lactoferrin and Intestinal-Diseases--Parasitic

Much has been learned in recent years about the mechanisms by which breastfeeding improves child health and survival. However, there has been little progress in using these insights to improve pediatric care. Factors that are important for protecting the breast fed infant might be expected to decrease the adverse effects of weaning on diarrhea, growth, and development. Lactoferrin, an iron-binding protein with multiple physiological functions (anti-microbial, anti-inflammatory, and immunomodulatory), is one of the most important proteins present in mammalian milk. Protection against gastroenteritis is the most likely biologically relevant activity of lactoferrin. Multiple in vitro and animal studies have shown a protective effect of lactoferrin on infections with enteric microorganisms, including rotavirus, Giardia, Shigella, Salmonella and the diarrheagenic Escherichia coli. Lactoferrin has two major effects on enteric pathogens: it inhibits growth and it impairs function of surface expressed virulence factors thereby decreasing their ability to adhere or to invade mammalian cells. Thus, lactoferrin may protect infants from gastrointestinal infection by preventing the attachment by enteropathogens in the gut. Recently several clinical trials in children have started to address this issue. Whether lactoferrin can prevent a significant portion of diarrheal disease remains to be determined.

Topics: Diarrhea, Infantile; Enterobacteriaceae; Enterovirus; Humans; Infant; Infant, Newborn; Intestinal Diseases, Parasitic; Lactoferrin

Topics: Administration, Oral; Animals; Bacterial Infections; Bacterial Vaccines; Gastric Acid; Humans; Immunity, Cellular; Immunity, Innate; Immunization, Passive; Immunoglobulin A; Interferons; Intestinal Diseases; Intestinal Diseases, Parasitic; Intestinal Mucosa; Intestines; Lactoferrin; Muramidase; Vaccination; Vaccines; Vaccines, Attenuated

Routine stool culture is used to evaluate patients with diarrheal illness. However, the results are often delayed, and the tests are very expensive. Therefore a rapid, simple method for screening would be a helpful adjunct in a diagnostic algorithm. Fecal leukocytes are found in diarrhea patients with diffuse colonic inflammation but missing in non-inflammatory cases, and are most commonly identified in infectious diarrheas of bacterial origin. It supports the use of immediate empiric therapy in very young, elderly and immunocompromised individuals. When negative, it may eliminate the need for stool culture in some cases of diarrhea. Recently, a new latex bead assay has been developed for the detection of lactoferrin, an iron binding glycoprotein found in polymorphonuclear leukocytes.. Evaluate the value of fecal leukocytes and lactoferrin in the workup of patients with diarrhea.. Fecal samples of 50 consecutive adult patients with acute or chronic diarrhea were tested for fecal leukocytes and lactoferrin. The results were compared with findings from fecal cultures, tests for parasite, Clostridium difficile A toxin latex test, data of the gastrointestinal examination and clinical evaluation. The authors defined two groups of the cases: the inflammatory and non-inflammatory diarrheas.. The sensitivity, specificity, positive and negative predictive value of microscopic leukocyte count and the lactoferrin test were 42 and 63%, 87 and 87%, 67 and 75%, 71 and 79% respectively.. In agreement with the literature the results of the present study indicate that fecal lactoferrin appears more sensitive than fecal leukocyte smear, and accurately rules out inflammatory diarrhea.

Topics: Adult; Aged; Algorithms; Diagnosis, Differential; Diarrhea; Enteritis; Feces; Female; Humans; Inflammatory Bowel Diseases; Intestinal Diseases, Parasitic; Lactoferrin; Leukocyte Count; Leukocytes; Male; Mass Screening; Middle Aged; Predictive Value of Tests; Sensitivity and Specificity

Topics: Agglutination Tests; Bacterial Infections; Breast Feeding; Child; Child, Preschool; Developing Countries; Diarrhea, Infantile; Feces; Helminthiasis; Humans; Infant; Intestinal Diseases, Parasitic; Lactoferrin; Leukocytes; Nicaragua