A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.

<h4>Aim</h4>To investigate the effect of influenza vaccination with or without probiotic supplementation on the immune response and incidence of influenza-like illness (ILI) in the elderly.<h4>Methods</h4>A randomized double-blind, placebo-controlled trial with a modified fac...

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Main Authors: Sukamto Koesnoe, Nuning Masjkuri, Asri Adisasmita, Samsuridjal Djauzi, Cissy Kartasasmita, Julitasari Sundoro, Mardiati Nadjib, Mondastri Korib, Alisa Nurul Muthia, Virly Nanda Muzellina, Ummu Habibah, Saskia Aziza Nursyirwan, Kristoforus Hendra Djaya, Novilia Sjafri Bachtiar, Rini Mulia Sari
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Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0250234&type=printable
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author Sukamto Koesnoe
Nuning Masjkuri
Asri Adisasmita
Samsuridjal Djauzi
Cissy Kartasasmita
Julitasari Sundoro
Mardiati Nadjib
Mondastri Korib
Alisa Nurul Muthia
Virly Nanda Muzellina
Ummu Habibah
Saskia Aziza Nursyirwan
Kristoforus Hendra Djaya
Novilia Sjafri Bachtiar
Rini Mulia Sari
author_facet Sukamto Koesnoe
Nuning Masjkuri
Asri Adisasmita
Samsuridjal Djauzi
Cissy Kartasasmita
Julitasari Sundoro
Mardiati Nadjib
Mondastri Korib
Alisa Nurul Muthia
Virly Nanda Muzellina
Ummu Habibah
Saskia Aziza Nursyirwan
Kristoforus Hendra Djaya
Novilia Sjafri Bachtiar
Rini Mulia Sari
author_sort Sukamto Koesnoe
collection DOAJ
description <h4>Aim</h4>To investigate the effect of influenza vaccination with or without probiotic supplementation on the immune response and incidence of influenza-like illness (ILI) in the elderly.<h4>Methods</h4>A randomized double-blind, placebo-controlled trial with a modified factorial design was conducted in 554 healthy elderly subjects aged 67 ± 5.6 (ranging from 60-90) years old in the Primary Health Care Center (Puskesmas area) of the Pulo Gadung District East Jakarta. Subjects received either a trivalent influenza vaccine or placebo at the start of the study, and a probiotic supplement (Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011) or a placebo for 6 months. Subjects were randomly assigned into four intervention groups: influenza vaccine and probiotics (n = 141), influenza vaccine and placebo (n = 136), placebo and probiotics (n = 140), and both placebo (n = 137). The primary outcome was ILI incidence within 6 months. The secondary outcomes were seroprotection and seroconversion rates at 1, 4, and 6 months after administering the interventions.<h4>Results</h4>This study showed that the trivalent influenza vaccine increased seroprotection (RR 3.6 [95%CI 2.92-4.47]; p<0.010) and seroconversion (RR 29.8 [95%CI 11.1-79.5]; p<0.010) rates 1 month after vaccination in elderly people while the probiotic supplement did not alter influenza antibody titers (p = 1.000 and p = 0.210). The relative ILI incidence risk was similar between vaccinated and non-vaccinated groups, as well as in the probiotic group compared to the non-probiotic group.<h4>Conclusion</h4>The tested trivalent influenza vaccine significantly induced seroprotection and seroconversion in the vaccinated subjects, while probiotics administration did not influence these parameters. Vaccinated individuals displayed a similarly low ILI incidence as those in the Control Group. However, the observed trend towards a reduction of ILI incidence with probiotics supplementation warrants further assessments in a larger, at-risk population.<h4>Clinical trial registry number</h4>NCT03695432.
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spelling doaj-art-a187dc17e8ec4a8dbb9a2e835b1194cf2025-08-20T02:46:25ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011612e025023410.1371/journal.pone.0250234A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.Sukamto KoesnoeNuning MasjkuriAsri AdisasmitaSamsuridjal DjauziCissy KartasasmitaJulitasari SundoroMardiati NadjibMondastri KoribAlisa Nurul MuthiaVirly Nanda MuzellinaUmmu HabibahSaskia Aziza NursyirwanKristoforus Hendra DjayaNovilia Sjafri BachtiarRini Mulia Sari<h4>Aim</h4>To investigate the effect of influenza vaccination with or without probiotic supplementation on the immune response and incidence of influenza-like illness (ILI) in the elderly.<h4>Methods</h4>A randomized double-blind, placebo-controlled trial with a modified factorial design was conducted in 554 healthy elderly subjects aged 67 ± 5.6 (ranging from 60-90) years old in the Primary Health Care Center (Puskesmas area) of the Pulo Gadung District East Jakarta. Subjects received either a trivalent influenza vaccine or placebo at the start of the study, and a probiotic supplement (Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011) or a placebo for 6 months. Subjects were randomly assigned into four intervention groups: influenza vaccine and probiotics (n = 141), influenza vaccine and placebo (n = 136), placebo and probiotics (n = 140), and both placebo (n = 137). The primary outcome was ILI incidence within 6 months. The secondary outcomes were seroprotection and seroconversion rates at 1, 4, and 6 months after administering the interventions.<h4>Results</h4>This study showed that the trivalent influenza vaccine increased seroprotection (RR 3.6 [95%CI 2.92-4.47]; p<0.010) and seroconversion (RR 29.8 [95%CI 11.1-79.5]; p<0.010) rates 1 month after vaccination in elderly people while the probiotic supplement did not alter influenza antibody titers (p = 1.000 and p = 0.210). The relative ILI incidence risk was similar between vaccinated and non-vaccinated groups, as well as in the probiotic group compared to the non-probiotic group.<h4>Conclusion</h4>The tested trivalent influenza vaccine significantly induced seroprotection and seroconversion in the vaccinated subjects, while probiotics administration did not influence these parameters. Vaccinated individuals displayed a similarly low ILI incidence as those in the Control Group. However, the observed trend towards a reduction of ILI incidence with probiotics supplementation warrants further assessments in a larger, at-risk population.<h4>Clinical trial registry number</h4>NCT03695432.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0250234&type=printable
spellingShingle Sukamto Koesnoe
Nuning Masjkuri
Asri Adisasmita
Samsuridjal Djauzi
Cissy Kartasasmita
Julitasari Sundoro
Mardiati Nadjib
Mondastri Korib
Alisa Nurul Muthia
Virly Nanda Muzellina
Ummu Habibah
Saskia Aziza Nursyirwan
Kristoforus Hendra Djaya
Novilia Sjafri Bachtiar
Rini Mulia Sari
A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.
PLoS ONE
title A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.
title_full A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.
title_fullStr A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.
title_full_unstemmed A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.
title_short A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia.
title_sort randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza like illness in an elderly population in indonesia
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0250234&type=printable
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