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Therefore, intranasal vaccination may be an effective immunization strategy, but requires appropriate mucosal vaccine delivery systems. In this work, chitosan was used as a mucosal delivery system to form chitosan\u2013<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>sa<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> nanoparticles based on ionotropic gelation methods and used to immunize <jats:styled-content style=\"fixed-case\">BALB<\/jats:styled-content>\/c mice intranasally. Compared to mice immunized with naked <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>sa<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>, levels of <jats:styled-content style=\"fixed-case\">IFN<\/jats:styled-content>\u2010<jats:italic>\u03b3<\/jats:italic>,<jats:styled-content style=\"fixed-case\"> IL<\/jats:styled-content>\u201017<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u20104 in spleen lymphocytes, the systemic (<jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>g<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content> in serum) and mucosal (<jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>g<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> in mucosal lavage) specific antibodies were enhanced significantly in mice inoculated with chitosan\u2013<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>sa<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>. Furthermore, increased protection against acute otitis media following middle ear challenge with pneumococcus serotype 14, and improved survival following intraperitoneal challenge with pneumococcus serotype 3 or serotype 14, was found in the mice immunized with chitosan\u2013<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>sa<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> nanoparticles. Thus, intranasal immunization with chitosan\u2013<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>sa<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> can successfully induce mucosal and systemic immune responses and increase protection against pneumococcal acute otitis media and invasive infections. Hence, intranasal immunization with <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>sa<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> protein, based on chitosan as a delivery system, is an efficient immunization strategy for preventing pneumococcal infections.<\/jats:p>","DOI":"10.1111\/sji.12267","type":"journal-article","created":{"date-parts":[[2015,1,6]],"date-time":"2015-01-06T13:13:40Z","timestamp":1420550020000},"page":"177-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Mucosal Immunization with PsaA Protein, Using Chitosan as a Delivery System, Increases Protection Against Acute Otitis Media and Invasive Infection by <i>Streptococcus pneumoniae<\/i>"],"prefix":"10.1111","volume":"81","author":[{"given":"J.\u2010H.","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Otology and Skull Base Surgery Eye Ear Nose &amp; Throat Hospital of Fudan 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