(American Journal of Pathology. 2000;156:1171-1176.)
© 2000 American Society for Investigative Pathology
Tumor Necrosis Factor Induces Tumor Necrosis via Tumor Necrosis Factor Receptor Type 1-Expressing Endothelial Cells of the Tumor Vasculature
Benjamin Stoelcker*,
Brigitte Ruhland*,
Thomas Hehlgans*,
Horst Bluethmann
,
Thomas Luther
and
Daniela N. Männel*
From the Institute of Pathology/Tumor Immunology,*
University of Regensburg, Regensburg, Germany; Pharmaceutical Research
Gene Technology,
F. Hoffmann-LaRoche, Basel,
Switzerland; and the Institute of Pathology,
Technical University Dresden, Dresden, Germany
 |
Abstract
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Activation of endothelial cells, fibrin
deposition, and coagulation within the tumor vasculature has
been shown in vivo to correlate with the occurrence of
tumor necrosis factor (TNF)-induced tumor necrosis in mice. In the
present study we investigated which target cells mediate the
TNF-induced necrosis in fibrosarcomas grown in wild type (wt),
TNF receptor type 1-deficient (TNFRp55-/-), and TNF receptor
type 2-deficient (TNFRp75-/-) mice. TNF administration resulted in
tumor necrosis exclusively in wt and TNFRp75-/-, but not
in TNFRp55-/- mice, indicating a dependence of TNF-mediated
tumor necrosis on the expression of TNF receptor type 1.
However, using wt and TNFRp55-/- fibrosarcomas in wt
mice, we found that TNF-mediated tumor necrosis was completely
independent of TNF receptor type 1 expression in tumor cells. Thus we
could exclude any direct tumoricidal effect of TNF in this model.
Soluble TNF induced leukostasis in wt and TNFRp75-/- mice but not in
TNFRp55-/- mice. TNF-induced leukostasis in TNFRp55-/- mice was
restored by adoptive bone marrow transplantation of wt hematopoietic
cells, but TNF failed to induce tumor necrosis in these
chimeric mice. Because TNF administration resulted in both activation
and focal damage of tumor endothelium, TNF receptor type
1-expressing cells of the tumor vasculature, likely to be
endothelial cells, appear to be target cells for mediating
TNF-induced tumor necrosis.
 |
Introduction
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Bacterial endotoxin (lipopolysaccharide, LPS) has long been
shown to have antitumor activity in vivo by induction of
tumor necrosis or tumor regression in mouse tumor
models.1-3
This finding led to the identification of
tumor necrosis factor (TNF) as the major mediator for the necrotizing
effect of LPS.4
TNF is a pleiotropic cytokine, which is
mainly produced by activated monocytes/macrophages, neutrophils, and T
cells.5
TNF exerts its activity via two distinct receptors
with an apparent molecular mass of 55 kd (TNF receptor type 1, TNFRp55)
and 75 kd (TNF receptor type 2, TNFRp75), respectively. These TNF
receptors are expressed on almost every cell type such as leukocytes,
endothelial cells, and tumor cells, but a number of differences in
TNFRp55- and TNFRp75-mediated signals are known.6
For
activation of blood-borne as well as endothelial cells, recombinant
human TNF (rhTNF), which only binds to the TNFRp55 in the mouse system,
is sufficient. Furthermore, the ability to induce tumor necrosis in
mice with rhTNF indicated an important role for the TNF receptor type 1
in mediating the necrotizing effects.
Earlier studies suggested that TNF acts
on the tumor-associated endogenic cells rather than directly on the
tumor cells because methylcholanthrene-induced fibrosarcomas, known to
be relatively insensitive to TNF-mediated cytotoxicity in
vitro, are extremely sensitive to the necrotizing effect in
vivo.7
Until now a TNF-mediated tumor cytotoxicity,
however, could not be fully excluded. In addition, it was demonstrated
that TNF-induced coagulation in the tumor vasculature may be one
potential mechanism for tumor necrosis.8
This was stressed
by the fact that necrosis was achieved through selective induction of
thrombosis within the tumor vessels by targeting procoagulant tissue
factor (TF), by means of a bispecific antibody to an experimentally
induced marker on tumor vascular endothelial cells.9
In a
less artificial system we could show that coagulation within the
vascular bed of the tumor correlated with the expression of tissue
factor (TF) on endothelial cells, which is known to be induced by TNF
in vivo.10
In addition, when TF expression was
inhibited by somatic gene transfer of I
B in this model, TNF-mediated
fibrin deposition was decreased and free blood flow could be
restored.11
Besides a direct endothelial cell stimulation
by LPS, TNF, or other cytokines, adhesion of lymphocytes to endothelium
or coculture of monocytes with endothelial cells can also induce TF
expression on endothelium.12-14
This, together with the
observation of TF expression on endothelial cells after TNFRp75
stimulation15
and the fact that activated monocytes also
express TF,16
leaves room for a potential role for both
leukocytes and endothelial cells in initiating tumor necrosis. However,
it is still unclear whether coagulation as a result of induction of TF
expression is the cause or rather a consequence of the disruption of
the tumor vasculature. Ruegg and co-workers demonstrated that TNF
reduces
vß3 integrin-mediated endothelial cell adhesion in
vitro, resulting in detachment and apoptotic cell
death.17
Such endothelial cell destruction has been
suggested to be the effector mechanism in the only antitumoral TNF
therapy of isolated limp perfusion currently used,18
which
points to the endothelium as a target for TNF-induced tumor necrosis.
Although in TNF-induced tumor necrosis a role of endothelial cells was
suggested by a number of previous studies, neither a direct tumor cell
cytotoxic activity nor a leukocyte-mediated event could be fully
excluded until now. By using mice and tumor cells deficient for TNFRs
and by generating bone marrow chimeric mice, we investigated the
mechanism by which recombinant soluble mouse TNF, which, in contrast to
human TNF, interacts with both the TNFRp55 and the TNFRp75, initiates
tumor necrosis.
 |
Materials and Methods
|
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Animals
Female wild-type (wt) mice of strain C57BL/6 and C57BL/6 x
129/Sv were obtained from Charles River, Germany, and from RCC,
Füllinsdorf, Switzerland, respectively. TNFRp55-deficient
mice (TNFRp55-/-),19
(kindly provided by K. Pfeffer,
Munich) and TNFRp75-deficient mice (TNFRp75-/-)20
have
been back-crossed six times to C57BL/6. Mice deficient for both TNF
receptors were obtained by crossing single TNFR-deficient mice and were
of hybrid C57BL/6 x 129/Sv background. Mice used for tumor
experiments were age- and sex-matched. All mice were fed with a
standard diet, received water ad libitum, and were kept in
the animal facility of the University of Regensburg according to
institutional guidelines and in accordance with the German law for
animal experimentation.
Reagents
Recombinant mouse (rm)TNF was expressed in Escherichia
coli and purified according to standard procedures. The specific
activity was 9 x 108
U/mg, as tested in the
L929 TNF bioassay in the presence of 2 µg/ml actinomycin D. LPS
contamination of the purified material was <0.16 µg/mg, as
determined in a Limulus lysate turbidity
assay.21
LPS from Salmonella minnesota (LPSW S.
minnesota 9700) was purchased from Difco (Detroit, MI).
Tumors
The wtBFS-1 MethA-induced fibrosarcoma was generated in a female
C57BL/6 mouse and the p55-/-BFS-1 MethA-induced fibrosarcoma in a
female TNFRp55-/- mouse by injection of 1 mg of 3-methylcholanthrene
(Sigma, Deisenhofen, Germany) dissolved in 200 µl tricaprylin (Sigma)
i.d. in the back of a mouse essentially as described
earlier.5
To adapt wtBFS-1 cells for growth in
C57BL/6 x 129/Sv mice, wtBFS-1 cells were passaged three times in
C57BL/6 x 129/Sv mice and named BFS-2c. The tumor cells were
maintained in vitro in RPMI 1640 supplemented with 5%
heat-inactivated fetal calf serum (all from Life Technologies,
Eggenstein, Germany).
Tumor Experiments
Mice received 1.5 x 106
BFS-1,
p55-/-BFS-1, or BFS-2c cells in 50 µl medium i.d. in the back, and
tumors were allowed to grow for 911 days to reach a size
approximately 8 mm in diameter before i.p. injection of rmTNF (5 µg)
in 100 µl PBS or 100 µl PBS alone as a control. After 12 hours or 2
days, mice were sacrificed and the tumors were removed for
immunohistochemistry or histology, respectively.
Histology
The tumors were excised, fixed overnight in 4% PBS-buffered
formalin, and embedded in paraffin. For immunohistochemistry, dewaxed
sections were treated with 0.05% pronase (Dako, Hamburg, Germany) (15
minutes, 37°C) before incubation with anti-von Willebrand factor
(vWF) antibody (Dako) (serum dilution 1:400, 1 hour, 37°C) to look
for vascular endothelial damage as described earlier.22
Central vertical sections (4 µm) were stained with hematoxylin and
eosin and examined with a Leitz Axioplan microscope (x40
magnification). The percentage of necrotic area versus total
tumor area of two sections per tumor was quantified using the image
analysis software analySIS (Soft-Imaging Software GmbH, Münster,
Germany). Tumors with >20% necrotic area were considered positive for
tumor necrosis.
Leukocyte Adhesion in Vivo
Mice received rmTNF (5 µg) i.p. in 100 µl PBS or PBS alone as
a control. After 4 hours, mice were sacrificed and the lungs were
removed and processed like the tumors. The sections were examined with
a Leitz Axioplan microscope (x160 magnification). Adherent leukocytes
in vessels with an inner diameter of 50150 µm were counted, and the
inner circumference of the vessels was measured using the image
analysis software analySIS (Soft-Imaging Software GmbH). To quantify
leukostasis, two sections per lung and at least five vessels per
section were examined and expressed as adherent leukocytes per mm
endothelium ± SE.
Adoptive Transfer of Bone Marrow Cells
Donor mice were sacrificed and the femurs were removed. The ends
of the femurs were cut off, gently ground in medium, and filtered
through a sieve (0.2-µm mesh) to remove bone fragments. The bone
marrow cells were flushed out of the femurs with ice-cold RPMI 1640
containing 5% fetal calf serum, using a syringe. Bone marrow cells
were pooled, washed twice, and resuspended in medium at a concentration
of 108/ml. After lethal x-irradiation (10 Gy)
recipient mice received 107
donor bone marrow
cells i.v. in 100 µl medium into the tail vein. For the following 2
weeks drinking water was supplemented with 0.1 g/l neomycin sulfate
(Sigma) and 10 mg/l polymycin (Sigma). Four weeks after reconstitution,
mice were used for tumor experiments.
PCR
To determine the quality of the adoptive cell transfer, PCR of
genomic DNA derived from leukocytes from reconstituted mice was
performed to test for the presence or absence of either TNFR allele.
Reconstituted mice were anesthetized and bled through the retroorbital
plexus into 0.1 mol/L citrate buffer (pH 8). Genomic DNA was isolated
from approximately 200 µl whole blood, using the Quiamp Blood
Kit (Quiagen, Hilden, Germany), following the suppliers instructions.
The following primers were used: gT6E515 (AGAAATGTCCCAGGTGATCTC),
gT6IP2 (TTGCCAGACGTTTGCAAGCG), and HSVTK-AS
(ATTCGGCAATGACAAGACGCTCC). PCR was carried out following the
instructions from Perkin-Elmer (Applied Biosystems, Weiterstadt,
Germany). By use of the primers gT6H515 and gT6IP2, a 600-bp fragment
of the wt TNFRp55 allele was amplified. By use of the primers
HSVTK-AS and gT6IP2, a 800-bp fragment of the mutated TNFRp55 allele
was amplified. The annealing temperature for the primers used was
63°C (0.5 minutes) and 72°C (1.5 minutes) for the elongation
reaction.
Statistics
P values were determined using Students
t-test.
 |
Results and Discussion
|
|---|
Generally, presence or deficiency of the TNFRp55 on the tumor or
on endogenic cells does not seem to affect tumor growth per
se. Wild-type (wtBFS-1 and BFS-2c) and TNFRp55-deficient
fibrosarcoma cells (p55-/-BFS-1) grew with similar growth
characteristics in C57BL/6 wt, TNFRp55-/-, and TNFRp75-/- mice. In
addition, tumors grew in a comparable way in mice deficient for both
TNF receptors (data not shown). Tumor-bearing wt or TNFR-deficient mice
were treated with rmTNF, and the incidence of tumor necrosis was
determined 2 days after treatment. Using these models, we found that
soluble rmTNF, which interacts with both TNFRp55 and TNFRp75, did
not induce necrosis in fibrosarcomas of TNFRp55-/- mice (Table 1)
. On the other hand, rmTNF treatment
caused necrosis in TNFRp75-/- mice, although to a somewhat reduced
rate as compared to wt mice (60% in TNFRp75-/- versus
84% in wt mice), which could be due to the enhancer function of the
TNFRp75 lacking in these mice. Although it was recently stated that
a TNF mutein with a specificity to TNFRp75 is capable of induction of
some tumor necrosis,23
our results from TNF-deficient mice
are clearly in line with the finding that rhTNF, which binds only to
the mouse TNFRp55 and does not interact with the mouse TNFRp75,
could also induce necrosis (ref. 7
and our own data). Interestingly,
LPS-induced tumor necrosis seems to be a more complex process, inasmuch
as LPS treatment, in contrast to that with rmTNF, still causes tumor
necrosis in TNFRp55-/- mice (data not shown). One reason for this
finding could be that LPS-induced, endogenously produced membrane-bound
TNF, before maturation to soluble TNF, preferentially activates cells
via TNFRp75.
When C57BL/6 wt mice bearing solid tumors derived from wt BFS-1 or
p55-/-BFS-1 cells were treated with rmTNF, we found that necrosis was
induced by rmTNF in p55BFS-1 tumors as efficiently as in wt BFS-1
tumors (Figure 1)
. The induction of
necrosis with rmTNF was obviously independent of the TNFRp55 expression
on the tumor cells, thus excluding any direct tumoricidal effect of
TNF. Therefore, we concluded that the presence of TNFRp55 on
tumor-associated, endogenic cells beside the tumor cells has to be
necessary and sufficient to mediate TNF-induced tumor necrosis.
Activation of endothelial cells, fibrin deposition, and coagulation
within the tumor vasculature has been shown in vivo to be
correlated with the occurrence of TNF-induced tumor necrosis in other
and very similar tumor models.8-11,24
Accordingly we
found in the TNF-treated tumors intravascular fibrin formation (not
shown). In addition, 12 hours after TNF administration we observed
increased amounts of vWF in the tumor endothelium by
immunohistochemistry (not shown), indicating an injury and/or
regeneration of endothelial cells.22,25
Therefore, one
potential mechanism for TNF-mediated tumor necrosis might be the
induction of a procoagulatory state within the tumor vasculature by
direct stimulation of TF expression on the tumor endothelium and/or via
activated blood leukocytes (ie, monocytes).10,12,13,26
In
addition, inflammatory mediators like LPS and TNF are known to induce
leukocyte sequestration.26,27
Four to twelve hours after
rmTNF treatment of tumor-bearing mice we observed leukostasis in the
vessels of different organ systems such as lung and kidney, but also in
the tumor vasculature (data not shown). Detection of leukostasis in the
tumor vessels, however, was difficult because of the structure
(diameter, wall thickness) of the tumor vasculature. Because
rmTNF-activated leukocytes release inflammatory cytokines (which,
furthermore, should be able to stimulate TF expression on endothelial
cells), rmTNF-induced adherence of activated leukocytes may contribute
to the tumor necrosis in our mouse model.
To analyze the TNF receptor-dependent effect of systemic rmTNF
treatment on the sequestration of peripheral blood leukocytes, the
occurrence of pulmonary leukostasis was quantified in wt and
TNFR-deficient mice 4 hours after TNF application. Administration of
rmTNF resulted in adhesion of leukocytes to lung vessels in wt and
TNFRp75-/- mice. However, as in tumor necrosis, soluble rmTNF was
not able to induce leukostasis in TNFRp55-/- mice (Figure 2B)
. To determine the role of
hematopoietic cells for mediating these rmTNF-induced effects, chimeric
mice were generated by adoptive bone marrow transplantation. Either
TNFRp55-/- mice received wt bone marrow cells or wt mice received
bone marrow cells from TNFRp55-/- donors. To test the successful
adoptive bone marrow cell transfer, the genotype of blood leukocytes in
chimeric mice was determined 4 weeks after reconstitution. In all
chimeric mice, specific bands of the donor genotype and the recipient
genotype were detectable, which was likely due to incomplete
reconstitution (Figure 2A)
. Nevertheless, adoptive transfer of
TNFRp55-positive bone marrow cells into TNFRp55-/- mice was
sufficient to restore rmTNF-induced sequestration of leukocytes in
TNFRp55-/- mice (Figure 2B)
, indicating that rmTNF was acting on the
hematopoietic cells for this function. In contrast, we could not induce
tumor necrosis with rmTNF in chimeric TNFRp55-/- mice, even after
reconstitution with wt bone marrow cells (Figure 3)
, whereas rmTNF caused tumor necrosis
in chimeric wt mice reconstituted with TNFRp55-/- bone marrow cells
as well as it did in wt mice reconstituted for control purposes with wt
bone marrow cells. LPS, in the same experiment, induced tumor necrosis
in TNFRp55-/- mice reconstituted with bone marrow from wt as well as
TNFRp55-/- mice, documenting the general ability for tumor necrosis
in such mice (data not shown).

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Figure 2. TNF-induced leukostasis in TNFR-deficient and bone marrow chimeric
mice. A: Genomic DNA was isolated from leukocytes of C57BL/6
wt (lanes 2 and
3) and TNFRp55-/- mice
(lanes 4 and
5), or TNFRp55-/- mice
reconstituted with wt bone marrow (lanes
69), or wt mice reconstituted with
TNFRp55-/- bone marrow (lanes
1013). The presence of the wt
(lanes 2, 4, 6, 8, 10,
12) or mutated
(lanes 3, 5, 7, 9, 11,
13) TNFRp55 allele was determined by PCR. A
DNA length standard is shown in lane 1. B:
C57BL/6 mice (wt, n =
6), TNFRp75-/- mice
(p75-/-, n =
6), TNFRp55-/- mice
(p55-/-, n =
6), or TNFRp55-/- mice reconstituted with wt
bone marrow cells (wt p55-/-,
n = 5) were treated i.p.
with rmTNF (5 µg in 100 µl
PBS) or PBS (100
µl). Bars represent the mean value ± SE
of adherent leukocytes per mm endothelium. *P <
0.001.
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Figure 3. TNF-induced tumor necrosis in bone marrow chimeric mice. Tumor
(wt BFS-1)-bearing
C57BL/6 wt mice reconstituted with wt bone marrow
(wt wt, n = 7, ,
), TNFRp55-/- mice reconstituted with wt
bone marrow (p55-/- wt,
n = 11, , ) or wt mice
reconstituted with TNFRp55-/- bone marrow
(wt p55-/-, n = 16, ,
) were treated with PBS
(100 µl, , , )
or rmTNF (5 µg in 100 µl PBS, , ,
) i.p. and tumor necrosis was determined 2
days after treatment. Pooled results from two experiments with at least
three mice per group are shown. P values for the
comparison of the PBS versus rmTNF-treated groups:
*P < 0.05.
|
|
Taken together, even though leukocyte adhesion after rmTNF treatment
was dependent on the presence of the TNFRp55 in the host cells, an
essential contribution of leukocytes to rmTNF-induced tumor necrosis is
unlikely, because in chimeric mice the occurrence of tumor necrosis did
not correlate with leukostasis. The hypothesis of TNF action on
endothelial cells for tumor necrosis induction,8,10
however, is strengthened by the finding that wt bone marrow
transplantation did not change the phenotype of the tumor-bearing
TNFRp55-/- mice, which are not able to mediate rmTNF-induced tumor
necrosis. In these mice the endothelial cells lining the vascular
system do not carry a functional TNFRp55 but only the adoptively
transferred hematopoietic cells. This demonstrated clearly that
rmTNF-induced tumor necrosis was not mediated by hematopoietic cells
like granulocytes, T cells, or monocytes/macrophages, but likely by
tumor vascular endothelium. This is in line with the observed toxic
effect on endothelial cells after therapeutic administration of TNF and
IFN
in isolated limp perfusion of melanoma patients.17
From these studies, disruption of the tumor vasculature is discussed as
result of anoikis due to decreased
vß3-dependent endothelial cell
adhesion and ensuing detachment of these cells.17
In conclusion, we found that 1) rmTNF does not directly exert a
cytotoxic effect on the tumor cells, 2) the TNFRp55 expression on
hematopoietic cells was essential for TNF-induced leukocyte
sequestration, 3) but not sufficient to mediate tumor necrosis. TNFR
type 1-expressing endothelial cells lining the tumor vasculature are
most likely the target cells for mediation of TNF-induced tumor
necrosis.
 |
Footnotes
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Address reprint requests to Dr. Daniela N. Männel, Department of Pathology, University of Regensburg, D-93042 Regensburg, Germany. E-mail: daniela.maennel{at}klinik.uni-regensburg.de
Accepted for publication December 7, 1999.
 |
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R. Gerl and D. L. Vaux
Apoptosis in the development and treatment of cancer
Carcinogenesis,
February 1, 2005;
26(2):
263 - 270.
[Abstract]
[Full Text]
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S. Mocellin, M. Provenzano, C. R. Rossi, P. Pilati, R. Scalerta, M. Lise, and D. Nitti
Induction of Endothelial Nitric Oxide Synthase Expression by Melanoma Sensitizes Endothelial Cells to Tumor Necrosis Factor-Driven Cytotoxicity
Clin. Cancer Res.,
October 15, 2004;
10(20):
6879 - 6886.
[Abstract]
[Full Text]
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G. Schwamberger, P. Hammerl, E. Ferber, M. Freudenberg, and C. Galanos
TNF revisited: TNF-independent antitumor activity in sera of mice sensitized with Propionibacterium acnes and challenged with lipopolysaccharide
J. Leukoc. Biol.,
December 1, 2003;
74(6):
1056 - 1063.
[Abstract]
[Full Text]
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P. Monti, B. E. Leone, F. Marchesi, G. Balzano, A. Zerbi, F. Scaltrini, C. Pasquali, G. Calori, F. Pessi, C. Sperti, et al.
The CC Chemokine MCP-1/CCL2 in Pancreatic Cancer Progression: Regulation of Expression and Potential Mechanisms of Antimalignant Activity
Cancer Res.,
November 1, 2003;
63(21):
7451 - 7461.
[Abstract]
[Full Text]
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P. C. Manegold, J. Hutter, S. A. Pahernik, K. Messmer, and M. Dellian
Platelet-endothelial interaction in tumor angiogenesis and microcirculation
Blood,
March 1, 2003;
101(5):
1970 - 1976.
[Abstract]
[Full Text]
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B. Stoelcker, T. Hehlgans, K. Weigl, H. Bluethmann, G. E. Grau, and D. N. Mannel
Requirement for Tumor Necrosis Factor Receptor 2 Expression on Vascular Cells To Induce Experimental Cerebral Malaria
Infect. Immun.,
October 1, 2002;
70(10):
5857 - 5859.
[Abstract]
[Full Text]
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W.-H. Shen, J.-H. Zhou, S. R. Broussard, G. G. Freund, R. Dantzer, and K. W. Kelley
Proinflammatory Cytokines Block Growth of Breast Cancer Cells by Impairing Signals from a Growth Factor Receptor
Cancer Res.,
August 15, 2002;
62(16):
4746 - 4756.
[Abstract]
[Full Text]
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T. Hehlgans, B. Stoelcker, P. Stopfer, P. Muller, G. Cernaianu, M. Guba, M. Steinbauer, S. A. Nedospasov, K. Pfeffer, and D. N. Mannel
Lymphotoxin-{beta} Receptor Immune Interaction Promotes Tumor Growth by Inducing Angiogenesis
Cancer Res.,
July 15, 2002;
62(14):
4034 - 4040.
[Abstract]
[Full Text]
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K. Hallermalm, K. Seki, C. Wei, C. Castelli, L. Rivoltini, R. Kiessling, and J. Levitskaya
Tumor necrosis factor-{alpha} induces coordinated changes in major histocompatibility class I presentation pathway, resulting in increased stability of class I complexes at the cell surface
Blood,
August 15, 2001;
98(4):
1108 - 1115.
[Abstract]
[Full Text]
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