Local immune response to repeated topical antigen application in the simian labial mucosa

Oral Mucosal Immunity and HIV/SIV Infection

Human Immunodeficiency Virus (HIV) transmission through genital and rectal mucosa has led to intensive study of mucosal immune responses to HIV and to the development of a vaccine administered locally. However, HIV transmission through the oral mucosa is a rare event. The oral mucosa represents a physical barrier and contains immunological elements to prevent the invasion of pathogenic organisms. This particular defense differs between micro-compartments represented by the salivary glands, oral mucosa, and palatine tonsils. Secretory immunity of the salivary glands, unique features of cellular structure in the oral mucosa and palatine tonsils, the high rate of oral blood flow, and innate factors in saliva may all contribute to the resistance to HIV/Simian Immunodeficiency Virus (SIV) oral mucosal infection. In the early stage of HIV infection, humoral and cellular immunity and innate immune functions in oral mucosa are maintained. However, these particular immune responses may all be impaired as a result of chronic HIV infection. A better understanding of oral mucosal immune mechanisms should lead to improved prevention of viral and bacterial infections, particularly in immunocompromised persons with Acquired Immune Deficiency Syndrome (AIDS), and to the development of a novel strategy for a mucosal AIDS vaccine, as well as vaccines to combat other oral diseases, such as dental caries and periodontal diseases.

Sublingual mucosa: A new vaccination route for systemic and mucosal immunity

Needle-free vaccine delivery has become a global priority, both to eliminate the risk of improper and unsafe needle use and to simplify vaccination procedures. In pursuit of greater ease of vaccination, a number of needle-free delivery routes have been explored, with mucosal routes being perhaps the most prominent. Since the vaccine administration route significantly affects immune responses, numerous researchers are attempting to develop alternative vaccine delivery methods including a mucosal route. My group's recent studies demonstrate the potential of the sublingual (s.l.) route for delivering vaccines capable of inducing mucosal as well as systemic immune responses. Sublingual administration conferred effective protection against a lethal challenge with influenza virus (H1N1) or genital papillomavirus. Moreover, CCR7-CCL19/CCL21-regulated dendritic cells are responsible for activation of T and B cells following s.l. administration. This review highlights current knowledge about the safety and effectiveness of s.l. vaccination and describes how s.l. vaccination can induce both systemic and mucosal immunity.

Neuroendocrine regulation of salivary IgA synthesis and secretion: implications for oral health

Secretory immunoglobulin A (S-IgA) represents the main adaptive immune mechanism in the oral cavity. The regulation of secretion and synthesis of S-IgA is not only dependent on prior antigenic stimulation, but is also under strong neuroendocrine control. Thus, alterations in neuroendocrine functioning (such as induced by stress, exercise, pregnancy, menstrual cycle, and pharmacological interventions) may affect salivary IgA levels. This review deals with the neuroendocrine regulation of synthesis and secretion of salivary IgA and its potential role in the maintenance of oral health.

Levels of parotid and submandibular/sublingual salivary immunoglobulin A in response to experimental gingivitis in humans

Salivary secretory IgA (s-IgA) is considered to act as an important first line of defense mechanism in the oral cavity. It has therefore been suggested that an increased antigenic load would induce an increase in salivary IgA production. This study investigated the pure glandular levels of salivary IgA in parotid and submandibular/sublingual (SM/SL) saliva during plaque accumulation leading to experimental gingivitis. Starting from regular oral hygiene, 14 healthy, nonsmoking men refrained from all oral hygiene measures for 12 days. On days -2, 0, 3, 6, and 12 a plaque index, a bleeding index, and unstimulated and stimulated saliva from the parotid and the SM/SL glands were measured. Salivary IgA was quantified using a sandwich ELISA. All subjects developed gingivitis as measured by a bleeding index. Compared to baseline the salivary flow rate was increased on day 12. Regarding the secretion rate of IgA there was a statistically significant increase in stimulated parotid saliva but not SM/SL saliva compared to baseline after 6 and 12 days without oral hygiene. No significant changes were observed for the concentration of IgA during the trial. Thus, in healthy subjects with regular oral hygiene the development of plaque induced gingivitis is associated with increased salivary gland output and increased total IgA output levels in stimulated parotid saliva but not in SM/SL saliva.

Current status of a mucosal vaccine against dental caries

The evidence of a specific bacterial cause of dental caries and of the function of the salivary glands as an effector site of the mucosal immune system has provided a scientific basis for the development of a vaccine against this highly prevalent and costly oral disease. Research efforts towards developing an effective and safe caries vaccine have been facilitated by progress in molecular biology, with the cloning and functional characterization of virulence factors from mutans streptococci, the principal causative agent of dental caries, and advancements in mucosal immunology, including the development of sophisticated antigen delivery systems and adjuvants that stimulate the induction of salivary immunoglobulin A antibody responses. Cell-surface fibrillar proteins, which mediate adherence to the salivary pellicle, and glucosyltransferase enzymes, which synthesize adhesive glucans and allow microbial accumulation, are virulence components of mutans streptococci, and primary candidates for a human caries vaccine. Infants, representing the primary target population for a caries vaccine, become mucosally immunocompetent and secrete salivary immunoglobulin A antibodies during the first weeks after birth, whereas mutans streptococci colonize the tooth surfaces at a discrete time period that extends around 26 months of life. Therefore, immunization when infants are about one year old may establish effective immunity against an ensuing colonization attempts by mutans streptococci. The present review critically evaluates recent progress in this field of dental research and attempts to stress the protective potential as well as limitations of caries immunization.

Simultaneous induction of specific immunoglobulin A--producing cells in major and minor salivary glands after tonsillar application of antigen in rabbits

The immunoglobulin A (IgA)-producing cells in the stroma of major salivary glands are induced by antigenic stimulation of the mucosal immune system. Whether such cells also are induced in minor salivary glands by this stimulation remains to be determined. After application of sheep red blood cells to the palatine tonsils every 3 days for 6 weeks, anti-sheep red blood cell IgA was detected in saliva both by agglutination tests and by enzyme-linked immunosorbent assay. Using enzyme-linked immunospot assay, an increase in the number of anti-sheep red blood cell IgA-producing cells was found in minor as well as in major salivary glands of the sixth week of application; such cells constituted 4.9% to 5.9% of the total number of IgA-producing cells in these tissues. Tonsillar application of whole cells of formalin-killed Streptococcus sobrinus induced anti-S. sobrinus IgA in saliva. The number of anti-S. sobrinus IgA-producing cells in the above glands simultaneously increased over 6 weeks, and reached 5.2-5.6% of the total number of IgA-producing cells.

Oral microbial ecology and the role of salivary immunoglobulin A

In the oral cavity, indigenous bacteria are often associated with two major oral diseases, caries and periodontal diseases. These diseases seem to appear following an imbalance in the oral resident microbiota, leading to the emergence of potentially pathogenic bacteria. To define the process involved in caries and periodontal diseases, it is necessary to understand the ecology of the oral cavity and to identify the factors responsible for the transition of the oral microbiota from a commensal to a pathogenic relationship with the host. The regulatory forces influencing the oral ecosystem can be divided into three major categories: host related, microbe related, and external factors. Among host factors, secretory immunoglobulin A (SIgA) constitutes the main specific immune defense mechanism in saliva and may play an important role in the homeostasis of the oral microbiota. Naturally occurring SIgA antibodies that are reactive against a variety of indigenous bacteria are detectable in saliva. These antibodies may control the oral microbiota by reducing the adherence of bacteria to the oral mucosa and teeth. It is thought that protection against bacterial etiologic agents of caries and periodontal diseases could be conferred by the induction of SIgA antibodies via the stimulation of the mucosal immune system. However, elucidation of the role of the SIgA immune system in controlling the oral indigenous microbiota is a prerequisite for the development of effective vaccines against these diseases. The role of SIgA antibodies in the acquisition and the regulation of the indigenous microbiota is still controversial. Our review discusses the importance of SIgA among the multiple factors that control the oral microbiota. It describes the oral ecosystems, the principal factors that may control the oral microbiota, a basic knowledge of the secretory immune system, the biological functions of SIgA, and, finally, experiments related to the role of SIgA in oral microbial ecology.

Local immune response in Helicobacter pylori-infected cats and identification of H. pylori in saliva, gastric fluid and faeces

Helicobacter pylori-infected cats were screened by culture and polymerase chain reaction (PCR) for the presence of H. pylori in salivary secretions, gastric juice, gastric tissue and faeces. H. pylori was cultured from salivary secretions in six of 12 (50%) cats and from gastric fluid samples in 11 of 12 (91%) cats. A 298 base pair polymerase chain reactions (PCR) product specific for an H. pylori 26000 MW surface protein was amplified from dental plaque samples from five of 12 (42%) cats and from the faeces of four of five (80%) cats studied. Analyses of serum and mucosal secretions by enzyme-linked immunosorbent assay (ELISA) revealed an H. pylori-specific immunoglobulin G (IgG) response, and elevated IgA anti-H. pylori antibody levels in salivary and local gastric secretions. Immunohistochemical analyses of gastric tissue revealed the presence of IgM+ B cells assembled into multiple lymphoid follicles surrounded by clusters of CD4+ and CD8+ T cells. The lamina propria also contained single cells or aggregates of IgA+ and IgM+ B cells. These observations show that H. pylori can be identified in feline mucosal secretions, and that a localized IgA immune response develops in gastric tissue of H. pylori-infected cats. The findings suggest a zoonotic risk from exposure to personnel handling H. pylori-infected cats in vivaria.

Acquired resistance and persistence of Candida albicans following oral candidiasis in the mouse: a model of the carrier state in humans

In our experimental model of oral candidiasis in the CD1 mouse, the primary infection showed reproducible Candida overgrowth kinetics with a peak level on day 5 of the infection. After day 7, the population stabilized at about 300 colony-forming units per excised mucosal tissue. The primary infection triggered an inflammatory response that resolved in under 8 days. At this point, the histological pattern of the mucosa reached a new equilibrium between recruited and resident mononuclear cells. The primary infection also rapidly stimulated cellular immunity, as measured from day 4 by a delayed-type hypersensitivity footpad reaction. Following a second topical challenge with Candida 30 days after the primary infection, the infection was barely detectable and a typical local delayed-type hypersensitivity reaction occurred between 24-72 h. It is proposed that acquired resistance, in conjunction with low-level persistence of Candida in our model, mimics the carrier state in sensitized humans.

Effect of age on immunoglobulin content and volume of human labial gland saliva

Stimulated lower labial (LLGF) and parotid salivary volumes and IgG, IgA, and IgM concentrations were measured in 264 subjects whose ages ranged from 17 to 76 years. A significant (p < 0.001) age-related decline in LLGF output was observed for subjects over this age range. Sixty-three percent of the subjects in the 18-20-year-old group (n = 46) secreted at least 10 microL of labial saliva in a 7-10-minute period, while approximately 70% of the subjects in the two oldest groups (61-70 and 71-76 years old) secreted less than 1 microL of LLGF during this time period (n = 64). No significant gender-based differences occurred in the volumes of labial saliva secreted. Stimulated parotid salivary flow showed no age-related trend in these subjects. Lower labial gland salivary IgA concentrations in an older population (mean age +/- SD = 55.6 yr +/- 1.3) were significantly lower (p < 0.025) than IgA concentrations in a younger population (20.7 yr +/- 0.8), when IgA was expressed as microgram/mL LLGF collected. Immunoglobulin A concentrations in parotid saliva and IgG and IgM concentrations in labial and parotid saliva were not significantly different when the two age populations were compared. These data suggest that the physiological and immunological potential of labial gland saliva may decrease with age.

Immunoglobulin isotypes in human minor gland saliva

Lower labial, upper labial, palatine (minor), and parotid (major) gland saliva samples from 18 young adult males were quantitatively assayed for the presence of IgA1, IgA2, IgM, and IgG. The mean (+/- standard deviation) concentrations of IgA (sum of IgA1 + IgA2) were 79 +/- 42 micrograms/mL (parotid), 111 +/- 42 micrograms/mL (lower labial), 69 +/- 72 micrograms/mL (upper labial), and 88 +/- 68 micrograms/mL (palatine). Total IgA concentrations were positively correlated among different minor-gland samples from the same subject, although these correlations did not reach significance. Upper-labial-gland saliva samples contained significantly (at least p less than 0.05) lower concentrations of IgA1 than those found in parotid or lower-labial minor-gland secretions. All three minor-gland sources of saliva contained significantly (p less than 0.002) higher levels of IgG than did parotid saliva. Upper-labial fluids had significantly (p less than 0.02) higher IgG concentrations than lower-labial saliva. IgM could be detected in 89% of parotid saliva samples and 75% of the palatine saliva samples. Palatine IgM concentrations (8.2 +/- 17.8 micrograms/mL) were significantly (p less than 0.05) higher than parotid IgM concentrations (0.6 +/- 0.4 micrograms/mL). IgM was detected much less frequently and at lower concentrations in lower- and upper-labial-gland saliva. These data reveal that minor-gland saliva from different oral sites may contain distinctive immunoglobulin isotype patterns, and expressions of host defense may vary within each micro-environment.

Effect of local deposition of antigen on salivary immune responses and reaccumulation of mutans streptococci

In this study glucosyltransferase (GTF) from Streptococcus sobrinus was topically administered onto the lower lips of young adults. The effect of this route of antigenic exposure on labial and parotid gland and serum antibody levels to GTF and on the reaccumulation of indigenous mutans streptococci after a dental prophylaxis was then measured. Young adults between 18 and 42 years of age were screened for levels of antibody activity to GTF in parotid and labial gland salivas and levels of mutans streptococci in their whole saliva. Prior to antigen administration, two groups were formed which had similar distributions of mutans streptococci in their whole saliva. Antigen (GTF) or placebo, each combined with aluminum phosphate (AP), was then administered to the lower lip daily for 5 days. Immediately prior to topical application of GTF or placebo to the labial salivary glands, all subjects were given a dental prophylaxis. Statistically significant differences in anti-GTF IgA antibody activity in parotid or labial salivas were not observed between the GTF-administered and the placebo groups during the 6 weeks following topical application. However, the proportions of indigenous mutans streptococci/total streptococcal flora, or total cultivable flora, were always lower in the whole salivas of the GTF, compared with the placebo group. These differences were statistically significant on days 13, 20, 34, and 41 after initial topical application. Delays in reaccumulation were significantly associated (P less than 0.025) with elevations in parotid saliva IgA antibody levels of all subjects. Seven of 10 of the subjects demonstrating this association were in the group to which GTF was topically administered.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of ocular hypersensitivity to dipivalyl epinephrine by component eye-drop testing

Dipivalyl epinephrine (dipivefrin) is a prodrug of epinephrine used for topical glaucoma therapy. Local side effects have been noted in approximately 20% of patients treated and include conjunctival hyperemia, foreign body sensation, and follicular conjunctivitis. We studied five patients with adverse local reactions to dipivefrin (Propine) eye drops. Propine contains the following: dipivefrin, 0.1%; mannitol, 1.89%; sodium metabisulfite, 0.075%; disodium edetate, 0.0127%; and benzalkonium chloride, 0.004%. Since the reactions could conceivably have been caused by an ingredient other than dipivefrin, we first patch tested the patients with the maximum recommended concentration of each ingredient. All patch tests were negative. Sterile ophthalmic solutions of each individual component at the concentrations used in the commercial product were then prepared. In a double-blinded study, the patients applied two drops of each preparation, twice daily for 1 week, with a 1-week, drug-free period between trials. Dipivefrin alone reproduced each patient's initial Propine-induced conjunctivitis; symptoms occurred unilaterally in one patient and bilaterally in the other four patients. This study indicates that testing with single component eye drops can identify the provocative component in ocular drug hypersensitivity and that these reactions can be unilateral.

Local oral immunization with synthetic peptides induces a dual mucosal IgG and salivary IgA antibody response and prevents colonization of Streptococcus mutans

A small cell surface antigen of Streptococcus mutans was partially sequenced and the amino terminal peptides of 11, 15 and 20 amino acid residues and a dimer of the 15 and 20 residues peptides were synthesized. The synthetic peptides (SP) were used in topical oral immunization of the gingivomucosal epithelium of macaque monkeys. Sequential examination for antibodies over a period of up to 30 weeks revealed that six applications of the linear or cyclized SP11 and a random SP11 induced negligible or very low antibody levels. In contrast, the SP17 (SP15 with added cysteine at each terminus), SP21 (SP20 with one cysteine) and the dimer (SP35) induced significant anti-SP as well as anti-native streptococcal antibodies in the gingival fluid and in saliva. The functional significance of this immune response was examined by studying its effect on oral colonization of S. mutans following feeding of a carbohydrate-rich diet. Whereas control animals, sham-immunized with a random SP of 11 residues, showed increased colonization of the teeth by S. mutans, there was no colonization or a significant reduction in colonization of animals immunized with the cyclized SP17, linear SP21 or dimerized SP35. These experiments suggest that local immunization with SP derived from the sequences of a streptococcal cell surface antigen induce a dual local immune response of gingival IgG and salivary IgA antibodies against the SP and native SA. These antibodies may be involved in preventing colonization of S. mutans, which is the principal agent in the development of dental caries.

Phenotype of mononuclear leucocytes resident in rat major salivary and lacrimal glands

The phenotypic distribution of lymphocytes and mononuclear phagocytes resident in rat secretory glands was examined. Isolated exocrine gland mononuclear leucocyte populations contained 50-61% W3/13+ T cells and greater proportions of W3/25+ T helper cells relative to OX8+ T suppressor cells. Surface Ig+ cells (sIg) constituted from 32% to 34% of the cells and their distribution was sIgM greater than sIgA greater than sIgG. The macrophage populations comprised from 0.02% to 0.1% of the unfractionated gland cells. Fractionated secretory gland-adherent cells consisted primarily of non-specific esterase+, phagocytic and Fc receptor-bearing cells. From 35% to 79% of the macrophages in exocrine glands expressed I-A molecules. The results suggest that exocrine glands have the ability to respond locally to an antigenic challenge independently of a central mucosal immune response.

Resident salivary gland macrophages function as accessory cells in antigen-dependent T-cell proliferation

The function of salivary gland macrophages in the induction of local immunity in secretory organs was investigated in Fischer 344 rats. Macrophages obtained from dispersed submandibular gland (SMG) cells were characterized and examined for their ability to present antigen to T cells. Populations of SMG-adherent cells contained approximately 80% macrophages, of which 46-62% were I-A+ cells. These numbers were from five to 10-fold greater than the I-A+ cells in macrophage populations from peritoneal exudates (5-11%). SMG macrophages functioned effectively as antigen-presenting cells. Antigen presentation was antigen specific, macrophage dose dependent and inhibitable by monoclonal anti-I-A antibodies. These studies suggest that a functional salivary-gland immune-response pathway exists that can function independently of a gut-associated lymphocyte-homing mechanism.

Immunological features of minor salivary gland saliva

Concentrations of IgA, IgG, IgM, and IgA subclasses were measured in 138 pairs of parotid gland saliva (PS) and labial gland saliva (LS), using an enzyme-linked immunosorbent assay (ELISA) technique in which levels of Ig were quantitated using affinity-purified anti-heavy chain reagents for capture and development. Both PS and LS were collected simultaneously during sour lemon drop stimulation. As previously observed, IgA was the dominant immunoglobulin in both salivary fluids, the concentrations of which were highly correlated within the subjects studied. The mean proportion of IgA1 to total IgA was slightly higher in LS (0.66), compared with PS (0.60). Little IgM was usually detected in either secretion. In contrast, LS had IgG concentrations (mean, 8.1 micrograms/ml) which were significantly higher (P less than 0.001) than those found in parotid saliva (mean, 0.3 micrograms/ml). Over 30% of the subjects had mean LS IgG levels above 10 micrograms/ml. The mean percentage of LS IgG to IgA was 20% in the 138 samples tested. Gel filtration of pairs of PS and LS from four individuals revealed IgM, IgA, and IgG to elute in positions commensurate with pentameric IgM, secretory IgA, and monomeric IgG. Little or no monomeric IgA could be detected. These results suggest that, in addition to IgA, the IgG isotype may also be important in antibody-mediated phenomena which occur in oral microenvironments bathed by minor salivary gland secretions.

The common mucosal immune system and current strategies for induction of immune responses in external secretions

The selective induction of antibodies in external secretions is desirable for the prevention of various systemic as well as predominantly mucosa-restricted infections. An enormous surface area of mucosal membranes is protected primarily by antibodies that belong, in many species, to the IgA isotype. Such antibodies are produced locally by large numbers of IgA-containing plasma cells distributed in subepithelial spaces of mucosal membranes and in the stroma of secretory glands. In humans and in some animal species, plasma-derived IgA antibodies do not enter external secretions in significant quantities and systemically administered preformed IgA antibodies would be of little use for passive immunization. Systemic administration of microbial antigens may boost an effective S-IgA immune response only in a situation whereby an immunized individual had previously encountered the same antigen by the mucosal route. Local injection of antigen in the vicinity of secretory glands is usually accompanied by an undesirable concomitant systemic response and frequently requires the addition of adjuvants that are unacceptable for administration in humans. Immunization routes that involve ingestion or possibly inhalation of antigens lead to the induction of not only local but also generalized immune responses manifested by the parallel appearance of S-Iga antibodies to ingested or inhaled antigens in secretions of glands distant from the site of immunization. Based on extensive studies in animal models as well as in humans, convincing evidence is available that antigen-sensitized and IgA-committed precursors of plasma cells from GALT are disseminated to the gut, other mucosa-associated tissues, and exocrine glands. However, due to the limited absorption of desired antigens from the gut lumen of orally immunized individuals, repeated large doses of antigens are required for an effective S-IgA response. Novel antigen delivery systems for the stimulation of such responses are currently being examined in several laboratories. Live attenuated or genetically manipulated bacteria expressing other microbial antigens have also been used for selective colonization of gut-associated lymphoid tissues. Unique antigen packaging and the use of adjuvants suitable for oral administration hold promise for an efficient antigen delivery to critical tissues in the intestine and deserve extensive exploration. The oral immunization route appears to have many advantages over systemic immunization.(ABSTRACT TRUNCATED AT 400 WORDS)

Minor salivary gland duct-associated lymphoid tissue (DALT) in monkeys changes with age

The duct-associated lymphoid tissue (DALT) of minor salivary glands (MSG) is accessible to oral antigens by retrograde passage. DALT responds immunologically to such purely local and duct-derived antigenic stimuli. This study addressed the question as to whether DALT, like other mammalian lymphoid tissues, would change with age. Labial and buccal mucosae of eight Macaca fascicularis animals of known age were processed for light microscopy by Epon embedding. Sections of approximately 1-2 microns thick were prepared, and a total of 144, more or less equidistant, labial and 63 buccal sections were selected and analyzed for various tissue components, by means of morphometric point-counting. The raw data were transformed into stereological parameters. The results showed that DALT and interacinar plasma cells are totally absent in the newborn monkey. They begin to appear early in life and reach a maximum volume density by one year of age. With further increasing age, the DALT volume showed a sharp decline, followed by a plateauing from year 3 onward, while the plasma cell concentration remained stable. This change was more pronounced in the labial mucosa. These observations on the age-related changes of simian DALT are suggestive of its antigen-induced and antigen-dependent nature. DALT, being part of the gut-associated lymphoid tissue, may play a substantial role in the local immuno-surveillance of the oral cavity.

Duct-associated lymphoid tissue (DALT) of minor salivary glands in the monkey, Cercopithecus aethiops

This study reports on the characteristic topographical distribution of DALT within the labial and buccal mucosae of Cercopithecus aethiops. A total of 140 labial and 24 buccal mucosal tissue blocks, originating from 11 animals, were examined light microscopically. All animals revealed DALT in varying numbers of Epon blocks. In C. aethiops, DALT is a comparatively rare phenomenon and appears to develop almost exclusively around MSG duct orifices and along the course of main ducts traversing the subepithelial lamina propria. The location of DALT in C. aethiops, therefore, seems to be anatomically more restricted than in other species (Macaca fascicularis and Macaca mulatta) in which DALT has been studied more extensively.

Duct-associated lymphoid tissue (DALT) of minor salivary glands and mucosal immunity

Minor salivary glands (MSG) play a substantial role in the secretory immunoglobulin A (sIgA)-mediated immunity of the oral cavity. There are two possibilities for the induction of this immunity: (i) an explicitly local antigenic stimulus, or (ii) a remote stimulus as part of the so-called 'common mucosal immune system'. This communication is an attempt to consolidate available evidence in support of both possibilities and to address the former in detail. Although there is strong circumstantial evidence supporting the feasibility of MSG functioning as a part of the common mucosal immune system, direct experimental evidence is yet to emerge. On the other hand, there is increasing structural and physiological evidence in support of MSG serving as a local immunological organ. The purely local response is attributed to the presence of MSG duct-associated lymphoid tissue (DALT), which is comparable to gut- or bronchial-associated lymphoid tissue (GALT or BALT) in origin, tissue organization and function. DALT is accessible to oral antigens by retrograde passage through MSG ducts. Repeated topical antigenic challenging via the oral mucosa may result in the appearance of interacinar plasma cells carrying specific homologous antibodies in MSG. Gut or enteric priming of the same antigen, by passing the oral mucosa by gastric intubation, need not evoke a remote immune response in MSG. Since DALT is more likely to occur in healthy, young growing individuals, who are less likely to undergo bioptic examination of MSG, it has not yet been documented in humans. The physiologically induced DALT is apt to be confused with focal accumulations of lymphoid tissue in pathologically altered MSG, as a consequence of local and some systemic autoimmune diseases. An attempt is made to demarcaate healthy and pathological MSG on the basis of currently available clinical, serological, immunological and genetic evidence.

Architecture of associations of minor salivary gland ducts and lymphoid follicles in Macaca fascicularis. An ultrastructural study

Previous light-microscopic and ultra-immunohistochemical tracer studies revealed the existence of an independent local immune response of the simian oral mucosa. This local response is attributed to the presence of minor salivary gland (MSG) duct-related lymphoid tissue. Semithin sections from a total of 263 Epon-embedded tissue blocks from the labial and buccal mucosae of seven monkeys, Macaca fascicularis, were analysed light-microscopically, and 10 suitable MSG duct/follicle assemblies were investigated ultrastructurally. These duct/follicle assemblies include follicular and parafollicular compartments with distinct fine-structural elements. The follicular area or germinal centre contains numerous small and large lymphoid cells, mitotic figures, plasmablasts, macrophages, and cells resembling the follicular dendritic cells with distinct desmosomal junctions. The parafollicular area, which includes the heavily infiltrated duct wall, contains numerous small lymphocytes, T-lymphoblasts, plasma cells and reticular cells resembling fibroblasts. A distinct feature of this compartment is the presence of high endothelial venules (HEV). The presence of HEV and numerous blast cells, resembling blast-forming T-lymphocytes activated in vitro, in a specific area of the duct/follicle assembly strongly suggests that this area is structurally and physiologically identical to the thymus-dependent area of other lymphoid tissues. In other words, the duct/follicle assemblies of simian MSG contain the various specific fine-structural elements that are suitable for antigen recognition and processing. These elements are distributed in discrete compartments comparable to the B- and T-cell areas of "classical" lymphoid tissue.

Effect of antigen form on local immunoglobulin A memory response of intestinal secretions to Shigella flexneri

An enhanced memory response, as shown by increased titers of specific immunoglobulin A (IgA), was seen in intestinal secretions from isolated Thiry-Vella loops in rabbits primed orally with live, locally invasive Shigella sp. X16 and challenged 60 days later with a single oral dose of the same antigen. Heat-killed shigella preparations, when used as either the priming or challenge antigen, did not elicit such a memory response in this system. In the present study, the role of antigen form and dosage in eliciting the enhanced local IgA response was investigated. A noninvasive strain, Shigella flexneri 2457-0, was capable of significantly enhancing the mucosal IgA memory response, whereas heat-killed Shigella sp. X16 was unable to augment the local IgA response, even when the priming dose was increased 100-fold. A proposed mucosal adjuvant, DEAE-dextran, given orally with live Shigella sp. X16, did not enhance the local IgA response. Viable, noninvasive shigellae were effective priming agents in enhancing the local IgA memory response. The poor mucosal response to heat-killed shigella preparations is thought to be related to an ineffective delivery of nonviable bacterial antigens into gut-associated lymphoid tissues. The ability of the live, noninvasive strain to elicit a vigorous local IgA memory response when given orally to rabbits was consistent with previous findings that live preparations elicit the best mucosal IgA response.

Local and systemic immune response to orally administered liposome-associated soluble S. mutans cell wall antigens

The aim of the present study was to develop an immunization procedure which preferentially stimulated the IgA system of rats, with release of IgA in secretions. Rats immunized by intragastric route with liposome-associated soluble antigen extracted from Streptococcus mutans cell wall, showed a significantly higher IgA (and IgG) response than did rats injected with the soluble antigen alone. In saliva, maximal antibody titres were obtained 11 days after the beginning of intubations for IgA, and 16 days for IgG. After a booster immunization, the secondary response occurred very quickly in saliva and, like the primary response, it was almost exclusively of the IgA class. This demonstrates, on one hand the existence of immunological memory in the IgA system and, on the other, the efficiency of liposomes as insoluble adjuvants in eliciting an immunological response.

Age-related decline of lymphoid-tissue components in the oral mucosa of the lip, cheek and soft palate of Macaca fascicularis

In three mature monkeys (Macaca fascicularis; 3.5 +/- 0.3 kg in weight), the labial, buccal and soft-palate mucosae were examined morphologically and stereologically. Using fixation by perfusion, standardized methods of tissue preparation and morphometric analysis at the light-microscopic level, the gross dimensions (i.e., epithelial thickness, width of combined lamina propria/submucosa) and the volumetric composition of the oral mucosae were estimated and compared with those of young animals examined previously. The data show (1) an age-related decline in the volume and prevalence of organized lymphoid tissue (i.e., lymphoid follicles associated with secretory ducts), (2) a stable plasma-cell density in the interglandular connective tissue, and (3) an increase of glandular tissue in mature versus young animals. It is suggested that the lymphoid follicles associated with secretory ducts, providing for plasma-cell generation, mirror the tonsillar lymphoid tissue declining after puberty.