Journal Article

Impact of Vitamin D Supplementation on Influenza Vaccine Response and Immune Functions in Deficient Elderly Persons: A Randomized Placebo-Controlled Trial

CHU Gabriel Montpied [Clermont-Ferrand] ; CHU Clermont-Ferrand, Vasson, Marie-Paule, M.-P, Talvas, Jeremie, Laurichesse, Henri, Brachet, Patrick, Image Science for Interventional Techniques (ISIT) ; Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Sapin, Vincent, Université d'Auvergne - Clermont-Ferrand I (UdA), Neuro-Dol (Neuro-Dol) ; Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies infectieuses et tropicales, Corbin, Violaine, Evrard, Bertrand, Unité de Nutrition Humaine (UNH) ; Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre d'Investigation Clinique [CHU Clermont-Ferrand] (CIC 1405) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction de la Recherche Clinique et de l’Innovation [CHU Clermont-Ferrand] (DRCI) ; CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service Biochim

2019

Overview

Immunosenescence contributes to reduced vaccine response in elderly persons, and is worsened by deficiencies in nutrients such as Vitamin (Vit-D). The immune system is a well-known target of Vit-D, which can both potentiate the innate immune response and inhibit the adaptive system, and so modulate vaccination response. This randomized placebo-controlled double-blind trial investigated whether Vit-D supplementation in deficient elderly persons could improve influenza seroprotection and immune response. Deficient volunteers (Vit-D serum <30 ng/mL) were assigned (V1) to receive either 100,000 IU/15 days of cholecalciferol (D, = 19), or a placebo (P, = 19), over a 3 month period. Influenza vaccination was performed at the end of this period (V2), and the vaccine response was evaluated 28 days later (V3). At each visit, serum cathelicidin, immune response to vaccination, plasma cytokines, lymphocyte phenotyping, and phagocyte ROS production were assessed. Levels of serum 25-(OH)D increased after supplementation (D group, V1 vs. V2: 20.7 ± 5.7 vs. 44.3 ± 8.6 ng/mL, < 0.001). No difference was observed for serum cathelicidin levels, antibody titers, and ROS production in D vs. P groups at V3. Lower plasma levels of TNFα ( = 0.040) and IL-6 ( = 0.046), and higher ones for TFGβ ( = 0.0028) were observed at V3. The Th1/Th2 ratio was lower in the D group at V2 (D: 0.12 ± 0.05 vs. P: 0.18 ± 0.05, = 0.039). Vit-D supplementation promotes a higher TGFβ plasma level in response to influenza vaccination without improving antibody production. This supplementation seems to direct the lymphocyte polarization toward a tolerogenic immune response. A deeper characterization of metabolic and molecular pathways of these observations will aid in the understanding of Vit-D's effects on cell-mediated immunity in aging. This clinical trial was registered at clinicaltrials.gov as NCT01893385.

• Publisher: CCSD,Frontiers,Frontiers Media SA,Frontiers Media S.A
• Subject: Aged / aging / Antibodies / Antigens / Bacterial infections / Blood / cathelicidin / Cell-mediated immunity / Clinical trials / cytokine / Cytokines / Dietary Supplements / Double-Blind Method / Female / Flow cytometry / Geriatrics / Humans / Immune response / Immune Tolerance / Immunology / Immunosenescence / Influenza / influenza vaccination / Influenza Vaccines - immunology / Influenza, Human - immunology / Innate immunity / leukocyte phenotyping / Leukocytes / Life Sciences / Lymphocytes / Lymphocytes T / Male / Medication / Neurons and Cognition / Older people / Orthomyxoviridae - physiology / Pharmaceutical sciences / Pharmacology / Placebo Effect / Placebos / Plasma levels / Statistical analysis / Th1 Cells - immunology / Th1-Th2 Balance / Th2 Cells - immunology / Transforming Growth Factor beta - blood / Vaccination / Vaccines / Vitamin D / Vitamin D - administration & dosage / Vitamin D Deficiency - immunology / vitamin-D deficiency