Czerkinsky C, Svennerholm A M, Holmgren J
Department of Medical Microbiology and Immunology, University of Göteborg, Sweden.
Clin Infect Dis. 1993 Mar;16 Suppl 2:S106-16. doi: 10.1093/clinids/16.supplement_2.s106.
It is now almost axiomatic that vaccines against enteric infections must be able to stimulate the gut lymphoid tissue to be efficacious and that this goal is usually better achieved by administering immunogens orally rather than parenterally. On the basis of the notion of a common mucosal immunologic system that provides immune reactivity not only at the site of antigen deposition but also at remote mucosal sites, there is much interest in developing oral vaccines against infections in the respiratory and urogenital tracts. Recent studies indicate that oral administration of small amounts of protein antigens that are chemically or genetically linked to intestinal binding carrier molecules (such as the B subunit of cholera toxin) can evoke vigorous mucosal and extramucosal immune responses. The apparent compartmentalization of systemic and mucosal immune responses may explain not only why parenteral vaccines are just partly effective in protecting against mucosal pathogens but also why currently employed immunoanalytical methods do not provide accurate information regarding mucosal immune status. Following the developments of oral vaccines against infections due to Vibrio cholerae and enterotoxigenic Escherichia coli, two archetypes of enteropathogens, we have devoted extensive efforts to gaining insight into the humoral and cellular events involved in the development of protective immunity in the human intestinal tract. We have developed preparative and analytical methods for studying vaccine-induced intestinal and extraintestinal immune responses in humans. These include techniques for collecting intestinal fluid and lymphoid cells as well as procedures to quantitate secretory antibodies and lymphokines secreted by activated intestinal immunocytes. These developments should serve the dual purpose of facilitating analyses of human mucosal immune responses in general and assessing the immunogenicity of enteric vaccines in particular.
现在几乎已成定论的是,针对肠道感染的疫苗必须能够刺激肠道淋巴组织才能有效,而且通常通过口服免疫原而非肠胃外给药能更好地实现这一目标。基于共同黏膜免疫系统的概念,该系统不仅能在抗原沉积部位提供免疫反应,还能在远端黏膜部位产生反应,因此人们对开发针对呼吸道和泌尿生殖道感染的口服疫苗兴趣浓厚。最近的研究表明,口服少量与肠道结合载体分子化学或基因相连的蛋白质抗原(如霍乱毒素B亚基)能引发强烈的黏膜和黏膜外免疫反应。全身免疫反应和黏膜免疫反应明显的分隔化,可能不仅解释了肠胃外疫苗在预防黏膜病原体方面为何仅部分有效,还解释了为何目前使用的免疫分析方法无法提供有关黏膜免疫状态的准确信息。继针对霍乱弧菌和产肠毒素大肠杆菌这两种肠道病原体感染的口服疫苗研发成功后,我们投入了大量精力深入了解人体肠道中保护性免疫发展过程中涉及的体液和细胞事件。我们已开发出用于研究人体疫苗诱导的肠道和肠道外免疫反应的制备和分析方法。这些方法包括收集肠道液和淋巴细胞的技术,以及定量活化肠道免疫细胞分泌的分泌性抗体和淋巴因子的程序。这些进展应能达到双重目的,既有助于总体上分析人体黏膜免疫反应,又尤其有助于评估肠道疫苗的免疫原性。