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Infection and Immunity, September 2001, p. 5883-5891, Vol. 69, No. 9
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.9.5883-5891.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Dietary Glycine Prevents Peptidoglycan Polysaccharide-Induced
Reactive Arthritis in the Rat: Role for Glycine-Gated Chloride
Channel
Xiangli
Li,1,2
Blair U.
Bradford,1
Michael D.
Wheeler,1
Stephen A.
Stimpson,3
Heather M.
Pink,3
Thomas A.
Brodie,3
John H.
Schwab,4 and
Ronald G.
Thurman1,*
Laboratory of Hepatobiology and Toxicology,
Department of Pharmacology,1 Department
of Nutrition,2 and Department of
Microbiology and Immunology,4 University of
North Carolina at Chapel Hill, and Glaxo-Wellcome, Research
Triangle Park,3 North Carolina
Received 28 November 2000/Returned for modification 29 January
2001/Accepted 21 May 2001
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ABSTRACT |
Peptidoglycan polysaccharide (PG-PS) is a primary structural
component of bacterial cell walls and causes rheumatoid-like arthritis
in rats. Recently, glycine has been shown to be a potential immunomodulator; therefore, the purpose of this study was to determine if glycine would be protective in a PG-PS model of arthritis in vivo.
In rats injected with PG-PS intra-articularly, ankle swelling increased
21% in 24 to 48 h and recovered in about 2 weeks. Three days
prior to reactivation with PG-PS given intravenously (i.v.), rats were
divided into two groups and fed a glycine-containing or
nitrogen-balanced control diet. After i.v. PG-PS treatment joint
swelling increased 2.1 ± 0.3 mm in controls but only 1.0 ± 0.2 mm in rats fed glycine. Infiltration of inflammatory cells, edema,
and synovial hyperplasia in the joint were significantly attenuated by
dietary glycine. Tumor necrosis factor alpha (TNF-
) mRNA was
detected in ankle homogenates from rats fed the control diet but not in
ankles from rats fed glycine. Moreover, intracellular calcium was
increased significantly in splenic macrophages treated with PG-PS; however, glycine blunted the increase about 50%. The inhibitory effect of glycine was reversed by low concentrations of
strychnine or chloride-free buffer, and it increased radiolabeled chloride influx nearly fourfold, an effect also inhibited by
strychnine. In isolated splenic macrophages, glycine blunted
translocation of the p65 subunit of NF-
B into the nucleus,
superoxide generation, and TNF-
production caused by PG-PS. Further,
mRNA for the beta subunit of the glycine receptor was detected in
splenic macrophages. This work supports the hypothesis that
glycine prevents reactive arthritis by blunting cytokine release from
macrophages by increasing chloride influx via a glycine-gated
chloride channel.
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INTRODUCTION |
Peptidoglycan polysaccharide (PG-PS)
is a primary structural component of bacterial cell walls, and
injection of PG-PS induces arthritis in the rat that resembles human
rheumatoid arthritis (29). The mechanism of the
pathogenic action of PG-PS remains largely unclear, but it is
thought that inflammation is due, in part, to stimulation of secretion
of tumor necrosis factor alpha (TNF-
), interleukin-1, and other
inflammatory cytokines as well as oxygen radicals from a variety of
inflammatory cells including macrophages (28, 29).
Indeed, PG-PS is concentrated in macrophages in the spleen,
liver, and mesenteric lymph nodes after systemic injection in rats
(28). Furthermore, PG-PS was detected in the joints of
patients with septic arthritis and rheumatoid arthritis, those
PG-PS-containing cells were mostly macrophages surrounded by T
lymphocytes. Recently, macrophages were reported to be required in bacterial and adjuvant-induced arthritis (15). The
depletion of macrophages attenuated the severity of the
arthritic lesions in joints.
NF-
B activation and TNF-
production from macrophages have
been shown to be important in the etiology of rheumatoid arthritis and
bacterial cell wall-induced arthritis (8, 23).
Treatment with anti-TNF-
antibody (7) or gene
therapy with I
B superrepressor inhibits the severity of
recurrent PG-PS-induced arthritis (23). Anti-TNF-
therapy is the most efficient new strategy in arthritis treatment from
clinical trials, and new drugs such as soluble TNF receptors represent
exciting new therapies for inflammatory arthritis, especially for
patients who do not respond to methotrexate (39). However,
widespread clinical use of these agents has limitations, not the
least of which is expense. Simpler and more economical treatment is needed.
Glycine is a nonessential amino acid and an inhibitory neurotransmitter
in the central nervous system. It can stimulate glycine-gated chloride
channels, leading to increased chloride influx that hyperpolarizes neuronal membranes and inhibits excitatory signal transduction (4, 26). Recently, glycine has been shown to be
immunosuppressive in several studies (35, 40). Glycine
ameliorates kidney and liver injury during endotoxin shock
(12), an effect that was due to the blocking of
intracellular calcium signaling and the production of TNF-
in
hepatic Kupffer cells via a glycine-gated chloride channel
(13, 41). Therefore, the purpose of this study was to
investigate whether glycine reduces PG-PS-induced arthritis in vivo
and whether a glycine-gated chloride channel is involved.
(A preliminary account of this work has appeared elsewhere
[18].)
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MATERIALS AND METHODS |
Arthritis model.
Male Lewis rats (175 to 200 g) were
injected intra-articularly with PG-PS (5 µg; Lee Labs, Garrison, Ga.)
in one ankle and sterile saline in the other ankle as a control
(30). After 2 weeks, rats were divided randomly into
control and glycine treatment groups; one group was given
nitrogen-balanced AIN-76 diet (20% casein), while the other group
received a glycine-containing diet (15% casein + 5% glycine;
Harlan Teklad, Madison, Wis.). Three days later, all rats were injected
intravenously (i.v.) with 200 µg of PG-PS to reactivate arthritis.
Joint swelling was evaluated by measurement of ankle diameter, using a
digital caliper by an individual who was blinded to the treatment
groups. Each joint was also evaluated using a limp score based on a
scale from 0 to 4: 0, normal gait; 1, slight alteration of motion; 2, occasional limp; 3, frequent limp but occasional joint use; 4, withdrawal of paw and no use of joint. One day after the peak of
swelling during the reactivation phase, blood samples were collected
for serum glycine measurements. During the experimental period, body
weight and food consumption were monitored.
Histology analysis.
After i.v. injection of PG-PS, ankles
were harvested 1 day after the peak of inflammation. Rats were
anesthetized with pentobarbital, and ankles were amputated, skinned,
and fixed in 10% formalin for histological evaluation. Tissues were
stained with hematoxylin and eosin. Histology was scored from 0 (no
damage) to 5 (severe damage) by evaluating panus formation,
inflammatory cell infiltration, synovial lining distension, edema, and
bone erosion by a observer blinded to treatment groups
(2).
Glycine measurement.
Rat serum was collected at the peak of
inflammation, and the glycine concentration was determined. In brief,
glycine was extracted from serum and benzoylated, and the resulting
hippuric acid was extracted and dried by nitrogen (24,
25). The concentration of a colored conjugate of hippuric acid
with dimethylaminobenzaldehyde was determined spectrophotometrically at
458 nm.
Splenic macrophage isolation and culture.
Rats were
anesthetized, and the spleen was isolated using aseptic techniques. The
spleen was teased apart, rinsed through mesh with minimal essential
medium, (MEM), and centrifuged; then cells were resuspended in RPMI
1640 containing 10% fetal bovine serum (FBS) and antibiotics (100 U of
penicillin G per ml and 100 µg of streptomycin sulfate 1 per ml). Ten
milliliters of 0.15 mM NH4Cl buffer was added to the cell
suspension for 1 min to lyse red cells. Splenocytes were centrifuged
(500 × g), the pellet was resuspended in medium, cell
number was determined using a hemocytometer, and viability was assessed
from trypan blue exclusion (>90%). To purify macrophages,
cells were seeded on coverslips or 24-well plates and cultured in RPMI
1640 for 30 min at 37°C in a 5% CO2 atmosphere.
Nonadherent cells were gently removed by replacing media three to five
times, and the number of adherent cells was calculated by difference.
Purity of macrophages was above 95% as determined by
Wright-Giemsa staining. For all experiments, cells were incubated in
RPMI 1640 24 h before use.
Measurement of intracellular calcium.
The intracellular
calcium concentration ([Ca2+]i) in splenic
macrophages was measured using the fluorescent
[Ca2+]i indicator dye fura-2 and a
microspectrofluorometer (InCyt Im2 imaging, Cincinnati, Ohio)
interfaced with an inverted microscope (TMS-F; Nikon, Tokyo, Japan).
Splenic macrophages cultured on coverslips were incubated in
modified Hanks' buffer (115 mM NaCl, 5 mM KCl, 0.3 mM
Na2HPO4, 0.4 mM KH2PO4,
5.6 mM glucose, 0.8 mM MgSO4, 1.26 mM CaCl2, 15 mM HEPES [pH 7.4]) containing 5 µM fura-2-acetoxymethyl ester
(Molecular Probes, Eugene, Oreg.) at room temperature for 30 min.
Coverslips with macrophages loaded with fura-2 were rinsed and
placed in chambers with buffer at room temperature. Changes in
fluorescence intensity of fura-2 at excitation wavelengths of 340 and
380 nm and emission at 510 nm were monitored. Each value was corrected
by subtracting the system dark noise and autofluorescence. [Ca2+]i was determined from the equation
[Ca2+]I = Kd[(R
Rmin)/(Rmax
R)] × (F0/Fs). Cells were
selected at random and analyzed using InCyt Im2 image acquisition and
analysis software.
Measurement of chloride uptake.
Assays for uptake of
chloride were conducted as described previously (32).
Briefly, about 5 × 105 cells were incubated with
buffer (20 mM HEPES, 118 mM NaCl, 4.7 mM KCl, 1.2 mM MgSO4,
2.5 mM CaCl2, 10 mM glucose) for 30 min at room
temperature. Coverslips were gently blotted dry and incubated for
5 s in a petri dish with 2 ml of buffer containing 2 µCi of 36Cl
per ml. The coverslips were washed with
ice-cold buffer, which terminated chloride uptake. Radioactivity was
detected by liquid scintillation spectroscopy using a Beckman LC6000SC
scintillation counter (Beckman Instruments Inc., Fullerton, Calif.).
Protein was determined by a Lowry assay (19).
Detection of NF-
B in splenic macrophages.
The p65
subunit of NF-
B was detected in splenic macrophages by a
method described previously (14). Isolated splenic
macrophages were incubated for 24 h before the addition of
PG-PS (20 µg/ml) in the presence or absence of 1 mM glycine. After 30 min, cells were fixed with 100% ice-cold methanol for 10 min and
blocked with 10% nonimmune goat serum (NGS; Sigma) for 30 min. Rabbit anti-p65 (Rockland, Gilbertsville, Pa.) antibody in 10% NGS was added
for 30 min, followed by the addition of rhodamine
isothiocyanate-conjugated goat anti-rabbit immunoglobulin G antibody in
10% NGS. Nuclear DNA was stained using Hoechst 33258, and p65 and
nuclear DNA were visualized with a fluorescence microscope.
Superoxide release assay.
Superoxide production was
determined from the superoxide dismutase-inhibitable reduction of
cytochrome c as described elsewhere (21).
Splenic macrophages (~106 /ml) were seeded onto
24-well plates with MEM plus 15% FBS, and cytochrome c was
added to each well at a final concentration of 0.8 mg/ml. Cells were
incubated with glycine (1 mM) for 3 min at room temperature before
addition of PG-PS. Cells were incubated for 15 min at 37°C,
supernatants were collected, and the reduction of cytochrome
c was measured by spectrophotometry at 550 nm. The differences in absorption between samples incubated in the presence and
absence of superoxide dismutase (85 U/ml) were compared, and superoxide
concentration was calculated using a millimolar extinction coefficient
of 18.5.
RT-PCR.
Ankles or splenic macrophages were
homogenized, and RNA was extracted with phenol-chloroform and ethanol
precipitation (1). For the synthesis of cDNA, reverse
transcription (RT) was performed using murine leukemia virus reverse
transcriptase. Primers for glycine receptor were designed based on the
cloned sequence of highly conserved regions in the beta subunit of the
glycine receptor from rat spinal cord (41). The forward
primer 5'-AGGTCATCTTCACCCTGAGGAGA-3' and the reverse primer
5'-CCAAGTCCAGTGTTGACTTCAATG-3' generated a 575-bp DNA
fragment. Primers for TNF-
were
5'-TACTGAACTTCGGGGTGATTGGTCC-3' and
5'-CAGCCTTGTCCCTTGAAGAGAACC-3', generating a 294-bp DNA
fragment. Primers for glyceraldehyde-3-phosphate dehydrogenase (G3PDH)
were 5'-TGAAGGTCGGTGTCAACGGATTTG-3' and
5'-GTACATCCGTACTCCAGGTGGTG-3' generating a 982-bp DNA
fragment. Primers were prepared at the nucleotide synthesis
facility at the University of North Carolina. Briefly, cDNA was
added to a mixture containing 20 µM primer, 2 mM deoxynucleoside
triphosphates, polymerase buffer, and Taq polymerase (1.25 U). The positive controls for G3PDH and TNF-
were plasmids of PCR
fragments from G3PDH and TNF-
cloned into the subcloning vector
pUC19. Amplification products were separated on a 1.5% agarose gel and
visualized by UV illumination.
DNA sequencing.
The PCR product generated using glycine
receptor primers from splenic macrophages was subcloned into
Escherichia coli, using a TOPO TA clone kit (Invitrogen,
Carlsbad, Calif.). Positive clones with the DNA fragment were selected
and amplified, and DNA was isolated from plasmid (Miniprep DNA
purification system; Promega). Plasmid DNA was sequenced in the
facility of University of North Carolina.
Statistical analysis.
All results were expressed as
means ± standard error of the means (SEM). Statistical
differences between groups were determined by using analysis of
variance (ANOVA) with either Tukey's post-hoc test or Scheffe's
post-hoc test where appropriate. Scores were compared by the
Mann-Whitney rank sum test. P < 0.05 was selected as
the criterion for significance before initiation of the study.
 |
RESULTS |
Body weight and food consumption.
During the course of this
study, body weight and food consumption were monitored. On average,
rats grew at the same rate over the course of the study, with a maximal
increase of 40 ± 0.5 g in 25 days. Food consumption increased steadily
over the first 18 days of the experiment. Rats were then randomly
divided into two groups; one group received a glycine-containing diet,
and the other control received a diet for 3 days prior to i.v.
injection of PG-PS. Rats in the two groups studied did not have
significantly different body weights throughout the experiment. Food
consumption was also not different before reactive arthritis. After the
reinjection of PG-PS, only on day 18, rats given the control diet
consumed 15.6 ± 0.5 g of food/day, while rats fed the
glycine diet consumed about 19.4 ± 1.2 g/day (P < 0.05).
Effect of glycine on PG-PS-induced arthritis.
In this model,
acute arthritis was induced by intra-articlular injection of PG-PS,
while recurrent arthritis was reactivated i.v. After intra-articular
injection of PG-PS, the ankles of PG-PS-treated rats swelled about 21%
in 2 to 3 days (Fig. 1 [representative experiment repeated twice]). The effect subsided substantially 4 days
after PG-PS and was nearly back to baseline in 2 weeks. At that time,
rats were divided into two groups and fed the control or
glycine-containing diet. Three days later, arthritis was reactivated by
an i.v. injection of PG-PS. The diameters of ankles of rats fed the
control diet reached a maximal value of 9.2 ± 0.2 mm, an increase
of 2.1 ± 0.3 mm over baseline; however, ankles of rats fed the
glycine diet had a maximal increase of only 1.0 ± 0.2 mm above
baseline (Fig. 1). Thus, feeding dietary glycine prior to PG-PS
reactivation prevented joint swelling significantly.

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FIG. 1.
Effect of dietary glycine on ankle diameter in PG-PS
induced arthritis. Arthritis was induced in rats fed control diet by
intra-articular (i.a.) injection of PG-PS (5 µg) into the ankle joint
as described in Materials and Methods, followed by recovery for 2 weeks. Three days prior to i.v. injection of PG-PS (200 µg), half of
the rats were switched to 5% glycine diet and control rats received a
diet balanced for nitrogen. Ankle diameter was measured as described in
Materials and Methods. Data are expressed as mean ± SEM
(n = 5) (*, P < 0.05; **,
P < 0.01 [one-way ANOVA with Tukey's post-hoc
test]).
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Ankle function was also impaired after injection of PG-PS. After the
intra-articular injection of PG-PS, the average limp score was nearly
maximal at 3.5 ± 0.4 and decreased to zero by day 5. After i.v.
PG-PS, rats fed the glycine diet had an average limp score of 1.2 ± 0.7, significantly lower than that of the control group (3.6 ± 0.4).
Serum was collected immediately after the peak of ankle swelling on day
22. In the control group, the serum glycine concentration was 0.18 ± 0.15 mM. In rats fed glycine, the glycine concentration was
0.95 ± 0.10 mM, similar to values shown to be protective in a
model of endotoxin shock (12).
Inflammation due to PG-PS.
One day after the peak of joint
swelling, severe infiltration of inflammatory cells and swelling both
in the synovium and surrounding tissue were observed in rats fed the
control diet (Fig. 2). Neovascularization
with occasional areas of hemorrhage and a few lymphocytic foci, chiefly
in the synovium, were observed in PG-PS-treated control rats. Synovial
cell hyperplasia was significant, with an increase in the number and
size of synovial cells in the tibiotarsal joint and in the bursa of the
Achilles tendon. In rats fed the glycine-containing diet, only a slight
increase in the number and size of synovial cells was observed. Several
parameters of histological changes are summarized in Table
1. Synovial hypertrophy, increases in
inflammatory cells, and edema were the main pathological changes
detected in the joints from control rats. Dietary glycine significantly
attenuated the synovial extension, edema, and inflammatory infiltration
to different extents. There was moderate cartilage destruction in
control ankles, while bone destruction was less extensive in joints of
rats in the glycine group (Table 1). Thus, consistent with the joint
swelling (Fig. 1), glycine blunted pathological changes in the joint
caused by PG-PS by about 50%.

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FIG. 2.
Histological analysis of ankle joints. Ankles were
collected 1 day after the peak of inflammation after PG-PS reactivation
as described in Materials and Methods and stained with hematoxylin and
eosin. Typical low-power (12.5×; top row) and higher-power (40×;
bottom row) photomicrographs are presented. Synovial tissue is marked
by arrows, and areas of inflammation are indicated by circles.
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One day after the peak of reactivation of arthritis by i.v. injection
of PG-PS, ankles were harvested and homogenized and RNA was isolated.
mRNA for TNF-
was detected in ankles from rats fed the control diet
(Fig. 3) but not in ankles from rats fed the glycine-containing diet.

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FIG. 3.
TNF- mRNA in ankles. Ankle mRNA transcripts were
amplified by RT-PCR from rats fed either control (joint-control) or
glycine (joint-glycine) diet 1 day after reactivation of arthritis
using PG-PS. Ankles were harvested, and RNA was isolated as described
in Materials and Methods. Markers (1.0 kb and 100 bp) and positive
controls specifically for TNF mRNA and G3PDH, the housekeeping gene,
were assayed simultaneously. The data are representative of two
independent experiments.
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Additionally, isolated splenic macrophages (0.8 × 106) were incubated with or without glycine (1 mM) for
1 h. The addition of glycine lowered the increase in TNF-
caused by PG-PS (50 µg/ml) from 1,014 ± 60 pg/ml to 717 ± 86 pg/ml (P < 0.05). In the absence of PG-PS, TNF-
levels were below detection limits.
Effect of PG-PS on intracellular calcium in splenic
macrophages.
Since rat joints are small, technical
difficulties were encountered in obtaining an adequate number of
synovial macrophages. Therefore, we used splenic
macrophages as a model to study the effect of glycine in
intracellular signaling. [Ca2+]i was
monitored after the addition of PG-PS (10 µg/ml) plus 5% rat serum
to splenic macrophages. Without addition of rat serum, PG-PS
did not increase calcium; however, with serum, PG-PS quickly increased
[Ca2+]i about 17-fold over basal values in
about 1 min; the level returned to baseline in 4 to 6 min (Fig.
4A). In contrast, after 3 min of
preincubation with 1 mM glycine, the increase in
[Ca2+]i was slow and peaked at a level much
lower than in control cells. On average, PG-PS increased
[Ca2+]i in splenic macrophages to
122 ± 8 nM. The maximal increase was blunted about 50% by 1 mM
glycine (Fig. 4C). Furthermore, the inhibitory effect of glycine was
dose dependent (Fig. 4B; half-maximal effect = 0.55 mM glycine).

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FIG. 4.
Effects of PG-PS and glycine on
[Ca2+]i and radiolabeled chloride uptake in
cultured splenic macrophages. (A)
[Ca2+]i was measured with the fluorescent
indicator fura-2 as described in Materials and Methods in isolated
splenic macrophages. Representative traces from cultured
splenic macrophages preincubated in modified Hanks' balanced
salt solution buffer in the presence or absence of glycine (1 mM) for 3 min and challenged with PG-PS (10 µg/ml). are shown. (B) Conditions
as in panel A except that the concentration of glycine was varied. Data
are expressed as means ± SEM (n = 6 to 10 cells)
from three individual experiments. *, P < 0.05
versus no glycine by one-way ANOVA with Scheffe's post-hoc test. (C)
Glycine (1 mM) or glycine plus strychnine (Strych; 1 µM) was added
for 3 min. in the presence or absence of chloride-containing buffer (no
Cl ) prior to calcium measurements. Data are mean ± SEM from five independent experiments (13 to 28 cells per group). *,
P < 0.05 compared to basal; #, P < 0.05 compared to glycine group by one-way ANOVA. (D) Non treated
splenic macrophages were incubated with
36Cl (2 µCi/ml) in the presence or absence
of glycine or glycine plus strychnine (1 µM). Data are presented as
percentage of 36Cl uptake in untreated
controls from five independent experiments (mean ± SEM). *,
P < 0.05 compared to untreated group; #, P < 0.05 compared to glycine group by one-way ANOVA on ranks with
Tukey's post-hoc test.
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To determine if the effect of glycine occurred through a glycine-gated
chloride channel, the specific glycine receptor antagonist strychnine
was studied. Preincubation of strychnine (1 µM) with glycine reversed
the inhibitory effect of glycine completely (Fig. 4C). Chloride-free
buffer also reversed the inhibitory effect of glycine significantly.
Glycine increases chloride influx.
Hyperpolarization of the
plasma membrane due to influx of chloride is the mechanism of the
inhibitory effect of glycine in the central nervous system and in a
variety of white blood cells (40). To investigate
whether glycine affects chloride influx in splenic
macrophages, radiolabeled chloride influx was measured. Indeed, glycine increased chloride uptake by splenic
macrophages about fourfold (Fig. 4D). This increase of chloride
influx by glycine was reduced significantly by strychnine.
Molecular evidence for a glycine receptor in splenic
macrophages.
Figure 5
demonstrates the detection of mRNA of the beta subunit of the glycine
receptor in splenic macrophages. The 575-bp fragment from
splenic macrophages was identical to the positive control from
the spinal cord, consistent with the finding that splenic
macrophages contain a beta subunit similar to the 58-kDa subunit in the spinal cord. Furthermore, the PCR product from splenic
macrophages was sequenced and found to have 98% homology with
a cDNA segment of the beta subunit of the glycine receptor (GenBank
accession no. X81202). This is the first study to provide molecular
evidence demonstrating the presence of a glycine-gated chloride channel
in splenic macrophages.

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FIG. 5.
Glycine receptor mRNA in splenic macrophages.
Total RNA was isolated from splenic macrophages as described in
Materials and Methods. The glycine receptor was identified by RT-PCR
using primers specific for conserved regions in the beta subunit,
(GlyR ). The negative control was total RNA from splenic
macrophages without RT. The PCR product was confirmed by
sequencing as described in Materials and Methods. The data are
representative of three independent experiments. Sizes are indicated in
base pairs.
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Detection of NF-
B in splenic macrophages.
The
pivotal transcription factor NF-
B is important for the production of
TNF-
. In untreated splenic macrophages, the p65 subunit of
NF-
B was detected in cytoplasm, indicating that it was in an
inactive form (Fig. 6, top row). PG-PS
stimulated the translocation of p65 into the nucleus in about 60% of
the cells (Fig. 6, middle row). In contrast, glycine (1 mM) blocked the nuclear translocation of p65 by PG-PS nearly completely (Fig. 6, bottom
row).

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FIG. 6.
Effects of PG-PS and glycine on nuclear translocation of
the p65 subunit of NF- B. Splenic macrophages were stimulated
with PG-PS (20 µg/ml) in the presence or absence of glycine (1 mM).
The p65 subunit in cells was detected with an anti-p65 antibody as
described in Materials and Methods. Nuclear DNA was stained using
Hoechst 33342, and the p65 subunit and nuclear DNA were visualized with
a fluorescence microscope. The data are representative of three
independent experiments. Top row, untreated cells; middle row, cells
treated with PG-PS (20 µg/ml) plus 5% rat serum; bottom row,
glycine-pretreated cells treated with PG-PS.
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Superoxide generation by splenic macrophages is inhibited
by glycine.
Phagocytes express NADPH oxidase in the cell membrane;
therefore, the effect of PG-PS on superoxide production by splenic macrophages was evaluated (Fig.
7). In the absence of PG-PS, cells generated superoxide at rates of 1.9 ± 0.5 nmol 106
cells/15 min. PG-PS (10 µg/ml) increased values to 8.5 ± 1.4 nmol/106 cells/15 min. Interestingly, the increase in
superoxide release due to PG-PS was reduced significantly (about 45%)
by glycine.

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FIG. 7.
Effect of glycine on superoxide production. Splenic
macrophages were incubated in MEM with 15% FBS, HEPES, and
antibiotics, and superoxide production was measured as described in
Materials and Methods. Briefly, glycine (1 mM) was added to cells 3 min
before the addition of PG-PS (10 µg/ml). Data are the means ± SEM from four independent experiments. *, P < 0.05
by one-way ANOVA with Tukey's post-hoc test compared with control
group; #, P < 0.05 by one-way ANOVA with Tukey's
post-hoc test compared with PG-PS alone.
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DISCUSSION |
Glycine inhibits PG-PS-induced arthritis.
The PG-PS-induced
arthritis model has been used widely in studies of the etiology of
rheumatoid arthritis because it mimics the clinical patterns observed
in arthritic patients (3). One intra-articular dose of
PG-PS causes a synovitis that reverts in a few days. Reactivation after
a small i.v. dose of PG-PS causes a more severe, chronic, cyclic
inflammation which is produced in the injured joint and eventually
causes permanent destruction (31). This cell wall complex
is resistant to breakdown in the body and remains in the tissue for
long periods of time (3). PG-PS is retained in the joints
and synovial fluid of some rheumatoid arthritis patients (16, 22,
37). Interestingly, overgrowth of small bowel bacteria induces
reactivation of arthritis possibly due to PG-PS; however, the mechanism
of the pathogenic actions of PG-PS is still unclear (11, 29,
34). PG-PS might induce a variety of persistent inflammatory
diseases (i.e., carditis, granulomatus hepatitis, and enterocolitis) by
production of cytokines and oxygen radicals (29). Here,
PG-PS-induced both acute and reactive inflammation in PG-PS-injected
ankles, as expected (Fig. 1), and elevated TNF-
mRNA in swollen
ankles (Fig. 3).
Dietary glycine increases blood glycine levels four- to fivefold to
levels which are protective in endotoxin shock and which prevent
experimental liver tumors (12, 27). In vivo, glycine significantly blunted joint swelling (Fig. 1) and reduced the limp
score of rats during reactive arthritis. Additionally, TNF-
mRNA
(Fig. 3) could not be detected in ankles from rats fed glycine, and
glycine reduced TNF-
production by macrophages about 30% in
vitro (Results). Therefore, it is hypothesized that dietary glycine
inhibits ankle inflammation by blunting TNF-
production.
Anti-inflammatory effect of glycine and role of the glycine
receptor.
The mechanism of PG-PS activation of macrophages
is not completely understood. It is suggested that PG-PS shares a
similar signaling pathway with lipopolysaccharide (LPS) by activating CD14 (6, 10). Recent work has demonstrated that knockout mice which lack the Toll-like receptor 4 (TLR4) do not respond to LPS
but do respond to PG-PS; however, mice without TLR2 respond similarly
to wild-type mice after LPS but not PG-PS (36). Moreover, TLR2 receptors are responsive to gram-positive bacteria (i.e., to
PG-PS) and activity of TLR2 is potentiated by CD14 (42). These studies support the hypothesis that TLR2 and CD14 are involved in
signaling due to PG-PS.
It is well known that intracellular calcium signals are important for
activation and release of cytokines from inflammatory cells (5,
38). Voltage-dependent calcium channels are opened based on the
membrane potential of the cell membrane (17). Signal transduction leads to depolarization of the plasma membrane, causing calcium influx. Like LPS, PG-PS increases intracellular calcium in
splenic macrophages, an effect dependent on serum binding
proteins (Fig. 4).
In phagocytes, one mechanism for superoxide generation is via NADPH
oxidase, which is regulated, directly or indirectly, by calcium
signaling. For example, increases in intracellular calcium activates
protein kinase C, resulting in an increase in NADPH oxidase which leads
to the production of oxidants, activation of NF-
B, and stimulation
of TNF-
production (33). PG-PS was reported to activate
NF-
B and increase the production of TNF-
(9, 10). In
this study, translocation of the p65 subunit of NF-
B into the
nucleus and production of TNF-
both in vitro and in vivo were also
observed (Fig. 3 and Results). Interestingly, glycine blunts the
elevation of intracellular calcium after PG-PS in a dose-dependent
manner (Fig. 4B), inhibits superoxide production (Fig. 7), and blunts
both nuclear translocation of NF-
B (Fig. 6) and TNF-
production
(Results). Differences in amplitude and duration of intracellular
calcium signals activate a variety of transcription factors. For
example, the amplitude of the calcium signal has been reported to be
critical for NF-
B activation (5). Changes in the
intracellular calcium signal patterns in macrophages by glycine
(Fig. 4) may explain the beneficial effect of glycine in PG-PS-induced
arthritis. Moreover, the results suggest that intracellular calcium
plays an important role in the intracellular signaling of PG-PS.
Glycine has long been known to be an inhibitory neurotransmitter in the
spinal cord (4) and acts by binding to receptors which are
localized largely in postsynaptic neuronal membranes. Glycine receptors
in the neuron are comprised of three distinct protein subunits: a
48-kDa alpha subunit, a 58-kDa beta subunit, and a cytoplasmic
anchoring protein, gephyrin. Glycine triggers the opening of this
chloride channel, leading to influx of chloride that hyperpolarizes the
cell membrane in opposition to the depolarizing action of excitatory
signals. In splenic macrophages, the inhibitory effect of
glycine is blocked by the high-affinity specific glycine receptor
against strychnine and is dependent on extracellular chloride (Fig. 4C
and D). Recently, evidence for a glycine-gated chloride channel has
also been obtained for other macrophages, such as Kupffer cells
(40). Here, the beta subunit of the glycine-gated chloride
channel, which was 98% identical to the cDNA segment of the mouse
glycine receptor from the GenBank database, was detected in splenic
macrophages (Fig. 5). Similarly, glycine increased the influx
of radiolabeled chloride into cells (Fig. 4D). Thus, the glycine
receptor of splenic macrophages is nearly identical to glycine
receptors described elsewhere (40). This finding supports
the hypothesis that glycine has direct effects on inflammatory cells.
Based on the data presented in this study, the following
mechanism is proposed to explain these findings (Fig.
8). PG-PS activates CD14 and TLR2,
which stimulates phospholipase C and increases intracellular calcium, a
critical signal in the inflammatory response. This causes assembly of
NADPH oxidase, most likely via protein kinase C, leading to superoxide
production, which causes translocation of NF-
B, resulting in TNF
production. Glycine blunts PG-PS-induced increases in
[Ca2+]i, an effect reversed by low
concentrations of strychnine and depletion of extracellular chloride
(Fig. 4C and D). Inhibition of superoxide production and TNF-
generation by glycine is most likely due to the blunting of calcium
signals. These data are consistent with the hypothesis that glycine
activates a glycine receptor (Fig. 5), leading to the influx of
chloride which hyperpolarizes the macrophage membrane and
decreases the opening time of voltage-dependent calcium channels. In
vivo treatment with glycine blocks PG-PS-induced arthritis likely via
this mechanism.

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|
FIG. 8.
Working hypothesis for the mechanism of action of
glycine in PG-PS-induced arthritis in the rat. PG-PS from gram-positive
bacteria plays an important role in the etiology of arthritis. It is
proposed that PG-PS stimulates CD14 and TLR2, resulting in increases in
intracellular calcium. This stimulates NADPH oxidase and generates
superoxide, which activates NF- B, leading to TNF- production.
Glycine (GLY) blunts PG-PS-induced increases in
[Ca2+]i, an effect reversed by low
concentrations of strychnine or depletion of chloride. The inhibition
of superoxide production and TNF- generation by glycine is most
likely due to blunting of the intracellular calcium signaling pathway.
These data are consistent with the hypothesis that glycine activates a
glycine receptor, leading to influx of chloride which hyperpolarizes
the macrophage membrane and decreases the opening time of
voltage-dependent calcium channels. In vivo treatment with glycine
blocks PG-PS-induced arthritis most likely via a similar mechanism.
|
|
Clinical significance.
In clinical trials, therapy against
TNF-
with soluble anti-TNF-
receptor or anti-TNF-
antibody
reduced the severity of rheumatoid arthritis (20). Soluble
TNF receptors which neutralize TNF-
before joints are damaged has
become a new exciting strategy for therapy (39).
Combination therapy of these drugs with methotrexate appears
particularly effective in patients whose disease persists despite
traditional drug therapy. However, these therapies are limited due to
expense or adverse side effects. Glycine, a dietary nutrient, is
anti-inflammatory and has protective effects in experimental arthritis
by reducing TNF-
production (Fig. 3). Since dietary glycine is
easily administered, inexpensive, and nontoxic, it could supplement
current therapies for arthritis.
 |
ACKNOWLEDGMENTS |
We gratefully acknowledge the technical expertise of Julie
Vorobiov, Center for Gastrointestinal Biology and Disease (P30 KD34987).
This work was supported by grants from NIH.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Laboratory
of Hepatobiology and Toxicology, Department of Pharmacology,
CB# 7365, Mary Ellen Jones Building, University of North Carolina,
Chapel Hill, NC 27599-7365. Phone: (919) 966-1154. Fax: (919) 966-1893. E-mail: thurman{at}med.unc.edu.
Editor:
R. N. Moore
 |
REFERENCES |
| 1.
|
Chomczynski, P., and N. Sacchi.
1987.
Single-step method of RNA isolation by acid guadinium thiocyanate-phenol-chloroform extraction.
Anal. Biochem.
162:156-159[Medline].
|
| 2.
|
Conway, J. G.,
J. A. Wakefield,
R. H. Brown,
B. E. Marron,
L. Sekut,
S. A. Stimpson,
A. McElroy,
J. A. Menius,
J. J. Jeffreys,
R. L. Clark,
G. M. McGeehan, and K. M. Connolly.
1995.
Inhibition of cartilage and bone destruction in adjuvant arthritis in the rat by a matrix metalloproteinase inhibitor.
J. Exp. Med
182:449-457[Abstract/Free Full Text].
|
| 3.
|
Cromartie, W. J.,
J. G. Craddock,
J. H. Schwab,
S. K. Anderle, and C.-H. Yang.
1977.
Arthritis in rats after systemic injection of streptococcal cells or cell walls.
J. Exp. Med.
146:1585-1602[Abstract/Free Full Text].
|
| 4.
|
Curtis, D. R.,
L. Hosli, and G. A. R. Johnston.
1967.
Inhibition of spinal neurons by glycine.
Nature
215:1502-1503[CrossRef][Medline].
|
| 5.
|
Dolmetsch, R. E.,
R. S. Lewis,
C. C. Goodnow, and J. I. Healy.
1997.
Differential activation of transcription factors induced by Ca2+ response amplitude and duration.
Nature
386:855-858[CrossRef][Medline].
|
| 6.
|
Dziarski, R.,
R. I. Tapping, and P. S. Tobias.
1998.
Binding of bacterial peptidoglycan to CD14.
J. Biol. Chem.
273:8680-8690[Abstract/Free Full Text].
|
| 7.
|
Feldmann, M.,
F. M. Brennan, and R. N. Maini.
1996.
Role of cytokines in rheumatoid arthritis.
Annu. Rev. Immunol.
14:397-440[CrossRef][Medline].
|
| 8.
|
Foxwell, B.,
K. Browne,
J. Bondeson,
C. Clarke,
R. de Martin,
F. Brennan, and M. Feldmann.
1998.
Efficient adenoviral infection with IkappaB alpha reveals that macrophage tumor necrosis factor alpha production in rheumatoid arthritis is NF-kappaB dependent.
Proc. Natl. Acad. Sci. USA
95:8211-8215[Abstract/Free Full Text].
|
| 9.
|
Gupta, D.,
Y. Jin, and R. Dziarski.
1995.
Peptidoglycan induces transcription and secretion of TNF-alpha and activation of lyn, extracellular signal-regulated kinase, and rsk signal transduction proteins in mouse macrophages.
J. Immunol.
155:2620-2630[Abstract].
|
| 10.
|
Gupta, D.,
T. N. Kirkland,
S. Viriyakosol, and R. Dziarski.
1996.
CD14 is a cell-activating receptor for bacterial peptidoglycan.
J. Biol. Chem.
271:23310-23316[Abstract/Free Full Text].
|
| 11.
|
Hazenberg, M. P.,
I. S. Klasen,
J. Kool,
J. G. Ruseler-van Embden, and A. J. Severijnen.
1992.
Are intestinal bacteria involved in the etiology of rheumatoid arthritis?
APMIS
100:1-9[Medline].
|
| 12.
|
Ikejima, K.,
Y. Iimuro,
D. T. Forman, and R. G. Thurman.
1996.
A diet containing glycine improves survival in endotoxin shock in the rat.
Am. J. Physiol.
271:G97-G103[Abstract/Free Full Text].
|
| 13.
|
Ikejima, K.,
W. Qu,
R. F. Stachlewitz, and R. G. Thurman.
1997.
Kupffer cells contain a glycine-gated chloride channel.
Am. J. Physiol.
272:G1581-G1586[Abstract/Free Full Text].
|
| 14.
|
Jobin, C.,
C. Hellerbrand,
L. L. Licato,
D. A. Brenner, and R. B. Sartor.
1998.
Mediation by NF-kappa B of cytokine induced expression of intercellular adhesion molecule 1 (ICAM-1) in an intestinal epithelial cell line, a process blocked by proteasome inhibitors.
Gut
42:779-787[Abstract/Free Full Text].
|
| 15.
|
Kinne, R. W.,
C. B. Schmidt-Weber,
R. Hoppe,
E. Buchner,
E. Palombo-Kinne,
E. Nuruberg, and F. Emmrich.
1995.
Long-term amelioration of rat adjuvant arthritis following systemic elimination of macrophages by clodronate-containing liposomes.
Arthritis Rheum.
38:1777-1790[Medline].
|
| 16.
|
Klasen, I. S.,
M. J. Melief,
T. J. Swaak,
A. J. Severijnen, and M. P. Hazenberg.
1993.
Responses of synovial fluid and peripheral blood mononuclear cells to bacterial antigens and autologous antigen presenting cells.
Ann. Rheum. Dis.
52:127-132[Abstract/Free Full Text].
|
| 17.
|
Krause, K. H., and M. J. Welsh.
1990.
Voltage-dependent and Ca2+-activated ion channels in human neutrophils.
J. Clin. Investig.
85:491-498.
|
| 18.
|
Li, X.,
B. U. Bradford,
S. A. Stimpson,
J. H. Schwab, and R. G. Thurman.
1999.
Splenic macrophages contain a glycine-gated chloride channel: studies with peptidoglycan-polysaccharide.
Arthritis Rheum.
42:S337.
|
| 19.
|
Lowry, O. H.,
N. J. Rosebrough,
A. L. Farr, and R. J. Randall.
1951.
Protein measurement with the Folin phenol reagent.
J. Biol. Chem.
193:265-275[Free Full Text].
|
| 20.
|
Maini, R. N.,
M. Elliott,
F. M. Brennan,
R. O. Williams, and M. Feldmann.
1997.
TNF blockade in rheumatoid arthritis: implications for therapy and pathogenesis.
APMIS
105:257-263[Medline].
|
| 21.
|
McCord, J. M., and I. Fridovich.
1969.
Superoxide dismutase: an enzymatic function of erythrocuprein (hemocuprein).
J. Biol. Chem.
244:6049-6055[Abstract/Free Full Text].
|
| 22.
|
Melief, M. J.,
M. A. Hoijer,
H. C. Van Paassen, and M. P. Hazenberg.
1995.
Presence of bacterial flora-derived antigen in synovial tissue macrophages and dendritic cells.
Br. J. Rheumatol.
34:1112-1116[Abstract/Free Full Text].
|
| 23.
|
Miagkov, A. V.,
D. V. Kovalenko,
C. E. Brown,
J. R. Didsbury,
J. P. Cogswell,
S. A. Stimpson,
A. S. Baldwin, and S. S. Makarov.
1998.
NF-kappaB activation provides the potential link between inflammation and hyperplasia in the arthritic joint.
Proc. Natl. Acad. Sci. USA
95:13859-13864[Abstract/Free Full Text].
|
| 24.
|
Ohmori, S.,
M. Ikeda,
S. Kira, and M. Ogata.
1977.
Colorimetric determination of hippuric acid in urine and liver homogenate.
Anal. Chem.
49:1494-1496[Medline].
|
| 25.
|
Ohmori, S.,
M. Ikeda,
Y. Watanabe, and K. Hirota.
1978.
A simple and specific determination of glycine in biological samples.
Anal. Biochem.
90:662-670[CrossRef][Medline].
|
| 26.
|
Rajendra, S.,
J. W. Lynch, and P. R. Schofield.
1997.
The glycine receptor.
Pharmacol. Ther.
73:121-146[CrossRef][Medline].
|
| 27.
|
Rose, M. L.,
J. Madren,
H. Bunzendahl, and R. G. Thurman.
1999.
Dietary glycine inhibits the growth of B16 melanoma tumors in mice.
Carcinogenesis
20:793-798[Abstract/Free Full Text].
|
| 28.
|
Sartor, R. B.,
T. M. Bond, and J. H. Schwab.
1988.
Systemic uptake and intestinal inflammatory effects of luminal bacterial cell wall polymers in rats with acute colonic injury.
Infect. Immun.
56:2101-2108[Abstract/Free Full Text].
|
| 29.
|
Schwab, J. H.
1993.
Phlogistic properties of peptidoglycan-polysaccharide polymers from cell walls of pathogenic and normal-flora bacteria which colonize humans.
Infect. Immun.
61:4535-4539[Abstract/Free Full Text].
|
| 30.
|
Schwab, J. H.
1995.
Bacterial cell-wall induced arthritis: models of chronic recurrent polyarthritis and reactivation of monoarticular arthritis, p. 431-446.
In
B. Henderson, J. C. W. Edwards, and E. R. Pettipher (ed.), Mechanisms and models in rheumatoid arthritis. Academic Press, London, England.
|
| 31.
|
Schwab, J. H.,
S. K. Anderle,
R. R. Brown,
F. G. Dalldorf, and R. C. Thompson.
1991.
Pro- and anti-inflammatory roles of interleukin-1 in recurrence of bacterial cell wall-induced arthritis is rats.
Infect. Immun.
59:4436-4442[Abstract/Free Full Text].
|
| 32.
|
Schwartz, R. D.,
P. D. Suzdak, and S. M. Paul.
1986.
Gamma-aminobutyric acid (GABA) and barbiturate receptor mediated 36Cl uptake in rat brain synaptoneurosomes: evidence for rapid desensitization of the GABA receptor-coupled chloride ion channel.
Mol. Pharmacol.
30:419-426[Abstract].
|
| 33.
|
Sen, C. K.,
S. Roy, and L. Packer.
1996.
Involvement of intracellular Ca2+ in oxidant-induced NF- B activation.
FEBS Lett.
385:58-62[CrossRef][Medline].
|
| 34.
|
Severijnen, A. J.,
R. Van Kleef,
M. P. Hazenberg, and J. P. van de Merwe.
1989.
Cell wall fragment from major residents of the human interstinal flora induce chronic arthritis in rats.
J. Rheumatol.
16:1061-1068[Medline].
|
| 35.
|
Stachlewitz, R. F.,
X. Li,
S. Smith,
H. Bunzendahl,
L. M. Graves, and R. G. Thurman.
2000.
Glycine inhibits growth of T lymphocytes by an IL-2-independent mechanism.
J. Immunol.
164:176-182[Abstract/Free Full Text].
|
| 36.
|
Takeuchi, O.,
K. Hoshino,
T. Kawai,
H. Sanjo,
H. Takada,
T. Ogawa,
K. Takeda, and S. Akira.
1999.
Differential roles of TLR2 and TLR4 in recognition of gram-negative and gram-positive bacterial cell wall components.
Immunity
11:443-451[CrossRef][Medline].
|
| 37.
|
van der Heijden, I. M.,
B. Wilbrink,
I. Tchetverikov,
L. M. Schouls,
M. P. Hazenberg,
F. C. Breedveld, and P. P. Tak.
2000.
Presence of bacterial DNA and bacterial peptidoglycans in joints of patients with rheumatioid arthritis and other arthritides.
Arthritis Rheum.
43:593-598[CrossRef][Medline].
|
| 38.
|
Watanabe, N.,
J. Suzuki, and Y. Kobayashi.
1996.
Role of calcium in tumor necrosis factor- produced by activated macrophages.
J. Biochem.
120:1190-1195[Abstract/Free Full Text].
|
| 39.
|
Weinblatt, M. E.,
J. M. Kremer,
A. D. Bankhurst,
K. J. Bulpitt,
R. M. Fleischmann,
R. I. Fox,
C. G. Jackson,
M. Lange, and D. J. Burge.
1999.
A trial of etanercept, a recombinant tumor necrosis factor receptor:Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate.
N. Engl. J. Med.
28:253-259.
|
| 40.
|
Wheeler, M. D.,
K. Ikejima,
N. Enomoto,
R. F. Stachlewitz,
V. Seabra,
Z. Zhong,
M. Yin,
P. Schemmer,
M. L. Rose,
I. Rusyn,
B. U. Bradford, and R. G. Thurman.
1999.
Glycine: a new anti-inflammatory immunonutrient.
Cell. Mol. Life Sci.
56:843-856[CrossRef][Medline].
|
| 41.
|
Wheeler, M. D.,
V. Seabra, and R. G. Thurman.
1999.
Molecular evidence for glycine-gated chloride channel in Kupffer cells, p. 153-155.
In
E. Wisse, D. L. Knook, and K. Wake (ed.), Cells of the hepatic sinusoid The Kupffer Cell Foundation, Leiden, The Netherlands.
|
| 42.
|
Yoshimura, A.,
E. Lien,
R. R. Ingalls,
E. Tuomanen,
R. Dziarski, and D. Golenbock.
1999.
Cutting edge: recognition of Gram-positive bacterial cell wall components by the innate immune system occurs via Toll-like receptor 2.
J. Immunol.
163:1-5[Abstract/Free Full Text].
|
Infection and Immunity, September 2001, p. 5883-5891, Vol. 69, No. 9
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.9.5883-5891.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
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