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Nutrition in acute and chronic diseases

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

Abstract

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.

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Fig. 1: Mechanism of IgAs production in GALT in response to a pathogen.

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Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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GQO, AESZ, and GGS were responsible for the main idea. GQO conducted the search of the studies and extract the information. GQO, MFRP, JGPC, AESZ, and GGS wrote the manuscript and designed the figure and table, and AESZ, GGS, and JGPC reviewed the final script.

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Correspondence to Aurora E Serralde-Zúñiga.

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Quiroz-Olguín, G., Gutiérrez-Salmeán, G., Posadas-Calleja, J.G. et al. The effect of enteral stimulation on the immune response of the intestinal mucosa and its application in nutritional support. Eur J Clin Nutr (2021). https://doi.org/10.1038/s41430-021-00877-7

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