Belyakov Igor M, Ahlers Jeffrey D
Midwest Research Institute, 110 Thomas Johnson Drive, Frederick, MD 21702, USA.
J Immunol. 2009 Dec 1;183(11):6883-92. doi: 10.4049/jimmunol.0901466.
The route of vaccination is important in influencing immune responses at the initial site of pathogen invasion where protection is most effective. Immune responses required for mucosal protection can differ vastly depending on the individual pathogen. For some mucosal pathogens, including acute self-limiting infections, high-titer neutralizing Abs that enter tissue parenchyma or transude into the mucosal lumen are sufficient for clearing cell-free virus. However, for pathogens causing chronic infections such as HIV, hepatitis C virus, herpes viruses, mycobacteria, and fungal and parasitic infections, a single arm of the immune response generated by systemic vaccination may be insufficient for protection. Induction of the mucosal innate and adaptive immune systems, including CD4+ T help, Th17, high avidity CD8+ CTL, and secretory IgA and IgG1 neutralizing Abs, at the site of pathogen entry may be required for effective protection against highly invasive pathogens that lead to chronic infection and may be generated predominantly by mucosal vaccination.
疫苗接种途径对于在病原体入侵的初始部位影响免疫反应很重要，而在此部位保护最为有效。黏膜保护所需的免疫反应会因个体病原体的不同而有很大差异。对于一些黏膜病原体，包括急性自限性感染，进入组织实质或渗入黏膜腔的高滴度中和抗体足以清除游离病毒。然而，对于导致慢性感染的病原体，如艾滋病毒、丙型肝炎病毒、疱疹病毒、分枝杆菌以及真菌和寄生虫感染，全身接种疫苗所产生的单一免疫反应分支可能不足以提供保护。对于有效抵御导致慢性感染的高侵袭性病原体，可能需要在病原体进入部位诱导黏膜固有免疫和适应性免疫系统，包括CD4 + T辅助细胞、Th17、高亲和力CD8 + 细胞毒性T淋巴细胞以及分泌型IgA和IgG1中和抗体，而这可能主要通过黏膜疫苗接种来实现。
