USE OF PREBIOTICS, PROBIOTICS AND SYNBIOTICS IN CLINICAL IMMUNONUTRITION

It is a recent observation that about 80 per cent of the body's immune system is localized in the gastrointestinal tract. This explains to a large extent why eating right is important for the modulation the immune response and prevention of disease. I addition it is increasingly recognized that the body has an important digestive system also in the lower gastrointestinal tract where numerous important substances are released by microbial enzymes and absorbed. Among these substances are short chain fatty acids, amino acids, various carbohydrates, polyamines, growth factors, coagulation factors, and many thousands of antioxidants, not only traditional vitamins but numerous flavonoids, carotenoids and similar plant- and vegetable produced antioxidants. Also consumption of health-promoting bacteria (probiotics) and vegetable fibres (prebiotics) from numerous sources are known to have strong health-promoting influence. It has been calculated that the intestine harbours about 300 000 genes, which is much more than the calculated about 60000 for the rest of the human body, indicating a till today totally unexpected metabolic activity in this part of the GI tract. There are seemingly several times more active enzymes in the intestine than in the rest of the body, ready to release hundred thousand or more of substances important for our health and well-being. In addition do the microbial cells produce signal molecules similar to cytokines but called bacteriokines and nitric oxide, with provide modulatory effects both on the mucosal cells, the mucosa-associated lymphoid system (MALT) and the rest of the immune system. Identification of various fermentation products, and often referred to as synbiotics, studies of their role in maintaining health and well-being should be a priority issue during the years to come.