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Critical Reviews™ in Immunology
IF: 1.352 5-Year IF: 3.347 SJR: 1.022 SNIP: 0.55 CiteScore™: 2.19

ISSN Print: 1040-8401
ISSN Online: 2162-6472

Critical Reviews™ in Immunology

DOI: 10.1615/CritRevImmunol.v27.i2.10
pages 97-140

Immune-Modulatory Effects and Potential Working Mechanisms of Orally Applied Nondigestible Carbohydrates

A. P. Vos
Department of Biomedical Research, Numico Research, Wageningen, The Netherlands
L. M'Rabet
Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
B. Stahl
Numico Research Germany, Friedrichsdorf, Germany
G. Boehm
Numico Research Germany, Friedrichsdorf, Germany; and Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands
Johan Garssen
Dept.of Biomedical Research,Numico Research,Wageningen; Utrecht Institute for Pharmaceutical Sciences,Utrecht University,Utrecht; National Institute of Public Health and Environment, Laboratory for Pathology and Immunobiology, Bilthoven, The Netherlands


Orally applied nondigestible carbohydrates (NDC) have been associated with immune-modulating effects and other health benefits. The effects of prebiotic carbohydrates have recently received much attention, but other NDC have been reported to induce immune modulation as well. Many different effects have been shown on parameters of innate and specific immunity, mostly in animal experiments or in vitro. Data from clinical trials are limited, but promising studies have reported beneficial effects on mucosal and systemic immunity in humans.
NDC are fermented to various degrees by the intestinal microbiota. Therefore, immune-modulatory properties have often been attributed to microbiota-dependent effects, especially in the case of prebiotic NDC. However, some NDC have been reported to bind to specific receptors on cells of the immune system, suggesting microbiota-independent, immune-modulatory effects play a role as well.
This review aims to provide an overview of the published immune-modulatory effects in vitro and in vivo induced by NDC such as fructans, galactooligosaccharides, β-glucans, pectins, and resistant starch. In addition, issues related to the underlying mechanisms are discussed: interaction between bacteria, their metabolites and the immune system, as well as direct effects of NDC via lectin receptors.