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In the vermiform appendix, this activity is centred on further developing the inventory of primary antibodies and the maturation of T- and B-lymphocyte cells in the follicles within the lymphoid tissue. Furthermore, the columnar epithelia,\u00a0enterocytes and goblet cells comprise the complement of cells that occupy the lamina propria and muscularis mucosae of the vermiform appendix\u2019s\u00a0mucosa, while macrophages and an abundance of\u00a0immunoglobulin A and immunoglobulin G generating plasma cells seed the lamina propria. Intraepithelial immune cells consisting predominantly of specific CD8+\u00a0T regulatory lymphocytes occupy sites in the appendix analogous to those present in the intestinal epithelia of the caecal colon. The complement of bacterial genera concealed in the vermiform appendix is posited extant as a biofilm inoculum of the intestinal\u00a0commensal microbiome. This facilitates re-inoculation of the proximal colon and to a lesser degree the terminal ilium post an intestinal perturbation such as occurs with daily lifestyle stressors, dietary choices and the short-term administration of antibiotics rather than an infectious fulminant colitis. A plausible appreciation results of\u00a0the importance\u00a0of\u00a0multiple immunological aspects of a healthy vermiform appendix and the provision of a commensal biofilm to the gut that repairs a dysbiotic microbiome contributing to balancing intestinal pro- and anti-inflammatory activity for maintaining homeostasis in the gut. Since the composition of the gut microbiome can vary over the short-term and long-term, it is plausible that the appendix inoculum may be instrumental in maintaining the intestinal microbiome.<\/jats:p>","DOI":"10.1042\/cs20180956","type":"journal-article","created":{"date-parts":[[2019,1,3]],"date-time":"2019-01-03T13:39:18Z","timestamp":1546522758000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":93,"title":["The vermiform appendix: an immunological organ sustaining a microbiome inoculum"],"prefix":"10.1042","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7490-9298","authenticated-orcid":false,"given":"Luis","family":"Vitetta","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney 2006, Australia"},{"name":"Medlab Clinical, Sydney 2015, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1977-6143","authenticated-orcid":false,"given":"Jiezhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Medlab Clinical, Sydney 2015, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-1222","authenticated-orcid":false,"given":"Stephen","family":"Clarke","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney 2006, Australia"},{"name":"Northern Clinical School, Kolling Institute of Medical Research, Pacific Hwy, St Leonards NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2019,1,3]]},"reference":[{"key":"2021113010062077600_B1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1002\/1097-0185(20001215)261:6<228::AID-AR1005>3.0.CO;2-O","article-title":"The primate appendix: a reassessment","volume":"261","author":"Fisher","year":"2000","journal-title":"Anat. 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