The effect of enteral stimulation on the immune response of the intestinal mucosa and its application in nutritional support

• Published in: European journal of clinical nutrition Vol. 75; no. 11; pp. 1533 - 1539
• Main Authors: Quiroz-Olguín, Gabriela, Gutiérrez-Salmeán, Gabriela, Posadas-Calleja, Juan G, Padilla-Rubio, María F, Serralde-Zúñiga, Aurora E
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2021; Nature Publishing Group
• Subjects: 59; 631/45/612; 64/60; 692/308/575; 82; 82/1; 82/80; Clinical Nutrition; Complications and side effects; Diet therapy; Enteral Nutrition - methods; Epidemiology; Fasting; Gut-associated lymphoid tissues; Health aspects; Humans; Immune response; Immune system; Immunity, Mucosal - physiology; Immunoglobulin A; Internal Medicine; Intestinal Mucosa; Intestine; Lymphoid tissue; Malnutrition; Medicine; Medicine & Public Health; Metabolic Diseases; Microbiota; Microorganisms; Mini Review; Mucosal immunity; Nosocomial infection; Nutrition; Nutrition assessment; Nutritional status; Nutritional Support; Parenteral Nutrition; Physiological aspects; Public Health; State-of-the-art reviews; Stimulation; Mexico
• DOI: 10.1038/s41430-021-00877-7
• ISSN: 0954-3007; 1476-5640

The intestine plays a fundamental role as a regulator of the mucosal immune response, mostly through the production and secretion of secretory Immunoglobulin A (sIgA) by the gut-associated lymphoid tissue (GALT). Enteral stimulation, a balance between the commensal microbiota and pathogenic microorganisms, in addition to an adequate nutritional status is required for the optimal immune function of the intestine. Fasting subjects or those supported only with parenteral nutrition, show a progressive anatomical and physiological deterioration of the GALT, triggering a series of alterations resulting in a decrease in the intestinal immune response, modification in the type of microbiota, and changes that lead to or aggravate malnutrition. Patients with malnutrition present an increase in the rate of nosocomial infections, hospital length of stay, and mortality. An adequate nutritional assessment at hospital admission and avoiding long periods of fasting are paramount to prevent these unfavorable outcomes. Herein, we present a mini-state of the art review on the role and importance of enteral stimulation by GALT-mediated immune response.