Antibiotics-Driven Gut Microbiome Perturbation Alters Immunity to Vaccines in Humans

Emerging evidence indicates a central role for the microbiome in immunity. However, causal evidence in humans is sparse. Here, we administered broad-spectrum antibiotics to healthy adults prior and subsequent to seasonal influenza vaccination. Despite a 10,000-fold reduction in gut bacterial load and long-lasting diminution in bacterial diversity, antibody responses were not significantly affected. However, in a second trial of subjects with low pre-existing antibody titers, there was significant impairment in H1N1-specific neutralization and binding IgG1 and IgA responses. In addition, in both studies antibiotics treatment resulted in (1) enhanced inflammatory signatures (including AP-1/NR4A expression), observed previously in the elderly, and increased dendritic cell activation; (2) divergent metabolic trajectories, with a 1,000-fold reduction in serum secondary bile acids, which was highly correlated with AP-1/NR4A signaling and inflammasome activation. Multi-omics integration revealed significant associations between bacterial species and metabolic phenotypes, highlighting a key role for the microbiome in modulating human immunity. [Display omitted] •Microbiome loss impairs antibody response in subjects with low pre-existing immunity•Antibiotics treatment leads to enhanced inflammatory signatures in the blood•Loss of secondary bile acids is linked to AP-1/NR4A and inflammasome activation•Integrative analysis reveals divergent mechanisms of microbiome influence on immunity Antibiotic-use-induced alterations to the gut microbiome can adversely affect immunogenicity and responses to influenza vaccination in humans.