To evaluate the in vitro antimicrobial/antivirulence action of bovine lactoferrin and its ability to synergize with levofloxacin against resistant Helicobacter pylori strains and to analyse the effect of levofloxacin, amoxicillin and esomeprazole with and without bovine lactoferrin as the first-line treatment for H. pylori infection.
The bovine lactoferrin antimicrobial/antivirulence effect was analysed in vitro by MIC/MBC determination and twitching motility against six clinical H. pylori strains and a reference strain. The synergism was evaluated using the chequerboard assay. The prospective therapeutic trial was carried out on two separate patient groups, one treated with esomeprazole/amoxicillin/levofloxacin and the other with esomeprazole/amoxicillin/levofloxacin/bovine lactoferrin. Treatment outcome was determined with the [13C]urea breath test.
In vitro, bovine lactoferrin inhibited the growth of 50% of strains at 10 mg/mL and expressed 50% bactericidal effect at 40 mg/mL. The combination of levofloxacin and bovine lactoferrin displayed a synergistic effect for all strains, with the best MIC reduction of 16- and 32-fold for levofloxacin and bovine lactoferrin, respectively. Bovine lactoferrin at one-fourth MIC reduced microbial motility significantly for all strains studied. In the in vivo study, 6 of 24 patients recruited had treatment failure recorded with esomeprazole/amoxicillin/levofloxacin (75% success, 95% CI 57.68%–92.32%), and in the group with esomeprazole/amoxicillin/levofloxacin/bovine lactoferrin, 2 out of 53 patients recruited had failure recorded (96.07% success, 95% CI 90.62%–101.38%).
Bovine lactoferrin can be considered a novel potentiator for restoring susceptibility in resistant H. pylori strains. Bovine lactoferrin added to a triple therapy in first-line treatment potentiates the therapeutic effect.
- Donovan Sharon M.; The Role of Lactoferrin in Gastrointestinal and Immune Development and Function: A Preclinical Perspective. The Journal of Pediatrics VOLUME 173, SUPPLEMENT , S16-S28, JUNE 01, 2016
- Doyle Lex W. & Jeanie L. Y. Cheong. Does bovine lactoferrin prevent late-onset neonatal sepsis? The Lancet VOLUME 393, ISSUE 10170, P382-384, FEBRUARY 02, 2019
- ELFIN Trial Investigators Group; Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial. Lancet VOLUME 393, ISSUE 10170, P423-433, FEBRUARY 02, 2019
- Kaur Gurpreet & Geeta Gathwala. Efficacy of Bovine Lactoferrin Supplementation in Preventing Late-onset Sepsis in low Birth Weight Neonates: A Randomized Placebo-Controlled Clinical Trial. Journal of Tropical Pediatrics, Volume 61, Issue 5, October 2015, Pages 370–376
- Legrand Dominique. Overview of Lactoferrin as a Natural Immune Modulator. The Journal of Pediatrics VOLUME 173, SUPPLEMENT , S10-S15, JUNE 01, 2016
- Pammi Mohan & Gautham Suresh; Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants. Cochrane Database Syst. Rev.2017 Jun 28;6(6):CD007137.
- Trend Stephanie et al.; Levels of innate immune factors in preterm and term mothers’ breast milk during the 1st month postpartum. British Journal of Nutrition Volume 115 supplement 7.
- Awadasseid A. et al.; Initial success in the identification and management of the coronavirus disease 2019 (COVID-19) indicates human-to-human transmission in Wuhan, China. Int J Biol Sci. 2020 Apr 6;16(11):1846-1860. doi: 10.7150/ijbs.45018. eCollection 2020.
- Binte Aziz Asma; Debate on Bacille Calmette-Guérin vaccination against COVID-19: Is it worth performing clinical trials? Biosafety and Health, 2020
- Blaess M. et al.; COVID-19/SARS-CoV-2 Infection: Lysosomes and Lysosomotropism Implicate New Treatment Strategies and Personal Risks. Int J Mol Sci. 2020 Jul 13;21(14):4953. doi: 10.3390/ijms21144953.
- Campione Elena et al.; Lactoferrin as Protective Natural Barrier of Respiratory and Intestinal Mucosa against Coronavirus Infection and Inflammation; Int. J. Mol. Sci. 2020, 21(14), 4903
- Chang Raymond, Tzi Bun Ng, Wei-ZenSun; Lactoferrin as potential preventative and adjunct treatment for COVID-19; International Journal of Antimicrobial Agents Volume 56, Issue 3, September 2020, 106118
- Church Dawson et al., App-Based Delivery of Clinical Emotional Freedom Techniques: Cross-Sectional Study of App User Self-Ratings; JMIR Mhealth Uhealth, 2020
- Deshmukh V, et al.; COVID-19: a conundrum to decipher. Eur Rev Med Pharmacol Sci. 2020 May;24(10):5830-5841. doi: 10.26355/eurrev_202005_21378.
- Drago-Serrano et al.; Lactoferrin: Balancing Ups and Downs of Inflammation Due to Microbial Infections; Int J Mol Sci, 2017
- Fernández-Lázaro Diego et al.; Physical Exercise as a Multimodal Tool for COVID-19: Could It Be Used as a Preventive Strategy? Int J Environ Res Public Health
- Jawhara et al.; Could Intravenous Immunoglobulin Collected from Recovered Coronavirus Patients Protect against COVID-19 and Strengthen the Immune System of New Patients? Int J Mol Sci, 2020
- Mirabelli Carmen et al.; Morphological Cell Profiling of SARS-CoV-2 Infection Identifies Drug Repurposing Candidates for COVID-19; BioRxiv. Preprint. NaN NaN [revised 2020 Sep 28].
- Root‐Bernstein Robert Age and Location in Severity of COVID‐19 Pathology: Do Lactoferrin and Pneumococcal Vaccination Explain Low Infant Mortality and Regional Differences?
- Universidad Peruana Cayetano Heredia; Lactoferrin for Prevention of COVID-19 in Health Care Workers
- Università Tor Vergata - Una risposta contro il Covid-19: la glicoproteina lattoferrina, una componente dell’immunità innata
- Zhai Xiaofeng et al; Comparison of Severe Acute Respiratory Syndrome Coronavirus 2 Spike Protein Binding to ACE2 Receptors from Human, Pets, Farm Animals, and Putative Intermediate Hosts.; J Virol. 2020 Jul 16;94(15):e00831-20. doi: 10.1128/J. Vi.00831-20. Print 2020 Jul 16.
- Zhang Wan-Ying et al.: Molecular mechanism prediction analysis of compound Kushen injection in the treatment of COVID-19 based on network pharmacology and molecular docking. Traditional Medicine Research 2020, 5 (5): 413-424. doi: 10.12032/TMR20200518180
- Zhang Wan-Ying et al.; Treating COVID-19 by traditional Chinese medicine: a charming strategy?Traditional Medicine Research 2020, Vol. 5 Issue (4): 178-181