production in vivo89 and viral infections have been shown to cause accumulation of MCs in the nasal mucosa during the first days of a symptomatic naturally acquired respiratory infection.90 However, the relevance and underlying mechanisms of MC infection and activation in settings of viral infections remain to be characterized in detail. Taken together, our observations suggest that MCs can detect viral infections via TLR3 and that TLR3-activated MCs contribute to antiviral host defense. Understanding the unique properties of MCs, the regulation of their cytokine and chemokine responses by viruses or viral products, and their interaction with specific T-cell subpopulations will be essential for the therapeutic manipulation of local immune responses and antiviral immunity.
We thank Katrin Streeck, Mandy Schröder, Martina Hein, and Renate Bergmann for excellent technical assistance; Andra Schromm for labeling of TLR3 antibodies; Florian Schiemann for help with chemotaxis assay; and Jodie Urcioli, Annette Wallisch, and Holger Heine for critical reading of the manuscript.
Submitted July 13, 2004; accepted April 4, 2005.
Supported in part by grants SFB 367, Project C11 (S.B.-P.) and MA 1909/4-2 (M. Maurer) from the Deutsche Forschungsgemeinschaft.
Prepublished online as Blood First Edition Paper, April 19, 2005; DOI 10.1182/blood-2004-07-2656.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
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