Loading…
Alpha 4-integrins mediate antigen-induced late bronchial responses and prolonged airway hyperresponsiveness in sheep
Eosinophils and T lymphocytes are thought to be involved in allergic airway inflammation. Both cells express the alpha 4 beta 1-integrin, very late antigen-4 (VLA-4, CD49d/CD29); alpha 4-integrins can promote cellular adhesion and activation. Therefore, we examined the in vivo effects of a blocking...
Saved in:
Published in: | The Journal of clinical investigation 1994-02, Vol.93 (2), p.776-787 |
---|---|
Main Authors: | , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c2162-c5569dcdf8e4dd1a33e1ca49c5dbf675e21f82f90dd880f04f1f974607c9ed483 |
---|---|
cites | |
container_end_page | 787 |
container_issue | 2 |
container_start_page | 776 |
container_title | The Journal of clinical investigation |
container_volume | 93 |
creator | Abraham, W M Sielczak, M W Ahmed, A Cortes, A Lauredo, I T Kim, J Pepinsky, B Benjamin, C D Leone, D R Lobb, R R |
description | Eosinophils and T lymphocytes are thought to be involved in allergic airway inflammation. Both cells express the alpha 4 beta 1-integrin, very late antigen-4 (VLA-4, CD49d/CD29); alpha 4-integrins can promote cellular adhesion and activation. Therefore, we examined the in vivo effects of a blocking anti-alpha 4 monoclonal antibody, HP 1/2, on antigen-induced early and late bronchial responses, airway hyperresponsiveness, inflammatory cell influx, and peripheral leukocyte counts in allergic sheep. Sheep blood lymphocytes, monocytes, and eosinophils expressed alpha 4 and bound HP 1/2. In control sheep, Ascaris antigen challenge produced early and late increases in specific lung resistance of 380 +/- 42% and 175 +/- 16% over baseline immediately and 7 h after challenge, respectively, as well as airway hyperresponsiveness continuing for 14 d after antigen challenge. Treatment with HP 1/2 (1 mg/kg, i.v.) 30 min before antigen challenge did not affect the early increase in specific lung resistance but inhibited the late-phase increase at 5-8 h by 75% (P < 0.05) and inhibited the post-antigen-induced airway hyperresponsiveness at 1, 2, 7, and 14 d (P < 0.05, for each time). Intravenous HP 1/2 given 2 h after antigen challenge likewise blocked late-phase airway changes and postchallenge airway hyperresponsiveness. Airway administration of HP 1/2 (16-mg dose) was also effective in blocking these antigen-induced changes. Response to HP 1/2 was specific since an isotypic monoclonal antibody, 1E6, was ineffective by intravenous and aerosol administration. Inhibition of leukocyte recruitment did not totally account for the activity of anti-alpha 4 antibody since HP 1/2 neither diminished the eosinopenia or lymphopenia that followed antigen challenge nor consistently altered the composition of leukocytes recovered by bronchoalveolar lavage. Because airway administration of HP 1/2 was also active, HP 1/2 may have inhibited cell activation. Reduction of platelet-activating factor-induced eosinophil peroxidase release from HP 1/2-treated eosinophils supports such a mechanism. These findings indicate a role for alpha 4-integrins in processes that lead to airway late phase responses and persisting airway hyperresponsiveness after antigen challenge. |
doi_str_mv | 10.1172/JCI117032 |
format | article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_293928</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>76368158</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2162-c5569dcdf8e4dd1a33e1ca49c5dbf675e21f82f90dd880f04f1f974607c9ed483</originalsourceid><addsrcrecordid>eNpVkUtLAzEUhbNQaq0u_AFCVoKL0bzmtXBRio9KwY2uQ5rcdCLTZEymSv-9U1qKrg7c-5374CB0RckdpSW7f53NByWcnaAxIYxmdcmrM3Se0ichVIhcjNCoopQLSseon7Zdo7DInO9hFZ1PeA3GqR6w8r1bgR86ZqPB4HZXXMbgdeNUiyOkLvgEaQAN7mJog18NmHLxR21xs-0gHhj3DR5Sws7j1AB0F-jUqjbB5UEn6OPp8X32ki3enuez6SLTjBYs03le1EYbW4EwhirOgWolap2bpS3KHBi1FbM1MaaqiCXCUluXoiClrsGIik_Qw35ut1kOX2nwfVSt7KJbq7iVQTn5v-NdI1fhW7Ka12znvzn4Y_jaQOrl2iUNbas8hE2SZcGLiuY78HYP6hhSimCPOyiRu1TkMZWBvf571JE8RMJ_AcGvjak</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>76368158</pqid></control><display><type>article</type><title>Alpha 4-integrins mediate antigen-induced late bronchial responses and prolonged airway hyperresponsiveness in sheep</title><source>Free E-Journal (出版社公開部分のみ)</source><source>PubMed Central</source><creator>Abraham, W M ; Sielczak, M W ; Ahmed, A ; Cortes, A ; Lauredo, I T ; Kim, J ; Pepinsky, B ; Benjamin, C D ; Leone, D R ; Lobb, R R</creator><creatorcontrib>Abraham, W M ; Sielczak, M W ; Ahmed, A ; Cortes, A ; Lauredo, I T ; Kim, J ; Pepinsky, B ; Benjamin, C D ; Leone, D R ; Lobb, R R</creatorcontrib><description>Eosinophils and T lymphocytes are thought to be involved in allergic airway inflammation. Both cells express the alpha 4 beta 1-integrin, very late antigen-4 (VLA-4, CD49d/CD29); alpha 4-integrins can promote cellular adhesion and activation. Therefore, we examined the in vivo effects of a blocking anti-alpha 4 monoclonal antibody, HP 1/2, on antigen-induced early and late bronchial responses, airway hyperresponsiveness, inflammatory cell influx, and peripheral leukocyte counts in allergic sheep. Sheep blood lymphocytes, monocytes, and eosinophils expressed alpha 4 and bound HP 1/2. In control sheep, Ascaris antigen challenge produced early and late increases in specific lung resistance of 380 +/- 42% and 175 +/- 16% over baseline immediately and 7 h after challenge, respectively, as well as airway hyperresponsiveness continuing for 14 d after antigen challenge. Treatment with HP 1/2 (1 mg/kg, i.v.) 30 min before antigen challenge did not affect the early increase in specific lung resistance but inhibited the late-phase increase at 5-8 h by 75% (P < 0.05) and inhibited the post-antigen-induced airway hyperresponsiveness at 1, 2, 7, and 14 d (P < 0.05, for each time). Intravenous HP 1/2 given 2 h after antigen challenge likewise blocked late-phase airway changes and postchallenge airway hyperresponsiveness. Airway administration of HP 1/2 (16-mg dose) was also effective in blocking these antigen-induced changes. Response to HP 1/2 was specific since an isotypic monoclonal antibody, 1E6, was ineffective by intravenous and aerosol administration. Inhibition of leukocyte recruitment did not totally account for the activity of anti-alpha 4 antibody since HP 1/2 neither diminished the eosinopenia or lymphopenia that followed antigen challenge nor consistently altered the composition of leukocytes recovered by bronchoalveolar lavage. Because airway administration of HP 1/2 was also active, HP 1/2 may have inhibited cell activation. Reduction of platelet-activating factor-induced eosinophil peroxidase release from HP 1/2-treated eosinophils supports such a mechanism. These findings indicate a role for alpha 4-integrins in processes that lead to airway late phase responses and persisting airway hyperresponsiveness after antigen challenge.</description><identifier>ISSN: 0021-9738</identifier><identifier>DOI: 10.1172/JCI117032</identifier><identifier>PMID: 8113411</identifier><language>eng</language><publisher>United States</publisher><subject>Aerosols ; Animals ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - pharmacology ; Antigens, Helminth - administration & dosage ; Antigens, Helminth - immunology ; Ascaris - immunology ; Bronchi - immunology ; Bronchi - physiology ; Eosinophils - immunology ; Eosinophils - physiology ; Flow Cytometry ; Hypersensitivity - immunology ; Hypersensitivity - physiopathology ; Injections, Intravenous ; Integrin alpha4 ; Integrins - immunology ; Integrins - physiology ; Leukocytes - immunology ; Leukocytes - physiology ; Leukocytes, Mononuclear - immunology ; Leukocytes, Mononuclear - physiology ; Lymphocytes - immunology ; Lymphocytes - physiology ; Respiratory Physiological Phenomena ; Respiratory System - immunology ; Respiratory System - physiopathology ; Sheep ; Time Factors</subject><ispartof>The Journal of clinical investigation, 1994-02, Vol.93 (2), p.776-787</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2162-c5569dcdf8e4dd1a33e1ca49c5dbf675e21f82f90dd880f04f1f974607c9ed483</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC293928/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC293928/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8113411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abraham, W M</creatorcontrib><creatorcontrib>Sielczak, M W</creatorcontrib><creatorcontrib>Ahmed, A</creatorcontrib><creatorcontrib>Cortes, A</creatorcontrib><creatorcontrib>Lauredo, I T</creatorcontrib><creatorcontrib>Kim, J</creatorcontrib><creatorcontrib>Pepinsky, B</creatorcontrib><creatorcontrib>Benjamin, C D</creatorcontrib><creatorcontrib>Leone, D R</creatorcontrib><creatorcontrib>Lobb, R R</creatorcontrib><title>Alpha 4-integrins mediate antigen-induced late bronchial responses and prolonged airway hyperresponsiveness in sheep</title><title>The Journal of clinical investigation</title><addtitle>J Clin Invest</addtitle><description>Eosinophils and T lymphocytes are thought to be involved in allergic airway inflammation. Both cells express the alpha 4 beta 1-integrin, very late antigen-4 (VLA-4, CD49d/CD29); alpha 4-integrins can promote cellular adhesion and activation. Therefore, we examined the in vivo effects of a blocking anti-alpha 4 monoclonal antibody, HP 1/2, on antigen-induced early and late bronchial responses, airway hyperresponsiveness, inflammatory cell influx, and peripheral leukocyte counts in allergic sheep. Sheep blood lymphocytes, monocytes, and eosinophils expressed alpha 4 and bound HP 1/2. In control sheep, Ascaris antigen challenge produced early and late increases in specific lung resistance of 380 +/- 42% and 175 +/- 16% over baseline immediately and 7 h after challenge, respectively, as well as airway hyperresponsiveness continuing for 14 d after antigen challenge. Treatment with HP 1/2 (1 mg/kg, i.v.) 30 min before antigen challenge did not affect the early increase in specific lung resistance but inhibited the late-phase increase at 5-8 h by 75% (P < 0.05) and inhibited the post-antigen-induced airway hyperresponsiveness at 1, 2, 7, and 14 d (P < 0.05, for each time). Intravenous HP 1/2 given 2 h after antigen challenge likewise blocked late-phase airway changes and postchallenge airway hyperresponsiveness. Airway administration of HP 1/2 (16-mg dose) was also effective in blocking these antigen-induced changes. Response to HP 1/2 was specific since an isotypic monoclonal antibody, 1E6, was ineffective by intravenous and aerosol administration. Inhibition of leukocyte recruitment did not totally account for the activity of anti-alpha 4 antibody since HP 1/2 neither diminished the eosinopenia or lymphopenia that followed antigen challenge nor consistently altered the composition of leukocytes recovered by bronchoalveolar lavage. Because airway administration of HP 1/2 was also active, HP 1/2 may have inhibited cell activation. Reduction of platelet-activating factor-induced eosinophil peroxidase release from HP 1/2-treated eosinophils supports such a mechanism. These findings indicate a role for alpha 4-integrins in processes that lead to airway late phase responses and persisting airway hyperresponsiveness after antigen challenge.</description><subject>Aerosols</subject><subject>Animals</subject><subject>Antibodies, Monoclonal - administration & dosage</subject><subject>Antibodies, Monoclonal - pharmacology</subject><subject>Antigens, Helminth - administration & dosage</subject><subject>Antigens, Helminth - immunology</subject><subject>Ascaris - immunology</subject><subject>Bronchi - immunology</subject><subject>Bronchi - physiology</subject><subject>Eosinophils - immunology</subject><subject>Eosinophils - physiology</subject><subject>Flow Cytometry</subject><subject>Hypersensitivity - immunology</subject><subject>Hypersensitivity - physiopathology</subject><subject>Injections, Intravenous</subject><subject>Integrin alpha4</subject><subject>Integrins - immunology</subject><subject>Integrins - physiology</subject><subject>Leukocytes - immunology</subject><subject>Leukocytes - physiology</subject><subject>Leukocytes, Mononuclear - immunology</subject><subject>Leukocytes, Mononuclear - physiology</subject><subject>Lymphocytes - immunology</subject><subject>Lymphocytes - physiology</subject><subject>Respiratory Physiological Phenomena</subject><subject>Respiratory System - immunology</subject><subject>Respiratory System - physiopathology</subject><subject>Sheep</subject><subject>Time Factors</subject><issn>0021-9738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><recordid>eNpVkUtLAzEUhbNQaq0u_AFCVoKL0bzmtXBRio9KwY2uQ5rcdCLTZEymSv-9U1qKrg7c-5374CB0RckdpSW7f53NByWcnaAxIYxmdcmrM3Se0ichVIhcjNCoopQLSseon7Zdo7DInO9hFZ1PeA3GqR6w8r1bgR86ZqPB4HZXXMbgdeNUiyOkLvgEaQAN7mJog18NmHLxR21xs-0gHhj3DR5Sws7j1AB0F-jUqjbB5UEn6OPp8X32ki3enuez6SLTjBYs03le1EYbW4EwhirOgWolap2bpS3KHBi1FbM1MaaqiCXCUluXoiClrsGIik_Qw35ut1kOX2nwfVSt7KJbq7iVQTn5v-NdI1fhW7Ka12znvzn4Y_jaQOrl2iUNbas8hE2SZcGLiuY78HYP6hhSimCPOyiRu1TkMZWBvf571JE8RMJ_AcGvjak</recordid><startdate>199402</startdate><enddate>199402</enddate><creator>Abraham, W M</creator><creator>Sielczak, M W</creator><creator>Ahmed, A</creator><creator>Cortes, A</creator><creator>Lauredo, I T</creator><creator>Kim, J</creator><creator>Pepinsky, B</creator><creator>Benjamin, C D</creator><creator>Leone, D R</creator><creator>Lobb, R R</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>199402</creationdate><title>Alpha 4-integrins mediate antigen-induced late bronchial responses and prolonged airway hyperresponsiveness in sheep</title><author>Abraham, W M ; Sielczak, M W ; Ahmed, A ; Cortes, A ; Lauredo, I T ; Kim, J ; Pepinsky, B ; Benjamin, C D ; Leone, D R ; Lobb, R R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2162-c5569dcdf8e4dd1a33e1ca49c5dbf675e21f82f90dd880f04f1f974607c9ed483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Aerosols</topic><topic>Animals</topic><topic>Antibodies, Monoclonal - administration & dosage</topic><topic>Antibodies, Monoclonal - pharmacology</topic><topic>Antigens, Helminth - administration & dosage</topic><topic>Antigens, Helminth - immunology</topic><topic>Ascaris - immunology</topic><topic>Bronchi - immunology</topic><topic>Bronchi - physiology</topic><topic>Eosinophils - immunology</topic><topic>Eosinophils - physiology</topic><topic>Flow Cytometry</topic><topic>Hypersensitivity - immunology</topic><topic>Hypersensitivity - physiopathology</topic><topic>Injections, Intravenous</topic><topic>Integrin alpha4</topic><topic>Integrins - immunology</topic><topic>Integrins - physiology</topic><topic>Leukocytes - immunology</topic><topic>Leukocytes - physiology</topic><topic>Leukocytes, Mononuclear - immunology</topic><topic>Leukocytes, Mononuclear - physiology</topic><topic>Lymphocytes - immunology</topic><topic>Lymphocytes - physiology</topic><topic>Respiratory Physiological Phenomena</topic><topic>Respiratory System - immunology</topic><topic>Respiratory System - physiopathology</topic><topic>Sheep</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abraham, W M</creatorcontrib><creatorcontrib>Sielczak, M W</creatorcontrib><creatorcontrib>Ahmed, A</creatorcontrib><creatorcontrib>Cortes, A</creatorcontrib><creatorcontrib>Lauredo, I T</creatorcontrib><creatorcontrib>Kim, J</creatorcontrib><creatorcontrib>Pepinsky, B</creatorcontrib><creatorcontrib>Benjamin, C D</creatorcontrib><creatorcontrib>Leone, D R</creatorcontrib><creatorcontrib>Lobb, R R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abraham, W M</au><au>Sielczak, M W</au><au>Ahmed, A</au><au>Cortes, A</au><au>Lauredo, I T</au><au>Kim, J</au><au>Pepinsky, B</au><au>Benjamin, C D</au><au>Leone, D R</au><au>Lobb, R R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alpha 4-integrins mediate antigen-induced late bronchial responses and prolonged airway hyperresponsiveness in sheep</atitle><jtitle>The Journal of clinical investigation</jtitle><addtitle>J Clin Invest</addtitle><date>1994-02</date><risdate>1994</risdate><volume>93</volume><issue>2</issue><spage>776</spage><epage>787</epage><pages>776-787</pages><issn>0021-9738</issn><abstract>Eosinophils and T lymphocytes are thought to be involved in allergic airway inflammation. Both cells express the alpha 4 beta 1-integrin, very late antigen-4 (VLA-4, CD49d/CD29); alpha 4-integrins can promote cellular adhesion and activation. Therefore, we examined the in vivo effects of a blocking anti-alpha 4 monoclonal antibody, HP 1/2, on antigen-induced early and late bronchial responses, airway hyperresponsiveness, inflammatory cell influx, and peripheral leukocyte counts in allergic sheep. Sheep blood lymphocytes, monocytes, and eosinophils expressed alpha 4 and bound HP 1/2. In control sheep, Ascaris antigen challenge produced early and late increases in specific lung resistance of 380 +/- 42% and 175 +/- 16% over baseline immediately and 7 h after challenge, respectively, as well as airway hyperresponsiveness continuing for 14 d after antigen challenge. Treatment with HP 1/2 (1 mg/kg, i.v.) 30 min before antigen challenge did not affect the early increase in specific lung resistance but inhibited the late-phase increase at 5-8 h by 75% (P < 0.05) and inhibited the post-antigen-induced airway hyperresponsiveness at 1, 2, 7, and 14 d (P < 0.05, for each time). Intravenous HP 1/2 given 2 h after antigen challenge likewise blocked late-phase airway changes and postchallenge airway hyperresponsiveness. Airway administration of HP 1/2 (16-mg dose) was also effective in blocking these antigen-induced changes. Response to HP 1/2 was specific since an isotypic monoclonal antibody, 1E6, was ineffective by intravenous and aerosol administration. Inhibition of leukocyte recruitment did not totally account for the activity of anti-alpha 4 antibody since HP 1/2 neither diminished the eosinopenia or lymphopenia that followed antigen challenge nor consistently altered the composition of leukocytes recovered by bronchoalveolar lavage. Because airway administration of HP 1/2 was also active, HP 1/2 may have inhibited cell activation. Reduction of platelet-activating factor-induced eosinophil peroxidase release from HP 1/2-treated eosinophils supports such a mechanism. These findings indicate a role for alpha 4-integrins in processes that lead to airway late phase responses and persisting airway hyperresponsiveness after antigen challenge.</abstract><cop>United States</cop><pmid>8113411</pmid><doi>10.1172/JCI117032</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0021-9738 |
ispartof | The Journal of clinical investigation, 1994-02, Vol.93 (2), p.776-787 |
issn | 0021-9738 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_293928 |
source | Free E-Journal (出版社公開部分のみ); PubMed Central |
subjects | Aerosols Animals Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal - pharmacology Antigens, Helminth - administration & dosage Antigens, Helminth - immunology Ascaris - immunology Bronchi - immunology Bronchi - physiology Eosinophils - immunology Eosinophils - physiology Flow Cytometry Hypersensitivity - immunology Hypersensitivity - physiopathology Injections, Intravenous Integrin alpha4 Integrins - immunology Integrins - physiology Leukocytes - immunology Leukocytes - physiology Leukocytes, Mononuclear - immunology Leukocytes, Mononuclear - physiology Lymphocytes - immunology Lymphocytes - physiology Respiratory Physiological Phenomena Respiratory System - immunology Respiratory System - physiopathology Sheep Time Factors |
title | Alpha 4-integrins mediate antigen-induced late bronchial responses and prolonged airway hyperresponsiveness in sheep |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T06%3A15%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Alpha%204-integrins%20mediate%20antigen-induced%20late%20bronchial%20responses%20and%20prolonged%20airway%20hyperresponsiveness%20in%20sheep&rft.jtitle=The%20Journal%20of%20clinical%20investigation&rft.au=Abraham,%20W%20M&rft.date=1994-02&rft.volume=93&rft.issue=2&rft.spage=776&rft.epage=787&rft.pages=776-787&rft.issn=0021-9738&rft_id=info:doi/10.1172/JCI117032&rft_dat=%3Cproquest_pubme%3E76368158%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c2162-c5569dcdf8e4dd1a33e1ca49c5dbf675e21f82f90dd880f04f1f974607c9ed483%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=76368158&rft_id=info:pmid/8113411&rfr_iscdi=true |