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Topic:Immune Response

The immune response in horses involves a complex network of cells, tissues, and molecules that work together to protect the animal from pathogens and other harmful agents. This process includes both innate and adaptive immune mechanisms. Innate immunity provides the first line of defense and involves components such as physical barriers, phagocytic cells, and the complement system. Adaptive immunity, on the other hand, is characterized by the activation of lymphocytes and the production of antibodies, which provide a targeted response to specific antigens. Key components of the equine immune system include T cells, B cells, and various cytokines that facilitate communication between immune cells. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, regulation, and implications of immune responses in equine health.
Altered expression of talin 1 in peripheral immune cells points to a significant role of the innate immune system in spontaneous autoimmune uveitis.
Journal of proteomics    January 28, 2012   Volume 75, Issue 14 4536-4544 doi: 10.1016/j.jprot.2012.01.023
Degroote RL, Hauck SM, Kremmer E, Amann B, Ueffing M, Deeg CA.The molecular mechanism which enables activated immune cells to cross the blood-retinal barrier in spontaneous autoimmune uveitis is yet to be unraveled. Equine recurrent uveitis is the only spontaneous animal model allowing us to investigate the autoimmune mediated transformation of leukocytes in the course of this sight threatening disease. Hypothesizing that peripheral blood immune cells change their protein expression pattern in spontaneous autoimmune uveitis, we used DIGE to detect proteins with altered abundance comparing peripheral immune cells of healthy and ERU diseased horses. Among ...
Equine influenza supplement.
Australian veterinary journal    January 20, 2012   Volume 90, Issue 1-2 3 doi: 10.1111/j.1751-0813.2011.00888.x
Jacobs K.No abstract available
Clinical and virological outcome of an infection with the Belgian equine arteritis virus strain 08P178.
Veterinary microbiology    January 18, 2012   Volume 157, Issue 3-4 333-344 doi: 10.1016/j.vetmic.2012.01.014
Vairo S, Vandekerckhove A, Steukers L, Glorieux S, Van den Broeck W, Nauwynck H.Equine viral arteritis (EVA) is an infectious disease with variable clinical outcome. Outbreaks, causing important economic losses, are becoming more frequent. Currently, there is a shortage of pathogenesis studies performed with European strains. In the present study, eight seronegative ponies were experimentally inoculated with the Belgian strain of equine arteritis virus (EAV) 08P178 (EU-1 clade) and monitored daily for clinical signs of EVA. Nasopharyngeal swabs, ocular swabs, bronchoalveolar cells and blood were collected for virological and serological testing. Two ponies were euthanized...
Maintaining health in foals: the role of colostrum constituents.
The Veterinary record    January 17, 2012   Volume 170, Issue 2 49-50 doi: 10.1136/vr.e187
Davis E.No abstract available
Inflammation and immune response of intra-articular serotype 2 adeno-associated virus or adenovirus vectors in a large animal model.
Arthritis    January 11, 2012   Volume 2012 735472 doi: 10.1155/2012/735472
Ishihara A, Bartlett JS, Bertone AL.Intra-articular gene therapy has potential for the treatment of osteoarthritis and rheumatoid arthritis. To quantify in vitro relative gene transduction, equine chondrocytes and synovial cells were treated with adenovirus vectors (Ad), serotype 2 adeno-associated virus vectors (rAAV2), or self-complementary (sc) AAV2 vectors carrying green fluorescent protein (GFP). Using 6 horses, bilateral metacarpophalangeal joints were injected with Ad, rAAV2, or scAAV2 vectors carrying GFP genes to assess the in vivo joint inflammation and neutralizing antibody (NAb) titer in serum and joint fluid. In vit...
Effect of corticotherapy on proteomics of endometrial fluid from mares susceptible to persistent postbreeding endometritis.
Theriogenology    January 5, 2012   Volume 77, Issue 7 1351-1359 doi: 10.1016/j.theriogenology.2011.10.042
Wolf CA, Maslchitzky E, Gregory RM, Jobim MI, Mattos RC.The objective was to determine the effects of corticotherapy, in the presence and absence of uterine inflammation, on proteomics of endometrial fluid from mares susceptible to endometritis. In 11 mares, estrus was induced seven times with 5 mg PGF(2α) given at 14-day intervals. The first estrus was a control (no treatment). During the third estrus, mares received glucocorticoid (GC) treatment (20 mg isoflupredone acetate) every 12 h, for three consecutive days. The fifth estrus was the Infected treatment (intrauterine infusion of 1 × 10(9) colony-forming unit/mL Streptococcus equi subspecies...
Immunological correlates of vaccination and infection for equine herpesvirus 1.
Clinical and vaccine immunology : CVI    December 28, 2011   Volume 19, Issue 2 235-241 doi: 10.1128/CVI.05522-11
Goodman LB, Wimer C, Dubovi EJ, Gold C, Wagner B.Equine herpesvirus 1 (EHV-1) induces a variety of disease manifestations, including respiratory disease, abortions, and myeloencephalopathy. Several vaccines are commercially available but could not previously be distinguished by serologic testing from infection with EHV-1 (or the closely related EHV-4). Currently available vaccines are not reliably protective against the severe manifestations of the disease, including fatal myeloencephalopathy. We determined immunological parameters that can differentiate vaccinated from previously infected animals by comparing humoral and cellular EHV-1-spec...
Effect of progesterone on the in vitro response of peripheral blood mononuclear cells stimulated by Escherichia coli in mares.
The Journal of veterinary medical science    December 13, 2011   Volume 74, Issue 5 629-632 doi: 10.1292/jvms.11-0364
Maeda Y, Ohtsuka H, Tomioka M, Tanabe T, Nambo Y, Uematsu H, Oikawa MA.Escherichia coli(E. coli) isolated from the uterus of a Thoroughbred mare with bacterial endometritis was used to evaluate the effect of progesterone (P(4)) on the immune response of mares. Peripheral blood mononuclear cells (PBMCs) were collected from 10 nonpregnant clinically healthy adult mares (range, 4-12 years) during diestrus, four Thoroughbreds and six Hokkaido native horses. Cell proliferation and expression of cytokine mRNA, including interferon (IFN)-γ, tumor necrosis factor (TNF)-α and interleukin (IL)-10, of PBMCs stimulated with E. coli and P(4) were examined in vitro. P(4) was...
Assessment of correlation between in vitro CD3+ T cell susceptibility to EAV infection and clinical outcome following experimental infection.
Veterinary microbiology    December 2, 2011   Volume 157, Issue 1-2 220-225 doi: 10.1016/j.vetmic.2011.11.031
Go YY, Cook RF, Fulgêncio JQ, Campos JR, Henney P, Timoney PJ, Horohov DW, Balasuriya UB.In a recent study, we demonstrated that the virulent Bucyrus strain (VBS) of EAV could infect in vitro a small population of CD3(+) T lymphocytes from some but not all horses. Furthermore, we have shown that a common haplotype is associated with this in vitro CD3(+) T cell susceptibility/resistance phenotype to EAV infection. In this study, we investigated whether the differences in the susceptibility or resistance of CD3(+) T cells in vitro correlate with the outcome and severity of clinical signs in vivo. Thus, horses were divided into two groups based on their CD3(+) T cell susceptible or r...
Comparison of the response to experimentally induced short-term inflammation in the temporomandibular and metacarpophalangeal joints of horses.
American journal of veterinary research    December 1, 2011   Volume 72, Issue 12 1586-1591 doi: 10.2460/ajvr.72.12.1586
Carmalt JL, Bell CD, Tatarniuk DM, Suri SS, Singh B, Waldner C.To investigate the relationship between inflammatory responses of the temporomandibular joint (TMJ) and the metacarpophalangeal (MCP) joint in clinically normal horses. Methods: 7 mature horses. Methods: In each horse, 1 TMJ and 1 MCP joint were injected with lipopolysaccharide (LPS; 0.0025 μg). The contralateral TMJ and MCP joint were injected with saline (0.9% NaCl) solution. Synovial fluid samples were collected from all 4 joints over 24 hours after injection. Concentrations of interleukin-6, tumor necrosis factor-α, transforming growth factor-β, and total protein were measured via immun...
ISCOM-matrix-based equine influenza (EIV) vaccine stimulates cell-mediated immunity in the horse.
Veterinary immunology and immunopathology    November 26, 2011   Volume 145, Issue 1-2 516-521 doi: 10.1016/j.vetimm.2011.11.019
Paillot R, Prowse L.The humoral immune response induced by ISCOM-matrix (Immuno Stimulating COMplex-Matrix)-adjuvanted equine influenza virus (EIV) vaccine is well documented in horses. ISCOM-matrix adjuvanted vaccines against human influenza are strong inducers of cell-mediated immunity (CMI), including T cell proliferation and virus-specific cytotoxic T cell. In the horse, the CMI response to equine influenza vaccination is less well characterised. An ISCOM-based vaccine has been shown to induce interferon gamma (IFN-γ) synthesis, a CMI marker, in the horse, but this has not been shown for the ISCOM-matrix vac...
Neutrophil function of neonatal foals is enhanced in vitro by CpG oligodeoxynucleotide stimulation.
Veterinary immunology and immunopathology    November 25, 2011   Volume 145, Issue 1-2 290-297 doi: 10.1016/j.vetimm.2011.11.012
Bordin AI, Liu M, Nerren JR, Buntain SL, Brake CN, Kogut MH, Cohen ND.Rhodococcus equi is an intracellular bacterium that causes pneumonia in foals and immunocompromised adult horses. Evidence exists that foals become infected with R. equi early in life, a period when innate immune responses are critically important for protection against infection. Neutrophils are innate immune cells that play a key role in defense against this bacterium. Enhancing neutrophil function during early life could thus help to protect foals against R. equi infection. The objective of our study was to determine whether in vitro incubation with the TLR9 agonist CpG 2142 would enhance d...
Neutrophil and cytokine dysregulation in hyperinsulinemic obese horses.
Veterinary immunology and immunopathology    November 25, 2011   Volume 145, Issue 1-2 283-289 doi: 10.1016/j.vetimm.2011.11.013
Holbrook TC, Tipton T, McFarlane D.Equine metabolic syndrome is characterized by obesity and regional adiposity coupled with evidence of recurrent laminitis. Although inflammation has been well characterized in several experimental models of acute laminitis, the inflammatory events associated with endocrinopathic laminitis are not well documented. The aim of this study was to characterize selected markers of inflammation in horses with clinical evidence of equine metabolic syndrome (EMS). Neutrophil phagocytosis and oxidative burst, as well as endogenous and stimulated cytokine expression were evaluated. A marked increase in ne...
Pulmonary inflammation due to exercise-induced pulmonary haemorrhage in Thoroughbred colts during race training.
Veterinary journal (London, England : 1997)    November 24, 2011   Volume 190, Issue 2 e3-e6 doi: 10.1016/j.tvjl.2010.08.009
Michelotto PV, Muehlmann LA, Zanatta AL, Bieberbach EWR, Kryczyk M, Fernandes LC, Nishiyama A.This study investigated the putative roles of inflammation and platelet-activating factor (PAF) in exercise-induced pulmonary haemorrhage (EIPH). Two-year-old Thoroughbred colts (n=37) were exercised on a racetrack for 5months before commencement of the study. Each colt was then exercised at 15-16m/s over 800-1000m and broncho-alveolar lavage fluid (BALF) was collected 24h later. The colts were subsequently divided into two groups on the basis of BALF analysis; an EIPH-positive group (presence of haemosiderophages, n=23) and an EIPH-negative group (absence of haemosiderophages, n=14). BALF fro...
Modulation of equine neutrophil adherence and migration by the annexin-1 derived N-terminal peptide, Ac2-26.
Veterinary immunology and immunopathology    November 19, 2011   Volume 145, Issue 1-2 214-222 doi: 10.1016/j.vetimm.2011.11.011
Brooks AC, Rickards KJ, Cunningham FM.Neutrophil activation, whilst a key component of host defence, must be tightly regulated in order to avoid an inappropriate cellular response. Annexin-1, which is present in large amounts in neutrophils, and its N-terminal peptides, reduce neutrophil accumulation but annexin peptides have also been shown to exhibit neutrophil activating properties. We have recently shown annexin-1 to be present in equine neutrophils and demonstrated that the annexin-1-derived peptide, Ac2-26, can both reduce superoxide production by these cells in response to other stimuli and directly induce free radical prod...
Oral rosmarinic acid-enhanced Mentha spicata modulates synovial fluid biomarkers of inflammation in horses challenged with intra-articular LPS.
Journal of veterinary pharmacology and therapeutics    November 9, 2011   Volume 35, Issue 5 495-502 doi: 10.1111/j.1365-2885.2011.01343.x
Pearson W, Fletcher RS, Kott LS.A biological extract of high-rosmarinic acid mint (HRAM) has previously demonstrated inhibitory effects on lipopolysaccharide (LPS)-induced prostaglandin E(2) (PGE(2)), nitric oxide (NO) and glycosaminoglycan (GAG) release in vitro. This study was undertaken to determine whether HRAM added to feed produces similar effects in horses challenged with intra-articular LPS. Eight horses received HRAM (0 or 28.1 ± 1.3 g/day; n = 4 per group) in their feed for 24 days in a blinded manner. On day 21, all horses received an intra-articular injection of LPS (0.3 ng) into their left or right intercarpal ...
The role of proliferation in the regulation of interferon gamma (IFNγ) expression in foals.
Developmental and comparative immunology    November 4, 2011   Volume 36, Issue 3 534-539 doi: 10.1016/j.dci.2011.09.009
Sun L, Adams AA, Betancourt A, Stewart JC, Liu C, Horohov DW.Interferon-gamma (IFNγ) plays an important role against viral and intracellular bacterial infections and its production is deficient in foals. Cellular proliferation provides an opportunity for de novo gene expression, though little is known about its role in regulating IFNγ expression in foals. While stimulation of foal peripheral blood mononuclear cells (PBMCs) with concanavalin A (ConA) increased the frequency of IFNγ(+) cells, the overall percentage of IFNγ(+) cells remained below that of adults. By contrast, the proliferative response of foal PBMC was significantly greater than that o...
Protective effects of passively transferred merozoite-specific antibodies against Theileria equi in horses with severe combined immunodeficiency.
Clinical and vaccine immunology : CVI    October 28, 2011   Volume 19, Issue 1 100-104 doi: 10.1128/CVI.05301-11
Mealey RH, Kappmeyer LS, Ueti MW, Wagner B, Knowles DP.Theileria equi immune plasma was infused into young horses (foals) with severe combined immunodeficiency. Although all foals became infected following intravenous challenge with homologous T. equi merozoite stabilate, delayed time to peak parasitemia occurred. Protective effects were associated with a predominance of passively transferred merozoite-specific IgG3.
Transfer of tumour necrosis factor-α via colostrum to foals.
The Veterinary record    October 25, 2011   Volume 170, Issue 2 51 doi: 10.1136/vr.100220
Secor EJ, Matychak MB, Felippe MJ.This study aimed to determine whether TNF-α is transferred to equine neonates via colostrum and the relationship between TNF-α and IgG concentrations in the equine neonate. Colostrum, presuckle and postsuckle foal serum samples were collected from healthy mares and their foals. Equine TNF-α ELISA and IgG SRID kits were used to determine the concentrations of TNF-α and IgG, respectively. Statistical analysis was performed using the Spearman rank correlation. TNF-α concentrations in all presuckle foal serum were below the limit of detection in 15/16 foals and increased in postsuckle foal se...
MyD88-dependent recruitment of monocytes and dendritic cells required for protection from pulmonary Burkholderia mallei infection.
Infection and immunity    October 24, 2011   Volume 80, Issue 1 110-120 doi: 10.1128/IAI.05819-11
Goodyear A, Troyer R, Bielefeldt-Ohmann H, Dow S.The Gram-negative bacterium Burkholderia mallei causes rapidly fatal illness in equines and humans when contracted by inhalation and also has the potential to be used as a bioweapon. However, little is known regarding the early innate immune responses and signaling mechanisms required to generate protection from pneumonic B. mallei infection. We showed previously that monocyte chemoattractant protein 1 (MCP-1) was a critical chemokine required for protection from pneumonic B. mallei infection. We have now extended those studies to identify key Toll-like receptor (TLR) signaling pathways, effec...
Mucosal co-immunization of mice with recombinant lactococci secreting VapA antigen and leptin elicits a protective immune response against Rhodococcus equi infection.
Vaccine    October 20, 2011   Volume 30, Issue 1 95-102 doi: 10.1016/j.vaccine.2011.10.026
Cauchard S, Bermúdez-Humarán LG, Blugeon S, Laugier C, Langella P, Cauchard J.Rhodococcus equi causes severe pneumonia in foals and has recently gained attention as a significant opportunistic pathogen in immunocompromised humans. However, no effective vaccine to prevent rhodococcosis is currently available. In this study, we have engineered the food-grade bacterium Lactococcus lactis to secrete the virulence-associated protein A from R. equi (LL-VapA). The immunogenic potential of LL-VapA strain was then evaluated after either intragastric or intranasal immunization in mice either alone or in combination with LL-Lep, a recombinant strain of L. lactis secreting biologic...
Genome-wide association study among four horse breeds identifies a common haplotype associated with in vitro CD3+ T cell susceptibility/resistance to equine arteritis virus infection.
Journal of virology    October 12, 2011   Volume 85, Issue 24 13174-13184 doi: 10.1128/JVI.06068-11
Go YY, Bailey E, Cook DG, Coleman SJ, Macleod JN, Chen KC, Timoney PJ, Balasuriya UB.Previously, we have shown that horses could be divided into susceptible and resistant groups based on an in vitro assay using dual-color flow cytometric analysis of CD3+ T cells infected with equine arteritis virus (EAV). Here, we demonstrate that the differences in in vitro susceptibility of equine CD3+ T lymphocytes to EAV infection have a genetic basis. To investigate the possible hereditary basis for this trait, we conducted a genome-wide association study (GWAS) to compare susceptible and resistant phenotypes. Testing of 267 DNA samples from four horse breeds that had a susceptible or a r...
Characterization of cytokines associated with Th17 cells in the eyes of horses with recurrent uveitis.
Veterinary ophthalmology    October 7, 2011   Volume 15, Issue 3 145-152 doi: 10.1111/j.1463-5224.2011.00951.x
Regan DP, Aarnio MC, Davis WS, Carmichael KP, Vandenplas ML, Lauderdale JD, Moore PA.Equine recurrent uveitis (ERU) is a spontaneous disease that is the most common cause of blindness in horses, affecting up to 15% of the horse population. Th17 cells are a major cell population driving the pathogenesis in several mouse models of autoimmune inflammation, including experimental autoimmune uveitis. The purpose of this study is to investigate the role a Th17 cell-mediated response plays in the pathogenesis of ERU. Methods: Banked, Davidson's-fixed equine globes histopathologically diagnosed with ERU (n = 7) were compared immunohistochemically with healthy control globes (n = 7). I...
A comparison of antibody responses to commercial equine influenza vaccines following primary vaccination of Thoroughbred weanlings–a randomised blind study.
Vaccine    October 5, 2011   Volume 29, Issue 49 9214-9223 doi: 10.1016/j.vaccine.2011.09.101
Gildea S, Arkins S, Walsh C, Cullinane A.Many racing authorities, sales companies and equestrian bodies have mandatory vaccination policies for equine influenza (EI). The consequences of lack of vaccine efficacy include clinical disease, disruption to training programmes, the cancellation of equestrian events and the introduction of virus to susceptible populations. The correlation between antibody against the virus haemagglutinin and protection against influenza has been well established. The objective of this study was to compare the antibody responses of 66 unvaccinated Thoroughbred weanlings on four different stud farms, followin...
Pathogen associated molecular pattern motifs from Gram-positive and Gram-negative bacteria induce different inflammatory mediator profiles in equine blood.
Veterinary journal (London, England : 1997)    October 4, 2011   Volume 192, Issue 3 455-460 doi: 10.1016/j.tvjl.2011.09.001
Declue AE, Johnson PJ, Day JL, Amorim JR, Honaker AR.Although the incidence of Gram-positive infection in horses is increasing, little is known about differences in inflammatory response between Gram-positive and Gram-negative organisms in this species. Equine blood was stimulated with components of both Gram-negative and Gram-positive organisms: lipopolysaccharide (LPS); lipoteichoic acid (LTA); peptidoglycan (PG); with combinations of LPS, LTA and PG; and with phosphate buffered saline (control). LPS, LTA and PG stimulated tumor necrosis factor (TNF) and interleukin (IL)-6 production but only LTA and PG stimulated IL-1β production from whole ...
Gene expression analysis in the thalamus and cerebrum of horses experimentally infected with West Nile virus.
PloS one    October 4, 2011   Volume 6, Issue 10 e24371 doi: 10.1371/journal.pone.0024371
Bourgeois MA, Denslow ND, Seino KS, Barber DS, Long MT.Gene expression associated with West Nile virus (WNV) infection was profiled in the central nervous system of horses. Pyrosequencing and library annotation was performed on pooled RNA from the CNS and lymphoid tissues on horses experimentally infected with WNV (vaccinated and naïve) and non-exposed controls. These sequences were used to create a custom microarray enriched for neurological and immunological sequences to quantitate gene expression in the thalamus and cerebrum of three experimentally infected groups of horses (naïve/WNV exposed, vaccinated/WNV exposed, and normal).From the sequ...
Oxidant-antioxidant imbalance in horses infected with equine infectious anaemia virus.
Veterinary journal (London, England : 1997)    October 1, 2011   Volume 192, Issue 3 449-454 doi: 10.1016/j.tvjl.2011.08.029
Bolfă PF, Leroux C, Pintea A, Andrei S, Cătoi C, Taulescu M, Tăbăran F, Spînu M.This study assesses the impact of equine infectious anaemia virus (EIAV) infection on the oxidant/antioxidant equilibrium of horses. Blood samples from 96 Romanian horses aged 1-25 years, were divided into different groups according to their EIAV-infection status, age, and time post-seroconversion. The effect of infection on oxidative stress was estimated by measuring enzymatic antioxidants (superoxide dismutase [SOD], glutathione peroxidase [GPx] and catalase), non-enzymatic antioxidants (uric acid and carotenoids), and lipid peroxidation (malondialdehyde [MDA]). Infection modified the oxidan...
Time-dependent changes of cytokines mRNA in bronchoalveolar lavage fluid from symptomatic recurrent airway obstruction-affected horses.
Polish journal of veterinary sciences    October 1, 2011   Volume 14, Issue 3 343-351 doi: 10.2478/v10181-011-0052-5
Pietra M, Cinotti S, Ducci A, Giunti M, Peli A.During an 18 day test, we measured the cytokine mRNA expression (Interleukin-1beta [IL-1beta], Interleukin-8 [IL-8], Interferon-gamma [IFN-gamma], Tumor Necrosis Factor-alpha [TNF-alpha]) of cells from bronchoalveolar lavage fluid [BALF] in five horses previously diagnosed with RAO, before and during challenge exposure, and after the desensitization phase which involved dexamethasone treatment and environmental modification. Simultaneously, the same cytokine mRNA expression of cells from BALF in four asymptomatic RAO-affected horses maintained outdoors was analyzed. An evident respiratory dist...
Antigenic and genetic evolution of equine influenza A (H3N8) virus from 1968 to 2007.
Journal of virology    September 21, 2011   Volume 85, Issue 23 12742-12749 doi: 10.1128/JVI.05319-11
Lewis NS, Daly JM, Russell CA, Horton DL, Skepner E, Bryant NA, Burke DF, Rash AS, Wood JL, Chambers TM, Fouchier RA, Mumford JA, Elton DM, Smith DJ.Equine influenza virus is a major respiratory pathogen in horses, and outbreaks of disease often lead to substantial disruption to and economic losses for equestrian industries. The hemagglutinin (HA) protein is of key importance in the control of equine influenza because HA is the primary target of the protective immune response and the main component of currently licensed influenza vaccines. However, the influenza virus HA protein changes over time, a process called antigenic drift, and vaccine strains must be updated to remain effective. Antigenic drift is assessed primarily by the hemagglu...
Lipopolysaccharide infusion up-regulates hepcidin mRNA expression in equine liver.
Innate immunity    September 16, 2011   Volume 18, Issue 3 438-446 doi: 10.1177/1753425911420181
Oliveira-Filho JP, Badial PR, Cunha PH, Peiró JR, Araújo JP, Divers TJ, Winand NJ, Borges AS.Hepcidin has been found to be the key regulator of iron metabolism that leads to hypoferremia during inflammation. Recent work has shown that equine hepcidin is predominantly expressed in the liver of horses. In this study, hepcidin gene expression was determined in the liver and bone marrow of six healthy horses after iv infusion of Escherichia coli O55:B5 LPS. The IL-6 gene expression was also determined in liver and bone marrow samples. Clinical and laboratory evaluations were measured at multiple time points between 0 and 240 h post-LPS infusion (PI). Liver and bone marrow biopsies were ...
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