{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T23:38:55Z","timestamp":1772840335504,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Conseller\u00eda de Sanitat Universal i Salut P\u00fablica (Generalitat Valenciana, Spain)","award":["VACOVID-ICI22-014 (UGP-21-280)"],"award-info":[{"award-number":["VACOVID-ICI22-014 (UGP-21-280)"]}]},{"name":"EU Operational Program of the European Regional Development Fund (ERDF) for the Valencian Community 2014\u20132020","award":["VACOVID-ICI22-014 (UGP-21-280)"],"award-info":[{"award-number":["VACOVID-ICI22-014 (UGP-21-280)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Understanding the immune response to SARS-CoV-2 vaccination in cancer patients remains a critical priority given their immunocompromised status. In this prospective observational study, we evaluated humoral and cellular immunity across three time points\u2014baseline, post-second dose, and post-booster\u2014in 23 breast cancer patients undergoing active treatment. IgG antibody levels showed a significant increase following vaccination, with a 300-fold rise after the second dose and a 2200-fold increase post-booster, indicating a strong humoral response. CD19+ B cells also increased significantly, supporting B cell-mediated activation. Although overall T cell frequencies remained stable, we observed a shift toward memory phenotypes, with decreased na\u00efve CD4+ and CD8+ T cells and increased central and peripheral memory subsets after the booster. Notably, CD8+ TEMRA cells expanded significantly, suggesting cytotoxic memory formation. Correlation analyses linked peripheral memory CD4+ T cells with anti-SARS-CoV-2 IgG titers, while CD8+ TEMRA cells showed an inverse association. Antigen-specific CD8+ T cell response was evaluated using APC-labeled MHC I Dextramer reagents. After the booster, 55.5% of patients developed detectable antigen-specific CD8+ T cells, whereas 44.5% did not. Importantly, one patient who failed to develop antigen-specific CD8+ T cells experienced a mild SARS-CoV-2 infection, suggesting that the absence of this response may increase susceptibility despite high IgG levels. These findings indicate that antigen-specific CD8+ T cell responses and antibody levels may act as complementary but not directly correlated arms of immunity. Microbiota profiling via sPLS-DA suggested weak but distinct microbial signatures associated with immune responsiveness, particularly enrichment of taxa such as Alistipes and Romoutsia among high-antibody responders. These findings emphasize that SARS-CoV-2 vaccination is immunogenic and well tolerated in breast cancer patients under therapy and highlight the need to further explore microbiota\u2013immune interactions to optimize vaccination strategies in oncology.<\/jats:p>","DOI":"10.3390\/pathogens14090947","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T10:08:58Z","timestamp":1758276538000},"page":"947","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Immunogenicity of SARS-CoV-2 mRNA Vaccine in Breast Cancer Patients Undergoing Active Treatment: A Prospective Observational Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7123-9834","authenticated-orcid":false,"given":"Mar\u00eda Leonor","family":"Fern\u00e1ndez-Murga","sequence":"first","affiliation":[{"name":"Molecular Oncology Laboratory, Arnau de Vilanova Hospital, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46015 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2509-1176","authenticated-orcid":false,"given":"Luc\u00eda","family":"Serrano-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Molecular Oncology Laboratory, Arnau de Vilanova Hospital, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46015 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0672-2541","authenticated-orcid":false,"given":"Giuseppe","family":"D\u2019Auria","sequence":"additional","affiliation":[{"name":"Sequencing and Bioinformatics Service, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Avda. de Catalunya 21, 46020 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Portero","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Molecular Oncology Laboratory, Arnau de Vilanova Hospital, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46015 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1073-269X","authenticated-orcid":false,"given":"Ll\u00facia","family":"Mart\u00ednez-Priego","sequence":"additional","affiliation":[{"name":"Sequencing and Bioinformatics Service, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Avda. de Catalunya 21, 46020 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loreto","family":"Ferr\u00fas-Abad","sequence":"additional","affiliation":[{"name":"Sequencing and Bioinformatics Service, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Avda. de Catalunya 21, 46020 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Griselda","family":"de Marco","sequence":"additional","affiliation":[{"name":"Sequencing and Bioinformatics Service, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Avda. de Catalunya 21, 46020 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Victoria","family":"Dom\u00ednguez-M\u00e1rquez","sequence":"additional","affiliation":[{"name":"Microbiology Department, Arnau de Vilanova Hospital, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46015 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4515-8293","authenticated-orcid":false,"given":"Antonio","family":"Llombart-Cussac","sequence":"additional","affiliation":[{"name":"Molecular Oncology Laboratory, Arnau de Vilanova Hospital, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), 46015 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/S1470-2045(21)00213-8","article-title":"Safety and Immunogenicity of One versus Two Doses of the COVID-19 Vaccine BNT162b2 for Patients with Cancer: Interim Analysis of a Prospective Observational Study","volume":"22","author":"Monin","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.ccell.2021.06.002","article-title":"Seroconversion Rates Following COVID-19 Vaccination among Patients with Cancer","volume":"39","author":"Thakkar","year":"2021","journal-title":"Cancer Cell"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.annonc.2020.12.019","article-title":"Commentary: SARS-CoV-2 Vaccines and Cancer Patients","volume":"32","author":"Corti","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1038\/s41571-022-00610-8","article-title":"COVID-19 Vaccines in Patients with Cancer: Immunogenicity, Efficacy and Safety","volume":"19","author":"Fendler","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1038\/s41586-020-2814-7","article-title":"COVID-19 Vaccine BNT162b1 Elicits Human Antibody and TH1 T Cell Responses","volume":"586","author":"Sahin","year":"2020","journal-title":"Nature"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and Efficacy of the BNT162b2 MRNA COVID-19 Vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1056\/NEJMoa2028436","article-title":"Safety and Immunogenicity of SARS-CoV-2 MRNA-1273 Vaccine in Older Adults","volume":"383","author":"Anderson","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1016\/j.ccell.2021.07.016","article-title":"Antibody and T Cell Immune Responses Following MRNA COVID-19 Vaccination in Patients with Cancer","volume":"39","author":"Ehmsen","year":"2021","journal-title":"Cancer Cell"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1038\/s41591-021-01386-7","article-title":"CD8+ T Cells Contribute to Survival in Patients with COVID-19 and Hematologic Cancer","volume":"27","author":"Bange","year":"2021","journal-title":"Nat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100283","DOI":"10.1016\/j.esmoop.2021.100283","article-title":"Serologic Response to COVID-19 Infection and\/or Vaccine in Cancer Patients on Active Treatment","volume":"6","author":"Grinshpun","year":"2021","journal-title":"ESMO Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1189\/jlb.5MR0617-216R","article-title":"The Potential of the Microbiota to Influence Vaccine Responses","volume":"103","author":"Lynn","year":"2018","journal-title":"J. Leukoc. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.cell.2014.03.011","article-title":"Role of the Microbiota in Immunity and Inflammation","volume":"157","author":"Belkaid","year":"2014","journal-title":"Cell"},{"key":"ref_13","first-page":"4311","article-title":"Vaccine-Induced T Follicular Helper Cell Responses Are Impaired in Human Infants","volume":"196","author":"Ruck","year":"2016","journal-title":"J. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1038\/nrgastro.2017.20","article-title":"Gut Microbiota Modulation of Chemotherapy Efficacy and Toxicity","volume":"14","author":"Alexander","year":"2017","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1126\/science.aan3706","article-title":"Gut Microbiome Influences Efficacy of PD-1-Based Immunotherapy against Epithelial Tumors","volume":"359","author":"Routy","year":"2018","journal-title":"Science"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1002\/cncr.30039","article-title":"The Role of the Gastrointestinal Microbiome in Infectious Complications during Induction Chemotherapy for Acute Myeloid Leukemia","volume":"122","author":"Smith","year":"2016","journal-title":"Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kim, J., Jeong, J., Lee, C.M., Lee, D.-W., Kang, C.K., Choe, P.G., Kim, N.J., Oh, M., Lee, C.-H., and Park, W.B. (2022). Prospective Longitudinal Analysis of Antibody Response after Standard and Booster Doses of SARS-CoV2 Vaccination in Patients with Early Breast Cancer. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.1028102"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S1470-2045(21)00715-4","article-title":"Immunogenicity and Safety of BNT162b2 MRNA Vaccine Booster in Actively Treated Patients with Cancer","volume":"23","author":"Ligumsky","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_19","first-page":"100445","article-title":"Breakthrough SARS-CoV-2 Infections among Patients with Cancer Following Two and Three Doses of COVID-19 MRNA Vaccines: A Retrospective Observational Study from the COVID-19 and Cancer Consortium","volume":"19","author":"Choueiri","year":"2023","journal-title":"Lancet Reg. Health-Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s10549-022-06693-2","article-title":"Efficacy and Impact of SARS-CoV-2 Vaccination on Cancer Treatment for Breast Cancer Patients: A Multi-Center Prospective Observational Study","volume":"195","author":"Terada","year":"2022","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Safarchi, A., Al-Qadami, G., Tran, C.D., and Conlon, M. (2025). Understanding Dysbiosis and Resilience in the Human Gut Microbiome: Biomarkers, Interventions, and Challenges. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1559521"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Fahn\u00f8e, U., Feng, S., Underwood, A.P., Jacobsen, K., Ameri, A., Blicher, T.H., S\u00f8lund, C.S., Rosenberg, B.R., Brix, L., and Weis, N. (2025). T Cell Receptor Usage and Epitope Specificity amongst CD8+ and CD4+ SARS-CoV-2-Specific T Cells. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1510436"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Underwood, A.P., S\u00f8lund, C., Jacobsen, K., Binderup, A., Fernandez-Antunez, C., Mikkelsen, L.S., Inekci, D., Villadsen, S.L., Castruita, J.A.S., and Pinholt, M. (2024). Neutralizing Antibody and CD8+ T Cell Responses Following BA.4\/5 Bivalent COVID-19 Booster Vaccination in Adults with and without Prior Exposure to SARS-CoV-2. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1353353"},{"key":"ref_24","unstructured":"Stackebrandt, E., and Goodfellow, M. (1991). Sequencing. Nucleic Acid Techniques in Bacterial Systematic, John Wiley and Sons."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1093\/nar\/gkz569","article-title":"High-Throughput Amplicon Sequencing of the Full-Length 16S RRNA Gene with Single-Nucleotide Resolution","volume":"47","author":"Callahan","year":"2019","journal-title":"Nucleic Acids Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1038\/nmeth.3869","article-title":"DADA2: High-Resolution Sample Inference from Illumina Amplicon Data","volume":"13","author":"Callahan","year":"2016","journal-title":"Nat. Methods"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"D590","DOI":"10.1093\/nar\/gks1219","article-title":"The SILVA Ribosomal RNA Gene Database Project: Improved Data Processing and Web-Based Tools","volume":"41","author":"Quast","year":"2013","journal-title":"Nucleic Acids Res."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"L\u00ea Cao, K.-A., Boitard, S., and Besse, P. (2011). Sparse PLS Discriminant Analysis: Biologically Relevant Feature Selection and Graphical Displays for Multiclass Problems. BMC Bioinform., 12.","DOI":"10.1186\/1471-2105-12-253"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Rohart, F., Gautier, B., Singh, A., and L\u00ea Cao, K.-A. (2017). MixOmics: An R Package for \u2018omics Feature Selection and Multiple Data Integration. PLoS Comput. Biol., 13.","DOI":"10.1101\/108597"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3055","DOI":"10.1093\/bioinformatics\/bty1054","article-title":"DIABLO: An Integrative Approach for Identifying Key Molecular Drivers from Multi-Omics Assays","volume":"35","author":"Singh","year":"2019","journal-title":"Bioinformatics"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.annonc.2021.04.019","article-title":"Impaired Immunogenicity of BNT162b2 Anti-SARS-CoV-2 Vaccine in Patients Treated for Solid Tumors","volume":"32","author":"Chamorey","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e02015","DOI":"10.1128\/JVI.02015-19","article-title":"Molecular Mechanism for Antibody-Dependent Enhancement of Coronavirus Entry","volume":"94","author":"Wan","year":"2020","journal-title":"J. Virol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"eabi6950","DOI":"10.1126\/sciimmunol.abi6950","article-title":"Distinct Antibody and Memory B Cell Responses in SARS-CoV-2 Na\u00efve and Recovered Individuals after MRNA Vaccination","volume":"6","author":"Goel","year":"2021","journal-title":"Sci. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/j.immuni.2021.08.001","article-title":"Rapid Induction of Antigen-Specific CD4+ T Cells Is Associated with Coordinated Humoral and Cellular Immunity to SARS-CoV-2 MRNA Vaccination","volume":"54","author":"Painter","year":"2021","journal-title":"Immunity"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1038\/s41586-021-03653-6","article-title":"BNT162b2 Vaccine Induces Neutralizing Antibodies and Poly-Specific T Cells in Humans","volume":"595","author":"Sahin","year":"2021","journal-title":"Nature"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1038\/s41586-021-03841-4","article-title":"Rapid and Stable Mobilization of CD8+ T Cells by SARS-CoV-2 MRNA Vaccine","volume":"597","author":"Oberhardt","year":"2021","journal-title":"Nature"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"108728","DOI":"10.1016\/j.celrep.2021.108728","article-title":"Early Induction of Functional SARS-CoV-2-Specific T Cells Associates with Rapid Viral Clearance and Mild Disease in COVID-19 Patients","volume":"34","author":"Tan","year":"2021","journal-title":"Cell Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1038\/s41586-022-04460-3","article-title":"T Cell Responses to SARS-CoV-2 Spike Cross-Recognize Omicron","volume":"603","author":"Keeton","year":"2022","journal-title":"Nature"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/s41423-020-0447-2","article-title":"High-Dimensional Immune Profiling by Mass Cytometry Revealed Immunosuppression and Dysfunction of Immunity in COVID-19 Patients","volume":"17","author":"Wang","year":"2020","journal-title":"Cell Mol. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1038\/s41590-020-0782-6","article-title":"Broad and Strong Memory CD4+ and CD8+ T Cells Induced by SARS-CoV-2 in UK Convalescent Individuals Following COVID-19","volume":"21","author":"Peng","year":"2020","journal-title":"Nat. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1056\/NEJMoa1406498","article-title":"Genetic Basis for Clinical Response to CTLA-4 Blockade in Melanoma","volume":"371","author":"Snyder","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Reiss, S., Baxter, A.E., Cirelli, K.M., Dan, J.M., Morou, A., Daigneault, A., Brassard, N., Silvestri, G., Routy, J.-P., and Havenar-Daughton, C. (2017). Comparative Analysis of Activation Induced Marker (AIM) Assays for Sensitive Identification of Antigen-Specific CD4 T Cells. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0186998"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Lefebvre, J.S., Masters, A.R., Hopkins, J.W., and Haynes, L. (2016). Age-Related Impairment of Humoral Response to Influenza Is Associated with Changes in Antigen Specific T Follicular Helper Cell Responses. Sci. Rep., 6.","DOI":"10.1038\/srep25051"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.cpt.2023.08.001","article-title":"Impact of Immunosenescence and Inflammaging on the Effects of Immune Checkpoint Inhibitors","volume":"2","author":"Hou","year":"2024","journal-title":"Cancer Pathog. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1016\/j.cell.2017.11.024","article-title":"Our Gut Microbiome: The Evolving Inner Self","volume":"171","author":"Kundu","year":"2017","journal-title":"Cell"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1038\/nature18848","article-title":"The Microbiota in Adaptive Immune Homeostasis and Disease","volume":"535","author":"Honda","year":"2016","journal-title":"Nature"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s12943-024-01990-4","article-title":"Modulation of the Tumor Microenvironment and Mechanism of Immunotherapy-Based Drug Resistance in Breast Cancer","volume":"23","author":"Kundu","year":"2024","journal-title":"Mol. Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/1462-2920.13589","article-title":"Formation of Propionate and Butyrate by the Human Colonic Microbiota","volume":"19","author":"Louis","year":"2017","journal-title":"Environ. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Abriouel, H., Lerma, L.L., Casado Mu\u00f1oz, M.d.C., Montoro, B.P., Kabisch, J., Pichner, R., Cho, G.-S., Neve, H., Fusco, V., and Franz, C.M.A.P. (2015). The Controversial Nature of the Weissella Genus: Technological and Functional Aspects versus Whole Genome Analysis-Based Pathogenic Potential for Their Application in Food and Health. Front. Microbiol., 6.","DOI":"10.3389\/fmicb.2015.01197"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e3698","DOI":"10.7717\/peerj.3698","article-title":"Genomic and Functional Analysis of Romboutsia ilealis CRIB T Reveals Adaptation to the Small Intestine","volume":"5","author":"Gerritsen","year":"2017","journal-title":"PeerJ"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"544","DOI":"10.4161\/gmic.29331","article-title":"Intestinal Microbiota in Metabolic Diseases","volume":"5","author":"Clavel","year":"2014","journal-title":"Gut Microbes"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Alhinai, E.A., Walton, G.E., and Commane, D.M. (2019). The Role of the Gut Microbiota in Colorectal Cancer Causation. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20215295"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.vaccine.2017.08.069","article-title":"The Influence of Probiotics on Vaccine Responses\u2014A Systematic Review","volume":"36","author":"Zimmermann","year":"2018","journal-title":"Vaccine"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/9\/947\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:48:43Z","timestamp":1760035723000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/9\/947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":53,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["pathogens14090947"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14090947","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]}}}