lactoferrin and Infant--Newborn--Diseases

The network meta-analysis (NMA) investigated the efficacy of six food supplements, namely glutamine, arginine, lactoferrin, prebiotics, synbiotics, and probiotics, in preventing necrotizing enterocolitis in premature infants.. MEDLINE, Embase, and Cochrane Library were searched. Randomized controlled trials comparing different food supplements for premature infants were included.. Probiotics (OR, 0.47; 95% CrI, 0.33-0.63), arginine (OR, 0.38; 95% CrI, 0.14-0.98), glutamine (OR, 0.30; 95% CrI, 0.079-0.90), and synbiotics (OR, 0.13; 95% CrI, 0.037-0.37). were associated with a decreased incidence of NEC. Only probiotics (OR, 0.81; 95% CrI, 0.69-0.95) and lactoferrin (OR, 0.74; 95% CrI, 0.54-0.92) achieved lower risk of sepsis. Probiotics (OR, 0.58; 95% CrI, 0.40-0.79), prebiotics (OR, 0.23; 95% CrI, 0.043-0.86), and synbiotics (OR, 0.15; 95% CrI, 0.035-0.50) were associated with lower odds of mortality. Probiotics (MD, -2.3; 95% CrI: -3.7- -0.63) appeared to have earlier age of attainment of full feeding.. Based on this NMA, probiotics and synbiotics had the potential to be the top two preferable food supplements.

Topics: Arginine; Enterocolitis, Necrotizing; Glutamine; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Lactoferrin; Network Meta-Analysis; Probiotics

Early adverse fetal environments can significantly disturb central nervous system (CNS) development and subsequently alter brain maturation. Nutritional status is a major variable to be considered during development and increasing evidence links neonate and preterm infant impaired brain growth with neurological and psychiatric diseases in adulthood. Breastfeeding is one of the main components required for healthy newborn development due to the many "constitutive" elements breastmilk contains. Maternal intake of specific nutrients during lactation may alter milk composition, thus affecting newborn nutrition and, potentially, brain development. Lactoferrin (Lf) is a major protein present in colostrum and the main protein in human milk, which plays an important role in the benefits of breastfeeding during postnatal development. It has been demonstrated that Lf has antimicrobial, as well as anti-inflammatory properties, and is potentially able to reduce the incidence of sepsis and necrotizing enterocolitis (NEC), which are particularly frequent in premature births. The anti-inflammatory effects of Lf can reduce birth-related pathologies by decreasing the release of pro-inflammatory factors and inhibiting premature cervix maturation (also related to commensal microbiome abnormalities) that could contribute to disrupting brain development. Pre-clinical evidence shows that Lf protects the developing brain from neuronal injury, enhances brain connectivity and neurotrophin production, and decreases inflammation in models of perinatal inflammatory challenge, intrauterine growth restriction (IUGR) and neonatal hypoxia-ischemia (HI). In this context, Lf can provide nutritional support for brain development and cognition and prevent the origin of neuropsychiatric diseases later in life. In this narrative review, we consider the role of certain nutrients during neurodevelopment linking to the latest research on lactoferrin with respect to neonatology. We also discuss new evidence indicating that early neuroprotective pathways modulated by Lf could prevent neurodegeneration through anti-inflammatory and immunomodulatory processes.

Topics: Adult; Brain; Enterocolitis, Necrotizing; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Lactoferrin; Longevity; Milk, Human; Pregnancy; Premature Birth

Newborn infants are at a high risk for infection due to an under-developed immune system, and human milk has been shown to exhibit substantial anti-infective properties that serve to bolster neonatal defenses against multiple infections. Lactoferrin is the dominant whey protein in human milk and has been demonstrated to perform a wide array of antimicrobial and immunomodulatory functions and play a critical role in protecting the newborn infant from infection. This review summarizes data describing the structure and important functions performed by lactoferrin in protecting the neonate from infection and contributing to the maturation of the newborn innate and adaptive immune systems. We also briefly discuss clinical trials examining the utility of lactoferrin supplementation in the prevention of sepsis and necrotizing enterocolitis in newborn infants. The data reviewed provide rationale for the continuation of studies to examine the effects of lactoferrin administration on the prevention of sepsis in the neonate.

Topics: Anti-Infective Agents; Dietary Supplements; Enterocolitis, Necrotizing; Gastrointestinal Microbiome; Gastrointestinal Tract; Humans; Immunologic Factors; Infant, Newborn; Infant, Newborn, Diseases; Lactoferrin; Milk, Human; Sepsis

Neonatal sepsis and necrotizing enterocolitis (NEC) are two most important neonatal problems in nursery which constitute the bulk of neonatal mortality and morbidity. Inflammatory mediators secondary to sepsis and NEC increases morbidity, by affecting various system of body like lung, brain and eye, thus causing long term implications. Lactoferrin (LF) is a component of breast milk and multiple actions that includes antimicrobial, antiviral, anti-fungal and anti-cancer and various other actions. Few studies have been completed and a number of them are in progress for evaluation of efficacy and safety of LF in the prevention of neonatal sepsis and NEC in field of neonatology. In future, LF prophylaxis and therapy may have a significant impact in improving clinical outcomes of vulnerable preterm neonates. This review analyse the role of lactoferrin in prevention of neonatal sepsis and NEC, with emphasis on mechanism of action, recent studies and current studies going on around the globe.

Topics: Anti-Infective Agents; Enterocolitis, Necrotizing; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Lactoferrin; Neonatology; Sepsis

Neonatal sepsis remains a feared cause of morbidity and mortality in the neonatal period. Maternal, neonatal, and environmental factors are associated with risk of infection, and a combination of prevention strategies, judicious neonatal evaluation, and early initiation of therapy are required to prevent adverse outcomes. This article reviews recent trends in epidemiology and provides an update on risk factors, diagnostic methods, and management of neonatal sepsis.

Topics: Adaptive Immunity; Anti-Infective Agents; Antibodies, Monoclonal; Antifungal Agents; Bacterial Infections; Biomarkers; Blood Cell Count; C-Reactive Protein; Candidiasis; Escherichia coli Infections; Fluconazole; Genomics; Humans; Immunity, Innate; Immunoglobulins, Intravenous; Infant, Newborn; Infant, Newborn, Diseases; Lactoferrin; Polymerase Chain Reaction; Predictive Value of Tests; Proteomics; Risk Factors; Sepsis; Streptococcal Infections; Streptococcus agalactiae

Severe infections represent the main cause of neonatal mortality and morbidity. Strategies of proven effectiveness in reducing the incidence of infection in neonatal intensive care units (NICUs) include hand hygiene practices and prevention of central venous catheter-related bloodstream infections. In recent years, new strategies have been developed to prevent infections in NICU including prevention of neonatal sepsis with lactoferrin, the use of heparin for the prevention of CRBSIs, the judicious use of antibiotics and chemoprophylaxis, prevention of invasive fungal infections with fluconazole, the use of specific anti-staphylococcal immunoglobulins, and the early identification of infants at higher risk of infection with the use of specific markers (mannose-binding lectin). This review will focus on these new strategies and on their role in clinical practice in order to further reduce the incidence of infection in NICU.

Topics: Antibiotic Prophylaxis; Antifungal Agents; Cross Infection; Heparin; Humans; Immunotherapy; Infant, Newborn; Infant, Newborn, Diseases; Infection Control; Intensive Care Units, Neonatal; Lactoferrin; Staphylococcal Infections; Staphylococcal Vaccines

Systemic infections in premature and term infants cause significant morbidity and mortality in spite of appropriate antimicrobial therapy. Consequently, immunotherapy has emerged as a potential adjuvant therapeutic modality to reduce the incidence and mortality associated with neonatal sepsis.. The most recent findings during the review period include systematic reviews of previously published trials evaluating the use of intravenous immunoglobulin and colony-stimulating factors in neonatal sepsis. In addition, the most recent trials describing the use of antistaphylococcal antibodies, probiotics, glutamine supplementation, recombinant human protein C, and lactoferrin in the prevention and treatment of neonatal sepsis have been reviewed.. Immunotherapy used as an adjuvant for the prevention and treatment of neonatal sepsis holds promise. Clinical trials specifically designed toward the neonatal population and appropriately powered to detect treatment differences are necessary prior to universal recommendation of these therapies in the nursery.

Topics: Colony-Stimulating Factors; Dietary Supplements; Glutamine; Humans; Immunoglobulins; Immunologic Factors; Immunotherapy; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Lactoferrin; Probiotics; Protein C; Recombinant Proteins; Sepsis; Treatment Outcome

Topics: Bacterial Infections; Digestive System; Gastrointestinal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Absorption; Iron; Lactoferrin; Lactoglobulins; Milk, Human

Samples of precolostrum (colostrum gravidarum), colostrum and mature milk obtained from five women during their antenatal and postnatal periods were measured for IgA, IgG, IgM, alpha-1-antitrypsin, lactoferrin, lysozyme, B1A globulin (C3) and B1E globulin (C4) by single radial immunodiffusion. Protein concentrations in precolostrum were equal to or greater than those found in colostrum obtained during the first 12-48 hours following delivery. Secretion of precolostrum is common, occurs early in the antenatal period and may often be of considerable volume. The anti-microbial proteins contained within this milk can be preserved intact by freezing. This represents an untapped pool of bacteriostatic proteins with specific activity against neonatal pathogens. We suggest that a potential protective effect against serious infection may be obtained by administering precolostrum to "at risk" infants during the first few days of life.

Topics: alpha 1-Antitrypsin; Colostrum; Complement C3; Complement C4; Female; Humans; Immunoglobulins; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Lactoferrin; Milk, Human; Muramidase; Pregnancy