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1

Jacobsen, Karen Ann. "Microenvironmental organization of B lymphopoiesis in mouse bone marrow : in vivo localisation of B lymphocyte precursors, molecular-interactions with stromal reticular cells, and macrophage-mediated deletion of apoptotic forms". Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=41346.

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The localisation of B lymphocyte precursor cells in mouse bone marrow and their associations with stromal reticular cells and macrophages have been investigated by in vivo radioimmunolabeling combined with light and electron microscope radioautography. Many early B lineage cells expressing the B220 glycoprotein prior to the expression of surface immunoglobulin and those regenerating after sub-lethal $ gamma$-irradiation, were located in bone-associated regions of femoral marrow. Labeled B220$ sp*$ lymphoid cells of undifferentiated morphology were closely associated with complex cytoplasmic processes of stromal reticular cells. The binding of a monoclonal antibody raised against a B lymphocyte-supportive stromal cell line (mAb KMI6), was highly restricted to the interface between stromal cells and undifferentiated lymphoid cells. The VCAM-1 specific mAb M/K-2, labeled electron-dense stromal cells that contacted lymphoid cells and a variety of other hemopoietic cell lineages. Within the bone marrow of normal mice there was evidence of death of B220$ sp+$ B lineage cells by apoptosis and their removal by macrophages. Cell loss, apoptosis and macrophage deletion of B precursor cells were greatly enhanced in E$ mu$-myc transgenic mice. The results reveal a complex in vivo microenvironmental organisation of B lymphocytopoiesis characterised by intimate interactions with stromal reticular cells and macrophages which regulate the development of precursor B cells and determine the ultimate output of B lymphocytes from the bone marrow.
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2

Ellabban, Wael. "Studies on precursors of human intestinal intraepithelial lymphocytes". Thesis, University of Nottingham, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289072.

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3

Parker, Mathew James David. "Control of growth and performance of precursor B lymphocytes". Thesis, University of Cambridge, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.614676.

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4

Kaminski, Eduardo Roman. "Cytotoxic T lymphocyte precursor frequencies (CTL-p) and their relevance to bone marrow transplantation". Thesis, Imperial College London, 1990. http://hdl.handle.net/10044/1/46378.

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5

Liu, Jing. "Regulation of VH replacement in human immature B cells by B cell receptor (BCR)-mediated signaling". Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2009. https://www.mhsl.uab.edu/dt/2010p/liu.pdf.

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6

D'ARGEMONT, CATHERINE. "La beta-2-microglobuline : un facteur chimiotactique pour les precurseurs des lymphocytes t". Paris 6, 1990. http://www.theses.fr/1990PA066464.

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Nous avons etudie les mecanismes controlant la colonisation du thymus par les cellules precurseurs des lymphocytes t chez les mammiferes en considerant l'hypothese selon laquelle l'epithelium thymique secrete des facteurs chimiotactiques capables d'attirer les precurseurs hematopoietiques medullaires. Le surnageant de la lignee epitheliale thymique de rat it45-r1 contient une proteine chimiotactique, baptisee thymotaxine, capable d'attirer in vitro des cellules de moelle osseuse de rat presentant des caracteristiques de cellules lymphoides immatures susceptibles de se differencier en lymphocytes t. La frequence de ces cellules dans la moelle osseuse de rat a ete evalue a 0. 015%. L'etude biochimique de la thymotaxine a revele son identite avec la beta-2-microglobuline (b2m). Cette proteine exerce son activite chimiotactique a une concentration optimale de 10##1#1m, qu'elle soit d'origine plasmatique ou recombinante. La b2m etant la chaine legere du complexe majeur d'histocompatibilite de classa i (cmh i), il nous a semble interessant d'utiliser la lignee it45-r1 pour etudier les mecanismes de production de cette proteine par des cellules exprimant les antigenes du cmh i. La secretion de b2m par ces cellules est constitutive, ne depend pas du taux d'expression du cmh i mais est due a une suspension de b2m intracellulaire et des transcrits codant pour cette proteine. A l'aide de cultures lymphoides, nous avons pu montre que l'un des evenements precoces induits par l'addition de b2m sur ces cellules est une augmentation de la concentration de calcium libre intracellulaire dependante d'un infux calcique. D'autre part, des resultats preliminaires indiquent que la b2m agirait grace a un recepteur membranaire specifique de 58 kd. L'expression de cette molecule par les cellules medullaires en culture mais pas par les thymocytes ou les cellules de moelle osseuse fraiche suggere une distribution cellulaire de ce recepteur differente de celle des antigenes du cmh i
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7

DOUAGI, IYADH. "Etude de l'engagement des precurseurs hematopoietiques et de leur differenciation en lymphocytes t et nk". Paris 6, 2001. http://www.theses.fr/2001PA066080.

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Les cellules qui composent le systeme hematopoietique presentent la particularite d'etre en constant renouvellement a partir de cellules souches hematopoietiques (csh) pendant toute la vie d'un individu. L'etude de ce systeme presente donc un interet majeur pour la comprehension des mecanismes cellulaires et moleculaires regissant l'engagement des precurseurs hematopoietiques dans les diverses voies de differenciations. De fait, la connaissance de la hierarchie ainsi que des precurseurs intermediaires entre la cellule souche et les cellules differenciees sont des pre-requis pour cette etude. Dans l'objectif de mieux comprendre ces mecanismes, nous avons focalise nos efforts a la caracterisation des precurseurs des lymphocytes t et nk. Nous avons montre qu'une fois dans le foie ftal, les precurseurs t proliferent avant de migrer probablement vers le thymus pour y subir les ultimes etapes de maturation. En parallele, nous avons observe qu'apres le stade 12 dpc, le thymus est colonise par nombre croissant de precurseurs nettement plus efficaces dans la generation de lymphocytes t que les premiers progeniteurs ayant colonise l'ebauche thymique. Cette conclusion, nous a conduit a envisager un scenario selon lequel le programme de differenciation vers la lignee t serait initie au niveau du foie ftal, avant l'arrivee de ces precurseurs t dans le thymus. De fait, l'analyse du potentiel de differenciation in vitro de differentes populations triees de cellules du foie ftal au stade 15 dpc nous a permis de montrer que la majorite des precurseurs t present dans cet organe etaient des precurseurs bipotent restreints aux lignees t et nk. Enfin, nous avons etendu notre etude a la caracterisation des precurseurs de cellules nk au niveau de la moelle osseuse adulte, ou nous avons identifie une population de progeniteurs engages vers la voie de differenciation nk.
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8

Maddila, Santhosh Chandar [Verfasser]. "Regulation of the opioid precursor proopiomelanocortin in lymphocytes in a rat model of inflammatory pain / Santhosh Chandar Maddila". Gießen : Universitätsbibliothek, 2015. http://d-nb.info/1068921897/34.

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9

Rizzuto, Gabrielle Ann. "Self-antigen specific CD8+ T cell precursor : frequency determines the quality of the anti-tumor immune response /". Access full-text from WCMC, 2008. http://proquest.umi.com/pqdweb?did=1621818951&sid=3&Fmt=2&clientId=8424&RQT=309&VName=PQD.

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10

Abduh, Maisa. "Follicular CD4 T Cells Tutor CD8 Early Memory Precursors : an Initiatory Journey to the Frontier of B Cell Territory". Thesis, Université Paris-Saclay (ComUE), 2018. http://www.theses.fr/2018SACLS371.

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Les lymphocytes T CD8+ spécifiques de l'antigène sont impliqués dans la réponse immunitaire adaptative et jouent un rôle essentiel dans la protection de l'hôte contre l'infection par des pathogènes intracellulaires. Cette protection de longue durée dépend de la génération de réponses lymphocytaires T CD8+ mémoires, hautement fonctionnelles en termes de fréquence et de fonctionnalité, après réinfection.Après présentation de l'antigène, une cellule T CD8 naïve subit une forte expansion clonale, générant une population hétérogène de cellules activées qui est dominée, au sommet de l'expansion, par des effecteurs CD8 de courte durée (SLEC). Cette expansion est suivie d'une phase de contraction massive par apoptose. Quelques cellules survivent à cette phase de contraction et finissent par se différencier en cellules mémoire hautement compétentes. Les processus par lesquels et le moment où se différencient les précurseurs de mémoire (MPECs) restent largement inconnus, tout comme les étapes ultérieures de leur maturation en cellules mémoire pleinement fonctionnelles. Les signaux d'aide provenant des cellules T CD4+ sont clairement requis tout au long du processus de maturation des MPEC.Notre équipe a montré que les lymphocytes T CD4+ régulateurs FoxP3+ (Tregs) favorisent la maturation des MPEC en limitant l'exposition à l'IL-2 et en fournissant des signaux inhibiteurs, mais ce n'est probablement qu'une facette de l'aide complexe et multiforme apportée par les cellules T CD4+ au MPEC. Les Tregs agissent sur des MPEC préexistants. Les réponses mémoire B et CD8+ partagent des caractéristiques communes, telles que l'expression du facteur de transcription Bcl-6. Les lymphocytes T CD4+ folliculaires (Tfh) sont les principaux producteurs de la cytokine IL-21. Bien que les mécanismes par lesquels les Tfh induisent l’expression de Bcl-6 dans les cellules B doivent être clarifiés, ils pourraient inclure l’IL-21 et l’interaction CD40-CD40L.Dans ce projet de thèse, nous avons étudié le rôle potentiel des Tfh dans l'initiation de la différenciation mémoire T CD8+, dans des modèles de souris transgéniques permettant une déplétion transitoire et sélective des Tfh, infectées par la bactérie recombinante Listeria monocytogenes-OVA.Nous avons montré que dès 2 jours après l'infection, les MPECs très précoces peuvent être identifiés par l’expression du récepteur de chimiokine CXCR5. Ces précurseurs précoces, qui ont un phénotype effecteur, se développent et migrent temporairement à la jonction des zones T et B, où ils interagissent avec les Tfh puis perdent leur expression CXCR5.Cette interaction avec les Tfh, considérés jusqu'à présent comme des auxiliaires exclusifs des cellules B, est nécessaire pour que les MPECs CD8+ deviennent des cellules mémoire compétentes sensibles à l'IL-21, capables de générer des réponses effectrices secondaires efficaces.Cette étude dévoile les premières étapes cruciales dans la génération de la mémoire CD8+, identifie CXCR5 comme le premier marqueur connu des MPECs CD8+, révèle l’implication fondamentale des Tfh dans le CD4 help et indique une coordination possible, via les Tfh, entre les voies de différentiation mémoire CD8+ et B. Ces résultats peuvent avoir des implications pour la conception du vaccin et de l'immunothérapie
Antigen-specific CD8 T cells are involved in the adaptive immune response and play a critical role in protecting the host from infection by intracellular pathogens. This long-lasting protection depends on the generation of memory CD8+ T cell responses, which are highly functional in terms of frequency and functionality, after secondary infection.Following antigen activation, a naive CD8 T cell undergoes strong clonal expansion, generating a heterogeneous population of activated cells that is dominated, at the peak of expansion, by short-lived CD8 effectors (SLECs). This expansion is followed by a phase of drastic contraction through massive apoptosis. A few cells survive this contraction phase and eventually become highly competent memory cells. Precisely when and how these memory precursors (MPECs) are generated is largely unknown, and so are the subsequent steps of their maturation into fully functional memory cells. Help signals from CD4+ T cells are clearly required throughout the MPEC maturation process.Our team has previously shown that FoxP3+ regulatory CD4+ T cells (Tregs) favor MPECs maturation by limiting exposure to IL-2 and by providing inhibitory signals, but this is probably only one facet of the complex and multifaceted help provided by CD4+ T cells to MPEC, and Tregs act on pre-existing MPECs.B-cell memory and CD8+ T cell memory share some common features, such as the expression of the transcription factor Bcl-6. Tfh are major producers of the cytokine IL-21. The mechanisms by which Tfh induces Bcl-6 in B-cells need to be clarified, they might include IL-21 and CD40-CD40L.In this PhD project, we have investigated the potential role of Tfh on the initiation of CD8 memory differentiation, in transgenic mice models, allowing transient and selective depletion of Tfh cells, infected by recombinant Listeria monocytogenes-OVA.We have shown that as early as 2 days after infection, very early memory precursors can be identified by their expression of the chemokine receptor CXCR5. These early precursors, which have an effector phenotype, expand and temporarily migrate to the junction of T-cell and B-cell zones, where they interact with follicular CD4 T cells (Tfh) then lose their CXCR5 expression.Remarkably, this interaction with Tfh, hitherto considered as exclusive B-cell helpers, is required for memory precursors to become competent memory cells responsive to IL-21 and capable of mounting efficient cytotoxic secondary effector responses.This study thus unveils critical early steps in the generation of CD8 memory, identifies CXCR5 as the earliest known marker of CD8 memory precursors, reveals a major helper role for Tfh, and points to possible coordination, through Tfh, between the pathways of CD8 and B-cell memory generation. These findings may have implications for vaccine and immunotherapy design
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11

Lim, Ai Ing. "Cytokine control of human innate lymphoid cell development and function". Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCC272/document.

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Les cellules lymphoïdes innées (ILC) représentent une famille de cellules hématopoïétiques récemment identifiée, qui joue un rôle essentiel dans la réponse immunitaire précoce via la production rapide de cytokines. Trois groupes - ou types - d’ILC ont été définis selon l’expression de certaines molécules membranaires ou intracellulaires, ainsi que la production différentielle de cytokines. Les ILC du groupe 1 (ILC1) expriment le facteur de transcription(FT) T-BET et sécrètent des cytokines inflammatoires de la réponse immune de type 1, l’IFN-? et le TNF-?. Les ILC2 sécrètent des cytokines associées à la réponse immune de type 2,notamment l’IL-5 et l’IL-13, et ce de façon dépendante du FT GATA-3. Enfin, les ILC3 se caractérisent par la production de cytokines telles que l’IL-17 et l’IL-22, et expriment le FTROR?t. J’ai étudié en utilisant des techniques de biologie moléculaire et cellulaire, et à partir d’échantillons sanguins et tissulaire de donneurs sains ou de patients atteints de maladies inflammatoires chroniques, la fonction de ces trois groupes d’ILC chez l’homme. Ces travaux ont permis la construction d’un nouveau modèle de développement de ces cellules à partir de précurseurs
Innate lymphoid cells (ILC) represent a novel family of hematopoietic effectors that serve essential roles in early immune response by rapid cytokines production. Three distinct groups of ILC subsets have been described. Group 1 ILC include cytotoxic natural killer (NK) cells and other type-1 cytokines (IFN-? and TNF-?) producing cells that regulated by T-BET. Group 2 ILC (ILC2) express GATA-3 and ROR?, secrete type-2 cytokines, IL-5 and IL-13. Group 3 ILC (ILC3) utilize ROR?t to drive production of the TH17-associated cytokines, IL-17 and/or IL-22. In this thesis, I have performed series of experiments to uncover the developmental pathway and function of human ILC that may allow us to harness ILC in diverse clinical settings. First, I analyzed the phenotypic and functional heterogeneity of human peripheral blood ILC2. I found human IL-13+ ILC2 can acquire the capacity to produce IFN-?, thereby generating ÔplasticÕ ILC2. ILC2 cultures demonstrated that IFN-?+ ILC2 clones could be derived and were stably associated with increased T-BET expression. The inductive mechanism for ILC2 plasticity was mapped to the IL-12/IL-12R signaling pathway and was confirmed through analysis of patients with Mendelian susceptibility to mycobacterial disease (MSMD) due to IL-12R?1 deficiencies that failed to generate plastic ILC2. This IL-13+IFN-?+ ILC2 are detected ex vivo in gut tissues from CrohnÕs patients. Second, I identified and isolated ILC precursors (ILCP) in peripheral blood of healthy donors. This circulating ILCP can give rise to four lineages of mature ILC including cytotoxic NK cells and helper ILC1, 2 and 3 in vitro and in vivo. Transcirptomic and epigenetic analysis showed ILCP have ILC-committed transcription factor profiles but have mature ILC signature locus at the epigenetics poised states. We further identified ILCP in various tissues including fetal liver, cord blood, postnatal lung and tonsil. Our result proposed a new model of ÒILC-poiesisÓ where circulating ILCP serve as cellular substrates to generate mature ILC subsets in tissues. Understanding the role of IL-12 on driving ILC2 to ILC1 plasticity may allow us to target plastic ILC2 in various diseases. The identification and isolation of ILCP from circulating blood allow further transfer into clinical setting for cellular therapy, especially for various diseases that ILC has been shown to be importance including infection, allergy, cancer and metabolic diseases
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12

Ma, Kuiying. "Regulation of early human T cell development Generation of adult human T-cell progenitors for immunotherapeutic applications TNFα enhances in vitro generation of T-cell precursors from human hematopoietic stem and progenitor cells". Thesis, Sorbonne Paris Cité, 2018. http://www.theses.fr/2018USPCB040.

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La première étape du développement lymphocytaire T se caractérise par la migration de progéniteurs hématopoïétiques dans le thymus et l'initiation du programme de différenciation T. La régulation du développement des lymphocytes T est étroitement associée au micro-environnement du thymus. Cependant, en raison de modèles d'étude limités, les mécanismes régulant le développement des lymphocytes T humains sont encore peu compris. Nous avons donc développé un système de culture in vitro sans stroma qui soutient le développement précoce des cellules T humaines à partir de cellules souches / progénitrices hématopoïétiques humaines néonatales et adultes. Ce système est basé sur un composant principal, le ligand de Notch DL-4. Les progéniteurs de cellules T générés dans le système de culture DL-4 présentent des caractéristiques similaires à ceux des thymocytes T immatures humains. De plus, ces cellules ont un potentiel de différenciation T puisqu'ils produisent des lymphocytes T matures avec un répertoire TCR très diversifié après transplantation à des souris NOD/SCID/gamma(c)- / - . Au cours de mon travail de thèse, j'ai optimisé le système de culture en ajoutant du TNFa, une cytokine naturellement exprimée dans le thymus et qui améliore considérablement la génération in vitro de progéniteurs T grâce à une augmentation de la survie et de la prolifération des précurseurs T, ainsi qu'en inhibant la différenciation myéloïde. J'ai également démontré que la régulation du TNFa sur les progéniteurs des lymphocytes T était principalement basée sur l'activation de la signalisation NFkB, ainsi que la régulation de l'expression d'un inhibiteur de l'apoptose. Dans l'ensemble, cette thèse décrit une stratégie basée sur la signalisation Notch et NFkB pour la génération in vitro de progéniteurs de cellules T humaines à partir de cellules souches / progénitrices hématopoïétiques. Cette stratégie fournit un modèle efficace pour l'étude fondamentale des régulateurs essentiels au cours du développement précoce des cellules T humaines. En outre, il fournit un modèle sûr pour fournir rapidement et abondamment des progéniteurs de cellules T humaines pour des applications cliniques
Thymus seeding progenitors migrate into the thymus and initiate T cell differentiation program. The regulation of T cell development is tightly associated with the thymus microenvironment. However, due to the limited model, the mechanism of human T cell development has not been deeply clarified. Thus, we developed an in vitro stroma-free system to support human early T cell development from both neonate and adult human hematopoietic stem / progenitor cells based on Notch ligand DL-4. These T cell progenitors generated in DL-4 system exhibit similar characters as human immature T thymocytes. Moreover, they were proved to have T cell reconstruct potential when transplanted to NOD/SCID/gamma(c)- / - mice, which could differentiate into mature T cell with highly diverse TCR repertoire. Furthermore, we optimized the system by involving TNFa cytokine, which could dramatically enhance the in vitro generation of T-cell progenitors through ameliorating cell survival and proliferation of T-cell precursors, as well as fastening early T lineage differentiation. We demonstrate the regulation of TNFa on T cell progenitors is mainly based on the activation of NFkB signaling, as well as its regulation on inhibitor of apoptosis protein. Overall, this thesis describes a strategy for in vitro generation of human T-cell progenitors from hematopoietic stem/ progenitor cells based on Notch signaling. This strategy provides an effective model for fundamental study to explore essential regulators during human early T cell development. Moreover, it provides a safe model to rapidly supply abundant human T-cell progenitors for clinical applications
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13

francesca, moretta. "ANALYSIS OF A “NOVEL” SUBSET OF CD34+ HAEMATOPOIETIC PRECURSORS IN PERIPHERAL BLOOD OF PATIENTS WITH CHRONIC INFLAMMATORY DISEASES". Doctoral thesis, 2019. http://hdl.handle.net/11562/995037.

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Background: in chronic inflammatory disorders, both infectious and non infectious, a novel population of CD34+ hemopoietic precursors is detectable in high proportions in peripheral blood (PB). These precursors display peculiar phenotypic characteristics, namely the expression of DNAM-1 (bright), an activating receptor expressed by natural killer (NK) cells and CXCR4, a chemokine receptor that suggests their recent exit from bone marrow (BM). In healthy donors (HD), these precursors are virtually undetectable in PB while they represent 10-15% of BM CD34+ cells. It is conceivable that, in chronic inflammatory processes, pro-inflammatory cytokines may favor the exit of this CD34+ subset. While their presence in PB during chronic inflammation may represent a homeostatic event to compensate an accelerated cell death, a major interest in these cells is related to their differentiating capacity, which has been analyzed in the present study. Methods: we evaluated by cytofluorimetric analysis the presence of CD34+ DNAM1bright CXCR4+ cells in different pathological conditions characterized by chronic inflammation including selected viral infections and autoimmune diseases and defined the phenotypic and functional characteristics of both NK and T cells generated in vitro from purified CD34+ DNAM1bright CXCR4+ progenitors. Results: first, we confirmed in our cohorts that patients with autoimmune diseases or with chronic viral infections display high proportions of CD34+DNAM-1brightCXCR4+ precursors, which could even outnumber the conventional CD34+DNAM-1-CXCR4- precursors. Analysis of the progenies of these cells cultured in the presence of appropriate cytokines, showed that both CD56+CD3- (NK) and CD56-CD3+ (T) cells can be generated. Comparison of the lymphoid progenies derived from precursors isolated from patients with viral infections versus patients with autoimmunity revealed a high prevalence of NK cells in the former, while, in autoimmunity, T cell progenies largely prevailed. In the first set of experiments, we focused on NK cell progenies, mostly from HIV and HCV infected patients. CD34+DNAM-1brightCXCR4+ cells gave rise, in approximately 20 days of colture, to sizeable populations of fully mature NK cells expressing KIRs, CD57, DNAM-1, NKG2D and NKG2C (a HLA-E specific activating receptor correlated with infection/sieropositivity for cytomegalovirus, CMV). This rapid differentiation towards mature NK cells was never occurring in conventional CD34+ precursors. Notably, the NKG2C+ progenies could undergo selective expansion upon NK cell colture with HLA-E-transfected 221 cell line. Further analysis of T cell progenies derived from highly purified (>99%) CD34+DNAM-1brightCXCR4+ precursors isolated from patients with autoimmune diseases, revealed the presence of both CD4+ and CD8+ T cells. Importantly, the large majority of cells expressed CXCR4 and the activating receptors DNAM-1 and NKG2D and 2B4 co-receptor. Analysis of CD4+ T cell progenies showed the presence of both Th1 star (Th1*) and Th17 subsets. Conclusions: the generation of T cells in the absence of thymic selection together with the expression of activating NK receptors capable of inducing a HLA-independent T-cell activation (or to amplify low affinity TCR responses) and the presence of Th1* and Th17 may suggest the possible involvement of these cells in the pathogenesis of self-damage in autoimmunity.
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14

Bloomenthal, John Isaac. "Biological activity and in vitro metabolism of defined Lipid A precursors in murine B lymphocytes". 1985. http://catalog.hathitrust.org/api/volumes/oclc/12759658.html.

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Thesis (M.S.)--University of Wisconsin--Madison, 1985.
Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 70-75).
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15

"The experience of Chinese parents of children with acute lymphocytic leukaemia (ALL)". 1996. http://library.cuhk.edu.hk/record=b5889284.

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by Betty Shuc Han Wills.
Year shown on spine: 1997.
Thesis (M.Phil.)--Chinese University of Hong Kong, 1996.
Includes bibliographical references (leaves 117-128).
ACKNOWLEDGMENT --- p.i
ABSTRACT --- p.ii
TABLE OF CONTENTS --- p.iv
LIST OF APPENDICES --- p.viii
Chapter CHAPTER 1 --- INTRODUCTION --- p.1
Chapter CHAPTER 2 --- LITERATURE REVIEW --- p.6
Parental Responses to the Diagnosis of Acute Lymphocytic Leukaemia (ALL) --- p.7
Disclosure Of the Child's Diagnosis --- p.10
Impact of Cancer Treatment on Parents --- p.14
Sources of Support for Parents --- p.18
Coping Strategies of Parents of Children With ALL --- p.20
Coping With The Uncertainty of the Disease --- p.23
Research Studies Involving Chinese Parents --- p.24
Summary Of Issues From Literature Review --- p.27
Chapter CHAPTER 3 --- METHODOLOGY
Research Design --- p.29
Sampling --- p.31
Data Collection Method --- p.32
Data Collection Procedure --- p.34
Ethical Considerations --- p.38
Pilot Study --- p.40
Data Analysis --- p.42
Issues of Reliability and Validity --- p.45
Validity --- p.45
Reliability --- p.48
Chapter CHAPTER 4 --- RESULTS & DISCUSSION
Introduction --- p.50
Chapter (I). --- Parents' Profile --- p.51
Demographic Characteristics Of The Parents
Chapter (II). --- Major categories Corresponding To Interviewing The Mothers --- p.54
Initial Reactions of the Child's Confirmed Diagnosis --- p.55
Unpreparedness for the child's Diagnosis
Suddenness of the Diagnosis --- p.56
Physical and psychological reactions to the child's Diagnosis --- p.58
Sources of Support for the Mothers --- p.62
The mothers' main source of support
Other sources of support for the mothers --- p.64
Disclosure Of Child's Diagnosis --- p.66
Disclosure of the child's diagnosis to the child
Disclosure of the child's diagnosis to members of the immediate and extended families --- p.68
Disclosure of child's diagnosis to non-family members --- p.70
Uncertainty Brought On By The Illness --- p.71
Waiting for confirmation of diagnosis
Uncertainty about the success of treatment --- p.73
Uncertainty about the child's future --- p.74
Changes In The Family Routine --- p.75
Needed to normalise family life
Chapter (III). --- Major Categories Corresponding to Interviewing The Fathers Initial reactions to the child's confirmed diagnosis of ALL --- p.78
Suddenness of diagnosis --- p.79
Physical and psychological reactions to the diagnosis --- p.80
Disclosure Of The Child's Diagnosis --- p.82
Disclosure of the child's diagnosis to the child
Disclosure of the child's diagnosis to members of the immediate and extended family --- p.85
Disclosure of the child's diagnosis to non-family members --- p.86
Sources Of Support For The Fathers --- p.87
Support from immediate and extended families
Support from medical professionals --- p.89
Support from friends --- p.90
Changes In The Family Routine --- p.91
Coping Strategies Utilised By The Fathers --- p.92
Open communication
Use of religious beliefs and rituals --- p.93
Chapter (IV). --- Comparison Of Categories Found Between The Mothers And The Fathers --- p.95
Initial reactions to the child's confirmed diagnosis of ALL
Disclosure of the child's diagnosis --- p.96
Sources of support for the parents --- p.100
Changes in the family routine --- p.101
Summary of findings --- p.103
Chapter (V). --- Differences between the initial and second interviews --- p.105
Chapter CHAPTER FIVE --- CONCLUSION
Limitations Of The Study --- p.108
Implications For Nursing Practice --- p.112
Recommendations For Future Research --- p.114
Conclusion --- p.115
REFERENCES --- p.117
APPENDIX I - PERSONAL DATA FORM --- p.129
APPENDIX II - INTERVIEW SCHEDULE --- p.130
APPENDIX III - CONSENT FORM --- p.134
APPENDIX IV - SAMPLE SCRIPT OF INTERVIEWS WITH MOTHERS --- p.135
APPENDIX V - MATRICES ON MOTHERS AND FATHERS --- p.140
APPENDIX VI - SAMPLE OF FIELD NOTES FOR MOTHERS AND FATHERS --- p.143
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