食用乳制品对疫苗免疫反应和免疫球蛋白的影响:系统性文献综述

Mina Suh, Meghan Mitchell, Naushin Hooda, Lauren C. Bylsma, Sarah S. Cohen
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摘要

随着 COVID-19 大流行的发生,公众对疫苗接种和免疫保护的兴趣与日俱增。乳制品是蛋白质和其他营养物质的重要来源,而有关乳制品对增强免疫反应的潜在健康影响的研究问题尚未解决。我们进行了一次系统的文献综述,对已发表的有关乳制品干预对以下方面影响的文献进行了归纳:1)疫苗特异性免疫反应;2)未接种疫苗时的免疫球蛋白。为了评估研究的有效性和质量,我们使用了营养与饮食学院质量标准检查表。共纳入 61 项研究(59 项临床试验、1 项队列研究和 1 项横断面调查),时间跨度为 1983 年至 2017 年。10 项试验评估了乳制品干预对疫苗特异性 IgG、IgA、IgM、疫苗特异性抗体滴度、血清保护率或血清转换率的影响。其中,7 项研究报告了乳制品干预对疫苗接种后破伤风抗体、破伤风抗体水平平均变化、阿德莱德沙门氏菌鞭毛蛋白总抗体滴度、乙型流感平均抗体滴度、流感特异性 IgA 和 IgG 水平以及甲型流感和乙型流感血清转换率或血清保护率的显著影响。研究结果各不相同,一些研究报告称免疫球蛋白(IgA、IgE或IgG)显著增强,而另一些研究则观察到组间无差异。这些研究没有调查免疫球蛋白变化的临床意义。乳制品及其成分可增强疫苗的功效。本综述强调了证据差距,并为进一步研究提供了潜在的路线图。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of Dairy Consumption on Vaccine Immune Response and Immunoglobulins: A Systematic Literature Review
Public health interest in vaccinations and immune protection has increased with the COVID-19 pandemic. Dairy products are an important source of protein and other nutrients, and there are unresolved research questions regarding the potential health impact of dairy products on the enhancement of immune response. A systematic literature review was conducted to synthesize the published literature reporting the effects of dairy interventions on: 1) the vaccine-specific immune response and 2) immunoglobulins in the absence of vaccination. To assess study validity and quality, we used the Academy of Nutrition and Dietetics Quality Criteria Checklist. Sixty-one studies (59 clinical trials, 1 cohort, 1 cross-sectional survey) were included, spanning 1983-2017. Ten trials evaluated the effect of dairy intervention on vaccine-specific IgG, IgA, IgM, vaccine-specific antibody titers, seroprotection rates, or seroconversion rates. Of these, 7 reported significant increases with dairy interventions for post-vaccine tetanus antibodies, mean change in tetanus antibody level, total antibody titers to flagellin from Salmonella Adelaide, mean antibody titers to influenza B, influenza-specific IgA and IgG levels, and seroconversion or seroprotection rates for influenza A and B. Fifty-six studies evaluated dairy’s effects on immunoglobulins without vaccinations. The results were heterogenous, with some studies reporting significant enhancement of immunoglobulins (IgA, IgE, or IgG), while others observed no differences between groups. Clinical relevance of the immunoglobulin changes was not investigated in these studies. Dairy products and their components could enhance the efficacy of vaccines. This review highlights the evidence gaps and provides a potential roadmap for additional research.
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