Hyperimmune bovine colostrum in the treatment of shigellosis in children: a double‐blind, randomized, controlled trial

Abstract

Immunological approaches have been considered as an alternative therapeutic option for the treatment of enteric infections over the past few years. Hyperimmune bovine colostrum (HBC) is a potentially innovative immunological option in the management of shigellosis together with traditional antibiotic therapy. Children aged 1‐12 y with a history of bloody mucoid diarrhoea of less than 5 d duration were enrolled after their stool specimen was found to be positive for Shigella dysenteriae type 1 antigen by a rapid diagnostic fluorescent antibody staining test. They were randomized to receive either HBC containing very high titres of antibody against S. dysenteriae type 1 antigen or bovine colostrum (BC) without any antibody. The study group received 100ml of HBC three times a day orally for 3 d and control group received BC. Children also received pivmecillinam in a dose of 50mg kg−1 d−1 in four divided doses orally for 5 d. Admission characteristics of the 34 children in the HBC group and 35 in the BC group were comparable. No significant differences were observed in duration of diarrhoea, fever, anorexia, abdominal pain, tenesmus, stool frequency or visible blood in the stool between the groups. Two (6%) children in the study and five (14%) in the control group remained stool culture positive for S. dysenteriae type 1, even after 5 d of sensitive antimicrobial therapy. Conclusion: The results indicate that HBC as an adjuvant is unable to show any beneficial effect in reducing the stool frequency, duration or severity of childhood shigellosis due to S. dysenteriae type 1 infection.

Milk immunoglobulins for health promotion

“…dysenteriae infection were treated with 100 ml of hyperimmune colostral preparation against Sh. dysenteriae antigen I in combination with an antibiotic (pivmecillinam) three times per day for 3 days, no difference was found in any clinical parameter when compared with patients treated with control preparation and antibiotic (Ashraf, Mahalanabis, Mitra, Tzipori, & Fuchs, 2001). This suggests that in shigellosis the specific colostral antibodies can prevent the infection but are not effective in treatment of an already established one.…”

Effect of orally administered bovine colostrum on cytokine production in vivo and in vitro in immunosuppressed mice

“…The immunomodulatory effects of bovine colostrum have been described previously in both human and animal studies (Ashraf, Mahalanabis, Mitra, Tzipori, & Fuchs, 2001;Bolke et al, 2002;Boudry et al, 2007;Wei, Xu, Cheng, & Xiong, 2007). For example, some researchers have shown that bovine colostrum supplementation can improve immune parameters in highly trained cyclists (Shing et al, 2007).…”

Chapter 8 Control of intestinal diseases by dietary supplementation with antibodies

“…A well-known method of preventing diarrhea in neonatal calves is twice a day administration of surplus colostrum of the first and second milking mixed with milk or milk substitute throughout the period of the greatest risk of diarrhea, usually up to 10-12 days of life (Castrucci et al, 1984;Möstl and Bürki, 1988;Gutzwiller, 2002). Cow colostrum from nonimmunized cows or cows hyperimmunized with rotavirus, coronavirus, Escherichia coli or Shigella successfully prevents diarrhea also in neonates of other species (Brunser et al, 1992;Klobasa et al, 1994;Tzipori et al, 1994;Gomez et al, 1998;Ashraf et al, 2001;Shibata et al, 2001).…”

“…The Ig additive in feed or in a milk-replacer (table 4) seems to be the most suitable for prophylaxis, whereas application in capsules or the administration of Ig concentrate is advisable in diarrhea therapy (Kelly et al, 1997;Graczyk et al, 1998Graczyk et al, , 1999Ashraf et al, 2001;He et al, 2001;Quigley et al, 2001;Solomon, 2002;Stefaniak et al, 2003Stefaniak et al, , 2004.…”