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Randomized clinical trial to determine whether a probiotic formulation containing 4 probiotic strains which belong to Lactiplantibacillus plantarum and Pediococcus acidilactici species can boost the immune response to influenza vaccination evaluated at 4 weeks in a population between 50 and 80 years of age. Secondary outcomes comprise evaluation of immune response at 8 weeks after vaccination, percentage of patients with seroconversion, incidence and duration of influenza-like infections and respiratory infections throughout a 4-month period and safety.
Double blind, randomized, placebo-controlled clinical trial to determine whether supplementation with a probiotic formulation containing 4 probiotic strains (L. plantarum CECT 30292, CECT7484, CECT7485 and P. acidilactici CECT7483) can improve immune response to seasonal influenza vaccination. Subjects with age comprised between 50 and 80 years who meet inclusion and exclusion criteria will be randomized 1:1 to one of the following study groups: one will receive probiotic formulation for 28 days (1 capsule/day) and the other will receive placebo, starting the same day of the influenza vaccination. Main study outcome will be immune response at 4 weeks after vaccination, which will be determined by analysis of specific IgG antibodies in serum against influenza A and B. Secondary outcomes comprise serum titers of specific IgG at 8 weeks after vaccination, percentage of patients with seroconversion at 4 and 8 weeks, evaluation of influenza-like infections or respiratory infections throughout a 4-month period and adverse events.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | Probiotic multi-strain formulation comprising L. plantarum CECT30292, CECT7484, CECT7585 and P. acidilactici and maltodextrin (E1400, qs) as excipient in hydroxymethylpropyl-cellulose (HPMC) capsules. Probiotic strains have Qualified Presumption of Safety (QPS) status by European Food Safety Authority |
|
| Placebo | Placebo Comparator | Maltodextrin (E1400, qs) in HPMC capsules |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Food Supplement | Dietary Supplement | Probiotic multistrain formulation containing Lactiplantibacillus plantarum CECT30292, CECT7484, CECT7485 and P. acidilactici CECT7483 for 28 days, starting the same day of influenza vaccination |
| Measure | Description | Time Frame |
|---|---|---|
| IgG antibodies against vaccine influenza antigens | Titer of specific total IgG antibodies against vaccine influenza A and B antigens at day 28 | 4 weeks (day 1 and day 28) |
| Measure | Description | Time Frame |
|---|---|---|
| IgG antibodies against vaccine influenza antigens | Titer of specific total IgG antibodies against vaccine influenza A and B antigens at day 56 | 8 weeks (day 1 and day 56) |
| IgM antibodies against vaccine influenza antigens |
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Inclusion Criteria:
Exclusion Criteria:
Exclusion criteria during the study:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital General de Granollers | Granollers | Barcelona | 08401 | Spain | ||
| Hospital Parc Tauli |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23002979 | Background | Lambert ND, Ovsyannikova IG, Pankratz VS, Jacobson RM, Poland GA. Understanding the immune response to seasonal influenza vaccination in older adults: a systems biology approach. Expert Rev Vaccines. 2012 Aug;11(8):985-94. doi: 10.1586/erv.12.61. | |
| 30551178 | Background | Ng TWY, Cowling BJ, Gao HZ, Thompson MG. Comparative Immunogenicity of Enhanced Seasonal Influenza Vaccines in Older Adults: A Systematic Review and Meta-analysis. J Infect Dis. 2019 Apr 19;219(10):1525-1535. doi: 10.1093/infdis/jiy720. |
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| ID | Term |
|---|---|
| D007251 | Influenza, Human |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D009976 | Orthomyxoviridae Infections |
| D012327 | RNA Virus Infections |
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| ID | Term |
|---|---|
| D019587 | Dietary Supplements |
| D019936 | Probiotics |
| ID | Term |
|---|---|
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
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Double blind, randomized controlled trial in 140 subjects 50-80 years old receiving influenza vaccination, who will be allocated to receive either an experimental product containing multi-strain probiotic formula or placebo for 28 days
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Both placebo and active product will be provided in identical packaging.
|
| Placebo | Dietary Supplement | One maltodextrin-containing capsule/day for 28 days, starting the same day of influenza vaccination |
|
Titer of specific total IgM antibodies against vaccine influenza A and B antigens at day 28 and 56
| 8 weeks (day 1 and day 56) |
| Seroconversion | Percentage of patients with seroconversion (defined as 4 fold change in influenza IgG antibodies concentration compared to baseline) at day 28 and 56 | 8 weeks (day 1,day 28 and 56) |
| Incidence of influenza like infections (ILI) | Cumulative incidence of influenza like infection (ILI), according to the European Diseases Prevention and Control Center (ECDC) criteria | 16 weeks (day 1, day 56) |
| Incidence of any other respiratory infections (including COVID-19) | Cumulative incidence of any other respiratory infections | 16 weeks (day 1, day 56) |
| Incidence of fever | Cumulative number of days with fever (> 37.5ºC) | 16 weeks (day 1, day 56) |
| Use of analgesics and antibiotics | Cumulative number of days using analgesics and antibiotics | 16 weeks (day 1, day 56) |
| Duration of vaccine-related symptoms: injection-site pain, swelling, redness | Duration (in days) of symptoms after receiving the flu vaccine. | 1 week (day 1, day 7) |
| Severity of vaccine-related symptoms: injection-site pain, swelling, redness | Severity of symptoms after receiving the flu vaccine. Measured on a 4-point scale: 0 = none , 1 = mild, 2 = moderate, and 3 = severe | 1 week (day 1, day 7) |
| Gastrointestinal symptoms | Gastrointestinal manifestations documented through questionnaire in participants diary. Measured on a 4-point scale: 0 = none , 1 = mild, 2 = moderate, and 3 = severe. | 4 weeks (day 1, day 28) |
| Adverse events | Frequency of adverse events reported in medical visits or patient diary | 8 weeks (day 56) |
| Albumin | Albumin concentration in blood | 4 weeks (day 1, day 28) |
| Alkaline phosphatase (ALP) | Alkaline phosphatase (ALP) concentration in blood | 4 weeks (day 1, day 28) |
| Gamma-glutamil transpeptidase (GGT) | Gamma-glutamil transpeptidase (GGT) concentration in blood | 4 weeks (day 1, day 28) |
| Aspartate aminotransferase (GOT) | Aspartate aminotransferase (AST) concentration in blood | 4 weeks (day 1, day 28) |
| Alanine aminotransferase (AST) | Aspartate aminotransferase (AST) concentration in blood | 4 weeks (day 1, day 28) |
| Basic hemogram | Blood cell count | 4 weeks (day 1, day 28) |
| Sabadell |
| Barcelona |
| 08208 |
| Spain |
| IDIAP Jordi Gol-Centro de Atención Primaria La Mina | Sant Adrià de Besòs | Barcelona | 08930 | Spain |
| Mutua de Terrassa | Terrassa | Barcelona | 08221 | Spain |
| FIBAO- Fundación para la Investigación Biosanitaria de Andalucia Oriental | Granada | 18002 | Spain |
| 33643929 | Background | Harper A, Vijayakumar V, Ouwehand AC, Ter Haar J, Obis D, Espadaler J, Binda S, Desiraju S, Day R. Viral Infections, the Microbiome, and Probiotics. Front Cell Infect Microbiol. 2021 Feb 12;10:596166. doi: 10.3389/fcimb.2020.596166. eCollection 2020. |
| 30019448 | Background | Trombetta CM, Remarque EJ, Mortier D, Montomoli E. Comparison of hemagglutination inhibition, single radial hemolysis, virus neutralization assays, and ELISA to detect antibody levels against seasonal influenza viruses. Influenza Other Respir Viruses. 2018 Nov;12(6):675-686. doi: 10.1111/irv.12591. Epub 2018 Aug 11. |
| 34002068 | Background | Lynn DJ, Benson SC, Lynn MA, Pulendran B. Modulation of immune responses to vaccination by the microbiota: implications and potential mechanisms. Nat Rev Immunol. 2022 Jan;22(1):33-46. doi: 10.1038/s41577-021-00554-7. Epub 2021 May 17. |
| 28923425 | Result | Zimmermann P, Curtis N. The influence of probiotics on vaccine responses - A systematic review. Vaccine. 2018 Jan 4;36(2):207-213. doi: 10.1016/j.vaccine.2017.08.069. Epub 2017 Sep 18. |
| 29416317 | Result | Yeh TL, Shih PC, Liu SJ, Lin CH, Liu JM, Lei WT, Lin CY. The influence of prebiotic or probiotic supplementation on antibody titers after influenza vaccination: a systematic review and meta-analysis of randomized controlled trials. Drug Des Devel Ther. 2018 Jan 25;12:217-230. doi: 10.2147/DDDT.S155110. eCollection 2018. |
| 33578007 | Result | Darbandi A, Asadi A, Ghanavati R, Afifirad R, Darb Emamie A, Kakanj M, Talebi M. The effect of probiotics on respiratory tract infection with special emphasis on COVID-19: Systemic review 2010-20. Int J Infect Dis. 2021 Apr;105:91-104. doi: 10.1016/j.ijid.2021.02.011. Epub 2021 Feb 9. |
| D014777 | Virus Diseases |
| D012140 | Respiratory Tract Diseases |