Lactobacillus GG as an Immune Adjuvant for Live Attenuated Influenza Vaccine in Healthy Adults: A Randomized Double Blind Placebo Controlled Trial Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019. Efficacy of daily intake of Lactobacillus casei Shirota on respiratory symptoms and influenza vaccination immune response: a randomized, double-blind, placebo-controlled trial in healthy elderly nursing home residents. Oral intake of Lactobacillus pentosus strain b240 accelerates salivary immunoglobulin A secretion in the elderly: A randomized, placebo-controlled, double-blind trial Lactobacillus plantarum CECT7315 and CECT7316 stimulate immunoglobulin production after influenza vaccination in elderly. Inulin-Type β2-1 Fructans have Some Effect on the Antibody Response to Seasonal Influenza Vaccination in Healthy Middle-Aged Humans Probiotic Effects on Cold and Influenza-Like Symptom Incidence and Duration in Children Nutritional formula improved immune profiles of seniors living in nursing homes. Effects of Bifidobacterium longum BB536 Administration on Influenza Infection, Influenza Vaccine Antibody Titer, and Cell-Mediated Immunity in the Elderly Effects of prebiotics on the immune response to vaccination in the elderly. Systemic Immunity-Enhancing Effects in Healthy Subjects Following Dietary Consumption of the Lactic Acid Bacterium Lactobacillus rhamnosus HN001 The effects of non-viable Lactobacillus on immune function in the elderly: a randomised, double-blind, placebo-controlled study Serum antibody responses after intradermal vaccination against influenza. A probiotic fermented dairy drink improves antibody response to influenza vaccination in the elderly in two randomised controlled trials. Evaluation of the immune benefits of two probiotic strains Bifidobacterium animalis ssp. lactis, BB-12® and Lactobacillus paracasei ssp. paracasei, L. casei 431® in an influenza vaccination model: a randomised, double-blind, placebo-controlled study. Nutritional formula enhanced immune function and reduced days of symptoms of upper respiratory tract infection in seniors. Oral intake of Lactobacillus fermentum CECT5716 enhances the effects of influenza vaccination. Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: a double blind, randomized, controlled trial. Impact of ageing and a synbiotic on the immune response to seasonal influenza vaccination; a randomised controlled trial Effect of Lactobacillus paracasei subsp. paracasei, L. casei 431 on immune response to influenza vaccination and upper respiratory tract infections in healthy adult volunteers: a randomized, double-blind, placebo-controlled, parallel-group study.
Background / Objectives : Live-attenuated influenza vaccine ( LAIV ) protects against influenza by mucosal activation of the immune system . Studies in animals and adults have demonstrated that probiotics improve the immune response to mucosally delivered vaccines . We hypothesized that Lactobacillus GG ( LGG ) would function as an immune adjuvant to increase rates of seroconversion after LAIV administration . Subjects/ Methods : We conducted a r and omized double-blind placebo-controlled pilot study to determine whether LGG improved rates of seroconversion after administration of LAIV . We studied 42 healthy adults during the 2007–2008 influenza season . All subjects received LAIV and then were r and omized to LGG or placebo , twice daily for 28 days . Hemagglutinin inhibition titers were assessed at baseline , at day 28 and at day 56 to determine the rates of seroconversion . Subjects were assessed for adverse events throughout the study period . Results : A total of 39 subjects completed the per- protocol analysis . Both LGG and LAIV were well tolerated . Protection rates against the vaccine H1N1 and B strains were suboptimal in subjects receiving LGG and placebo . For the H3N2 strain , 84 % receiving LGG vs 55 % receiving placebo had a protective titer 28 days after vaccination ( odds of having a protective titer was 1.84 95 % confidence interval 1.04–3.22 , P=0.048 ) . Conclusion : Lactobacillus GG is potential as an important adjuvant to improve influenza vaccine immunogenicity . Future studies of probiotics as immune adjuvants might need to specifically consider examining vaccine-naïve or sero-negative subjects , target mucosal immune responses or focus on groups known to have poor response to influenza vaccines BACKGROUND The aging process can lead to a decline in cellular immunity . Therefore , the elderly could benefit from safe and effective interventions that restore cellular immune functions . OBJECTIVE We determined whether dietary supplementation with the known immunostimulating probiotic Bifidobacterium lactis HN019 could enhance aspects of cellular immunity in elderly subjects . DESIGN Thirty healthy elderly volunteers ( age range : 63 - 84 y ; median : 69 y ) participated in a 3-stage dietary supplementation trial lasting 9 wk . During stage 1 ( run-in ) , subjects consumed low-fat milk ( 200 mL twice daily for 3 wk ) as a base-diet control . During stage 2 ( intervention ) , they consumed milk supplemented with B. lactis HN019 in a typical dose ( 5 x 10(10 ) organisms/d ) or a low dose ( 5 x 10(9 ) organisms/d ) for 3 wk . During stage 3 ( washout ) , they consumed low-fat milk for 3 wk . Changes in the relative proportions of leukocyte subsets and ex vivo leukocyte phagocytic and tumor-cell-killing activity were determined longitudinally by assaying peripheral blood sample s. RESULTS Increases in the proportions of total , helper ( CD4(+ ) ) , and activated ( CD25(+ ) ) T lymphocytes and natural killer cells were measured in the subjects ' blood after consumption of B. lactis HN019 . The ex vivo phagocytic capacity of mononuclear and polymorphonuclear phagocytes and the tumoricidal activity of natural killer cells were also elevated after B. lactis HN019 consumption . The greatest changes in immunity were found in subjects who had poor pretreatment immune responses . In general , the 2 doses of B. lactis HN019 had similar effectiveness . CONCLUSION B. lactis HN019 could be an effective probiotic dietary supplement for enhancing some aspects of cellular immunity in the elderly BACKGROUND Age is associated with immune dysregulation , which results in an increased infection rate and reduced effectiveness of vaccination . OBJECTIVE We assessed whether an intervention with Lactobacillus casei Shirota ( LcS ) in elderly nursing home residents reduced their susceptibility to respiratory symptoms and improved their immune response to influenza vaccination  . DESIGN Between October 2007 and April 2008 , a r and omized , double-blind , placebo-controlled trial was conducted in 737 healthy people aged ≥ 65 y in 53 nursing homes in Antwerp , Belgium . Volunteers were r and omly assigned to receive a probiotic ( n = 375 ; 2 bottles of fermented milk that contained ≥ 6.5 × 10(9 ) live LcS/bottle ) or a placebo ( n = 362 ; similar drink with no bacteria ) for 176 d. After 21 d , all subjects received an influenza vaccination . Primary outcome parameters were the number of days with respiratory symptoms , the probability of respiratory symptoms , and antiinfluenza antibody titer by hemagglutination inhibition after vaccination . RESULTS Univariate and multivariate modeling showed no effect of the probiotic on clinical outcome parameters . Generalized linear mixed modeling showed no effect of the probiotic itself on the probability of respiratory symptoms [ OR of probiotic : 0.8715 ; 95 % CI : 0.6168 , 1.2887 ) . No significant difference regarding the influenza-vaccination immune response was shown . CONCLUSION The results of this study show that daily consumption of a fermented milk drink that contains LcS has no statistically or clinical ly significant effect on the protection against respiratory symptoms . This trial was registered at clinical trials.gov as NCT00849277 Background Immunoglobulin A ( IgA ) secretion in saliva decreases with age and may be the cause of increased vulnerability of the elderly to respiratory infections . The effect of oral intake of lactic acid bacteria on salivary secretory IgA ( SIgA ) in the elderly has not been reported . The objective of this study was to demonstrate the acceleration of salivary SIgA secretion by oral intake of Lactobacillus pentosus strain b240 ( b240 ) in the elderly . Results A total of 80 healthy elderly individuals were r and omly allocated to either an intervention ( i.e. , b240 ) or a control ( i.e. , placebo ) group . The elderly individuals in the b240 group were given a sterile water beverage ( 125 mL ) containing heat-killed b240 ( 4 × 109 cells ) , while those in the placebo group were given only a sterile water beverage ( 125 mL ) ; both groups received their respective beverages once daily for 12 weeks . Saliva was collected before initiation of the study and every 2 weeks thereafter . Saliva flow rate and SIgA concentration were determined , and the SIgA secretion rate was calculated . The mean salivary SIgA secretion rate in the b240 group steadily increased until week 4 ( exhibiting a 20 % elevation relative to that at week 0 ) , and then remained stable until week 12 . Changes in SIgA secretion rate over the intervention period were significantly greater in the b240 group than in the placebo group . The treatment groups exhibited no significant differences in adverse events . Conclusions Oral intake of L. pentosus strain b240 for 12 weeks significantly accelerated salivary SIgA secretion , thereby indicating its potential utility in the improvement of mucosal immunity and resistance against infection in the elderly OBJECTIVE The effectiveness of influenza vaccination in preventing illness is lower in the elderly ; this is why the ability of Lactobacillus plantarum CECT 7315/7316 to stimulate the response to  influenza vaccination  in elderly was evaluated . RESEARCH METHODS AND PROCEDURES A r and omized , double-blind , placebo-controlled human trial including 60 institutionalized volunteers aged 65 - 85 years was performed . All the volunteers were vaccinated with a trivalent influenza vaccine ( A/Wisconsin/67/2005 NYMC X-161B ( H3N2 ) , A/Solomon Isl and s/3/2006 ( H1N1 ) and B/Malaysia/2506/2004 ) for the Spanish vaccine campaign 2006/2007 . The consumption of the probiotic began between three and four months after the vaccination . Volunteers were r and omly assigned to one of three following groups : group A ( receiving 5 * 10(9 ) cfu/day of L. plantarum CECT 7315/7316 in 20 g powdered skim milk ) , group B ( receiving 5 * 10(8 ) cfu/day of L. plantarum CECT 7315/7316 in 20 g powdered skim milk ) and group C or placebo ( 20 g powered skim milk ) . The participants consumed the probiotic during 3 months . RESULTS The consumption of L. plantarum CECT 7315/7316 during 3 months after influenza vaccination increased the levels of influenza-specific IgA and IgG antibodies . Moreover , a trend towards an increase in influenza-specific IgM antibodies was also observed . CONCLUSION L. plantarum CECT7315/7316 has an immunostimulating effect and could be used to improve the response to influenza vaccination in elderly β2 - 1 fructans are prebiotics and , as such , may modulate some aspects of immune function . Improved immune function could enhance the host ’s ability to respond to infections . There is limited information on the effects of β2 - 1 fructans on immune responses  in humans . The objective of the study was to determine the effect of a specific combination of long-chain inulin and oligofructose ( Orafti ® Synergy1 ) on immune function in middle-aged humans , with the primary outcome being response to seasonal influenza vaccination . Healthy middle-aged humans ( 45–63 years of age ) were r and omly allocated to consume β2 - 1 fructans in the form of Orafti ® Synergy1 ( 8 g/day ; n = 22 ) or maltodextrin as control ( 8 g/day ; n = 21 ) for 8 weeks . After 4 weeks , participants received the 2008/2009 seasonal influenza vaccine . Blood and saliva sample s were collected prior to vaccination and 2 and 4 weeks after vaccination . They were used to measure various immune parameters . The primary outcome was the serum concentration of anti-vaccine antibodies . Serum antibody titers against the vaccine and vaccine-specific immunoglobulin concentrations increased post-vaccination . Antibodies to the H3N2-like hemagglutinin type 3 , neuraminidase type 2-like strain were higher in the Synergy1 group ( P = 0.020 for overall effect of treatment group ) , as was serum vaccine-specific IgG1 2 weeks post-vaccination ( P = 0.028 versus control ) . There were no other differences between groups in antibody titers or anti-vaccine immunoglobulin concentrations , in blood immune cell phenotypes , or in a range of immune parameters . It is concluded that Orafti ® Synergy1 , a combination of β2 - 1 fructans , can enhance some aspects of the immune response in healthy middle-aged adults , but that this is not a global effect OBJECTIVE : Probiotic consumption effects on cold and influenza-like symptom incidence and duration were evaluated in healthy children during the winter season . METHODS : In this double-blind , placebo-controlled study , 326 eligible children ( 3–5 years of age ) were assigned r and omly to receive placebo ( N = 104 ) , Lactobacillus acidophilus NCFM ( N = 110 ) , or L acidophilus NCFM in combination with Bifidobacterium animalis subsp lactis Bi-07 ( N = 112 ) . Children were treated twice daily for 6 months . RESULTS : Relative to the placebo group , single and combination probiotics  reduced fever incidence by 53.0 % ( P = .0085 ) and 72.7 % ( P = .0009 ) , coughing incidence by 41.4 % ( P = .027 ) and 62.1 % ( P = .005 ) , and rhinorrhea incidence by 28.2 % ( P = .68 ) and 58.8 % ( P = .03 ) , respectively . Fever , coughing , and rhinorrhea duration was decreased significantly , relative to placebo , by 32 % ( single strain ; P = .0023 ) and 48 % ( strain combination ; P < .001 ) . Antibiotic use incidence was reduced , relative to placebo , by 68.4 % ( single strain ; P = .0002 ) and 84.2 % ( strain combination ; P < .0001 ) . Subjects receiving probiotic products had significant reductions in days absent from group child care , by 31.8 % ( single strain ; P = .002 ) and 27.7 % ( strain combination ; P < .001 ) , compared with subjects receiving placebo treatment . CONCLUSION : Daily dietary probiotic supplementation for 6 months was a safe effective way to reduce fever , rhinorrhea , and cough incidence and duration and antibiotic prescription incidence , as well as the number of missed school days attributable to illness , for children 3 to 5 years of age OBJECTIVES To assess whether an experimental nutritional formula ( EXP ) supports immune function in seniors living in long-term care facilities . DESIGN Prospect i ve , r and omized , double-blind , controlled trial conducted September 2002 through January 2003 . SETTING North central Florida nursing homes . PARTICIPANTS Subjects aged 65 and older ( n = 157 ) . INTERVENTION Subjects received 240 mL/d of EXP or st and ard liquid nutrition ( CON ) for 4 weeks before and 6 weeks after an influenza vaccination . MEASUREMENTS Influenza vaccine antibody responses , immunophenotyping , lymphocyte activation , cytokines , and clinical measures ( fever , number of prescribed antibiotics ) . RESULTS Ninety-two subjects ( n = 40 , CON ; n = 52 , EXP ) completed the study . Geometric mean antibody titers were similar between groups , yet the percentage of subjects with H1N1 antibody titers greater than 100 postvaccination was higher in the EXP group than in the CON group ( 43 % vs 23 % , P=.047 ) . Similar trends were found for the percentage of subjects ( intent to treat ) with fourfold increases against the B/Hong Kong component ( 64 % vs 46 % , P = .09 ) or with H3N2 antibody titers of 40 or more ( 97 % vs 89 % , P=.06 ) . EXP subjects had higher levels of influenza-activated lymphocytes ( CD69 + and CD25 + ) . Cytokine production after mitogen activation was lower in EXP than CON subjects ( interleukin (IL)-6 : 20+/-3 vs 29+/-3 ng/mL , P = .045 ; IL-10 : 310+/-60 vs 603+/-140 pg/mL , P = .06 ) . Fewer EXP subjects were treated for fever ( 5 % vs 16 % , P = .02 ) or prescribed antibiotics ( 7 vs 11 new antibiotics/100 days of study , P = .06 ) . CONCLUSION Seniors consuming the EXP formula demonstrated enhanced immune function , indicated by increased influenza vaccine response and lymphocyte activation , less fever , and fewer newly prescribed antibiotics than those consuming a st and ard ready-to-drink nutritional supplement Twenty-seven elderly subjects ( mean age 86.7±6.6 years ) were pre-administered a test food containing 1 × 1011 cfu of BB536 daily for 5 weeks ( P1 ) , during which they also received influenza vaccination at week 3 . The subjects were then r and omized to a BB536 group and a placebo group for 14 weeks ( P2 ) . The proportion of subjects who contracted influenza was significantly lower in BB536 group than in the to placebo group . The proportion of subjects with fever was also significantly lower in the BB536 group than in the placebo group . In the P1 period , the NK cell activity and the bactericidal activity of the neutrophils were significantly higher at week 5 than to before BB536 administration . In the P2 period , although NK cell activity and neutrophilic activities declined at the end of the study in both the placebo and the BB536 group , neutrophil phagocytic activity and NK cell activity tended to maintain slightly higher levels in the BB536 group than in the placebo group . These results suggest that continuous ingestion of BB536 reduces the incidence of influenza and fever , probably by potentiating innate immunity BACKGROUND Prebiotics stimulate the growth of bifidogenic bacteria in the gut . The aim of this work was to assess the effects of a prebiotic mixture on the immune response in healthy elderly people . METHODS Healthy free-living elderly people ( age , > or = 70 years ) , receiving a nutritional supplement that provided 1.6 MJ , 15 g of protein , and 50 % of vitamin daily reference values per day , were r and omly assigned to receive a prebiotic mixture ( 6 g/d of a 70 % raftilose and 30 % raftiline mixture ) or placebo ( 6 g of maltodextrin powder ) for 28 weeks . At week 2 of the study , all subjects were vaccinated with influenza and pneumococcal vaccines . At weeks 0 , 2 , and 8 of the study , serum total proteins , albumin , immunoglobulins , saliva secretory immunoglobulin A ( IgA ) , and serum titers of influenza A and B and pneumococcal antibodies were measured . At week 8 , cultured peripheral monocyte cell secretion of interleukin-4 , interferon-gamma , and lymphocyte proliferation , stimulated with phytohemagglutinin and influenza antigen , were measured . RESULTS Sixty-six subjects were considered eligible for the study , and 43 ( 20 receiving prebiotics and 23 receiving placebo ) were considered for final analyses on a per protocol basis . No changes in serum proteins , albumin , immunoglobulins , and secretory IgA were observed . Antibodies against influenza B and pneumococcus increased significantly from weeks 0 to 8 , with no significant differences between groups . Antibodies against influenza A did not increase . No effects of prebiotics on interleukin-4 and interferon-gamma secretion by cultured monocytes were observed . CONCLUSIONS No immunological effects of prebiotics were observed in this study Objective : To determine the effects of the probiotic lactic acid bacterium , Lactobacillus rhamnosus HN001 , on natural cellular immunity when delivered orally in normal low-fat milk ( LFM ) or lactose-hydrolyzed low-fat milk ( LFM-LH ) . Design : A three stage , pre-post intervention trial , spanning nine weeks . Setting : Taipei Medical College Hospital , Taipei , Taiwan . Subjects : Fifty-two healthy middle-aged and elderly volunteers ( 17 males , 35 females ; median age 63.5 , range 44–80 ) . Interventions : Stage 1 ( run-in diet ) : 25g/200 mL reconstituted LFM powder , twice daily for 3 weeks . Stage 2 ( probiotic intervention ) : LFM or LFM-LH , supplemented with 109 CFUs/g L. rhamnosus HN001 in each case , for 3 weeks . Stage 3 ( wash-out ) : LFM for 3 weeks . Measures of Outcome : In vitro phagocytic capacity of peripheral blood polymorphonuclear ( PMN ) leukocytes ; in vitro tumoricidal activity of natural killer ( NK ) leukocytes . Results : Immunological responses were unaffected by the run-in diet of LFM alone . In contrast , the relative proportion of PMN cells showing phagocytic activity increased by 19 % and 15 % , respectively , following consumption of HN001 in either LFM or LFM-LH ; the relative level of NK cell tumor killing activity increased by 71 % and 147 % . In most cases these levels declined following cessation , but remained above baseline . Conclusions : Dietary consumption of L. rhamnosus HN001 , in a base of low-fat milk or lactose-hydrolyzed low-fat milk , appears to enhance systemic cellular immune responses and may be useful as a dietary supplement to boost natural immunity Abstract Forty-two participants in two nursing homes who were ≥65 years of age were r and omised to receive a jelly containing 10 billion heat-killed Lactobacillus paracasei MCC1849 cells ( LP group ) or a placebo jelly without lactobacilli ( placebo group ) for 6 weeks . Three weeks after beginning jelly intake , all subjects received an influenza vaccination ( A/H1N1 , A/H2N3 and B ) . Blood sample s were collected before and after the treatment period . There were no significant differences in immune parameters , including in antibody responses against the vaccination , between the groups . In the subgroup of the oldest old , defined as ≥85 years of age ( n = 27 )  , the antibody responses to the A/H1N1 and B antigens , which were impaired in the placebo group , were improved in the LP group . No significant effects of non-viable L. paracasei MCC1849 were observed in the elderly . A possible beneficial effect in the oldest old should be explored in further large-scale studies BACKGROUND If found to be safe and immunogenic , reduced doses of influenza vaccine given by the intradermal route could increase the number of available doses of vaccine . METHODS In an open-label study , we r and omly assigned 119 subjects to receive an intradermal injection of trivalent inactivated influenza vaccine , containing 6 mug of hemagglutinin for each antigen ( 40 percent of the usual dose ) , and 119 to receive an intramuscular injection of the st and ard dose of 15 mug of hemagglutinin for each antigen . The two groups were subdivided according to age ( 18 to 60 years and older than 60 years ) . RESULTS Among subjects who were 18 to 60 years of age , serum antibody responses were vigorous and did not differ significantly between the intradermal and intramuscular groups , and all subjects had hemagglutination-inhibition ( HAI ) titers of at least 1:40 . Although the subjects who were older than 60 years of age also had a vigorous antibody response , there was a trend toward a better response in the intramuscular route , but this finding was significant only for antigen to the H3N2 strain . Nevertheless , 100 percent of older subjects in the intramuscular group and 93 percent of such subjects in the intradermal group had an HAI antibody titer to the H3N2 strain of more than 1:40 , and 100 percent in each group had a titer of this level for both the H1N1 and B strains . Local pain was significantly more common in the intramuscular group than in the intradermal group among subjects who were 18 to 60 years of age but not among subjects who were over 60 years old . Signs of local inflammation were significantly more common among subjects in the intradermal group than among those in the intramuscular group , in both age groups . CONCLUSIONS As compared with an intramuscular injection of full-dose influenza vaccine , an intradermal injection of a reduced dose result ed in similarly vigorous antibody responses among persons 18 to 60 years of age but not among those over the age of 60 years BACKGROUND Influenza vaccination is recommended for the elderly in many countries , but immune responses are weaker compared to younger adults . OBJECTIVE To investigate the impact of daily consumption of a probiotic dairy drink on the immune response to  influenza vaccination  in an elderly population of healthy volunteers over 70 years of age . DESIGN Two r and omised , multicentre , double-blind , controlled studies were conducted during two vaccination seasons in 2005 - 2006 ( pilot ) and 2006 - 2007 ( confirmatory ) . Eighty-six and 222 elderly volunteers consumed either a fermented dairy drink , containing the probiotic strain Lactobacillus casei DN-114 001 and yoghurt ferments ( Actimel , or a non-fermented control dairy product twice daily for a period of 7 weeks ( pilot ) or 13 weeks ( confirmatory ) . Vaccination occurred after 4 weeks of product consumption . Geometric mean antibody titres ( GMT ) against the 3 viral strains composing the vaccine ( H1N1 , H3N2 , and B ) were measured at several time intervals post-vaccination by haemagglutination inhibition test . RESULTS In the pilot study , the influenza-specific antibody titres increased after vaccination , being consistently higher in the probiotic product group compared to the control group under product consumption . Similarly , in the confirmatory study , titres against the B strain increased significantly more in the probiotic group than in the control group at 3 , 6 and 9 weeks post-vaccination under product consumption ( p=0.020 ) . Significant differences in seroconversion between the groups by intended to treat analysis were still found 5 months after vaccination . Similar GMT results were observed for the H3N2 strain and H1N1 strain , confirming the results of the pilot study . CONCLUSION These studies demonstrate that daily consumption of this particular probiotic product increased relevant specific antibody responses to influenza vaccination in individuals of over 70 years of age and may therefore provide a health benefit in this population The present study investigated the ability of Bifidobacterium animalis ssp . lactis ( BB-12 ® ) and Lactobacillus paracasei ssp . paracasei ( L. casei 431 ® ) to modulate the immune system using a vaccination model in healthy subjects . A r and omised , double-blind , placebo-controlled , parallel-group study was conducted in 211 subjects ( 56 % females , mean age 33·2 ( sd 13·1 ) years ) . Subjects consumed a minimum of 10⁹ colony-forming units of BB-12 ® ( capsule ) or L. casei 431 ® ( dairy drink ) or a matching placebo once daily for 6 weeks . After 2 weeks , a seasonal influenza vaccination was given . Plasma and saliva sample s were collected at baseline and after 6 weeks for the analysis of antibodies , cytokines and innate immune parameters . Changes from baseline in vaccine-specific plasma IgG , IgG1 and IgG3 were significantly greater in both probiotic groups v. the corresponding placebo group ( L. casei 431 ® , P = 0·01 for IgG ; P < 0·001 for remaining comparisons ) . The number of subjects obtaining a substantial increase in specific IgG ( defined as ≥ 2-fold above baseline ) was significantly greater in both probiotic groups v. placebo ( BB-12 ® , P < 0·001 for IgG , IgG1 and IgG3 ; L. casei 431 ® , P < 0·001 for IgG1 and IgG3 ) . Significantly greater mean fold increases for vaccine-specific secretory IgA in saliva were observed in both probiotic groups v. placebo ( BB-12 ® , P = 0·017 ; L. casei 431 ® , P = 0·035 ) . Similar results were observed for total antibody concentrations . No differences were found for plasma cytokines or innate immune parameters . Data herein show that supplementation with BB-12 ® or L. casei 431 ® may be an effective means to improve immune function by augmenting systemic and mucosal immune responses to challenge OBJECTIVES To assess whether an experimental nutritional formula , given as a supplement , would reduce days of symptoms of  upper respiratory tract infection ( URTI ) and affect antibody and lymphocyte proliferative responses to influenza vaccine . DESIGN A prospect i ve , r and omized , double-blind , controlled trial was conducted between October 1999 and April 2000 . SETTING Assisted- and independent-living facilities in North Central Florida . PARTICIPANTS Sixty-six individuals , aged 65 and older . INTERVENTION Subjects received 8 oz/d of an experimental formula containing antioxidants , zinc , selenium , fermentable oligosaccharides , and structured triacylglycerol or an isoenergetic , isonitrogenous control formula for 183 days . MEASUREMENTS Subjects recorded daily symptoms of URTI . Antibody titers and lymphocyte proliferation to three influenza vaccine components were measured on Days 57 and 183 . RESULTS Eighteen subjects in the control group and 16 subjects in the experimental group consumed an average of 7 ounces of formula daily and completed the 183-day study . Median days of symptoms of URTI were 3 ( range 0 - 69 , total days=156 ) and 0 ( range 0 - 49 , total days=78 ) for the control and experimental groups , respectively ( P=.049 ) . On Day 57 , seven of 17 ( 41 % ) subjects in the control group and 13 of 15 ( 87 % ) subjects in the experimental group achieved a fourfold or greater increase in serum antibody titer to A/Beijing ( P=.012 ) . Lymphocyte proliferation to influenza vaccine components was greater in the experimental ( median=1,365 cpm , range=0 - 14,955 cpm ) than the control group ( median=136 cpm , range=0 - 4,270 cpm ) ( P=.013 ) . CONCLUSION Subjects consuming an experimental nutritional formula experienced enhanced immune function and fewer days of URTI symptoms OBJECTIVE We studied the coadjuvant capability of oral consumption of the breast-milk-isolated strain Lactobacillus fermentum ( CECT5716 ) for an anti-influenza vaccine . METHODS A r and omized , double-blinded , placebo-controlled human clinical trial including 50 volunteers ( 31 male and 19 female ) was performed to address the immunologic effects of an intramuscular anti-influenza vaccine in adults ( 33.0 + /- 7.7 y old ) . Fifty percent of volunteers received an oral daily dose of methylcellulose ( placebo ) or probiotic bacteria ( 1 x 10(10 ) colony-forming units/d ) 2 wk before vaccination and 2 wk after vaccination . RESULTS Two weeks after vaccination there was an increase in the proportion of natural killer cells in the probiotic group but not in the placebo group . The vaccination induced an increase in T-helper type 1 cytokine concentrations and in T-helper and T-cytotoxic proportions in both groups ; however , the probiotic group showed a significant higher induction in some of these parameters . Regarding the humoral effects , induction of antibody response in the placebo group could not be detected . In the case of the probiotic group , a significant increase in antigen specific immunoglobulin A was detected . Although an increase in total immunoglobulin M was observed , changes in anti-influenza antigen specific immunoglobulin M were not observed . The incidence of an influenza-like illness during 5 mo after vaccination ( October to February ) was lower in the group consuming the probiotic bacteria . CONCLUSION Oral administration of the strain L. fermentum CECT5716 potentates the immunologic response of an anti-influenza vaccine and may provide enhanced systemic protection from infection by increasing the T-helper type 1 response and virus-neutralizing antibodies BACKGROUND & AIMS The aim of this study was to investigate whether the consumption of Lactobacillus gasseri PA 16/8 , Bifidobacterium longum SP 07/3 , B. bifidum MF 20/5 ( 5 x 10(7 ) cfu/tablet ) during at least 3 months influences the severity of symptoms and the incidence and duration of the common cold . METHODS A r and omized , double-blind , placebo-controlled intervention study was performed over at least 3 months during two winter/spring periods . Four hundred and seventy nine healthy adults ( aged 18 - 67 ) were supplemented daily with vitamins and minerals with or without the probiotic bacteria .  Cellular immune parameters were evaluated in a r and omly drawn subgroup of 122 volunteers before and after 14 days of supplementation . During common cold episodes , the participants recorded symptoms daily . Stool sample s were collected before and after 14 days of probiotic supplementation to quantify fecal Lactobacilli and Bifidobacteria using qRT-PCR . RESULTS The total symptom score , the duration of common cold episodes , and days with fever during an episode were lower in the probiotic-treated group than in the control group : 79.3+/-7.4 vs. 102.5+/-12.2 points ( P = 0.056 ) , 7.0+/-0.5 vs. 8.9+/-1.0 days ( P = 0.045 ) , 0.24+/-0.1 vs. 1.0+/-0.3 days ( P = 0.017 ) . A significantly higher enhancement of cytotoxic plus T suppressor cells ( CD8 + ) and a higher enhancement of T helper cells ( CD4 + ) was observed in the probiotic-treated group . Fecal lactobacilli and bifidobacteria increased significantly after probiotic supplementation . CONCLUSIONS The intake of probiotic bacteria during at least 3 months significantly shortened common cold episodes by almost 2 days and reduced the severity of symptoms Summary Background & aims Ageing increases risk of respiratory infections and impairs the response to influenza vaccination . Pre- and pro-biotics offer an opportunity to modulate anti-viral defenses and the response to vaccination via alteration of the gut microbiota . This study investigated the effect of a novel probiotic , Bifidobacterium longum bv . infantis CCUG 52486 , combined with a prebiotic , gluco-oligosaccharide , on the B and T cell response to seasonal influenza vaccination in young and older subjects . Methods In a double-blind , r and omized controlled trial , 58 young ( 18–35 y ) and 54 older ( 60–85 y ) subjects were supplemented with the synbiotic for 8 weeks . At 4 weeks they were administered with a seasonal influenza vaccine .  B and T cell phenotype and responsiveness to in vitro re-stimulation with the vaccine were assessed at baseline , 4 , 6 and 8 weeks . Results B and T cell profiles differed markedly between young and older subjects . Vaccination increased numbers of memory , IgA+ memory , IgG+ memory and total IgG+ B cells in young subjects , but failed to do so in older subjects and did not significantly alter T cell subsets . Seroconversion to the H1N1 subunit in the older subjects was associated with higher post-vaccination numbers of plasma B cells , but seroconversion was less consistently associated with T cell phenotype . B and T cell subsets from both young and older subjects demonstrated a strong antigen-specific recall challenge , and although not influenced by age , responsiveness to the recall challenge was associated with seroconversion . In older subjects , CMV seropositivity was associated with a significantly lower recall response to the vaccine , but the synbiotic did not affect the responsiveness of B or T cells to re-stimulation with influenza vaccine . Conclusions Antigen-specific B and T cell activation following an in vitro recall challenge with the influenza vaccine was influenced by CMV seropositivity , but not by a synbiotic . Registered under Clinical Trials.gov Identifier no. NCT01066377 BACKGROUND Probiotics can modulate the immune system in healthy individuals and may help reduce symptoms related to respiratory infections . OBJECTIVE The objective of the study was to investigate the effect of the probiotic strain Lactobacillus paracasei subsp . paracasei , L. casei 431 ( Chr . Hansen A/S ) ( hereafter , L. casei 431 ) on immune response to influenza vaccination and respiratory symptoms in healthy adults . DESIGN A r and omized double-blind , placebo-controlled trial was conducted in 1104 healthy subjects aged 18 - 60 y at 2 centers in Germany and Denmark . Subjects were r and omly assigned to receive an acidified milk drink containing ≥10(9 ) colony-forming units of L. casei 431 ( n = 553 ) or placebo ( n = 551 ) for 42 d. After 21 d , subjects received the seasonal influenza vaccination . The primary outcome was seroprotection rate ( anti-influenza antibody titers by hemagglutination inhibition ) 21 d after vaccination . Other outcomes were seroconversion rate and mean titers , influenza A-specific antibodies and incidence , and duration and severity of upper respiratory symptoms . Antibiotic use and use of health care re sources were recorded . RESULTS There was no effect of L. casei 431 on immune responses to influenza vaccination . Generalized linear mixed modeling showed a shorter duration of upper respiratory symptoms in the probiotic group than in the placebo group ( mean ± SD : 6.4 ± 6.1 vs. 7.3 ± 9.7 d , P = 0.0059 ) in the last 3 wk of the intervention period . No statistically significant differences were found for incidence or severity . CONCLUSIONS Daily consumption of L. casei 431 result ed in no observable effect on the components of the immune response to influenza vaccination but reduced the duration of upper respiratory symptoms . The trial was registered at www.is rct n.com as IS RCT N08280229
We conducted a meta- analysis to evaluate the effects of probiotics and prebiotics on the immune response to influenza vaccination in adults .