Immune Function Clinical Trial
Official title:
Investigation of the Effects of a Prebiotic Supplement on Immune Function in Healthy Human Adults
Prebiotics are naturally occurring carbohydrates found in a variety of edible plants. They are not digested by mammalian enzymes, and so reach the gut intact, where they are fermented by some species of intestinal bacteria. This fermentation is thought to have several benefits for the host including improving immune function. There are numerous methods available for assessing the human immune response. Response to vaccination is thought to be a good method for this. Not many studies have examined the effect of prebiotics on the human immune response to vaccination. Thus the investigators propose to test the effect of a prebiotic on the immune response in healthy volunteers including their response to the current flu vaccine. The investigators hypothesise that the prebiotic will enhance the immune response including the response to the vaccine.
Prebiotics are naturally occurring carbohydrates found in a variety of edible plants. They
are not digested by mammalian enzymes, and so reach the gut intact, where they are fermented
by some species of intestinal bacteria. This fermentation is thought to have several
benefits for the host including improving the immune response. Inulin-type fructans
(oligofructose and inulin) are classified as prebiotics. Inulin is found naturally in
significant amounts in a variety of plants foods, such as bananas, leeks, onions,
artichokes, wheat and chicory. Synergy1 is a prebiotic preparation produced by Beneo-Orafti,
and containing a mixture of oligofructose and inulin derived from chicory.
Fructooligosaccharides including Synergy1 are widely used by the food industry and are
commonly found as a source of insoluble fibre in many biscuit, bakery, cereal and dairy
products.
There is increasing evidence that the changes in the intestinal microflora that occur with
the consumption of fructooligosaccharides can modulate immune parameters, not only in the
gut-associated lymphoid tissue, but also secondary lymphoid tissues and the peripheral
circulation. Much of the evidence for beneficial effects of fructooligosaccharides on immune
function comes from animal models e.g. rats, mice, dogs and pigs. Results from these studies
show that the innate and adaptive immune systems of both the gut associated lymphoid tissue
and the systemic immune system can be modified by fructooligosaccharides. However, there are
few human studies so far which have investigated the effects of prebiotics on immune
function, and these studies mostly rely on systemic markers of immunity. The results show
little effect of fructooligosaccharides on innate immune function, but mixed results are
reported regarding the adaptive immune system, suggesting that there may by improvement on
this aspect of immunity with increased intake of fructooligosaccharides. The small number of
published human studies led Watzl et al. (2005) to suggest that more human studies are
needed to find out whether inulin and/or oligofructose have the potential to modulate
systemic immunity in well-nourished individuals.
There are numerous methods available for assessing the human immune response. These have
been evaluated by a panel of European experts (Albers et al. 2005). Based on its biological
relevance, sensitivity and practical feasibility, response to vaccination was identified by
this panel as the gold standard for measuring the functioning of the immune system in vivo
(Albers et al. 2005). A small number of studies have studied the effect of
fructooligosaccharides on the human immune response using vaccination response as the
outcome, but only four of these examined fructooligosaccharides in the absence of other
additional nutrients and of these two studies were in infants. Thus, the number of studies
examining the immunologic impact of fructooligosaccharides in adult humans and using the
gold standard outcome is very limited. From a public health perspective, it would be of
importance, if fructooligosaccharides can improve immune function especially in older adults
who are at risk of age-related immune decline. Thus, we propose to use a commercially
available influenza vaccine (Imuvac®) to stimulate the immune response in healthy human
adults, and to use this to assess the effect of a well defined prebiotic preparation
commonly used in the food industry (Synergy1).
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Basic Science
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