Objective: We have previously reported that 125µg of glucosyltransferase-enriched Streptococcus mutans antigens (E-GTF) can induce an immune response by intranasal (IN) but not tonsillar (IT) immunization of humans. The purpose of this study was to determine if immunization of subjects previously immunized by IN or IT route would result in enhanced response when re-immunized 2 years later by IN compared to a control group (CG) not previously immunized. Methods: Fourteen subjects previously immunized IN or IT with 125µg of E-GTF and 12 CG were immunized twice within a 7 day interval with 62.5µg of E-GTF administered by nasal spray. Nasal wash, parotid saliva, and serum were collected prior to and periodically for 3 months following immunization and assayed for anti-E-GTF activity by ELISA. Results were analyzed by a mixed model procedure with p<0.05 level of significance. Results: A significant IgA1 anti-E-GTF response was observed (p<0.02) in mucosal secretions and serum from all 3 groups. A nasal wash IgA anti-E-GTF response occurred on day 21 (>100% mean increase over baseline) and persisted throughout the study period. The IN group response was higher (+60-200%) than the IT and CG. The salivary IgA anti-E-GTF response was lower than the nasal wash response and no difference between any groups were observed except on day 56 when the mean increase in the IN group was 80% higher than the IT and CG. Serum IgA anti-E-GTF response was much higher (40-90% mean increase over baseline) and occurred earlier in the IN compared to the IT and CG. The IgG response in the IN group was higher than the IT but not CG. Conclusions: These results indicate that human nasal but not tonsillar immunization primes the immune system for another IN immunization with S. mutans antigens given 2 years later. Supported by USPHS DE09846, DE08182 and 09081

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