ELFIN, the United Kingdom preterm lactoferrin trial: interpretation and future questions

Berrington, Janet; McGuire, William; Embleton, Nicholas

doi:10.1139/bcb-2020-0073

Cited by 8 publications

(4 citation statements)

References 39 publications

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“…In another large randomized controlled trial, 2,203 preterm infants (less than 32 weeks) with gestation from 37 hospitals in the United Kingdom were randomly assigned to receive either bLf or an equivalent dose of sucrose placebo until 34 weeks of gestation. Surprisingly, the results showed that enteral supplementation with bLf does not reduce the risk of LOS infection in very preterm infants (58), which is also supported by subsequent studies (59,60). Studies also indicate that LfcinB is conductive in maintaining and repairing intestinal mucosal tissues and preventing intestinal infection caused by rotavirus (61).…”

Section: Lf and Gastrointestinal Healthmentioning

confidence: 69%

Lactoferrin: A glycoprotein that plays an active role in human health

Cao

Ren

et al. 2023

Front. Nutr.

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Lactoferrin (Lf), existing widely in human and mammalian milk, is a multifunctional glycoprotein with many functions, such as immune regulation, anti-inflammation, antibacterial, antiviral, and antioxidant. These extensive functions largely attribute to its ability to chelate iron and interfere with the cellular receptors of pathogenic microorganisms and their hosts. Moreover, it is non-toxic and has good compatibility with other supplements. Thus, Lf has been widely used in food nutrition, drug carriers, biotechnology, and feed development. Although Lf has been continuously explored and studied, a more comprehensive and systematic compendium is still required. This review presents the recent advances in the structure and physicochemical properties of Lf as well as clinical studies on human diseases, with the aim of providing a reference for further research of Lf and the development of its related functional products.

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Section: Lf and Gastrointestinal Healthmentioning

confidence: 69%

Lactoferrin: A glycoprotein that plays an active role in human health

Cao

Ren

et al. 2023

Front. Nutr.

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“…Bovine lactoferrin, alone or in combination with the probiotic Lactobacillus rhamnosus GG has been demonstrated to reduce the first episode of late-onset sepsis in very low birth weight neonates [ 46 ], including candidiasis, apparently in newborns not receiving fluconazole prophylaxis [ 47 ]. However, these results have not been confirmed in a recent large randomized clinical trial [ 48 ].…”

Section: Other Prophylaxis Including Non-pharmacological Approachesmentioning

confidence: 90%

Prophylaxis of Invasive Fungal Infection in Neonates: A Narrative Review for Practical Purposes

Ferrando

Castagnola

2023

JoF

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Candida albicans is the most frequent cause of invasive fungal disease in preterm and/or low birth weight neonates, followed by Candida parapsilosis, whilst infections from other species are rare. Considering the severity of the disease, associated with poor clinical signs and diagnostic difficulties, primary prophylaxis becomes relevant. This paper summarizes the pathogenesis and clinical presentation of invasive candidiasis in neonates, focusing on prophylaxis. For late onset invasive disease, e.g., those occurring after the 3rd (or 7th according to some definitions) day of life possible approaches are the use of fluconazole, recommended in case of weight <1000 g or <1500 g if the local incidence of invasive candidiasis is higher than 2%, or the use of nystatin (for patients < 1500 g). Micafungin must be used in case of colonization by Candida auris, or in centers with a high prevalence of this pathogen. Concurrently, correct management of the central venous catheter and isolation procedures, with special regard to patients colonized by resistant strains, are fundamental. Other approaches such as reduced use of H2 blockers and broad-spectrum antibiotics (e.g., 3rd generation cephalosporins or carbapenems) and promotion of breast feeding proved useful. Reduction of early-onset infections (those occurring in the first 3 days of life) can also be obtained by treating maternal vulvo–vaginal candidiasis, which can represent a fastidious problem during pregnancy. In this case, topic azoles (the only recommendable treatment) can represent a kind of “prophylaxis” of early neonatal candidiasis. However, it must always be remembered that prophylaxis reduces the risk of invasive candidiasis but can not completely eliminate its occurrence, with the parallel risk of selecting for antifungal-resistant strains. Clinicians must maintain a high level of suspicion to start an appropriate therapy and strict epidemiological surveillance to identify the occurrence of clusters and the appearance of strains resistant to prophylaxis.

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“…However, a meta-analysis of data from 12 RCTs showed that LF supplementation in enteral feeding of preterm infants reduces the risk of late infections rather in small studies with poor methodology and publication bias, while large studies with a good methodological quality show no evidence of an effect [ 178 ]. The Enteral Lactoferrin in Neonates (ELFIN) study from the UK, published later, also failed to show that bLF given to premature infants was effective in reducing late sepsis and necrotizing enterocolitis [ 179 , 180 ]. Contradictory results were also obtained in studies on adult patients suffering from acute sepsis.…”

Section: The Role Of Lactoferrin In Lung Diseasesmentioning

confidence: 99%

Potential of Lactoferrin in the Treatment of Lung Diseases

et al. 2023

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Lactoferrin (LF) is a multifunctional iron-binding glycoprotein that exhibits a variety of properties, such as immunomodulatory, anti-inflammatory, antimicrobial, and anticancer, that can be used to treat numerous diseases. Lung diseases continue to be the leading cause of death and disability worldwide. Many of the therapies currently used to treat these diseases have limited efficacy or are associated with side effects. Therefore, there is a constant pursuit for new drugs and therapies, and LF is frequently considered a therapeutic agent and/or adjunct to drug-based therapies for the treatment of lung diseases. This article focuses on a review of the existing and most up-to-date literature on the contribution of the beneficial effects of LF on the treatment of lung diseases, including asthma, viral infections, cystic fibrosis, or lung cancer, among others. Although in vitro and in vivo studies indicate significant potency of LF in the treatment of the listed diseases, only in the case of respiratory tract infections do human studies seem to confirm them by demonstrating the effectiveness of LF in reducing episodes of illness and shortening the recovery period. For lung cancer, COVID-19 and sepsis, the reports are conflicting, and for other diseases, there is a paucity of human studies conclusively confirming the beneficial effects of LF.

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ELFIN, the United Kingdom preterm lactoferrin trial: interpretation and future questions

Cited by 8 publications

References 39 publications

Lactoferrin: A glycoprotein that plays an active role in human health

Lactoferrin: A glycoprotein that plays an active role in human health

Prophylaxis of Invasive Fungal Infection in Neonates: A Narrative Review for Practical Purposes

Potential of Lactoferrin in the Treatment of Lung Diseases

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