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European Journal of Nutrition

, Volume 43, Supplement 2, pp ii118–ii173 | Cite as

PASSCLAIM1—Gut health and immunity

  • John H. Cummings
  • Jean-Michel Antoine
  • Fernando Azpiroz
  • Raphaelle Bourdet-Sicard
  • Per Brandtzaeg
  • Philip C. Calder
  • Glenn R. Gibson
  • Francisco Guarner
  • Erika Isolauri
  • Daphne Pannemans
  • Colette Shortt
  • Sandra Tuijtelaars
  • Bernhard Watzl
ORIGINAL CONTRIBUTION

Summary.

Background:

The gut and immune system form a complex integrated structure that has evolved to provide effective digestion and defence against ingested toxins and pathogenic bacteria. However, great variation exists in what is considered normal healthy gut and immune function. Thus, whilst it is possible to measure many aspects of digestion and immunity, it is more difficult to interpret the benefits to individuals of variation within what is considered to be a normal range. Nevertheless, it is important to set standards for optimal function for use both by the consumer, industry and those concerned with the public health. The digestive tract is most frequently the object of functional and health claims and a large market already exists for gut-functional foods worldwide.

Aim:

To define normal function of the gut and immune system and describe available methods of measuring it.

Results:

We have defined normal bowel habit and transit time, identified their role as risk factors for disease and how they may be measured. Similarly, we have tried to define what is a healthy gut flora in terms of the dominant genera and their metabolism and listed the many, varied and novel methods for determining these parameters.

It has proved less easy to provide boundaries for what constitutes optimal or improved gastric emptying, gut motility, nutrient and water absorption and the function of organs such as the liver, gallbladder and pancreas. The many tests of these functions are described.

We have discussed gastrointestinal well being. Sensations arising from the gut can be both pleasant and unpleasant. However, the characteristics of well being are ill defined and merge imperceptibly from acceptable to unacceptable, a state that is subjective. Nevertheless, we feel this is an important area for future work and method development.

The immune system is even more difficult to make quantitative judgements about. When it is defective, then clinical problems ensure, but this is an uncommon state. The innate and adaptive immune systems work synergistically together and comprise many cellular and humoral factors. The adaptive system is extremely sophisticated and between the two arms of immunity there is great redundancy, which provides robust defences. New aspects of immune function are discovered regularly. It is not clear whether immune function can be „improved“.

Measuring aspects of immune function is possible but there is no one test that will define either the status or functional capacity of the immune system. Human studies are often limited by the ability to sample only blood or secretions such as saliva but it should be remembered that only 2% of lymphocytes circulate at any given time, which limits interpretation of data.

We recommend assessing the functional capacity of the immune system by:

measuring specific cell functions ex vivo

measuring in vivo responses to challenge, e. g. change in antibody in blood or response to antigens

determining the incidence and severity of infection in target populations during naturally occurring episodes or in response to attenuated pathogens.

Key words

functional foods biomarkers gastrointestinal tract microflora digestion immune system 

Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  • John H. Cummings
    • 1
  • Jean-Michel Antoine
    • 2
  • Fernando Azpiroz
    • 3
  • Raphaelle Bourdet-Sicard
    • 4
  • Per Brandtzaeg
    • 5
  • Philip C. Calder
    • 6
  • Glenn R. Gibson
    • 7
  • Francisco Guarner
    • 8
  • Erika Isolauri
    • 9
  • Daphne Pannemans
    • 10
  • Colette Shortt
    • 11
  • Sandra Tuijtelaars
    • 12
  • Bernhard Watzl
    • 13
  1. 1.Pathology and NeuroscienceUniversity of Dundee Ninewells Hospital and Medical SchoolDundee, DD1 9SYUK
  2. 2.Danone VitapolePalaiseau, CedexFrance
  3. 3.Hospital General Vall d’HebronDigestive System Research UnitBarcelonaSpain
  4. 4.Danone VitapolePalaiseau, CedexFrance
  5. 5.University of Oslo LIIPAT—Institute of Pathology, University Hospital RikshospitaletOsloNorway
  6. 6.University of Southampton, Institute of Human Nutrition, School of MedicineSouthampton, SO16 7PXUK
  7. 7.University of Reading Microbiology LaboratoryWhiteknights House Reading, RG6 6AH
  8. 8.Hospital General Vall d’HebronDigestive System Research UnitBarcelonaSpain
  9. 9.University of Turku, Department of PaediatricsTurkuFinland
  10. 10.Former ILSI EuropeBrusselsBelgium
  11. 11.Yakult UK LtdWestway Estate, Acton London, W3 7XSUK
  12. 12.ILSI EuropeBrusselsBelgium
  13. 13.Federal Research Centre for NutritionInstitute of Nutritional PhysiologyKarlsruheGermany

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