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Toleranzinduktion gegen Nickel

Vom Tiermodell zum Menschen

Tolerance induction towards nickel

From animal model to humans

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Zusammenfassung

Nickel ist das häufigste Kontaktallergen des Menschen. Dennoch waren bis vor kurzem viele Fragen insbesondere bezüglich der Toleranzmechanismen gegenüber Nickel nicht geklärt. Neben humanen Ex-vivo-, Interventions- und Beobachtungsstudien hat die Etablierung eines reproduzierbaren Mausmodells nun dazu beigetragen, diese Mechanismen besser zu analysieren. Erst das genauere Verständnis der Pathogenese der Nickelallergie und Toleranz gegenüber Nickel durch Untersuchungen im Tiermodell sowie in humanen Studien wird dazu beitragen, eine gezielte Prävention bzw. Therapie der Nickelallergie zu entwickeln. Wir beabsichtigen, mit dieser Arbeit einen Überblick über die im Tiermodell und im Menschen erhobenen Erkenntnisse zur Nickelallergie und vor allem zur oralen Toleranzinduktion gegenüber Nickel zu geben.

Abstract

Nickel is the most common contact allergen in humans. Until recently, many questions concerning tolerance mechanisms to nickel were unresolved. Besides human ex vivo, intervention and observation studies, the establishment of a reproducible mouse model has contributed to the analysis of these mechanisms. A more detailed understanding of the pathogenesis of nickel allergy and tolerance towards nickel by investigations in an animal model and in human studies is a prerequisite for developing specific prevention and therapy of nickel allergy. With this article, we provide a review of the investigations concerning nickel allergy and give perspectives towards oral tolerance induction to nickel in the animal model and in humans.

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Literatur

  1. Anke M, Groppel B, Kronemann H et al. (1984) Nickel-an essential element. IARC Sci Publ 53:339–365

    CAS  PubMed  Google Scholar 

  2. Artik S, von Vultée C, Gleichmann E et al. (1999) Nickel allergy in mice: enhanced sensitization capacity of nickel at higher oxidation states. J Immunol 163:1143–1152

    CAS  PubMed  Google Scholar 

  3. Artik S, Haarhuis K, Wu X et al. (2001) Tolerance to nickel: Oral nickel administration induces a high frequency of anergic T cells with persistent suppressor activity. J Immunol 167:6794–6803

    CAS  PubMed  Google Scholar 

  4. Bagot M, Charue D, Flechet ML et al. (1995) Oral desensitization in nickel allergy induces a decrease in nickel-specific T-cells. Eur J Dermatol 5:614–617

    Google Scholar 

  5. Bagot M, Terki N, Bacha S et al. (1999) Per os desensitization in nickel contact eczema: a double-blind placebo-controlled clinico-biological study. Ann Dermatol Venereol 126:502–504

    CAS  PubMed  Google Scholar 

  6. Barrett RD, Bishara SE, Quinn J (1993) Biodegradation of orthodontic appliances. Part I. Biodegradation of nickel and chromium in vitro. Am J Orthod Dentofacial Orthop 103:8–14

    CAS  PubMed  Google Scholar 

  7. Basketter DA, Dooms-Goossens A, Karlberg AT et al. (1995) The chemistry of contact allergy; why is a molecule allergenic? Contact Dermatitis 32:65–73

    CAS  PubMed  Google Scholar 

  8. Begerow J, Schauer M, Dunemann L (1997) Werkstoffe der konservierenden Zahnheilkunde. In: Wichmann E, Schlipköter HW, Fülgraff W (Hrsg) Handbuch für Umweltmedizin. Ecomed Verlag, 11. Erg. Lfg., S 1–21

  9. Borg L, Christensen JM, Kristiansen J et al. (2000) Nickel-induced cytokine production from mononuclear cells in nickel-sensitive individuals and controls. Cytokine profiles in nickel-sensitive individuals with nickel allergy-related hand eczema before and after nickel challenge. Arch Dermatol Res 292:285–291

    Article  CAS  PubMed  Google Scholar 

  10. Boscolo P, Andreassi M, Sabbioni E et al. (1999) Systemic effects of ingested nickel on the immune system of nickel sensitised women. Life Sci 64:1485–1491

    Article  CAS  PubMed  Google Scholar 

  11. Büdinger L, Neuser N, Totzke U et al. (2001) Preferential usage of TCR-Vβ17 by peripheral and cutaneous T cells in nickel-induced contact dermatitis. J Immunol 167:6038–6044

    PubMed  Google Scholar 

  12. Bunselmeyer B, Bergmann KC (1998) Nickelgehalte deutscher Lebensmittel. Allergo J 7:419–424

    Google Scholar 

  13. Cavani A, Mei D, Guerra E et al. (1998) Patients with allergic contact dermatitis to nickel and nonallergic individuals display different nickel-specific T cell responses. Evidence for the presence of effector CD8+ and regulatory CD4+ T cells. J Invest Dermatol 111:621–628

    Article  CAS  PubMed  Google Scholar 

  14. Cavani A, Nasorri F, Prezzi C et al. (2000) Human CD4+ T lymphocytes with remarkable regulatory functions on dendritic cells and nickel-specific Th1 immune responses. J Invest Dermatol 114:295–302

    Article  CAS  PubMed  Google Scholar 

  15. Cavani A, Albanesi C, Traidl C et al. (2001) Effector and regulatory T cells in allergic contact dermatitis. Trends Immunol 22:118–120

    Article  CAS  PubMed  Google Scholar 

  16. Cederbrant K, Hultman P, Marcusson JA et al. (1997) In vitro lymphocyte proliferation as compared to patch test using gold, palladium and nickel. Int Arch Allergy Immunol 112:212–217

    CAS  PubMed  Google Scholar 

  17. Chang TJ, Werd MB, Hovelsen C (1995) Metallic implants used in foot surgery. Clin Podiatr Med Surg 12:457–474

    CAS  PubMed  Google Scholar 

  18. Chen Y, Kuchroo VK, Inobe J et al. (1994) Regulatory T cell clones induced by oral tolerance: suppression of autoimmune encephalomyelitis. Science 265:1237–1240

    CAS  PubMed  Google Scholar 

  19. Christensen OB, Beckstead JH, Daniels TE et al. (1985) Pathogenesis of orally induced flare-up reactions at old patch sites in nickel allergy. Acta Derm Venereol 65:298–304

    CAS  PubMed  Google Scholar 

  20. Cobbold S, Waldmann H (1998) Infectious tolerance. Curr Opin Immunol 10:518–524

    Article  CAS  PubMed  Google Scholar 

  21. di Gioacchino M, Boscolo P, Cavallucci E et al. (2000) Lymphocyte subset changes in blood and gastrointestinal mucosa after oral nickel challenge in nickel-sensitized women. Contact Dermatitis 43:206–211

    Article  PubMed  Google Scholar 

  22. Everness KM, Gawkrodger DJ, Botham PA et al. (1990) The discrimination between nickel-sensitive and non-nickel-sensitive subjects by an in vitro lymphocyte transformation test. Br J Dermatol 122:293–298

    CAS  PubMed  Google Scholar 

  23. Gamerdinger K, Moulon C, Karp DR et al. (2003) A new type of metal recognition by human T cells: contact residues for peptide-independent bridging of T cell receptor and major histocompatibility complex by nickel. J Exp Med 197:1345–1353

    Article  CAS  PubMed  Google Scholar 

  24. Gawkrodger DJ, Cook SW, Fell GS et al. (1986) Nickel dermatitis: the reaction to oral nickel challenge. Br J Dermatol 115:33–38

    CAS  Google Scholar 

  25. Goebel C, Kubicka-Muranyi M, Tonn T et al. (1995) Phagocytes render chemicals immunogenic: oxidation of gold(I) to the T cell-sensitizing gold(III) metabolite generated by mononuclear phagocytes. Arch Toxicol 69:450–459

    Article  CAS  PubMed  Google Scholar 

  26. Griem P, Takahashi K, Kalbacher H et al. (1995) The antirheumatic drug disodium aurothiomalate inhibits CD4+ T cell recognition of peptides containing two or more cysteine residues. J Immunol 155:1575–1587

    CAS  PubMed  Google Scholar 

  27. Griem P, Panthel K, Kalbacher H et al. (1996) Alteration of a model antigen by Au(III) leads to T cell sensitization to cryptic peptides. Eur J Immunol 26:279–287

    CAS  PubMed  Google Scholar 

  28. Griem P, Wulferink M, Sachs B et al. (1998) Allergic and autoimmune reactions to xenobiotics: how do they arise? Immunol Today 19:133–141

    Article  CAS  PubMed  Google Scholar 

  29. Groux H, O’Garra A, Bigler M et al. (1997) A CD4+ T-cell subset inhibits antigen-specific T-cell responses and prevents colitis. Nature 389:737–742

    Article  CAS  PubMed  Google Scholar 

  30. Haber LT, Diamond GL, Zhao Q et al. (2000) Hazard identification and dose response of ingested nickel-soluble salts. Regul Toxicol Pharmacol 31:231–241

    Article  CAS  PubMed  Google Scholar 

  31. Hensten-Pettersen A (1992) Casting alloys: side-effects. Adv Dent Res 6:38–43

    CAS  PubMed  Google Scholar 

  32. Hierholzer S (1998) Metallentfernung: Anmerkungen zur Metallurgie und Biokompatibilität. OP Journal 14:4–8

    Google Scholar 

  33. Homey B, Zlotnik A (1999) Chemokines in allergy. Curr Opin Immunol 11:626–634

    Article  CAS  PubMed  Google Scholar 

  34. Ishii N, Moriguchi N, Nakajima H et al. (1993) Nickel sulfate-specific suppressor T cells induced by nickel sulfate in drinking water. J Dermatol Sci 6:159–164

    CAS  PubMed  Google Scholar 

  35. Jakobson E, Masjedi K, Ahlborg N et al. (2002) Cytokine production in nickel-sensitized individuals analysed with enzyme-linked immunospot assay: possible implication for diagnosis. Br J Dermatol 147:442–449

    Article  CAS  PubMed  Google Scholar 

  36. Jensen CS, Lisby S, Baadsgaard O et al. (2002) Decrease in nickel sensitization in a Danish schoolgirl population with ears pierced after implementation of a nickel-exposure regulation. Br J Dermatol 146:636–642

    Article  PubMed  Google Scholar 

  37. Jonuleit H, Schmitt E, Schuler G et al. (2000) Induction of interleukin 10-producing, nonproliferating CD4+ T cells with regulatory properties by repetitive stimulation with allogeneic immature human dendritic cells. J Exp Med 192:1213–1222

    Article  CAS  PubMed  Google Scholar 

  38. Kaaber K, Veien NK, Tjell JC (1978) Low nickel diet in the treatment of patients with chronic nickel dermatitis. Br J Dermatol 98:197–201

    CAS  PubMed  Google Scholar 

  39. Kapsenberg ML, Res P, Bos JD et al. (1987) Nickel-specific T lymphocyte clones derived from allergic nickel-contact dermatitis lesions in man: heterogeneity based on requirement of dendritic antigen-presenting cell subsets. Eur J Immunol 17:861–865

    CAS  PubMed  Google Scholar 

  40. Kapsenberg ML, Van der Pouw-Kraan T, Stiekema FE et al. (1988) Direct and indirect nickel-specific stimulation of T lymphocytes from patients with allergic contact dermatitis to nickel. Eur J Immunol 18:977–982

    CAS  PubMed  Google Scholar 

  41. Kapsenberg ML, Wierenga EA, Stiekema FE et al. (1992) Th1 lymphokine production profiles of nickel-specific CD4+T-lymphocyte clones from nickel contact allergic and non-allergic individuals. J Invest Dermatol 98:59–63

    Article  CAS  PubMed  Google Scholar 

  42. Kerosuo H, Moe G, Kleven E (1995) In vitro release of nickel and chromium from different types of simulated orthodontic appliances. Angle Orthod 65:111–116

    CAS  PubMed  Google Scholar 

  43. Kerosuo H, Kullaa A, Kerosuo E et al. (1996) Nickel allergy in adolescents in relation to orthodontic treatment and piercing of ears. Am J Orthod Dentofacial Orthop 109:148–154

    CAS  PubMed  Google Scholar 

  44. Kronin V, Wu L, Gong S et al. (2000) DEC-205 as a marker of dendritic cells with regulatory effects on CD8 T cell responses. Int Immunol 12:731–735

    Article  CAS  PubMed  Google Scholar 

  45. Lindemann M, Bohmer J, Zabel M et al. (2003) ELISpot: a new tool for the detection of nickel sensitization. Clin Exp Allergy 33:992–998

    Google Scholar 

  46. Lisby S, Hansen LH, Menné T et al. (1999) Nickel-induced proliferation of both memory and naive T cells in patch test-negative individuals. Clin Exp Immunol 117:217–222

    Google Scholar 

  47. Lisby S, Hansen LH, Skov L et al. (1999) Nickel-induced activation of T cells in individuals with negative patch test to nickel sulphate. Arch Dermatol Res 291:247–252

    Article  CAS  PubMed  Google Scholar 

  48. Lu L, Vollmer J, Moulon C et al. (2003) Components of the ligand for a Ni++ reactive human T cell clone. J Exp Med 197:567–574

    Article  CAS  PubMed  Google Scholar 

  49. Macleod TM, Hutchinson F, Raffle EJ (1970) The uptake of labelled thymidine by leucocytes of nickel sensitive patients. Br J Dermatol 82:487–492

    CAS  PubMed  Google Scholar 

  50. Mastromatteo E (1988) Nickel and its compounds. In: Zenz C (ed) Occupational medicine, 2nd edn. Year Book Medical Publishers, Chicago, pp 597–608

  51. Menné T, Nieboer E (1989) Metal contact dermatitis: a common and potentially debilitating disease. Endeavour 13:117–122

    PubMed  Google Scholar 

  52. Mobley HL, Island MD, Hausinger RP (1995) Molecular biology of microbial ureases. Microbiol Rev 59:451–480

    CAS  PubMed  Google Scholar 

  53. Morris DL (1998) Intradermal testing and sublingual desensitization for nickel. Cutis 61:129–132

    CAS  PubMed  Google Scholar 

  54. Mortz CG, Lauritsen JM, Bindslev-Jensen C et al. (2002) Nickel sensitization in adolescents and association with ear piercing, use of dental braces and hand eczema. The Odense Adolescence Cohort Study on Atopic Diseases and Dermatitis (TOACS). Acta Derm Venereol 82:359–364

    Article  CAS  PubMed  Google Scholar 

  55. Moulon C, Vollmer J, Weltzien HU (1995) Characterization of processing requirements and metal cross-reactivities in T cell clones from patients with allergic contact dermatitis to nickel. Eur J Immunol 25:3308–3315

    CAS  PubMed  Google Scholar 

  56. Moulon C, Choleva Y, Thierse HJ et al. (2003) T cell receptor transfection shows non-HLA-restricted recognition of nickel by CD8+ human T cells to be mediated by alphabeta T cell receptors. J Invest Dermatol 121:496–501

    CAS  PubMed  Google Scholar 

  57. Nakada T, Iijima M, Nakayama H et al. (1997) Role of ear piercing in metal allergic contact dermatitis. Contact Dermatitis 36:233–236

    CAS  PubMed  Google Scholar 

  58. Nielsen GD, Jepsen LV, Jorgensen PJ et al. (1990) Nickel-sensitive patients with vesicular hand eczema: oral challenge with a diet naturally high in nickel. Br J Dermatol 122:299–308

    CAS  PubMed  Google Scholar 

  59. Nordlind K (1984) Lymphocyte transformation test in diagnosis of nickel allergy. A comparison between the separation of peripheral blood lymphocytes on Ficoll-Paque, Percoll or by gravity sedimentation. Int Arch Allergy Appl Immunol 73:151–154

    CAS  PubMed  Google Scholar 

  60. Panzani RC, Schiavino D, Nucera E et al. (1995) Oral hyposensitization to nickel allergy: preliminary clinical results. Int Arch Allergy Immunol 107:251–254

    CAS  PubMed  Google Scholar 

  61. Park HY, Shearer TR (1983) In vitro release of nickel and chromium from simulated orthodontic appliances. Am J Orthod 84:156–159

    Article  CAS  PubMed  Google Scholar 

  62. Probst P, Kuntzlin D, Fleischer B (1995) TH2-type infiltrating T cells in nickel-induced contact dermatitis. Cell Immunol 165:134–140

    Article  CAS  PubMed  Google Scholar 

  63. Räsänen L, Tuomi ML (1992) Diagnostic value of the lymphocyte proliferation test in nickel contact allergy and provocation in occupational coin dermatitis. Contact Dermatitis 27:250–254

    PubMed  Google Scholar 

  64. Read S, Mauze S, Asseman C et al. (1998) CD38+ CD45RBlow CD4+ T cells: a population of T cells with immune regulatory activities in vitro. Eur J Immunol 28:3435–3447

    Article  CAS  PubMed  Google Scholar 

  65. Res P, Kapsenberg ML, Bos JD (1987) The crucial role of human dendritic antigen-presenting cell subsets in nickel-specific T-cell proliferation. J Invest Dermatol 88:550–554

    Article  CAS  PubMed  Google Scholar 

  66. Roelofs-Haarhuis K, Wu X, Nowak M et al. (2003) Infectious nickel tolerance: a reciprocal interplay of tolerogenic APCs and T suppressor cells that is driven by immunization. J Immunol 171:2863–2872

    CAS  PubMed  Google Scholar 

  67. Santucci B, Cristaudo A, Cannistraci C et al. (1988) Nickel sensitivity: effects of prolonged oral intake of the element. Contact Dermatitis 19:202–205

    CAS  PubMed  Google Scholar 

  68. Santucci B, Manna F, Cristaudo A et al. (1990) Serum concentrations in nickel-sensitive patients after prolonged oral administration. Contact Dermatitis 22:253–256

    CAS  PubMed  Google Scholar 

  69. Santucci B, Manna F, Cannistraci C et al. (1994) Serum and urine concentrations in nickel-sensitive patients after prolonged oral administration. Contact Dermatitis 30:97–101

    CAS  PubMed  Google Scholar 

  70. Schäfer T, Böhler E, Wichmann HE et al. (2000) Die KORA-Allergie-Studie: Ergebnisse der Epikutantestung. Allergo J 9:474–479

    Google Scholar 

  71. Schuhmann D, Kubicka-Muranyi M, Mirtschewa J et al. (1990) Adverse immune reactions to gold. I. Chronic treatment with an Au(I) drug sensitizes mouse T cells not to Au(I), but to Au(III) and induces autoantibody formation. J Immunol 145:2132–2139

    CAS  PubMed  Google Scholar 

  72. Schuppe HC, Haas-Raida D, Kulig J et al. (1992) T-cell-dependent popliteal lymph node reactions to platinum compounds in mice. Int Arch Allergy Immunol 97:308–314

    CAS  PubMed  Google Scholar 

  73. Sebastiani S, Allavena P, Albanesi C et al. (2001) Chemokine receptor expression and function in CD4+ T lymphocytes with regulatory activity. J Immunol 166:996–1002

    CAS  PubMed  Google Scholar 

  74. Sjovall P, Christensen OB, Moller H (1987) Oral hyposensitization in nickel allergy. J Am Acad Dermatol 17:774–778

    Google Scholar 

  75. Smith-Sivertsen T, Tchachtchine V, Lund E (2002) Environmental nickel pollution: does it protect against nickel allergy? J Am Acad Dermatol 46:460–462

    Article  PubMed  Google Scholar 

  76. Sosroseno W (1995) The immunology of nickel-induced allergic contact dermatitis. Asian Pac J Allergy Immunol 13:173–181

    CAS  PubMed  Google Scholar 

  77. Steinbrink K, Wolfl M, Jonuleit H et al. (1997) Induction of tolerance by IL-10-treated dendritic cells. J Immunol 159:4772–4780

    CAS  PubMed  Google Scholar 

  78. Svejgaard E, Morling N, Svejgaard A et al. (1978) Lymphocyte transformation induced by nickel sulphate: an in vitro study of subjects with and without a positive nickel patch test. Acta Derm Venereol 58:245–250

    CAS  PubMed  Google Scholar 

  79. Todd DJ, Burrows D (1989) Nickel allergy in relationship to previous oral and cutaneous nickel contact. Ulster Med J 58:168–171

    CAS  PubMed  Google Scholar 

  80. van den Broeke LT, Heffler LC, Tengvall Linder M et al. (1999) Direct Ni2+ antigen formation on cultured human dendritic cells. Immunology 96:578–585

    Article  PubMed  Google Scholar 

  81. van Hoogstraten IM, Andersen KE, von Blomberg BM et al. (1991) Reduced frequency of nickel allergy upon oral nickel contact at an early age. Clin Exp Immunol 85:441–445

    PubMed  Google Scholar 

  82. van Hoogstraten IM, Boden D, von Blomberg ME et al. (1992) Persistent immune tolerance to nickel and chromium by oral administration prior to cutaneous sensitization. J Invest Dermatol 99:608–616

    Article  PubMed  Google Scholar 

  83. van Hoogstraten IM, Bos C, Boden D et al. (1993) Oral induction of tolerance to nickel sensitization in mice. J Invest Dermatol 101:26–31

    Article  PubMed  Google Scholar 

  84. van Hoogstraten IM, von Blomberg BM, Boden D et al. (1994) Non-sensitizing epicutaneous skin tests prevent subsequent induction of immune tolerance. J Invest Dermatol 102:80–83

    Article  PubMed  Google Scholar 

  85. Veien NK, Menné T (1990) Nickel contact allergy and a nickel-restricted diet. Semin Dermatol 9:197–205

    CAS  PubMed  Google Scholar 

  86. Veien NK, Hattel T, Laurberg G (1993) Low nickel diet: an open, prospective trial. J Am Acad Dermatol 29:1002–1007

    CAS  PubMed  Google Scholar 

  87. Vendetti S, Chai JG, Dyson J et al. (2000) Anergic T cells inhibit the antigen-presenting function of dendritic cells. J Immunol 165:1175–1181

    CAS  PubMed  Google Scholar 

  88. Vollmer J, Fritz M, Dormoy A et al. (1997) Dominance of the BV17 element in nickel-specific human T cell receptors relates to severity of contact sensitivity. Eur J Immunol 27:1865–1874

    CAS  PubMed  Google Scholar 

  89. Vollmer J, Weltzien HU, Gamerdinger K et al. (2000) Antigen contacts by Ni-reactive TCR: typical alphass chain cooperation versus alpha chain-dominated specificity. Int Immunol 12:1723–1731

    Article  CAS  PubMed  Google Scholar 

  90. von Blomberg-van der Flier M, van der Burg CK, Pos O et al. (1987) In vitro studies in nickel allergy: diagnostic value of a dual parameter analysis. J Invest Dermatol 88:362–368

    Article  PubMed  Google Scholar 

  91. Vreeburg KJ, de Groot K, von Blomberg M et al. (1984) Induction of immunological tolerance by oral administration of nickel and chromium. J Dent Res 63:124–128

    CAS  PubMed  Google Scholar 

  92. Vreeburg KJ, de Groot K, van Hoogstraten IM et al. (1991) Successful induction of allergic contact dermatitis to mercury and chromium in mice. Int Arch Allergy Appl Immunol 96:179–183

    CAS  PubMed  Google Scholar 

  93. Vyskocil A, Viau C, Cizkova M (1994) Chronic nephrotoxicity of soluble nickel in rats. Hum Exp Toxicol 13:689–693

    CAS  PubMed  Google Scholar 

  94. Weinlich G, Heine M, Stossel H et al. (1998) Entry into afferent lymphatics and maturation in situ of migrating murine cutaneous dendritic cells. J Invest Dermatol 110:441–448

    Article  CAS  PubMed  Google Scholar 

  95. Werfel T, Hentschel M, Kapp A et al. (1997) Dichotomy of blood- and skin-derived IL-4-producing allergen-specific T cells and restricted V beta repertoire in nickel-mediated contact dermatitis. J Immunol 158:2500–2505

    CAS  PubMed  Google Scholar 

  96. Weston WL, Bruckner A (2000) Allergic contact dermatitis. Pediatr Clin North Am 47:897–907

    Google Scholar 

  97. Zollner T, Neubert C, Wettstein A et al. (1998) The T-cell receptor Vbeta repertoire of nickel-specific T cells. Arch Dermatol Res 290:397–401

    Article  CAS  PubMed  Google Scholar 

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Artik, S., Gleichmann, E. & Ruzicka, T. Toleranzinduktion gegen Nickel. Hautarzt 55, 1052–1059 (2004). https://doi.org/10.1007/s00105-004-0815-3

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