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Tim-4 alleviates acute hepatic injury by modulating homeostasis and function of NKT cells. Tim-4 通过调节 NKT 细胞的稳态和功能减轻急性肝损伤。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-22 DOI: 10.1093/cei/uxae063
Yingchun Wang, Yuzhen Wang, Yutong Ge, Zhuanchang Wu, Xuetian Yue, Chunyang Li, Xiaohong Liang, Chunhong Ma, Pin Wang, Lifen Gao

T-cell immunoglobulin and mucin domain-containing molecule 4 (Tim-4) is an immune checkpoint molecule, which involves in numerous inflammatory diseases. Tim-4 is mainly expressed on antigen presenting cells. However, increasing evidences have shown that Tim-4 is also expressed on natural killer T (NKT) cells. The role of Tim-4 in maintaining NKT cell homeostasis and function remains unknown. In this study, we explored the effect of Tim-4 on NKT cells in acute liver injury. This study found that Tim-4 expression on hepatic NKT cells was elevated during acute liver injury. Tim-4 deficiency enhanced IFN-γ, TNF-α expression while impaired IL-4 production in NKT cells. Loss of Tim-4 drove NKT cell effector lineages to be skewed to NKT1 subset. Furthermore, Tim-4 KO mice were more susceptible to α-GalCer challenge. In conclusion, our findings indicate that Tim-4 plays an important role in regulating homeostasis and function of NKT cells in acute liver injury. Therefore, Tim-4 might become a new regulator of NKT cells and a potential target for the therapy of acute hepatitis.

含 T 细胞免疫球蛋白和粘蛋白结构域的分子 4(Tim-4)是一种免疫检查点分子,与多种炎症性疾病有关。Tim-4 主要在抗原呈递细胞上表达。然而,越来越多的证据表明,Tim-4 也在自然杀伤 T(NKT)细胞上表达。Tim-4 在维持 NKT 细胞稳态和功能方面的作用仍然未知。本研究探讨了 Tim-4 对急性肝损伤中 NKT 细胞的影响。研究发现,在急性肝损伤期间,肝NKT细胞上的Tim-4表达升高。Tim-4缺乏会增强NKT细胞中IFN-γ、TNF-α的表达,同时影响IL-4的产生。Tim-4的缺失导致NKT细胞效应系向NKT1亚群倾斜。此外,Tim-4 KO 小鼠更容易受到 α-GalCer 的挑战。总之,我们的研究结果表明,Tim-4 在调节急性肝损伤中 NKT 细胞的平衡和功能方面发挥着重要作用。因此,Tim-4可能成为NKT细胞新的调节因子和治疗急性肝炎的潜在靶点。
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引用次数: 0
C/EBPε and its acetylation in PMN enhance the tolerance to trauma. PMN 中的 C/EBPε 及其乙酰化可增强对创伤的耐受性。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-19 DOI: 10.1093/cei/uxae061
Shaowen Cheng, Junyu Zhu, Yangyang Bian, Jiangling Yao, Wei Zhang, Shuangqin Yin, Tianyin Kuang, Lina Xian, Huaping Liang

Severe trauma can lead to numerous serious complications, threating the well-being and vitality of the afflicted. The quantity and functionality of PMNs undergo rapid transformations in response to severe trauma, playing a pivotal role in the trauma response. The absence of CCAAT/enhancer-binding protein ε (C/EBPε) profoundly impairs the functionality of polymorphonuclear neutrophils (PMNs), a function of paramount importance in trauma. In this study, by generating mice with C/EBPε knocked out or overexpressed, we substantiate that C/EBPε ensures the restoration of PMN function, enhancing the expression of antimicrobial proteins and thereby promoting trauma recovery. Furthermore, diminished expression of C/EBPε is observed in trauma patients, with levels displaying a negative correlation with ISS and APACHE II scores, suggesting its potential as a prognostic indicator for clinical treatment. Mechanistically, we uncover the upregulation of SIRT1 and the inhibition of P300 participating in the suppression of C/EBPε acetylation, consequently reducing the resilience of mice to trauma. As therapeutic interventions, whether through the sole administration of PMN, NAM treatment, or their combination, all result in an increased survival rate in traumatic mice. In conclusion, our study elucidates the role of C/EBPε in enhancing the resilience to trauma and identifies C/EBPε acetylation as a critical regulatory mechanism, offering potential therapeutic approaches involving PMN transfusion and NAM treatment.

严重创伤可导致多种严重并发症,威胁患者的健康和生命。PMNs 的数量和功能在严重创伤时会发生迅速变化,在创伤反应中起着关键作用。CCAAT/增强子结合蛋白ε(C/EBPε)的缺失会严重损害多形核中性粒细胞(PMNs)的功能,而这一功能在创伤中至关重要。在本研究中,我们通过产生 C/EBPε 被敲除或过表达的小鼠,证实了 C/EBPε 可确保 PMN 功能的恢复,增强抗微生物蛋白的表达,从而促进创伤的恢复。此外,在创伤患者中观察到 C/EBPε 的表达减少,其水平与 ISS 和 APACHE II 评分呈负相关,这表明它有可能成为临床治疗的预后指标。从机理上讲,我们发现 SIRT1 的上调和 P300 的抑制参与了对 C/EBPε 乙酰化的抑制,从而降低了小鼠对创伤的恢复能力。作为治疗干预措施,无论是单独给予 PMN、NAM 治疗,还是两者结合使用,都能提高创伤小鼠的存活率。总之,我们的研究阐明了C/EBPε在增强创伤恢复能力中的作用,并确定了C/EBPε乙酰化是一种关键的调节机制,为涉及PMN输注和NAM治疗的潜在治疗方法提供了可能。
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引用次数: 0
Response to Letter to the Editor: Tubulin beta is not the target of antineutrophil antibodies in primary sclerosing cholangitis. 回应致编辑的信:原发性硬化性胆管炎的抗中性粒细胞抗体的靶点不是β-管壁蛋白。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-19 DOI: 10.1093/cei/uxae064
Beate Preuß, Reinhild Klein
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引用次数: 0
Human Genetic and Immunological Determinants of SARS-CoV-2 Infection and Multisystem Inflammatory Syndrome in Children. 儿童 SARS-CoV-2 感染和多系统炎症综合征的人类遗传学和免疫学决定因素。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-19 DOI: 10.1093/cei/uxae062
Halima Kholaiq, Yousra Abdelmoumen, Abderrahmane Moundir, Assiya El Kettani, Fatima Ailal, Ibtihal Benhsaien, Fatima Adnane, Asmaa Drissi Bourhanbour, Naima Amenzoui, Jalila El Bakkouri, Ahmed Aziz Bousfiha

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces pneumonia and acute respiratory failure in Coronavirus Disease 2019 (COVID-19) patients with inborn errors of immunity to type I interferon (IFN-I). The impact of SARS-CoV-2 infection varies widely, ranging from mild respiratory symptoms to life-threatening illness and organ failure, with a higher incidence in men than in women. Approximately 3 to 5% of critical COVID-19 patients under 60 and a smaller percentage of elderly patients exhibit genetic defects in IFN-I production, including X-chromosome-linked TLR7 and autosomal TLR3 deficiencies. Around 15 to 20% of cases over 70 years old, and a smaller percentage of younger patients, present with preexisting autoantibodies neutralizing type I interferons. Additionally, innate errors affecting the control of the response to type I interferon have been associated with pediatric multisystem inflammatory syndrome (MIS-C). Several studies have described rare errors of immunity, such as XIAP deficiency, CYBB, SOCS1, OAS1/2, and RNASEL, as underlying factors in MIS-C susceptibility. However, further investigations in expanded patient cohorts are needed to validate these findings and pave the way for new genetic approaches to MIS-C. This review aims to present recent evidence from the scientific literature on genetic and immunological abnormalities predisposing individuals to critical SARS-CoV-2 infection through IFN-I. We will also discuss multisystem inflammatory syndrome in children (MIS-C). Understanding the immunological mechanisms and pathogenesis of severe COVID-19 may inform personalized patient care and population protection strategies against future serious viral infections.

严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)会诱发对 I 型干扰素(IFN-I)有先天性免疫错误的 2019 年冠状病毒病(COVID-19)患者出现肺炎和急性呼吸衰竭。SARS-CoV-2感染的影响差异很大,从轻微的呼吸道症状到危及生命的疾病和器官衰竭,男性的发病率高于女性。在 60 岁以下的 COVID-19 重症患者中,约有 3%至 5%的患者和较小比例的老年患者在 IFN-I 生成方面存在遗传缺陷,包括与 X 染色体相关的 TLR7 和常染色体 TLR3 缺陷。在 70 岁以上的病例中,约有 15%至 20%的患者会出现中和 I 型干扰素的自身抗体,年轻患者的比例较小。此外,影响对 I 型干扰素反应控制的先天性错误也与小儿多系统炎症综合征(MIS-C)有关。一些研究已将罕见的免疫错误(如 XIAP 缺乏症、CYBB、SOCS1、OAS1/2 和 RNASEL)描述为导致 MIS-C 易感性的潜在因素。然而,要验证这些发现并为 MIS-C 的新遗传方法铺平道路,还需要在更大的患者群体中开展进一步研究。本综述旨在介绍科学文献中关于遗传和免疫学异常易使个体通过 IFN-I 感染严重 SARS-CoV-2 的最新证据。我们还将讨论儿童多系统炎症综合征(MIS-C)。了解重症 COVID-19 的免疫学机制和发病机理可为个性化患者护理和人群保护策略提供依据,从而预防未来的严重病毒感染。
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引用次数: 0
Screening and Anti-angiogenesis Activity of Chiloscyllium plagiosum Anti-human VEGFR2 Single-domain Antibody. Chiloscyllium plagiosum 抗人血管内皮生长因子受体 2 单域抗体的筛选和抗血管生成活性
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-19 DOI: 10.1093/cei/uxae060
Yanwen Guo, Ruiqi Wang, Yun Wang, Feijian Zheng, Jianqing Chen, Zhengbing Lyu, Chen Yuan, Lili Liu, Xiaofeng Jiang

Recently, the incidence of malignant tumors is on the rise and searching for new treatments on it has become the research priority. Blocking the vascular endothelial growth factor (VEGF) and its receptor (VEGFR) is one of the treatment strategies that used in the development of specific anti-angiogenic drugs. The deficiencies in tissue penetration and affinity maturation become the weakness of these drugs in anti-tumors applications. The single heavy chain antibody found in Chiloscyllium plagiosum, which has a low molecular weight and superior tissue penetration of variable region (VNARs), was considered to have the high antigen binding activity and stability. This type of antibody has a simple structure that can be prokaryoticaly expressed, which makes it easily to produce new antiangiogenic target drugs. Specific anti-IgNAR rabbit multiple antibodies have been used to assess the level of VNARs in sharks and have shown a significant enrichment of IgNAR after triple immunization. An anti-VEGFR2 phage library was used for the targeted VNARs screening, and five candidate VNARs sequences were subsequently obtained by phage screening, followed by combined screening with the transcriptome library, and analysis of conserved regions along with 3D modelling matched the VNAR profile. ELISA and cell-based assays showed that two of the VNARs, VNAR-A6 and VNAR-E3, had a superior antigen affinity and anti-angiogenic activity thereby being able to inhibit human Umbilical Vein Endothelial Cells proliferation and migration. The anti-VEGFR2 VNARs derived from the immunized Chiloscyllium plagiosum and screened by phage library, which provide the new research ideas and specific approaches for the development of new drugs. The anti-VEGFR2 VNARs are capable for blocking the VEGF-VEGFR pathway, which of these may contribute to expanding the use of anti-angiogenic drugs.

近来,恶性肿瘤的发病率呈上升趋势,寻找新的治疗方法已成为研究的重点。阻断血管内皮生长因子(VEGF)及其受体(VEGFR)是开发特定抗血管生成药物的治疗策略之一。组织穿透性和亲和力成熟度方面的缺陷成为这些药物在抗肿瘤应用中的弱点。鹅掌楸中发现的单重链抗体分子量低,可变区(VNARs)的组织穿透性强,被认为具有较高的抗原结合活性和稳定性。这类抗体结构简单,可以原核表达,易于生产新型抗血管生成靶向药物。特异性抗 IgNAR 兔多抗已被用于评估鲨鱼体内的 VNAR 水平,结果显示三联免疫后 IgNAR 显著富集。使用抗血管内皮生长因子受体2噬菌体文库进行靶向VNARs筛选,随后通过噬菌体筛选获得了五个候选VNARs序列,再与转录组文库进行联合筛选,分析保守区域并建立三维模型,结果与VNAR概况相匹配。ELISA 和基于细胞的检测表明,其中两个 VNARs(VNAR-A6 和 VNAR-E3)具有卓越的抗原亲和力和抗血管生成活性,因此能够抑制人脐静脉内皮细胞的增殖和迁移。这些抗血管内皮生长因子受体2(anti-VEGFR2)VNARs来源于免疫接种的鹅掌楸,并通过噬菌体文库进行了筛选,为新药开发提供了新的研究思路和特异性方法。抗血管内皮生长因子受体2(VEGFR2)VNARs能够阻断血管内皮生长因子-血管内皮生长因子受体通路,有助于扩大抗血管生成药物的应用范围。
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引用次数: 0
Protecting children and adults with primary antibody deficiencies against common and emergent pathogens and non-infectious complications. 保护初级抗体缺乏症儿童和成人免受常见病原体、突发病原体和非感染性并发症的侵害。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-16 DOI: 10.1093/cei/uxae059
Olaf Neth, Nizar Mahlaoui, Charlotte Cunningham-Rundles

Prevention and treatment of infections are primary goals of treatment of children and adults with primary immune deficiencies due to decreased antibody production. Approaches to these goals include immunoglobulin replacement therapy, vaccination, and prophylactic treatment with antimicrobials. In this review, the infectious and non-infectious complications of antibody deficiencies will be discussed along with the limited number of studies, that support the effective use of the available therapies and to drive the development of new therapies. Some illustrative case studies will be presented and the outlook for additional controlled clinical trials and potential for therapies driven by the underlying disease genetics will be considered.

预防和治疗感染是治疗因抗体生成减少而出现原发性免疫缺陷的儿童和成人的主要目标。实现这些目标的方法包括免疫球蛋白替代疗法、疫苗接种和抗菌药物预防性治疗。本综述将讨论抗体缺乏症的感染性和非感染性并发症,以及支持有效使用现有疗法和推动新疗法开发的数量有限的研究。本综述将介绍一些说明性病例研究,并探讨更多临床对照试验的前景以及由潜在疾病遗传学驱动的疗法的潜力。
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引用次数: 0
Cellular immune response to the anti-SARS-CoV-2 BNT162b2 mRNA vaccine in pediatric autoimmune inflammatory rheumatic disease patients and controls. 小儿自身免疫性炎症性风湿病患者和对照组对抗 SARS-CoV-2 BNT162b2 mRNA 疫苗的细胞免疫反应。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-12 DOI: 10.1093/cei/uxae044
Tali Eviatar, Adi Pappo, Tal Freund, Yishai Friedlander, Ori Elkayam, David Hagin, Merav Heshin-Bekenstein

This paper aims to compare the cellular immune response to the SARS-CoV-2 BNT162b2 vaccine of pediatric patients with autoimmune inflammatory rheumatic disease (pAIIRD) and healthy controls. A prospective longitudinal study was conducted between April 2021 and December 2022 at the Tel Aviv Medical Center. Children <18 years, with pediatric-onset AIIRD and healthy controls, who have received at least two doses of the BNT162b2 vaccine, were included. Humoral response was evaluated by serum levels of anti-SARS-CoV-2 receptor-binding domain antibodies. Cellular response was evaluated by flow cytometry, measuring IFNγ and TNFα production by CD4+ T cells following stimulation with SARS-CoV-2 Spike peptide mix. The study included 20 pAIIRD patients and 11 controls. The mean age of participants was 12.6 ± 2.94 years, with 58.1% females. The cellular response to the BNT162b2 vaccine was statistically similar in both groups. However, the humoral response was statistically lower in pAIIRD compared with the healthy control group. There was no statistically significant correlation between the humoral response and cellular response. During the study period, 43.75% of AIIRD children and 72.7% of controls had a breakthrough COVID-19 infection (P = 0.48). Bivariate models examining the effect of the cellular response and presence of an AIIRD on breakthrough infections found no effect. Compared with healthy controls, pAIIRD demonstrated similar cellular responses. Patients showed reduced humoral response compared with healthy adolescents, but similar breakthrough infection rates. These findings may support the importance of the cellular response in protecting against COVID-19 infections.

本文旨在比较自身免疫性炎症性风湿病(pAIIRD)儿科患者和健康对照组对 SARS-CoV2 BNT162b2 疫苗的细胞免疫反应。一项前瞻性纵向研究于 2021 年 4 月至 2022 年 12 月在特拉维夫医疗中心进行。儿童
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引用次数: 0
Effector CD4+ T-cell subsets in Takayasu arteritis-differences between the peripheral blood and the aorta. 高安动脉炎的效应 CD4+ T 细胞亚群--外周血和主动脉之间的差异。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-12 DOI: 10.1093/cei/uxae046
Bruna Savioli, Heron Fernandes Vieira Torquato, Edgar Julian Paredes-Gamero, Andréia Fabiana do Vale Franco, Carolina de Oliveira Gigek, Ricardo Artigiani Neto, Alexandre Wagner Silva de Souza

Takayasu arteritis (TAK) is a granulomatous vasculitis that affects large arteries. T cells are important in TAK pathophysiology as these cells orchestrate granulomatous infiltration in arteries. This study aims to evaluate effector CD4+ T cells in the peripheral blood and the aortic wall of TAK patients and to analyze associations with disease activity and therapy. We performed a longitudinal study including 30 TAK patients and 30 controls. CD3+ T cells, CD3+CD4- T cells, CD4+ T cells, and Th1, Th2, and Th17 cells were evaluated in peripheral blood by flow cytometry, and the expression of CD4, CD8, Tbet, GATA-3, and RORγT was analyzed in the aorta of six patients by immunohistochemistry. TAK patients presented lower CD3+ T cells and CD4+ T cells (P = 0.031 and P = 0.039, respectively) than controls. Patients with active disease and those in remission had higher proportions of Th17 cells than controls (P = 0.016 and P = 0.004, respectively). Therapy for TAK did not result in significant differences concerning CD4+ effector T-cell subpopulations. Disease duration correlated with the number and percentage of Th2 cells (rho = -0.610 and rho = -0.463, respectively) and with Th17 cells (rho = -0.365 and rho = -0.568). In the aorta, the expression of CD8 was higher than CD4, whereas GATA-3, Tbet, and RORγT were expressed in this order of frequency. In conclusion, TAK patients present an increased Th17 response in the peripheral blood regardless of disease activity, whereas in the aortic tissue CD8 cells and the Th2 response were predominant.

高安动脉炎(TAK)是一种影响大动脉的肉芽肿性血管炎。T细胞在TAK病理生理学中起着重要作用,因为这些细胞能协调动脉中的肉芽肿浸润。本研究旨在评估 TAK 患者外周血和主动脉壁中的效应 CD4+ T 细胞,并分析其与疾病活动和治疗的关系。我们进行了一项纵向研究,其中包括 30 名 TAK 患者和 30 名对照组。通过流式细胞术评估了外周血中的CD3+ T细胞、CD3+CD4- T细胞、CD4+ T细胞以及Th1、Th2和Th17细胞,并通过免疫组化分析了6名患者主动脉中CD4、CD8、Tbet、GATA-3和RORγT的表达。与对照组相比,TAK 患者的 CD3+ T 细胞和 CD4+ T 细胞数量较低(分别为 p=0.031 和 p=0.039)。活动期患者和缓解期患者的Th17细胞比例高于对照组(分别为p=0.016和p=0.004)。TAK治疗并未导致CD4+效应T细胞亚群的显著差异。疾病持续时间与Th2细胞的数量和百分比相关(rho=-0.610和rho=-0.463),与Th17细胞相关(rho=-0.365和rho=-0.568)。在主动脉中,CD8的表达高于CD4,而GATA-3、Tbet和RORγT的表达频率依次为CD4、Tbet和RORγT。总之,无论疾病活动如何,TAK 患者外周血中 Th17 反应增加,而在主动脉组织中 CD8 细胞和 Th2 反应占主导地位。
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引用次数: 0
Impact on in-depth immunophenotyping of delay to peripheral blood processing. 外周血处理延迟对深入免疫分型的影响。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-12 DOI: 10.1093/cei/uxae041
Lauren E Higdon, Sheila Scheiding, Anna M Kus, Noha Lim, S Alice Long, Mark S Anderson, Alice E Wiedeman

Peripheral blood mononuclear cell (PBMC) immunophenotyping is crucial in tracking activation, disease state, and response to therapy in human subjects. Many studies require the shipping of blood from clinical sites to a laboratory for processing to PBMC, which can lead to delays that impact sample quality. We used an extensive cytometry by time-of-flight (CyTOF) immunophenotyping panel to analyze the impacts of delays to processing and distinct storage conditions on cell composition and quality of PBMC from seven adults across a range of ages, including two with rheumatoid arthritis. Two or more days of delay to processing resulted in extensive red blood cell contamination and increased variability of cell counts. While total memory and naïve B- and T-cell populations were maintained, 4-day delays reduced the frequencies of monocytes. Variation across all immune subsets increased with delays of up to 7 days in processing. Unbiased clustering analysis to define more granular subsets confirmed changes in PBMC composition, including decreases of classical and non-classical monocytes, basophils, plasmacytoid dendritic cells, and follicular helper T cells, with each subset impacted at a distinct time of delay. Expression of activation markers and chemokine receptors changed by Day 2, with differential impacts across subsets and markers. Our data support existing recommendations to process PBMC within 36 h of collection but provide guidance on appropriate immunophenotyping experiments with longer delays.

外周血单核细胞(PBMC)免疫分型对于跟踪人体活化、疾病状态和治疗反应至关重要。许多研究需要将血液从临床地点运送到实验室处理成 PBMC,这可能会导致延误,影响样本质量。我们使用了大量的飞行时间细胞计数法(CyTOF)免疫表型面板来分析延迟处理和不同储存条件对细胞组成和 PBMC 质量的影响,这些样本来自七个不同年龄段的成年人,其中包括两名类风湿性关节炎患者。延迟两天或两天以上处理会导致大量红细胞污染和细胞计数变异性增加。虽然记忆细胞、幼稚 B 细胞和 T 细胞总数得以保持,但延迟四天处理会降低单核细胞的频率。处理时间延迟七天,所有免疫亚群的变异都会增加。通过无偏聚类分析确定更细粒度的亚群,证实了 PBMC 组成的变化,包括经典和非经典单核细胞、嗜碱性粒细胞、浆细胞树突状细胞和滤泡辅助 T 细胞的减少,每个亚群都在不同的延迟时间受到影响。活化标志物和趋化因子受体的表达在第二天发生了变化,不同亚群和标志物受到的影响也不同。我们的数据支持现有的建议,即在采集后 36 小时内处理 PBMC,但也为延迟更长时间进行适当的免疫分型实验提供了指导。
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引用次数: 0
Correction to: Type 1 interferon auto-antibodies are elevated in patients with decompensated liver cirrhosis. 更正为肝硬化失代偿期患者的 1 型干扰素自身抗体升高。
IF 3.4 3区 医学 Q3 IMMUNOLOGY Pub Date : 2024-07-12 DOI: 10.1093/cei/uxae024
{"title":"Correction to: Type 1 interferon auto-antibodies are elevated in patients with decompensated liver cirrhosis.","authors":"","doi":"10.1093/cei/uxae024","DOIUrl":"10.1093/cei/uxae024","url":null,"abstract":"","PeriodicalId":10268,"journal":{"name":"Clinical and experimental immunology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140189524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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