Polysaccharides (PS) have historically been viewed as T cell-independent antigens. However, in this paper I propose a new concept, based on substantial data from my laboratory over the previous 10 years, that during infections with PS-encapsulated extracellular bacteria, PS-specific IgG responses are largely CD4(+) T cell dependent. Thus, capsular PS is typically encountered by the immune system covalently attached to the underlying subcapsular bacterial domain. I speculate that noncovalent association of PS with immunogenic proteins within the bacterial particle leads to recruitment of protein-specific CD4(+) T cell help for the anti-PS response. However, differences in the composition and/or structure of the subcapsular domain of different extracellular bacteria may result in distinct anti-PS responses as well as differential effects on the immune response to coimmunizing soluble antigens. CD4(+) T cell help for IgG anti-PS responses during infections with extracellular bacteria is likely to promote opsonic clearance of these rapidly growing pathogens. However, the expression of immunosuppressive components by certain bacteria may also serve to dampen such responses.
© 2012 New York Academy of Sciences.