Strategies of immunization against mucosal infections

The presence of secretory (S-) IgA in middle-ear fluid and localization of IgA-secreting cells in its mucosae suggest that the middle ear is an effect or site of the mucosal immune system. Several strategies have been devised to induce potent, long-lasting, and recallable mucosal S-IgA antibodies, as well as circulating IgG antibodies and Th1- or Th2-type help, according to the most appropriate responses for a particular infection. Application of immunogens to inductive sites in the upper respiratory tract may be most ef fective for generating responses in the middle ear and nasopharynx for prot ection against the organisms responsible for otitis media. (C) 2000 Elsevie r Science Ltd. All rights reserved.