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Interactions between the immune system and the intestinal microbiota may play a role in coeliac disease (CD). In the present study, the potential effects of Bifidobacterium longum CECT 7347 in children with newly diagnosed CD were evaluated. A double-blind, randomised, placebo-controlled trial was conducted in thirty-three children who received a capsule containing either B. longum CECT 7347 (10 9 colony-forming units) or placebo (excipients) daily for 3 months together with a gluten-free diet (GFD). Outcome measures (baseline and post-intervention) included immune phenotype of peripheral blood cells, serum cytokine concentration, faecal secretory IgA (sIgA) content, anthropometric parameters and intestinal microbiota composition. Comparisons between the groups revealed greater height percentile increases ( P = 0·048) in the B. longum CECT 7347 group than in the placebo group, as well as decreased peripheral CD3 + T lymphocytes ( P = 0·004) and slightly reduced TNF-α concentration ( P = 0·067). Within-group comparisons of baseline and final values did not reveal any differences in T lymphocytes and cytokines in the placebo group, while decreased CD3 + ( P = 0·013) and human leucocyte antigen (HLA)-DR + T lymphocytes ( P = 0·029) and slightly reduced TNF-α concentration ( P = 0·085) were detected in the B. longum CECT 7347 group. Comparison between the groups showed that the administration of B. longum CECT 7347 reduced the numbers of the Bacteroides fragilis group ( P = 0·020) and the content of sIgA in stools ( P = 0·011) compared with the administration of placebo. Although this is a first exploratory intervention with limitations, the findings suggest that B. longum CECT 7347 could help improve the health status of CD patients who tend to show alterations in gut microbiota composition and a biased immune response even on a GFD.

Purpose Currently, there is no consensus concerning the possible beneficial colonic and systemic effects of prebiotic-containing infant formula. This study assesses whether the feeding of a galactooligosaccharides (GOS)-containing infant formula (0.44 g/dl of GOS) and the subsequent feeding of a GOS-containing follow-on formula (0.50 g/dl of GOS) have a prebiotic effect on intestinal microbiota that helps to decrease infections and allergy manifestations in healthy infants during the first year of life. Methods A multicentre, randomised, double-blind and placebo-controlled trial was carried out on 365 healthy term infants enrolled before 8 weeks of age and randomly assigned to a formula with or without GOS, until 12 months of age. The incidence of infections and allergy manifestations, the antibiotics prescribed and faecal characteristics were recorded up to 12 months of age, while faecal samples were collected up to 4 months for the measurement of secretory immunoglobulin A, short-chain fatty acids and microbiota. Results A prebiotic effect on the faecal analysis was observed at 4 months of life. The GOS group showed a lower faecal pH ( P  = 0.019), a lower decreasing trend in secretory immunoglobulin A ( P  = 0.078), lower butyric acid concentration ( P  = 0.040) and an increase in Bifidobacterium counts ( P  = 0.010). Changes in faecal characteristics involved greater frequency ( P  < 0.001) and softer consistency ( P  < 0.05). The incidence of infections or allergic manifestations during the first year of life was similar in both groups, with no statistical differences ( P  > 0.05). Conclusions The feeding of GOS-containing infant formula produced a definite prebiotic effect consisting of changes in faecal composition and microbiota, and in faecal consistency and the frequency of defaecation. No changes in the incidence of infection or allergic manifestation during the first year of life were observed.

We prospectively examined whether psychological factors influence (a) respiratory tract infection (RTI) risk and (b) the mucosal immune response to exercise. In Study 1, n = 406 adults (67% male) recorded RTI symptoms for two weeks before and after a marathon. In Study 2, under controlled laboratory conditions, n = 45 adults (51% male) completed 60 min of running at 65% V̇O2peak (EX) and seated rest (CON) in randomised order. Anxiety, total mood disturbance (TMD) and perceived psychological stress were measured before exercise. Saliva collected pre‐ and post‐exercise was analysed for secretory immunoglobulin A (SIgA). Fifty runners suffered an RTI post‐marathon. Runners prospectively reporting high trait anxiety or TMD were more likely to suffer an RTI post‐marathon (OR [95% CI] = 1.06 [1.02–1.11] and 1.04 [1.01–1.07], respectively). Higher trait anxiety and TMD were associated with a greater reduction in saliva SIgA (p < 0.05). There was no association between mucosal immunity and RTI risk (OR [95% CI] = 1.00 [0.97–1.01]). In Study 2, despite no significant difference between EX and CON (p > 0.05), psychological factors were associated with the SIgA secretion rate response to exercise in men (trait anxiety, state anxiety, TMD, psychological stress: r = −0.55, −0.65, −0.61 and −0.66, respectively; p < 0.01). In conclusion, anxiety and mood disturbance were prospectively associated with infection risk after a marathon and the mucosal immune response to exercise. Athletes should optimise psychological well‐being to support immune health. Researchers should take account of psychological factors when examining the mucosal immune response to exercise. Highlights Psychological factors, including anxiety and mood disturbance, were prospectively associated with respiratory infection risk after a marathon and the mucosal immune response to exercise. Athletes should take steps to minimise exposure to high stress and anxiety and improve mood prior to competition to support immune health and infection resistance. Researchers should account for psychological stress and anxiety when examining the immune response to exercise.

A Proteosome-adjuvanted trivalent inactivated influenza vaccine (P-TIV) administered intra-nasally was shown to be safe, well tolerated and immunogenic in both systemic and mucosal compartments, and effective at preventing illness associated with evidence of influenza infection. In two separate studies using the human viral challenge model, subjects were selected to be immunologically naive to A/Panama/2007/1999 (H3N2) virus and then dosed via nasal spray with one of three regimens of P-TIV or placebo. One or two doses, 15 μg or 30 μg, were given either once only or twice 14 days apart (1 x 30 μg, 2 x 30 μg, 2 x 15 μg) and subjects were challenged with A/Panama/2007/1999 (H3N2) virus. Immune responses to the vaccine antigens were measured by haemagglutination inhibition assay (HAI) and nasal wash secretory IgA (sIgA) antibodies. Vaccine reactogenicity was mild, predictable and generally consistent with earlier Phase I studies with this vaccine. Seroconversion to A/Panama/2007/1999 (H3N2), following vaccination but prior to challenge, occurred in 57% to 77% of subjects in active dosing groups and 2% of placebo subjects. The greatest relative rise in sIgA, following vaccination but prior to challenge, was observed in groups that received 2 doses. Intranasal vaccination significantly protected against influenza (as defined by influenza symptoms combined with A/Panama seroconversion) following challenge with A/Panama/2007/1999 (H3N2). When data were pooled from both studies, efficacy ranged from 58% to 82% in active dosing groups for any influenza symptoms with seroconversion, 67% to 85% for systemic or lower respiratory illness and seroconversion, and 65% to 100% for febrile illness and seroconversion. The two dose regimen was found to be superior to the single dose regimen. In this study, protection against illness associated with evidence of influenza infection (evidence determined by seroconversion) following challenge with virus, significantly correlated with pre-challenge HAI titres (p = 0.0003) and mucosal sIgA (p≤0.0001) individually, and HAI (p = 0.028) and sIgA (p = 0.0014) together. HAI and sIgA levels were inversely related to rates of illness. ClinicalTrials.gov NCT02522754.

Although some probiotic bacteria have been reported to prevent infections in children, there are few well-designed double-blind studies. Here we evaluated the effects of a probiotic strain of lactic acid bacteria (LAB), Pediococcus acidilactici K15, on viral respiratory tract infections in preschool children. A four-month, randomized, double-blind, placebo-controlled study was performed in 172 healthy children aged 3 to 6 years. Subjects were administered dextrin alone or dextrin including heat-killed K15 (5 × 1010 bacteria). The number of febrile days was the primary outcome. The number of absent days from preschools and the influenza incidence were secondary outcomes. Secretory IgA (sIgA) concentrations in saliva were measured as an exploratory outcome. The primary and secondary outcomes were not significantly different between both groups. Analyses in children with little intake of fermented foods including LAB showed that the duration of a fever significantly decreased by K15 intake. The salivary sIgA level in the K15 group was maintained significantly higher than it was in the placebo group. The effects of K15 on preventing viral respiratory tract infections were not observed without the restriction of fermented foods intake. However, K15 supported anti-infectious immune systems in children who took less fermented foods and the maintenance of salivary sIgA levels in all subjects.

Background Saliva is a useful diagnostic tool for analysis in sports, exercise and nutrition research, as collection is easy and non-invasive and it contains a large number of analytes affected by a range of physiological and pathological stressors and conditions. This study examined key salivary electrolytes and stress and immune markers in males and females at rest and during exercise. Methods Unstimulated whole saliva from 20 healthy, recreationally active participants (8 males and 12 females) was analysed for flow rate, osmolality, sodium (Na + ), potassium (K + ), chloride (Cl − ), secretory immunoglobulin A (SIgA), α-amylase activity and cortisol during both rest and moderate intensity (70% peak power) cycling exercise in a randomised crossover design. Each trial lasted 60 min and sampling was carried out at 15 and 45 min after the start of the trial. Saliva was collected using the gold-standard drool method; participants were required to provide at least 1 mL sample over 2 or 3-min period. Results Females showed a greater response to steady-state exercise stress than males, with significant increases in osmolality ( P < 0.001), α-amylase activity ( P = 0.001) and secretion rate ( P = 0.023) and SIgA secretion rate ( P = 0.023), with trends for an increase in K + ( P = 0.053) and decrease in Cl− ( P = 0.067). There were no differences between rest and exercise for any salivary analytes in males. In addition, females showed a trend for higher levels of cortisol than males at both rest ( P = 0.099) and exercise ( P = 0.070), as well as a higher heart rate ( P < 0.001) and greater ratings of perceived exertion ( P < 0.001) during the exercise trial. The coordination of the two stress response pathways (α-amylase vs cortisol) was positive in males ( r = 0.799; P = 0.017) yet negative in females ( r = −0.475; P = 0.036). Conclusions Males and females show a markedly different response to steady-state exercise stress as measured in unstimulated whole saliva.

PurposePeriods of intensified training are associated with immune disturbances, The aim was to investigate the effects of supplementation with Chlorella pyrenoidosa (Chlorella) on secretory IgA (sIgA) responses to 2 days intensified training.MethodsTwenty-six subjects (age 29.1 ± 8.7 years; VO2max 53.7 ± 11.7 ml kg min−1) provided resting saliva samples for determination of sIgA, at baseline (week-0) and following 4, 5, and 6 weeks (weeks-4, -5, -6) of daily supplementation with 6 g/day Chlorella (n = 13) or placebo (PLA, n = 13). During week-4 a 2-day intensified training period was undertaken [morning and afternoon sessions each day, respectively: VO2max test; high-intensity interval training (HIIT, 3 × 30 s Wingate sprints); 90 min at ~60% VO2max; 3 × 30 s HIIT].ResultsChlorella increased resting sIgA secretion rate (trial × time, P = 0.016: no change with PLA but increases with Chlorella at week-4, week-5 and week-6, P = 0.020, <0.001, and 0.016). PLA vs Chlorella: week-0 = 54 ± 33 vs 57 ± 37 µg/min; week-4 = 54 ± 35 vs 83 ± 57 µg/min; week-5 = 63 ± 46 vs 98 ± 47 µg/min; week-6 = 58 ± 35 vs 85 ± 59 µg/min. Minimal acute changes in sIgA were seen in response to individual exercise bouts, but it was higher at some times in the Chlorella group (for bouts 2 and 3).ConclusionSupplementation with Chlorella has beneficial effects on resting sIgA, which might be beneficial during periods of intensified training.

The gut microbiota plays an important role in the development of the immune and gastrointestinal systems of infants. In the present study, we investigated whether increased salmon consumption during pregnancy, maternal weight gain during pregnancy or mode of infant feeding alter the markers of gut immune defence and inflammation. Women (n 123) who rarely ate oily fish were randomly assigned to continue consuming their habitual diet or to consume two 150 g portions of farmed salmon per week from 20 weeks of pregnancy to delivery. Faecal samples were collected from the mothers (n 75) at 38 weeks of gestation and from their infants (n 38) on days 7, 14, 28 and 84 post-partum. Fluorescence in situ hybridisation was used to determine faecal microbiota composition and ELISA to measure faecal secretory IgA (sIgA) and calprotectin concentrations. There was no effect of salmon consumption on maternal faecal microbiota or on maternal or infant faecal sIgA and calprotectin concentrations. The degree of weight gain influenced maternal faecal microbiota, and the mode of infant feeding influenced infant faecal microbiota. Faecal samples collected from infants in the salmon group tended to have lower bacterial counts of the Atopobium cluster compared with those collected from infants in the control group (P= 0·097). This difference was significant in the formula-fed infants (P< 0·05), but not in the exclusively breast-fed infants. In conclusion, the impact of oily fish consumption during pregnancy on maternal and infant gut microbiota composition is limited, but significant differences are associated with maternal weight gain during pregnancy and mode of infant feeding.

The aim of this study was to evaluate the effect on oral health, at age 9 years, of daily oral supplementation with the probiotic Lactobacillus reuteri, strain ATCC 55730, to mothers during the last month of gestation and to children through the first year of life. The study was a single-blind, placebo-controlled, multicenter trial involving 113 children: 60 in the probiotic and 53 in the placebo group. The subjects underwent clinical and radiographic examination of the primary dentition and carious lesions, plaque and gingivitis were recorded. Saliva and plaque were sampled for determination of mutans streptococci (MS) and lactobacilli (LB) in saliva and plaque as well as salivary secretory IgA (SIgA). Forty-nine (82%) children in the probiotic group and 31 (58%) in the placebo group were caries-free (p < 0.01). The prevalence of approximal caries lesions was lower in the probiotic group (0.67 ± 1.61 vs. 1.53 ± 2.64; p < 0.05) and there were fewer sites with gingivitis compared to the placebo group (p < 0.05). There were no significant differences between the groups with respect to frequency of toothbrushing, plaque and dietary habits, but to intake of fluoride supplements (p < 0.05). There were no intergroup differences with respect to L. reuteri, MS, LB or SIgA in saliva. Within the limitation of this study it seems that daily supplementation with L. reuteri from birth and during the first year of life is associated with reduced caries prevalence and gingivitis score in the primary dentition at 9 years of age.

The aim of the present study was to evaluate the safety, tolerance and preventive effect on atopic dermatitis of an experimental α-lactalbumin-enriched and symbiotic-supplemented infant formula. A total of ninety-seven non-breastfed term neonates were enrolled into a double-blind, multicentre, randomised controlled trial in which they received experimental (n 48) or standard formula (n 49) for 6 months. The primary outcome was weight at 6 months of age. Secondary outcomes were gastrointestinal tolerance and manifestation of atopic dermatitis. Faecal secretory IgA (SIgA) concentration and microbiota composition of forty-three infants were analysed at 1 and 6 months. Growth was similar in both groups. At 1 month, compared to those in the control group, infants in the experimental group exhibited less crying or agitation, and more quiet behaviour (P = 0·03). At 6 months, atopic dermatitis was less frequently observed in the experimental group (P < 0·05). Decrease of faecal SIgA concentration between 1 and 6 months was mainly observed in the control group. This decrease was significantly associated with atopic dermatitis (P < 0·014) and negatively correlated to the level of colonisation by bifidobacteria (P < 0·005). In conclusion, compared to the control formula, the experimental formula guaranteed a similar growth, was better tolerated at 1 month and had a protective effect against the development of atopic dermatitis.