The influence of prebiotic or probiotic supplementation on antibody titers after influenza vaccination: a systematic review and meta-analysis of randomized controlled trials
Received 25 October 2017
Accepted for publication 14 December 2017
Published 25 January 2018 Volume 2018:12 Pages 217—230
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Qiongyu Guo
Tzu-Lin Yeh,1 Pei-Ching Shih,1 Shu-Jung Liu,2 Chao-Hsu Lin,3 Jui-Ming Liu,4,5 Wei-Te Lei,3,* Chien-Yu Lin3,*
1Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, 2Department of Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, 3Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, 4Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 5Department of Medicine, National Yang-Ming University, Taipei, Taiwan
*These authors contributed equally to this work
Background: Influenza infection is a common disease with a huge disease burden. Influenza vaccination has been widely used, but concerns regarding vaccine efficacy exist, especially in the elderly. Probiotics are live microorganisms with immunomodulatory effects and may enhance the immune responses to influenza vaccination.
Methods: We conducted a systematic review and meta-analysis to determine the influence of prebiotics/probiotics/synbiotics supplementation on vaccine responses to influenza vaccination. Studies were systematically identified from electronic databases up to July 2017. Information regarding study population, influenza vaccination, components of supplements, and immune responses were extracted and analyzed. Twelve studies, investigating a total of 688 participants, were included in this review.
Results: Patients with prebiotics/probiotics supplements were found to have higher influenza hemagglutination inhibition antibody titers after vaccination (for A/H1N1, 42.89 vs 35.76, mean difference =7.14, 95% CI =2.73, 11.55, P=0.002; for A/H3N2, 105.4 vs 88.25, mean difference =17.19, 95% CI =3.39, 30.99, P=0.01; for B strain, 34.87 vs 30.73, mean difference =4.17, 95% CI =0.37, 7.96, P=0.03).
Conclusion: Supplementation with prebiotics or probiotics may enhance the influenza hemagglutination inhibition antibody titers in all A/H1N1, A/H3N2, and B strains (20%, 19.5%, and 13.6% increases, respectively). Concomitant prebiotics or probiotics supplementation with influenza vaccination may hold great promise for improving vaccine efficacy. However, high heterogeneity was observed and further studies are warranted.
Keywords: influenza, influenza vaccine, probiotics, prebiotics, synbiotics, antibody titer, immune response
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