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1.
Cell Immunol ; 269(2): 74-7, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21570678

RESUMO

BACKGROUND: Despite lots of research efforts, the pathology of head and neck cancer remains elusive. Accumulating evidence suggests that the innate and adaptive immunity plays an important role in HNSCC (Head and Neck Squamous Cell Carcinoma) development. Recently, a new T helper cell subset additional to the classical Th1 and Th2 cells was identified called Th17 cells, due to their secretion of IL-17. However, Th17 cells also produce additional proinflammatory cytokines and many other cytokines are involved in their differentiation and expansion. It was shown that Th17 cells play a prominent role in host defense but are also associated with the development of autoimmune diseases. The role of Th17 cells in cancer pathogenesis remains nebulous. METHODS: Th17 cells of peripheral blood, primary tumors and metastatic lymph nodes were FACS analyzed for their CD161 expression. Supernatants of the permanent HNSCC cell line BHY were used to induce Th17 cells by HNSCC tumor mileu. RESULTS: Here we show that Th17 cells from patients with HNSCC downregulate the Th17 cell surface receptor CD161 in peripheral blood as well as in primary tumors and especially in metastatic lymph nodes. CONCLUSION: We have showed for the first time alterations of Th17 cell phenotype in HNSCC patients.


Assuntos
Carcinoma de Células Escamosas/imunologia , Neoplasias de Cabeça e Pescoço/imunologia , Subfamília B de Receptores Semelhantes a Lectina de Células NK/metabolismo , Células Th17/imunologia , Células Th17/metabolismo , Idoso , Brefeldina A/farmacologia , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Meios de Cultivo Condicionados/farmacologia , Neoplasias de Cabeça e Pescoço/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Ionomicina/farmacologia , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Linfonodos/imunologia , Linfonodos/patologia , Ativação Linfocitária/efeitos dos fármacos , Pessoa de Meia-Idade , Metástase Neoplásica/imunologia , Metástase Neoplásica/patologia , Acetato de Tetradecanoilforbol/farmacologia , Células Th17/efeitos dos fármacos , Células Th17/patologia
2.
In Vivo ; 20(1): 45-8, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16433027

RESUMO

BACKGROUND: Cytokine profiles of permanent cell lines of head and neck squamous cell carcinoma (HNSCC) were analyzed to define the cytokine levels secreted in the absence of immune cells. MATERIALS AND METHODS: Cytokine profiles of IL-4, IL-6, IL-8 and IL-10 were analyzed in the supematants of 4 different permanent HNSCC cell lines using the Bio-Plex human cytokine assay system. RESULTS: In HNSCC, IL-6 and IL-8 are involved in oncogenic processes, while IL-4 and IL-10 suppress proper immune responses in the tumor microenvironment. Our data indicate that, in the absence of tumor-infiltrating immune cells, HNSCC secretes high levels of the proto-oncogenic cytokines IL-6 and IL-8, but no significant levels of the immune suppressors IL-4 and IL-10. CONCLUSION: The data strongly suggest that the intercellular crosstalk between cells of HNSCC and tumor-infiltrating immune cells in vivo is required to stimulate an increased production of immune suppressive mediators in head and neck cancer.


Assuntos
Carcinoma de Células Escamosas/metabolismo , Neoplasias de Cabeça e Pescoço/metabolismo , Interleucinas/metabolismo , Carcinoma de Células Escamosas/patologia , Linhagem Celular Tumoral , Neoplasias de Cabeça e Pescoço/patologia , Humanos
3.
Cell Metab ; 24(5): 657-671, 2016 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-27641098

RESUMO

Elevated lactate dehydrogenase A (LDHA) expression is associated with poor outcome in tumor patients. Here we show that LDHA-associated lactic acid accumulation in melanomas inhibits tumor surveillance by T and NK cells. In immunocompetent C57BL/6 mice, tumors with reduced lactic acid production (Ldhalow) developed significantly slower than control tumors and showed increased infiltration with IFN-γ-producing T and NK cells. However, in Rag2-/-γc-/- mice, lacking lymphocytes and NK cells, and in Ifng-/- mice, Ldhalow and control cells formed tumors at similar rates. Pathophysiological concentrations of lactic acid prevented upregulation of nuclear factor of activated T cells (NFAT) in T and NK cells, resulting in diminished IFN-γ production. Database analyses revealed negative correlations between LDHA expression and T cell activation markers in human melanoma patients. Our results demonstrate that lactic acid is a potent inhibitor of function and survival of T and NK cells leading to tumor immune escape.


Assuntos
Vigilância Imunológica , Células Matadoras Naturais/imunologia , L-Lactato Desidrogenase/metabolismo , Ácido Láctico/biossíntese , Melanoma/imunologia , Linfócitos T/imunologia , Animais , Apoptose/efeitos dos fármacos , Linfócitos T CD8-Positivos/imunologia , Contagem de Células , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/imunologia , Citocinas/biossíntese , Glicólise/efeitos dos fármacos , Humanos , Vigilância Imunológica/efeitos dos fármacos , Interferon gama/farmacologia , Isoenzimas/metabolismo , Células Matadoras Naturais/efeitos dos fármacos , Lactato Desidrogenase 5 , Ácido Láctico/farmacologia , Masculino , Melanoma/patologia , Camundongos Endogâmicos C57BL , Fatores de Transcrição NFATC/metabolismo , Fenótipo , Lactato de Sódio/farmacologia , Linfócitos T/efeitos dos fármacos , Regulação para Cima/efeitos dos fármacos
4.
Eur J Cancer ; 50(12): 2152-61, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24915776

RESUMO

BACKGROUND: Membrane-bound complement restriction proteins (mCRPs) CD46, CD55 and CD59 enable tumour cells to evade complement dependent cytotoxicity and antibody-dependent killing mechanisms. But less is known about the role of these mCRPs in head and neck cancer. METHODS: In this study we determined the expression of the mCRPs on head and neck squamous cell carcinoma (HNSCC) cell lines, on tumour tissue and TDLNs (tumour-draining lymph nodes) as well as on lymphocytes from HNSCC patients. The influence of the HNSCC microenvironment on the mCRP regulation was analysed using Flow Cytometry, Western blotting and small interfering RNAs (siRNA) transfection studies. RESULTS: We examined the effects of the HNSCC tumour milieu on the expression levels of CD46, CD55 and CD59. We investigated the susceptibility of HNSCC cells to CDC (complement-dependent cytotoxicity) while silencing the mCRPs. Our results demonstrate a huge influence of the HNSCC tumour microenvironment on the regulation of mCRP expression and show a reciprocal regulation between the different mCRPs themselves. CONCLUSIONS: In summary, our data indicate that HNSCC has evolved different strategies to evade complement attacks and that the tumour microenvironment leads to the enhancement of complement resistance of the surrounding tissue.


Assuntos
Antígenos CD55/fisiologia , Antígenos CD59/fisiologia , Carcinoma de Células Escamosas/imunologia , Ativação do Complemento/fisiologia , Neoplasias de Cabeça e Pescoço/imunologia , Proteína Cofatora de Membrana/fisiologia , Neoplasias Bucais/imunologia , Microambiente Tumoral/fisiologia , Idoso , Idoso de 80 Anos ou mais , Linhagem Celular Tumoral , Feminino , Inativação Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas de Cabeça e Pescoço , Microambiente Tumoral/imunologia
5.
Thyroid ; 24(5): 888-96, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24460670

RESUMO

BACKGROUND: The impact of excessive iodine intake on the development of autoimmune thyroiditis (AIT) is still under debate. Transgenic, antibody-devoid TAZ10 mice spontaneously develop AIT due to autoreactive thyroperoxidase-specific T cells. In this model, development of AIT is determined by a T cell infiltration of the thyroid gland leading to an elevation of serum thyrotropin (TSH) levels and significant weight gain. In the present study we investigated the impact of moderate and high iodine supplementation on the course of disease in these mice, which are immunologically prone to AIT. METHODS: In addition to normal nutrition, mice were supplemented for 20 weeks with 2.5 µg versus 5 µg iodine per milliliter drinking water, which corresponds to a human daily iodine supplementation of 150 µg, 315 µg, and 615 µg iodine. AIT-defining parameters (weight gain, elevation of serum TSH levels, cellular infiltration of the thyroid) and immunologic effects were analyzed. RESULTS: No significant differences were displayed when comparing weight and serum TSH levels in the iodine-supplemented versus control groups. Increased thyroid infiltrates with CD8⁺ T cells were detected by fluorescein-activated cell sorter (FACS) and immunofluorescence staining in mice supplemented with elevated iodine amounts (315 µg and 615 µg iodine per day, respectively). Immunologic monitoring revealed selective changes in immune cell frequencies (CD8⁺ and regulatory T cells, natural killer [NK] cells) and cytokine production (interferon-γ, interleukin-1α, and interleukin-17), however, without affecting the overall immune balance. CONCLUSION: Our results demonstrate that elevated iodine supplementation has no physical impact on the course of disease in transgenic, antibody-devoid TAZ10 mice, which are immunologically prone to AIT.


Assuntos
Suplementos Nutricionais , Imunidade Celular , Fatores Imunológicos/uso terapêutico , Iodo/uso terapêutico , Células Th1/imunologia , Glândula Tireoide/imunologia , Tireoidite Autoimune/dietoterapia , Animais , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/patologia , Citocinas/sangue , Citocinas/metabolismo , Feminino , Fatores Imunológicos/administração & dosagem , Iodo/administração & dosagem , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/metabolismo , Células Matadoras Naturais/patologia , Masculino , Camundongos Transgênicos , Tamanho do Órgão , Organismos Livres de Patógenos Específicos , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/metabolismo , Linfócitos T Reguladores/patologia , Células Th1/metabolismo , Células Th1/patologia , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Tireoidite Autoimune/imunologia , Tireoidite Autoimune/metabolismo , Tireoidite Autoimune/patologia , Tireotropina/sangue , Aumento de Peso
6.
Innate Immun ; 19(1): 42-52, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22710762

RESUMO

Neonates demonstrate functional immaturity and dysregulation of immune responses leading to systemic inflammation and enhanced apoptosis of immune cells. Thalidomide has already been proven to differentially regulate immune responses and support anti-apoptosis in immunodeficiency syndromes. Thus, it was the aim of this study to evaluate the effects of thalidomide on the cytokine response and apoptosis of neonatal immune cells. After whole blood culture and stimulation of cord and adult blood samples, the intracytoplasmic expression and the secreted amounts of IL-2, TNF-α, IFN-γ, IL-6, IL-10 and IL-8 were assessed by flow cytometry and Cytokine Bead Array. Apoptosis was detected using Annexin-V staining. Bcl-2 expression was analysed using the Cytokine Bead Array Apoptosis Kit. Exposure to thalidomide (100 µg/ml) reduced the intracytoplasmic pro-inflammatory cytokine production of neonatal monocytes and the IFN-γ production of neonatal lymphocytes. In supernatants, the addition of thalidomide resulted in reduction of TNF-α, IL-6, IL-10 and, by trend, IFN-γ. While stimulated neonatal lymphocytes exhibited susceptibility to apoptosis, thalidomide tended to diminish apoptotic cells. Bcl-2 expression tended to be increased after addition of thalidomide. The potent anti-inflammatory effects of thalidomide and its anti-apoptotic properties in cord blood immune cells provide the basis for future strategies to optimise treatment of neonatal infections and immunodeficiency syndromes.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Células Sanguíneas/efeitos dos fármacos , Síndromes de Imunodeficiência/imunologia , Infecções/imunologia , Talidomida/farmacologia , Adulto , Apoptose/efeitos dos fármacos , Células Sanguíneas/imunologia , Separação Celular , Células Cultivadas , Citocinas/genética , Citocinas/metabolismo , Sangue Fetal/imunologia , Citometria de Fluxo , Humanos , Síndromes de Imunodeficiência/tratamento farmacológico , Recém-Nascido , Infecções/tratamento farmacológico , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo
7.
J Clin Endocrinol Metab ; 97(4): 1347-54, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22259066

RESUMO

CONTEXT: Hashimoto's thyroiditis (HT) is a common autoimmune disease leading to thyroid destruction due to lymphocytic infiltration. Only rare data are available regarding the recognition of specific cellular antigens, e.g. of thyroperoxidase (TPO) and thyroglobulin (Tg). OBJECTIVE: The aim of this study was to quantify and characterize TPO- and Tg-epitope-specific CD8-positive T cells of HT patients. DESIGN: Six different human leukocyte antigen (HLA)-A2 restricted, TPO- or Tg-specific tetramers were synthesized and used for measuring CD8-positive T cells in HT patients and controls. RESULTS: The frequency of peripheral TPO- and Tg-specific CD8-positive T cells was significantly higher in HLA-A2-positive HT patients (2.8 ± 9.5%) compared with HLA-A2-negative HT patients (0.5 ± 0.7%), HLA-A2-positive nonautoimmune goiter patients (0.2 ± 0.4%), and HLA-A2-positive healthy controls (0.1 ± 0.2%). The frequency of Tg-specific T cells (3.0%) was very similar to those of TPO-specific CD8-positive T cells (2.9%). Subgroup analyses revealed a steady increase of the number of epitope-specific CD8-positive T cells from 0.6 ± 1.0% at initial diagnosis up to 9.4 ± 18.3% in patients with long-lasting disease. Analyses of the number of thyroid-infiltrating cells as well as the cytotoxic capacity revealed a similar picture for TPO- and Tg-specific T cells. CONCLUSION: We here report for the first time that both antigens, TPO and Tg, are recognized by CD8-positive T cells and are involved in the thyroid destruction process leading to clinical disease manifestation.


Assuntos
Citotoxicidade Celular Dependente de Anticorpos , Autoanticorpos/análise , Doença de Hashimoto/imunologia , Imunidade Celular , Iodeto Peroxidase/antagonistas & inibidores , Proteínas de Ligação ao Ferro/antagonistas & inibidores , Tireoglobulina/antagonistas & inibidores , Glândula Tireoide/imunologia , Adulto , Idoso , Especificidade de Anticorpos , Autoanticorpos/química , Autoantígenos/química , Biópsia por Agulha Fina , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/patologia , Epitopos/análise , Epitopos/química , Feminino , Bócio/imunologia , Bócio/metabolismo , Bócio/patologia , Antígeno HLA-A2/metabolismo , Doença de Hashimoto/metabolismo , Doença de Hashimoto/patologia , Humanos , Iodeto Peroxidase/química , Proteínas de Ligação ao Ferro/química , Masculino , Pessoa de Meia-Idade , Tireoglobulina/química , Glândula Tireoide/patologia , Adulto Jovem
8.
Endocrinology ; 153(9): 4367-79, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22733969

RESUMO

Natural killer (NK) cells belong to the innate immune system. Besides their role in antitumor immunity, NK cells also regulate the activity of other cells of the immune system, including dendritic cells, macrophages, and T cells, and may, therefore, be involved in autoimmune processes. The aim of the present study was to clarify the role of NK cells within this context. Using two mouse models for type 1 diabetes mellitus, a new subset of NK cells with regulatory function was identified. These cells were generated from conventional NK cells by incubation with IL-18 and are characterized by the expression of the surface markers CD117 (also known as c-Kit, stem cell factor receptor) and programmed death (PD)-ligand 1. In vitro analyses demonstrated a direct lysis activity of IL-18-stimulated NK cells against activated insulin-specific CD8(+) T cells in a PD-1/PD-ligand 1-dependent manner. Flow cytometry analyses revealed a large increase of splenic and lymphatic NK1.1(+)/c-Kit(+) NK cells in nonobese diabetic mice at 8 wk of age, the time point of acceleration of adaptive cytotoxic immunity. Adoptive transfer of unstimulated and IL-18-stimulated NK cells into streptozotocin-treated mice led to a delayed diabetes development and partial disease prevention in the group treated with IL-18-stimulated NK cells. Consistent with these data, mild diabetes was associated with increased numbers of NK1.1(+)/c-Kit(+) NK cells within the islets. Our results demonstrate a direct link between innate and adaptive immunity in autoimmunity with newly identified immunoregulatory NK cells displaying a potential role as immunosuppressors.


Assuntos
Autoimunidade/imunologia , Antígenos CD8/metabolismo , Células Matadoras Naturais/imunologia , Linfócitos T/imunologia , Linfócitos T/metabolismo , Animais , Apoptose/fisiologia , Células Cultivadas , Diabetes Mellitus Experimental/imunologia , Diabetes Mellitus Experimental/metabolismo , Citometria de Fluxo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos NOD , Microscopia de Fluorescência , Reação em Cadeia da Polimerase Via Transcriptase Reversa
9.
Oncol Rep ; 26(3): 615-20, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21687955

RESUMO

Human plasmacytoid dendritic cells (PDCs) are present in solid tumor tissue and metastatic cervical lymph nodes (CLN) in head and neck squamous cell carcinoma (HNSCC). We recently showed that classical PDC functions are heavily disturbed in the tumor microenvironment. In this study we present a new approach to the subject by introducing 3 PDC subsets in HNSCC, characterized by the surface markers CD25, CD56 and CD203c. The first subset, positive for CD25, is significantly induced by HNSCC in vitro and present in metastatic lymph nodes in vivo. This subset can be phenotypically subdivided into matured cells and into a group expressing early T cell markers. Functionally this subgroup is associated with the secretion of IL-8. The second subset, positive for CD56, constitutes 4-5% of all PDCs and is significantly down-regulated by HNSCC. Furthermore, this population sporadically expresses perforin/granzyme B and is absent in metastatic lymph nodes. The third subset, positive for the basophile marker CD203c, is inducible by crosslinking BDCA-2 in the presence of HNSCC and IL-4. Future studies will have to clarify the in vivo relevance of the different PDC subsets in HNSCC.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/patologia , Células Dendríticas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Adolescente , Adulto , Idoso , Antígenos de Diferenciação/metabolismo , Antígeno CD56/metabolismo , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/metabolismo , Linhagem Celular Tumoral , Células Dendríticas/metabolismo , Neoplasias de Cabeça e Pescoço/sangue , Neoplasias de Cabeça e Pescoço/metabolismo , Humanos , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Lectinas Tipo C/metabolismo , Linfonodos/metabolismo , Linfonodos/patologia , Metástase Linfática , Glicoproteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Fenótipo , Diester Fosfórico Hidrolases/metabolismo , Pirofosfatases/metabolismo , Receptores Imunológicos/metabolismo , Adulto Jovem
10.
PLoS One ; 6(1): e15997, 2011 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-21264308

RESUMO

Human Plasmacytoid Dendritic Cells (PDCs) infiltrating solid tumor tissues and draining lymph nodes of Head and Neck Squamous Cell Carcinoma (HNSCC) show an impaired immune response. In addition to an attenuated secretion of IFN-α little is known about other HNSCC-induced functional alterations in PDCs. Particular objectives in this project were to gain new insights regarding tumor-induced phenotypical and functional alterations in the PDC population. We showed by FACS analysis and RT-PCR that HNSCC orchestrates an as yet unknown subpopulation exhibiting functional autonomy in-vitro and in-vivo besides bearing phenotypical resemblance to PDCs and T cells. A subset, positive for the PDC markers CD123, BDCA-2, HLA-DR and the T cell receptor αß (TCR-αß) was significantly induced subsequent to stimulation with HNSCC in-vitro (p = 0.009) and also present in metastatic lymph nodes in-vivo. This subgroup could be functionally distinguished due to an enhanced production of IL-2 (p = 0.02), IL-6 (p = 0.0007) and TGF-ß (not significant). Furthermore, after exposure to HNSCC cells, mRNA levels revealed a D-J-beta rearrangement of the TCR-beta chain besides a strong enhancement of the CD3ε chain in the PDC population. Our data indicate an interface between the PDC and T cell lineage. These findings will improve our understanding of phenotypical and functional intricacies concerning the very heterogeneous PDC population in-vivo.


Assuntos
Antígenos de Superfície , Carcinoma de Células Escamosas/patologia , Neoplasias de Cabeça e Pescoço/patologia , Receptores de Antígenos de Linfócitos T alfa-beta/análise , Carcinoma de Células Escamosas/imunologia , Linhagem da Célula , Antígenos HLA-DR/imunologia , Neoplasias de Cabeça e Pescoço/imunologia , Humanos , Subunidade alfa de Receptor de Interleucina-3/imunologia , Lectinas Tipo C/imunologia , Glicoproteínas de Membrana/imunologia , Receptores Imunológicos/imunologia
11.
Anticancer Res ; 29(8): 3019-25, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19661310

RESUMO

BACKGROUND: Plasmacytoid dendritic cells (PDCs) infiltrating solid tumor tissues and draining lymph nodes of head and neck squamous cell carcinoma (HNSCC) show an impaired immune response. Immunosuppressive cytokines secreted by HNSCC have been recognized to account for reduced interferon-alpha (IFN-alpha) production, whereas the influence on PDC migration has not yet been investigated. MATERIALS AND METHODS: PDCs were isolated from human peripheral blood by magnetic bead separation. Cellular functions and characteristics were analyzed using flow cytometry, migration assays and ELISA techniques. RESULTS: We show that HNSCC and CpG oligonucleotides controversially influence the migration and IFN-alpha production of PDCs. Furthermore we demonstrate that HNSCC induced migration towards stromal cell-derived factor-1 (SDF-1) and macrophage inflammatory protein 1 beta (MIP-1beta) is not dependent upon the surface density of chemokine (CXC motif) receptor 4 (CXCR4) and chemokine (C-C motif) receptor 5 (CCR5). CONCLUSION: We propose that HNSCC triggered PDC migration is most likely linked to a multilevel process strongly modulated by tumor microenvironmental influences.


Assuntos
Carcinoma de Células Escamosas/imunologia , Movimento Celular , Células Dendríticas/imunologia , Células Dendríticas/patologia , Neoplasias de Cabeça e Pescoço/imunologia , Interferon-alfa/metabolismo , Oligodesoxirribonucleotídeos/farmacologia , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Quimiocina CCL4/metabolismo , Quimiocina CXCL12/metabolismo , Células Dendríticas/metabolismo , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Neoplasias de Cabeça e Pescoço/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Receptores CCR5/metabolismo , Receptores CXCR4/metabolismo , Células Tumorais Cultivadas
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