The Intestinal Immune System

The IIS is a particular immune system anatomically and functionally distinct from that present at the peripheral level (30-32). It is in contact with an enormous quantity of Ags, food proteins and intestinal bacteria, and does not mount an inflammatory response against them. At the same time, it has to protect against enteric pathogens and toxins.

The IIS is mainly located in the small intestine and colon with differences in the anatomical patterning and physiological functions. It is important to be aware of the compartmentalization of the intestine even if the IIS associated with the small intestine has been subject to more studies and is the most widely described. According to the compartment, differences in immune regulations in response to local Ags can be easily understood: food Ags are more numerous in the small intestine while in the ileum and colon they have essentially been digested and absorbed. In contrast, commensal microbes are scarce in the duodenum but more numerous in the ileum and above all in the colon.

Three lines of defense are present: (i) natural defenses: stomach acidity, bile salts, mucus, motility, permeability, (ii) innate immune responses: Ag capture, cytokine secretion, TLRs, and (iii) acquired immune responses namely oral tolerance (OT) and secretory IgA (sIgA) response. All of them interact together.

Many results presented in this review are derived from studies with mice. Note for some results, it is not certain whether they reflect what is happening in humans (33,34).

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