Figure 1. The common mucosal immune system.

Luminal antigens are transported to the nasopharynx-associated lymphoid tissue (NALT) and Peyer's patches through microfold (M) cells that are present in the epithelium overlying NALT and Peyer's-patch follicles. Dendritic cells process and present antigens to T cells in these lymphoid tissues. CD4⁺ T cells that are stimulated by dendritic cells then preferentially induce IgA-committed B-cell development in the germinal centre of the lymphoid follicle. After IgA class switching and affinity maturation, B cells rapidly migrate from NALT and Peyer's patches to the regional cervical lymph nodes and mesenteric lymph nodes respectively, through the efferent lymphatics. Finally, antigen-specific CD4⁺ T cells and IgA⁺ B cells migrate to effector sites (such as the nasal passage and intestinal lamina propria) through the thoracic duct and blood circulation. IgA⁺ B cells and plasmablasts then differentiate into IgA-producing plasma cells in the presence of cytokines (such as interleukin-5 (IL-5) and IL-6) that are produced by T helper 2 (T_H2) cells, and they subsequently produce dimeric (or polymeric) forms of IgA. These dimeric forms of IgA then become secretory IgA by binding to polymeric Ig receptors (which become the secretory component in the process of secretory IgA formation) that are displayed on the monolayer of epithelial cells lining the mucosa. Secretory IgA is then released into the nasal passage and intestinal tract. TCR, T-cell receptor.