Holmgren J
Department of Medical Microbiology and Immunology, University of Göteborg, Sweden.
FEMS Microbiol Immunol. 1991 Dec;4(1):1-9. doi: 10.1111/j.1574-6968.1991.tb04964.x.
The gut mucosal immune system is a critical component of the body's defense against pathogenic organisms, especially those responsible for enteric infections associated with diarrhoeal disease. Attempts to vaccinate against infections of mucosal tissues have been less successful than vaccination against systemic infections, to a large extent reflecting a still incomplete knowledge about the most efficient means for inducing protective local immune responses at these sites. Secretory IgA (SIgA) is the predominating immunoglobulin along mucosal surfaces, and SIgA antibodies generated in gastrointestinal, respiratory or genito-urinary mucosal tissues can confer protection against infections affecting or originating in these sites. An efficacious intestinal SIgA immunity-inducing oral vaccine against cholera has been developed recently, and development of oral vaccines against other enteric infections such as those caused by enterotoxigenic Escherichia coli, Shigella and rotaviruses is in progress as well. Based on the concept of a common mucosal immune system through which activated lymphocytes from the gut can disseminate immunity to other mucosal and glandular tissues, there is currently also much interest in the possibility of developing oral vaccines against infections in the respiratory and urogenital tracts. However, the large and repeated antigen doses often required to achieve a protective immune response still makes this vaccination approach impractical for many purified antigens. There is, therefore, a great need to develop strategies for enhancing delivery of antigen to the mucosal immune system as well as to identify mucosa-active immunostimulating agents (adjuvants). These and other aspects of mucosal immunity in relation to immunization and vaccine development are discussed in this short review article.
肠道黏膜免疫系统是机体抵御病原微生物的关键组成部分，尤其是那些导致与腹泻病相关的肠道感染的病原微生物。针对黏膜组织感染进行疫苗接种的尝试，其成功率低于针对全身性感染的疫苗接种，这在很大程度上反映出，对于在这些部位诱导保护性局部免疫反应的最有效方法，我们仍了解不足。分泌型IgA（SIgA）是沿黏膜表面占主导地位的免疫球蛋白，在胃肠道、呼吸道或泌尿生殖黏膜组织中产生的SIgA抗体可抵御影响这些部位或源自这些部位的感染。最近已研发出一种针对霍乱的有效诱导肠道SIgA免疫的口服疫苗，针对其他肠道感染（如由产肠毒素大肠杆菌、志贺氏菌和轮状病毒引起的感染）的口服疫苗也在研发中。基于共同黏膜免疫系统的概念，即来自肠道的活化淋巴细胞可通过该系统将免疫力传播至其他黏膜和腺组织，目前人们也对研发针对呼吸道和泌尿生殖道感染的口服疫苗很感兴趣。然而，为实现保护性免疫反应通常所需的大量且重复的抗原剂量，仍使这种疫苗接种方法对于许多纯化抗原而言不切实际。因此，迫切需要制定策略来增强抗原向黏膜免疫系统的递送，并鉴定黏膜活性免疫刺激剂（佐剂）。本文简短综述将讨论黏膜免疫与免疫接种及疫苗研发相关的这些及其他方面。
