Interactions between human microbiota and vaccines; Current perspectives

Keikha, Masoud; Zandhaghighi, Mehdi; Zahedani, Shahram Shahraki
doi:10.1016/j.vacun.2022.12.006
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    "titulo" => "Interactions between human microbiota and vaccines&#59; Current perspectives"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="p0005" class="elsevierStylePara elsevierViewall">Although vaccination remains the most effective strategy for preventing infectious diseases as well as reducing disease severity&#44; observations reveal that induced immune responses are highly variable between individuals as well as various populations worldwide&#46;<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a> Indeed&#44; the effectiveness of several vaccines&#44; e&#46;g&#46;&#44; Bacillus Calmette&#8211;Guerin &#40;BCG&#41;&#44; poliomyelitis&#44; rotavirus&#44; malaria&#44; and yellow fever&#44; vary widely in various regions of the world&#46;<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a> Understanding the foundation of this inconsistency is a crucial step in developing human health&#46;</p><p id="p0010" class="elsevierStylePara elsevierViewall">According to current scientific literature&#44; repetitive gastrointestinal infections are linked to the failure of oral vaccines&#44; particularly in low-income and middle-income countries&#46; In this context&#44; only 58&#37; of Nicaraguan and 46&#37; of Bangladeshi children respond to the oral rotavirus vaccine &#40;RV&#41;&#44; whereas the RV vaccine&#39;s efficacy in Finland is over 98&#37;&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> Recent studies have focused on the association between the human microbiome and vaccine-specific immune response&#46;<a class="elsevierStyleCrossRefs" href="#bb0015"><span class="elsevierStyleSup">3&#8211;5</span></a> The human microbiota contains thousands of commensal microorganisms that reside in the gut&#44; lung&#44; skin&#44; as well as other mucosal epithelial surfaces&#46; The microbiota could have influenced human pathophysiological events through metabolizing nutrients&#44; hampering pathogen colonization&#44; synthesizing various metabolites&#44; as well as strengthening mucosal immunity&#46;<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a> The human microbiota also has an impact on susceptibility to the cardiovascular&#44; central nervous system&#44; digestive&#44; allergic&#44; and autoimmune diseases&#44; or even anti-programmed cell death protein 1 &#40;anti-PD-1&#41;-based cancer immunotherapy&#46;<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a></p><p id="p0015" class="elsevierStylePara elsevierViewall">As a result of these findings&#44; the gut microbial community developing at an early stage of life plays an essential role in developing and shaping immune responses&#46;<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a> Gut-associated lymphoid tissue &#40;GALT&#41; influences the maturation of immune cells via stimulating the pattern recognition receptors &#40;PRRs&#41; in leukocytes&#44; differentiation of immune cells resulting in microbial metabolites&#44; and polyclonal stimulation immune responses&#44; as well as pre-defined immune memory for combating pathogens after exposure&#46;<a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a> Despite extensive research on the impact of microbiota on the immune system&#44; the effect of human microbial communities on the immune response to vaccination remains poorly understood&#46; Understanding the sophisticated interactions between human microbiota and vaccines can lead to optimal immunogenicity of current vaccines&#46;</p><p id="p0020" class="elsevierStylePara elsevierViewall">According to the literature&#44; the microbial composition could be linked to variance in responses to oral vaccines&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a> In addition to the impact that microbial composition might have&#44; researchers have found that toll-like receptor &#40;TLR5&#41;-mediated by microbiota was necessary to activate antibody response to influenza vaccine in mice model&#46;<a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a> Primary experiments have shown that germ-free animals lacking microbiota reduced the quantity and function of lymphoid cells&#46;<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> Moreover&#44; impaired immune response&#44; such as insufficient IgA-producing plasma cells&#44; and reduced antibody titers in response to respiratory infections in sterile mice or antibody-treated mice are suggested&#46;<a class="elsevierStyleCrossRef" href="#bb0055"><span class="elsevierStyleSup">11</span></a> Human investigations confirmed the impairment of vaccine-induced antibodies when there is a disturbance of the microbiota&#46;<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a> Thus&#44; the human microbial composition would play an important role in vaccine-induced immune responses &#40;<a class="elsevierStyleCrossRef" href="#f0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><p id="p0030" class="elsevierStylePara elsevierViewall">Antibiotic-induced disbiosis is related to the reduction of IgG response&#44; T-cell subsets&#44; and dendritic cells &#40;DCs&#41;&#44; as well as a reduction of lymph nodes within human tissue in response to various oral vaccines&#46;<a class="elsevierStyleCrossRef" href="#bb0060"><span class="elsevierStyleSup">12</span></a> Furthermore&#44; there is numerous of evidence for impaired inflammation and mortality during airway infection following the depletion of the intestinal microbiome in animal models&#46;<a class="elsevierStyleCrossRef" href="#bb0065"><span class="elsevierStyleSup">13</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0070"><span class="elsevierStyleSup">14</span></a> Both small and large intestines include a large number of circulating immune cells&#44; e&#46;g&#46;&#44; B lymphocytes and T lymphocytes&#44; as well as antigen-presenting cells &#40;APCs&#41; that gut bacterial communities can shape the maturation of immune response in the intestinal luz&#46; In this relation&#44; immune-related responses to oral vaccines&#44; such as polio&#44; cholera&#44; typhoid fever&#44; and rotavirus&#44; are the most live-attenuated live vaccines and would be influenced by gut microbiota compositions&#46;<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a> However&#44; the microbiota can also influence the immune response at a distance from the originating colonization site&#46;<a class="elsevierStyleCrossRef" href="#bb0075"><span class="elsevierStyleSup">15</span></a> Conserved microbial structures from the gut microbiota community are disseminated to the spleen to stimulate the production of IgG&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> Williams et al&#46; have suggested that HIV vaccine-induced exclusive lymphocytes originate from the initial pool of intestinal cross-reactive immune cells&#46;<a class="elsevierStyleCrossRef" href="#bb0080"><span class="elsevierStyleSup">16</span></a> Another study by Macia et al&#46; showed that the short-chain fatty acids &#40;SCFAs&#41; produced by gut microbiota have beneficial effects on plasma cell differentiation and antibody responses&#46;<a class="elsevierStyleCrossRef" href="#bb0090"><span class="elsevierStyleSup">18</span></a></p><p id="p0035" class="elsevierStylePara elsevierViewall">Several human trials have been conducted to support the impact that human microbiota can have on the vaccine-induced immune response&#46; Recently&#44; the association between microbiota composition and oral rotavirus vaccination in responders and non-responders has been an issue in various countries&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a> The <span class="elsevierStyleItalic">Bifidobacterium</span> abundance correlates with a strong response to polio&#44; BCG&#44; tetanus toxoid&#44; and hepatitis B virus oral vaccines&#46;<a class="elsevierStyleCrossRef" href="#bb0095"><span class="elsevierStyleSup">19</span></a> Consistent with these findings&#44; several studies have shown that alternations in alpha and beta diversity of the compost gut-microbial communities and reduction of bacterial richness could impair host protection to the acquisition of lung infections&#44; i&#46;e&#46;&#44; SARS-CoV-2 infection&#46;<a class="elsevierStyleCrossRef" href="#bb0100"><span class="elsevierStyleSup">20</span></a> In relation to this issue&#44; probiotics being also live organisms confers a health benefit to the host following gastrointestinal disbiosis&#46;<a class="elsevierStyleCrossRef" href="#bb0105"><span class="elsevierStyleSup">21</span></a> Oral administration of <span class="elsevierStyleItalic">Lactobacillus</span> as a prophylactic route in a mouse model showed activation of both innate as well as adaptive immunity against influenza infection&#46;<a class="elsevierStyleCrossRef" href="#bb0110"><span class="elsevierStyleSup">22</span></a> Likewise&#44; a meta-analysis has confirmed the clinical efficacy of probiotic supplementation for the reduction of respiratory infections&#46;<a class="elsevierStyleCrossRef" href="#bb0115"><span class="elsevierStyleSup">23</span></a> There are several experiments regarding the positive influence of probiotic administration to enhance vaccine-induced-immune response when administrating&#44; i&#46;e&#46;&#44; polio&#44; rotavirus&#44; diphtheria&#44; HBV&#44; tetanus&#44; Hib&#44; and pneumococcus vaccines&#46;<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bb0120"><span class="elsevierStyleSup">24</span></a></p><p id="p0040" class="elsevierStylePara elsevierViewall">In conclusion&#44; the microbiota composition has beneficial effects on the maturation of immune responses as well as the effectiveness of vaccine-induced immune responses&#46; However&#44; the mechanism of action remains unclear&#46; In this context&#44; probiotics confer benefits by boosting vaccine-specific immunity&#46; In contrast&#44; a few controversial studies report the adverse effects of probiotics on immune-induced vaccine responses might confound results&#46;<a class="elsevierStyleCrossRef" href="#bb0125"><span class="elsevierStyleSup">25</span></a> However&#44; factors such as type of vaccine&#44; dose&#44; administration route&#44; and duration of probiotic supplementation might confound results&#46; Overall&#44; maintaining microbiota&#44; probiotic supplementation&#44; and the incorporation of bacterial metabolites such as SCFAs&#44; tryptophan metabolite&#44; polysaccharide A&#44; sphingolipids&#44; as well as muramyl dipeptide can play important roles in the enhancement of immune response to vaccines&#46;</p></span>"
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