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1.
J Invest Dermatol ; 124(1): 116-8, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15654963

ABSTRACT

The CD1 family of cell surface glycoprotein has been demonstrated to be a third lineage of antigen-presenting molecules for specific T cell responses. They present lipidic, glycolipidic antigen and hydrophobic peptide to T cells. CD1d restricted T cells play a role in autoimmune disease and in tumor immunity. Transforming growth factor beta (TGFbeta), a member of the family of polypeptide growth factors synthetized by human keratinocytes, has inhibitory effects on proliferation and differentiation of immune cells, especially on CD1d-restricted natural killer T cells. These properties led us to investigate the role of TGFbeta in CD1d expression on dendritic cells (DC), which are known to play a key role in initiation of the immune response. Here, we observed CD1d molecules on DC developed from PBMC with GM-CSF and IL4 but not with GM-CSF, IL4 and TGFbeta for 7 d. RT-PCR and FACS analysis (mAb 42.1) performed at various stages of differentiation on CD34+ HPC show that CD1d mRNA levels and CD1d molecule expression at the cell surface decreased progressively during the differentiation process. Thus, while committing DC-precursors differentiation toward the Langerhans cell (LC) pathway, TGFbeta likely inhibits CD1d transcription. Therefore, LC freshly recovered from epidermal sheet were evaluated by flow cytometry. In accordance with in vitro observation, they did not expressed measurable levels of CD1d molecules at the cell membrane. Thus, TGFbeta produced by keratinocytes contribute to selectively downregulate CD1d expression on intraepidermal-resident LC.


Subject(s)
Antigens, CD1/genetics , Dendritic Cells/cytology , Dendritic Cells/physiology , Transforming Growth Factor beta/pharmacology , Antigens, CD1d , Antigens, CD34/metabolism , Cell Differentiation/immunology , Cell Lineage/immunology , Fetal Blood/cytology , Flow Cytometry , Gene Expression/drug effects , Hematopoietic Stem Cells/cytology , Hematopoietic Stem Cells/physiology , Humans , Langerhans Cells/cytology , Langerhans Cells/physiology , Monocytes/cytology
2.
J Exp Med ; 196(4): 417-30, 2002 Aug 19.
Article in English | MEDLINE | ID: mdl-12186835

ABSTRACT

The coordinated migration and maturation of dendritic cells (DCs) such as intraepithelial Langerhans cells (LCs) is considered critical for T cell priming in response to inflammation in the periphery. However, little is known about the role of inflammatory mediators for LC maturation and recruitment to lymph nodes in vivo. Here we show in human dermatopathic lymphadenitis (DL), which features an expanded population of LCs in one draining lymph node associated with inflammatory lesions in its tributary skin area, that the Langerin/CD207(+) LCs constitute a predominant population of immature DCs, which express CD1a, and CD68, but not CD83, CD86, and DC-lysosomal-associated membrane protein (LAMP)/CD208. Using LC-type cells generated in vitro in the presence of transforming growth factor (TGF)-beta1, we further found that tumor necrosis factor (TNF)-alpha, as a prototype proinflammatory factor, and a variety of inflammatory stimuli and bacterial products, increase Langerin expression and Langerin dependent Birbeck granules formation in cell which nevertheless lack costimulatory molecules, DC-LAMP/CD208 and potent T cell stimulatory activity but express CCR7 and respond to the lymph node homing chemokines CCL19 and CCL21. This indicates that LC migration and maturation can be independently regulated events. We suggest that during DL, inflammatory stimuli in the skin increase the migration of LCs to the lymph node but without associated maturation. Immature LCs might regulate immune responses during chronic inflammation.


Subject(s)
Langerhans Cells/immunology , Lectins, C-Type , Lymph Nodes/immunology , Lymphadenitis/immunology , Mannose-Binding Lectins , Skin/immunology , Adolescent , Adult , Antigens, CD , Antigens, Surface/biosynthesis , Biomarkers , Cell Differentiation , Cell Movement/immunology , Cells, Cultured , Chemokine CCL19 , Chemokine CCL21 , Chemokines, CC/immunology , Chemokines, CC/pharmacology , Chronic Disease , Escherichia coli/immunology , Female , HLA-DR Antigens/biosynthesis , Humans , Immunophenotyping , Langerhans Cells/cytology , Langerhans Cells/physiology , Ligands , Lipopolysaccharides/immunology , Lipopolysaccharides/pharmacology , Lymph Nodes/cytology , Lymph Nodes/pathology , Lymphadenitis/pathology , Male , Middle Aged , Monocytes/cytology , Monocytes/drug effects , Monocytes/immunology , Mycobacterium bovis/immunology , Receptors, CCR7 , Receptors, Chemokine/immunology , Tumor Necrosis Factor-alpha/immunology , Tumor Necrosis Factor-alpha/pharmacology
3.
J Immunol ; 167(10): 5767-74, 2001 Nov 15.
Article in English | MEDLINE | ID: mdl-11698450

ABSTRACT

In a search for genes expressed by dendritic cells (DC), we have cloned cDNAs encoding different forms of an asialoglycoprotein receptor (ASGPR). The DC-ASGPR represents long and short isoforms of human macrophage lectin, a Ca(2+)-dependent type II transmembrane lectin displaying considerable homology with the H1 and H2 subunits of the hepatic ASGPR. Immunoprecipitation from DC using an anti-DC-ASGPR mAb yielded a major 40-kDa protein with an isoelectric point of 8.2. DC-ASGPR mRNA was observed predominantly in immune tissues. Both isoforms were detected in DC and granulocytes, but not in T, B, or NK cells, or monocytes. DC-ASGPR species were restricted to the CD14-derived DC obtained from CD34(+) progenitors, while absent from the CD1a-derived subset. Accordingly, both monocyte-derived DC and tonsillar interstitial-type DC expressed DC-ASGPR protein, while Langerhans-type cells did not. Furthermore, DC-ASGPR is a feature of immaturity, as expression was lost upon CD40 activation. In agreement with the presence of tyrosine-based and dileucine motifs in the intracytoplasmic domain, mAb against DC-ASGPR was rapidly internalized by DC at 37 degrees C. Finally, intracellular DC-ASGPR was localized to early endosomes, suggesting that the receptor recycles to the cell surface following internalization of ligand. Our findings identify DC-ASGPR/human macrophage lectin as a feature of immature DC, and as another lectin important for the specialized Ag-capture function of DC.


Subject(s)
Dendritic Cells/immunology , Endocytosis , Lectins, C-Type , Receptors, Cell Surface/biosynthesis , Receptors, Cell Surface/physiology , Amino Acid Sequence , Animals , Asialoglycoprotein Receptor , CD40 Antigens/metabolism , Cells, Cultured , Cloning, Molecular , Endosomes/chemistry , Granulocytes/immunology , Humans , Lectins/genetics , Membrane Proteins/genetics , Mice , Molecular Sequence Data , Monocytes/immunology , Phylogeny , RNA, Messenger/biosynthesis , Rats , Receptors, Cell Surface/genetics , Sequence Homology, Amino Acid , Stem Cells/immunology
4.
Pathol Biol (Paris) ; 49(6): 454-5, 2001 Jul.
Article in French | MEDLINE | ID: mdl-11484603

ABSTRACT

Generation of monoclonal antibodies restricted to human dendritic cells generated from CD34+ hematopoietic precursors has enabled the identification of Langerin, a Ca(++)-dependent type II lectin. Only expressed by Langerhans cells, Langerin is responsible for Birbeck granule formation by membrane superimposition and zippering. Furthermore, cell-surface Langerin is rapidly internalized into Birbeck granules, and does not colocalize with MHC class II rich compartments. Langerin gene transfected into mouse fibroblasts induces the formation of Birbeck granule-like structures, that would permit a better understanding of the function of Birbeck granules.


Subject(s)
Antigens, Surface/immunology , Cytoplasmic Granules/ultrastructure , Dendritic Cells/immunology , Langerhans Cells/immunology , Langerhans Cells/ultrastructure , Lectins, C-Type , Lectins/immunology , Mannose-Binding Lectins , Animals , Antigens, CD , Calcium/physiology , Fibroblasts/physiology , Fibroblasts/ultrastructure , Humans , Mice , Transfection
5.
Blood ; 97(5): 1241-8, 2001 Mar 01.
Article in English | MEDLINE | ID: mdl-11222366

ABSTRACT

Langerhans cell histiocytosis (LCH) consists of lesions composed of cells with a dendritic Langerhans cell (LC) phenotype. The clinical course of LCH ranges from spontaneous resolution to a chronic and sometimes lethal disease. We studied 25 patients with various clinical forms of the disease. In bone and chronic lesions, LCH cells had immature phenotype and function. They coexpressed LC antigens CD1a and Langerin together with monocyte antigens CD68 and CD14. Class II antigens were intracellular and LCH cells almost never expressed CD83 or CD86 or dendritic cell (DC)-Lamp, despite their CD40 expression. Consistently, LCH cells sorted from bone lesions (eosinophilic granuloma) poorly stimulated allogeneic T-cell proliferation in vitro. Strikingly, however, in vitro treatment with CD40L induced the expression of membrane class II and CD86 and strongly increased LCH cell allostimulatory activity to a level similar to that of mature DCs. Numerous interleukin-10-positive (IL-10(+)), Langerin(-), and CD68(+) macrophages were found within bone and lymph node lesions. In patients with self-healing and/or isolated cutaneous disease, LCH cells had a more mature phenotype. LCH cells were frequently CD14(-) and CD86(+), and macrophages were rare or absent, as were IL-10-expressing cells. We conclude that LCH cells in the bone and/or chronic forms of the disease accumulate within the tissues in an immature state and that most probably result from extrinsic signals and may be induced to differentiate toward mature DCs after CD40 triggering. Drugs that enhance the in vivo maturation of these immature DCs, or that induce their death, may be of therapeutic benefit.


Subject(s)
Histiocytosis, Langerhans-Cell/pathology , Langerhans Cells/cytology , Lectins, C-Type , Mannose-Binding Lectins , Antigens, CD/biosynthesis , Antigens, CD/metabolism , Antigens, Differentiation, Myelomonocytic/biosynthesis , Antigens, Surface/biosynthesis , B7-2 Antigen , CD40 Antigens/pharmacology , Cell Differentiation , Cellular Senescence/drug effects , Cellular Senescence/physiology , Eosinophilic Granuloma/pathology , Histocompatibility Antigens Class II/metabolism , Interleukin-10/metabolism , Langerhans Cells/immunology , Langerhans Cells/metabolism , Lipopolysaccharide Receptors/biosynthesis , Macrophages/metabolism , Membrane Glycoproteins/metabolism
6.
Immunity ; 12(1): 71-81, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10661407

ABSTRACT

We have identified a type II Ca2+-dependent lectin displaying mannose-binding specificity, exclusively expressed by Langerhans cells (LC), and named Langerin. LC are uniquely characterized by Birbeck granules (BG), which are organelles consisting of superimposed and zippered membranes. Here, we have shown that Langerin is constitutively associated with BG and that antibody to Langerin is internalized into these structures. Remarkably, transfection of Langerin cDNA into fibroblasts created a compact network of membrane structures with typical features of BG. Langerin is thus a potent inducer of membrane superimposition and zippering leading to BG formation. Our data suggest that induction of BG is a consequence of the antigen-capture function of Langerin, allowing routing into these organelles and providing access to a nonclassical antigen-processing pathway.


Subject(s)
Antigens, Surface/physiology , Endocytosis/physiology , Langerhans Cells/physiology , Lectins, C-Type , Mannose-Binding Lectins , Amino Acid Sequence , Animals , Antibodies, Monoclonal/immunology , Antigens, CD , Antigens, Surface/chemistry , Antigens, Surface/genetics , Antigens, Surface/immunology , Base Sequence , Binding Sites , Cells, Cultured , Cytoplasm/metabolism , DNA, Complementary , Epitopes, B-Lymphocyte/immunology , Gene Expression , Humans , Intracellular Fluid/immunology , Langerhans Cells/cytology , Langerhans Cells/metabolism , Mice , Molecular Sequence Data , Proline , RNA, Messenger , Rats , Transfection
7.
J Exp Med ; 190(10): 1417-26, 1999 Nov 15.
Article in English | MEDLINE | ID: mdl-10562317

ABSTRACT

We have analyzed the presence of immature and mature dendritic cells (DCs) within adenocarcinoma of the breast using immunohistochemistry. Immature DCs were defined by expression of CD1a-, Langerin-, and intracellular major histocompatibility complex class II-rich vesicles. Mature DCs were defined by expression of CD83 and DC-Lamp. Breast carcinoma cells were defined by morphology and/or cytokeratin expression. We demonstrate two levels of heterogeneity of DCs infiltrating breast carcinoma tissue: (a) immature CD1a(+) DCs, mostly of the Langerhans cell type (Langerin(+)), were retained within the tumor bed in 32/32 samples and (b) mature DCs, CD83(+)DC-Lamp(+), present in 20/32 samples, are confined to peritumoral areas. The high numbers of immature DCs found in the tumor may be best explained by high levels of macrophage inflammatory protein 3alpha expression by virtually all tumor cells. Confirming the immature/mature DC compartmentalization pattern, in vitro-generated immature DCs adhere to the tumor cells, whereas mature DCs adhere selectively to peritumoral areas. In some cases, T cells are clustering around the mature DCs in peritumoral areas, thus resembling the DC-T cell clusters of secondary lymphoid organs, which are characteristic of ongoing immune reactions.


Subject(s)
Breast Neoplasms/immunology , Dendritic Cells/physiology , Macrophage Inflammatory Proteins , Receptors, Chemokine , Adult , Aged , Antigens, CD , Antigens, CD1/analysis , Chemokine CCL20 , Chemokines, CC/genetics , Female , Histocompatibility Antigens Class II/analysis , Humans , Immunoglobulins/analysis , Membrane Glycoproteins/analysis , Middle Aged , RNA, Messenger/analysis , Receptors, CCR6 , CD83 Antigen
8.
J Leukoc Biol ; 66(5): 781-91, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10577510

ABSTRACT

In vivo, dendritic cells (DC) form a network comprising different populations. In particular, Langerhans cells (LC) appear as a unique population of cells dependent on transforming growth factor beta(TGF-beta) for its development. In this study, we show that endogenous TGF-beta is required for the development of both LC and non-LC DC from CD34+ hematopoietic progenitor cells (HPC) through induction of DC progenitor proliferation and of CD1a+ and CD14+ DC precursor differentiation. We further demonstrate that addition of exogenous TGF-beta polarized the differentiation of CD34+ HPC toward LC through induction of differentiation of CD14+ DC precursors into E-cadherin+, Lag+CD68-, and Factor XIIIa-LC, displaying typical Birbeck granules. LC generated from CD34+ HPC in the presence of exogenous TGF-beta displayed overlapping functions with CD1a+ precursor-derived DC. In particular, unlike CD14(+)-derived DC obtained in the absence of TGF-beta, they neither secreted interleukin-10 (IL-10) on CD40 triggering nor stimulated the differentiation of CD40-activated naive B cells. Finally, IL-4, when combined with granulocyte-macrophage colony-stimulating factor (GM-CSF), induced TGF-beta-independent development of non-LC DC from CD34+ HPC. Similarly, the development of DC from monocytes with GM-CSF and IL-4 was TGF-beta independent. Collectively these results show that TGF-beta polarized CD34+ HPC differentiation toward LC, whereas IL-4 induced non-LC DC development independently of TGF-beta.


Subject(s)
Antigens, CD34 , Dendritic Cells/cytology , Interleukin-4/physiology , Langerhans Cells/cytology , Transforming Growth Factor beta/physiology , Animals , Antigens, CD1/immunology , B-Lymphocytes/cytology , B-Lymphocytes/immunology , Cell Differentiation/physiology , Cell Polarity , Dendritic Cells/immunology , Granulocyte-Macrophage Colony-Stimulating Factor/immunology , Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology , Hematopoietic Stem Cells/cytology , Hematopoietic Stem Cells/immunology , Humans , Interleukin-10/immunology , Langerhans Cells/immunology , Lipopolysaccharide Receptors/immunology , Mice , Recombinant Proteins , Tumor Necrosis Factor-alpha/immunology , Tumor Necrosis Factor-alpha/pharmacology
9.
Eur J Immunol ; 29(9): 2695-704, 1999 09.
Article in English | MEDLINE | ID: mdl-10508244

ABSTRACT

We generated monoclonal antibody (mAb) DCGM4 by immunization with human dendritic cells (DC) from CD34+ progenitors cultured with granulocyte-macrophage colony-stimulating factor and TNF-alpha. mAb DCGM4 was selected for its reactivity with a cell surface epitope present only on a subset of DC. Reactivity was strongly enhanced by the Langerhans cell (LC) differentiation factor TGF-beta and down-regulated by CD40 ligation. mAb DCGM4 selectively stained LC, hence we propose that the antigen be termed Langerin. mAb DCGM4 also stained intracytoplasmically, but neither colocalized with MHC class II nor with lysosomal LAMP-1 markers. Notably, mAb DCGM4 was rapidly internalized at 37 degrees C, but did not gain access to MHC class II compartments. Finally, Langerin was immunoprecipitated as a 40-kDa protein with a pI of 5.2 - 5.5. mAb DCGM4 will be useful to further characterize Langerin, an LC-restricted molecule involved in routing of cell surface material in immature DC.


Subject(s)
Antibodies, Monoclonal/metabolism , Antigens, Surface/immunology , Langerhans Cells/chemistry , Lectins, C-Type , Mannose-Binding Lectins , Membrane Glycoproteins/immunology , Antigen-Antibody Reactions , Antigens, CD , Antigens, Surface/biosynthesis , Antigens, Surface/isolation & purification , Antigens, Surface/physiology , CD40 Antigens/metabolism , CD40 Ligand , Cell Separation , Down-Regulation/immunology , Humans , Langerhans Cells/metabolism , Langerhans Cells/ultrastructure , Ligands , Membrane Glycoproteins/biosynthesis , Membrane Glycoproteins/isolation & purification , Membrane Glycoproteins/metabolism , Membrane Glycoproteins/physiology , Molecular Weight
10.
J Immunol ; 163(4): 1973-83, 1999 Aug 15.
Article in English | MEDLINE | ID: mdl-10438934

ABSTRACT

We have identified a novel member of the calcium-dependent (C-type) lectin family. This molecule, designated DCIR (for dendritic cell (DC) immunoreceptor), is a type II membrane glycoprotein of 237 aa with a single carbohydrate recognition domain (CRD), closest in homology to those of the macrophage lectin and hepatic asialoglycoprotein receptors. The intracellular domain of DCIR contains a consensus immunoreceptor tyrosine-based inhibitory motif. A mouse cDNA, encoding a homologous protein has been identified. Northern blot analysis showed DCIR mRNA to be predominantly transcribed in hematopoietic tissues. The gene encoding human DCIR was localized to chromosome 12p13, in a region close to the NK gene complex. Unlike members of this complex, DCIR displays a typical lectin CRD rather than an NK cell type extracellular domain, and was expressed on DC, monocytes, macrophages, B lymphocytes, and granulocytes, but not detected on NK and T cells. DCIR was strongly expressed by DC derived from blood monocytes cultured with GM-CSF and IL-4. DCIR was mostly expressed by monocyte-related rather than Langerhans cell related DC obtained from CD34+ progenitor cells. Finally, DCIR expression was down-regulated by signals inducing DC maturation such as CD40 ligand, LPS, or TNF-alpha. Thus, DCIR is differentially expressed on DC depending on their origin and stage of maturation/activation. DCIR represents a novel surface molecule expressed by Ag presenting cells, and of potential importance in regulation of DC function.


Subject(s)
Dendritic Cells/metabolism , Lectins, C-Type , Membrane Glycoproteins/biosynthesis , Peptide Fragments/biosynthesis , Receptors, Immunologic , Receptors, Mitogen/biosynthesis , Amino Acid Sequence , Animals , B-Lymphocytes/metabolism , Base Sequence , Cell Differentiation/genetics , Cell Differentiation/immunology , Cells, Cultured , Chromosomes, Human, Pair 12 , Cloning, Molecular , DNA, Complementary/isolation & purification , Dendritic Cells/cytology , Dendritic Cells/immunology , Gene Dosage , Hematopoietic Stem Cells/metabolism , Humans , Intracellular Fluid/metabolism , Liver/metabolism , Lymphoid Tissue/metabolism , Macrophages/immunology , Macrophages/metabolism , Membrane Glycoproteins/chemistry , Membrane Glycoproteins/genetics , Mice , Molecular Sequence Data , Multigene Family/immunology , Organ Specificity/genetics , Peptide Fragments/chemistry , Peptide Fragments/genetics , Receptors, Mitogen/chemistry , Receptors, Mitogen/genetics , Sequence Homology, Amino Acid , Tyrosine/metabolism
11.
J Immunol ; 163(3): 1409-19, 1999 Aug 01.
Article in English | MEDLINE | ID: mdl-10415041

ABSTRACT

Based on the relative expression of CD11c and CD1a, we have identified three fractions of dendritic cells (DCs) in human peripheral blood, including a direct precursor of Langerhans cells (LCs). The first two fractions were CD11c+ DCs, comprised of a major CD1a+/CD11c+ population (fraction 1), and a minor CD1a-/CD11c+ component (fraction 2). Both CD11c+ fractions displayed a monocyte-like morphology, endocytosed FITC-dextran, expressed CD45RO and myeloid markers such as CD13 and CD33, and possessed the receptor for GM-CSF. The third fraction was comprised of CD1a-/CD11c- DCs (fraction 3) and resembled plasmacytoid T cells. These did not uptake FITC-dextran, were negative for myeloid markers (CD13/CD33), and expressed CD45RA and a high level of IL-3Ralpha, but not GM-CSF receptors. After culture with IL-3, fraction 3 acquired the characteristics of mature DCs; however, the expression of CD62L (lymph node-homing molecules) remained unchanged, indicating that fraction 3 can be a precursor pool for previously described plasmacytoid T cells in lymphoid organs. Strikingly, the CD1a+/CD11c+ DCs (fraction 1) quickly acquired LC characteristics when cultured in the presence of GM-CSF + IL-4 + TGF-beta1. Thus, E-cadherin, Langerin, and Lag Ag were expressed within 1 day of culture, and typical Birbeck granules were observed. In contrast, neither CD1a-/CD11c+ (fraction 2) nor CD1a-/CD11c- (fraction 3) cells had the capacity to differentiate into LCs. Furthermore, CD14+ monocytes only expressed E-cadherin, but lacked the other LC markers after culture in these cytokines. Therefore, CD1a+/CD11c+ DCs are the direct precursors of LCs in peripheral blood.


Subject(s)
Antigens, CD1/blood , Dendritic Cells/immunology , Integrin alphaXbeta2/blood , Langerhans Cells/immunology , Stem Cells/immunology , Cell Differentiation/immunology , Cell Separation , Cells, Cultured , Dendritic Cells/cytology , Dendritic Cells/ultrastructure , Flow Cytometry , Humans , Immunophenotyping , Langerhans Cells/cytology , Lipopolysaccharide Receptors/biosynthesis , Lymphocyte Culture Test, Mixed , Stem Cells/cytology , Time Factors
12.
Exp Hematol ; 27(12): 1768-75, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10641594

ABSTRACT

A subset of dendritic cells called germinal center dendritic cells (GCDC) has recently been described inside germinal center from reactive lymphoid organs. We investigated this newly recognized population in follicular lymphoma (FL), which is considered to be the pathologic counterpart of germinal center B cells. Immunohistochemistry analysis with a panel of antibodies demonstrated the presence of a cell population with the peculiar GCDC phenotype in FL biopsies and a similar localization of these cells inside tumoral and reactive follicles. Therefore, we analyzed the relationships between GCDC and the other cell subsets of the tumor follicles. Some of CD4+ and CD8+ T lymphocytes present inside the follicle were found to be in close association with GCDC, suggesting a potential implication of GCDC in their activation. In addition, the distribution of GCDC inside FL and reactive follicles did not appear disrupted, in contrast to follicular dendritic cells, the other follicle dendritic cell type. Finally, we demonstrated that GCDC could be detected from FL lymph node cell suspension by flow cytometry. Taken together, these results indicate that FL development is not associated with a disappearance of GCDC or with a lack of physical interactions between GCDC and T cells inside the follicles. In addition, the fact that GCDC can be observed in FL samples by flow cytometry should allow their purification to further study their putative role in FL development and maintenance.


Subject(s)
Dendritic Cells, Follicular/pathology , Lymphoma, Follicular/pathology , Adult , Aged , Antigens, CD , Cell Communication , Dendritic Cells, Follicular/immunology , Humans , Immunophenotyping , Lymphoma, Follicular/immunology , Male , Middle Aged
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