Mycoplasma Lipid-Antigen
Dr. Kazuhiro Matsuda is continued in research about the mycoplasma lipid
antigen for years. Molecular mechanisms of lipid-antigen recognition are
important in the frontier of immunology. To prevent infectious diseases
through vaccination, it is important to identify specific antigens. Therefore,
structural analysis of lipid-antigens is critical for understanding the
mechanisms of molecular interactions involved in the pathogenesis of immune
abnormalities, and for devising strategies surrounding immune system regulation
and drug discovery. He has done structural analyses and chemical synthesis
of mycoplasma lipid antigens, and further, he has revealed the lipid-antigens
are useful biomarkers for mycoplasma infectious diseases, and are superior
in specificity and sensitivity to conventional methods. He established
the new approaches based on lipid-antigens revealed strategies for diagnosis
of microorganism infections and novel vaccine development.
Antigens: Lipids
Molecular mechanisms of lipid-antigen recognition are important in the frontier of immunology. Possible pathogeneses of autoimmune diseases and tumours now include infections with microorganisms. Therefore, the role of vaccines is increasingly important, as advancing technology has now broadened the targets of vaccination to include a greater number of infectious diseases, tumours, chronic infections, autoimmune diseases and allergies. In order to prevent infectious diseases through vaccination, it is important to identify specific antigens which often exist in the cell membrane and capsule and also become the centre of host-pathogen interactions. Structural analysis of lipid-antigens is critical for understanding the mechanisms of molecular interactions involved in the pathogenesis of immune abnormalities, and for devising strategies surrounding immune system regulation and drug discovery.
Vaccines have been used for prevention and treatment of infectious diseases for more than two centuries. Vaccination is generally considered to be the most effective method for prevention of infectious diseases. The role of vaccination has become increasingly more important due to the increasing number of targets of vaccines, including a greater number of infectious diseases, tumours, chronic infections, autoimmune diseases and allergies.
Recognition of the pathogeneses of autoimmune diseases and tumours has been changing. It is now recognized that some autoimmune diseases and tumours are caused by infections with microorganisms such as bacteria and viruses. Chronic or repetitive infections with microorganisms are triggers of chronic inflammatory diseases and the resulting appearance of downstream disorders such as autoimmune diseases and tumours. Although there are multistep processes for disease mechanisms, both environmental and genetic factors contribute to the pathogenesis of chronic inflammatory diseases, autoimmune diseases and tumours.
Vaccination, by definition, is the administration of antigenic material (the vaccine) that is designed to stimulate adaptive immunity to a particular disease. Naturally, the identification of the key antigens of microbial pathogens is an important aspect of vaccine development. An antigen is a substance (molecule) that induces production of specific antibodies (humoral immunity), activation of specific immune cells (cellular immunity) or interacts specifically with the products of the host’s immune response.
Antigenic determinants (also called epitopes), which are responsible for the specificity of the antibody, are usually parts of proteins, nucleic acids, polysaccharides, phospholipids, glycolipids or other biological macromolecules. It has become well known that different populations of T lymphocytes recognize not only peptides in the context of major histocompatability complex (MHC) class I and class II molecules, but also recognize foreign and self-lipids (lipid-antigens) in association with CD1 proteins (as CD1 proteins share structural similarities with MHC class I molecules) . Progress in the field of lipid immunology has been more recent than in the field protein immunology, and has been due largely to recent advances in lipid and membrane chemistry.
Immune response to antigens
Most infectious diseases caused by bacteria begin with microbial colonization of a host surface: typically the skin, respiratory tract, gastrointestinal tract or the genitourinary tract. Humans are constantly exposed to a large number of diverse microorganisms that can cause infections. Many organisms that usually coexist harmoniously with the human host become pathogens only if the balance of the commensal relationship is disrupted. Other microorganisms are more invasive, and they overtly attack the host’s normal surface barriers and internal defence mechanisms. The human host has evolved a complex array of protective mechanisms designed to defend itself against these continuous microbial challenges.
CD1-restricted lipid antigen presentation
The former paradigm was that T cells recognize peptide antigens presented by MHC class I or II molecules. Recently, it has been demonstrated that lipids can be presented by APC through the CD1 family of molecules (termed CD1-restricted antigen presentation). The structure of the CD1 family of molecules is close to that of MHC class I and II molecules (Porcelli et al., 1998). The hydrophobic tail groups of glycolipids are captured by the hydrophobic groove of CD1 molecules, similar to how hydrophobic portions of peptides are captured by the groove of MHC molecules.
Natural killer T (NKT) cells, which recognize the CD1 molecule, are a heterogeneous group of T cells that share properties of both T cells and natural killer (NK) cells. NKT differ from conventional αβ T cells in that their TCRs are far more limited in diversity and in that they recognize lipids and glycolipids presented by CD1 molecules. Like other 'unconventional' T cell subsets bearing invariant TCRs, such as CD1-restricted Natural Killer T cells, γδ T cells exhibit the more evolutionarily primitive innate immune system. The antigenic molecules that activate γδ T cells are still largely unknown. However, γδ T cells are believed to have a prominent role in recognition of lipid antigens. See also Natural Killer T Cells, Natural Killer (NK) Cells.
These lipid and glycolipid antigens include naturally occurring foreign glycolipids from intracellular pathogens and synthetic glycolipids that are related in structure to mammalian glycolipids. The portals and pockets of CD1 antigen-binding grooves influence ligand specificity and facilitate presentation of a surprisingly diverse set of antigenic lipids, glycolipids, lipopeptides and even some small, non-lipidic molecules. Presentation of antigens by CD1 proteins requires uptake and intracellular processing by APCs. There is evidence for the existence of cellular pathways that lead to presentation of both exogenous and endogenous lipid antigens
Antiphospholipid syndrome
The first report on antiphospholipids was made by Wasserman in 1906 and concerned anticardiolipin antibodies in patients with syphilis. Plasma-containing proteins that prolonged phospholipid-dependent in vitro clotting assays were first described in patients with systemic lupus erythematosus (SLE) in 1952. Further addition of phospholipids to that assay system appeared to neutralize the lupus anticoagulant (LA) reaction. SLE is a disease of unknown cause in which tissues and cells are damaged by pathogenic autoantibodies and immune complexes. The malar (“butterfly”) rash is a fixed, flat or raised erythematous rash over the cheeks and bridge of the nose and can involve the chin and ears. Most SLE patients experience arthritis, glomerulonephritis and central nervous system manifestations. Anaemia is observed in most SLE patients when the disease is active.
Antiglycolipid syndrome
Gangliosides, which are important constituents of the plasma membrane, are particularly abundant in the nervous system. Autoantibodies to gangliosides are found in the serum of patients with several neurological disorders such as Guillain-Barre syndrome (GBS), Fisher syndrome, sensory ataxic neuropathy and multifocal motor neuropathy. Anti-ganglioside (GD1, GM1, GQ1) and –sulfatide antibodies have been reported in these disorders. Of note, GBS and Fisher syndrome often occur after Campylobacter jejuni infections The GM1 epitope is present in LPS of the Penner 19 type, and the specific serotype Penner 19 is frequently isolated from patients with GBS. Campylobacter jejuni can be serotyped by differences in the carbohydrate structure of its LPS, which is a major constituent of the outer membrane of Gram-negative bacteria.
Guillain-Barré syndrome subsequent to Mycoplasma pneumoniae infection has also been reported to be present in GBS patients with preceding M. pneumoniae infection. Anti-Galactosylceramide (Anti-GalCer) antibody reactivity is present in GBS patients. There was a report of a patient with GBS after M. pneumoniae infection who had serum IgG antibodies to GM1b ganglioside as well as to the cold agglutinins. The cold agglutinins are polyclonal IgM autoantibodies to the I antigen of erythrocytes.
Blood group antigens
ABO blood group substances from erythrocytes were shown to be glycolipid antigens in 1965. Biochemical studies have demonstrated that many important blood group antigens are complex carbohydrates. The biosynthetic pathways that form antigens in the ABH (ABO), Lewis, P and I blood group systems are interrelated. These oligosaccharide antigens may exist free in solution. In addition, they may be covalently attached to lipid molecules (ceramide) to form glycosphingolipids. They may also be attached to polypeptides to form mucins, integral membrane glycoproteins or soluble glycoproteins.
The immune response to carbohydrate antigens, particularly when presented as repetitive epitopes, is usually independent of the thymus. In this case, multivalent antigens directly stimulate B cells to synthesize antibodies without the aid of helper T cells. Thymus-independent immune responses classically result in production of IgM antibodies. Most antibodies to carbohydrate blood group antigens are, in fact, IgM. Surprisingly, individuals lacking a carbohydrate blood group antigen on their red cells often have "naturally occurring" IgM antibodies to blood group antigens in their serum. The current understanding of this phenomenon is not that these antibodies spontaneously arise without previous antigenic stimulation. Rather, the understanding is that cross-reacting antigens are present in the environment, such as with gut bacteria, and stimulate specific IgM production.
In contrast, high-titres of IgG antibodies to carbohydrate antigens can be found in some individuals. Production of these antibodies may be stimulated by thymus-dependent forms of oligosaccharide, perhaps as individual epitopes on glycoproteins. In this way T-cells help to create a switch from production of IgM to IgG isotypes. This isotype-switching phenomenon is not yet clearly understood.
Forssman antigens have been identified from red blood cells, and are mainly responsible for haemolysis of sheep erythrocytes in the presence of globoside antiserum and complement components. The P blood group system consists of three glycosphingolipid antigens: P, P1 and pk. After microbial infection, antibodies against P antigen cause haemolysis and anaemia. The P and pk antigens have been identified as globoside and trihexosyl ceramide, respectively.
Antibodies specific for the I antigens are clinically relevant in cold-type autoimmune haemolytic anaemia. Patients with infectious diseases such as infectious mononucleosis and M. pneumoniae often develop cold agglutinins to anti-i and anti-I specificity, respectively.
Tumour-specific antigens
Tumour-associated glycosphingolipids have attracted a great deal of interest in tumour research, particularly with regard to the potential role of tumour-associated glycosphingolipid antigens as targets for monoclonal antibodies in diagnosis and therapy of tumours. The role of glycosphingolipids has not been fully elucidated, but it has been suggested that they are involved in cellular events that may play an important biological role in tumour cell growth and in the invasive and metastatic properties of cancerous tumours (Matsuda et al., 1993).
Microbial lipid antigens
Basically, Gram-negative bacteria contain LPS anchored by lipid A. LTA structures are present in Gram-positive bacteria, Mycoplasma, Treponema and some Gram-negative bacteriaThe lipid antigens of bacterial cell walls have adjuvant effects and specific immunogenicities that induce immune responses.
Human-related Mycoplasma Lipid-antigen ELISA
Mycoplasma lipid-antigens as biomarkers and vaccines
Why early diagnosis of Mycoplasma pneumoniae-infection is desired?
- First causative bacteria of acute bronchitis (LRTI)
- Third causative agent of pneumonia
- In every day practice the etiology of CAP is unknown in up to 70% of patients.
- Diagnosis of acute infections remains difficult.
- However, non-reliable epidemiological data because of the diagnostic problem
- To select antibiotics for lower respiratory infection (LRTI) or CAP
- To diagnose extrapulmonary manifestations, chronic and mycoplasma-related diseases
- Mycoplasma pneumoniae infection sometimes associated with serious illness.
- Because of the global spread of antimicrobial (macrolide-lincosamide) resistance is a current problem.
- Wide spreading nature because of the prolonged cough in schools, hospitals etc.
- Early diagnosis is desired also from the viewpoint of medical economics.
What is Mycoplasma pneumoniae?
- a leading pathogen of both upper and lower human respiratory infections (URTI and LRTI) , in all age groups.
- known as the cause of “primary atypical pneumonia” or “community-acquired pneumonia (CAP)”.
Epidermology mycoplasma pneumonia
- National Institute of Infectious Diseases (Japan)
- IDWR(Infectious Diseases Weekly Report)
- Weekly reported cases per sentinel in comparison with past 10 years
- Incidence : Each Year an estimated 1 million cases and, this year 4-5 million cases
- Center for Disease Control and Prevention (CDC) (USA)
- Home page > Disease Listing
- Each Year an estimated 2 million cases and 100,000 pneumonia-related hospitalizations occur in the United States.
- Trend : Unknown. However with improved diagnostic testing, more cases may be identified.
Landscape of Mycoplasma pneumoniae infectious diseases
Mycoplasma pneumoniae infectious diseases is not only respiratory diseases, but also diseases of the whole body. Mycoplasma pneumonia is frequently associated with extra pulmonary manifestations such as encephalitis.
Mccoplasma infection is an exacerbating factor for asthma/COPD.
Mycoplasma pneumonia is sometimes accompanied by other clinical syndromes:
Stevens-Johnson syndrome, nephritis (including IgA nephritis), autoimmune
haemolytic anaemia, meningoencephalitis, GBS and acute psychosis (Mycoplasma
related diseases) Mycoplasma pneumoniae infection causes wide variety of
disease such as asthma, neurological disorders, and arthritis. In particular,
for diseases with rather chronic nature such as asthma or arthritis.
Why a reliable methodology for early diagnosis of Mycoplasma pneumoniae-infection
is desired?
Diagnosis of Mycoplamsa infection is still not easy practically. Therefore, a reliable methodology being able to definitely exclude the infection by M. pneumoniae with higher specificity has been desired.
- For the selection of the correct antibiotics
- To see the effect of antibiotics
- To reveal the landscape of mycoplasma infection
- For the reliable epidemiological study
- What performance is desired?
- As early as possible: sensitive and specific
- Able to see the clinical course: quantitative
What are tha problems of diagnosis?
Molecular detection method such as polymerase chain reaction (PCR) was expected to be a promising tool for the rapid diagnosis of M. pneumoniae infection and has been shown to be sufficiently sensitive and specific. However, there are some limitations for the routine use of this methodology in clinical practice; molecular detection requires DNA extraction and therefore, is not suitable for routine diagnostic laboratories, in addition to that, its sensitivity is dependent on the sample type and PCR inhibitors contained in the sample. So, even when a result of PCR is negative, it does not always mean that the patient is not infected with M. pneumoniae.
Another important point is that molecular detection cannot distinguish
between infection and colonization.
The condition of the respiratory tract sample does nor reflect the clinical state, because Mycoplasma pneumoniae infections is not only respiratory diseases, but also diseases of the whole body.
In this respect, serology reflects the systemic reaction for M. pneumoniae
infection (Beersma, 2005)(Dorigo-Zetsma, 1999). The diagnosis of M. pneumoniae
infection, therefore, should be usually based on serology .
The current problems in serological methods
Serological methods usually include cold agglutination, complement fixation,
PA, and ELISA.
The PA test is the most widely method used in Japan because it is easy to perform and gives semi-quantitative results with acceptable sensitivity. However, the there is some ambiguity in the visual interpretation for agglutination. The PA test is not able to distinguish between IgM and IgG class.
To distinguish clearly current infection from past infection (clinical course), there has been a need for ELISA system to detect IgM, IgG, and IgA class antibodies separately.
Problem is the quality of antigens to detect anti-M. pneumoniae antibodies. However, also suffer from a problems arising from the nature of extracted antigens and non-specific reactions; the antigenicity of cellular extracts may different from each not be completely uniform in nature among lots of culture.
How the problems could be overcome?
The quality of Antigens is important.
These conventional methods suffer from relatively low specificity of antigens
because the antigens used are derived from partially purified extracts
from mass cultured mycoplasma cells.
We focused on the small antigenic molecules of mycoplasmas, which are derived
from the M. pneumoniae cell membrane component and functions as a major
immunodeterminant.
What is Mycoplasma lipid-antigens?
Cold agglutinin antibodies are found in the serum of as many as 70% of
patients with mycoplasma pneumonia. The immunogenicity of M. pneumoniae
is thought to be mainly due to membrane glycolipids.
The antigens of compliment fixation test (CF) are lipid antigens extracted
from mycoplasma. CF is reflect the condition of adult mycoplasma infection
, and related to IgG. However, t has been described that non-specific reactions,
therefore, leading to the low specificity.
Because the mycoplasma lipid-antigens have both carbohydrates as specific
antigens for antibody-mediated immunity (humoral immunity) and lipid-antigen
presentation (cellular immunity) specific characteristics, it is expected
that these lipid-antigens could be used as therapeutic drugs.
Mycrobial lipid-antigens
Microbial cell walls containing glycolipids and phospholipids are rich
in antigens, which are mainly located on the surface of microbial cell
membranes.
Microbial antigens predominantly acting on antigen presentation machinery,
and have a profound adjuvant effect on the immune response. This may further
be linked to an intracellular trafficking pathway thought to be presented
by CD1 to the specific populations of T cells.
Microbial lipid antigens, such as LPS (endotoxin), LTAs, lipoarabinomannan (LAM) and mycoplasma lipid antigens, have activities to stimulate the immune system. These lipid antigens exert a wide variety of biological effects in humans, and are also called immunostimulants (immunomodulators).
Too complex to utilize usually
Microbial cell walls containing glycolipids and phospholipids are rich
in antigens, which are mainly located on the surface of microbial cell
membranes. Microbial antigens predominantly acting on antigen presentation
machinery through its ligation of Toll-like receptor, which have a profound
adjuvant effect on the immune response. This may further be linked to an
intracellular trafficking pathway thought to be presented by CD1 to the
specific populations of T cells.
Microbial lipid antigens, such as LPS (endotoxin), LTAs, lipoarabinomannan
(LAM) and mycoplasma lipid antigens, have activities to stimulate the immune
system. These lipid antigens exert a wide variety of biological effects
in humans, and are also called immunostimulants (immunomodulators).
Chemically synthesized natural compounds or derivatives are expected as
a potential antigens and/or adjuvants for vaccine development. Synthesized
Lipid A, monophosphoryl lipid A (MPL), is one of such compounds, although
is not completely same as natural compounds. Conversely, the chemically
synthesized mycoplasma lipid antigen is distinguishable, because it is
completely same as natural compound. Since the lipid antigen is a specific
antigen for both humoral immunity and cellular immunity, it is expected
to be a promising strategy to develop a novel generation vaccine.
Here, it is focused on the lipid antigens of human pathogenic bacteria. Basically, Gram-negative bacteria contain LPS anchored by lipid A. LTA structures are present in Gram-positive bacteria, Mycoplasma, Treponema and some Gram-negative bacteria. The lipid antigens of bacterial cell walls have adjuvant effects and specific immunogenicities that induce immune responses.
Mycoplasma lipid-antigens
Mycoplasma pneumoniae lipid-antigen –GGLs : GGL Glc-type and GGL Gal-type
M. fermentans has lipid-antigens –GGPLs: GGPL-I and GGPL-III
Encyclopedia of Life Science
Patents
It is thought that the lipid antigens of the cell membrane of mycoplasmas play an important role in the immune response, and that the cell membrane is in direct contact with the external world. The proteins and lipids of mycoplasma membranes are the main immunogens and antigens that are recognized by anti-mycoplasma sera. Both proteins and lipids play a major role in growth and metabolic inhibition tests for mycoplasmas. Glycolipids play a main role in the assay for the M. pneumoniae and M. fermentans complement binding assays.
As a solution to the problem of a lack of antigen, small antigenic molecules
of mycoplasmas have been found to be lipid-antigens. The structures of
the mycoplasma lipid-antigens were then determined and chemically synthesized.
M. fermentans has specific lipid-antigens called GGPL-I and GGPL-III, and
M. pneumoniae also has specific lipid-antigen GGL moieties (Matsuda et
al., 1994; Matsuda et al., 1997; Nishida et al., 1999; Nishida et al.,
1999; Miyachi et al., 2009). The complete structures of the immunodeterminants
of glycolipid antigens have been determined using instrumental analyses
including nuclear magnetic resonance, mass spectrometry and chemical syntheses.
Mycoplasma pneumoniae lipid-antigen GGLs (GGL Gal-type and GGL Glc-type)
M. pneumoniae is a leading pathogen of both upper and lower human respiratory infections. Mycoplasma pneumonia, known as the cause of “primary atypical pneumonia”, is sometimes accompanied by other clinical syndromes: Stevens-Johnson syndrome, nephritis (including IgA nephritis), autoimmune haemolytic anaemia, meningoencephalitis, GBS and acute psychosis. Cold agglutinin anti-I antibodies are found in the serum of as many as 70% of patients with mycoplasma pneumonia. The immunogenicity of M. pneumoniae is thought to be mainly due to membrane glycolipids. See also Molecular Mimicry.
Mycoplasma lipid-antigens are useful biomarkers for induced levels of antibodies,
and are superior in specificity and sensitivity to conventional biomarkers.
Mycoplasma fermentans lipid-antigen phosphocholine-containing glycoglycerolipids (GGPL).
Recently, evidence has accumulated that M. fermentans is a pathogen of
rheumatoid arthritis (RA). M. fermentans has frequently been isolated from
the synovial fluid of patients with rheumatoid arthritis, and exhibits
agglutinating activity towards erythrocytes. Moreover, M. fermentans has
been shown to induce experimental arthritis in rabbits following inoculation
of the trachea and knee joint (Rivera et al., 2002). GGPL, which have strong
antigenicity and are species-specific immunological determinants of M.
fermentans (Matsuda et al., 1997b), surprisingly have characteristic phosphocholine-containing
glycoglycerolipids and can be clearly distinguished from other human related
mycoplasma species through lipid analysis. Phylogenetic data strongly support
the notion that mycoplasma species evolved from ancestors that are common
to Gram-positive bacteria. This potential relationship suggests that it
would be interesting to examine the distribution of GGPL in other microorganisms,
as these lipid antigens are synthesized with specific enzymes (Fujiwara
et al., 2010; Ishida et al., 2009).
GGL Glc-type lipid-antigen ELISA
Early diagnosis of Mycoplasma pneumonie infection is important to prevent
because of the appearance of antibiotics resistant mycoplasma, and also
from the viewpoint of medical economics.
New ELISA which utilize chemically synthesized mycoplasma species-specific
lipid-antigen (anti- GGL Glc-type ELISAs ) are superior to conventional
methods.
In child patients, the anti-GGL Glc-type ELISA (IgM ) is much more suitable
for the rapid early diagnosis of M pneumoniae infection than currently
available conventional serological methods, and also anti-GGL Glc-type
ELISA (IgG ) reflect the status of infection.
In adult patients, the anti-GGL Glc-type ELISAs (IgM /IgG/IgA) are available to diagnose Mycoplasma pneumoniae infection suitable for the early diagnosis of M pneumoniae infection and follow the clinical course quantitatively
The anti-GGL Glc-type ELISAs enable the studies for the links to chronic diseases, extrapulmonary diseases, and possibly M. pneumoniae infection-related disease, such as asthma rheumatoid arthritis.
Mycoplasma fermentans glycolipid-antigen as a pathogen of rheumatoid arthritis.
Mycoplasma fermentans has been suspected as one of the causative pathogenic microorganisms of rheumatoid arthritis (RA) however, the pathogenic mechanism is still unclear. We, previously, reported that glycolipid-antigens (GGPL-I and III) are the major antigens of M. fermentans. Monoclonal antibody against the GGPL-III could detect the existence of the GGPL-III antigens in synovial tissues from RA patients. GGPL-III antigens were detected in 38.1% (32/84) of RA patient's tissues, but not in osteoarthritis (OA) and normal synovial tissues. Immunoelectron microscopy revealed that a part of GGPL-III antigens are located at endoplasmic reticulum. GGPL-III significantly induced TNF-alpha and IL-6 production from peripheral blood mononulear cells, and also proliferation of synovial fibroblasts. Further study is necessary to prove that M. fermentans is a causative microorganism of RA; however, the new mechanisms of disease pathogenesis provides hope for the development of effective and safe immunotherapeutic strategies based on the lipid-antigen, GGPL-III, in the near future.
Biochem Biophys Res Commun. 2008 May 2;369(2):561-6. Epub 2008 Feb 26.
Mycoplasma lipid-antigens as immunoregulators in autoimmune diseases
For the study of the innate immune response in infectious diseases and
autoimmunity, as well as tumors, natural killer T (NKT) cells have become
a major focus. Recognizing phospholipid and glycolipid antigens presented
by CD1 molecules the novel T lymphocytes produce both Th1 and Th2 cytokines.
Most mouse and human B cells express CD1d. Interactions between CD1d expressed
on B cells and CD1d-restricted T cells may play a role in determining amount,
isotype, and specificity of the antibodies produced.
Mycoplasmas have been reported as pathogens of autoimmune diseases, rheumatic diseases, asthma, neurological disorders, so on. Anti-glycolipid, such as Gal-cer, antibodies are reported to be present in the patients of autoimmune diseases with preceding mycoplasma infection. Mycoplasma lipid-antigens induce anti-mycoplasma antibodies, and they also act as autoantibodies. We have succeeded to determine the structures of the lipid-antigens, and revealed molecular mimicry. These lipid-antigens may be useful for the analysis of the signaling mechanism bridging innate and acquired immunity.
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