Bovine Lactoferrin in the Prevention of Antibiotic-Associated Diarrhea in Children: A Randomized Clinical Trial

Wronowski, Michał; Kotowska, Maria; Banasiuk, Marcin; Kotowski, Artur; Kuźmicka, Weronika; Albrecht, Piotr

doi:10.3389/fped.2021.675606

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…Several studies assessed the efficacy of lactoferrin in neonates, infants, and children on gut health and neonatal sepsis and found that it is effective with almost no adverse effects. 10 , 11 The efficacy of lactoferrin in the treatment of IBD-related anemia was not previously studied. Therefore, the aim of this study was to compare the effect of lactoferrin versus oral ferrous sulfate as an iron supplement in the treatment of IDA in children with IBD.…”

Section: Introductionmentioning

confidence: 99%

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

et al. 2022

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Background Iron-deficiency anemia (IDA) is common in children with inflammatory bowel disease (IBD); however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. We compared the effect of lactoferrin versus oral ferrous sulfate for the treatment of IDA in children with IBD. Methods Ninety-two IBD children with IDA were included but only 80 children completed the study and they were randomized into two groups: ferrous sulfate group (n = 40) who received ferrous sulfate 6 mg/kg/day for 3 months and lactoferrin group (n = 40) who received lactoferrin 100 mg/day for 3 months. Complete blood count, serum iron, total iron-binding capacity (TIBC), transferrin saturation (TS), serum ferritin, interleukin-6 (IL-6), and hepcidin 25 were measured before and after the treatment. Results Hemoglobin (Hb), mean corpuscular volume, serum iron, TS, and serum ferritin significantly increased, while TIBC decreased significantly after the administration of either ferrous sulfate or lactoferrin compared to their baseline data. In addition, lactoferrin significantly increased Hb, serum iron, TS, and serum ferritin compared to ferrous sulfate. Moreover, lactoferrin significantly decreased IL-6 and hepcidin levels. Conclusion Lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA. Clinical trial registration The study was registered at www.pactr.org (PACTR202002763901803). Impact Iron-deficiency anemia (IDA) in children with inflammatory bowel disease (IBD) is treated with oral iron therapy; however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. To the best of our knowledge, our study was the first in pediatrics that compared the effect of lactoferrin versus oral ferrous sulfate as an iron supplement for the treatment of IDA in children with IBD. We found that lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.

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Section: Introductionmentioning

confidence: 99%

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

et al. 2022

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“…Bacteroidetes and Firmicutes account for 90% of the human GM (Jandhyala SM et al 2015). The proportions of Firmicutes, including Listeria and Streptococcus, are reported to decrease in response to diseases (Lanza VF et al 2015;Wronowski MF et al 2021). Gram-positive bacteria, such as Lactococcus, Lactobacillus, and Listeria, help to maintain the composition of the GM and prevent pathogen invasion (Garneau JE et al 2008).…”

Section: Discussionmentioning

confidence: 99%

Portulaca oleracea exhibited anti-coccidian activity, fortified the gut microbiota of Hu lambs

li,

liu

et al. 2024

Preprint

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Coccidia of the genus Eimeriaare important pathogens that cause coccidiosis in livestockand poultry. Due to the expansion of intensive farming, coccidiosis has become more difficult to control. In addition, the continued use of anti-coccidiosis drugs has led to drug resistance and residue. Some herbs used in traditional Chinese medicine (TCM) have been shown to alleviate the clinical symptoms of coccidiosis, while enhancing immunity and growth performance (GP) of livestock and poultry. Previous in vitro and in vivo studies have reported that the TCM herb Portulaca oleracea exhibited anti-parasitic activities. In total, 36 female Hu lambs were equally divided into six treatment groups: PL (low-dose P. oleracea), PH (high-dose P. oleracea), PW (P. oleracea water extract), PE (P. oleracea ethanol extract), DIC (diclazuril), and CON (control). The treatment period was 14 days. The McMaster counting method was used to evaluate the anti-coccidiosis effects of the different treatments. Untargeted metabolomics and 16S rRNA gene sequencing were used to investigate the effects of treatment on the gut microbiota (GM) and GP. The results showed that P. oleracea ameliorated coccidiosis, improved GP, increased the abundances of beneficial bacteria, and maintained the composition of the GM, but failed to completely clear coccidian oocysts. The Firmicutes to Bacteroidesratio was significantly increased in the PH group. P. oleracea increased metabolism of tryptophan as well as some vitamins and cofactors in the GM and decreased the relative content of arginine, tryptophan, niacin, and other nutrients, thereby promoting intestinal health and enhancing GP. As an alternative to the anti-coccidiosis drug DIC, P. oleraceaeffectively inhibited growth of coccidia, maintained the composition of the GM, promoted intestinal health, and increased nutrient digestibility.

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“…The results of this study are similar to those of Li ( 43 ) on the effect of Astragalus membranaceus polysaccharides on intestinal flora diversity of AAD diarrhea mice. Firmicutes are usually the representative of the intestinal flora of healthy individuals and may decrease with the occurrence of diseases ( 44 ). They contain a large number of Gram-positive bacteria, such as Lactococcus, Lactobacillus, Listeri , and so on, most of which are considered beneficial bacteria, helping to maintain the intestinal flora balance and prevent pathogen invasion ( 45 ); However, Bacteroidota is composed of common intestinal disease-related microorganisms, which have a relatively high risk of diarrhea and other diseases and are negatively correlated with inflammatory cytokines ( 46 ).…”

Section: Discussionmentioning

confidence: 99%

Regulatory Effect of Lactiplantibacillus plantarum 2-33 on Intestinal Microbiota of Mice With Antibiotic-Associated Diarrhea

Bao

et al. 2022

Front. Nutr.

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Diarrhea is one of the common adverse reactions in antibiotic treatment, which is usually caused by the imbalance of intestinal flora, and probiotics play an important role in the structure of intestinal flora. Therefore, this experiment studied the regulatory effect of Lactiplantibacillus plantarum 2-33 on antibiotic-associated diarrhea (AAD) mice. First, the AAD mice model was established by the mixed antibiotic solution of gentamicin sulfate and cefradine. Then, the physiological indexes and diarrhea of mice were observed and recorded by gastric perfusion of low dose (1.0 × 107 CFU/ml), medium dose (1.0 × 108CFU/ml), and high dose (1.0 × 109 CFU/ml) strain 2-33. 16S rRNA gene V3-V4 regions were sequenced in colon contents of mice in control group, model group, self-healing group, and experimental group, respectively, and the diversity of intestinal flora and gene function prediction were analyzed. The results showed that the intestinal flora of AAD mice was not significantly regulated by gastric perfusion of strain 2-33 to 7 days, but the relative abundance and diversity of intestinal flora of AAD mice were significantly improved by gastric perfusion to 14 days (p < 0.05). In addition, at the genus level, the relative abundance of Lactobacillus increased significantly, and the relative abundance of Enterococcus and Bacillus decreased significantly (p < 0.05). In addition, the regulation of strain 2-33 on intestinal flora of AAD mice was time- and dose-dependent, short-term gastric perfusion, and low dose had no significant effect (p > 0.05). Strain 2-33 can significantly increase the levels of anti-inflammatory cytokines IL-4 and IL-10, significantly decrease the levels of proinflammatory cytokines TNF-α and IFN-γ (p < 0.05), and can also adjust carbohydrate metabolism, amino acid metabolism, and energy metabolism to normal levels, thus accelerating the recovery of intestinal flora structure of AAD mice. In summary, strain 2-33 can improve the structure and diversity of intestinal flora of AAD mice, balance the level of substance and energy metabolism, and play a positive role in relieving diarrhea, maintaining and improving the intestinal microecological balance.

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Bovine Lactoferrin in the Prevention of Antibiotic-Associated Diarrhea in Children: A Randomized Clinical Trial

Cited by 6 publications

References 29 publications

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

Portulaca oleracea exhibited anti-coccidian activity, fortified the gut microbiota of Hu lambs

Regulatory Effect of Lactiplantibacillus plantarum 2-33 on Intestinal Microbiota of Mice With Antibiotic-Associated Diarrhea

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