Dietary Inulin to Improve SARS-CoV-2 Vaccine Response in Kidney Transplant Recipients: The RIVASTIM-Inulin Randomised Controlled Trial.

Autor:	Singer J; Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia., Tunbridge MJ; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia., Shi B; Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia., Perkins GB; Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia.; Immunology Directorate, SA Pathology, Adelaide, SA 5000, Australia., Chai CS; Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia., Salehi T; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia., Sim BZ; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia., Kireta S; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia., Johnston JK; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia., Akerman A; Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia., Milogiannakis V; Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia., Aggarwal A; Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia., Turville S; Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia., Hissaria P; Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia.; Department of Immunology and Allergy, Royal Adelaide Hospital, Adelaide, SA 5000, Australia., Ying T; Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia., Wu H; Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia., Grubor-Bauk B; Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia.; Viral Immunology Group, Basil Hetzel Institute for Translational Health Research, University of Adelaide, Adelaide, SA 5011, Australia., Coates PT; Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.; Adelaide Medical School, University of Adelaide, Adelaide, SA 5000, Australia., Chadban SJ; Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.; Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia.
Jazyk:	angličtina
Zdroj:	Vaccines [Vaccines (Basel)] 2024 Jun 03; Vol. 12 (6). Date of Electronic Publication: 2024 Jun 03.
DOI:	10.3390/vaccines12060608
Abstrakt:	Kidney transplant recipients are at an increased risk of hospitalisation and death from SARS-CoV-2 infection, and standard two-dose vaccination schedules are typically inadequate to generate protective immunity. Gut dysbiosis, which is common among kidney transplant recipients and known to effect systemic immunity, may be a contributing factor to a lack of vaccine immunogenicity in this at-risk cohort. The gut microbiota modulates vaccine responses, with the production of immunomodulatory short-chain fatty acids by bacteria such as Bifidobacterium associated with heightened vaccine responses in both observational and experimental studies. As SCFA-producing populations in the gut microbiota are enhanced by diets rich in non-digestible fibre, dietary supplementation with prebiotic fibre emerges as a potential adjuvant strategy to correct dysbiosis and improve vaccine-induced immunity. In a randomised, double-bind, placebo-controlled trial of 72 kidney transplant recipients, we found dietary supplementation with prebiotic inulin for 4 weeks before and after a third SARS-CoV2 mRNA vaccine to be feasible, tolerable, and safe. Inulin supplementation resulted in an increase in gut Bifidobacterium , as determined by 16S RNA sequencing, but did not increase in vitro neutralisation of live SARS-CoV-2 virus at 4 weeks following a third vaccination. Dietary fibre supplementation is a feasible strategy with the potential to enhance vaccine-induced immunity and warrants further investigation.
Databáze:	MEDLINE
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