Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials - PubMed (original) (raw)

Review

Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Wei-Te Lei et al. Nutrients. 2017.

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.

Keywords: influenza vaccine; meta-analysis; prebiotics; probiotics; seroconversion; seroprotection; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) flow diagram.

Figure 2

Forest plots of seroprotection and seroconversion rate of H1N1 strain. (a) Forest plot of seroprotection rate of H1N1 strain; (b) Forest plot of seroconversion rate of H1N1 strain. The bold data represents total participants of all included studies and the Odds ratio (OR) between the probiotics/prebiotics group and the placebo group. The diamond stands for the pooled OR. Weights are from random-effects model. CI: confidence interval.

Figure 3

Forest plots of seroprotection and seroconversion rate of H3N2 strain. (a) Forest plot of seroprotection rate of H3N2 strain; (b) Forest plot of seroconversion rate of H3N2 strain. The bold data represents total participants of all included studies and the Odds ratio (OR) between the probiotics/prebiotics group and the placebo group. The diamond stands for the pooled OR. Weights are from random-effects model. CI: confidence interval.

Figure 4

Forest plots of seroprotection and seroconversion rate of B strain. (a) Forest plot of seroprotection rate of B strain; (b) Forest plot of seroconversion rate of B strain. The bold data represents total participants of all included studies and the Odds ratio (OR) between the probiotics/prebiotics group and the placebo group. The diamond stands for the pooled OR. Weights are from random-effects model. CI: confidence interval.

Figure 5

Forest plots of subgroup analysis by intervention type of seroconversion rate of H1N1 and H3N2 strains. (a) Forest plot of subgroup analysis by intervention type of seroconversion rate for influenza H1N1 strain; (b) Forest plot of subgroup analysis by intervention type of seroconversion rate for influenza H3N2 strain. The bold data represents total participants of all included studies and the Odds ratio (OR) between the probiotics/prebiotics group and the placebo group. The diamond stands for the pooled OR. Weights are from random-effects model. CI: confidence interval.

Figure 5

Figure 6

Forest plots of subgroup analysis by participants of seroconversion rate of H1N1 and H3N2 strains. (a) Forest plot of subgroup analysis by health status of participants of seroconversion rate for influenza H1N1 strain; (b) Forest plot of subgroup analysis by health status of participants of seroconversion rate for influenza H3N2 strain. The bold data represents total participants of all included studies and the Odds ratio (OR) between the probiotics/prebiotics group and the placebo group. The diamond stands for the pooled OR. Weights are from random-effects model. CI: confidence interval.

Figure 6

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Effect of Probiotics and Prebiotics on Immune Response to Influenza Vaccination in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials - PubMed (original) (raw)