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1.
Microbes Infect ; 8(1): 285-93, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16182587

RESUMEN

Human metapneumovirus (HMPV) is a recently discovered pathogen first identified in respiratory specimens from young children suffering from clinical respiratory syndromes ranging from mild to severe lower respiratory tract illness. HMPV has worldwide prevalence, and is a leading cause of respiratory tract infection in the first years of life, with a spectrum of disease similar to respiratory syncytial virus (RSV). The disease burden associated with HMPV infection has not been fully elucidated; however, studies indicate that HMPV may cause upper or lower respiratory tract illness in patients between ages 2 months and 87 years, may co-circulate with RSV, and HMPV infection may be associated with asthma exacerbation. The mechanisms and effector pathways contributing to immunity or disease pathogenesis following infection are not fully understood; however, given the clinical significance of HMPV, there is a need for a fundamental understanding of the immune and pathophysiological processes that occur following infection to provide the foundation necessary for the development of effective vaccine or therapeutic intervention strategies. This review provides a current perspective on the processes associated with HMPV infection, immunity, and disease pathogenesis.


Asunto(s)
Metapneumovirus/fisiología , Infecciones por Paramyxoviridae/virología , Infecciones por Virus Sincitial Respiratorio/virología , Asma/etiología , Asma/inmunología , Asma/fisiopatología , Asma/virología , Humanos , Metapneumovirus/inmunología , Metapneumovirus/patogenicidad , Infecciones por Paramyxoviridae/diagnóstico , Infecciones por Paramyxoviridae/epidemiología , Infecciones por Paramyxoviridae/inmunología , Infecciones por Virus Sincitial Respiratorio/complicaciones , Infecciones por Virus Sincitial Respiratorio/inmunología , Virus Sincitial Respiratorio Humano/inmunología
2.
Pharmacol Ther ; 107(3): 329-42, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15923040

RESUMEN

Ross River virus (RRV) is a mosquito-borne alphavirus indigenous to Australia and the Western Pacific region and is responsible for several thousand cases of human RRV disease (RRVD) per annum. The disease primarily involves polyarthritis/arthralgia, with many patients also presenting with rash, myalgia, fever, and/or lethargy. The symptoms can be debilitating at onset, but they usually resolve within 3-6 months. Recent insights into the RRV-host relationship, associated pathology, and molecular biology of infection have generated a number of potential avenues for improved treatment. Although vaccine development has been proposed, the small market size and potential for antibody-dependent enhancement (ADE) of disease make this approach unattractive. Recent insights into the molecular basis of RRV-ADE and the virus's ability to manipulate host inflammatory and immune responses create potential new opportunities for therapeutic invention. Such interventions should overcome virus-induced dysregulation of protective host responses to promote viral clearance and/or ameliorate inflammatory immunopathology.


Asunto(s)
Infecciones por Alphavirus/fisiopatología , Virus del Río Ross/patogenicidad , Infecciones por Alphavirus/tratamiento farmacológico , Infecciones por Alphavirus/epidemiología , Infecciones por Alphavirus/inmunología , Animales , Formación de Anticuerpos , Australia/epidemiología , Modelos Animales de Enfermedad , Humanos , Incidencia , Inflamación , Macrófagos , Ratones , Islas del Pacífico/epidemiología , Linfocitos T , Carga Viral , Vacunas Virales
3.
Trends Immunol ; 25(12): 636-9, 2004 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-15530831

RESUMEN

The World Health Organization (WHO) announced the eradication of smallpox twenty-five years ago this month. This conquest of an infectious disease, which has been the bane of humankind for centuries, still stands as the WHO's greatest achievement. The anniversary of such a scientific and medical landmark provides an appropriate occasion to reflect on this feat and to assess the significance and necessity of the poxvirus research that has followed this.


Asunto(s)
Viruela , Animales , Citocinas/biosíntesis , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Infecciones por Poxviridae/inmunología , Infecciones por Poxviridae/prevención & control , Proyectos de Investigación , Transducción de Señal , Viruela/historia , Viruela/prevención & control
4.
Lab Invest ; 84(11): 1418-29, 2004 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-15322564

RESUMEN

The chemokines are a large gene superfamily with critical roles in development and immunity. The chemokine receptor CXCR3 appears to play a major role in the trafficking of activated Th1 lymphocytes. There are at least three major ligands for CXCR3: mig/CXCL9, IP-10/CXCL10 and I-TAC/CXCL11, and of these three ligands, CXCL11 is the least well-characterized. In this study, we have cloned a rat ortholog of CXCL11, evaluated its function, and examined its expression in the Th-1-mediated disease, experimental autoimmune encephalomyelitis (EAE) in the rat. Based on its predicted primary amino-acid sequence, rat I-TAC/CXCL11 was synthesized and shown to induce chemotaxis of activated rat T lymphocytes in vitro and the in vivo migration of T lymphocytes when injected into the skin. I-TAC/CXCL11 expression, as determined by RT-PCR, increased in lymph node and spinal cord tissue collected from rats in which EAE had been actively induced, and in spinal cord tissue from rats in which EAE had been passively induced. The kinetics of expression were similar to that of CXCR3 and IP-10/CXCL10, although expression of both CXCR3 and IP-10/CXCL10 was more intense than that of I-TAC/CXCL11 and increased more rapidly in both lymph nodes and the spinal cord. Only minor levels of expression of the related chemokine mig/CXCL9 were observed. Immunohistochemistry revealed that the major cellular source of I-TAC/CXCL11 in the central nervous system (CNS) during EAE is likely to be the astrocyte. Together, these data indicate that I-TAC/CXCL11 is expressed in the CNS during the clinical phase of EAE. However, the observation that I-TAC/CXCL11 is expressed after receptor expression is detected suggests that it is not essential for the initial migration of CXCR3-bearing cells into the CNS.


Asunto(s)
Quimiocinas CC/metabolismo , Quimiocinas CXC/metabolismo , Encefalomielitis Autoinmune Experimental/metabolismo , Receptores de Quimiocina/metabolismo , Secuencia de Aminoácidos , Animales , Células Cultivadas , Quimiocina CCL11 , Quimiocina CXCL11 , Quimiocinas CC/genética , Quimiocinas CXC/genética , Quimiocinas CXC/farmacología , Quimiotaxis/efectos de los fármacos , Clonación Molecular , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Encefalomielitis Autoinmune Experimental/patología , Femenino , Humanos , Ligandos , Ganglios Linfáticos/efectos de los fármacos , Ganglios Linfáticos/patología , Datos de Secuencia Molecular , ARN Mensajero/metabolismo , Ratas , Ratas Endogámicas Lew , Receptores CXCR3 , Receptores de Quimiocina/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Bazo/efectos de los fármacos , Bazo/patología , Linfocitos T/efectos de los fármacos , Linfocitos T/patología
5.
Virology ; 326(1): 1-5, 2004 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-15262489

RESUMEN

Mice treated with a single injection of formalin-fixed Coxiella burnetii showed a significant increase in resistance to vaccinia virus (VV) infection compared to untreated mice. C. burnetii stimulated dramatically high levels of nitric oxide (NO) in the serum of treated mice, suggesting that NO might play a role in resistance to virus infection. To test this hypothesis, the effect of C. burnetii treatment on VV replication was examined in NOS2-/- and wild-type mice. C. burnetii treatment inhibited VV replication in both the knockout and wild-type mice but the effect was significantly greater in the NOS2-/- mice. Experiments in IFNgamma receptor knockout mice indicated that the nonspecific antiviral immunity induced by C. burnetii was dependent on IFNgamma and not NO. In the absence of NO, indoleamine 2,3-dioxygenase (IDO) was increased in C. burnetii-treated mice and this may contribute to the accelerated virus clearance in NOS2-/- mice.


Asunto(s)
Vacunas Bacterianas/administración & dosificación , Vacunas Bacterianas/inmunología , Coxiella burnetii/inmunología , Óxido Nítrico/sangre , Vacunación , Virus Vaccinia , Vaccinia/prevención & control , Animales , Antígenos Bacterianos/inmunología , Modelos Animales de Enfermedad , Femenino , Formaldehído , Indolamina-Pirrol 2,3,-Dioxigenasa , Interferón gamma/sangre , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Óxido Nítrico Sintasa/deficiencia , Óxido Nítrico Sintasa/genética , Receptores de Interferón/deficiencia , Receptores de Interferón/genética , Triptófano Oxigenasa/metabolismo , Vaccinia/sangre , Vaccinia/metabolismo , Virus Vaccinia/fisiología , Replicación Viral/inmunología , Receptor de Interferón gamma
6.
Eur J Immunol ; 33(12): 3377-85, 2003 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-14635046

RESUMEN

The pathogenesis of human asthma and the development of key features of pulmonary allergy in mouse models has been critically linked to IL-13. Analyses of the receptor components employed by IL-13 have shown that delivery of this cytokine to the airways of naive IL-4Ralpha gene targeted (IL-4Ralpha(-/-)) mice fails to induce disease, suggesting that this membrane protein is critical for transducing IL-13-mediated responses. The current study demonstrates that, in contrast to naive mice, T helper 2 bias, airways hyperreactivity (AHR) and tissue eosinophilia develop in Ovalbumin-sensitized IL-4Ralpha(-/-) mice and that these responses can be inhibited by the IL-13 antagonist sIL-13Ralpha2Fc. Therefore, antigen stimulation induces an IL-13-regulated response that is independent of IL-4Ralpha. To determine the role of IL-5 and eosinophils in the development of disease in antigen-exposed IL-4Ralpha(-/-) mice, pulmonary allergy was examined in mice deficient in both factors. IL-4Ralpha/IL-5(-/-) mice were significantly defective in their ability to produce IL-13 and failed to develop AHR, suggesting that IL-5 indirectly regulates AHR in allergic IL-4Ralpha(-/-) mice by an IL-13-dependent mechanism. Collectively, these results demonstrate that IL-13-dependent processes regulating the development of AHR and T helper bias persist in the in the lungs of allergic IL-4Ralpha(-/-) mice.


Asunto(s)
Hiperreactividad Bronquial/etiología , Interleucina-13/fisiología , Interleucina-5/fisiología , Receptores de Interleucina-4/fisiología , Animales , Eosinofilia/etiología , Interferón gamma/biosíntesis , Subunidad alfa1 del Receptor de Interleucina-13 , Ratones , Ratones Endogámicos BALB C , Moco/metabolismo , Ovalbúmina/inmunología , Subunidades de Proteína , Receptores de Interleucina/análisis , Receptores de Interleucina-13 , Células TH1/inmunología , Células Th2/inmunología
7.
J Allergy Clin Immunol ; 112(5): 935-43, 2003 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-14610483

RESUMEN

BACKGROUND: Eotaxin-2 is a member of the eotaxin subfamily of CC chemokines that display eosinophil-specific, chemotactic properties and has been associated with allergic disorders. However, the contribution of eotaxin-2 to the development of defined pathogenic features of allergic disease remains to be defined. OBJECTIVE: We sought to determine whether eotaxin-2 was a cofactor with IL-5 for the regulation of pulmonary eosinophilia and to identify the combined role of these molecules in the induction of phenotypic characteristics of allergic lung disease. METHODS: We instilled recombinant eotaxin-2 into the airways of wild-type mice that had been treated systemically with IL-5 or into IL-5-transgenic mice and characterized pulmonary eosinophil numbers, IL-13 production, and airway hyperreactivity (AHR) to methacholine. Mice deficient in the IL-4 receptor alpha-chain, IL-13, and signal transducers and activators of transcription 6 or mice treated with anti-CCR3 monoclonal antibody were also used. RESULTS: Eotaxin-2 and IL-5 cooperatively promoted eosinophil accumulation, IL-13 production, and AHR to methacholine. Neither eotaxin-2 nor IL-5 alone induced these features of allergic disease. IL-13 production was critically dependent on eotaxin-2- and IL-5-regulated eosinophilia, which predisposed to the development of AHR. AHR was dependent on IL-13 and signaling through the IL-4R alpha-chain and signal transducers and activators of transcription 6 pathways and the presence of eosinophils in the lung. CONCLUSION: These investigations demonstrate important cooperativity between eotaxin-2, IL-5, and IL-13 signaling systems and eosinophils for the development of hallmark features of allergic disease of the lung.


Asunto(s)
Hiperreactividad Bronquial/inducido químicamente , Quimiocinas CC , Interleucina-13/biosíntesis , Interleucina-5 , Pulmón/metabolismo , Eosinofilia Pulmonar/inducido químicamente , Aerosoles , Animales , Hiperreactividad Bronquial/fisiopatología , Broncoconstrictores/administración & dosificación , Quimiocina CCL24 , Quimiocinas CC/administración & dosificación , Sinergismo Farmacológico , Eosinófilos/patología , Instilación de Medicamentos , Recuento de Leucocitos , Pulmón/efectos de los fármacos , Cloruro de Metacolina/administración & dosificación , Ratones , Ratones Endogámicos BALB C , Ratones Noqueados/genética , Ratones Transgénicos/genética , Eosinofilia Pulmonar/patología , Receptores de Interleucina-4/genética , Receptores de Interleucina-4/metabolismo , Proteínas Recombinantes/administración & dosificación , Factor de Transcripción STAT6 , Transactivadores/deficiencia , Transactivadores/metabolismo
10.
Proc Natl Acad Sci U S A ; 99(21): 13819-24, 2002 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-12364588

RESUMEN

Subneutralizing concentrations of antibody may enhance virus infection by bringing the virus-antibody complex into contact with the cell surface Fc receptors; this interaction facilitates entry of virus into the cell and is referred to as antibody-dependent enhancement (ADE) of infection. Northern analysis of macrophage RNA demonstrated that ADE infection by the indigenous Australian alphavirus Ross River (RRV-ADE) ablated or diminished message for tumor necrosis factor alpha (TNF-alpha), nitric-oxide synthase 2 (NOS2), and IFN regulatory factor 1 (IRF-1), as well as for IFN-inducible protein 10 (IP-10) and IFN-beta; the transcription of a control gene was unaffected. Additionally, electrophoretic mobility-shift assay (EMSA) studies showed that transcription factor IFN-alpha-activated factor (AAF), IFN-stimulated gene factor 3 (ISGF3), and nuclear factor-kappaB (NF-kappaB) complex formation in macrophage nuclear extracts were specifically suppressed post-RRV-ADE infection, emphasizing the capacity for ADE infections to compromise antiviral responses at the transcriptional level. The suppression of antiviral transcription factor complexes was shown to depend on replicating virus and was not simply a result of general antibody-Fc-receptor interaction. Although only a minority of cells ( approximately 15%) were shown to be positive for RRV by immunostaining techniques post ADE, molecular (RT-PCR) analysis showed that unstained cells carried RRV-RNA, indicating a higher level of viral infectivity than previously suspected. Electron microscopy studies confirmed this observation. Furthermore, levels of cellular IL-10 protein were dramatically elevated in RRV-ADE cultures. This evidence demonstrates that RRV can potently disrupt the activation of specific antiviral pathways via ADE infection pathways, and may suggest a significant mechanism in the infection and pathogenesis of other ADE viruses.


Asunto(s)
Anticuerpos Antivirales/metabolismo , Proteínas de Unión al ADN/metabolismo , FN-kappa B/metabolismo , Virus del Río Ross/inmunología , Virus del Río Ross/patogenicidad , Transactivadores/metabolismo , Infecciones por Alphavirus/inmunología , Infecciones por Alphavirus/metabolismo , Infecciones por Alphavirus/virología , Animales , Línea Celular , Quimiocina CXCL10 , Quimiocinas CXC/genética , Proteínas de Unión al ADN/genética , Expresión Génica , Factor 1 Regulador del Interferón , Factor 3 de Genes Estimulados por el Interferón , Subunidad gamma del Factor 3 de Genes Estimulados por el Interferón , Interferón beta/genética , Interleucina-10/metabolismo , Cinética , Lipopolisacáridos/toxicidad , Macrófagos/metabolismo , Macrófagos/virología , Ratones , Óxido Nítrico Sintasa/genética , Óxido Nítrico Sintasa de Tipo II , Fosfoproteínas/genética , Factor de Transcripción STAT1 , Factores de Transcripción/genética , Factor de Necrosis Tumoral alfa/genética
11.
J Leukoc Biol ; 72(3): 429-39, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12223509

RESUMEN

Virus infection presents a significant challenge to host survival. The capacity of the virus to replicate and persist in the host is dependent on the status of the host antiviral defense mechanisms. The study of antiviral immunity has revealed effective antiviral host immune responses and enhanced our knowledge of the diversity of viral immunomodulatory strategies that undermine these defences. This review describes the diverse approaches that are used by RNA viruses to trick or evade immune detection and response systems. Some of these approaches include the specific targeting of the major histocompatibility complex-restricted antigen presentation pathways, apoptosis, disruption of cytokine function and signaling, exploitation of the chemokine system, and interference with humoral immune responses. A detailed insight into interactions of viruses with the immune system may provide direction in the development of new vaccine strategies and novel antiviral compounds.


Asunto(s)
Virus ARN/fisiología , Virosis/inmunología , Adulto , Anticuerpos Antivirales/biosíntesis , Presentación de Antígeno , Apoptosis , Quimiocinas/fisiología , Niño , Citocinas/fisiología , Diseño de Fármacos , VIH/fisiología , Humanos , Inmunidad Celular , Interferones/fisiología , Modelos Biológicos , Imitación Molecular , Virus ARN/genética , Virus ARN/crecimiento & desarrollo , Virus ARN/inmunología , Transducción de Señal , Proteínas Virales/fisiología , Vacunas Virales , Virosis/virología , Replicación Viral
12.
J Biol Chem ; 277(44): 41906-15, 2002 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-12194977

RESUMEN

Transmembrane tryptase (TMT)/tryptase gamma is a membrane-bound serine protease stored in the secretory granules of human and mouse lung mast cells (MCs). We now show that TMT reaches the external face of the plasma membrane when MCs are induced to degranulate. Analysis of purified recombinant TMT revealed that it is a two-chain neutral protease. Thus, TMT is the only MC protease identified so far which retains its 18-residue propeptide when proteolytically activated. The genes that encode TMT and tryptase betaI reside on human chromosome 16p13.3. However, substrate specificity studies revealed that TMT and tryptase betaI are functionally distinct even though they are approximately 50% identical. Although TMT is rapidly inactivated by the human plasma serpin alpha(1)-antitrypsin in vitro, administration of recombinant TMT (but not recombinant tryptase betaI) into the trachea of mice leads to airway hyperresponsiveness (AHR) and increased expression of interleukin (IL) 13. T cells also increase their expression of IL-13 mRNA when exposed to TMT in vitro. TMT is therefore a novel exocytosed surface mediator that can stimulate those cell types that are in close proximity. TMT induces AHR in normal mice but not in transgenic mice that lack signal transducer and activator of transcription (STAT) 6 or the alpha-chain of the cytokine receptor that recognizes both IL-4 and IL-13. Based on these data, we conclude that TMT is an exocytosed MC neutral protease that induces AHR in lungs primarily by activating an IL-13/IL-4Ralpha/STAT6-dependent pathway.


Asunto(s)
Hiperreactividad Bronquial/etiología , Exocitosis , Interleucina-13/fisiología , Proteínas de la Membrana/fisiología , Receptores de Interleucina-4/fisiología , Serina Endopeptidasas/fisiología , Transactivadores/fisiología , Animales , Células Cultivadas , Humanos , Subunidad alfa1 del Receptor de Interleucina-13 , Masculino , Mastocitos/enzimología , Ratones , Ratones Endogámicos BALB C , Receptores de Interleucina/fisiología , Receptores de Interleucina-13 , Proteínas Recombinantes/aislamiento & purificación , Factor de Transcripción STAT6 , Serina Endopeptidasas/química , Transducción de Señal , Triptasas
13.
J Exp Med ; 195(11): 1433-44, 2002 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-12045241

RESUMEN

Interleukin (IL)-5 and IL-13 are thought to play key roles in the pathogenesis of asthma. Although both cytokines use eotaxin to regulate eosinophilia, IL-13 is thought to operate a separate pathway to IL-5 to induce airways hyperreactivity (AHR) in the allergic lung. However, identification of the key pathway(s) used by IL-5 and IL-13 in the disease process is confounded by the failure of anti-IL-5 or anti-IL-13 treatments to completely inhibit the accumulation of eosinophils in lung tissue. By using mice deficient in both IL-5 and eotaxin (IL-5/eotaxin(-/-)) we have abolished tissue eosinophilia and the induction of AHR in the allergic lung. Notably, in mice deficient in IL-5/eotaxin the ability of CD4(+) T helper cell (Th)2 lymphocytes to produce IL-13, a critical regulator of airways smooth muscle constriction and obstruction, was significantly impaired. Moreover, the transfer of eosinophils to IL-5/eotaxin(-/-) mice overcame the intrinsic defect in T cell IL-13 production. Thus, factors produced by eosinophils may either directly or indirectly modulate the production of IL-13 during Th2 cell development. Our data show that IL-5 and eotaxin intrinsically modulate IL-13 production from Th2 cells and that these signaling systems are not necessarily independent effector pathways and may also be integrated to regulate aspects of allergic disease.


Asunto(s)
Asma/complicaciones , Hiperreactividad Bronquial/metabolismo , Linfocitos T CD4-Positivos/metabolismo , Quimiocinas CC/metabolismo , Eosinofilia/metabolismo , Interleucina-13/metabolismo , Interleucina-5/metabolismo , Traslado Adoptivo , Animales , Asma/inmunología , Asma/metabolismo , Hiperreactividad Bronquial/complicaciones , Hiperreactividad Bronquial/inmunología , Hiperreactividad Bronquial/patología , Linfocitos T CD4-Positivos/inmunología , Quimiocina CCL11 , Quimiocinas CC/sangre , Quimiocinas CC/genética , Modelos Animales de Enfermedad , Eosinofilia/complicaciones , Eosinofilia/inmunología , Eosinofilia/patología , Eosinófilos/metabolismo , Eosinófilos/trasplante , Eliminación de Gen , Humanos , Interleucina-13/biosíntesis , Interleucina-18/metabolismo , Interleucina-5/sangre , Interleucina-5/genética , Ratones , Ratones Endogámicos BALB C , ARN Mensajero/genética , ARN Mensajero/metabolismo , Transducción de Señal , Esputo/metabolismo , Células Th2/inmunología , Células Th2/metabolismo
14.
Trends Mol Med ; 8(4): 162-7, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11927273

RESUMEN

Extensive clinical investigations have implicated eosinophils in the pathogenesis of asthma. In a recent clinical trial, humanized monoclonal antibody to interleukin (IL)-5 significantly limited eosinophil migration to the lung. However, treatment did not affect the development of the late-phase response or airways hyperresponsiveness in experimental asthma. Although IL-5 is a key regulator of eosinophilia and attenuation of its actions without signs of clinical improvement raises questions about the contribution of these cells to disease, further studies are warranted to define the effects of anti-IL-5 in the processes that lead to chronic asthma. Furthermore, eosinophil accumulation into allergic tissues should not be viewed as a process that is exclusively regulated by IL-5 but one in which IL-5 greatly contributes. Indeed, data on anti-IL-5 treatments (human and animal models) are confounded by the failure of this approach to completely resolve tissue eosinophilia and the belief that IL-5 alone is the critical molecular switch for eosinophil development and migration. The contribution of these IL-5-independent pathways should be considered when assessing the role of eosinophils in disease processes.


Asunto(s)
Asma/inmunología , Asma/terapia , Eosinófilos/metabolismo , Interleucina-5/metabolismo , Animales , Asma/fisiopatología , Hiperreactividad Bronquial , Modelos Animales de Enfermedad , Eosinofilia , Eosinófilos/inmunología , Humanos , Interleucina-5/inmunología , Pulmón/inmunología , Pulmón/patología , Pulmón/fisiología , Pulmón/fisiopatología , Modelos Biológicos
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