Mucosal immunity in the female genital tract: relevance to vaccination efforts against the human immunodeficiency virus.

The development of vaccines that induce specific immune responses in the genital tract secretions would have far-reaching implications for the prevention of AIDS and other sexually transmitted diseases. Most of the currently studied vaccines utilize systemic routes of immunization that are of limited value for the prevention of mucosa-contracted diseases. The relative contribution of antigen-sensitized cells and IgA-committed lymphocytes from IgA inductive sites (e.g., Peyer's patches and rectal tonsils) to remote or adjacent effector sites (e.g., salivary glands and female genital tract) as manifested by the appearance of corresponding secretory antibodies has not been studied in humans despite its unquestionable practical importance. Exploitation of immunization routes that are effective for induction of mucosal immune responses and reflect our current knowledge of the origin of antibodies and of specific antibody-forming cells in mucosal tissues is likely to reduce the incidence of many infectious diseases including AIDS.