title: Mucosal immunity in the genital tract: prospects for vaccines against sexually transmitted diseases--a review.
abstract: OBJECTIVE
  Consistent with the absence of protective immunity resulting from previous infection with Neisseria gonorrhoeae, the genital mucosal immune response in human gonorrhea is weak: only low levels of immunoglobulin G (IgG) and immunoglobulin A (IgA) antibodies are detectable against gonococci, and inflammatory cytokine responses are poor.
  
  
  METHODS
  Mucosal immunization strategies designed to induce persisting genital antibody responses might afford protection against infection, if appropriate conserved antigens can also be identified.
  
  
  RESULTS
  Intragastric or intranasal immunization with bacterial antigens expressed as recombinant chimeric proteins with cholera toxin A2/B subunits induced persisting IgA antibodies in genital and other secretions, and circulating IgG antibodies.
  
  
  CONCLUSIONS
  Although gonococci may avoid inducing or even suppress immune responses during natural infection, alternative approaches to vaccine development may be successful. However, inadequate understanding of the origins of antibodies in the genital tract, and their effector mechanisms, will need to be rectified to make this possible.
authors.affiliation: Department of Microbiology, University of Alabama at Birmingham 35294, USA.
authors.forename: M W
authors.initials: MW
authors.lastname: Russell
authors.forename: S R
authors.initials: SR
authors.lastname: Hedges
authors.forename: H Y
authors.initials: HY
authors.lastname: Wu
authors.forename: E W
authors.initials: EW
authors.lastname: Hook
authors.forename: J
authors.initials: J
authors.lastname: Mestecky
mesh_terms: D001428:Bacterial Vaccines / Q000008:administration & dosage / Q000276:immunology*; D005260:Female; D005836:Genitalia, Female / Q000276:immunology*; D006069:Gonorrhea / Q000276:immunology* / Q000517:prevention & control; D006801:Humans; D018928:Immunity, Mucosal; D009344:Neisseria gonorrhoeae / Q000276:immunology*; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000276:immunology*
chemical_list: D001428:Bacterial Vaccines; D014614:Vaccines, Synthetic