29 This dataset was extended to nearly 4000 patients and found 4 

29 This dataset was extended to nearly 4000 patients and found 4 year unadjusted survival for those with and without significant RAS to be 57% and 89%, respectively. Survival related to the grade of stenosis, with even mild/moderate lesions (<50%) having significant impact on survival.30 Although these figures are compelling, they do not prove a causal relationship as the presence of stenosis may portent a more diffuse atherosclerotic process. Analysis of over 16 million Medicare claims between 1992 and 2004 confirms increased all cause mortality in patients with ARVD,

with adjusted hazard ratios for death compared with the general population as high as 2.28.31 A complex interplay buy Nutlin-3a between ARVD and the heart is well defined. In all, 95% of patients with ARVD have an abnormality of cardiac structure or function32

and have high mortality from cardiac causes in prospective study.33 A 2005 review of over 1 million Medicare patients showed increases in numbers of all cardiovascular events in those diagnosed with ARVD with annual atherosclerotic heart disease incidence 30.4% compared with 7.4% the general population, Selleckchem p38 MAPK inhibitor CCF (19.5% vs 5.6%), cerebrovascular disease events (17.6% vs 5.3%) and death (16.6% vs 6.3%). These risks were typically highest in the first 6 to 9 months after diagnosis. A review of 146 000 incident US dialysis patients aged over 67 found that patients with ARVD as the primary cause of renal failure, and those with ARVD associated with an alternative renal pathology had higher hazard ratios for cardiovascular events when compared with the remainder of the dialysis

population.34 Proteinuria represents tubulo-interstitial and glomerular injury, and is recognized in many, if not all forms of renal disease as a predictor of progressive dysfunction. Patients with ARVD can have histological patterns discrete from direct ischaemic responses, for example, focal segmental glomerulosclerosis35 and atheroembolic disease. High level, even nephrotic range36 proteinuria can be found in ARVD with increases relating to significantly lower Mannose-binding protein-associated serine protease glomerular filtration rate (GFR),37 but not to arterial patency.38,39 A negative correlation between renal functional outcome and proteinuria has been demonstrated.33 The absence of correlation between level of proteinuria and degree of stenosis suggests down-stream parenchymal damage is the major determinant of outcome. This suggestion is supported by a retrospective review of 83 patients who underwent revascularization, where proteinuria of >0.6 g/day was found to be an independent risk factor for lack of functional improvement or deterioration of function following revascularization.40 Over three decades renal revascularization techniques have evolved from surgical, to angioplasty and more recently, endovascular stenting. The heterogeneity of techniques makes comparison of published data challenging. RCT were limited by small patient numbers and short follow-up periods.

Such documents are peer-reviewed, but not copy-edited or typeset

Such documents are peer-reviewed, but not copy-edited or typeset. They are made available as submitted

by the authors. “
“Mucosal Leishmaniasis (ML) may occur in both nasal and oral mucosa. However, despite the impressive tissue destruction, little is known about the oral involvement. To compare some changes underlying inflammation in oral and nasal ML, we performed immunohistochemistry on mucosal tissue of 20 patients with ML (nasal [n = 12]; oral [n = 8] lesions) and 20 healthy donors using antibodies that recognize inflammatory markers (CD3, CD4, CD8, CD22, CD68, neutrophil elastase, CD1a, CLA, Ki67, Bcl-2, NOS2, CD62E, Fas and FasL). A significantly larger number of cells, mainly T cells and macrophages, were observed in lesions than in healthy tissue. In addition, high nitric oxide synthase 2 (NOS2) expression

was associated with a reduced detection of parasites, highlighting the https://www.selleckchem.com/products/Gefitinib.html importance of NOS2 for parasite elimination. Oral lesions had higher numbers of neutrophils, parasites, proliferating cells and NOS2 than nasal lesions. These findings, together with the shorter duration of oral lesions and more intense symptoms, suggest a more recent inflammatory process. It could be explained by lesion-induced oral cavity changes that lead to eating difficulties and social stigma. In addition, the frequent poor Buparlisib tooth conservation and gingival inflammation tend to amplify tissue destruction and symptoms and may impair and confuse the correct diagnosis,

thus delaying the onset of specific treatment. American tegumentary leishmaniasis (ATL) is a parasitic disease caused by Leishmania protozoa, which are transmitted by insects of the genus Lutzomyia (1). The most common clinical presentation is the presence of cutaneous lesions (2). However, about 3–5% of patients infected with Leishmania (Viannia) braziliensis progress to mucosal leishmaniasis, which mainly affects nasal, oral and laryngeal mucosae (2–4). They are characterized by difficulties in parasite identification and large tissue 5-FU datasheet destruction (5–7). However, the exact mechanisms underlying the formation of mucosal lesions remain unknown (1). The affected mucosa is pale and hyperemic and appears rough, crusty and ulcerative. Nasal septal perforation might be observed in severe cases. Oral lesions frequently involve the lip and palate, although lesions in the uvula, gingiva, tonsils and tongue are reported. The oral mucosa generally appears swollen, ulcerated with a granular bottom and/or presents ulcerovegetative lesions (2–4). To our knowledge, few studies have investigated the in situ immune response in mucosal leishmaniasis (4,6,8–13), and there are no studies comparing the inflammatory activity between nasal and oral infected or healthy mucosae. Here, we characterize the inflammatory infiltrate of oral and nasal lesions or healthy tissues by immunohistochemistry. Forty oral (O) and nasal (N) mucosa samples obtained by biopsy were examined.

During the last decade, monoclonal antibodies targeting these hav

During the last decade, monoclonal antibodies targeting these have been tested in clinical trials. Specific therapy targeted against tumour necrosis factor (TNF)-α alone using anti-TNF-α mAbs or soluble TNF-α receptors has been effective in murine collagen-induced arthritis (CIA) by reducing the incidence and severity of disease [16]. Recent studies have shown that therapy with rituximab is one of find more the treatment options for optimizing RA therapy [17]. Furthermore, mAbs directed against this CaMBP gives a promising result in the AIA model, which is

a reliable model for RA because it mimics exactly RA of the human joint [18]. In the present study, our data indicate that 67 kDa protein isolated from SF of RA patients is rheumatoid factor (RF), which is calcium-binding in nature and mediates the inflammatory and destructive process in RA. Monoclonal antibody for novel angiogenic protein (NAP) was produced and the same was used to explore the synergistic role of VEGF and NAP to evaluate the relationship of these proteins in RA. We also studied the correlation of important angiogenic markers CD31, an endothelial cell proliferation indicator, and fms-like tyrosine kinase (Flt1), the receptor for VEGF in AIA and the NAP-induced arthritis (NIA) model. Using enzyme-linked immunosorbent assay (ELISA) and immunohistochemical studies we found that a high level of VEGF is expressed with increased microvessel density

(MVD) in RA. Monoclonal antibodies directed against NAP ameliorate the disease incidence in NIA and an established AIA BI 2536 ic50 rat model. Our studies indicated that anti-NAP mAbs have a potent anti-arthritic effect which targets angiogenesis and can be useful for individualization of therapeutic strategies in treatment of Megestrol Acetate RA. Patients who fulfilled the American College of Rheumatology

criteria for RA [19] were recruited from the out-patient Department of Pathology, JSS Hospital, Mysore, with the approval of the medical college ethics committee and as per the guidelines of the Institutional Review Board. Informed consent was obtained from all the patients. The patient group comprised seven women and three men, with an age range of 38–67 years. Patients had active disease and disease duration of ≤ 2 years. All knee joints demonstrated signs of active synovitis at the time of aspiration. Wistar rats (aged 4–5 months) were obtained from the central animal facility of the Department of Zoology, University of Mysore, Mysore, India. All the animal experiments were approved by the Institutional Animal Ethics Committee, University of Mysore, Mysore and studies were conducted according to the guidelines of the Committee for Purpose of Control and Supervision of Experiments on Animals (CPCSEA), Government of India, India. Novel angiogenic protein was isolated and purified from human SF of patients with RA, as per the method described previously by us [20].

However,

unlike NFAT and AP-1 factors that interact and c

However,

unlike NFAT and AP-1 factors that interact and collaborate in binding to DNA, NFAT, and NF-κB seem neither to interact nor to collaborate. We show here that NF-κB1/p50 and c-Rel, the most prominent NF-κB proteins in BCR-induced splenic B cells, control the induction of NFATc1/αA, a prominent short NFATc1 isoform. In part, this is mediated through two composite κB/NFAT-binding sites in the inducible Nfatc1 P1 promoter that directs the induction of NFATc1/αA by BCR signals. In concert with coreceptor signals that induce NF-κB factors, BCR signaling induces a persistent generation of NFATc1/αA. These data suggest a tight connection between NFATc1 and NF-κB induction in B lymphocytes contributing to the effector function of peripheral B cells. “
“Ficolins are soluble molecules of the innate immune system that recognize carbohydrate molecules on microbial pathogens, apoptotic and necrotic

learn more cells. They act through two distinct routes: initiating the lectin pathway of complement activation and mediating a primitive opsonophagocytosis. In this study, we measured plasma levels of ficolin-2 and ficolin-3 in 60 pre-eclamptic patients, 60 healthy this website pregnant women and 59 healthy non-pregnant women by enzyme-linked immunosorbent assay (ELISA). Circulating levels of complement activation products (C4d, C3a, SC5b9), angiogenic factors (soluble fms-like tyrosine kinase-1, placental growth factor) and markers of endothelial activation (von Willebrand factor antigen), endothelial injury (fibronectin) and trophoblast debris (cell-free fetal DNA) were also determined. Plasma levels click here of ficolin-2 were significantly lower in healthy pregnant than in healthy non-pregnant women, while ficolin-3 levels did not differ significantly between the two groups. Furthermore, pre-eclamptic patients had significantly lower ficolin-2 and ficolin-3 concentrations than healthy non-pregnant and pregnant women. In the pre-eclamptic group,

plasma ficolin-2 levels showed a significant positive correlation with serum placental growth factor (PlGF) concentrations and significant inverse correlations with serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1), blood urea nitrogen and creatinine, serum lactate dehydrogenase activities, as well as with plasma VWF:antigen, fibronectin and cell-free fetal DNA concentrations. In conclusion, circulating levels of ficolin-2 are decreased in the third trimester of normal pregnancy. There is a further decrease in plasma ficolin-2 concentrations in pre-eclampsia, which might contribute to the development of the maternal syndrome of the disease through impaired removal of the trophoblast-derived material released into the maternal circulation by the hypoxic and oxidatively stressed pre-eclamptic placenta.

1,2 Hypertension, endocrine abnormalities such as insulin resista

1,2 Hypertension, endocrine abnormalities such as insulin resistance, and psychosocial complications are also implicated with sleep disorders.3–6 Treatment of SA has been shown to improve hypertension, cognitive function and glucose control.7–9 Hypertension is closely linked with SA and may mediate the association between SA and kidney disease. The NVP-LDE225 Institute of Medicine estimates that 60 million people in the USA have sleep disorders, of which SA is a significant component.10 The Seventh Report of

the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends consideration SA in patients with hypertension.11 Because sleep disorders may present with non-specific complaints, many physicians may fail to recognize SA. Polysomnography with sleep study has been the gold standard for diagnosing SA. The degree of severity, type (central vs obstructive) and response to positive airway pressure can be assessed with polysomnography. With the exception of interventional techniques such as surgery or tracheotomy,

treatment with positive airway devices is generally considered the standard of care. A high prevalence of SA has been demonstrated in dialysis patients12,13 compared with the 2–4% estimated in the general population.14 MLN0128 in vitro The uremic milieu is the likely mechanism responsible for SA. However, the association between SA and CKD extends beyond the ESRD population. SA appears to be more prevalent with early click here CKD, proteinuria and even renal transplantation. This review examines the prevalence of SA in patients with CKD, including patients with early-stage CKD, proteinuria, ESRD and those who have received renal transplants.

SA may be vary in form and aetiology within the different stages of CKD. Aside from established practices and guidelines for SA, we discuss our rationale for screening recommendations and management of SA with specific regard to the CKD population. The high prevalence of SA in the ESRD population is well described (see Table 1).12,13,15–24 Previous studies using polysomnography (e.g. sleep studies) or profiling of ESRD patients with sleep habit questionnaires (e.g. Berlin questionnaire25) demonstrated a high rate of sleep disturbances in this population.12,26 Compared with the general population where the prevalence of SA is estimated to be 2–4%, prevalence in the ESRD populations appears to be 30% or more.13,14 SA was diagnosed in up to 70% of selected patients who were assessed with polysomnography.17 In an attempt at direct comparison between haemodialysis (HD) patients and non-CKD patients, Unruh et al.24 performed polysomnography on 46 HD patients and 137 controls matched for age, gender, body mass and race who were participants in the Sleep Heart Health Study.27 The study demonstrated a 4.07 (95% confidence interval 1.83–9.07) odds ratio for sleep-disordered breathing in the HD patients compared with subjects without CKD.

In the present paper

we report a rare case of chronic rhi

In the present paper

we report a rare case of chronic rhinocerebral mucormycosis. An 85-year-old male with a 6-month history of purulent and odorous nasal discharge, and sporadic episodes of epistaxis and anosmia, presented to the outpatient department of our clinic. Initial cultures were positive only for Pseudomonas aeruginosa. The patient was unresponsive to ciprofloxacin treatment, developing necrotic areas of the nasal septum suspicious for rhinocerebral mucormycosis. Histone Methyltransferase inhibitor Admission to the ENT clinic followed, with histopathologic evaluation of the vomer bone confirming the diagnosis. The patient was treated with amphotericin B and was discharged 3 weeks later on oral posaconazole therapy. Chronic rhinocerebral mucormycosis may present with atypical symptoms or coinfection with another agent. A high degree of clinical suspicion is required for correct diagnosis and prompt initiation of appropriate treatment. “
“Malassezia spp. form part of the normal human cutaneous flora and

are implicated in several mild, but recurrent cutaneous diseases, such as pityriasis versicolor, Malassezia folliculitis, seborrhoeic dermatitis, and, with lesser frequency, a range of selleckchem other dermatological disorders. Malassezia spp. have also been associated with cutaneous and systemic diseases in immunocompromised patients including folliculitis, seborrhoeic dermatitis, catheter-related fungaemia and a variety of deeply invasive infections. In this review, we provide an overview of the epidemiology, risk factors, pathogenesis, clinical manifestations, diagnosis, treatment and outcome of cutaneous and invasive Malassezia infections in immunocompromised patients. Members of the genus Malassezia are opportunistic yeasts that belong to the basidiomycetous yeasts and are classified as the Malasseziales (Ustilaginomycetes, Basidiomycota). In 1996, the revision of the Malassezia genus classified the genus into seven species on the basis of morphology, ultrastructure, physiology Urocanase and molecular biology: M. globosa;

M. restricta; M. obtusa; M. slooffiae; M. sympodialis; M. furfur and the non-lipid dependent M. pachydermatis.1 Since then, however, further six new Malassezia spp. have been identified including M. dermatis, M. japonica, M. yamotoensis, M. caprae, M. nana and M. equina.2–5Malassezia spp. form part of the normal human cutaneous flora and are implicated in mild, but often recurrent cutaneous diseases such as pityriasis versicolor, Malassezia folliculitis, seborrhoeic dermatitis, and, with lesser frequency, a range of other dermatological disorders. In immunocompromised patients, Malassezia spp. may be associated with several skin conditions and systemic diseases, including folliculitis, seborrhoeic dermatitis, catheter-related fungaemia and sepsis and a variety of deeply invasive infections.

Identification of a triggering mechanism will represent a major s

Identification of a triggering mechanism will represent a major step forward towards disruption of the differentiation process and effective control of Toxoplasma infections. The process of reactivation (bradyzoite-to-tachyzoite differentiation) is critical to pathogeneses but one that is highly understudied. It is tempting to assume that reactivation may be a direct reversal of the tachyzoite-to-bradyzoite differentiation check details process. This could provide the premise for comparing gene expression patterns during differentiation

in both directions. Perhaps more challenging is the question of why some differentiation processes are reversible (e.g. tachyzoite-bradyzoite), while others are not (e.g. sporozoite–tachyzoite). A better understanding of the molecular mechanisms driving these processes could provide the tools required to arrest parasites growth and prevent the fatal effects of reactivation. While the sequencing Hydroxychloroquine of the Toxoplasma genome has been a significant step forward, transcript expression data and proteomic studies are important to better understand the functional significance that

is merely hinted at in the genome. In recent years, Toxoplasma has been the subject of a plethora of proteomic studies, the likes of which have been extensively covered in an excellent review by Weiss et al. (58). These proteomic studies have proven to be an invaluable resource for documenting the actively expressed proteins in tachyzoites and for better characterizing significant subproteomes, including the rhoptries and micronemes. The proteomic data from these studies also provide a wealth of information RG7420 supplier to validate and improve current gene prediction algorithms. The need for such improvements is highlighted by the global proteomic studies of Dybas et al. (59), which estimate that the currently employed gene prediction

algorithms exhibit false-negative rates ranging from 31 to 42%. Rather than recapitulate what was summarized by Weiss et al. (58), we herein present a summary of more recent developments in the field of Toxoplasma proteomics. The hydrophobic nature of many membrane proteins has been a long-standing hindrance to performing successful proteomic studies on them, as they are largely insoluble in aqueous solution. Detergents are needed to solubilize the proteins, although the inclusion of these detergents has numerous negative effects on subsequent proteomic studies. As an example, ionization products of the detergents can obscure relevant, less abundant peptide products. A common way to surmount the problem of excess detergents in proteomic studies is to resolve the solubilized proteins with one-dimensional gel electrophoresis and couple that with tandem mass spectrometry analysis (1D LC–MS/MS). This was one of the three approaches that Che et al.

In literature, little is discussed on this topic and surgical str

In literature, little is discussed on this topic and surgical strategies are not indicated to repair the vascular pedicle in order to avoid flap failure preserving reconstruction outcome. The authors present their experience on intraoperative vascular pedicle damage and develop an algorithmic approach regarding types of vascular pedicle damage and available options to repair them in attempt to salvage the flap. From Fluorouracil March 2003 to August 2012, 209

patients (mean age 48 years, range 26–78) underwent breast reconstruction with LD flap at our institution; among these 186 cases were treated for immediate reconstruction and 23 cases for delayed one. TD pedicle damage by the general surgeon occurred in five cases, three of which were found during immediate reconstruction and two were observed in patients who underwent prior surgery. Patients’ data are shown selleck in Table 1. Thoracodorsal vein (TDV) injury was found in four cases. Among them, two were cauterized in their proximal segment; one was longitudinally damaged while a ligature completely occluding the TDV was observed in the last one. In another case both thoracodorsal artery

and vein (TDA and TDV) were cauterized in their proximal segment for about 2 cm. In case of TDV cauterization injury, 1 cm was resected and the end-to-end anastomosis was performed between proximal stump of TDV and the circumflex scapular vein (CSV), while microsurgical repair was carried out in case of sharply damage. The extensive occlusion of TDV required sectioning TD pedicle and conversion to free flap, re-vascularising the flap with an end-to-end anastomoses selleck kinase inhibitor to internal mammary vessels (IMV). Injury of both TDA and TDV required resection of 3 cm of their length; artery was repaired by direct anastomosis while the vein was anastomosed to CSV after its transposition. On a series of 209 patients who underwent reconstruction with

LD flap, TD pedicle has been damaged during axillae dissection by the general surgeon in five cases (2.4%), and different microsurgical techniques were used in attempt to salvage the flaps and outcomes of breast reconstruction. Total flap survival occurred in all case of TDV damage. Among them, in one case a venous congestion of LD flap resulted in a rippling phenomenon to the inferior-medial quadrant. Major complications such as partial flap ischemia developed only in the case of injury of both artery and vein, which required subtotal muscle resection and sub-pectoral prosthesis positioning leading to severe breast asymmetry and shape distortion. Each reconstructive procedure has its own particular indications and limitations and their misunderstanding may lead to suboptimal outcomes.

Both adaptive and innate immune effector mechanisms are believed

Both adaptive and innate immune effector mechanisms are believed to contribute to tissue disease aetiology. HLA-E is a non-classical MHC class Ib molecule that acts as the ligand for the NKG2A inhibitory receptor present on natural killer (NK) and CD8+ cells. Peptide binding and stabilization of HLA-E is often considered to signal infection or cell stress. Here we examine the up-regulation of HLA-E in MS brain tissue. Expression is significantly increased in white matter lesions in the brain of MS patients compared with Y-27632 concentration white matter of neurologically healthy controls.

Furthermore, using quantitative immunohistochemistry and confocal microscopy, we show increased HLA-E protein expression in endothelial cells of active MS lesions. Non-inflammatory chronic lesions express significantly less HLA-E protein, comparable to levels found in white matter from controls. Increased HLA-E protein levels were associated with higher scores of inflammation. These PLX4032 cost results suggest the potential for an effect in central nervous system pathogenesis from HLA-E modulation in stressed tissue. Co-localization with infiltrating CD8+ cells implicates a possible role for HLA-E-restricted regulatory CD8+ cells, as has been proposed in other autoimmune diseases. “
“Perforin (P) is a prototypical cytotoxic molecule involved in cell-mediated immunity against various pathogens, alloantigens and particularly different tumours. The purpose

of this study was to determine P expression in different lymphocyte subpopulations isolated from

peripheral blood and prostate tissue of patients with benign prostatic hyperplasia (BPH) and prostate cancer (PCa) and compare it with the P expression found in the control group. Twenty subjects were recruited in each of the groups. Prostate mononuclear cells of the BPH and PCa tissues were isolated ID-8 by enzymatic digestion and gradient density centrifugation, whereas peripheral blood mononuclear cells were isolated by gradient density centrifugation alone. Cells and tissue samples were labelled using monoclonal antibodies against P and different surface antigens (CD3, CD4, CD8 and CD56) and analysed by immunofluorescence and flow cytometry. Total P expression in peripheral blood lymphocytes did not differ significantly between BPH/PCa patients and control group, although the BPH and PCa tissue showed lower P expression level. A negative correlation between prostate-specific antigen levels and the overall percentage of P+, CD3+CD56−P+, and CD3−CD56+P+ cells in the prostate tissue was observed only in patients with PCa. Our findings indicate that the low frequency of P+ lymphocytes, including T, NKT and NK cells, in the prostate tissue of patients with BPH and, particularly, PCa could be the consequence of local tissue microenvironment and one of the mechanisms involved in the pathogenesis of prostate hyperplasia following malignant alteration.

By contrast,

the attenuation of signalling in Siglec-G-de

By contrast,

the attenuation of signalling in Siglec-G-deficient mice under the same conditions may be insufficient to prevent B-cell activation and antibody secretion. Alternatively, accumulating B1-like B cells in dnRAG1 mice may be intrinsically resistant to (auto)antigenic stimulation. This possibility is supported by experiments showing that B cells from dnRAG1 mice exhibit impaired responses BAY 73-4506 supplier toward antigenic stimuli in vitro and immunization by thymus-independent antigens in vivo (Fig. 3). Whether genetic manipulation of BCR signalling pathways in dnRAG1 mice can promote (auto)antibody production in these animals is a focus of future investigation. Both the B1 and the MZ B-cell populations are known to be enriched for cells with poly-reactive and/or weakly self-reactive BCRs.53 B cells with such specificities could be potentially dangerous if allowed to undergo affinity maturation toward host antigens, but are generally Lumacaftor solubility dmso tolerated by the host because of the useful role they play in recognizing bacterial antigens to promote early immune responses against these organisms.45,46

There remains some uncertainty over the extent to which BCR specificity controls lineage specification of B1 B cells.54 The data presented here suggest that splenic B1-like B cells accumulating in dnRAG1 mice acquire this phenotype based on their BCR specificity, because enforced expression of a heavy chain transgene specific for

Calpain dsDNA (56Rki) in dnRAG1 mice blocks their accumulation, and instead promotes expansion of MZ-like B cells (Fig. 7). The latter result is particularly interesting in light of evidence showing that anti-dsDNA B cells that fail to edit BCR specificity away from dsDNA, but that possess cross-reactivity toward intracellular antigens, may acquire the phenotype of a B cell found in the MZ and remain sequestered there as a means to escape editing pressure.55 The fact that B cells with a B1 phenotype are normally detected at low levels in the spleen, but are significantly increased in dnRAG1 mice, raises the question of whether B cells normally present in this compartment have been positively selected into this reservoir, or whether this population represents a safe anatomical repository for peripheral B cells that have attempted to undergo receptor editing, but still retain vestiges of self-reactivity at levels that are tolerated by the host. These possibilities are not necessarily mutually exclusive. The selection model of B1 B-cell differentiation argues that if this self-specificity is retained, then the B cell would adopt a B1-like phenotype. The expansion of splenic B1 B cells in dnRAG1 mice suggests that the antigenic specificities represented in this population are tolerated by the host if they cannot be successfully edited.