**3. Young coconut fruit and kaffir lime fruit as immunonutrition for the treatment of sepsis by Lipopolysaccaride** *Escherichia coli* **(infectious disease) through antioxidant activity**

Young hybrid coconut (*Cocus nucifera* L.) and kaffir lime (*Citrus hystrix*) contain antioxidant compounds that are used as immunonutrient agents. A study has been conducted on a test dosage form of 100 mg/kgbw/day made from a mixture of young coconuts with a concentration of 20% flesh with added coconut water and 1 ml of kaffir lime juice, assessed as having the potential to be developed as an immunonutrient agent in sepsis in mice. White male induced sepsis with *Escherichia coli* Lipopolysaccharide through the antioxidant activity of the phytonutrients contained in the test preparation. Based on the antioxidant activity test of the preparations KJ1, KJ2 and KJ3, which are test preparations added with 1 ml of kaffir lime juice, it turns out to be able to increase the antioxidant activity of the preparations when compared to preparations that are not given additional kaffir lime juice, namely preparations K1, K2 and K3. This is closely related because of the

#### *Potential Natural Product from Tropical Fruits: A Mixture Young Coconut Fruit and Kaffir… DOI: http://dx.doi.org/10.5772/intechopen.99005*

effect of adding kaffir lime to the process of inhibiting rancidity or rancidity. The test preparation was KJ1 from 15% young coconut flesh with coconut water and 1 ml of kaffir lime juice was added. KJ2 of young coconut flesh 20% with coconut water and added 1 ml of kaffir lime juice. KJ3 from young coconut flesh 25% with coconut water and added 1 ml of kaffir lime juice. Next K1 of young coconut flesh 15% with coconut water. K2 of young coconut flesh 20% with coconut water. K3 from young coconut flesh 25% with coconut water [27].

The rancidity of processed coconut meat can be overcome by adding ingredients that contain antioxidants, one of which is kaffir lime juice. The effect of the addition of kaffir lime (*Citrus hystrix*) on the process of inhibiting rancidity or rancidity arising from the oxidation of unsaturated fatty acids contained in processed coconut meat [28].

The presence of antioxidant content in the test preparation of a mixture of meat and coconut water with the addition of kaffir lime juice is thought to act as a cofactor that plays a role in the immune response, especially as an enzyme catalyst and antioxidant [8].

Antioxidants play an important role in minimizing cellular damage due to increased production of reactive oxygen and nitrogen species (eg, oxidative stress). Antioxidant defense systems include enzymes (e.g., superoxide dismutase, glutathione peroxidase), trace elements (e.g., selenium, zinc), vitamins (e.g., vitamins C, E, beta-carotene), sulfhydryl group donors (e.g., glutathione), and glutamine. Critical illness is associated with deficits in circulating antioxidants due to sepsis-induced redistribution from blood to tissues and decreased nutrient intake [29].

The resulting decrease in antioxidant potential increases cellular oxidative injury (particularly lipid peroxidation). A number of clinical studies have explored the potential benefits of supplementation with antioxidants. Combinations and doses of single antioxidants vary widely. Heyland *et al*. conducted a meta-analysis of clinical studies of trace elements and vitamin supplements in critically ill patients. They concluded that trace elements and vitamins that support antioxidant function, particularly high doses of selenium (either alone or in combination with other antioxidants), are safe and may be associated with reduced mortality. However, the optimal combination and dose of micronutrients remains to be determined [30].
