Breast Milk and Saliva Lactoferrin Levels and Postnatal Cytomegalovirus Infection

Abstract

Objective Very low birth weight preterm infants are at risk for life-threatening infections in the NICU. Breast milk protects against infections but carries the risk of infection by cytomegalovirus (CMV) shed in mother's milk. Lactoferrin is a breast milk and saliva protein with potent neutralizing activity against CMV. Study Design VLBW, maternal breast milk fed infants in the NICU and their lactating mothers were enrolled and followed for 3 months/discharge. Breast milk and infant saliva samples were collected biweekly. Maternal CMV status was determined on breast milk. CMV was measured using quantitative polymerase chain reaction and lactoferrin by enzyme-linked immunosorbent assay. Results In an in vitro neutralization assay, the IC90 of purified human lactoferrin against CMV was 2.08 ng/mL. Bovine lactoferrins were more potent, IC90s > 10-fold higher. Lactoferrin was detected in all breast milk (median: 3.3 × 106 ng/mL) and saliva (median: 84.4 ng/swab) samples. Median CMV load in breast milk was 893 copies/mL. There was no correlation between breast milk lactoferrin concentration and CMV load. Five infants acquired postnatal CMV. There was no difference in saliva or breast milk lactoferrin concentration for mother–infant pairs and postnatal CMV acquisition. Conclusion Lactoferrin neutralizes CMV in vitro, but concentrations in breast milk and saliva are likely too low for effective neutralization in vivo.

Transmission of Cytomegalovirus via Breast Milk in Low Birth Weight and Premature Infants: A Systematic Review

“…In vitro study by Weimer (2021) 11 showed 90% inhibitory concentration (IC90) of purified human lactoferrin against CMV was 2.08 ng/mL. The IC90 values for bovine lactoferrins were > 10-fold higher.…”

Transmission of Cytomegalovirus via Breast Milk in Low Birth Weight and Premature Infants: A Systematic Review

“…In vitro study by Weimer (2021) 11 showed 90% inhibitory concentration (IC90) of purified human lactoferrin against CMV was 2.08 ng/mL. The IC90 values for bovine lactoferrins were > 10-fold higher.…”

The effect of using edible coating fortified with lactoferrin on the shelf life of oriental sausage

“…It has a significant antibacterial effect, especially when it is iron-free; it binds to lipomannan, one of the bacterial cell wall components, or it binds to proteins on the surface of bacteria (Kell et al, 2020). LF also has antioxidant, antiviral, anti-inflammatory, immune-modulating, and anti-cancer properties; which have been confirmed by numerous studies that recorded the beneficial effects of LF on the intestinal epithelium through stimulation and developing of the intestinal epithelial cells, which optimizes the digestive processes and absorption of nutrients, and protects against the action of pathogens and food allergens (Weimer et al, 2020; El-Sherbeny and El-Shenawy, 2023). Lactoferrin has antibacterial properties against both Gram-negative and Gram-positive bacteria, making it useful in the fight against foodborne pathogens through prevention of the biofilm formation by pathogenic bacteria such as Staphylococcus aureus or Pseudomonas aeruginosa, as well as direct inhibition or killing of microbial cells and immune system activation/inhibition (Jahani et al, 2015).…”

Congenital cytomegalovirus retinitis of prematurity: a case report and literature review

“…Short-term pasteurization (heating at 62.5°C for 5 s) partially decreases the infection risk, but transmission remains possible ( 53 ). Importantly, maternal immunity (e.g., serum-neutralizing antibodies or lactoferrin in breast milk) does not provide protective immunity for preterm infants ( 54 , 55 ). Therefore, clinical decisions must weigh the benefits of breast milk against the risk of CMV infection.…”

Transmission of Cytomegalovirus via Breast Milk in Low Birth Weight and Premature Infants: A Systematic Review

“…In vitro study by Weimer (2021) 11 showed 90% inhibitory concentration (IC90) of purified human lactoferrin against CMV was 2.08 ng/mL. The IC90 values for bovine lactoferrins were > 10-fold higher.…”

The effect of using edible coating fortified with lactoferrin on the shelf life of oriental sausage

“…It has a significant antibacterial effect, especially when it is iron-free; it binds to lipomannan, one of the bacterial cell wall components, or it binds to proteins on the surface of bacteria (Kell et al, 2020). LF also has antioxidant, antiviral, anti-inflammatory, immune-modulating, and anti-cancer properties; which have been confirmed by numerous studies that recorded the beneficial effects of LF on the intestinal epithelium through stimulation and developing of the intestinal epithelial cells, which optimizes the digestive processes and absorption of nutrients, and protects against the action of pathogens and food allergens (Weimer et al, 2020; El-Sherbeny and El-Shenawy, 2023). Lactoferrin has antibacterial properties against both Gram-negative and Gram-positive bacteria, making it useful in the fight against foodborne pathogens through prevention of the biofilm formation by pathogenic bacteria such as Staphylococcus aureus or Pseudomonas aeruginosa, as well as direct inhibition or killing of microbial cells and immune system activation/inhibition (Jahani et al, 2015).…”

Congenital cytomegalovirus retinitis of prematurity: a case report and literature review

“…Short-term pasteurization (heating at 62.5°C for 5 s) partially decreases the infection risk, but transmission remains possible ( 53 ). Importantly, maternal immunity (e.g., serum-neutralizing antibodies or lactoferrin in breast milk) does not provide protective immunity for preterm infants ( 54 , 55 ). Therefore, clinical decisions must weigh the benefits of breast milk against the risk of CMV infection.…”

Transmission of Cytomegalovirus via Breast Milk in Low Birth Weight and Premature Infants: A Systematic Review

“…In vitro study by Weimer (2021) 11 showed 90% inhibitory concentration (IC90) of purified human lactoferrin against CMV was 2.08 ng/mL. The IC90 values for bovine lactoferrins were > 10-fold higher.…”

The effect of using edible coating fortified with lactoferrin on the shelf life of oriental sausage

“…It has a significant antibacterial effect, especially when it is iron-free; it binds to lipomannan, one of the bacterial cell wall components, or it binds to proteins on the surface of bacteria (Kell et al, 2020). LF also has antioxidant, antiviral, anti-inflammatory, immune-modulating, and anti-cancer properties; which have been confirmed by numerous studies that recorded the beneficial effects of LF on the intestinal epithelium through stimulation and developing of the intestinal epithelial cells, which optimizes the digestive processes and absorption of nutrients, and protects against the action of pathogens and food allergens (Weimer et al, 2020; El-Sherbeny and El-Shenawy, 2023). Lactoferrin has antibacterial properties against both Gram-negative and Gram-positive bacteria, making it useful in the fight against foodborne pathogens through prevention of the biofilm formation by pathogenic bacteria such as Staphylococcus aureus or Pseudomonas aeruginosa, as well as direct inhibition or killing of microbial cells and immune system activation/inhibition (Jahani et al, 2015).…”

Congenital cytomegalovirus retinitis of prematurity: a case report and literature review

“…Short-term pasteurization (heating at 62.5°C for 5 s) partially decreases the infection risk, but transmission remains possible ( 53 ). Importantly, maternal immunity (e.g., serum-neutralizing antibodies or lactoferrin in breast milk) does not provide protective immunity for preterm infants ( 54 , 55 ). Therefore, clinical decisions must weigh the benefits of breast milk against the risk of CMV infection.…”