Ethical constraints restrict direct tracking of immune-cell migration throughout the human body in vivo. We, therefore, used deletion of the immunoglobulin M (IgM) heavy-chain constant-gene (C) segment as a marker to provide a dispersal signature of an effector B-cell subset (IgD ؉ IgM ؊ CD38 ؉ ) induced selectively in human tonsils. By DNA analysis, the C deletion identified dissemination of such blasts and their plasma-cell progeny to peripheral blood, lymph nodes, and bone marrow, as well as to mucosae and glands of the upper airways. Also the endocervix was often positive, while the small intestine was mainly negative, as could be expected from the identified homingmolecule profile of the marker cells, with relatively low levels of integrin ␣47 and CC chemokine receptor 9 (CCR9). Of further importance for vaccine design, the circulating cells expressed abundantly CD62L (L-selectin) and CCR7, which provided a mechanism for integration of respiratory and systemic immunity. Most mucosal vaccines are at present administered perorally, and our results suggested that the nasal route is no alternative for vaccination against rotavirus or other small-intestinal infections in humans. However, immunization of nasopharynx-associated lymphoid tissue clearly appears preferable to target respiratory pathogens and may to some extent also protect against infections of the female genital tract.
IntroductionMost pathogens use mucosae as portals of entry, and mucosal vaccines are therefore desirable, 1 particularly to elicit secretory IgA (SIgA) antibodies. 2,3 The secretory antibody system represents a major first-line defense and is triggered by antigens targeting mucosa-associated lymphoid tissue (MALT), which samples antigens directly from epithelial surfaces. 4 T and B cells activated in MALT home preferentially to mucosal effector sites, where B cells after extravasation undergo terminal differentiation. The local plasma-cell (PC) progeny cooperates with the polymeric Ig receptor (pIgR) to provide SIgA and secretory IgM (SIgM) antibodies. 5,6 Thus, locally produced IgA dimers and IgM pentamers are actively exported by the pIgR. For this epithelial transport mechanism to be operative, the Ig polymers depend on a selective structural incorporation of the J chain, 6,7 although the cytoplasmic expression of this peptide is a common characteristic of mucosal PCs regardless of their concurrent Ig isotype. 8,9 Induction of immunity at various mucosae is clearly an integrated response, but the traditional term "a common mucosal immune system" has detracted from the fact that there may be considerable compartmentalization. 4,5 This has been difficult to substantiate, however, because no inherent marker exists for mucosal B cells that unequivocally identify their MALT origin. Also notably, homing studies performed with primed human T cells, traced by 111 In labeling or gene marking, have provided conflicting results. 10,11 Nevertheless, rational site selection for mucosally applied vaccines would require detailed knowledge of w...