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: (i) Enhanced inflammatory signatures
(including AP-1/NR4A expression), observed previously in the elderly, and increased
dendritic cell activation; (ii) Divergent metabolic trajectories, with a 1000-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.