Mucosal immunity to poliovirus

A cornerstone of the global initiative to eradicate polio is the widespread use of live and inactivated poliovirus vaccines in extensive public health campaigns designed to prevent the development of paralytic disease and interrupt transmission of the virus. Central to these efforts is the goal of inducing mucosal immunity able to limit virus replication in the intestine. Recent clinical trials have evaluated new combined regimens of poliovirus vaccines, and demonstrated clear differences in their ability to restrict virus shedding in stool after oral challenge with live virus. Analyses of mucosal immunity accompanying these trials support a critical role for enteric neutralizing IgA in limiting the magnitude and duration of virus shedding. This review summarizes key findings in vaccine-induced intestinal immunity to poliovirus in infants, older children, and adults. The impact of immunization on development and maintenance of protective immunity to poliovirus and the implications for global eradication are discussed.

Automated summary

The global initiative to eradicate polio focuses on inducing mucosal immunity to limit virus replication in the intestine and restrict virus shedding through the widespread use of live and inactivated poliovirus vaccines. Recent clinical trials have shown clear differences in the ability of new combined vaccine regimens to limit virus shedding after oral challenge with live virus, with enteric neutralizing IgA playing a critical role in this process. This review summarizes key findings in vaccine-induced intestinal immunity and discusses the impact of immunization on global polio eradication efforts.