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MHC class II

MHC Class II molecules are a class of major histocompatibility complex (MHC) molecules normally found only on professional antigen-presenting cells such as dendritic cells, mononuclear phagocytes, some endothelial cells, thymic epithelial cells, and B cells. These cells are important in initiating immune responses.

MHC Class II
Schematic representation of MHC class II
Identifiers
SymbolMHC Class II
Membranome63

The antigens presented by class II peptides are derived from extracellular proteins (not cytosolic as in MHC class I).

Loading of a MHC class II molecule occurs by phagocytosis; extracellular proteins are endocytosed, digested in lysosomes, and the resulting epitopic peptide fragments are loaded onto MHC class II molecules prior to their migration to the cell surface.

In humans, the MHC class II protein complex is encoded by the human leukocyte antigen gene complex (HLA). HLAs corresponding to MHC class II are HLA-DP, HLA-DM, HLA-DOA, HLA-DOB, HLA-DQ, and HLA-DR.

Mutations in the HLA gene complex can lead to bare lymphocyte syndrome (BLS), which is a type of MHC class II deficiency.

Structure edit

Like MHC class I molecules, class II molecules are also heterodimers, but in this case consist of two homogenous peptides, an α and β chain, both of which are encoded in the MHC.[1] The subdesignation α1, α2, etc. refers to separate domains within the HLA gene; each domain is usually encoded by a different exon within the gene, and some genes have further domains that encode leader sequences, transmembrane sequences, etc. These molecules have both extracellular regions as well as a transmembrane sequence and a cytoplasmic tail. The α1 and β1 regions of the chains come together to make a membrane-distal peptide-binding domain, while the α2 and β2 regions, the remaining extracellular parts of the chains, form a membrane-proximal immunoglobulin-like domain. The antigen binding groove, where the antigen or peptide binds, is made up of two α-helixes walls and β-sheet.[2]

Because the antigen-binding groove of MHC class II molecules is open at both ends while the corresponding groove on class I molecules is closed at each end, the antigens presented by MHC class II molecules are longer, generally between 15 and 24 amino acid residues long.

Expression edit

These molecules are constitutively expressed in professional, immune antigen-presenting cells, but may also be induced on other cells by interferon γ.[3] They are expressed on the epithelial cells in the thymus and on APCs in the periphery. MHC class II expression is closely regulated in APCs by CIITA, which is the MHC class II transactivator. CIITA is solely expressed on professional APCs; however, non-professional APCs can also regulate CIITA activity and MHC II expression. As mentioned interferon γ (IFN γ ) triggers the expression of CIITA and is also responsible for converting monocytes which are MHC class II negative cells into functional APCs that express MHC class II on their surfaces.[4]

MHC class II is also expressed on group 3 innate lymphoid cells.

Importance edit

Having MHC class II molecules present proper peptides that are bound stably is essential for overall immune function.

[5] Because class II MHC is loaded with extracellular proteins, it is mainly concerned with presentation of extracellular pathogens (for example, bacteria that might be infecting a wound or the blood). Class II molecules interact mainly with immune cells, like the T helper cell (CD4+). The peptide presented regulates how T cells respond to an infection.[5] Stable peptide binding is essential to prevent detachment and degradation of a peptide, which could occur without secure attachment to the MHC molecule.[5] This would prevent T cell recognition of the antigen, T cell recruitment, and a proper immune response.[5] The triggered appropriate immune response may include localized inflammation and swelling due to recruitment of phagocytes or may lead to a full-force antibody immune response due to activation of B cells.

Synthesis edit

During synthesis of class II MHC in the endoplasmic reticulum, the α and β chains are produced and complexed with a special polypeptide known as the invariant chain.[6] The nascent MHC class II protein in the rough ER has its peptide-binding cleft blocked by the invariant chain (Ii; a trimer) to prevent it from binding cellular peptides or peptides from the endogenous pathway (such as those that would be loaded onto class I MHC).

The invariant chain also facilitates the export of class II MHC from the ER to the Golgi apparatus, followed by fusion with a late endosome containing endocytosed, degraded proteins. The invariant chain is then broken down in stages by proteases called cathepsins, leaving only a small fragment known as CLIP which maintains blockage of the peptide binding cleft on the MHC molecule. A MHC class II-like structure, HLA-DM, facilitates CLIP removal and allows the binding of peptides with higher affinities. The stable class II MHC is then presented on the cell surface.

Recycling of MHC class II complexes edit

After MHC class II complexes are synthesized and presented on APCs they are unable to be expressed on the cell surface indefinitely, due to the internalization of the plasma membrane by the APCs(antigen presenting cells). In some cells, antigens bind to recycled MHC class II molecules while they are in the early endosomes, while other cells such as dendritic cells internalize antigens via receptor-mediated endocytosis and create MHC class II molecules plus peptide in the endosomal-lysosomal antigen processing compartment which is independent of the synthesis of new MHC class II complexes. These suggest that after the antigen is internalized, already existent MHC class II complexes on mature dendritic cells can be recycled and developed into new MHC class II molecules plus peptide.[4]

Antigen processing and presentation edit

Unlike MHC I, MHC II is meant to present extracellular pathogens rather than intracellular. Furthermore, the first step is to acquire the pathogen through phagocytosis. The pathogen is then broken down in a lysosome and a desired component is then acquired and loaded onto a MHC II molecule. The MHC II molecule then travels to the surface to present the antigen to a helper T cell. MHC II active helper T cells which help release cytokines and other things which will help induce other cells which help to combat the pathogens outside the cells.

Genes edit

Pathways controlling MHC class II antigen presentation edit

Pathway: PSD4–ARL14/ARF7–MYO1E edit

Molecules involved edit

Several molecules are involved in this pathway.[7]

  • PIK3R2[8] and PIP5K1A[9] are two kinases that create substrates for PSD4.
  • PSD4[10][11] (Pleckstrin and Sec7 Domain containing 4) is a GEF (Guanine nucleotide Exchange Factor) that loads ARL14/ARF7 with GTP.
  • ARL14/ARF7[12] is a Small GTPase protein that is selectively expressed in immune cells. This protein is localized within MHC-II compartments in immature dendritic cells.
  • ARF7EP[13] is an effector of ARL14/ARF7 that interacts with MYO1E.
  • MYO1E[14] is a protein that controls MHC-II compartments with an actin-based mechanism.

Pathway edit

PIK3R2 and PIP5K1A are two kinases that phosphorylate Phosphatidylinositol (PIP) providing PSD4 with substrates for its GTP loading ability. PSD4 as a guanine exchange factor, loads ARL14/ARF7 with GTP. Subsequently, ARF7EP interacts with MYO1E which binds itself to actin myofibers. Altogether, this complex contributes to maintain MHC-II loaded vesicles within the immature dendritic cell, impeding its translocation to the cell membrane.

 
Pathway showing how MHC-II distribution is controlled within Immature Dendritic Cells.

Bare lymphocyte syndrome edit

One type of MHC class II deficiency, also called bare lymphocyte syndrome, is due to mutations in the genes that code for transcription factors that regulate the expression of the MHC class II genes.[15] It results in the depletion of CD4 T cells and some immunoglobulin isotypes even though there are normal levels of both CD8 Cells and B cells present. Deficient MHC class II molecules are unable to present antigens to T cells and properly activate T cells. T cells are then unable to proliferate, and secrete cytokines which normally participate in the immune response. Not only do the deficient MHC class II molecules affect the activation and proliferation of T cells but also the rest of the immune response cascade which includes B cells. Therefore, with this decrease in the number of T cells, the T cells cannot interact and activate the B cells. Normally when B cells are activated they divide, proliferate and differentiate, which includes the differentiation of these cells into plasma cells which are responsible for producing antibodies.[16] However, when there is a deficiency in MHC class II molecules B cells are not activated and cannot differentiate into plasma cells which causes them to be deficient in antibodies which are unable to perform as they are expected. The only current form of treatment is a bone-marrow transplant however even this does not cure the disease and most patients do not live past age ten.[17]

MHC class II and Type I diabetes edit

MHC class II genes and molecules are related to a multitude of different diseases, one of which being Type I diabetes. HLA class II genes are the most important genes associated with the risk of inheriting Type I diabetes, accounting for about 40-50% of heritability. Alleles of these genes that affect peptide binding to the MHC class II molecules seem to impact Type I diabetes risk the most. Specific allele polymorphisms have been identified to increase the risk (such as DRB1 and DQB1). Others have been associated with a resistance to the disease.[18]

See also edit

References edit

  1. ^ . Archived from the original on 2008-12-26. Retrieved 2009-01-21.
  2. ^ Jones EY, Fugger L, Strominger JL, Siebold C (April 2006). "MHC class II proteins and disease: a structural perspective". Nature Reviews. Immunology. 6 (4): 271–82. doi:10.1038/nri1805. PMID 16557259. S2CID 131777.
  3. ^ Ting JP, Trowsdale J (April 2002). "Genetic control of MHC class II expression". Cell. 109 Suppl (2): S21-33. doi:10.1016/s0092-8674(02)00696-7. PMID 11983150.
  4. ^ a b Roche PA, Furuta K (April 2015). "The ins and outs of MHC class II-mediated antigen processing and presentation". Nature Reviews. Immunology. 15 (4): 203–16. doi:10.1038/nri3818. PMC 6314495. PMID 25720354.
  5. ^ a b c d Owen JA, Punt J, Stranford SA, Jones PP, Kuby J (2013). Kuby Immunology (7th ed.). New York: W H Freeman & Co. ISBN 978-1-4641-1991-0. OCLC 820117219.
  6. ^ Cresswell, Peter (1996-02-23). "Invariant Chain Structure and MHC Class II Function". Cell. 84 (4): 505–507. doi:10.1016/S0092-8674(00)81025-9. ISSN 0092-8674. PMID 8598037. S2CID 8199773.
  7. ^ Paul P, van den Hoorn T, Jongsma ML, Bakker MJ, Hengeveld R, Janssen L, Cresswell P, Egan DA, van Ham M, Ten Brinke A, Ovaa H, Beijersbergen RL, Kuijl C, Neefjes J (April 2011). "A Genome-wide multidimensional RNAi screen reveals pathways controlling MHC class II antigen presentation". Cell. 145 (2): 268–83. doi:10.1016/j.cell.2011.03.023. PMID 21458045.
  8. ^ "PIK3R2 phosphoinositide-3-kinase, regulatory subunit 2 (beta) [Homo sapiens (human)&#93". Entrez Gene.
  9. ^ "PIP5K1A phosphatidylinositol-4-phosphate 5-kinase, type I, alpha [Homo sapiens (human)". Entrez Gene.
  10. ^ PSD4 pleckstrin and Sec7 domain containing 4 [Homo sapiens (human)] - Gene - NCBI
  11. ^ Prigent M, Dubois T, Raposo G, Derrien V, Tenza D, Rossé C, Camonis J, Chavrier P (December 2003). "ARF6 controls post-endocytic recycling through its downstream exocyst complex effector". The Journal of Cell Biology. 163 (5): 1111–21. doi:10.1083/jcb.200305029. PMC 2173613. PMID 14662749.
  12. ^ "ARL14 ADP-ribosylation factor-like 14 [Homo sapiens (human)". Entrez Gene.
  13. ^ "ARL14EP ADP-ribosylation factor-like 14 effector protein [Homo sapiens (human)". Entrez Gene.
  14. ^ "MYO1E myosin IE [Homo sapiens (human)". Entrez Gene.
  15. ^ Steimle V, Otten LA, Zufferey M, Mach B (June 2007). "Complementation cloning of an MHC class II transactivator mutated in hereditary MHC class II deficiency (or bare lymphocyte syndrome). 1993". Journal of Immunology. 178 (11): 6677–88. PMID 17513710.
  16. ^ Mak TW, Saunders ME (2006). The immune response basic and clinical principles. Amsterdam: Elsevier/Academic. ISBN 978-0-12-088451-3. OCLC 986987876.
  17. ^ Serrano-Martín MM, Moreno-Pérez D, García-Martín FJ, Jurado-Ortiz A (March 2007). "[Major histocompatibility complex class II deficiency]". Anales de Pediatria (in Spanish). 66 (3): 305–8. doi:10.1157/13099694. PMID 17349258.
  18. ^ Xie Z, Chang C, Zhou Z (October 2014). "Molecular mechanisms in autoimmune type 1 diabetes: a critical review". Clinical Reviews in Allergy & Immunology. 47 (2): 174–92. doi:10.1007/s12016-014-8422-2. PMID 24752371. S2CID 26085603.

External links edit

class, class, molecules, class, major, histocompatibility, complex, molecules, normally, found, only, professional, antigen, presenting, cells, such, dendritic, cells, mononuclear, phagocytes, some, endothelial, cells, thymic, epithelial, cells, cells, these, . MHC Class II molecules are a class of major histocompatibility complex MHC molecules normally found only on professional antigen presenting cells such as dendritic cells mononuclear phagocytes some endothelial cells thymic epithelial cells and B cells These cells are important in initiating immune responses MHC Class IISchematic representation of MHC class IIIdentifiersSymbolMHC Class IIMembranome63The antigens presented by class II peptides are derived from extracellular proteins not cytosolic as in MHC class I Loading of a MHC class II molecule occurs by phagocytosis extracellular proteins are endocytosed digested in lysosomes and the resulting epitopic peptide fragments are loaded onto MHC class II molecules prior to their migration to the cell surface In humans the MHC class II protein complex is encoded by the human leukocyte antigen gene complex HLA HLAs corresponding to MHC class II are HLA DP HLA DM HLA DOA HLA DOB HLA DQ and HLA DR Mutations in the HLA gene complex can lead to bare lymphocyte syndrome BLS which is a type of MHC class II deficiency Contents 1 Structure 2 Expression 3 Importance 4 Synthesis 5 Recycling of MHC class II complexes 6 Antigen processing and presentation 7 Genes 8 Pathways controlling MHC class II antigen presentation 8 1 Pathway PSD4 ARL14 ARF7 MYO1E 8 1 1 Molecules involved 8 1 2 Pathway 9 Bare lymphocyte syndrome 10 MHC class II and Type I diabetes 11 See also 12 References 13 External linksStructure editLike MHC class I molecules class II molecules are also heterodimers but in this case consist of two homogenous peptides an a and b chain both of which are encoded in the MHC 1 The subdesignation a1 a2 etc refers to separate domains within the HLA gene each domain is usually encoded by a different exon within the gene and some genes have further domains that encode leader sequences transmembrane sequences etc These molecules have both extracellular regions as well as a transmembrane sequence and a cytoplasmic tail The a1 and b1 regions of the chains come together to make a membrane distal peptide binding domain while the a2 and b2 regions the remaining extracellular parts of the chains form a membrane proximal immunoglobulin like domain The antigen binding groove where the antigen or peptide binds is made up of two a helixes walls and b sheet 2 Because the antigen binding groove of MHC class II molecules is open at both ends while the corresponding groove on class I molecules is closed at each end the antigens presented by MHC class II molecules are longer generally between 15 and 24 amino acid residues long Expression editThese molecules are constitutively expressed in professional immune antigen presenting cells but may also be induced on other cells by interferon g 3 They are expressed on the epithelial cells in the thymus and on APCs in the periphery MHC class II expression is closely regulated in APCs by CIITA which is the MHC class II transactivator CIITA is solely expressed on professional APCs however non professional APCs can also regulate CIITA activity and MHC II expression As mentioned interferon g IFN g triggers the expression of CIITA and is also responsible for converting monocytes which are MHC class II negative cells into functional APCs that express MHC class II on their surfaces 4 MHC class II is also expressed on group 3 innate lymphoid cells Importance editHaving MHC class II molecules present proper peptides that are bound stably is essential for overall immune function 5 Because class II MHC is loaded with extracellular proteins it is mainly concerned with presentation of extracellular pathogens for example bacteria that might be infecting a wound or the blood Class II molecules interact mainly with immune cells like the T helper cell CD4 The peptide presented regulates how T cells respond to an infection 5 Stable peptide binding is essential to prevent detachment and degradation of a peptide which could occur without secure attachment to the MHC molecule 5 This would prevent T cell recognition of the antigen T cell recruitment and a proper immune response 5 The triggered appropriate immune response may include localized inflammation and swelling due to recruitment of phagocytes or may lead to a full force antibody immune response due to activation of B cells Synthesis editThis section needs additional citations for verification Please help improve this article by adding citations to reliable sources in this section Unsourced material may be challenged and removed June 2020 Learn how and when to remove this template message During synthesis of class II MHC in the endoplasmic reticulum the a and b chains are produced and complexed with a special polypeptide known as the invariant chain 6 The nascent MHC class II protein in the rough ER has its peptide binding cleft blocked by the invariant chain Ii a trimer to prevent it from binding cellular peptides or peptides from the endogenous pathway such as those that would be loaded onto class I MHC The invariant chain also facilitates the export of class II MHC from the ER to the Golgi apparatus followed by fusion with a late endosome containing endocytosed degraded proteins The invariant chain is then broken down in stages by proteases called cathepsins leaving only a small fragment known as CLIP which maintains blockage of the peptide binding cleft on the MHC molecule A MHC class II like structure HLA DM facilitates CLIP removal and allows the binding of peptides with higher affinities The stable class II MHC is then presented on the cell surface Recycling of MHC class II complexes editAfter MHC class II complexes are synthesized and presented on APCs they are unable to be expressed on the cell surface indefinitely due to the internalization of the plasma membrane by the APCs antigen presenting cells In some cells antigens bind to recycled MHC class II molecules while they are in the early endosomes while other cells such as dendritic cells internalize antigens via receptor mediated endocytosis and create MHC class II molecules plus peptide in the endosomal lysosomal antigen processing compartment which is independent of the synthesis of new MHC class II complexes These suggest that after the antigen is internalized already existent MHC class II complexes on mature dendritic cells can be recycled and developed into new MHC class II molecules plus peptide 4 Antigen processing and presentation editUnlike MHC I MHC II is meant to present extracellular pathogens rather than intracellular Furthermore the first step is to acquire the pathogen through phagocytosis The pathogen is then broken down in a lysosome and a desired component is then acquired and loaded onto a MHC II molecule The MHC II molecule then travels to the surface to present the antigen to a helper T cell MHC II active helper T cells which help release cytokines and other things which will help induce other cells which help to combat the pathogens outside the cells Genes editAlpha BetaHLA DM HLA DMA HLA DMBHLA DO HLA DOA HLA DOBHLA DP HLA DPA1 HLA DPB1HLA DQ HLA DQA1 HLA DQA2 HLA DQB1 HLA DQB2HLA DR HLA DRA HLA DRB1 HLA DRB3 HLA DRB4 HLA DRB5Pathways controlling MHC class II antigen presentation editPathway PSD4 ARL14 ARF7 MYO1E edit Molecules involved edit Several molecules are involved in this pathway 7 PIK3R2 8 and PIP5K1A 9 are two kinases that create substrates for PSD4 PSD4 10 11 Pleckstrin and Sec7 Domain containing 4 is a GEF Guanine nucleotide Exchange Factor that loads ARL14 ARF7 with GTP ARL14 ARF7 12 is a Small GTPase protein that is selectively expressed in immune cells This protein is localized within MHC II compartments in immature dendritic cells ARF7EP 13 is an effector of ARL14 ARF7 that interacts with MYO1E MYO1E 14 is a protein that controls MHC II compartments with an actin based mechanism Pathway edit PIK3R2 and PIP5K1A are two kinases that phosphorylate Phosphatidylinositol PIP providing PSD4 with substrates for its GTP loading ability PSD4 as a guanine exchange factor loads ARL14 ARF7 with GTP Subsequently ARF7EP interacts with MYO1E which binds itself to actin myofibers Altogether this complex contributes to maintain MHC II loaded vesicles within the immature dendritic cell impeding its translocation to the cell membrane nbsp Pathway showing how MHC II distribution is controlled within Immature Dendritic Cells Bare lymphocyte syndrome editOne type of MHC class II deficiency also called bare lymphocyte syndrome is due to mutations in the genes that code for transcription factors that regulate the expression of the MHC class II genes 15 It results in the depletion of CD4 T cells and some immunoglobulin isotypes even though there are normal levels of both CD8 Cells and B cells present Deficient MHC class II molecules are unable to present antigens to T cells and properly activate T cells T cells are then unable to proliferate and secrete cytokines which normally participate in the immune response Not only do the deficient MHC class II molecules affect the activation and proliferation of T cells but also the rest of the immune response cascade which includes B cells Therefore with this decrease in the number of T cells the T cells cannot interact and activate the B cells Normally when B cells are activated they divide proliferate and differentiate which includes the differentiation of these cells into plasma cells which are responsible for producing antibodies 16 However when there is a deficiency in MHC class II molecules B cells are not activated and cannot differentiate into plasma cells which causes them to be deficient in antibodies which are unable to perform as they are expected The only current form of treatment is a bone marrow transplant however even this does not cure the disease and most patients do not live past age ten 17 MHC class II and Type I diabetes editMHC class II genes and molecules are related to a multitude of different diseases one of which being Type I diabetes HLA class II genes are the most important genes associated with the risk of inheriting Type I diabetes accounting for about 40 50 of heritability Alleles of these genes that affect peptide binding to the MHC class II molecules seem to impact Type I diabetes risk the most Specific allele polymorphisms have been identified to increase the risk such as DRB1 and DQB1 Others have been associated with a resistance to the disease 18 See also editCross presentation Bare lymphocyte syndromeReferences edit Histocompatibility Archived from the original on 2008 12 26 Retrieved 2009 01 21 Jones EY Fugger L Strominger JL Siebold C April 2006 MHC class II proteins and disease a structural perspective Nature Reviews Immunology 6 4 271 82 doi 10 1038 nri1805 PMID 16557259 S2CID 131777 Ting JP Trowsdale J April 2002 Genetic control of MHC class II expression Cell 109 Suppl 2 S21 33 doi 10 1016 s0092 8674 02 00696 7 PMID 11983150 a b Roche PA Furuta K April 2015 The ins and outs of MHC class II mediated antigen processing and presentation Nature Reviews Immunology 15 4 203 16 doi 10 1038 nri3818 PMC 6314495 PMID 25720354 a b c d Owen JA Punt J Stranford SA Jones PP Kuby J 2013 Kuby Immunology 7th ed New York W H Freeman amp Co ISBN 978 1 4641 1991 0 OCLC 820117219 Cresswell Peter 1996 02 23 Invariant Chain Structure and MHC Class II Function Cell 84 4 505 507 doi 10 1016 S0092 8674 00 81025 9 ISSN 0092 8674 PMID 8598037 S2CID 8199773 Paul P van den Hoorn T Jongsma ML Bakker MJ Hengeveld R Janssen L Cresswell P Egan DA van Ham M Ten Brinke A Ovaa H Beijersbergen RL Kuijl C Neefjes J April 2011 A Genome wide multidimensional RNAi screen reveals pathways controlling MHC class II antigen presentation Cell 145 2 268 83 doi 10 1016 j cell 2011 03 023 PMID 21458045 PIK3R2 phosphoinositide 3 kinase regulatory subunit 2 beta Homo sapiens human amp 93 Entrez Gene PIP5K1A phosphatidylinositol 4 phosphate 5 kinase type I alpha Homo sapiens human Entrez Gene PSD4 pleckstrin and Sec7 domain containing 4 Homo sapiens human Gene NCBI Prigent M Dubois T Raposo G Derrien V Tenza D Rosse C Camonis J Chavrier P December 2003 ARF6 controls post endocytic recycling through its downstream exocyst complex effector The Journal of Cell Biology 163 5 1111 21 doi 10 1083 jcb 200305029 PMC 2173613 PMID 14662749 ARL14 ADP ribosylation factor like 14 Homo sapiens human Entrez Gene ARL14EP ADP ribosylation factor like 14 effector protein Homo sapiens human Entrez Gene MYO1E myosin IE Homo sapiens human Entrez Gene Steimle V Otten LA Zufferey M Mach B June 2007 Complementation cloning of an MHC class II transactivator mutated in hereditary MHC class II deficiency or bare lymphocyte syndrome 1993 Journal of Immunology 178 11 6677 88 PMID 17513710 Mak TW Saunders ME 2006 The immune response basic and clinical principles Amsterdam Elsevier Academic ISBN 978 0 12 088451 3 OCLC 986987876 Serrano Martin MM Moreno Perez D Garcia Martin FJ Jurado Ortiz A March 2007 Major histocompatibility complex class II deficiency Anales de Pediatria in Spanish 66 3 305 8 doi 10 1157 13099694 PMID 17349258 Xie Z Chang C Zhou Z October 2014 Molecular mechanisms in autoimmune type 1 diabetes a critical review Clinical Reviews in Allergy amp Immunology 47 2 174 92 doi 10 1007 s12016 014 8422 2 PMID 24752371 S2CID 26085603 External links editHistocompatibility Antigens Class II at the U S National Library of Medicine Medical Subject Headings MeSH MHC Class II Genes at the U S National Library of Medicine Medical Subject Headings MeSH Retrieved from https en wikipedia org w index php title MHC class II amp oldid 1167887132, wikipedia, wiki, book, books, library,

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