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Computationally designed proteins mimic antibody immune evasion in viral evolution 计算设计的蛋白质模拟病毒进化中的抗体免疫逃避
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-08 DOI: 10.1016/j.immuni.2025.04.015
Noor Youssef, Sarah Gurev, Fadi Ghantous, Kelly P. Brock, Javier A. Jaimes, Nicole N. Thadani, Ann Dauphin, Amy C. Sherman, Leonid Yurkovetskiy, Daria Soto, Ralph Estanboulieh, Ben Kotzen, Pascal Notin, Aaron W. Kollasch, Alexander A. Cohen, Sandra E. Dross, Jesse Erasmus, Deborah H. Fuller, Pamela J. Bjorkman, Jacob E. Lemieux, Debora S. Marks
{"title":"Computationally designed proteins mimic antibody immune evasion in viral evolution","authors":"Noor Youssef, Sarah Gurev, Fadi Ghantous, Kelly P. Brock, Javier A. Jaimes, Nicole N. Thadani, Ann Dauphin, Amy C. Sherman, Leonid Yurkovetskiy, Daria Soto, Ralph Estanboulieh, Ben Kotzen, Pascal Notin, Aaron W. Kollasch, Alexander A. Cohen, Sandra E. Dross, Jesse Erasmus, Deborah H. Fuller, Pamela J. Bjorkman, Jacob E. Lemieux, Debora S. Marks","doi":"10.1016/j.immuni.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.015","url":null,"abstract":"Recurrent waves of viral infection necessitate vaccines and therapeutics that remain effective against emerging viruses. Our ability to evaluate interventions is currently limited to assessments against past or circulating variants, which likely differ in their immune escape potential compared with future variants. To address this, we developed EVE-Vax, a computational method for designing antigens that foreshadow immune escape observed in future viral variants. We designed 83 SARS-CoV-2 spike proteins that transduced ACE2-positive cells and displayed neutralization resistance comparable to variants that emerged up to 12 months later in the COVID-19 pandemic. Designed spikes foretold antibody escape from B.1-BA.4/5 bivalent booster sera seen in later variants. The designed constructs also highlighted the increased neutralization breadth elicited by nanoparticle-based, compared with mRNA-based, boosters in non-human primates. Our approach offers targeted panels of synthetic proteins that map the immune landscape for early vaccine and therapeutic evaluation against future viral strains.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"54 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Somatic hypermutation unlocks antibody specificities beyond the primary repertoire 体细胞超突变解锁抗体特异性超出了主要曲目
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-07 DOI: 10.1016/j.immuni.2025.04.014
Teng Zuo, Avneesh Gautam, Shahab Saghaei, Sweta N. Khobragade, Rahaman Ahmed, Azadeh Mahdavinia, Mehrdad Zarghami, Gaspar A. Pacheco, Kenneth Green, Meghan Travers, Nicholas Garcia, Zahra Allahyari, Vishal Rao, Sachin Kumar, Robert Novak, Joyce K. Hwang, Duane R. Wesemann
{"title":"Somatic hypermutation unlocks antibody specificities beyond the primary repertoire","authors":"Teng Zuo, Avneesh Gautam, Shahab Saghaei, Sweta N. Khobragade, Rahaman Ahmed, Azadeh Mahdavinia, Mehrdad Zarghami, Gaspar A. Pacheco, Kenneth Green, Meghan Travers, Nicholas Garcia, Zahra Allahyari, Vishal Rao, Sachin Kumar, Robert Novak, Joyce K. Hwang, Duane R. Wesemann","doi":"10.1016/j.immuni.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.014","url":null,"abstract":"B cell somatic hypermutation (SHM) and selection in germinal centers (GCs) enhance antibody affinity for antigen. Here, we investigated whether SHM-based antibody evolution is restricted to specificities established through V(D)J recombination in the primary repertoire. Tracking pre-defined non-specific B cells across multiple immunization models revealed that non-cognate B cells within GCs undergo SHM. Under conditions of limited B cell competition, these B cells generated <em>de novo</em> antigen recognition to multiple epitopes across diverse model antigens. Phylogenetic analyses identified diverse mutational pathways leading to new antigen affinities, and enhanced T cell co-stimulation further promoted new antigen recognition. Our data support a model in which B cell competition—rather than an intrinsic requirement for specific affinity—limits the emergence of new affinities through SHM, highlighting the mammalian adaptive immune system’s ability to explore antibody-antigen interactions beyond those encoded by the V(D)J-dependent primary repertoire, demonstrating the flexibility of SHM in not only ripening but also reshaping specificity.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"50 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vaccination of nonhuman primates elicits a broadly neutralizing antibody lineage targeting a quaternary epitope on the HIV-1 Env trimer 非人灵长类动物的疫苗接种引发了一种广泛中和的抗体谱系,靶向HIV-1 Env三聚体上的一个四级表位
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-07 DOI: 10.1016/j.immuni.2025.04.010
Fabian-Alexander Schleich, Shridhar Bale, Javier Guenaga, Gabriel Ozorowski, Monika Àdori, Xiaohe Lin, Xaquin Castro Dopico, Richard Wilson, Mark Chernyshev, Alma Teresia Cotgreave, Marco Mandolesi, Jocelyn Cluff, Esmeralda D. Doyle, Leigh M. Sewall, Wen-Hsin Lee, Shiyu Zhang, Sijy O’Dell, Brandon S. Healy, Deuk Lim, Vanessa R. Lewis, Richard T. Wyatt
{"title":"Vaccination of nonhuman primates elicits a broadly neutralizing antibody lineage targeting a quaternary epitope on the HIV-1 Env trimer","authors":"Fabian-Alexander Schleich, Shridhar Bale, Javier Guenaga, Gabriel Ozorowski, Monika Àdori, Xiaohe Lin, Xaquin Castro Dopico, Richard Wilson, Mark Chernyshev, Alma Teresia Cotgreave, Marco Mandolesi, Jocelyn Cluff, Esmeralda D. Doyle, Leigh M. Sewall, Wen-Hsin Lee, Shiyu Zhang, Sijy O’Dell, Brandon S. Healy, Deuk Lim, Vanessa R. Lewis, Richard T. Wyatt","doi":"10.1016/j.immuni.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.010","url":null,"abstract":"The elicitation of cross-neutralizing antibodies to the HIV-1 envelope glycoprotein (Env) by vaccination remains a major challenge. Here, we immunized previously Env-immunized nonhuman primates with a series of near-native trimers that possessed N-glycan deletions proximal to the conserved CD4 binding site (CD4bs) to focus B cells to this region. Following heterologous boosting with fully glycosylated trimers, we detected tier 2 cross-neutralizing activity in the serum of several animals. Isolation of 185 matched heavy- and light-chain sequences from Env-binding memory B cells from an early responder identified a broadly neutralizing antibody lineage, LJF-0034, which neutralized nearly 70% of an 84-member HIV-1 global panel. High-resolution cryoelectron microscopy (cryo-EM) structures revealed a bifurcated binding mode that bridged the CD4bs to V3 across the gp120:120 interface on two adjacent protomers, evading the proximal N276 glycan impediment to the CD4bs, allowing neutralization breadth. This quaternary epitope defines a potential target for future HIV-1 vaccine development.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"141 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Phosphoantigen-induced inside-out stabilization of butyrophilin receptor complexes drives dimerization-dependent γδ TCR activation 磷酸抗原诱导的亲丁酸蛋白受体复合物的内向外稳定驱动二聚化依赖性γδ TCR激活
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-06 DOI: 10.1016/j.immuni.2025.04.012
Yuwei Zhu, Wenbo Gao, Jianlin Zheng, Ye Bai, Xinyu Tian, Tengjin Huang, Zebin Lu, De Dong, Anqi Zhang, Changyou Guo, Zhiwei Huang
{"title":"Phosphoantigen-induced inside-out stabilization of butyrophilin receptor complexes drives dimerization-dependent γδ TCR activation","authors":"Yuwei Zhu, Wenbo Gao, Jianlin Zheng, Ye Bai, Xinyu Tian, Tengjin Huang, Zebin Lu, De Dong, Anqi Zhang, Changyou Guo, Zhiwei Huang","doi":"10.1016/j.immuni.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.012","url":null,"abstract":"Phosphoantigens (pAgs), produced by infected or cancer cells, trigger the assembly of a membrane receptor complex comprising butyrophilin (BTN) members BTN3A1 and BTN2A1, leading to the activation of γδ T cells. BTN3A2 or BTN3A3 forms heteromers with BTN3A1, exhibiting higher γδ T cell receptor (TCR)-stimulating activity than BTN3A1 homomers. Cryoelectron microscopy (cryo-EM) structure reveals a pAg-induced BTN2A1-BTN3A1 heterotetramer with a 2:2 stoichiometry, stabilized by interactions between the intracellular B30.2 domains and the extracellular immunoglobulin V (IgV) domains. BTN3A2 or BTN3A3 heterodimerizes with BTN3A1, forming a pAg-induced tetrameric complex with BTN2A1. However, BTN3A1 heterodimers are more stable than BTN3A1 homodimers in this interaction. Cryo-EM reveals that BTN2A1-BTN3A1-BTN3A2 binds two γδ TCR ectodomains, with one being sandwiched between the IgV domains of BTN2A1 and BTN3A2, while the other interacts with the free BTN2A1 IgV in the complex, as evidenced by functional data. Together, our findings uncover the mechanism of ligand-induced inside-out stabilization of BTN receptor complexes for dimeric activation of γδ TCR.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"20 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microglia transcriptional states and their functional significance: Context drives diversity 小胶质细胞转录状态及其功能意义:环境驱动多样性
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-06 DOI: 10.1016/j.immuni.2025.04.009
Constanze Depp, Jordan L. Doman, Maximilian Hingerl, Judy Xia, Beth Stevens
{"title":"Microglia transcriptional states and their functional significance: Context drives diversity","authors":"Constanze Depp, Jordan L. Doman, Maximilian Hingerl, Judy Xia, Beth Stevens","doi":"10.1016/j.immuni.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.009","url":null,"abstract":"In the brain, microglia are continuously exposed to a dynamic microenvironment throughout life, requiring them to adapt accordingly to specific developmental or disease-related demands. The advent of single-cell sequencing technologies has revealed the diversity of microglial transcriptional states. In this review, we explore the various contexts that drive transcriptional diversity in microglia and assess the extent to which non-homeostatic conditions induce context-specific signatures. We discuss our current understanding and knowledge gaps regarding the relationship between transcriptional states and microglial function, review the influence of complex microenvironments and prior experiences on microglial state induction, and highlight strategies to bridge the gap between mouse and human studies to advance microglia-targeting therapeutics.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"50 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Niche-specific therapeutic targeting of myeloid cells in the central nervous system 中枢神经系统骨髓细胞的靶向治疗
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-04 DOI: 10.1016/j.immuni.2025.03.016
Maximilian Frosch, Marco Prinz
{"title":"Niche-specific therapeutic targeting of myeloid cells in the central nervous system","authors":"Maximilian Frosch, Marco Prinz","doi":"10.1016/j.immuni.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.03.016","url":null,"abstract":"The central nervous system (CNS) can be subdivided into distinct anatomical and functional compartments, including the parenchyma, perivascular space, leptomeninges, and dura mater, etc. Each compartment hosts distinct immune cell populations, such as monocytes and diverse macrophages, which play critical roles in local tissue homeostasis and regional disease pathogenesis. Advances in single-cell technologies have revealed complex immune cell compositions and functions in these anatomical regions. This review summarizes the latest approaches for modulating myeloid cell subsets in a compartment-specific manner, including cellular strategies such as stem cell therapy, <em>ex vivo</em> gene treatment, bone marrow transplantation, as well as non-cellular strategies like antibodies, small molecules, and viral gene delivery to augment CNS immune responses and improve disease outcomes. We also discuss the challenges and requirements of translating targeting strategies from mice to humans.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"46 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Glymphatics and meningeal lymphatics unlock the brain-immune code 淋巴细胞学和脑膜淋巴学解开了大脑免疫密码
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-04 DOI: 10.1016/j.immuni.2025.03.006
Min Woo Kim, Jonathan Kipnis
{"title":"Glymphatics and meningeal lymphatics unlock the brain-immune code","authors":"Min Woo Kim, Jonathan Kipnis","doi":"10.1016/j.immuni.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.03.006","url":null,"abstract":"The central nervous system (CNS) was once perceived as entirely shielded from the immune system, protected behind the blood-brain barrier and thought to lack lymphatic drainage. However, recent evidence has challenged many dogmas in neuroimmunology. Indeed, by means of glymphatics, brain-derived “waste” from deep within the CNS mobilizes toward immunologically active brain borders, where meningeal lymphatic vessels are appropriately positioned to drain antigens from the brain to the periphery. Accordingly, the presentation of brain-derived self-peptides emerges at the brain’s borders and drives T cell responses with suppressive properties, critical in allowing active immunosurveillance while limiting aberrant immune reactivity. Taking into consideration these concepts, we further discuss how inflammation, aging, and neurodegenerative diseases potentially reshape the repertoire of self-antigens and immune cells, disrupting the healthy dialogue between the CNS and immune system. Collectively, this evolving perspective unveils new therapeutic avenues for CNS pathologies.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"94 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Border-associated macrophages as gatekeepers of brain homeostasis and immunity 边界相关巨噬细胞作为脑内稳态和免疫的守门人
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-04 DOI: 10.1016/j.immuni.2025.04.005
Mónica Vara-Pérez, Kiavash Movahedi
{"title":"Border-associated macrophages as gatekeepers of brain homeostasis and immunity","authors":"Mónica Vara-Pérez, Kiavash Movahedi","doi":"10.1016/j.immuni.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.005","url":null,"abstract":"The brain’s border tissues serve as essential hubs for neuroimmune regulation and the trafficking of biomaterials to and from the brain. These complex tissues—including the meninges, perivascular spaces, choroid plexus, and circumventricular organs—balance the brain’s need for immune privilege with immune surveillance and blood-brain communication. Macrophages are integral components of these tissues, taking up key strategic positions within the brain’s circulatory system. These border-associated macrophages, or “BAMs,” are therefore emerging as pivotal for brain homeostasis and disease. BAMs perform trophic functions that help to support border homeostasis but also act as immune sentinels essential for border defense. In this review, we integrate recent findings on BAM origins, cell states, and functions, aiming to provide global insights and perspectives on the complex relationship between these macrophages and their border niche.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"20 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alzheimer’s disease and age-related macular degeneration: Shared and distinct immune mechanisms 阿尔茨海默病和年龄相关性黄斑变性:共享和独特的免疫机制
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-04 DOI: 10.1016/j.immuni.2025.04.013
Oleg Butovsky, Neta Rosenzweig
{"title":"Alzheimer’s disease and age-related macular degeneration: Shared and distinct immune mechanisms","authors":"Oleg Butovsky, Neta Rosenzweig","doi":"10.1016/j.immuni.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.013","url":null,"abstract":"Alzheimer’s disease (AD) and age-related macular degeneration (AMD) represent the leading causes of dementia and vision impairment in the elderly, respectively. The retina is an extension of the brain, yet these two central nervous system (CNS) compartments are often studied separately. Despite affecting cognition vs. vision, AD and AMD share neuroinflammatory pathways. By comparing these diseases, we can identify converging immune mechanisms and potential cross-applicable therapies. Here, we review immune mechanisms highlighting the shared and distinct aspects of these two age-related neurodegenerative conditions, focusing on responses to hallmark disease manifestations, the opposite role of overlapping immune risk loci, and potential unified therapeutic approaches. We also discuss unique tissue requirements that may dictate different outcomes of conserved immune mechanisms and how we can reciprocally utilize lessons from AD therapeutics to AMD. Looking forward, we suggest promising directions for research, including the exploration of regenerative medicine, gene therapies, and innovative diagnostics.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"59 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of specialized sensory neuron subtypes in modulating peripheral immune responses 特殊感觉神经元亚型在调节外周免疫反应中的作用
IF 32.4 1区 医学
Immunity Pub Date : 2025-05-04 DOI: 10.1016/j.immuni.2025.04.008
Théo Crosson, Ninon Bretaud, Sophie Ugolini
{"title":"Role of specialized sensory neuron subtypes in modulating peripheral immune responses","authors":"Théo Crosson, Ninon Bretaud, Sophie Ugolini","doi":"10.1016/j.immuni.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.immuni.2025.04.008","url":null,"abstract":"The immune and sensory nervous systems detect diverse threats, from tissue damage to infection, and coordinate protective responses to restore homeostasis. Like immune cells, sensory neurons exhibit remarkable heterogeneity, with advanced genetic models revealing that distinct subsets differentially regulate immune responses. Here, we review how various immune signals engage distinct subtypes of sensory neurons to mediate inflammatory pain, itch, relief, protective behavioral adaptations, and autonomic reflexes. We also highlight how specialized sensory neuron populations modulate immune function through the release of neuropeptides, neurokines, or glutamate. This functional specialization enables precise immunomodulation adapted to the kinetics and nature of immune responses, positioning sensory neurons as key regulators of host defense and tissue homeostasis.","PeriodicalId":13269,"journal":{"name":"Immunity","volume":"51 1","pages":""},"PeriodicalIF":32.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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