Abstract
BackgroundIn preterm infants, a decreased immunological response and lower serological effectiveness are observed after immunizations due to ineffectiveness of both humoral and cellular immune mechanisms.ObjectiveTo determine the effect of 80% neutral oligosaccharides [small-chain galacto-oligosaccharides/long-chain fructo-oligosaccharides (scGOS/lcFOS)] in combination with 20% pectin-derived acidic oligosaccharides (pAOS) on antibody concentrations after DTaP-IPV-Hib immunization in preterm infants.DesignIn this randomized clinical trial, preterm infants with gestational age <32 weeks and/or birth weight <1500 g received enteral supplementation with scGOS/lcFOS/pAOS or placebo (maltodextrin) between days 3 and 30 of life. Blood samples were collected at 5 and 12 months of age.ResultsIn total, 113 infants were included. Baseline and nutritional characteristics were not different in both groups. Geometric mean titers were not different after prebiotic supplementation at 5 months, Ptx (37/44 EU/ml), FHA (78/96 EU/ml), Prn (78/80 EU/ml), Diphtheria (0.40/0.57 IU/ml), Tetanus (0.74/0.99 IU/ml) and Hib (0.35/0.63 µg/ml), and at 12 months Ptx (55/66 EU/ml), FHA (122/119 EU/ml), Prn (116/106 Eu/ml), Diphtheria (0.88/1.11 IU/ml), Tetanus (1.64/1.79 IU/ml) and Hib (2.91/2.55 µg/ml).ConclusionsEnteral supplementation of neutral (scGOS/lcFOS) and acidic oligosaccharides (pAOS) does not improve the immunization response in preterm infants.Trial RegistrationControlled-Trials.com ISRCTN16211826 ISRCTN16211826
Highlights
Preterm infants have an immature immune system
Preterm infants receive less immunoglobulin G (IgG) from their mothers during pregnancy than term infants, which makes them vulnerable for infectious diseases during the first months of life. [1,2,3] Primary immunizations of infants in the Netherlands with a diphtheria, tetanus, acellullar pertussis, polio and Haemophilus influenzae type b combination vaccine (DTaP-IPV-Hib) are recommended at the age of 2, 3 and 4 months followed by a booster dose at 11 months, irrespective of gestational age (GA) at birth [4]
Lower antibody responses to Hib have been found in several studies in preterm infants with a GA,32 weeks compared with term infants. [5,6,7] immunoglobulin G (IgG) antibody response after acellullar pertussis immunization was lower in preterm infants compared with term infants [8]
Summary
A decreased immunological response and lower serological effectiveness are observed after immunizations due to ineffectiveness of both humoral and cellular immune mechanisms These have been measured in antibody responses after vaccinations. [5,6,7] immunoglobulin G (IgG) antibody response after acellullar pertussis immunization was lower in preterm infants compared with term infants [8]. In previous studies in preterm and term infants, supplementation with neutral oligosaccharides stimulated a bifidogenic intestinal microflora with a decrease of pathogens.
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