Mucosal vaccines the promise and the challenge.pdfVIP

R E V I E W S Mucosal vaccines: the promise and the challenge ‡ Marian R. Neutra* and Pamela A. Kozlowski* Abstract | Most infectious agents enter the body at mucosal surfaces and therefore mucosal immune responses function as a first line of defence. Protective mucosal immune responses are most effectively induced by mucosal immunization through oral, nasal, rectal or vaginal routes, but the vast majority of vaccines in use today are administered by injection. As discussed in this Review, current research is providing new insights into the function of mucosal tissues and the interplay of innate and adaptive immune responses that results in immune protection at mucosal surfaces. These advances promise to accelerate the development and testing of new mucosal vaccines against many human diseases including HIV/AIDS. Mucosal surfaces are enormous surface areas that are of mucosal T cells is labour intensive and technically vulnerable to infection by pathogenic microorganisms. challenging. As a result, only a few mucosal vaccines The adaptive immune system is designed to distinguish have been approved for human use in the United States antigens, pathogens and vaccines that enter the body or elsewhere. These include oral vaccines against polio- 3