title: Probiotics, antibiotics and the immune responses to vaccines.
abstract: Orally delivered vaccines have been shown to perform poorly in developing countries. There are marked differences in the structure and the luminal environment of the gut in developing countries resulting in changes in immune and barrier function. Recent studies using newly developed technology and analytic methods have made it increasingly clear that the intestinal microbiota activate a multitude of pathways that control innate and adaptive immunity in the gut. Several hypotheses have been proposed for the underperformance of oral vaccines in developing countries, and modulation of the intestinal microbiota is now being tested in human clinical trials. Supplementation with specific strains of probiotics has been shown to have modulatory effects on intestinal and systemic immune responses in animal models and forms the basis for human studies with vaccines. However, most studies published so far that have evaluated the immune response to vaccines in children and adults have been small and results have varied by age, antigen, type of antibody response and probiotic strain. Use of anthelminthic drugs in children has been shown to possibly increase immunogenicity following oral cholera vaccination, lending further support to the rationale for modulation of the immune response to oral vaccination through the intestinal microbiome.
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Ira
authors.initials: I
authors.lastname: Praharaj
authors.affiliation: Low Cost Effective Care Unit, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Sushil M
authors.initials: SM
authors.lastname: John
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Rini
authors.initials: R
authors.lastname: Bandyopadhyay
authors.affiliation: Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India gkang@cmcvellore.ac.in.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003906:Developing Countries; D006801:Humans; D019936:Probiotics; D014612:Vaccines / Q000008:administration & dosage* / Q000276:immunology*
chemical_list: D000900:Anti-Bacterial Agents; D014612:Vaccines
keywords: anthelminthics; antibiotics; microbiota; oral vaccines; probiotics; vaccines