Neutral and Acidic Oligosaccharides Supplementation Does Not Increase the Vaccine Antibody Response in Preterm Infants in a Randomized Clinical Trial

Abstract

BackgroundIn preterm infants, a decreased immunological response and lower serological effectiveness are observed after immunizations due to ineffectiveness of both humoral and cellular immune mechanisms.ObjectiveTo determine the effect of 80% neutral oligosaccharides [small-chain galacto-oligosaccharides/long-chain fructo-oligosaccharides (scGOS/lcFOS)] in combination with 20% pectin-derived acidic oligosaccharides (pAOS) on antibody concentrations after DTaP-IPV-Hib immunization in preterm infants.DesignIn this randomized clinical trial, preterm infants with gestational age <32 weeks and/or birth weight <1500 g received enteral supplementation with scGOS/lcFOS/pAOS or placebo (maltodextrin) between days 3 and 30 of life. Blood samples were collected at 5 and 12 months of age.ResultsIn total, 113 infants were included. Baseline and nutritional characteristics were not different in both groups. Geometric mean titers were not different after prebiotic supplementation at 5 months, Ptx (37/44 EU/ml), FHA (78/96 EU/ml), Prn (78/80 EU/ml), Diphtheria (0.40/0.57 IU/ml), Tetanus (0.74/0.99 IU/ml) and Hib (0.35/0.63 µg/ml), and at 12 months Ptx (55/66 EU/ml), FHA (122/119 EU/ml), Prn (116/106 Eu/ml), Diphtheria (0.88/1.11 IU/ml), Tetanus (1.64/1.79 IU/ml) and Hib (2.91/2.55 µg/ml).ConclusionsEnteral supplementation of neutral (scGOS/lcFOS) and acidic oligosaccharides (pAOS) does not improve the immunization response in preterm infants.Trial RegistrationControlled-Trials.com ISRCTN16211826 ISRCTN16211826

Chain length‐dependent effects of inulin‐type fructan dietary fiber on human systemic immune responses against hepatitis‐B

“…The lack of effect of short chain ITFs is corroborated by Duggan et al ., who found no effect on antibody response after vaccination with H. influenza type B vaccine in 6–12 month old infants supplemented with short chain ITFs (all fructan DP < 10, over 25% ≥ DP5, less than 75% DP ≤4; 0.7 g/day) . Also in other studies, in infants supplemented with prebiotic mixtures with short‐chain ITFs vaccine potentiating effects were not induced . Our data are in line with these findings, as short‐chain ITFs are virtually ineffective in Th1 stimulation, which is required for adequate responses to these vaccines.…”

Prevention of Necrotizing Enterocolitis Through Manipulation of the Intestinal Microbiota of the Premature Infant

“…A meta-analysis including 7 trials in premature infants found that supplementation with prebiotics increased fecal Bifidobacteria and Lactobacilli , but did not improve the outcomes of NEC, sepsis or time to full enteral feeding 114 . Limited follow-up studies of premature infants treated with prebiotic supplements show no significant decrease in allergic or infectious diseases or vaccine response at 12 months of age 128, 129 . Two possible explanations for the limited efficacy of prebiotics in premature infants include 1) lack of specificity of commercial prebiotics (i.e.…”

Prebiotics in infant nutrition: a critical appraisal

“…Focus on the potential role of this mixture in preterm infants was put by Westerbeek and coworkers in 5 following papers [69][70][71][72][73] .…”

“…In the same year the same group [73] tested preterm infants to establish a potential link between the use of these prebiotics and the vaccine antibody response. The selected vaccination was a diphtheria, tetanus, acellullar pertussis, polio and Haemophilus influenzae type b combination vaccine.…”

“…A number of papers reported the outcomes of prebiotic supplementation in preterm infants [20,[50][51][52][56][57][58][69][70][71][72][73]77,88]. No problems of tolerance and safety were reported, regardless of the prebiotic mixture and dose used, even when a very high dose of GOS/FOS [56], higher than those used in full term infants (0.4 or 0.8 g 100/mL) was aimed to evaluate tolerability and reduce stool viscosity and accelerate gastrointestinal transport, in order to improve feeding tolerance.…”