Effect of probiotics and prebiotics on immune response to influenza vaccination in adults: A systematic review and meta-analysis of randomized controlled trials

Abstract

Abstract:We conducted a meta-analysis to evaluate the effects of probiotics and prebiotics on the immune response to influenza vaccination in adults. We conducted a literature search of Pubmed, Embase, the Cochrane Library, the Cumulative Index to Nursing and Allied Health (CINAHL), Airiti Library, and PerioPath Index to Taiwan Periodical Literature in Taiwan. Databases were searched from inception to July 2017. We used the Cochrane Review risk of bias assessment tool to assess randomized controlled trial (RCT) quality. A total of 20 RCTs comprising 1979 adults were included in our systematic review. Nine RCTs including 623 participants had sufficient data to be pooled in a meta-analysis. Participants who took probiotics or prebiotics showed significant improvements in the H1N1 strain seroprotection rate (with an odds ratio (OR) of 1.83 and a 95% confidence interval (CI) of 1.19-2.82, p = 0.006, I 2 = 0%), the H3N2 strain seroprotection rate (OR = 2.85, 95% CI = 1.59-5.10, p < 0.001, I 2 = 0%), and the B strain seroconversion rate (OR = 2.11, 95% CI = 1.38-3.21, p < 0.001, I 2 = 0%). This meta-analysis suggested that probiotics and prebiotics are effective in elevating immunogenicity by influencing seroconversion and seroprotection rates in adults inoculated with influenza vaccines.

Gut Microbiota-targeted Interventions for Reducing the Incidence, Duration, and Severity of Respiratory Tract Infections in Healthy Non-elderly Adults

“…Studies examining effects of established prebiotics on immune responses to vaccinations against RTI-causing viruses have been collated in two recent meta-analyses. 34 , 35 In the first, prebiotics were found to increase the odds of achieving H1N1 and H3N2, but not B-strain, seroprotection following vaccination, but had no effect on seroconversion rates (Table II ). 34 The second meta-analysis reported that prebiotics increased postvaccination antibody titers for H1N1, but not H3N2 or B strains (Table II ).…”

“… 34 , 35 In the first, prebiotics were found to increase the odds of achieving H1N1 and H3N2, but not B-strain, seroprotection following vaccination, but had no effect on seroconversion rates (Table II ). 34 The second meta-analysis reported that prebiotics increased postvaccination antibody titers for H1N1, but not H3N2 or B strains (Table II ). 35 Only one study included in those meta-analyses was conducted in a healthy non-elderly adult population, and, in that study, no effects of long-chain inulin and oligofructose supplementation on the immune response to vaccination were observed (Table S3).…”

“… 19 Several studies have examined whether probiotics improve immune responses to vaccinations against viruses that cause RTI, most often examining vaccine responses against seasonal influenza strains (H1N1, H3N2, and B-strain) (Table S3). Results from many of those studies have been collated in two recent meta-analyses 34 , 35 and a systematic review. 36 In one meta-analysis, 34 probiotics were found to increase the odds of achieving seroprotection following H3N2, but not H1N1 or B-strain vaccination, and increase the odds of seroconversion following H3N2 and B-strain, but not H1N1 vaccination (Table II ).…”

“…Results from many of those studies have been collated in two recent meta-analyses 34 , 35 and a systematic review. 36 In one meta-analysis, 34 probiotics were found to increase the odds of achieving seroprotection following H3N2, but not H1N1 or B-strain vaccination, and increase the odds of seroconversion following H3N2 and B-strain, but not H1N1 vaccination (Table II ). A separate meta-analysis reported that probiotics increased antibody titers following H1N1 and H3N2, but not B-strain, vaccination (Table II ).…”

“…However, recent systematic reviews and meta-analyses provide some evidence supporting the efficacy of prebiotic and/or synbiotic products for these purposes in infant, child, and/or elderly adult populations. 34 , 35 , 58 Additional evidence suggests that certain nondigestible fermentable carbohydrates and plant-derived phenolic compounds that modulate the gut microbiota in a nonselective manner, or are metabolized and biotransformed by the gut microbiota, may also have some efficacy for reducing RTI incidence, duration, and/or severity. 52 , 54 , 57 Thus, research in healthy non-elderly adult populations, to include military personnel, is warranted.…”