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Infection and Immunity, December 2005, p. 7906-7913, Vol. 73, No. 12
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.12.7906-7913.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Section Parasitology, Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,1 Equipe Parasitologie Moléculaire et Cellulaire, Laboratoire Biologie des Protistes, UMR CNRS 6023, Université Blaise Pascal, 63177 Aubière Cedex, France,2 Department of Medical Biochemistry, University of Amsterdam, Amsterdam, The Netherlands,3 Department of Human Retrovirology, University of Amsterdam, Amsterdam, The Netherlands,4 Department of Parasitology, Harbour Hospital, Rotterdam, The Netherlands5
Received 18 April 2005/ Returned for modification 19 May 2005/ Accepted 10 August 2005
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Microsporidia have been recognized as major opportunistic pathogens in immunocompromised patients, especially those with AIDS. The clinical manifestations of infection with microsporidia of the Encephalitozoon species, E. intestinalis, E. hellem, and E. cuniculi, are mainly gastrointestinal, but rhinosinusitis, keratoconjunctivitis, hepatitis, nephritis, and encephalitis have also been reported (13, 30). Information on infection of immunocompetent individuals is scarce, and only a few cases have been described (1, 10, 20, 21, 24, 27). Diagnosis of microsporidiosis can be performed by detection of spores in patient material by microscopy or by PCR. However, in immunocompetent individuals shedding of spores is usually transient, and therefore serological techniques were developed to diagnose microsporidiosis indirectly. In these studies a high seroprevalence against the polar tube and anchoring disk of E. intestinalis was found in Dutch blood donors (8%) and pregnant French women (5%) using an enzyme-linked immunosorbent assay, counterimmunoelectrophoresis, and an immunofluorescence assay (IFA) (29). This suggested that infection of immunocompetent individuals with microsporidia might be more common than previously recognized, but the individuals could remain asymptomatic (1, 29, 31).
In this study we analyzed the immunoglobulin G (IgG) immune response of immunocompetent individuals to the polar tube and anchoring disk of E. intestinalis in order to study the antigenic constituents and the mechanism(s) underlying this commonly occurring immune response.
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Human sera. Human anti-polar tube sera and human control sera that were not reactive with the polar tube were obtained from a group of 300 healthy blood donors in The Netherlands and 276 healthy pregnant women in France, using consecutively collected sera. These sera were used in a previous study (29).
Indirect immunofluorescence. The indirect immunofluorescence technique for cultured microsporidia with human sera has been described elsewhere (27). Briefly, microsporidia were grown on 18-well glass slides, fixed, and incubated with diluted human sera (1:100) or anti-polar tube protein-specific mouse antibody (1:500). Bound antibodies were detected with fluorescein isothiocyanate (FITC)-labeled anti-human or mouse IgG, examined with a Leitz fluorescence microscope, and photographed.
Confocal microscopy. For simultaneous detection of microsporidian spore wall protein 1 (SWP1) and polar tube staining by human sera, microsporidia were incubated with diluted mouse antibody specific for anti-recombinant SWP1 (anti-recSWP1) (23) (1:100) and human anti-polar tube serum (1:100). Bound antibodies were detected with tetramethyl rhodamine isocyanate-labeled anti-mouse IgG and FITC-labeled anti-human IgG. For detection of fluorescent signals a Leica SP2 AOBS system was used. The microsporidia were imaged in a 1024 x 1024 format with a pixel size of 55 nm using a x63 Planapo Oil objective (NA 1.32) and 2x line averaging. The excitation and detection wavelengths of FITC were 488 nm and 500 to 550 nm, respectively, and the excitation and detection wavelengths of Texas Red were 561 nm and 570 to 680 nm, respectively. In order to avoid cross talk between the two fluorophores, images were acquired in a sequential scanning mode. After this red and green images were merged to obtain a red-green-blue image.
Antigen preparation. For sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) antigen preparation, purified spores (approximately 6 x 109 spores) were pelleted by centrifugation and resuspended in 4 ml of 2.5% SDS in PBS. After eight freeze-thaw cycles the suspension was sonicated on ice six times for 30 s (30-kHz microprobe; Soniprep 150; MSE, Loughborough, Great Britain) and centrifuged at 18,000 x g for 5 min. The pellet was dissolved in 2.5% SDS in PBS with 100 mM dithiothreitol (DTT) and incubated at room temperature for 48 h. The suspension was centrifuged again at 18,000 x g, and the supernatant was used as the antigen. For two-dimensional (2D) electrophoresis E. intestinalis spores (approximately 3 x 109 spores) were resuspended by vigorous vortexing in 500 µl of 2.2 M thiourea-7.7 M urea-2% Triton X-100-100 mM DTT. After incubation at room temperature for 1 h, the suspension was centrifuged at 18,000 x g for 5 min, and the supernatant was used as the antigen.
SDS-PAGE and Western blot analysis. SDS-PAGE was performed using standard procedures. Briefly, 100 µl of the lysate was suspended in SDS-PAGE sample buffer (with 5% 2-mercaptoethanol) to obtain a final volume of 200 µl, boiled for 3 min, and size fractionated by 10% SDS-PAGE. After electrophoresis, proteins were transferred to polyvinylidene difluoride (PVDF) membranes overnight. The transferred proteins were visualized using ponceau red dye staining. Incubation was performed with a multiscreen apparatus (Mini-Protean II; Bio-Rad) to create individual lanes on a single blot, unless indicated otherwise. For detection, human sera were diluted 1:500, anti-recombinant E. intestinalis PTP1 (anti-recEiPTP1) was diluted 1:2,000, anti-PTP2 (3) was diluted 1:1,000, and anti-PTP3 (23) was diluted 1:500, and the preparations were incubated with the blot for 1 h. Isotype-specific antibodies conjugated to peroxidase were obtained from DAKO (Glostrup, Denmark) and were used at a 1:2,000 dilution for 45 min. A chemiluminescent substrate (ECL) was prepared as recommended by the manufacturer (Amersham, United Kingdom). The PVDF membranes were incubated with the ECL substrate for 1 min, wrapped in plastic, and used to expose X-ray film for 3 min, 1 min, and 30 s.
2D electrophoresis and Western blot analysis. Samples were applied to 18-cm IPG strips (pH 3 to 10; NL; Amersham Biosciences), which were allowed to rehydrate for 10 h at room temperature in the presence of the appropriate amounts of IPG buffer (protocol of Amersham Biosciences). First-dimension isoelectric focusing at 4°C was started by using 200 V for 30 min and two prefocusing steps consisting of 30 min at 400 V and 30 min at 600 V. The voltage was raised to a maximum of 3,500 V in 2.5 h, and the treatment was continued until at least 75 kV · h was reached, after which the IPG strips were stored at 80°C until they were used. For the second dimension, focused strips were equilibrated for 30 min at room temperature in 50 mM Tris-HCl (pH 8.8)-6 M urea- 30% (vol/vol) glycerol-2% SDS-1% (wt/vol) DTT, and this was followed by an identical incubation in which the DTT was replaced with 2.5% (wt/vol) iodoacetamide. Next, the strips and a broad-range marker (Bio-Rad, Hercules, CA) were placed on 12% polyacrylamide gels, and vertical electrophoresis was carried out using the Iso-Dalt system (Amersham Biosciences). After transfer of proteins to PVDF, the blot was incubated with mouse anti-recEiPTP1 (1:2,000) for 1 h, washed, and incubated with anti-mouse horseradish peroxidase conjugate (1:2,000). After detection of the PTP1 signal by ECL, antibodies were stripped from the blot by incubation in 62.5 mM Tris-HCl (pH 6.8)-2% SDS-100 mM 2-mercaptoethanol for 30 min at 50°C. The blot was rinsed twice for 5 min in PBS-Tween 20 (0.1%) and exposed to X-ray film for 10 min to ensure that all of the ECL signal was removed. This procedure was repeated twice with the same blot for two different human anti-polar tube sera diluted 1:1,000.
TFMS deglycosylation.
E. intestinalis spore proteins in PBS containing 2.5% SDS and 100 mM DTT were dialyzed overnight against PBS and centrifuged in a Speed Vac at 60°C until they were completely dry. The pellet was dissolved in 50 µl of trifluoromethanesulfonic acid (TFMS)-anisole (9:1) and incubated for 1 h at 20°C. The 50-µl mixture was then added to 500 µl of ice-cold pyridine-diethyl ether (1:9) and centrifuged for 10 min at 18,000 x g. The resulting pellet was air dried and dissolved in 100 µl of 100 mM NH4HCO3, and this was followed by overnight dialysis against 100 mM NH4HCO3 (8). As a control, recombinant human glycosylated
-galactosidase (Replagal; Transkaryotic Therapies) was treated with TFMS in the absence or presence of E. intestinalis protein extract. One half of each sample was used for PAGE followed by Coomassie blue staining, while the other half was used for Western blot analysis using anti-recEiPTP1 and two human anti-polar tube sera.
Production of anti-recEiPTP1 antibody. DNA from E. intestinalis spores was obtained by boiling purified spores at 100°C for 10 min in sterile water. The major part of the E. intestinalis ptp1 gene (coding for amino acids 23 to 371) was PCR amplified using forward primer PTP1EiD (5'-CGGGATCCACAACTGTGCTGTGTGGAGAT-3') with a BamHI restriction site at the 5' end and reverse primer PTP1EiR (5'-CGGAATTCGCATTGTTGTTGGCAGCAAGC-3') with an EcoRI site at the 5' end. PCR amplification was performed using a Perkin-Elmer DNA thermal cycler 2400 apparatus with 50-µl reaction mixture and standard conditions (Eurobio). After the DNA was denatured at 94°C for 3 min, 35 cycles consisting of 20 s of denaturation at 94°C, 30 s of annealing at 55°C, and 1 min of extension at 72°C were performed, and this was followed by a final 10-min extension step at 72°C. The PCR product was analyzed by electrophoresis on a 1% agarose gel and was purified with a QIAquick gel extraction kit (QIAGEN). After digestion with restriction enzymes BamHI and EcoRI, the PCR product was cloned into a modified prokaryotic expression vector, pGEX-4T1 (Pharmacia). This vector was modified by insertion of an in-frame eight-histidine tag between XhoI and NotI restriction sites. The resulting recombinant plasmid was introduced into the Escherichia coli BL21+ strain. E. intestinalis PTP1 was expressed as a glutathione S-transferase (GST)-PTP1-His8 fusion protein after induction with 2 mM isopropyl-ß-D-thiogalactopyranoside (IPTG) for 4 h. The recombinant protein was then purified by chromatography on an Ni-nitrilotriacetic acid column (QIAGEN), excised from Coomassie blue-stained gels, and crushed in PBS. Mouse polyclonal antibodies to recombinant E. intestinalis PTP1 were obtained by intraperitoneally inoculating Swiss mice with crushed gel samples homogenized with Freund's complete adjuvant for the first injection and with Freund's incomplete adjuvant for the subsequent injections (after 14, 21, and 28 days). Preimmune and immune sera collected 1 week after the last booster were stored at 20°C.
Infection inhibition assay. Human lung mucoepidermoid cells (NCI-H292) were seeded in a flat-bottom 96-well plate (Costar) and grown to subconfluency. The medium was refreshed, and human anti-polar tube serum or control serum was added at various concentrations (0, 10, 20, 30, or 40%; final volume, 100 µl). Then 105 purified E. intestinalis spores were added to each well, and the infection was allowed to proceed for 24 h. The culture medium with the extracellular spores was then removed by two washes with 150 µl of medium. Fresh medium containing human anti-polar tube serum or control serum was again added to a final volume of 100 µl. Medium containing newly produced spores was collected after 48 h and used for DNA extraction and subsequent PCR analysis.
DNA extraction and PCR analysis. To 100 µl of culture supernatant 200 µl of 5.6 M guanidine thiocyanate-18 mM EDTA-1% Triton X-100-25 mM Tris-HCl (pH 6.4) was added. From 200 µl of this suspension DNA was extracted using a High Pure PCR template preparation kit (Roche). The DNA was eluted in 200 µl of 10 mM Tris-HCl (pH 8.5). A low-cycle-number PCR (23 cycles) was performed with the isolated DNA, which amplified part of the small-subunit rRNA of E. intestinalis, as described previously (22). Amplification products were size fractionated on a 1% agarose gel and visualized by ethidium bromide staining.
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FIG. 1. Reactivity of human sera with E. intestinalis in indirect IFA and on spore protein blots. (A) Human anti-polar tube serum in IFA of cultured E. intestinalis spores. The extruded polar tube (pt) and the anchoring region (ar) are strongly labeled. The spore body is not labeled. (B) Western blot analysis of E. intestinalis spore protein extract prepared in the presence of 100 mM DTT (lanes 1 to 13) or in the absence of DTT (lanes 14 to 17) and incubated with human sera. Lanes 4 to 17 were incubated with human anti-polar tube sera; in lanes 1 to 3 human control sera (negative in IFA) were used. The positions of molecular weight markers (in kDa) are indicated on the left. (C) Western blot analysis of E. intestinalis spore protein extract with 12 human anti-polar tube sera (top panel) and a mouse polyclonal antibody against E. cuniculi PTP2 (bottom panel). Note the differences in molecular weight of the 55-kDa antigen recognized by individual human sera.
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The 55-kDa antigens recognized by human sera correspond to PTP1, the major polar tube protein in Encephalitozoon spp. The identities of the 55-kDa antigens were investigated further by comparing their signals with those of the three known polar tube constituents of E. intestinalis (PTP1, PTP2, and the PTP3-like protein) on Western blots. Antibodies against PTP2 and PTP3 of E. cuniculi were produced in a previous study, and they are known to cross-react with homologous proteins from E. intestinalis (4, 5, 23). These antibodies could therefore be used directly for the analysis of E. intestinalis proteins. Antibodies against PTP1 of E. cuniculi did not react with E. intestinalis spore extracts due to the extensive sequence divergence of PTP1 from E. cuniculi and E. intestinalis (not shown). We therefore cloned the ptp1 sequence of E. intestinalis and produced recombinant E. intestinalis PTP1 that was N terminally fused to GST and C terminally fused to an eight-His tag. Mouse polyclonal antibodies were raised against this recEiPTP1 fusion protein. To investigate if the 55-kDa antigens recognized by the human anti-polar tube sera comigrated with one of the known E. intestinalis polar tube proteins, a Western blot with E. intestinalis spore extract was incubated with antibodies against PTP1, PTP2, and two human anti-polar tube sera. The anti-recEiPTP1 produced a relatively broad band between 50 and 60 kDa that comigrated with the 55-kDa antigens recognized by the human anti-polar tube sera. The positions of PTP2 and PTP3 did not correspond to the signal obtained with the human sera (not shown). To confirm that the human anti-polar tube sera indeed recognized PTP1 of E. intestinalis, blots of 2D gels containing total spore proteins were prepared, and part of each blot was subsequently incubated with the anti-recEiPTP1 antibody. As shown in Fig. 2, PTP1 was separated into four spots with different isoelectric points around pI 5, which is in agreement with the calculated pI (pI 4.9) (4). After stripping and incubation of the same blot with human anti-polar tube serum, the same four spots were stained. Subsequent stripping and incubation with a different human anti-polar tube serum gave identical results (not shown). This further indicated that the 55-kDa antigens of the polar tube recognized by human sera are indeed E. intestinalis PTP1.
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FIG. 2. 2D Western blot analysis. A protein extract of E. intestinalis spores was fractionated by 2D electrophoresis (A) (Coomassie blue staining), transferred to a PVDF membrane and incubated with anti-recEiPTP1 (B), stripped of all binding antibody, and subsequently incubated with human anti-polar tube serum (C). The four isoelectric variants of PTP1 around pI 5 are at the same position in panels B and C (indicated by open arrowheads). The position of the high-molecular-weight smear recognized by the human anti-polar tube serum is indicated by a solid arrowhead in panel C. The positions of molecular weight markers (in kDa) are indicated on the left, and the direction of the isoelectric focusing gradient is indicated at the top.
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-galactosidase (Replagal; TKT), to the E. intestinalis spore extract showed that deglycosylation using TFMS was effective, however. The multiple forms of differentially glycosylated
-galactosidase between 45 and 50 kDa (lane E) were reduced to a single protein band at 40 kDa both in the absence (lane D) and in the presence (lane C) of the E. intestinalis spore protein extract. The protein fractions shown in lanes A, B, and C were subsequently used to produce a Western blot (Fig. 3, bottom panel) that was incubated with the anti-recEiPTP1 antibody (lanes 1, 4, and 7) and two human anti-polar tube sera (lanes 2, 5, and 8 and lanes 3, 6, and 9). TFMS treatment induced a shift in the molecular weight of PTP1 from 50 to 60 kDa to 45kDa, showing that PTP1 was deglycosylated (compare lane 1 with lanes 4 and 7), but it had no effect on the molecular weight of PTP2, PTP3, or SWP1 (not shown). Increasing the length of the TFMS treatment from 1 h to 16 h did not lead to a further decrease in the molecular weight of PTP1 (not shown). The overall mouse polyclonal antibody reactivity, however, was not greatly reduced upon TFMS treatment. In sharp contrast, the recognition of two human anti-polar tube sera was reduced to background levels following deglycosylation; the signals around 55 kDa and the high-molecular-weight smear were no longer visible after TFMS treatment (compare lanes 2 to 3 with lanes 5 to 6 and 8 to 9).
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FIG. 3. SDS-PAGE and Western blot analysis of E. intestinalis spore protein extract before and after TFMS treatment. A Coomassie blue-stained gel of E. intestinalis spore protein extract (top panel, lane A) was deglycosylated with TFMS in the absence (lane B) or in the presence (lane C) of the control protein -galactosidase. The patterns for the control glycoprotein alone before TFMS treatment (lane E) and after TFMS treatment (lane D) are also shown. Protein fractions A, B, and C were size fractionated by SDS-PAGE, transferred to a single PVDF membrane (bottom panel), and incubated with anti-recEiPTP1 (lanes 1, 4 and 7) and two human anti-polar tube sera (lanes 2 and 3). The molecular weight of PTP1 decreased after TFMS treatment (lanes 4 and 7), while the reactivity of the human sera was lost after TFMS treatment (lanes 5, 6, 8, and 9). The positions of molecular weight markers (in kDa) are indicated on the left (lane M).
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FIG. 4. IFA and Western blot analysis of Encephalitozoon spp. Cultured E. intestinalis, E. hellem, and E. cuniculi were incubated with human anti-polar tube serum (A to C) and anti-recEiPTP1 (D to F). E. intestinalis and E. cuniculi spores were also double immunostained (G and H) with human anti-polar tube serum and detected with an FITC-conjugated secondary antibody (green fluorescence), and the anti-spore wall antibody, anti-recSWP1, was detected with a tetramethyl rhodamine isocyanate-conjugated secondary antibody (red fluorescence). The arrowheads indicate the strongly fluorescent anchoring region. Bars = 5 µm. Spore protein extracts of E. intestinalis (I), E. hellem (J), and E. cuniculi (K) were used for SDS-PAGE, transferred to PVDF membranes, and incubated with anti-recEiPTP1 (lanes 1, 4, and 7) and the two human anti-polar tube sera (lanes 2, 3, 5, 6, 8, and 9). The locations of glycosylated PTP1 in the polar tube and of the glycosylated proteins in the high-molecular-weight smear of the anchoring region are indicated schematically on the right. The positions of molecular weight markers (in kDa) are indicated on the left.
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Human anti-polar tube sera partially inhibit infection by E. intestinalis in vitro. To evaluate the effect of human anti-polar tube antibody on the infection efficiency of cultured lung mucoepidermoid host cells by E. intestinalis, an in vitro assay was used. E. intestinalis spores were added to the host cells in the presence of various concentrations of human anti-polar tube sera or a control serum (Fig. 5). The production of spores was analyzed by semiquantitative PCR, which amplified part of the small-subunit rRNA gene of E. intestinalis. Both anti-polar tube sera were able to partially inhibit spore production at the lowest serum concentration (10%), based on the decrease in the PCR signal after addition of human anti-polar tube serum to the culture medium (Fig. 5A and B, lanes 3). Higher concentrations of anti-polar tube sera in the culture medium did not lead to a further increase in infection inhibition (lanes 4 to 6). The control serum had no effect on spore production (Fig. 5C).
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FIG. 5. Human polar tube sera partially inhibit E. intestinalis infection in vitro. Human lung mucoepidermoid cells were infected with E. intestinalis spores in the absence (lanes 2) or in the presence (lanes 3 to 6) of various concentrations (10 to 40%) of two human anti-polar tube sera (A and B) or normal human serum (C). The production of spores was analyzed by semiquantitative PCR amplification of part of the small-subunit rRNA gene of E. intestinalis. The PCR signal specifically decreased in the cultures with human anti-polar tube serum. Lanes 1 contained noninfected host cells, and for lanes 7 no template was added to the PCR mixture. The size marker (lanes M) was a 100-bp ladder.
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Although all human anti-polar tube sera recognized PTP1, there appeared to be slight differences in the molecular weight of the PTP1 recognized by individual sera (Fig. 1B). This suggests that there is a spectrum of PTP1 molecules with various degrees of O mannosylation that result in slightly different antibody recognition on a blot, which is not uncommon for glycosylated antigens (6). Interestingly, glycosylation of PTP1 and the anchoring region appeared to be very similar in E. intestinalis and E. hellem but different in E. cuniculi. Human anti-polar tube sera efficiently recognized the anchoring region of all three species and PTP1 of E. intestinalis and E. hellem, but not PTP1 of E. cuniculi. This suggests that the glycosylation patterns of E. cuniculi PTP1 are different from those of the other two species. Possibly, the difference reflects host specificity, with glycosylation of PTP1 being optimized for adherence to the receptor(s) of the most important host.
The exact mechanism by which the prevalent and abundant anti-polar tube IgG antibodies are induced remains obscure. Studies of the humoral response during systemic infection with microsporidia have shown that in addition to polar tube constituents many other microsporidial proteins are recognized (7, 16, 27, 32). Humans probably have frequent contact with microsporidia, by the oral or respiratory route, without progress toward systemic disease (30). Whether these contacts could induce only anti-polar tube antibodies is still unknown. Presentation of immunogenic carbohydrate moieties to the epithelial surface of the gut in general does not elicit systemic IgG antibody responses. In AIDS patients worldwide E. intestinalis is the predominant opportunistic infecting Encephalitozoon species, and E. cuniculi infection has been reported only infrequently (13, 30). In agreement with these data is our observation in humans of the presence of anti-polar tube antibodies to E. intestinalis but the absence of such antibodies (directed only to the polar tube) to E. cuniculi (26; data not shown). O mannosylation, especially of cell wall components, is widespread in bacteria and several eukaryotes. This suggests that the antibody response could also be induced by a more common pathogen with O mannosylation patterns very similar to those of Encephalitozoon, which could be a more distantly related species of microsporidia or fungi. However, we could not find any cross-reactivity of the anti-polar tube antibodies against the two most common fungi that cause systemic disease, Aspergillus spp. and Candida spp. (27; data not shown).
Human anti-polar tube sera were found to partially inhibit infection of host cells by E. intestinalis in vitro. This indicates that these antibodies may contribute to antibody-mediated protection against microsporidial cell invasion by binding to the carbohydrate part of PTP1, thereby preventing efficient adherence of the polar tube to the host cell. An antibody against the microsporidial exospore was also shown to decrease infection of host cells in vitro. Similar to our results, the decrease was not dependent on the antibody concentration (11). In vivo, the anti-polar tube antibodies could further influence the host-parasite interaction by affecting antibody-mediated mechanisms, such as opsonin-dependent phagocytosis, again stressing the importance of these broad-specificity antibodies.
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