Recent research developments have identified the gastrointestinal tract as the most metabolically active organ after surgical stress. In addition to fulfilling its role as an organ of digestion and absorption, the gut must maintain immunologic function in order to protect the host from invading pathogens. Central to the function of the intestinal immune system is the expression of secretory IgA, the most abundant immunoglobulin in external secretions. The synthesis and expression of IgA in secretions appear to be sensitive to dietary alteration and may be impaired after surgical stress. Data are presented suggesting that maintenance of gut mass and barrier function to bacteria via dietary manipulation may be essential to ensure host survival during critical illness. (Journal of Parenteral and Enteral Nutrition 14: 109S-113S 1990)
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