Effects of a Formula Containing Two Types of Prebiotics, Bifidogenic Growth Stimulator and Galacto-oligosaccharide, and Fermented Milk Products on Intestinal Microbiota and Antibody Response to Influenza Vaccine in Elderly Patients: A Randomized Controlled Trial

Abstract

We investigated the effect of a formula containing two different prebiotics (bifidogenic growth stimulator and galacto-oligosaccharide) and fermented milk products on intestinal microbiota and antibody responses to an influenza vaccine in enterally fed elderly in-patients. Patients were administered either formula containing prebiotics and fermented milk products (group F: n = 12, 79.9 ± 9.5 years old) or standard formula (group C: n = 12, 80.7 ± 10.1 years old) via percutaneous endoscopic gastrostomy during a 14-week intervention period. Subjects were immunized with an influenza vaccine (A/H1N1, A/H3N2, and B) at week 4 of the intervention. Blood biochemical indices, intestinal bacteria populations and antibody titers were analyzed. Bifidobacterium counts increased significantly in group F compared with group C. The enhanced antibody titers against A/H1N1 were maintained in group F for a longer period compared with group C. The titers against A/H3N2 were unchanged between both groups, and those against B were significantly lower in group F than in group C, although few subjects had seroprotective titers against A/H3N2 and B. These results suggest that administration of the formula containing prebiotics and fermented milk products may maintain antibody titers for longer periods through the improvement of intestinal microbiota.

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

“…Meta-analysis was performed using Review Manager (RevMan) [ Figure 1 shows the search process and outcomes. A total of 19 publications with 20 RCTs were included for our systematic review [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. Two trials (a pilot and a confirmatory study) with different patient numbers, treatment protocols, and years of study were published together [35].…”

“…Two trials (a pilot and a confirmatory study) with different patient numbers, treatment protocols, and years of study were published together [35]. Thirteen trials focused on probiotics [22,[26][27][28][29][30][31][32][33][34][35][36], while the other six RCTs focused on prebiotics [23][24][25][37][38][39]. Only one study concentrated on synbiotics [21].…”

“…Seven RCTs enrolled healthy adults or older adults [21,25,26,30,32,34,36], and two trials enrolled healthy older adults [38,39]. In another eleven trials, subjects living in hospitals, nursing homes, or long-term care facilities were enrolled [22][23][24][27][28][29]31,33,35,37]. Participants fed by enteral tube or percutaneous endoscopic gastrostomy were enrolled in three studies conducted in Japan [23,24,27].…”

An Enteral Formula Containing Fermented Milk Products and Prebiotics Promotes Glucagon-Like Peptide-1 Secretion via Short Chain Fatty Acid Signaling

“…The quantification of Bifidobacterium was carried out using qPCR and a 7300 Real Time PCR System (Applied Biosystems, Foster City, CA, USA) following the methods of Nagafuchi et al [10]. The total DNA template was extracted from the cecal contents using a QIAamp DNA Stool mini kit (Qiagen).…”

“…PF contains products obtained from milk fermentation by Lactobacillus bulgaricus and Streptococcus thermophilus, prebiotics such as galacto-oligosaccharides (GOS) and bifidogenic growth stimulator (BGS), and more water-soluble dietary fiber than that in standard formula (SF). In human clinical trials, elderly people who received PF as part of their enteral nutrition showed an increase in Bifidobacterium counts in their feces and an improvement in stool quality [10,11]. In addition, PF administration was associated with an increase in the number of Bifidobacterium in the cecum and SCFA levels in a rat enteral nutrition model [12].…”