Mucosal and Cellular Immune Responses to Norwalk Virus

J Infect Dis. 2015 Aug 1;212(3):397-405. doi: 10.1093/infdis/jiv053. Epub 2015 Jan 29.


Background: Noroviruses are a leading cause of acute gastroenteritis worldwide. Mucosal and cellular immune responses remain poorly understood, with most studies of noroviruses having focused on serological responses to infection.

Methods: We used saliva, feces, and peripheral blood mononuclear cells collected from persons who were administered Norwalk virus (NV) to characterize mucosal (salivary and fecal immunoglobulin A [IgA]) and cellular (NV-specific IgA and immunoglobulin G [IgG] antibody-secreting cells and total and NV-specific IgA and IgG memory B cells) immune responses following infection.

Results: Prechallenge levels of NV-specific salivary IgA and NV-specific memory IgG cells correlated with protection from gastroenteritis, whereas prechallenge levels of NV-specific fecal IgA correlated with a reduced viral load. Antibody-secreting cell responses were biased toward IgA, while memory B-cell responses were biased toward IgG. NV-specific memory B cells but not antibody-secreting cells persisted 180 days after infection.

Conclusions: NV-specific salivary IgA and NV-specific memory IgG cells were identified as new correlates of protection against NV gastroenteritis. Understanding the relative importance of mucosal, cellular, and humoral immunity is important in developing vaccine strategies for norovirus disease prevention.

Keywords: IgA; IgG; Norovirus; Norwalk virus; antibody-secreting cells; correlate of protection; fecal IgA; immune response; memory B cells; salivary IgA.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology*
  • Caliciviridae Infections / immunology*
  • Caliciviridae Infections / virology
  • Feces / chemistry
  • Gastroenteritis / immunology*
  • Gastroenteritis / virology
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin A / immunology*
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology*
  • Leukocytes, Mononuclear / immunology
  • Norwalk virus / immunology*
  • Saliva / chemistry


  • Antibodies, Viral
  • Immunoglobulin A
  • Immunoglobulin G