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Der Gastrointestinaltrakt als Immunorgan: Das darmassoziierte Immunsystem

Gut mucosal immune mechanisms: The gut-associated lymphoid tissue (GALT)

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Summary

The gastrointestinal mucosa separates the intraluminal gastrointestinal fluid, which contains a high number of antigens from different sources, and prevents free access of antigens to the body. Simultaneously, it allows some vital host-environment interactions. A number of unspecific factors are important in preventing antigen invasion. The specific mucosal immunity is related to secretory IgA. IgA is derived from mucosal plasma cells after antigen-induced proliferation of its precursors in Peyer's patches. These IgA-positive B-lymphoblasts migrate through the systemic circulation and then “home” to the mucosa. IgA is translocated as a dimer to the gut lumen after attachment to the secretory component (SC). Part of it is excreted into the bile via small bile ducts after portal and possibly systemic circulation and binding to SC. T cells and mast cells are also considered to show migration and homing phenomena. In addition to the gut, some other mucosa-associated lymphoid tissues, (e.g. bronchus, mammary, salivary and lacrimal glands as well as the female genital tract), can participate in homing. Little is known about the local regulatory mechanisms, which allow an immunoglobulin class specifity of immune responses. Induction of local immunity and specific systemic tolerance seems to be a characteristic immune response of the gut-associated lymphoid tissue (GALT). The knowledge of the local immune system allows a better understanding of many aspects of gastrointestinal pathology, especially in immuno-inflammatory and immunoproliferative diseases as well as in gastrointestinal immunodeficiency syndromes.

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Literatur

  1. Ament ME, Rubin CE (1972) Relation of giardiasis to abnormal intestinal structure and function in gastrointestinal immunodeficiency syndromes. Gastroenterology 62:216–226

    Google Scholar 

  2. Amman AJ, Hong R (1971) Selective IgA deficiency: presentation of 30 cases and a review of the literature. Medicine 50:223–236

    Google Scholar 

  3. Andrew E, Hall JG (1982) IgA antibodies in the bile of rats. I. Some characteristics of the primary response. Immunology 45:169–175

    Google Scholar 

  4. Bartnik W, ReMine SG, Chiba M, Thayer WR, Shorter RG (1980) Isolation and characterization of colonic intraepithelial and lamina proprial lymphocytes. Gastroenterology 78:976–985

    Google Scholar 

  5. Beachey EH (1982) Die Adhärenz von Bakterien an Schleimhautoberflächen. Immun Infekt 10:51–56

    Google Scholar 

  6. Belut D, Moneret-Vautrin DA, Nicolas JP, Grilliat JP (1980) IgE levels in intestinal juice. Dig Dis Sci 25:323–332

    Google Scholar 

  7. Bhalla DK, Owen RL (1982) Cell renewal and migration in lymphoid follicles of Peyer's patches and cecum — an autoradiographic study in mice. Gastroenterology 82:232–242

    Google Scholar 

  8. Bienenstock J, Befus AD (1980) Mucosal immunology. Immunology 41:249–270

    Google Scholar 

  9. Bienenstock J, Befus AD (1983) Some thoughts on the biologic role of immunoglobulin A. Gastroenterology 84:178–185

    Google Scholar 

  10. Börsch G (1984) Allergische Manifestationen am Verdauungstrakt. In: Hornbostel H, Kaufmann W, Siegenthaler W (Hrsg) Innere Medizin in Praxis und Klinik. Bd. IV. (3. neubearb. Aufl.). Thieme, Stuttgart

    Google Scholar 

  11. Brandtzaeg P (1981) The humoral immune systems of the human gastrointestinal tract. Monogr Allergy 17:195–221

    Google Scholar 

  12. Brandtzaeg P (1981) Transport models for secretory IgA and secretory IgM. Clin Exp Immunol 44:221–232

    Google Scholar 

  13. Brandtzaeg P, Baklien K (1976) Immunoglobulin-producing cells in the intestine in health and disease. Clin Gastroenterol 5:251–270

    Google Scholar 

  14. Brown WR (1978) Relationships between immunoglobulins and the intestinal epithelium. Gastroenterology 75:129–138

    Google Scholar 

  15. Brown WR, Isobe Y, Nakane PK (1976) Studies on translocation of immunoglobulins across intestinal epithelium. II. Immunoelectron-microscopic localization of immunoglobulins and secretory component in human intestinal mucosa. Gastroenterology 71:985–995

    Google Scholar 

  16. Brown WR, Smith PD, Lee E, McCalmon RT, Nagura H (1982) A search for an enriched source of polymeric IgA in human thoracic duct lymph, portal vein blood and aortic blood. Clin Exp Immunol 48:85–90

    Google Scholar 

  17. Buckley RH, Dees SC (1969) Correlation of milk precipitins with IgA deficiency. N Engl J Med 281:465–469

    Google Scholar 

  18. Chandy KG, Hübscher SG, Elias E, Berg J, Khan M, Burnett D (1983) Dual role of the liver in regulating circulating polymeric IgA in man: studies on patients with liver disease. Clin Exp Immunol 52:207–218

    Google Scholar 

  19. Clancy R, Bienenstock J (1976) Secretion immunoglobulins. Clin Gastroenterol 5:229–250

    Google Scholar 

  20. Conley ME, Koopman WJ (1983) Serum IgA1 and IgA2 in normal adults and patients with systemic lupus erythematosus and hepatic disease. Clin Immunol Immunopathol 26:390–397

    Google Scholar 

  21. Crabbé PA, Heremans JF (1967) Selective IgA deficiency with steatorrhea. Am J Med 42:319–326

    Google Scholar 

  22. Cunningham-Rundles C, Brandeis WE, Good RA, Day NK (1978) Milk precipitins, circulating immune complexes, and IgA deficiency. Proc Natl Acad Sci USA 75:3387–3389

    Google Scholar 

  23. Dahlgren U, Ahlstedt S, Andersson T, Hedman L, Hanson LA (1983) IgA antibodies in rat bile are not solely derived from thoracic duct lymph. Scand J Immunol 17:569–574

    Google Scholar 

  24. Dancygier H, Klein U, Classen M (1983) Das zelluläre Immunsystem der extrahepatischen Gallenwege des Menschen. Z Gastroenterol 21:406

    Google Scholar 

  25. Delacroix D, Vaerman JP (1981) Reassessment of levels of secretory IgA in pathological sera using a quantitative radioimmunoassay. Clin Exp Immunol 43:633–640

    Google Scholar 

  26. Delacroix DL, Dive C, Rambaud JC, Vaerman JP (1982) IgA subclasses in various secretions and in serum. Immunology 47:383–385

    Google Scholar 

  27. Delacroix DL, Reynaert M, Pauwels S, Geubel AP, Vaerman JP (1982) High serum levels of secretory IgA in liver disease. Possible liver origin of the circulating secretory component. Dig Dis Sci 27:333–340

    Google Scholar 

  28. Delacroix DL, Vaerman JP (1982) Secretory component (SC): preferential binding to heavy (>11S) IgA polymers and IgM in serum, in contrast to predominance of 11S and free SC forms in secretions. Clin Exp Immunol 49:717–724

    Google Scholar 

  29. Delacroix DL, Elkon KB, Geubel AP, Hodgson HF, Dive C, Vaerman JP (1983) Changes in size, subclass, and metabolic properties of serum immunoglobulin A in liver diseases and in other diseases with high serum immunoglobulin A. J Clin Invest 71:358–367

    Google Scholar 

  30. Dietschy JM, Sallee VL, Wilson FA (1971) Unstirred water layers and absorption across the intestinal mucosa. Gastroenterology 61:932–934

    Google Scholar 

  31. Doe WF (1979) Alpha heavy chain disease and related small-intestinal lymphomas. In: Asquith P (ed) Immunology of the gastrointestinal tract. Churchill Livingstone, Edinburgh London New York, pp 306–315

    Google Scholar 

  32. Doe WF (1981) Intestinal mucosal injury. Clin Gastroenterol 10:583–604

    Google Scholar 

  33. Dooley JS, Potter BJ, Thomas HC, Sherlock S (1982) A comparative study of the biliary secretion of human dimeric and monomeric IgA in the rat and in man. Hepatology 2:323–327

    Google Scholar 

  34. Eckhardt R, Meyer zum Büschenfelde KH (1983) Dünndarm als Immunorgan. Immunologie des Dünndarms. In: Caspary WF (Hrsg) Handbuch der inneren Medizin. 3. Bd, T 3A (Dünndarm A). Springer, Berlin Heidelberg New York, pp 73–104

    Google Scholar 

  35. Ecknauer R (1982) Die Barrierefunktion des Magen-Darm-Trakts. Z Gastroenterol 20:150–163

    Google Scholar 

  36. Elson CO, Heck JA, Strober W (1979) T-cell regulation of murine IgA synthesis. J Exp Med 149:632–643

    Google Scholar 

  37. Ferguson A (1977) Intraepithelial lymphocytes of the small intestine. Gut 18:921–937

    Google Scholar 

  38. Forstner JF (1978) Intestinal mucins in health and disease. Digestion 17:234–263

    Google Scholar 

  39. Gebbers JO, Laissue JA, Otto HF (1981) Moderne Aspekte zur funktionellen Morphologie des Kolons. Colo-Proctol 3:211–226

    Google Scholar 

  40. Gebbers JO, Otto HF (1982) Immunhistologische Befunde. In: Müller-Wieland K (Hrsg) Handbuch der inneren Medizin. 3. Bd T 4 (Dickdarm). Springer, Berlin Heidelberg New York, S 341–359

    Google Scholar 

  41. Gershon RK, Eardley DD, Durum S, Green DR, Shen FW, Yamauchi K, Cantor H, Murphy DB (1981) Contrasuppression. A novel immuno-regulatory activity. J Exp Med 153:1533–1546

    Google Scholar 

  42. Gillon J (1981) Where do mucosal mast cells acquire IgE? Immunol Today 2:80–81

    Google Scholar 

  43. Goodacre R, Davidson R, Singal D, Bienenstock J (1979) Morphologic and functional characteristics of human intestinal lymphoid cells isolated by a mechanical technique. Gastroenterology 76:300–308

    Google Scholar 

  44. Green DR, Gold J, St Martin S, Gershon R, Gershon RK (1982) Microenvironmental immunoregulation: possible role of contrasuppressor cells in maintaining immune responses in gut-associated lymphoid tissues. Proc Natl Acad Sci USA 79:889–892

    Google Scholar 

  45. Heatley RV (1983) The gastrointestinal mast cell. Scand J Gastroenterol 18:449–453

    Google Scholar 

  46. Hodges JR, Wright R (1982) Normal immune responses in the gut and liver. Clin Sci 63:339–347

    Google Scholar 

  47. Hopf U, Brandtzaeg P, Hütteroth TH, Meyer zum Büschenfelde KH (1978) In vivo and in vitro binding of IgA to the plasma membrane of hepatocytes. Scand J Immunol 8:543–549

    Google Scholar 

  48. Inman LR, Cantey JR (1983) Specific adherence of Escherichia coli (Strain RDEC-1) to membranous (M) cells of the Peyer's patch in Escherichia coli diarrhea in the rabbit. J Clin Invest 71:1–8

    Google Scholar 

  49. Isaacson P (1982) Immunoperoxidase study of the secretory immunoglobulin system and lysozyme in normal and diseased gastric mucosa. Gut 23:578–588

    Google Scholar 

  50. Jonsson J, Schilling W, Forsberg M (1982) Colostral IgA binding to wheat gluten and gliadin. Clin Exp Immunol 50:203–208

    Google Scholar 

  51. Kagnoff MF (1981) Immunology of the digestive system. In: Johnson LR (ed) Physiology of the gastrointestinal tract. Raven Press, New York, pp 1337–1359

    Google Scholar 

  52. Kalsi J, Delacroix DL, Hodgson HJF (1983) IgA in alcoholic cirrhosis. Clin Exp Immunol 52:499–504

    Google Scholar 

  53. Kawanishi H, Saltzman LE, Strober W (1982) Characteristics and regulatory function of murine con A-induced, cloned T cells obtained from Peyer's patches and spleen: mechanisms regulating isotype-specific immunoglobulin production by Peyer's patch B cells. J Immunol 129:475–483

    Google Scholar 

  54. Kaye MD, Whorwell PJ, Wright R (1983) Gastric mucosal lymphocyte subpopulations in pernicious anemia and in normal stomach. Clin Immunol Immunopathol 28:431–440

    Google Scholar 

  55. Khojasteh A, Haghshenass M, Haghighi P (1983) Immunoproliferative small intestinal disease. A “third world lesion”. N Engl J Med 308:1401–1405

    Google Scholar 

  56. Kluge F, Koch HK, Köttgen E, Gerok W (1983) Glutensensitive Enteropathie — im Lichte neuer klinischer und pathogenetischer Aspekte. Klin Wochenschr 61:669–679

    Google Scholar 

  57. Kolb E (1983) Neuere immunbiochemische Erkenntnisse zur Funktion des Immunsystems in der Schleimhaut des Magen-Darm-Kanals. Z Gesamte Inn Med 38:337–344

    Google Scholar 

  58. Kutteh WH, Prince SJ, Philips JO, Spenney JG, Mestecky J (1982) Properties of immunoglobulin A in serum of individuals with liver diseases and in hepatic bile. Gastroenterology 82:184–193

    Google Scholar 

  59. Kutteh WH, Prince SJ, Mestecky J (1982) Tissue origins of human polymeric and monomeric IgA. J Immunol 128:990–995

    Google Scholar 

  60. Lebenthal E, Clark B (1981) Immunoglobulin concentrations in the duodenal fluids of infants and children. Am J Gastroenterol 75:436–439

    Google Scholar 

  61. Lyscom N, Brueton MJ (1982) Intraepithelial, lamina propria and Peyer's patch lymphocytes of the rat small intestine: isolation and characterization in terms of immunoglobulin markers and receptors for monoclonal antibodies. Immunology 45:775–783

    Google Scholar 

  62. MacDermott RP, Bragdon MJ, Jenkins KM, Franklin GO, Shedlofsky S, Kodner IJ (1981) Human intestinal mononuclear cells. II. Demonstration of a naturally occurring subclass of T cells which respond in the allogeneic mixed leukocyte reaction but do not effect cell-mediated lympholysis. Gastroenterology 80:748–757

    Google Scholar 

  63. Magnusson KE, Stjernström I (1982) Mucosal barrier mechanisms. Interplay between secretory IgA (SigA), IgG and mucins on the surface properties and association of salmonellae with intestine and granulocytes. Immunology 45:239–248

    Google Scholar 

  64. Marsh MN (1980) Studies of intestinal lymphoid tissue. III. Quantitative analyses of epithelial lymphocytes in the small intestine of human control subjects and of patients with celiac sprue. Gastroenterology 79:481–492

    Google Scholar 

  65. Marsh MN, Haeney MR (1983) Studies of intestinal lymphoid tissue. VI — Proliferative response of small intestinal epithelial lymphocytes distinguishes gluten- from non-gluten-induced enteropathy. J Clin Pathol 36:149–160

    Google Scholar 

  66. McClelland DBL (1979) Bacterial and viral infections of the gastrointestinal tract. In: Asquith P (ed) Immunology of the gastrointestinal tract. Churchill Livingstone, Edinburgh London New York, pp 214–245

    Google Scholar 

  67. McDermott MR, Bienenstock J (1979) Evidence for a common mucosal immunologic system. I. Migration of B immunoblasts into intestinal, respiratory, and genital tissues. J Immunol 122:1892–1898

    Google Scholar 

  68. McGuigan JE, Leibach JR (1978) Immunology and disease of the gastrointestinal tract. In: Sleisenger MH, Fordtran JS (eds) Gastrointestinal disease. Saunders, Philadelphia London Toronto, pp 52–79

    Google Scholar 

  69. Nagura H, Smith PD, Nakane PK, Brown WR (1981) IgA in human bile and liver. J Immunol 126:587–595

    Google Scholar 

  70. Otto HF (1983) Topographie, makroskopische Anatomie und Histologie. In: Caspary WF (Hrsg) Handbuch der inneren Medizin. 3. Bd, T 3A (Dünndarm A). Springer, Berlin Heidelberg New York, S 29–69

    Google Scholar 

  71. Otto HF, Gebbers JO, Laissue JA (1982) Zur funktionellen Bedeutung des intestinalen Immunsystems. Eine Übersicht. 1. T.: Orthologie. Z Gastroenterol 20:125–138

    Google Scholar 

  72. Otto HF, Gebbers JO, Laissue JA (1982) Zur funktionellen Bedeutung des intestinalen Immunsystems. Eine Übersicht. 2. T.: Pathologie. Z Gastroenterol 20:245–256

    Google Scholar 

  73. Owen RL (1977) Sequential uptake of horseradish peroxidase by lymphoid follicle epithelium of Peyer's patches in the normal unobstructed mouse intestine: an ultrastructural study. Gastroenterology 72:440–451

    Google Scholar 

  74. Owen RL (1983) And now pathophysiology of M cells — good news and bad news from Peyer's patches (editorial). Gastroenterology 85:468–470

    Google Scholar 

  75. Owen RL, Jones AL (1974) Epithelial cell specialization within human Peyer's patches: an ultrastructural study of intestinal lymphoid follicles. Gastroenterology 66:189–203

    Google Scholar 

  76. Pabst R (1983) Der Verdauungstrakt als Immunorgan. Med Klin 78:36–42

    Google Scholar 

  77. Parrott DMV (1976) The gut as a lymphoid organ. Clin Gastroenterol 5:211–228

    Google Scholar 

  78. Pearce FL, Befus AD, Gauldie J, Bienenstock J (1982) Mucosal mast cells. II. Effects of anti-allergic compounds on histamine secretion by isolated intestinal mast cells. J Immunol 128:2481–2486

    Google Scholar 

  79. Pelletier G, Briantais MJ, Buffet C, Pillot J, Etienne JP (1982) Serum and intestinal secretory IgA in alcoholic cirrhosis of the liver. Gut 23:475–480

    Google Scholar 

  80. Peppard JV, Orlans E, Andrew E, Payne AWR (1982) Elimination into bile of circulating antigen by endogenous IgA antibody in rats. Immunology 45:467–472

    Google Scholar 

  81. Petty RE, Palmer NR, Cassidy JT, Tubergen DG, Sullivan DB (1979) The association of autoimmune diseases and anti-IgA antibodies in patients with selective IgA deficiency. Clin Exp Immunol 37:83–88

    Google Scholar 

  82. Pierce NF, Cray WC Jr (1982) Determinants of the localization, magnitude, and duration of a specific mucosal IgA plasma cell response in enterically immunized rats. J Immunol 128:1311–1315

    Google Scholar 

  83. Poulter LW (1983) Antigen presenting cells in situ: their identification and involvement in immunopathology. Clin Exp Immunol 53:513–520

    Google Scholar 

  84. Rank J, Wilson ID (1983) Changes in IgA following varying degrees of biliary obstruction in the rat. Hepatology 3:241–247

    Google Scholar 

  85. Ross IN, Asquith P (1979) Primary immune deficiency. In: Asquith P (ed) Immunology of the gastrointestinal tract. Churchill Livingstone, Edinburgh London New York, pp 152–182

    Google Scholar 

  86. Ruchti C, Gerber HA, Hess MW, Keller HU, Cottier H (1980) Zur Barrierefunktion des menschlichen Darms: Mechanismen des Antigeneintritts und der antimikrobiellen Schutzfunktionen. Ther Umsch 37:161–167

    Google Scholar 

  87. Samson RR, McClelland DBL, Shearman DJC (1973) Studies on the quantitation of immunoglobulin in human intestinal secretions. Gut 14:616–626

    Google Scholar 

  88. Schmiegel WH, Hamann A, Thiele HG (1982) Darmassoziiertes Immunsystem. Dtsch Med Wochenschr 107:267–270

    Google Scholar 

  89. Schmiegel WH, Thiele HG (1982) Immunregulation durch das darmassoziierte Immunsystem. Immun Infekt 10:169–174

    Google Scholar 

  90. Seifert J (1983) Resorption von Makromolekülen aus dem Magen-Darm-Trakt. In: Caspary WF (Hrsg) Handbuch der inneren Medizin. 3. Bd, T. 3A (Dünndarm A). Springer, Berlin Heidelberg New York, S 394–418

    Google Scholar 

  91. Selby WS, Janossy G, Jewell DP (1981) Immunohistological characterisation of intraepithelial lymphocytes of the human gastrointestinal tract. Gut 22:169–176

    Google Scholar 

  92. Selby WS, Janossy G, Goldstein G, Jewell DP (1981) T lymphocyte subsets in human intestinal mucosa: the distribution and relationship to MHC-derived antigens. Clin Exp Immunol 44:453–458

    Google Scholar 

  93. Shorter RG, Tomasi TB Jr (1982) Gut immune mechanisms. Adv Intern Med 27:247–280

    Google Scholar 

  94. Signer E, Bürgin-Wolff A (1978) Immunologie des Gastrointestinaltrakts. Ther Umsch 35:635–641

    Google Scholar 

  95. Skinner JM (1975) The immunocytes of the gastrointestinal tract. In: Truelove SC, Goodman MJ (eds) Topics in gastroenterology 3. Blackwell, Oxford London Edinburgh Melbourne, pp 227–243

    Google Scholar 

  96. Strickland RG (1983) Immunoregulatory mechanisms in nonspecific inflammatory bowel disease. Ann Rev Med 34:195–204

    Google Scholar 

  97. Strober W (1982) The regulation of mucosal immune system. J Allergy Clin Immunol 70:225–230

    Google Scholar 

  98. Strober W, Krakauer R, Klaeveman HL, Reynolds HY, Nelson DL (1976) Secretory component deficiency. A disorder of the IgA immune system. N Engl J Med 294:351–356

    Google Scholar 

  99. Strober W, Richman LK, Elson CO (1981) The regulation of gastrointestinal immune responses. Immunol Today 2:156–162

    Google Scholar 

  100. Swinson CM, Slavin G, Coles EC, Booth CC (1983) Coeliac disease and malignancy. Lancet 1:111–115

    Google Scholar 

  101. Thiele HG, Schmiegel WH, Bläker F (1982) Immunophänomene bei chronisch entzündlichen Darmerkrankungen. In: Müller-Wieland K (Hrsg) Handbuch der inneren Medizin. Bd. 3, T. 4 (Dickdarm). Springer, Berlin Heidelberg New York, S 361–388

    Google Scholar 

  102. Tidball CS (1971) The nature of the intestinal epithelial barrier. Dig Dis Sci 16:745–767

    Google Scholar 

  103. Tomasi TB Jr, Zigelbaum S (1963) The selective occurrence of γ A globulins in certain body fluids. J Clin Invest 42:1552–1560

    Google Scholar 

  104. Tomasi TB Jr, Larson L, Challacombe S, McNabb P (1980) Mucosal immunity: the origin and migration patterns of cells in the secretory system. J Allergy Clin Immunol 65:12–19

    Google Scholar 

  105. Volkheimer G (1977) Persorption of particles: physiology and pharmacology. Adv Pharmacol Chemother 14:163–187

    Google Scholar 

  106. Waldmann TA, Misiti J, Nelson DL, Kraemer KH (1983) Ataxia-teleangiectasia: a multisystem hereditary disease with immunodeficiency, impaired organ maturation, X-ray hypersensitivity, and a high incidence of neoplasia (NIH conference). Ann Intern Med 99:367–379

    Google Scholar 

  107. Walker WA (1981) Intestinal transport of macromolecules. In: Johnson LR (ed) Physiology of the gastrointestinal tract. Raven Press, New York, pp 1271–1289

    Google Scholar 

  108. Walker WA, Isselbacher KJ (1974) Uptake and transport of macromolecules by the intestine. Possible role in clinical disorders. Gastroenterology 67:531–550

    Google Scholar 

  109. Walker WA, Wu M, Isselbacher KJ, Bloch KJ (1975) Intestinal uptake of macromolecules. IV. The effect of pancreatic duct ligation on the breakdown of antigen and antigen-antibody complexes on the intestinal surface. Gastroenterology 69:1223–1229

    Google Scholar 

  110. Walker WA, Isselbacher KJ (1977) Intestinal antibodies. N Engl J Med 297:767–773

    Google Scholar 

  111. Webster ADB (1976) The gut and immunodeficiency disorders. Clin Gastroenterol 5:323–340

    Google Scholar 

  112. Wijesinha SS, Steer HW (1982) Studies of the immunoglobulin-producing cells of the human intestine: the defunctioned bowel. Gut 23:211–214

    Google Scholar 

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Börsch, G. Der Gastrointestinaltrakt als Immunorgan: Das darmassoziierte Immunsystem. Klin Wochenschr 62, 699–709 (1984). https://doi.org/10.1007/BF01725702

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