herpes antibodies but no outbreaks

Holm CK, Jensen SB, Jakobsen MR, Cheshenko N, Horan KA, Moeller HB, Gonzalez-Dosal R, Rasmussen SB, Christensen MH, Yarovinsky TO, Rixon FJ, Herold BC, Fitzgerald KA, Paludan SR. Virus-cell fusion as a trigger of innate immunity dependent on the adaptor STING. This chemokine treatment, or pull, recruits a large number of circulating HSV-specific CD8 T cells, and a proportion of these cells are retained in the vagina up to 12 weeks post-pull. Genital herpes: Overview - InformedHealth.org - NCBI Bookshelf Different patterns of peripheral migration by memory CD4+ and CD8+ T cells. 26th ed. As latent virus only transcribes LATs, and no viral proteins, memory CD8 T cells in the ganglia are likely responding to antigens produced from the very low level of frequent reactivation that is predicted to occur in neurons (14). This content is owned by the AAFP. 8600 Rockville Pike ScienceDaily. Mackay LK, Stock AT, Ma JZ, Jones CM, Kent SJ, Mueller SN, Heath WR, Carbone FR, Gebhardt T. Long-lived epithelial immunity by tissueresident memory T (TRM) cells in the absence of persisting local antigen presentation. Preventive treatment with medication may be considered if someone has severe or very frequent herpes outbreaks. Genital herpes - Symptoms and causes - Mayo Clinic Reinert LS, Harder L, Holm CK, Iversen MB, Horan KA, Dagns-Hansen F, Ulhi BP, Holm TH, Mogensen TH, Owens T, Nyengaard JR, Thomsen AR, Paludan SR. TLR3 deficiency renders astrocytes permissive to herpes simplex virus infection and facilitates establishment of CNS infection in mice. Copyright 1997-2023, A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited without authorization. FAQ: Herpes | MIT Medical Intravaginal immunization of mice with an attenuated HSV-2 prevents disease and death caused by a lethal challenge with WT HSV-2 (73). It looks for antibodies to herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). What Does a Positive Herpes IgM Test Result Mean? - Verywell Health We hope that these data will result in further discussions regarding control programs for HSV-2 in the United States.". Upon infection, engagement of pattern recognition receptors (PRRs) by the virus initiates an antiviral program by the host. A future challenge is to understand the determinant of protective immunity in humans if we were to have any chances of creating an efficacious vaccine against genital herpes. Response to infection first occurs in the target keratinocytes and tissue-resident hematopoietic cells. In recurring episodes of genital herpes, the severity of symptoms correlates with the extent of viral spread and the speed with which the virus is controlled. But it also can occur during a recurrent outbreak in a woman who was infected before pregnancy, although the risk is much lower. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. Th1 entry into the genital tract does not appear to depend on these two chemokines, and thus far the signals required to recruit Th1 cells into the genital tract are unknown (31). The body can then use these antibodies to respond more quickly to future outbreaks. Li T, Diner BA, Chen J, Cristea IM. E. Tronstein, C. Johnston, M.-L. Huang, S. Selke, A. Magaret, T. Warren, L. Corey, A. Wald. Facts & Brochures Genital Herpes - CDC Detailed Fact Sheet What is genital herpes? There are two types of HSV that can cause genital herpes: 1) HSV-1 and 2) HSV-2. Long-lived cytotoxic T lymphocyte memory in mucosal tissues after mucosal but not systemic immunization. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. While both CD8 and CD4 T cells infiltrate the ganglia after HSV-1 infection, only depletion of CD8 T cells leads to rapid reactivation of virus in the ganglia (44, 45). Although ivag immunization is a useful tool for studying immune responses against HSV-2 in animal models, it has not translated into a vaccine option in humans. March 9, 2018 person getting their blood taken to test for herpes Getty Images In a perfect world, testing for STIs would be as simple as taking an online quiz. It is not a substitute for the advice of a physician. HSV is NOT a catastrophe in pregnancy. This is for information and navigating living with HSV. Herpes Simplex Virus-Specific Memory CD8+ T Cells Are Selectively Activated and Retained in Latently Infected Sensory Ganglia. The herpes simplex virus antibodies test is a blood test that screens for the herpes simplex virus (HSV). Genital herpes infections can be asymptomatic, or can show up as outbreaks of blisters or sores. When the needle is inserted to draw blood, some people feel a little pain. is also a founding member of Hi-Ethics. This pool of CD8 TRM can protect against disease through a neuroprotective mechanism, rather than through mucosal viral control. Persons with herpes simplex virus type 2, but without - ScienceDaily Tissue-resident T cells mediate control of HSV-2 infection. They can still able to spread the virus. Search for doctors near you. Some labs use different measurements or test different samples. After getting infected, many people have recurrent episodes of . The .gov means its official. HSV shedding occurs with great frequency and cannot be entirely controlled. About 70% of adults have been infected by HSV-1 and have antibodies against the virus. and our Activation of the innate immune response is critical for the induction of adaptive immunity. However, a follow-up study with the same vaccine in a generalized group of women seronegative for both HSV-1 and -2 found no protection against HSV-2 infection or disease, although a higher rate of efficacy was observed against HSV-1 (60). About 70% of adults have been infected by HSV-1 and have antibodies against the virus. Thus, the risk of transmission from an infected patient to a partner may be present even though overt signs of viral reactivation are absent. HSV is spread through direct contact with herpes sores, usually during vaginal, oral, or anal sex. Wilson AC, Mohr I. Avoid sexual contact from the time you feel these symptoms coming on until a few days after the scabs have gone away. Genital herpes is a common sexually transmitted disease that is caused by the herpes simplex virus. People with HSV-2 infection have an increased risk of getting human immunodeficiency virus (HIV) if they have sex with an HIV-infected partner. This vaccine elicits IFN--producing cells in mice. Lee HK, Zamora M, Linehan MM, Iijima N, Gonzalez D, Haberman A, Iwasaki A. While there is no cure for herpes, there are medicines that can help manage the condition. The HSV-2 subtype of the herpes virus causes genital sores, as well as swollen lymph nodes, body aches, and . Containment of viral spread by CD8 T cells appears to occur very rapidly, as infected cells are killed within hours (11). Further, antibodies are sufficient to protect the host from primary genital HSV infection if they exist in sufficient quantity at the site of infection. Multiple studies have emphasized a role for memory T cells in protecting the genital mucosa against infection. If sores are on the genitals, a stinging or burning feeling while urinating is common. Can anyone give any insight on how you can have herpes without blood antibodies? Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). Antiviral medications taken during an outbreak can shorten the length and severity of the outbreak. Mucosal control within the prime and pull system could be improved with different pull signals or alternative priming agents or routes, as other studies have suggested that local T cell populations are capable of reducing viral titers within the epithelium. When tested for therapeutic activity in guinea pigs, while there was no significant decrease in lesion score or mean duration, there was a significant decrease in the frequency of recurrences (71). Whether you call it a cold sore or a fever blister, oral herpes is a common infection of the mouth area that is caused by herpes simplex virus type 1 (HSV-1). As a service to our customers we are providing this early version of the manuscript. In mice, TLR3 deficiency leads to increased susceptibility to CNS infection after genital infection with HSV-2, and alters the tropism of the virus within the CNS (39). A herpes IgM ( immunoglobulin M) test is a blood test that can detect early herpes simplex virus (HSV) infection. It is important that you see a healthcare provider, especially if you've never had an outbreak before. More recently, cyclic-GMP-AMP synthase (cGAS) has also been shown to bind cytosolic DNA, which can then go on to activate stimulator of interferon genes (STING) through a secondary messenger (22, 23). Herpes: HSV-1 and HSV-2 | Johns Hopkins Medicine Li Z, Palaniyandi S, Zeng R, Tuo W, Roopenian DC, Zhu X. The decision depends on many factors, including where the sores are on your body and whether the fetus would come into contact with them during delivery. Protection conferred by serum Ig against genital HSV-2 challenge appears to occur through the Fc neonatal receptor (FcRn), which is expressed by the epithelial lining of mucosal surfaces, including the genital tract, and mediates transcytosis of IgG to the lumen (57). Recognition of herpesviruses by the innate immune system. How long does it take for herpes symptoms to show up? - Medical News Today Learn more about A.D.A.M. The vast majority of existing successful vaccines for infectious agents rely on antibodies for protection (77). sharing sensitive information, make sure youre on a federal Chiu Y-H, MacMillan JB, Chen ZJ. Inclusion in an NLM database does not imply endorsement of, or agreement with, B) Parenteral immunization, on the other hand, only leads to circulating immunity, which is suboptimal in protecting against contraction of genital herpes in humans. Persons who have tested positive for herpes simplex virus type 2 (HSV-2) but do not have symptoms or genital lesions still experience virus shedding during subclinical (without clinical manifestations) episodes, suggesting a high risk of transmission from persons with unrecognized HSV-2 infection, according to a study in the April 13 issue of JAMA, a theme issue on infectious disease and immunology. Is it true that genital herpes is hard to diagnose? The second type of herpes simplex virus, HSV-2, almost always infects the genitals, so if a test shows antibodies to HSV-2 in your blood, you probably have genital herpes. It does not explain all of the proper treatments or methods of care. Genital herpes is a sexually transmitted infection (STI). Immunization of mice induces both CD4 and CD8 T cell responses, while immunization of both mice and guinea pigs elicits serum antibody. Positive results were obtained on 6.4 percent of all days tested, but in 36 percent of the cases, the participants had no apparent genital lesions. Some people infected with the virus may have very mild symptoms or no symptoms. Tests can be done to help determine if you have a recent infection. STD Facts - Genital Herpes - Centers for Disease Control and Prevention Philadelphia, PA: Elsevier; 2020:chap 350. A cultured affair: HSV latency and reactivation in neurons. Financial support for ScienceDaily comes from advertisements and referral programs, where indicated. The development . The publisher's final edited version of this article is available at. Culturing a sample from an active outbreak of HSV is the best method to diagnose a current infection. Ideally, a prophylactic vaccine to prevent infection could protect both the recipient of the vaccine as well as any potential sexual partners. It is treatable but not curable. An official website of the United States government. Sexually Transmitted Infection (STI): An infection that is spread by sexual contact. This is a place to ask questions about herpes RESPECTFULLY. This was almost identical to the first cohort, who had initially reported not having a history of genital herpes. For additional information visit Linking to and Using Content from MedlinePlus. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. This indicates that the bulk of days of shedding in persons with asymptomatic HSV-2 is unrecognized, and people may engage in sexual activity not knowing that they are at risk for transmitting the virus to sexual partners. Rathinam VAK, Jiang Z, Waggoner SN, Sharma S, Cole LE, Waggoner L, Vanaja SK, Monks BG, Ganesan S, Latz E, Hornung V, Vogel SN, Szomolanyi-Tsuda E, Fitzgerald KA. DO NOT share your towels, toothbrush, or lipstick. A) Intravaginal immunization with attenuated HSV can establish lymphoid clusters containing CD4 T cells in the lamina propria, CD8 TRM in the epitheliun and may retain B cells/antibody secreting cells (ASC). Orzalli MH, DeLuca NA, Knipe DM. A serum herpes simplex antibodies test is a blood test that checks for the presence of antibodies to the. Hoshino Y, Pesnicak L, Dowdell KC, Burbelo PD, Knipe DM, Straus SE, Cohen JI. Recent reports have shown that autophagy, a cellular homeostatic process that recycles cytoplasmic components, plays an important role in controlling viral infection in neurons. If you have sores or warning signs of an outbreak at the time of delivery, you may need to have a cesarean delivery to reduce chance of infection. HSV-2 causes genital herpes. Additional lesions, on the other hand, appear to develop from the spread of cell-free virus released from the initial site of infection, leading to the appearance of closely spaced individual lesions (11). Campadelli-Fiume G, Menotti L, Avitabile E, Gianni T. Viral and cellular contributions to herpes simplex virus entry into the cell. An Antibodies Test for Herpes Simplex Virus - WebMD The most recent therapeutic vaccine to complete phase III clinical trial was the disabled infectious single cycle (DISC) vaccine, which was a replication deficient gH deletion HSV mutant (69). Both vaccines induced high serum titers of HSV neutralizing antibody, and HerpeVac also elicited Th1 responses (58, 59). Morrison LA, Da Costa XJ, Knipe DM. Herpes (HSV) Test: MedlinePlus Medical Test Immediate IFN- production in the tissue was shown to be the main effector mechanism by which Th1 cells protect against genital HSV-2 infection (50, 53). The blood test can show the type of HSV, but it cannot tell how you . Philadelphia, PA: Elsevier; 2020:chap 135. If you have genital herpes, you need to take steps to avoid passing HSV to your sexual partners: Tell current sexual partners that you have genital herpes. To use the sharing features on this page, please enable JavaScript. Koelle DM, Corey L. Herpes Simplex: Insights on Pathogenesis and Possible Vaccines. Read common questions on the coronavirus and ACOGs evidence-based answers. How to Prevent Sexually Transmitted Infections (STIs), Disorders of the Vulva: Common Causes of Vulvar Pain, Burning, and Itching, COVID-19, Gynecologist Visits, and Telehealth: Answers From Ob-Gyns, Copyright 2023 American College of Obstetricians and Gynecologists, Privacy Statement I had a vaginal exam where doctors did say it looked like I had HSV, but my skin was too healed to get an accurate swab. During this time, the sores break open and release fluid. Upon genital HSV-2 infection, Tregs unexpectedly appear to regulate the proper localization of innate immune cells. The larger question that now remains is the role of antiviral therapy, which has historically been used only in patients with frequent outbreaks, with the intent of decreasing symptoms and viral transmission. She informed me that she spoke with the infectious diseases department and they said you can have herpes without antibodies. Skoberne M, Cardin R, Lee A, Kazimirova A, Zielinski V, Garvie D, Lundberg A, Larson S, Bravo FJ, Bernstein DI, Flechtner JB, Long D. An Adjuvanted Herpes Simplex Virus 2 Subunit Vaccine Elicits a T Cell Response in Mice and Is an Effective Therapeutic Vaccine in Guinea Pigs. Shin H, Iwasaki A. This route of immunization establishes tissue-resident cellular responses and increases virus-specific IgG in the vagina, which together can confer robust immunity (73). While it was originally thought that HSV-2 was largely silent during asymptomatic phases, mathematical modeling suggests that HSV-2 may be reactivating with great frequency in very small numbers of neurons at any given time, leading to the near-continuous release of HSV-2 into the genital epithelium, although this release may not necessarily be detectable (14). Chentoufi AA, Kritzer E, Tran MV, Dasgupta G, Lim CH, Yu DC, Afifi RE, Jiang X, Carpenter D, Osorio N, Hsiang C, Nesburn AB, Wechsler SL, BenMohamed L. The Herpes Simplex Virus 1 Latency-Associated Transcript Promotes Functional Exhaustion of Virus-Specific CD8+ T Cells in Latently Infected Trigeminal Ganglia: a Novel Immune Evasion Mechanism. This work is supported by NIH grants (AI054359, AI062428) and by Women's Health Research at Yale to A.I.. Persons with herpes simplex virus type 2, but without symptoms, still shed virus. However, very little virus is detected in the ganglia, suggesting that prime and pull may prevent establishment of latency in neurons. Read ACOGs complete disclaimer. URL of this page: //medlineplus.gov/ency/article/003352.htm. This study showed that type I IFNs and autophagy work together to provide optimal protection against HSV-1 infection in neurons (42). Resistance to HSV-1 infection in the epithelium resides with the novel innate sensor, IFI-16. Phase I Study of a Herpes Simplex Virus Type 2 (HSV-2) DNA Vaccine Administered to Healthy, HSV-2-Seronegative Adults by a Needle-Free Injection System. I was swabbed and again it came back negative. The sores often are grouped in clusters, and the area where the sores appear may be swollen and tender. FOIA HSV can also lead to the activation of inflammasomes, although unlike other dsDNA viruses, this activation occurs independently of absent in melanoma 2 (AIM2) (24) and is instead mediated by IFI16 (25). However, the holes in our understanding of how to build the right type of immunity against HSV-2 infection in humans are slowly closing. Goethals S, Ydens E, Timmerman V, Janssens S. Toll-like receptor expression in the peripheral nerve. Don't have an ob-gyn? Schiffer JT, Abu-Raddad L, Mark KE, Zhu J, Selke S, Magaret A, Wald A, Corey L. Frequent Release of Low Amounts of Herpes Simplex Virus from Neurons: Results of a Mathematical Model. Mackay LK, Wakim L, van Vliet CJ, Jones CM, Mueller SN, Bannard O, Fearon DT, Heath WR, Carbone FR. Khan R. Women. The sample is taken to the lab and tested for the presence and amount of antibodies. Memory T cells in nonlymphoid tissue that provide enhanced local immunity during infection with herpes simplex virus. Sores heal more quicklywithin 37 days in most cases. URAC's accreditation program is an independent audit to verify that A.D.A.M. 2013 Oct; 34(10): 10.1016/j.it.2013.08.001. Schiffer JT, Corey L. Herpes simplex virus. Gebhardt T, Whitney PG, Zaid A, Mackay LK, Brooks AG, Heath WR, Carbone FR, Mueller SN. However, it is important to educate and counsel patients about the risk of HSV transmission to sexual partners. Herpes Outbreak Timeline: How Long Does It Take Herpes to Show Up? de Bruyn G, Vargas-Cortez M, Warren T, Tyring SK, Fife KH, Lalezari J, Brady RC, Shahmanesh M, Kinghorn G, Beutner KR, Patel R, Drehobl MA, Horner P, Kurtz TO, McDermott S, Wald A, Corey L. A randomized controlled trial of a replication defective (gH deletion) herpes simplex virus vaccine for the treatment of recurrent genital herpes among immunocompetent subjects. Neutralizing antibody levels waned in the months after boosting with HerpeVac, but no correlation was found between antibody levels and increased risk for HSV-2 contraction (58, 60). Of these, a phase I study using a DNA vaccine encoding HSV glycoprotein D was most recently completed. Privacy Policy. Have any problems using the site? Antibodies to SARS-CoV-2, the virus that causes COVID-19, were present in the blood of 96.4% of Americans over the age of 16 by September 2022. The blood test for herpes can be done when no sores are present. Content on this website is for information only. Herpes simplex virus (HSV), known as herpes, is a common infection that can cause painful blisters or ulcers. If left untreated, HIV can cause acquired immunodeficiency syndrome (AIDS). These myths exaggerate the true risk of herpes in pregnancy. www.cdc.gov/std/treatment-guidelines/default.htm, Linking to and Using Content from MedlinePlus, U.S. Department of Health and Human Services, Hematoma (blood accumulating under the skin), Infection (a slight risk any time the skin is broken). Intranasal immunization can lead to higher titers of HSV-specific IgA and IgG in the genital tract, increases the number of cytolytic lymphocytes in the tissue and improved protection against genital challenge compared to controls immunized through other routes (74, 75). A herpes infection can be life threatening to a baby. Genital Herpes - CDC Basic Fact Sheet Infection in pregnant women may also result in vertical transmission to the fetus, which can cause fatal herpes encephalitis in the newborn child. HSV also can be present on the skin even if there are no sores. Despite this, the Chiron vaccine showed no efficacy in prevention of either disease or infection with HSV-2 in enrollees (58). Thanks so much, Scan this QR code to download the app now. Others feel only a prick or stinging sensation. Entry of HSV into a cell occurs primarily by viral fusion and is mediated by engagement of multiple receptors by viral glycoproteins (6). Efficient mucosal vaccination mediated by the neonatal Fc receptor. Nakanishi Y, Lu B, Gerard C, Iwasaki A. CD8+ T lymphocyte mobilization to virus-infected tissue requires CD4+ T-cell help. The https:// ensures that you are connecting to the This is called a false negative. Serum herpes simplex antibodies - MedlinePlus Over a period of days, the sores become crusted and then heal without leaving scars. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Studies have shown that viral reactivation, and more importantly viral shedding, can occur in the absence of any clinical symptoms (12, 13). Why Marketing Claims for Infant Formula Should be Banned. T cells may also be recruited to the vagina after i.n. Depletion of CD4 T cells from ivag immunized mice leads to a loss of protective immunity, whereas depletion of CD8 T cells or B cells has minimal effect (50, 52). For trusted, in-depth advice from ob-gyns, turn to Your Pregnancy and Childbirth: Month to Month. Generating protective immunity against genital herpes - PMC The first HerpeVac study found that while men were unprotected by the vaccine, 74% vaccine efficacy was observed in women from discordant couples who were seronegative for both HSV-1 and HSV-2 (59). It may be "asleep" (dormant), and cause no symptoms, or it may flare up and cause symptoms. Cattamanchi A, Posavad CM, Wald A, Baine Y, Moses J, Higgins TJ, Ginsberg R, Ciccarelli R, Corey L, Koelle DM. No special steps are needed to prepare for this test. This raises the possibility that specialized intrinsic mechanisms may mediate antiviral defense in neurons. Other names: herpes culture, herpes simplex viral culture, HSV-1 antibodies, HSV-2 antibodies, HSV DNA. When this happens, the virus then travels along the nerves, back to where it first entered the body, and causes a new outbreak of sores and blisters. Terms and Conditions of Use, Get the latest on COVID-19, pregnancy, and breastfeeding. Schiffer JT, Abu-Raddad L, Mark KE, Zhu J, Selke S, Koelle DM, Wald A, Corey L. Mucosal host immune response predicts the severity and duration of herpes simplex virus-2 genital tract shedding episodes. This is a sensible mechanism for renewable cell types, but not for non-renewable cell types such as neurons. 2000;62 (5):1142-1145. The prior assumption has been that asymptomatic shedding occurred only in women who shed the virus from the cervix or vaginal mucosa. See permissionsforcopyrightquestions and/or permission requests. Instead, it looks for IgM, a type of antibody. Impaired intrinsic immunity to HSV-1 in human iPSC-derived TLR3-deficient CNS cells. Dendritic Cell-Induced Memory T Cell Activation in Nonlymphoid Tissues. If you have sores on your breast, you should not breastfeed your baby from that breast. is among the first to achieve this important distinction for online health information and services. B cell depletion from immunized animals does not appear to affect the outcome of disease after WT HSV-2 genital challenge, but ivag immunized B cell deficient mice do not fare as well as their WT counterparts, suggesting that B cells may play a role in initiating a primary response against genital HSV-2 (50, 56). She didnt explain how this happened so Im wondering if any of you know? A cluster of blisters that quickly merge and rupture, forming open ulcers Oozing and crusting Itching and pain Pain with urination (with genital herpes) It is important to note that not everyone who gets HSV-1 or HSV-2 develops symptoms. Unlike the functionally exhausted state of CD8 T cells during chronic infections such as HIV and hepatitis C (47), memory CD8 T cells within the latently infected ganglia appear to remain functional and capable of mounting recall responses (44, 48). In: Bennett JE, Dolin R, Blaser MJ, eds. Both vaccines were subunit vaccines targeted against either HSV-2 glycoprotein B and D (Chiron) or glycoprotein D (HerpeVac, GSK) alone. "Persons with herpes simplex virus type 2, but without symptoms, still shed virus." Does Everyone Have Herpes? 13 FAQs About HSV, Cold Sores, More - Healthline Jiang X, Clark RA, Liu L, Wagers AJ, Fuhlbrigge RC, Kupper TS. National Library of Medicine Latency-associated transcript, or LAT, is the only HSV-associated transcript that is produced during the latent phase of infection, and it has been proposed that LATs actively promote viral latency and host cell survival through several different mechanisms (7). The development of antibodies to HSV-1 or -2 means that future outbreaks will not be as severe as the initial outbreaks. Some people have painful outbreaks with many sores. I went to a clinic where they swabbed me and that came back negative. Knickelbein JE, Khanna KM, Yee MB, Baty CJ, Kinchington PR, Hendricks RL. Furthermore, immunization of monkeys with HIV-1 gp41 through the mucosal intranasal (i.n.) Even if your partners do not have sores, they may want to be tested. The World Health Organization (WHO) estimate that 3.7 billion people under the age of 50 have an HSV-1 infection, which usually causes oral herpes. A.D.A.M. Iijima N, Linehan MM, Zamora M, Butkus D, Dunn R, Kehry MR, Laufer TM, Iwasaki A. Dendritic cells and B cells maximize mucosal Th1 memory response to herpes simplex virus.
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