Dose Effect of Bovine Lactoferrin Fortification on Iron Metabolism of Anemic Infants

Background Iron-deficiency anemia (IDA) is common in children with inflammatory bowel disease (IBD); however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. We compared the effect of lactoferrin versus oral ferrous sulfate for the treatment of IDA in children with IBD. Methods Ninety-two IBD children with IDA were included but only 80 children completed the study and they were randomized into two groups: ferrous sulfate group (n = 40) who received ferrous sulfate 6 mg/kg/day for 3 months and lactoferrin group (n = 40) who received lactoferrin 100 mg/day for 3 months. Complete blood count, serum iron, total iron-binding capacity (TIBC), transferrin saturation (TS), serum ferritin, interleukin-6 (IL-6), and hepcidin 25 were measured before and after the treatment. Results Hemoglobin (Hb), mean corpuscular volume, serum iron, TS, and serum ferritin significantly increased, while TIBC decreased significantly after the administration of either ferrous sulfate or lactoferrin compared to their baseline data. In addition, lactoferrin significantly increased Hb, serum iron, TS, and serum ferritin compared to ferrous sulfate. Moreover, lactoferrin significantly decreased IL-6 and hepcidin levels. Conclusion Lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA. Clinical trial registration The study was registered at www.pactr.org (PACTR202002763901803). Impact Iron-deficiency anemia (IDA) in children with inflammatory bowel disease (IBD) is treated with oral iron therapy; however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. To the best of our knowledge, our study was the first in pediatrics that compared the effect of lactoferrin versus oral ferrous sulfate as an iron supplement for the treatment of IDA in children with IBD. We found that lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.

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“…6 Lactoferrin has been reported as an effective therapy in the treatment of anemia in both pediatrics and adults. 7 – 9…”

Section: Introductionmentioning

confidence: 99%

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

et al. 2022

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“…After 3 months, this group, compared to the placebo one, showed significantly higher levels of hemoglobin (Hb). As shown in this study, it is important to mention that after 1 month, there was no difference in the Hb concentration between the blf and placebo group, suggesting that the efficacy of blf depends on the intervention time and it should be more than 1 month [ 50 ]. In 2016, Rezk et al showed that in pregnant women (second trimester) affected by iron deficiency anemia, the use of lf was more effective than ferrous sulfate [ 51 ].…”

Section: Resultsmentioning

confidence: 99%

Lactoferrin: Cytokine Modulation and Application in Clinical Practice

Presti

Manti

Parisi

et al. 2021

JCM

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Multiple properties of lactoferrin have been reported in the literature so far. Decades of in vitro and in vivo studies have demonstrated the important antimicrobial, anti-inflammatory, anti-oxidant, and immunomodulating properties. It suggests the use of lactoferrin as an effective and safe option for the treatment of several common disorders. Herein, we show the applications of lactoferrin in clinical practice, highlighting its evidence-based capacities for the treatment of heterogeneous disorders, such as allergic, gastrointestinal, and respiratory diseases, and hematologic, oncologic, gynecologic, dermatologic, and dental disorders. Moreover, the widespread use of lactoferrin in neonatology is summarized here. As a result of its antiviral properties, lactoferrin has also been proposed as a valid option for the treatment for COVID-19 patients. Here, the uses of lactoferrin in clinical practice as a new, safe, and evidence-based treatment for many types of disorders are summarized.

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“…With regard to added lactoferrin, at least four previous studies have suggested possible improvement in iron status [9][10][11]31]. Chierici et al found significantly higher serum ferritin levels at day 90 and 150 [11]; King et al reported significantly higher hematocrit levels but no difference in hemoglobin levels [9] and Ke et al observed improved iron status markers, including lower prevalence of ID [31].…”

Section: Discussionmentioning

confidence: 99%

“…Lactoferrin is a major iron carrier in human milk but its role in infant iron absorption is unclear. Improved iron status has been observed following bovine lactoferrin supplementation but previous results are divergent [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Reducing Iron Content in Infant Formula from 8 to 2 mg/L Does Not Increase the Risk of Iron Deficiency at 4 or 6 Months of Age: A Randomized Controlled Trial

et al. 2020

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Many infant formulas are fortified with iron at 8–14 mg/L whereas breast milk contains about 0.3 mg/L. Another major difference between breast milk and infant formula is its high concentration of lactoferrin, a bioactive iron-binding protein. The aim of the present study was to investigate how reducing the iron content and adding bovine lactoferrin to infant formula affects iron status, health and development. Swedish healthy full-term formula-fed infants (n = 180) were randomized in a double-blind controlled trial. From 6 weeks to 6 months of age, 72 infants received low-iron formula (2 mg/L) fortified with bovine lactoferrin (1.0 g/L) (Lf+), 72 received low-iron formula un-fortified with lactoferrin (Lf−) and 36 received standard formula with 8 mg of iron/L and no lactoferrin fortification as controls (CF). Iron status and prevalence of iron deficiency (ID) were assessed at 4 and 6 months. All iron status indicators were unaffected by lactoferrin. At 4 and 6 months, the geometric means of ferritin for the combined low-iron groups compared to the CF-group were 67.7 vs. 88.7 and 39.5 vs. 50.9 µg/L, respectively (p = 0.054 and p = 0.056). No significant differences were found for other iron status indicators. In the low-iron group only one infant (0.7%) at 4 months and none at 6 months developed ID. Conclusion: Iron fortification of 2 mg/L is an adequate level during the first half of infancy for healthy term infants in a well-nourished population. Adding lactoferrin does not affect iron status.

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Dose Effect of Bovine Lactoferrin Fortification on Iron Metabolism of Anemic Infants

Cited by 13 publications

References 34 publications

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

Lactoferrin: Cytokine Modulation and Application in Clinical Practice

Reducing Iron Content in Infant Formula from 8 to 2 mg/L Does Not Increase the Risk of Iron Deficiency at 4 or 6 Months of Age: A Randomized Controlled Trial

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