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Infection and Immunity, April 2005, p. 2184-2189, Vol. 73, No. 4
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.4.2184-2189.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Effect of B7-2 and CD40 Signals from Activated Antigen-Presenting Cells on the Ability of Zwitterionic Polysaccharides To Induce T-Cell Stimulation
Tom Li Stephen,1,
Marcus Niemeyer,2,
Arthur O. Tzianabos,2
Martin Kroenke,1
Dennis L. Kasper,2,3 and
Wiltrud M. Kalka-Moll1,2,4*
Institute for Medical Microbiology, Immunology and Hygiene,1
First Department of Medicine, University of Cologne, Germany,4
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital,2
Department of Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts3
Received 3 September 2004/
Accepted 25 October 2004

ABSTRACT
Carbohydrates have been thought to stimulate immune responses
independently of T cells; however, zwitterionic polysaccharides
(ZPSs) from the capsules of some bacteria elicit potent CD4
+-T-cell
responses in vivo and in vitro. We demonstrated that HLA-DR
on professional antigen-presenting cells (APCs) is required
for ZPS-induced T-cell proliferation in vitro (
15). Recently,
it was shown that ZPSs are processed to low-molecular-weight
carbohydrates by a nitric oxide-mediated mechanism in endosomes
and locate in the major histocompatibility complex class II
pathway (
5,
15). The effect of the ZPS-mediated expression of
HLA-DR and costimulatory molecules on the APC and T-cell engagement
and subsequent T-cell activation has not been elucidated. Herein,
we report that ZPS-mediated induction of HLA-DR-surface expression
and T-cell proliferation are maximally enhanced after incubation
of APCs for 8 h with ZPS. Treatment of APCs with bafilomycin
A inhibits the up-regulation of ZPS-mediated HLA-DR surface
expression and leads to inhibition of T-cell proliferation.
Monoclonal antibodies (MAbs) to the costimulatory molecules
B7-2 and CD40L specifically block ZPS-mediated T-cell activation,
while a MAb to B7-1 does not. Surface expression of B7-2 and
B7-1 but not of CD40 is maximally enhanced at 8 to 16 h of treatment
of APCs with ZPS. The results demonstrate that the cellular
immune response to ZPS depends on the translocation of HLA-DR
to the cell surface and requires costimulation via B7-2 and
CD40 on activated APCs. The implication is that activation of
ZPS-specific T cells requires an orchestrated arrangement of
both presenting and costimulatory molecules to form an immunological
synapse.

INTRODUCTION
Most pathogenic extracellular bacteria produce large-molecular-mass
surface polysaccharides, usually in the form of a capsule that
coats the bacterial cell surface. The classification of polysaccharides
as T-cell-independent type 2 (TI-2) antigens is based on the
lack of T-cell-dependent responses to these typically negatively
charged or uncharged molecules (
12,
13). In view of their immunogenic
characteristics, bacterial zwitterionic polysaccharides (ZPSs)
isolated from strains of
Bacteroides fragilis,
Staphylococcus aureus, and
Streptococcus pneumoniae type 1 represent an unusual
group of bacterial carbohydrates. ZPSs have unique immunological
properties: molecules as small as 17 kDa elicit a potent CD4
+-T-cell
response in vitro and in vivo (
16). Structure-function studies
have shown that the proliferative response of T cells depends
on free amino (positively charged) and carboxyl or phosphate
groups (negatively charged) on each repeating unit (
31,
32).
The mediation of proliferation of human T cells in vitro is
characterized by a requirement for direct interaction of T cells
with HLA-DR-bearing antigen-presenting cells (APCs). ZPSs colocalize
with HLA-DR in compartments of the endocytic pathway and on
the cell surface (
15). They are processed to low-molecular-weight
carbohydrates by a nitric-oxide-dependent mechanism in endosomes
and bind to major histocompatibility complex class II (MHC-II)
inside APCs (
5). Nuclear magnetic resonance studies of ZPS from
B. fragilis and
S. pneumoniae type 1 suggest possible sites
for binding to the

-helices of HLA-DR (
17,
33,
34).
Contact of T cells with processed antigen presented by MHC molecules results in T-cell activation through the dynamic interaction of multiple membrane molecules generating the necessary intracellular signals. Through the mediation of the MHC molecules, the T-cell receptor (TCR) and the CD3 molecule initiate the activation signal 1. However, this interaction by itself is not sufficient to fully activate naïve T cells. A subsequent antigen-nonspecific costimulatory signal (signal 2) is required. Interaction of CD28 on T cells with its ligands B7-1 and B7-2 on APCs comprises a major costimulatory pathway controlling T-cell response to a variety of antigens, promoting cell cycle progression, and increasing interleukin-2 production (3, 28). Once a naïve T cell is activated through signal 1 and signal 2, it expresses a number of proteins that contribute to sustaining or modifying the costimulatory signals. For example, binding of CD40-CD40 ligand (CD154) transmits bidirectional activation signals to the T cell and the APC (10, 35). These best-characterized costimulatory molecules can be either constitutively expressed or induced on activated APCs.
The activation of APCs by TI-2 polysaccharides and the role of costimulatory molecules during the humoral immune response to these antigens have been reported in various experimental systems. Heparan sulfate and hyaluronic acid induce a phenotypic and functional maturation of dendritic cells (DCs) (18, 27). The immune response to alpha (1
3) dextran was dependent on the CD28-B7-1 pathway. In contrast, immune responses to capsular polysaccharides of some S. pneumoniae serotypes, to NP-Ficoll, and to the capsular polysaccharide of Cryptococcus neoformans depended upon the CD40-CD40L pathway (1, 8, 14, 25). In an animal model for abscess formation, inhibition of the CD28-B7-2 pathway prevented abscess formation following challenge with live B. fragilis plus adjuvant (30). However, the role of costimulation in the cell-mediated immune response to purified ZPS in vitro has not been investigated. In this study, we show that ZPSs induce APC activation and expression of HLA-DR. T-cell proliferation resulting from ZPS activation of APCs depends upon the costimulatory molecules B7-2 and CD40. In vitro, ZPS-mediated cellular immune response requires the B7-2 and CD40 molecules in addition to the retrograde transport of the HLA-DR molecule to the cell surface.

MATERIALS AND METHODS
Antigens.
S. pneumoniae type 1 capsular polysaccharide (Sp1) was obtained
from the American Type Culture Collection (Manassas, Va.) and
treated with 2 M NaOH for 1 h at 80°C to remove C substance
(a contaminating cell wall polysaccharide). After purification
by gel filtration chromatography with Sephracyl S-400 HR (Amersham
Pharmacia Biotech, Piscataway, N.J.), the Sp1 was concentrated
by ultrafiltration and lyophilization and stored at a concentration
of 1 mg/ml in 0.15 M phosphate-buffered saline. The polysaccharide
antigen was purified aseptically with sterile water. The instruments
and devices used in the antigen purification process were deproteinated
by treatment with sulfuric and chromic acid and depyrogenated
by heat inactivation for 4 h at 240°C or by treatment with
1 to 2 M sodium hydroxide buffer. The antigens were analyzed
for protein by the bicinchoninic acid method (Pierce, Rockford,
Ill.) and by UV absorbance at 280 nm, for nucleic acid by UV
absorbance at 260 nm, and for endotoxin (lipopolysaccharide
[LPS]) by the limulus amebocyte lysate test (Charles River Endosafe,
Charleston, S.C.). In the limulus test, the antigens were evaluated
alone and in the presence of LPS; LPS alone served as a positive
control. In addition, the polysaccharide antigen was subjected
to high-resolution (500 MHz) proton nuclear magnetic resonance
spectroscopy (
16). Sp1 was found to contain no detectable protein
and no detectable nucleic acid. Endotoxin was not detectable
in the above preparations according to the limulus test with
a sensitivity of <8 pg of LPS/mg of Sp1 (<0.4 pg of LPS/ml
of culture medium containing 50 µg of Sp1) which corresponds
to <0.028 endotoxin units [EU/mg of Sp1 (<0.0012 EU/ml
of culture medium containing 50 µg of Sp1). Tetanus toxoid
(TT) was a generous gift from Chiron Behring, Marburg, Germany,
and was further purified by gel filtration chromatography with
Sephracyl S-400 HR (Amersham Pharmacia Biotech) and ultrafiltration.
It was found to contain no detectable nucleic acid and <8
pg of LPS/mg of TT containing 293 limit of flocculation (LF)
units (0.054 pg of LPS/ml of culture medium containing 2 LF
TT) which corresponds to <0.028 EU/mg of TT (<0.00019
EU/ml of culture medium containing 2 LF TT).
S. aureus enterotoxin
A (SEA) and LPS from
Escherichia coli O111:B4 were purchased
from Sigma Chemical (St. Louis, Mo.).
APCs and cell culture.
Mononuclear cells from healthy donors were isolated by centrifugation in Ficoll-Hypaque gradients (7). CD19+ B cells and CD14+ monocytes were negatively selected by immunomagnetic separation (Dynal, Inc., Lake Success, N.Y.). Immature DCs were generated from CD14+ monocytes by the addition of interleukin-4 (1,500 U/ml of culture medium) and granulocyte-macrophage colony-stimulating factor (500 U/ml of culture medium) every 48 h for 5 days in RPMI-1640 supplemented with L-glutamine, sodium pyruvate, penicillin-streptomycin, nonessential amino acids, 2-mercaptoethanol, and 10% fetal bovine serum (FBS; Life Technologies, Gaithersburg, Md.) (2, 29). The purity of the B-cell, monocyte, and DC populations was confirmed by flow cytometry (
95%). For the surface expression studies, mononuclear cells, monocytes, B cells, and immature DCs were incubated for different time periods ranging from 1 to 48 h with Sp1, TT, SEA, or in medium alone. The concentrations of antigens used was shown to be optimal to induce 80% of maximal T-cell proliferation in preliminary experiments. In the case of treatment of APCs with bafilomycin A1 (BFA), APCs were treated for 30 min with BFA before antigens were added.
T-cell proliferation assays.
T cells were isolated by centrifugation in Ficoll-Hypaque gradients and purified with nylon wool and immunomagnetic beads (7). The purity of the CD3+ and CD4+CD8 cell populations was confirmed by flow cytometry (
95%). T cells (5 x 104 per well) were incubated with
-irradiated mononuclear cells (APCs; (105/well) in triplicate (at 37°C in 5% CO2) with antigens, antibodies, or medium alone for different intervals in a 96-well plate in RPMI-1640 supplemented with L-glutamine, sodium pyruvate, penicillin-streptomycin, nonessential amino acids, 2-mercaptoethanol, and 10% FBS (Life Technologies). APCs were irradiated with 2,500 rad. The number of APCs was shown to be optimal in preliminary experiments, as were the concentrations of antigens (80% of maximal T-cell proliferation) and antibodies (maximal blocking effect) and the incubation period (4 to 9 days). In proliferation assays in the presence of blocking antibodies, the following purified monoclonal antibodies (MAbs) without azide and endotoxin were used: B7-1 (also known as CD80; L307.4), B7-2 (CD86; IT2.2), CD40L (CD154; TRAP-1), and isotype controls from BD PharMingen (San Diego, Calif.). The antibodies were added 30 min before the antigens. In proliferation assays studying the influence of the antigen incubation time or of BFA treatment of APCs on T-cell proliferation, APCs were washed 10 times after a defined time interval before T cells were added. T-cell proliferation was quantitated by [3H]thymidine incorporation (1 µCi/well) for 6 h. Assays were performed at three or more independent time points. The results were expressed as counts per minute (cpm), stimulation index, or percentage of inhibition of the stimulation index of the positive control.
Flow cytometry.
After washing, cells were incubated with MAbs at the concentration recommended by the manufacturer at 4°C for 30 min in phosphate-buffered saline with 10% FBS. Subsequently, they were fixedafter gating for viable cells by forward and side scatter characteristicsand analyzed by FACScan (Becton Dickinson) using CELLQuest software (Becton Dickinson). The following purified fluorescein isothiocyanate- or phycoerythrin-conjugated MAbs directed to various cell surface antigens were used: MAbs against human CD14 (M5E2), CD19 (Leu-12), CD40 (5C3), B7-1 (also CD80; L307.4), B7-2 (also CD86; IT2.2), and HLA-DR (L243 and TÜ36), all of which plus the isotype control antibodies were obtained from BD PharMingen. The results were expressed as mean fluorescence intensity (MFI) of fluorescence-labeled surface cells in case the whole APC population of nonstimulated cells was 100% positive for the surface marker or as percentage of fluorescence-labeled APCs from the whole APC population in case the nontreated cells were not 100% positive for the surface marker.
Statistical analysis.
Results for the various groups in T-cell proliferation assays were compared by a Student's t test.

RESULTS
ZPSs increase surface expression of HLA-DR in APCs.
Fluorescent staining of the surface marker HLA-DR showed that
Sp1 induced a twofold increase of HLA-DR surface expression
on monocytes, which peaked at 8 h of incubation (Fig.
1). Induced
HLA-DR expression was eliminated at 24 h of incubation. Incubation
of B cells with Sp1 showed increased HLA-DR surface expression
with similar kinetics (data not shown). HLA-DR surface expression
was upregulated after 48 h of incubation of immature monocyte-derived
DCs with Sp1 (Table
1). The increased surface expression of
HLA-DR on ZPS-treated APCs correlated with specific mRNA transcription.
Monocytes incubated with Sp1 for 8 h exhibited a 6.4-fold increase
of HLA-DR mRNA transcription (data not shown). We compared the
kinetics of ZPS-mediated HLA-DR surface expression with two
control antigens. TT is a conventional protein antigen that
exhibits a T-cell response after being processed in the endocytic
pathway and presented on the cell surface by MHC-II molecules.
Processing and presentation by APCs require cellular activation
through transport of MHC-II-peptide complexes from lysosomes
to the cell surface. In contrast, the superantigen SEA does
not require processing for induction of an immune response,
and therefore APCs do not need to be activated. SEA binds simultaneously
to the

-chain of the MHC-II molecule and ß-chain of
the TCR. Incubation of APCs with TT (optimal dose) resulted
in a nearly linear increase in HLA-DR over a 24-h period. Treating
APCs with SEA resulted in no significant increase in HLA-DR
(Fig.
1).
Duration of APC treatment with ZPS influences T-cell proliferation.
Kinetics studies examining the influence of the duration of
incubation with antigen at 37°C on T-cell proliferation
by Sp1 showed, as with control TT antigen, maximal proliferation
after an incubation period of 8 h. In contrast, T-cell proliferation
induced by SEA reached maximal levels after incubation for 30
min (Fig.
2).
ZPS-mediated T-cell proliferation requires upregulation of HLA-DR surface expression.
To address whether enhanced HLA-DR transcription and HLA-DR
transport to the cell surface with subsequent surface expression
are required for ZPS-mediated T-cell proliferation, APCs were
treated with BFA. BFA prevents the acidification in endolysosomal
compartments through specific inhibition of the vacuolar-type
H
+-ATPase. As a result, loading of antigens on MHC-II molecules
and transport of these molecules to the cell surface are decreased.
Gamma-irradiated mononuclear cells were treated with BFA at
different concentrations, with or without antigens, or in medium
alone. The density of HLA-DR molecules on the cell surface of
APCs treated with the highest dose of BFA and stimulated with
Sp1, TT, and SEA was comparable to the HLA-DR surface expression
of nonstimulated APCs (Table
2). After extensive washing, T
cells were added, and T-cell proliferation was evaluated. BFA
reduced T-cell proliferation in a dose-dependent manner by over
50% when APCs were stimulated with Sp1 and TT but not with SEA
(Fig.
3). Therefore, decreased T-cell proliferation was associated
with decreased HLA-DR translocation to the cell surface.
ZPS-induced T-cell proliferation requires costimulation by B7-2/CD28 and CD40/CD40L.
In vitro, T-cell proliferation assays were performed in the
presence of blocking antibodies to B7-1, B7-2, and CD40L and
appropriate isotype-matched control antibodies. T-cell proliferation
mediated by Sp1 was significantly inhibited by specific antibodies
to B7-2 compared with Sp1-mediated T-cell proliferation in the
presence of the isotype-matched control. A specific antibody
to B7-1 did not influence the Sp1-mediated T-cell proliferation
in vitro (Fig.
4, panel A). The addition of an antibody to CD40L
decreased T-cell proliferation significantly compared with the
T-cell response in the absence of the blocking antibody (Fig.
4, panel B).
ZPS increases surface expression of B7-1 and B7-2, but not of CD40.
Fluorescent staining of APCs for the costimulation surface markers
B7-1, B7-2, and CD40 showed that treatment with Sp1 increased
the expression of B7-1 and B7-2 on monocyte-derived DCs (Table
1), on monocytes (Fig.
5), and on B cells (data not shown).
Upregulation was maximally increased at 8 to 16 h of incubation
of monocytes with Sp1. After a 24-h incubation with ZPS, B7-2
surface expression was eliminated, while B7-1 expression was
still increased at a low level. The MFI of B7-1 of Sp1-treated
monocytes was maximally 21 (data not shown). CD40 surface expression
was induced neither on B cells (Fig.
5) nor on monocytes (data
not shown) when incubated with Sp1 alone or with Sp1 in the
presence of T cells. About 30% of the nontreated or Sp1-treated
B cells expressed CD40 with a maximum MFI of 30.

DISCUSSION
Previous reports have shown that ZPSs can stimulate CD4
+-T-cell
activation in vitro and that T-cell activation by these polysaccharides,
which have both positive and negative charges, is specific to
the charge motif of the ZPS tested and is not due to contaminating
peptides (
4,
31). We showed that T-cell activation by ZPS requires
direct interaction of CD4
+ T cells and APCs expressing HLA-DR
(
15). Recent studies demonstrate depolymerization of ZPS in
endosomes and localization of ZPS in the MHC-II endocytic pathway
(
5,
15). These observations imply presentation to T cells through
MHC-II and a fundamental shift in the MHC-II presentation paradigm.
To investigate the detailed mechanisms of APC activation that
result in APC and T-cell engagement with immune synapse formation
and subsequent T-cell stimulation, we hypothesized (i) that
activation of APCs resulting in transcription, translation,
retrograde transport, and upregulation of surface expression
of HLA-DR is required for ZPS-mediated T-cell stimulation in
vitro and (ii) that T-cell activation relies on costimulatory
interactions between APCs and T cells via the B7-CD28 pathway
and on specific interaction between CD40 and CD40L. We have
shown previously that monocytes, DCs, and B cells were all able
to serve as APCs for ZPS-mediated T-cell activation. Electron
and fluorescence microscopy studies have revealed colocalization
of ZPS with HLA-DR in compartments of the endocytic pathway
(
5,
15). Kinetics studies investigating the influence of the
duration of APC treatment with ZPS show that incubation times
comparable to those for TT (conventional antigen) are required
for the induction of T-cell activation, thus supporting the
implication that time for intracellular processing and transport
of the MHC-II and ZPS complex to the cell surface might be a
prerequisite for T-cell activation. We demonstrate that all
professional APCs become activated by ZPS, as is evident through
the upregulation of mRNA transcription and surface expression
of HLA-DR, which indicate transport of newly synthesized HLA-DR
molecules to the cell surface. Kinetics studies of monocytes
and B cells demonstrated that they are maximally activated after
8 h. Expression of HLA-DR on the APC following ZPS incubation
was eliminated at 24 h. Previously, antibody-mediated blockade
of HLA-DR was shown to inhibit T-cell proliferation (
15). Here
we demonstrate that, associated with a BFA-induced quantitative
decrease in expression of HLA-DR molecules on the APC, there
is a decrease in ZPS-mediated T-cell proliferation. These results
might be explained by a failure of APC activation and subsequent
decreased transport of HLA-DR to the cell surface. However,
if ZPS stimulated T cells via a superantigen-like mechanism,
the quantity of HLA-DR on the cell surface should be sufficient
(as demonstrated with SEA). The inhibition of ZPS-induced T-cell
proliferation by BFA may also reflect a decreased transport
of HLA-DR/ZPS complex to the cell surface because an acidic
pH in lysosomes and exchange of self-peptide with the polysaccharide
are also inhibited by BFA.
Recently published studies have demonstrated differential requirements for B7-1 and B7-2 in mediating T-cell-dependent host responses to a bacterial polysaccharide linked to an immunogenic protein or to a lipopolysaccharide. The antibody response to a group C meningococcal capsular conjugate vaccine is inhibited by antibodies to B7-2 but not to B7-1 (20). In another report, the immunoglobulin G antibody response to a type III group B Streptococcus glycoconjugate vaccine depended on either B7-1 or B7-2 (11). B7-1 is crucial for LPS-induced T-cell proliferation (21). The finding that specific antibody to B7-2 and not to B7-1 prevented T-cell proliferation stimulated by ZPS is intriguing. The result indicates that B7-1 is not required for ZPS-induced T-cell proliferation. Treatment of APCs induced at 8 to 16 h a maximum increase of B7-1 surface expression at a low level on about 20% of monocytes. The blocking antibody to B7-1 might not exhibit an effect on T-cell proliferation because surface expression of B7-1 is not high enough and of no biological relevance. Surface expression of B7-2 was maximally increased at 8 to 16 h of treatment on all APCs. After a 24-h incubation with ZPS, B7-2 surface expression was eliminated. In an earlier report, we demonstrated that abscess formation induced by B. fragilis was prevented by a specific antibody to B7-2 and not to B7-1. Furthermore, blockade of the B7-CD28 axis by administration of the CTLA4Ig fusion protein at the time of challenge with B. fragilis prevented abscess formation, whereas administration delayed by 24 or 48 h resulted in a loss of protective efficacy (30). These results corroborate our finding that activation of APCs, including the induction of HLA-DR and costimulatory molecules, is initiated shortly following treatment with ZPS.
Thymus-dependent antigens (e.g., proteins) require participation of CD4+ T cells to generate an immune response. The immune response to thymus-dependent antigens critically depends on the interaction between CD40L, a molecule that is transiently expressed on the surface of activated CD4+ T lymphocytes, and CD40 expressed on surface APCs, predominantly on B cells (23). As for ZPS, neutralization of CD40L resulted in an inhibition of ZPS-mediated T-cell proliferation. CD40 surface expression was not induced on B cells or monocytes by stimulation with ZPS. About 30% of nontreated and ZPS-treated B cells expressed CD40 on their surface. The results demonstrate that upregulation of CD40 surface expression is not a prerequisite for ZPS-induced T-cell proliferation. However, binding of CD40-CD40L is required to sustain the bidirectional signals necessary for the initiation of T-cell proliferation mediated by ZPS.
T cells are normally activated through direct contact with an APC. When T cells and APCs come in contact, they must overcome the electrostatic repulsion caused by their negative surface electric charges (24, 26). The attractive force necessary to overcome this barrier is largely mediated by the action of adhesion molecules. ZPSs rapidly bind to the surface of APCs (15). The high density of charge on ZPS molecules facilitates electrostatic interactions between APCs and T cells and may help to bypass the electrostatic repulsion, resulting in the uncommon kinetics of surface expression of HLA-DR and costimulatory molecules. During the initiation of T-cell activation, a number of key receptor-ligand complexes accumulate in discrete geometric patterns at the APC-T-cell interface (6, 9, 19, 22, 36). This complex has been referred to as the "supramolecular activation cluster" (22) or the "immunological synapse" (9) and has been suggested to potentiate TCR signaling (6). Our data demonstrate that ZPSs promote CD4+-T-cell proliferation via the first signal, provided by retrogradely transported HLA-DR, and the second signal, provided by the costimulatory molecules B7-2 and CD40, on activated APCs in a unique pattern.

ACKNOWLEDGMENTS
We thank Helena Frank and April Arrasate for their excellent
technical assistance, Thomas Berger and Paula Bryant for helpful
technical advice, and Jaylyn Olivo for editorial services.
This work was supported in part by the Deutsche Forschungsgemeinschaft (KA 1398/2 to W.M.K.), by the Bundesministerium für Bildung und Forschung (01KI9953 to W.M.K.), by the Maria-Pesch Foundation (364552 to W.M.K.), and by the National Institute of Allergy and Infectious Diseases (AI 34073 and AI 39576 to D.L.K.).

FOOTNOTES
* Corresponding author. Mailing address: Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Medical Center, Goldenfelsstr. 19-21, 50935 Cologne, Germany. Phone: 49 221 478 7650. Fax: 49 221 478 86004. E-mail:
Wiltrud.Kalka-Moll{at}medizin.uni-koeln.de.

Editor: J. N. Weiser
T.L.S. and M. N. contributed equally to the present study. 

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Infection and Immunity, April 2005, p. 2184-2189, Vol. 73, No. 4
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.4.2184-2189.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
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