Abstract

BackgroundThe bacillus Calmette-Guérin (BCG) vaccine protects against tuberculosis and heterologous infections but elicits high inter-individual variation in specific and nonspecific, or trained, immune responses. While the gut microbiome is increasingly recognized as an important modulator of vaccine responses and immunity in general, its potential role in BCG-induced protection is largely unknown.ResultsStool and blood were collected from 321 healthy adults before BCG vaccination, followed by blood sampling after 2 weeks and 3 months. Metagenomics based on de novo genome assembly reveals 43 immunomodulatory taxa. The nonspecific, trained immune response is detected by altered production of cytokines IL-6, IL-1β, and TNF-α upon ex vivo blood restimulation with Staphylococcus aureus and negatively correlates with abundance of Roseburia. The specific response, measured by IFN-γ production upon Mycobacterium tuberculosis stimulation, is associated positively with Ruminococcus and Eggerthella lenta. The identified immunomodulatory taxa also have the strongest effects on circulating metabolites, with Roseburia affecting phenylalanine metabolism. This is corroborated by abundances of relevant enzymes, suggesting alternate phenylalanine metabolism modules are activated in a Roseburia species-dependent manner.ConclusionsVariability in cytokine production after BCG vaccination is associated with the abundance of microbial genomes, which in turn affect or produce metabolites in circulation. Roseburia is found to alter both trained immune responses and phenylalanine metabolism, revealing microbes and microbial products that may alter BCG-induced immunity. Together, our findings contribute to the understanding of specific and trained immune responses after BCG vaccination.

Highlights

  • The bacillus Calmette-Guérin (BCG) vaccine protects against tuberculosis and heterologous infections but elicits high inter-individual variation in specific and nonspecific, or trained, immune responses

  • The bacillus Calmette-Guérin (BCG) vaccine consists of the live attenuated microorganism Mycobacterium bovis and partially protects against tuberculosis caused by Mycobacterium tuberculosis in humans

  • Microbial profile of study cohort To study the influence of the microbiome on BCG-induced trained immunity, we vaccinated 321 healthy individuals of Western European background with BCG [18–75 years old, median age 23 years, 57% female, 83% body mass index (BMI) between 18.5 and 25]

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Summary

Introduction

The bacillus Calmette-Guérin (BCG) vaccine protects against tuberculosis and heterologous infections but elicits high inter-individual variation in specific and nonspecific, or trained, immune responses. In monocytes and natural killer cells, trained immunity induced by BCG vaccination leads to increased production of pro-inflammatory cytokines upon restimulation with nonspecific pathogens, such as Staphylococcus aureus and Candida albicans [6, 7]. These effects are enabled by modulation of hematopoietic stem and progenitor cells in the bone marrow [8, 9] and last for at least 1 year [10]. BCG is not effective in all individuals, and host and environmental factors underlying inter-individual variability of specific and trained immune responses to BCG vaccination are currently incompletely understood [6, 11]

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