Viable Vibrio cholerae O1 were inoculated into the intestinal lumen of nonimmune rabbits. The vibrios were phagocytosed by M cells over Peyer's patch lymphoid follicles, carried in vesicles through the epithelium, and discharged among underlying lymphocytes and macrophages. Autoradiography of V. cholerae labeled with [2-3H]adenine confirmed transport. Indigenous bacteria with and without capsules were also taken up from control loops and carried through M cells into Peyer's patches. V. cholerae killed by acidification, formalin, heat, or UV irradiation were not taken up, a result that may have relevance for development of oral vaccines. Ruthenium red stain revealed gaps in the layer of mucus over M cells, glycocalyx bridging the space between vibrios and M cell microvilli, and knobby projections over membranes of M cell microvilli; these projections were not found over absorptive cells. M cells thus convey viable enteric microbes, including V. cholerae that are not otherwise invasive, into intestinal lymphoid tissue, where mucosal immune responses are initiated. Uptake and transport by M cells may also assist certain pathogenic bacteria in traversing the mucosal barrier and initiating systemic infection.

M cells are specialized epithelial cells over lymphoid follicles in Peyer's patches which take up viruses, bacteria, and antigenic macromolecules from the intestinal lumen. Unlike ordinary enterocytes which sequester pinocytosed material in lysosomes, M cells transport such material across the epithelium to antigen-processing areas in lymphoid follicle domes, suggesting a difference in lysosomal activity or a different route for movement of endocytic vesicles. Ileal Peyer's patches in rats were examined by electron microscopy to identify lysosomes by acid phosphatase activity. Acid phosphatase was found in dense bodies in enterocytes but not in M cells. Stereological analysis showed the volume fraction occupied by dense bodies in M cells to be 16 times less than in enterocytes (P less than .0005), even though the volume fractions of cytoplasm occupied by mitochondria in M cells and enterocytes were not significantly different. The small volume fraction of dense bodies and the absence of acid phosphatase activity in M cells thus correlate with absence of lysosomal degradation of luminal microorganisms during transport into lymphoid follicles by M cells and may provide not only a complete array of microbial antigens for initiation of immune responses, but also a route through the mucosal barrier for microorganisms which can evade local containment mechanisms.