In defense of mucosal surfaces. Regulation and manipulation of the mucosal immune system.

The mucosal immune system defends the host against pathogens, most of which invade through mucosal surfaces. Antigen sampling in the mucosal immune system in the intestine occurs constantly in specialized inductive sites known as gut associated lymphoreticular tissue or GALT. Antigen-primed cells then migrate to effector sites in the gut lamina propria and epithelium as well as to other mucosal tissues. A variety of strategies are being pursued to develop effective oral vaccines that will protect mucosal surfaces. Some approaches involve recently identified mucosal adjuvants, the best known of which is cholera toxin. One approach is illustrated in which antigen and adjuvant are incorporated in the inner water phase of a water-in-oil-in-water or multiple emulsion, thus protecting antigen and delivering it into GALT.