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Biomedical subjects

G N Abraham

Publications and source records attributed to G N Abraham.

At least 37 records · Page 2Linked to original sources

Detection and mapping of polymorphic KpnI alleles in the human T-cell receptor constant beta-2 locus.

Southern blot analysis with human T-cell receptor (TcR) beta-chain specific cDNA probes revealed two novel allelic forms of the TcR beta-2 gene locus. Three different genotypes were noted based on the presence of polymorphic KpnI restriction fragments: I, 5.7 kb fragment only; II, 3.9 kb and 1.8 kb fragments only; III, all three polymorphic fragments. This hybridization pattern suggested that the presence or absence of a polymorphic KpnI site within the 5.7 kb fragment defines the two different allelic forms of the TcR beta chain locus. By Southern blot analysis of genomic DNA from T-cell lines with deleted C-beta-1 regions and computer-assisted restriction site mapping of germline and cDNA sequences of the C-beta-2 locus, the polymorphic KpnI site was localized at 24 bp 5' to the third exon of the C-beta-2 gene. It was determined that the polymorphic KpnI site and the earlier described polymorphic BglII site located 5' to the C-beta-2 gene are not co-inherited. No difference was noted in distribution of the KpnI genotypes and allelic frequencies between 26 normal individuals and 22 patients with systemic lupus erythematosus. However, this newly characterized polymorphism of the TcR locus should provide a useful tool to analyse the role of inherited genetic variations in the function of T lymphocytes under normal and pathological conditions.

Alleles↗

Clonal B cell expansions in patients with essential mixed cryoglobulinaemia.

In essential mixed, type II, cryoglobulinaemia (EMC) monoclonal autoantibodies with rheumatoid factor activity are synthesized at an accelerated rate by non-malignant B lymphocytes. In order to determine if the high cryoglobulin production rate is related to a clonal B cell expansion, cell surface markers of peripheral blood lymphocytes (PBL) were analysed by flow cytometry and the rearrangement of immunoglobulin (Ig) genes was investigated by Southern blot analysis of DNA extracted from the PBL of 12 EMC patients. Clonal expansion of B cells could be detected using DNA probes specific for the c kappa, c-mu, and JH genes in four out of 12 patients, two of whom also showed specific expansions of mu heavy and kappa light chain bearing cells using flow cytometry. The rearrangement of the c-myc locus was also noted in one of the patients with detectable Ig gene rearrangements. Demonstration of clonal B cell expansions in EMC patients shows that the clonal type of Ig gene rearrangements are not unique markers of malignant lymphomas but may also occur in autoimmune lymphoproliferative disorders. Since malignant B cell lymphomas can develop in a small number of EMC cases, the follow-up of these patients should be pursued indefinitely.

Adult↗

Aberrant immunoglobulin and c-myc gene rearrangements in patients with nonmalignant monoclonal cryoglobulinemia.

The status of the immunoglobulin (Ig) genes was investigated in patients with idiopathic nonmalignant monoclonal IgG cryoglobulinemia (NCG). In NCG, monoclonal antibodies are synthesized at an accelerated rate by nonmalignant B lymphocytes. In order to determine whether this high production rate is related to a clonal B cell expansion, the rearrangement of the Ig genes was investigated by Southern blot analysis of genomic DNA extracted from the peripheral blood lymphocytes of four NCG patients. In three of four (VI, BR, and CH) clonal expansion of B cells was detected using probes specific for the c kappa, JH, c gamma 4 genes (in accordance with detecting IgG kappa cryoproteins in these patients). BamHI digestion of DNA from VI and BR produced three rearranged fragments which cohybridized with JH and c mu probes. This finding suggested the presence of additional nonsecretory B cell clones and/or disruption of the gene segments spanned by and detected with the probes. In VI the idiotype of the IgG cryoglobulin was also detected in association with IgM in the supernatant of Epstein-Barr virus-stimulated B lymphocytes using a murine monoclonal anti-idiotypic antibody. In addition, the possibility of aberrant gene rearrangements was supported by noting the alteration of the c-myc gene locus in genomic DNA from peripheral blood leukocytes of VI and CH. Northern blot analysis of RNA isolated from peripheral blood B cells of VI and CH demonstrated aberrant transcripts of the c-myc gene, showing an active role of the altered c-myc locus. Detection of c-myc rearrangement in NCG patients clearly shows that this event may not be a final step in malignant B cell transformation; however, it may be related to the clonal expansion and high rate of cryoglobulin synthesis of nonmalignant B lymphocytes.

Adult↗

Human Fc gamma receptors: stable inter-donor variation in quantitative expression on platelets correlates with functional responses.

Evidence has recently been presented that a 40,000 dalton membrane sialoglycoprotein (p40) shared by monocytes and granulocytes serves as the human platelet receptor for aggregated IgG. We now report that the platelets of normal donors exhibit stable quantitative differences in the expression of this receptor molecule, as determined by flow cytometry using fluorescent staining with murine monoclonal antibody to p40 (mab IV.3). These inter-donor differences were reproducible on repeated testing over at least 4 mo. In concurrent assays, the binding of mab IV.3 to each donor's platelets was highly correlated with the binding of heat-aggregated human IgG, also assayed by flow cytometry. The biological relevance of this quantitative variation in IV.3 binding is suggested by its reproducible correlation with platelet responsiveness to aggregated IgG measured by aggregometry. Such stable quantitative variation in platelet Fc receptor expression among individual humans could contribute to differences in severity of certain pathologic processes initiated by IgG-containing immune complexes.

Antibodies, Monoclonal↗

Isoelectric focusing characterization of IgM-VKiiib immunoglobulin light chains and their association with anti-IgG autoantibodies in essential mixed cryoglobulinaemia, Sjögren's syndrome and rheumatoid arthritis.

Previous studies have demonstrated that the IgM monoclonal anti-IgG autoantibodies (AGAs) characteristic of essential mixed cryoglobulinaemia (EMC) display preferential use of kappa light chains of the VKiiib sub-subgroup. In order to gain insights as to the possible basis for this V region selection, IgM-VKiiib immunoglobulin was affinity purified from normal human serum, analysed by dissociating two-dimensional gel electrophoresis and compared to the two-dimensional gel patterns of IgM-VKiiib anti-IgG autoantibodies (AGAs) from patients with essential mixed cryoglobulinaemia (EMC). The results suggest that only part of the available VKiiib light chain repertoire is selected by EMC AGAs. When AGAs from EMC, rheumatoid arthritis (RA) and primary Sjögren's syndrome (SS) patients were analysed by ELISA, it was found that the association of the VKiiib light chains with anti-IgG autoantibodies differed significantly among the three diseases. In fact, in RA there appeared to be a negative selection against the use of VKiiib in AGAs. Clearly, the VKiiib determinant is not required for anti-IgG autoreactivity. The possibility emerges, therefore, that the genesis and perpetuation of AGA synthesis in these diseases may follow quite different pathways.

Adult↗

Characterization of monoclonal IgG cryoglobulins: fine-structural and morphological analysis.

The morphology of the amorphous, gelatinous, and crystalline varieties of monoclonal IgG cryoglobulins was analyzed by light and transmission and scanning electron microscopy. Each cryoglobulin had a characteristic fine structure that correlated with its gross morphology. Transmission electron microscopy showed that the amorphous precipitates were random and disorganized molecular clumps. In contrast, cryogels were thin-walled, well-organized, and hydrated strawlike clusters, whereas cryocrystals formed tightly compacted, highly structured molecular clusters. Crystals that formed in blood produced rouleaux, and analysis by scanning electron microscopy indicated that the crystals could form thick-walled, branching, macromolecular nets that could physically trap cells. The morphological properties provided visual impressions by which cryoglobulins could cause clinical disease secondary to vascular occlusion produced by self-associated IgG cryoglobulin molecules.

Cryoglobulins↗

The low affinity 40,000 Fc gamma receptor and the transferrin receptor can be alternative or simultaneous target structures on cells sensitive for natural killing.

The role of the low avidity 40,000 dalton receptor for IgG (Fc gamma R) present on K562 and U937 cells in sensitivity to natural killing (NK) was studied by using a murine monoclonal antibody (mAb) specific for the 40,000 dalton Fc gamma R (alpha Fc gamma R mAb). Pretreatment of K562 target cells with intact alpha Fc gamma R mAb or its Fab fragment or anti-transferrin receptor (alpha TFR) mAb partially blocked in a dose-dependent manner, NK activity to K562 cells. However, combined pretreatment with alpha Fc gamma R and alpha TFR mAb completely blocked NK activity against K562 targets. As compared with K562 cells, lower levels of NK were elicited against Molt-4, U937, HL-60, and Daudi targets. Although NK activity to Molt-4 targets was not affected by alpha Fc gamma R mAb, it was fully prevented by pretreatment with alpha TFR mAb. In contrast, NK to U937 cells was not influenced by alpha TFR mAb, but it was strongly inhibited by alpha Fc gamma R mAb. The resistance of 3H-TdR-prelabeled adherent HEp-2 cells to natural cell-mediated cytotoxicity was not affected by either mAb. Lectin-dependent cell-mediated cytotoxicity (LDCC) against HEp-2 cells due to the presence of concanavalin A, and was completely abrogated by pretreatment of the targets with alpha TFR mAb, but was unaffected by alpha Fc gamma R mAb. By use of the flow cytometer, a significant correlation was detected between the relative expression of 40,000 dalton Fc gamma R and the susceptibility to NK, whereas the expression of TFR was discordant from NK sensitivity. As determined in the single cell cytotoxicity assay alpha Fc gamma R mAb reduced the frequency of target binding effector cells without affecting the number of dead bound targets. This pattern of inhibition was found against both K562 and U937 targets. Alternatively, alpha TFR mAb inhibited both binding and killing of K562 and Molt-4 targets. Because pretreatment of HEp-2 cells with alpha TFR mAb did not influence conjugate formation, the blocking of LDCC to HEp-2 cells by alpha TFR mAb can be related to post-binding events. These data show that although both the 40,000 dalton Fc gamma R and the TFR can be target structures for NK cell recognition, the TFR may also play an important role in the post-binding events.

Antibodies, Monoclonal↗

Propolypeptide of von Willebrand factor circulates in blood and is identical to von Willebrand antigen II.

The generally mild bleeding disorder of von Willebrand disease is associated with abnormalities of two distinct plasma proteins, the large multimeric von Willebrand factor (vWF), which mediates platelet adhesion, and von Willebrand antigen II (vW AgII), which is of unknown function. The two proteins were found to have a common biosynthetic origin in endothelial cells and megakaryocytes, which explains their simultaneous absence in the severe form of this hereditary disease. Shared amino acid sequences from a 100-kilodalton plasma glycoprotein and from vW AgII are identical to amino acid sequences predicted from a complementary DNA clone encoding the 5' end of vWF. In addition, these proteins have identical molecular weights and immunologic cross reactivities. Monoclonal antibodies prepared against both proteins recognize epitopes on the pro-vWF subunit and on a 100-kilodalton protein that are not present on the mature vWF subunit in endothelial cell lysates. In contrast, polyclonal antibodies against vWF recognize both pro-vWF and vWF subunits. Thus, the 100-kilodalton plasma glycoprotein and vW AgII are identical proteins and represent an extremely large propolypeptide that is first cleaved from pro-vWF during intracellular processing and then released into plasma.

Amino Acid Sequence↗

Identification of a second class of IgG Fc receptors on human neutrophils. A 40 kilodalton molecule also found on eosinophils.

We describe a newly recognized 40 kD FcR for IgG on human neutrophilic granulocytes. An mAb (IV3) developed against the IgG FcR of K562 cells, and specific as well for a 40 kD FcR on human monocytes and platelets, was found to purify by affinity adsorption a 40 kD protein from detergent lysates of surface-radioiodinated neutrophils. This protein, proteolytically degraded to 33 kD when purified in the absence of diisopropylfluorophosphate, is distinct from the 51-73 kD protein precipitated by the anti-neutrophil FcR mAb, 3G8, previously described by others. Complete inhibition of binding of rabbit IgG-coated erythrocytes to neutrophils was achieved only when both antibodies, IV3 and 3G8, were used. Fab fragments of IV3 were as effective inhibitors as the intact molecule. IV3 IgG or Fab fragments completely and selectively inhibited immune complex-mediated generation of superoxide by human neutrophils; superoxide generation by other stimulants was not abrogated by IV3. This antibody (IV3) bound also to human eosinophils and completely inhibited the binding of IgG-coated erythrocytes to eosinophils. IV3 appears to define the human homolog of the murine macrophage FcRII identified initially by mAb 2.4G2 and present in the mouse on both neutrophils and eosinophils.

Antibodies, Monoclonal↗

Human monocytes and U937 cells bear two distinct Fc receptors for IgG.

Several convergent lines of evidence have led us to propose that human monocytes and the related cell line U937 possess a second class of IgG Fc receptor (FcR) in addition to the 72-Kd high affinity FcR previously described. IgG affinity purification from detergent lysates of surface radiolabeled U937 cells has yielded both a 40-Kd IgG-binding membrane protein (p40) and the 72-Kd FcR protein. By the same procedure, only the p40 was isolated from the erythroblast cell line K562 and from the B cell lines, Daudi and Raji. Serologic cross-reactivity between the 40-Kd FcR on U937 and Daudi cells was demonstrated using a goat anti-FcR antiserum. A murine (m) monoclonal antibody, raised against the FcR of K562 cells, precipitated the 40-Kd FcR from lysates of U937 and K562 cells but not from Daudi or Raji cells. This antibody, referred to as anti-p40 (IV.3), selectively inhibited the binding of murine IgG1-coated erythrocytes to U937 cells, whereas monomeric human IgG selectively inhibited binding of human anti-Rh(D)-coated erythrocytes to U937 cells. Both Daudi and U937 cells mediated mIgG1 anti-T3 (Leu-4)-induced stimulation of T lymphocytes. In contrast, mIgG2a anti-T3 (OKT3)-induced stimulation was supported effectively by U937 cells but only modestly by Daudi cells. Intact IgG or Fab fragments of anti-p40 (IV.3) blocked mIgG1 anti-T3 (Leu-4) stimulation but not mIgG2a anti-T3 (OKT3) stimulation of T cells; monomeric human IgG blocked only OKT3-induced stimulation. The simplest interpretation of these results is that human monocytes and U937 cells bear two classes of IgG FcR, one of 72 Kd and the other, as described above, of 40 Kd. We propose that the 72-Kd FcR mediates rosette formation with red cells coated by human anti-Rh IgG as well as T cell stimulation by mIgG2a anti-T3 (OKT3) and that the 40-Kd FcR mediates rosette formation with erythrocytes bearing mIgG1 as well as T cell stimulation by mIgG1 anti-T3 (Leu-4). Furthermore, we suggest that these two FcR are the human homologues of the murine macrophage FcRI (binding mIgG2a) and FcRII (binding mIgG2b/1).

Animals↗

The V kappa IIIb light chain sub-subgroup. II. Isotype expression in acquired hypogammaglobulinaemia and as a function of age.

The V kappa IIIb sub-subgroup of the human immunoglobulin V kappa III light chain subgroup has at least two unique properties. First, some IgM monoclonal autoantibodies, in particular cryoprecipitable anti-IgG (Kunkel et al., 1974; Ledford et al., 1983), anti-low density lipoprotein (Ledford et al., 1983) and certain cold agglutinin (Feizi et al., 1976) antibodies predominantly contain V kappa IIIb light chains. Second, in normal adult human serum, V kappa IIIb comprises approximately 25% of the IgM but less than 0.4% of the IgG or IgA kappa-chain pools (Moynihan, Looney & Abraham, 1985). Studies have suggested an altered regulation of IgM, IgG, and IgA-V kappa IIIb in some patients with acquired hypogammaglobulinaemia, a heterogeneous group of immunodeficiencies with low serum levels of Ig. An increase in the serum levels of V kappa IIIb light chains has been noted in some of these patients (Solomon & Mclaughlin, 1969) which is apparently due to elevated levels of light chains of the V kappa IIIb sub-subgroup (Greenstein & Abraham, 1984). However, the isotype association of V kappa IIIb in these patients has not been determined. In order to clarify whether the noted increase in V kappa IIIb levels is due to its selective expression with IgM or to an abnormality of immunoregulation, the heavy chain isotypes associated with V kappa IIIb light chains have been determined in a previously studied group of adults with acquired hypogammaglobulinaemia (Greenstein & Abraham, 1984). Further, the isotype distribution of V kappa IIIb light chains in another group of functional, albeit transient, hypogammaglobulinaemics (i.e. normal neonates) has also been studied by measuring IgM-V kappa IIIb levels in cord blood, and compared to the V kappa IIIb serum levels found in aged adults (mean age 75 years).

Adult↗

Human platelet Fc receptor for immunoglobulin G. Identification as a 40,000-molecular-weight membrane protein shared by monocytes.

We have recently shown that human monocytes and U937 cells possess two molecular classes of Fc gamma receptor. One, a 72,000-mol-wt sialoglycoprotein, has high affinity for certain subclasses of human and murine monomeric IgG. The other is a 40,000-mol-wt protein (p40) with low affinity for monomeric IgG but with the capacity to bind IgG aggregates or IgG-coated particles. In the present study, a 40,000-mol-wt single chain protein, apparently identical to p40 from U937 cells, was isolated from surface-radioiodinated human platelets by affinity purification using a murine IgG2b monoclonal antibody to p40. This 40,000-mol-wt protein was not seen when control IgG2b or unrelated murine monoclonal antibodies were employed in place of anti-p40. The same 40,000-mol-wt protein was also recovered from an IgG-Sepharose affinity adsorbent, but not from ovalbumin-or myoglobin-Sepharose. The 72,000-mol-wt Fc gamma receptor of monocytes was not identified on platelets. Monoclonal anti-p40 and Fab fragments derived from this antibody blocked platelet aggregation by heat-aggregated human IgG, whereas a control murine IgG2b protein had little or no inhibitory effect at 500-1,000-fold higher concentrations. A murine IgG1 monoclonal antibody, reactive with an unrelated platelet-specific membrane antigen, did not inhibit platelet responses to aggregated IgG. Anti-p40 did not affect platelet aggregation by thrombin, collagen, or fibrinogen plus ADP. Although anti-p40 did not directly aggregate platelets in the concentrations employed, cross-linking with F(ab')2 goat anti-murine Ig induced apyrase-sensitive aggregation of anti-p40-treated platelets. This indicates that p40 possesses transmembrane linkage for platelet activation and secretion. These observations strongly suggest that this newly recognized 40,000-mol-wt platelet membrane protein serves as an Fc gamma receptor.

Antibodies, Monoclonal↗

The VKIIIb light chain sub-subgroup: restricted association with mu heavy chain in normal human serum.

The VKIII human kappa light chain subgroup has been serologically and structurally divided into two sub-subgroups, VKIIIa and VKIIIb. VKIIIb has been shown by others to be strikingly prevalent in IgM autoantibodies, but no studies have been performed to determine heavy chain isotype association with VKIIIb light chain in normal human serum. The VKIIIb sub-subgroup was shown here to be associated with mu heavy chain in normal human serum, but was not detected in association with gamma or alpha heavy chain. Approximately 25 +/- 15% of IgM-kappa was determined to be VKIIIb. Both intact IgG and purified light chains from pooled IgG did not bind monoclonal anti-VKIIIb, indicating that the determinants recognized by anti-VKIIIb are not merely masked in intact IgG. These results are the first report of a light chain sub-subgroup showing preferential association with a heavy chain isotype.

Enzyme-Linked Immunosorbent Assay↗

Reversible self-association of a human myeloma protein. Thermodynamics and relevance to viscosity effects and solubility.

Monoclonal IgG paraproteins associated with multiple myeloma, Felty's syndrome, and idiopathic cryoglobulinemia frequently produce disease due to a tendency to self-associate in vivo. The insolubility and viscosity effects of these proteins are of specific interest as molecular disease mechanisms. In sedimentation equilibrium studies at 21 degrees C an IgG1-lambda myeloma protein (IgG-MIT) associated with the hyperviscosity syndrome is shown to undergo a reversible polymerization reaction. On the basis of the theory and data-fitting methods of Adams and co-workers [Tang, L. H., Powell, D. R., Escott, B. M., & Adams, E. T., Jr. (1977) Biophys. Chem. 7, 121-139], the data are consistent with a nonideal cooperative indefinite (SEK type III) model self-association in which one equilibrium constant (K12 = 6.3 X 10(3) L/m) governs dimerization while another (K = 1.7 X 10(4) L/m) governs all subsequent additions of monomer to the polymer. Temperature effects on K12 and K between 11 and 30 degrees C suggest negative van't Hoff enthalpies for all association steps and a positive entropy change [delta S degree = 2.5 cal/(mol-deg)] for steps beyond the dimer. An increase in ionic strength from I = 0.03 to I = 0.18 promotes the polymerization of IgG-MIT through a marked increase in K while paradoxically enhancing bulk solubility. These results suggest that this self-association proceeds through a combination of weak nonionic and hydrophobic interactions. The enhancement of both polymerization and solubility by increased ionic strength suggests that the hyperviscosity induced by IgG-MIT results from its ability to form large, highly soluble polymers in serum.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Size, shape, and hydration of a self-associating human IgG myeloma protein: axial asymmetry as a contributing factor in serum hyperviscosity.

Studies of sedimentation, diffusion, viscosity, and buoyant density have been carried out on a human IgG1-lambda myeloma protein (IgG-MIT) isolated from the serum of a patient with multiple myeloma and the hyperviscosity syndrome. In comparison with pooled normal IgG, IgG-MIT exhibits smaller sedimentation and diffusion coefficients, a larger intrinsic viscosity, and a larger frictional ratio. The preferential hydration of IgG-MIT in cesium chloride was found to be within the range of values typically observed for globular proteins. The data are consistent with prolate ellipsoid geometry, and suggest that the axial ratio of the IgG-MIT monomer is approximately 50% greater than that typically observed for IgG. The concentration dependencies of the hydrodynamic data for IgG-MIT confirm the previous finding of reversible, concentration-dependent self-association for this protein. IgG-MIT thus represents the first reported instance of an IgG paraprotein for which in vivo hyperviscosity effects appear attributable to a twofold mechanism involving geometric asymmetry and concentration-dependent polymerization. The results are discussed in terms of the significant heterogeneity in molecular dimensions which may exist among normal IgG proteins.

Biopolymers↗

Monoclonal antibodies reactive with idiotypic and variable-region specific determinants on human immunoglobulins.

Monoclonal antibody JG-B1, specific for the human VKIIIb sub-subgroup of L chains, and JG-B4 specific for an idiotypic determinant on Glo, a monoclonal human IgM-VKIIIb anti-IgG, were produced and characterized. The VKIIIb determinant was detected on L chains alone and intact immunoglobulins with VKIIIb L chains. However, the idiotypic determinant was expressed only on IgM-Glo and required association of H and L chains. Binding of the immunogen Glo, to its antigen-IgG partially inhibited anti-idiotype and anti-VKIIIb binding. Cross-inhibition experiments demonstrated that intact pentameric IgM-Glo expressed one-half the number of idiotypic sites as VKIIIb determinants. However, Glo half-molecules expressed equal numbers of idiotypic and VKIIIb determinants. This is the first described monoclonal antibody produced by hybridoma technology which recognizes an antigenic determinant specific for a single variable region in intact immunoglobulin.

Animals↗

VK IIIb expression is altered in acquired and drug-induced hypogammaglobulinaemia.

The Kappa chain variable region subgroup restriction of immunoglobulin (Ig) from patients with acquired hypogammaglobulinaemia, agammaglobulinaemia and drug-induced immunosuppression has been studied. The percent of K chain-containing Ig which expresses the VK IIIb variable region sub-subgroup was determined with a previously characterized murine monoclonal anti-VK IIIb antibody. The VK IIIb sub-subgroup percent was increased in sera from patients with idiopathic hypogammaglobulinaemia, as well as patients who became hypogammaglobulinaemic following immunosuppression. The implications of the results to the regulation of the human immune and autoimmune response are discussed.

Agammaglobulinemia↗

The Fc portion of intact IgG blocks stimulation of human PBMC by anti-T3.

The means by which normal human serum inhibits the activation of PBMC by OKT3 has been investigated. The Fc portion of intact IgG is shown to be the major inhibitor in human serum of this OKT3-induced stimulation. Furthermore, inhibition by IgG subclasses correlated with their ability to bind to the monocyte Fc receptor, i.e., IgG1 and IgG3 produced greater inhibition than IgG2 and IgG4, and this inhibition was competitive. In contrast, hypogammaglobulinemic serum, IgA, IgM, and F(ab')2 of IgG were not inhibitory relative to intact IgG or Fc of IgG. Because of the similarities between T3 and the idiotype-defined T cell receptor for antigen, these investigations suggest that IgG might modulate the interactions between the T cell recognition complex and anti-idiotype antibody, thus regulating the idiotype network.

Antibodies, Monoclonal↗