Innate immune defense against microbial invasion and infection in the genitourinary mucosa relies mainly on the epithelial lining, as in other mucosal barriers. Stratified squamous epithelium lines the vaginal mucosa and terminal male urethra, and a single layer of mucus-secreting columnar epithelium lines the upper female genital tract. The vaginal epithelium contains Langerhans cells, and a variety of DCs and macrophages have been described beneath the epithelium in vagina, endocervix, and urethra. There are also resident B and T cells in the genital mucosa. Differences in the phenotype of the DCs and macrophages in the female genital mucosa from those in the gastrointestinal tract may underlie the greater susceptibility of the latter to HIV infection. There is little regional specialization of the adaptive immune system in the genitourinary mucosa, which lacks prominent mucosa-associated lymphoid tissues. Unlike other mucosa, in which IgA is the dominant antibody isotype, most of the antibodies in genital secretions are IgGs, about half of which are produced by plasma cells in genital tract mucosa; the rest are from the circulation.
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