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The laryngeal mucosa is divided into two layers in terms of expression of antigen presenting molecules by epithelial cells: a superior, CD1d-rich layer and and deep, MHC Class1 -rich layer. We hypothesize that challenges which break down intercellular adhesion permit the presentation of incident antigens directly to the more ‘pro-inflammatory’ deeper layer, resulting in chronicity. Dendritic cells straddle the basement membrane and may orchestrate this response.
