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Published in: Acta Neuropathologica Communications 1/2014

Open Access 01-12-2014 | Research

A new animal model of spontaneous autoimmune peripheral polyneuropathy: implications for Guillain-Barré syndrome

Authors: Mu Yang, Anthony Rainone, Xiang Qun Shi, Sylvie Fournier, Ji Zhang

Published in: Acta Neuropathologica Communications | Issue 1/2014

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Abstract

Background

Spontaneous autoimmune peripheral neuropathy including Guillain-Barré Syndrome (GBS) represents as one of the serious emergencies in neurology. Although pathological changes have been well documented, molecular and cellular mechanisms of GBS are still under-explored, partially due to short of appropriate animal models. The field lacks of spontaneous and translatable models for mechanistic investigations. As GBS is preceded often by viral or bacterial infection, a condition can enhance co-stimulatory activity; we sought to investigate the critical role of T cell co-stimulation in this autoimmune disease.

Results

Our previous study reported that transgene-derived constitutive expression of co-stimulator B7.2 on antigen presenting cells of the nervous tissues drove spontaneous neurological disorders. Depletion of CD4+ T cells in L31 mice accelerated the onset and increased the prevalence of the disease. In the current study, we further demonstrated that L31/CD4-/- mice exhibited both motor and sensory deficits, including weakness and paresis of limbs, numbness to mechanical stimuli and hypersensitivity to thermal stimulation. Pathological changes were characterized by massive infiltration of macrophages and CD8+ T cells, demyelination and axonal damage in peripheral nerves, while changes in spinal cords could be secondary to the PNS damage. In symptomatic L31/CD4-/- mice, the disruption of the blood neural barriers was observed mainly in peripheral nerves. Interestingly, the infiltration of immune cells was initiated in pre-symptomatic L31/CD4-/- mice, prior to the disease onset, in the DRG and spinal roots where the blood nerve barrier is virtually absent.

Conclusions

L31/CD4-/- mice mimic most parts of clinical and pathological signatures of GBS in human; thus providing an unconventional opportunity to experimentally explore the critical events that lead to spontaneous, autoimmune demyelinating disease of the peripheral nervous system.
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Literature
1.
go back to reference Yuki N, Hartung HP: Guillain-Barre syndrome. N Engl J Med 2012, 366: 2294–2304. 10.1056/NEJMra1114525 10.1056/NEJMra1114525CrossRefPubMed Yuki N, Hartung HP: Guillain-Barre syndrome. N Engl J Med 2012, 366: 2294–2304. 10.1056/NEJMra1114525 10.1056/NEJMra1114525CrossRefPubMed
2.
go back to reference Brostoff SW, Levit S, Powers JM: Induction of experimental allergic neuritis with a peptide from myelin P2 basic protein. Nature 1977, 268: 752–753. 10.1038/268752a0CrossRefPubMed Brostoff SW, Levit S, Powers JM: Induction of experimental allergic neuritis with a peptide from myelin P2 basic protein. Nature 1977, 268: 752–753. 10.1038/268752a0CrossRefPubMed
3.
go back to reference Waksman BH, Adams RD: Allergic neuritis: an experimental disease of rabbits induced by the injection of peripheral nervous tissue and adjuvants. J Exp Med 1955, 102: 213–236. 10.1084/jem.102.2.213CrossRefPubMedPubMedCentral Waksman BH, Adams RD: Allergic neuritis: an experimental disease of rabbits induced by the injection of peripheral nervous tissue and adjuvants. J Exp Med 1955, 102: 213–236. 10.1084/jem.102.2.213CrossRefPubMedPubMedCentral
4.
go back to reference Wekerle H, Flugel A, Fugger L, Schett G, Serreze D: Autoimmunity’s next top models. Nat Med 2012, 18: 66–70. 10.1038/nm.2635 10.1038/nm.2635CrossRefPubMed Wekerle H, Flugel A, Fugger L, Schett G, Serreze D: Autoimmunity’s next top models. Nat Med 2012, 18: 66–70. 10.1038/nm.2635 10.1038/nm.2635CrossRefPubMed
5.
go back to reference Salomon B, Rhee L, Bour-Jordan H, Hsin H, Montag A, Soliven B, Arcella J, Girvin AM, Padilla J, Miller SD, Bluestone JA: Development of spontaneous autoimmune peripheral polyneuropathy in B7–2-deficient NOD mice. J Exp Med 2001, 194: 677–684. 10.1084/jem.194.5.677CrossRefPubMedPubMedCentral Salomon B, Rhee L, Bour-Jordan H, Hsin H, Montag A, Soliven B, Arcella J, Girvin AM, Padilla J, Miller SD, Bluestone JA: Development of spontaneous autoimmune peripheral polyneuropathy in B7–2-deficient NOD mice. J Exp Med 2001, 194: 677–684. 10.1084/jem.194.5.677CrossRefPubMedPubMedCentral
6.
go back to reference Stuart RW, Racke MK: Targeting T cell costimulation in autoimmune disease. Expert Opin Ther Targets 2002, 6: 275–289. 10.1517/14728222.6.3.275 10.1517/14728222.6.3.275CrossRefPubMed Stuart RW, Racke MK: Targeting T cell costimulation in autoimmune disease. Expert Opin Ther Targets 2002, 6: 275–289. 10.1517/14728222.6.3.275 10.1517/14728222.6.3.275CrossRefPubMed
7.
go back to reference Ichiki Y, He XS, Shimoda S, Ishibashi H, Keeffe EB, Rossaro L, Gershwin ME: T cell immunity in hepatitis B and hepatitis C virus infection: implications for autoimmunity. Autoimmun Rev 2005, 4: 82–95. 10.1016/j.autrev.2004.12.003 10.1016/j.autrev.2004.12.003CrossRefPubMed Ichiki Y, He XS, Shimoda S, Ishibashi H, Keeffe EB, Rossaro L, Gershwin ME: T cell immunity in hepatitis B and hepatitis C virus infection: implications for autoimmunity. Autoimmun Rev 2005, 4: 82–95. 10.1016/j.autrev.2004.12.003 10.1016/j.autrev.2004.12.003CrossRefPubMed
8.
go back to reference Kissler S, Anderton SM, Wraith DC: Antigen-presenting cell activation: a link between infection and autoimmunity? J Autoimmun 2001, 16: 303–308. 10.1006/jaut.2000.0498 10.1006/jaut.2000.0498CrossRefPubMed Kissler S, Anderton SM, Wraith DC: Antigen-presenting cell activation: a link between infection and autoimmunity? J Autoimmun 2001, 16: 303–308. 10.1006/jaut.2000.0498 10.1006/jaut.2000.0498CrossRefPubMed
9.
go back to reference Kiefer R, Dangond F, Mueller M, Toyka KV, Hafler DA, Hartung HP: Enhanced B7 costimulatory molecule expression in inflammatory human sural nerve biopsies. J Neurol Neurosurg Psychiatry 2000, 69: 362–368. 10.1136/jnnp.69.3.362CrossRefPubMedPubMedCentral Kiefer R, Dangond F, Mueller M, Toyka KV, Hafler DA, Hartung HP: Enhanced B7 costimulatory molecule expression in inflammatory human sural nerve biopsies. J Neurol Neurosurg Psychiatry 2000, 69: 362–368. 10.1136/jnnp.69.3.362CrossRefPubMedPubMedCentral
10.
go back to reference Windhagen A, Newcombe J, Dangond F, Strand C, Woodroofe MN, Cuzner ML, Hafler DA: Expression of costimulatory molecules B7–1 (CD80), B7–2 (CD86), and interleukin 12 cytokine in multiple sclerosis lesions. J Exp Med 1995, 182: 1985–1996. 10.1084/jem.182.6.1985CrossRefPubMed Windhagen A, Newcombe J, Dangond F, Strand C, Woodroofe MN, Cuzner ML, Hafler DA: Expression of costimulatory molecules B7–1 (CD80), B7–2 (CD86), and interleukin 12 cytokine in multiple sclerosis lesions. J Exp Med 1995, 182: 1985–1996. 10.1084/jem.182.6.1985CrossRefPubMed
11.
go back to reference Schmidt J, Elflein K, Stienekemeier M, Rodriguez-Palmero M, Schneider C, Toyka KV, Gold R, Hunig T: Treatment and prevention of experimental autoimmune neuritis with superagonistic CD28-specific monoclonal antibodies. J Neuroimmunol 2003, 140: 143–152. 10.1016/S0165-5728(03)00182-6CrossRefPubMed Schmidt J, Elflein K, Stienekemeier M, Rodriguez-Palmero M, Schneider C, Toyka KV, Gold R, Hunig T: Treatment and prevention of experimental autoimmune neuritis with superagonistic CD28-specific monoclonal antibodies. J Neuroimmunol 2003, 140: 143–152. 10.1016/S0165-5728(03)00182-6CrossRefPubMed
12.
go back to reference Zehntner SP, Brisebois M, Tran E, Owens T, Fournier S: Constitutive expression of a costimulatory ligand on antigen-presenting cells in the nervous system drives demyelinating disease. FASEB J 2003, 17: 1910–1912. 10.1096/fj.03–0199fjePubMed Zehntner SP, Brisebois M, Tran E, Owens T, Fournier S: Constitutive expression of a costimulatory ligand on antigen-presenting cells in the nervous system drives demyelinating disease. FASEB J 2003, 17: 1910–1912. 10.1096/fj.03–0199fjePubMed
13.
go back to reference Brisebois M, Zehntner SP, Estrada J, Owens T, Fournier S: A pathogenic role for CD8+ T cells in a spontaneous model of demyelinating disease. J Immunol 2006, 177: 2403–2411.CrossRefPubMed Brisebois M, Zehntner SP, Estrada J, Owens T, Fournier S: A pathogenic role for CD8+ T cells in a spontaneous model of demyelinating disease. J Immunol 2006, 177: 2403–2411.CrossRefPubMed
14.
go back to reference Fournier S, Rathmell JC, Goodnow CC, Allison JP: T cell-mediated elimination of B7.2 transgenic B cells. Immunity 1997, 6: 327–339. 10.1016/S1074-7613(00)80335-0CrossRefPubMed Fournier S, Rathmell JC, Goodnow CC, Allison JP: T cell-mediated elimination of B7.2 transgenic B cells. Immunity 1997, 6: 327–339. 10.1016/S1074-7613(00)80335-0CrossRefPubMed
15.
go back to reference Zhang J, Shi XQ, Echeverry S, Mogil JS, De Koninck Y, Rivest S: Expression of CCR2 in both resident and bone marrow-derived microglia plays a critical role in neuropathic pain. J Neurosci 2007, 27: 12396–12406. 10.1523/JNEUROSCI.3016–07.2007 10.1523/JNEUROSCI.3016-07.2007CrossRefPubMed Zhang J, Shi XQ, Echeverry S, Mogil JS, De Koninck Y, Rivest S: Expression of CCR2 in both resident and bone marrow-derived microglia plays a critical role in neuropathic pain. J Neurosci 2007, 27: 12396–12406. 10.1523/JNEUROSCI.3016–07.2007 10.1523/JNEUROSCI.3016-07.2007CrossRefPubMed
16.
go back to reference Echeverry S, Wu Y, Zhang J: Selectively reducing cytokine/chemokine expressing macrophages in injured nerves impairs the development of neuropathic pain. Exp Neurol 2013, 240: 205–218. 10.1016/j.expneurol.2012.11.013CrossRefPubMed Echeverry S, Wu Y, Zhang J: Selectively reducing cytokine/chemokine expressing macrophages in injured nerves impairs the development of neuropathic pain. Exp Neurol 2013, 240: 205–218. 10.1016/j.expneurol.2012.11.013CrossRefPubMed
17.
go back to reference Echeverry S, Shi XQ, Rivest S, Zhang J: Peripheral nerve injury alters blood-spinal cord barrier functional and molecular integrity through a selective inflammatory pathway. J Neurosci 2011, 31: 10819–10828. 10.1523/JNEUROSCI.1642–11.2011 10.1523/JNEUROSCI.1642-11.2011CrossRefPubMed Echeverry S, Shi XQ, Rivest S, Zhang J: Peripheral nerve injury alters blood-spinal cord barrier functional and molecular integrity through a selective inflammatory pathway. J Neurosci 2011, 31: 10819–10828. 10.1523/JNEUROSCI.1642–11.2011 10.1523/JNEUROSCI.1642-11.2011CrossRefPubMed
18.
go back to reference Monaco S, Gehrmann J, Raivich G, Kreutzberg GW: MHC-positive, ramified macrophages in the normal and injured rat peripheral nervous system. J Neurocytol 1992, 21: 623–634. 10.1007/BF01191724CrossRefPubMed Monaco S, Gehrmann J, Raivich G, Kreutzberg GW: MHC-positive, ramified macrophages in the normal and injured rat peripheral nervous system. J Neurocytol 1992, 21: 623–634. 10.1007/BF01191724CrossRefPubMed
19.
go back to reference Zhang J, De Koninck Y: Spatial and temporal relationship between monocyte chemoattractant protein-1 expression and spinal glial activation following peripheral nerve injury. J Neurochem 2006, 97: 772–783. 10.1111/j.1471–4159.2006.03746.x 10.1111/j.1471-4159.2006.03746.xCrossRefPubMed Zhang J, De Koninck Y: Spatial and temporal relationship between monocyte chemoattractant protein-1 expression and spinal glial activation following peripheral nerve injury. J Neurochem 2006, 97: 772–783. 10.1111/j.1471–4159.2006.03746.x 10.1111/j.1471-4159.2006.03746.xCrossRefPubMed
20.
go back to reference Sejvar JJ, Kohl KS, Gidudu J, Amato A, Bakshi N, Baxter R, Burwen DR, Cornblath DR, Cleerbout J, Edwards KM, Heininger U, Hughes R, Khuri-Bulos N, Korinthenberg R, Law BJ, Munro U, Maltezou HC, Nell P, Oleske J, Sparks R, Velentgas P, Vermeer P, Wiznitzer M, Brighton Collaboration GBSWG: Guillain-Barre syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 2011, 29: 599–612. doi:10.1016/j.vaccine.2010.06.003 10.1016/j.vaccine.2010.06.003CrossRefPubMed Sejvar JJ, Kohl KS, Gidudu J, Amato A, Bakshi N, Baxter R, Burwen DR, Cornblath DR, Cleerbout J, Edwards KM, Heininger U, Hughes R, Khuri-Bulos N, Korinthenberg R, Law BJ, Munro U, Maltezou HC, Nell P, Oleske J, Sparks R, Velentgas P, Vermeer P, Wiznitzer M, Brighton Collaboration GBSWG: Guillain-Barre syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 2011, 29: 599–612. doi:10.1016/j.vaccine.2010.06.003 10.1016/j.vaccine.2010.06.003CrossRefPubMed
21.
go back to reference Asbury AK, Cornblath DR: Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 1990, 27(Suppl):S21-S24.CrossRefPubMed Asbury AK, Cornblath DR: Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 1990, 27(Suppl):S21-S24.CrossRefPubMed
22.
go back to reference Ruts L, Drenthen J, Jongen JL, Hop WC, Visser GH, Jacobs BC, van Doorn PA, Dutch GBSSG: Pain in Guillain-Barre syndrome: a long-term follow-up study. Neurology 2010, 75: 1439–1447. 10.1212/WNL.0b013e3181f88345 10.1212/WNL.0b013e3181f88345CrossRefPubMed Ruts L, Drenthen J, Jongen JL, Hop WC, Visser GH, Jacobs BC, van Doorn PA, Dutch GBSSG: Pain in Guillain-Barre syndrome: a long-term follow-up study. Neurology 2010, 75: 1439–1447. 10.1212/WNL.0b013e3181f88345 10.1212/WNL.0b013e3181f88345CrossRefPubMed
23.
go back to reference van Doorn PA, Ruts L, Jacobs BC: Clinical features, pathogenesis, and treatment of Guillain-Barre syndrome. Lancet Neurol 2008, 7: 939–950. 10.1016/S1474–4422(08)70215–1 10.1016/S1474-4422(08)70215-1CrossRefPubMed van Doorn PA, Ruts L, Jacobs BC: Clinical features, pathogenesis, and treatment of Guillain-Barre syndrome. Lancet Neurol 2008, 7: 939–950. 10.1016/S1474–4422(08)70215–1 10.1016/S1474-4422(08)70215-1CrossRefPubMed
24.
go back to reference Honavar M, Tharakan JK, Hughes RA, Leibowitz S, Winer JB: A clinicopathological study of the Guillain-Barre syndrome. Nine cases and literature review. Brain 1991, 114(Pt 3):1245–1269.CrossRefPubMed Honavar M, Tharakan JK, Hughes RA, Leibowitz S, Winer JB: A clinicopathological study of the Guillain-Barre syndrome. Nine cases and literature review. Brain 1991, 114(Pt 3):1245–1269.CrossRefPubMed
25.
go back to reference Maier H, Schmidbauer M, Pfausler B, Schmutzhard E, Budka H: Central nervous system pathology in patients with the Guillain-Barre syndrome. Brain 1997, 120(Pt 3):451–464.CrossRefPubMed Maier H, Schmidbauer M, Pfausler B, Schmutzhard E, Budka H: Central nervous system pathology in patients with the Guillain-Barre syndrome. Brain 1997, 120(Pt 3):451–464.CrossRefPubMed
26.
go back to reference Maurer M, Gold R: Animal models of immune-mediated neuropathies. Curr Opin Neurol 2002, 15: 617–622. 10.1097/00019052-200210000-00013CrossRefPubMed Maurer M, Gold R: Animal models of immune-mediated neuropathies. Curr Opin Neurol 2002, 15: 617–622. 10.1097/00019052-200210000-00013CrossRefPubMed
27.
go back to reference Freeman GJ, Gribben JG, Boussiotis VA, Ng JW, Restivo VA Jr, Lombard LA, Gray GS, Nadler LM: Cloning of B7–2: a CTLA-4 counter-receptor that costimulates human T cell proliferation. Science 1993, 262: 909–911. 10.1126/science.7694363CrossRefPubMed Freeman GJ, Gribben JG, Boussiotis VA, Ng JW, Restivo VA Jr, Lombard LA, Gray GS, Nadler LM: Cloning of B7–2: a CTLA-4 counter-receptor that costimulates human T cell proliferation. Science 1993, 262: 909–911. 10.1126/science.7694363CrossRefPubMed
28.
go back to reference Ye G, Barrera C, Fan X, Gourley WK, Crowe SE, Ernst PB, Reyes VE: Expression of B7–1 and B7–2 costimulatory molecules by human gastric epithelial cells: potential role in CD4+ T cell activation during Helicobacter pylori infection. J Clin Invest 1997, 99: 1628–1636. 10.1172/JCI119325 10.1172/JCI119325CrossRefPubMedPubMedCentral Ye G, Barrera C, Fan X, Gourley WK, Crowe SE, Ernst PB, Reyes VE: Expression of B7–1 and B7–2 costimulatory molecules by human gastric epithelial cells: potential role in CD4+ T cell activation during Helicobacter pylori infection. J Clin Invest 1997, 99: 1628–1636. 10.1172/JCI119325 10.1172/JCI119325CrossRefPubMedPubMedCentral
29.
go back to reference Hartung HP, Toyka KV: T-cell and macrophage activation in experimental autoimmune neuritis and Guillain-Barre syndrome. Ann Neurol 1990, 27(Suppl):S57-S63.CrossRefPubMed Hartung HP, Toyka KV: T-cell and macrophage activation in experimental autoimmune neuritis and Guillain-Barre syndrome. Ann Neurol 1990, 27(Suppl):S57-S63.CrossRefPubMed
30.
go back to reference Linington C, Izumo S, Suzuki M, Uyemura K, Meyermann R, Wekerle H: A permanent rat T cell line that mediates experimental allergic neuritis in the Lewis rat in vivo. J Immunol 1984, 133: 1946–1950.PubMed Linington C, Izumo S, Suzuki M, Uyemura K, Meyermann R, Wekerle H: A permanent rat T cell line that mediates experimental allergic neuritis in the Lewis rat in vivo. J Immunol 1984, 133: 1946–1950.PubMed
31.
go back to reference Hamaguchi K, Ohno R, Tsuji T, Yamashita T, Negishi T, Nomura K, Hosokawa T: Activated T lymphocyte subsets in experimental allergic neuritis. J Neuroimmunol 1991, 34: 191–196. 10.1016/0165-5728(91)90129-UCrossRefPubMed Hamaguchi K, Ohno R, Tsuji T, Yamashita T, Negishi T, Nomura K, Hosokawa T: Activated T lymphocyte subsets in experimental allergic neuritis. J Neuroimmunol 1991, 34: 191–196. 10.1016/0165-5728(91)90129-UCrossRefPubMed
32.
go back to reference Zhu Y, Bao L, Zhu S, Chen Z, van der Meide P, Nennesmo I, Winblad B, Ljunggren HG, Zhu J: CD4 and CD8 T cells, but not B cells, are critical to the control of murine experimental autoimmune neuritis. Exp Neurol 2002, 177: 314–320. 10.1006/exnr.2002.7944CrossRefPubMed Zhu Y, Bao L, Zhu S, Chen Z, van der Meide P, Nennesmo I, Winblad B, Ljunggren HG, Zhu J: CD4 and CD8 T cells, but not B cells, are critical to the control of murine experimental autoimmune neuritis. Exp Neurol 2002, 177: 314–320. 10.1006/exnr.2002.7944CrossRefPubMed
33.
go back to reference Wanschitz J, Maier H, Lassmann H, Budka H, Berger T: Distinct time pattern of complement activation and cytotoxic T cell response in Guillain-Barre syndrome. Brain 2003, 126: 2034–2042. 10.1093/brain/awg207 10.1093/brain/awg207CrossRefPubMed Wanschitz J, Maier H, Lassmann H, Budka H, Berger T: Distinct time pattern of complement activation and cytotoxic T cell response in Guillain-Barre syndrome. Brain 2003, 126: 2034–2042. 10.1093/brain/awg207 10.1093/brain/awg207CrossRefPubMed
34.
go back to reference Dimachkie MM, Barohn RJ: Guillain-barre syndrome. Curr Treat Options Neurol 2013, 15: 338–349. 10.1007/s11940–013–0231-z 10.1007/s11940-013-0231-zCrossRefPubMed Dimachkie MM, Barohn RJ: Guillain-barre syndrome. Curr Treat Options Neurol 2013, 15: 338–349. 10.1007/s11940–013–0231-z 10.1007/s11940-013-0231-zCrossRefPubMed
35.
go back to reference Ho TW, Li CY, Cornblath DR, Gao CY, Asbury AK, Griffin JW, McKhann GM: Patterns of recovery in the Guillain-Barre syndromes. Neurology 1997, 48: 695–700. 10.1212/WNL.48.3.695CrossRefPubMed Ho TW, Li CY, Cornblath DR, Gao CY, Asbury AK, Griffin JW, McKhann GM: Patterns of recovery in the Guillain-Barre syndromes. Neurology 1997, 48: 695–700. 10.1212/WNL.48.3.695CrossRefPubMed
36.
go back to reference Feasby TE: Axonal Guillain-Barre syndrome. Muscle Nerve 1994, 17: 678–679. 10.1002/mus.880170618 10.1002/mus.880170618CrossRefPubMed Feasby TE: Axonal Guillain-Barre syndrome. Muscle Nerve 1994, 17: 678–679. 10.1002/mus.880170618 10.1002/mus.880170618CrossRefPubMed
37.
go back to reference Weerasuriya A, Mizisin AP: The blood-nerve barrier: structure and functional significance. Methods Mol Biol 2011, 686: 149–173. 10.1007/978–1-60761–938–3_6 10.1007/978-1-60761-938-3_6CrossRefPubMed Weerasuriya A, Mizisin AP: The blood-nerve barrier: structure and functional significance. Methods Mol Biol 2011, 686: 149–173. 10.1007/978–1-60761–938–3_6 10.1007/978-1-60761-938-3_6CrossRefPubMed
Metadata
Title
A new animal model of spontaneous autoimmune peripheral polyneuropathy: implications for Guillain-Barré syndrome
Authors
Mu Yang
Anthony Rainone
Xiang Qun Shi
Sylvie Fournier
Ji Zhang
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Acta Neuropathologica Communications / Issue 1/2014
Electronic ISSN: 2051-5960
DOI
https://doi.org/10.1186/2051-5960-2-5

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