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Immunohistological comparison of TGF-β and HLA-DR expression by macrophages and CD3+ T cells in onchocercomas from untreated hyporeactive and hyperreactive patients in Liberia and Ghana. (A-B) Nodule centre with strong (hyporeactive) and weak (hyperreactive) TGF-β expression (arrows) around older female worms. (C-D) Details of TGF-βhigh (hyporeactive) and TGF-βlow (hyperreactive) nuclei and cytoplasm of macrophages (arrow) adjacent to female worms (f), while a small giant cell, attached to the cuticle, is negative (*). (E-H) Serial sections with strong (hyporeactive) and weak or negative (hyperreactive) TGF-β (E-F) and HLA-DR (G-H) expression (arrows) mainly in macrophages adjacent to productive female worms and an attached HLA-DR+ giant cell (*). Immune cells further distant from the worm are HLA-DR+ (arrowhead in H), whereas they are TGF-β-positive (F) and macrophages adjacent to the worm are HLA-DR-negative (H). (J-M) Moribund or dead mf in a nodular microgranuloma being attacked by macrophages strongly (hyporeactive) or faintly (hyperreactive) expressing TGF-β or HLA-DR (arrows). (K+M) are serial sections. (N-Q) Mainly CD3+ T lymphocytes express TGF-β strongly in a nodule from a hyporeactive and weakly in a nodule from a hyperreactive patient. (N+P and O+Q) are serial sections. (P+Q) CD3-staining. Scale bars=50 µm.