More than 120 inherited primary immunodeficiency diseases have been discovered in the past five decades, and the precise genetic defect in many of these diseases has now been identified. Increasing understanding of these molecular defects has considerably influenced both basic and translational research, and this has extended to many branches of medicine. Recent advances in both diagnosis and therapeutic modalities have allowed these defects to be identified earlier and to be more precisely defined, and they have also resulted in more promising long-term outcomes. The prospect of gene therapy continues to be included in the armamentarium of treatment considerations, because these conditions could be among the first to benefit from gene-therapy trials in humans.

The intestinal epithelium has emerged as one of the links between the innate and adaptive immune systems. Novel roles have been elucidated for its participation in antigen uptake and presentation, costimulatory signaling, and intestinal homeostasis. Its concomitant interaction with immune cells and commensal flora demonstrates the epithelium's multifaceted responsibility in protecting against intestinal pathology while maintaining immune competence. Its functional capacity is now more clearly defined in disease states such as celiac disease, Crohn's disease, and ulcerative colitis and in maintaining intestinal integrity through toll-like receptor signaling pathways.

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The mucosal immune system serves to protect its host from a variety of pathogens while simultaneously allowing for tolerance under normal circumstances to prevent inflammatory disease.