Lactoferrin supplementation for taste and smell abnormalities among patients receiving cancer chemotherapy

Abstract

Purpose: Taste and smell abnormalities (TSA) are common in patients receiving chemotherapy and may lead to altered nutritional intake, treatment withdrawal, and impaired quality of life. Lipid peroxidation in the oral cavity is one cause of TSA. Lactoferrin (LFN), an iron-binding salivary protein, reduces production of lipid oxidation byproducts and has been shown to reduce perception of unpleasant avors. To assess the feasibility of LFN as a treatment for TSA, we conducted pilot investigations among patients with cancer who self-reported TSA following onset of chemotherapy. The primary objective was to assess change in subjective taste and smell perception from baseline to completion of 30-days of LFN supplementation.Methods: Patients were treated with 750mg LFN daily for 30 days and followed for an additional 30 days without LFN. TSA was measured via the taste and smell questionnaire (TSQ) including taste (score 0-10), smell (score 0-6), and composite scores (0-16, 0=no TSA) at baseline, day 30, and day 60.Results: 26 patients enrolled; 19 remained on study at day 30 and 17 at day 60. Baseline mean TSQ scores were 6.5 (taste), 3.1 (smell) and 9.6 (composite). By day 30, mean composite TSQ score improved by 1.7 (p=0.018); taste and smell improved by 0.6 (p=.062) and 1.1 (p=.042) respectively. From baseline to day 60, mean composite TSQ score improved by 3.8 (p<.0001); taste and smell improved by 1.9 (p=.001) and 1.8 (p=.003).Conclusions: Further evaluation of LFN is warranted to determine its value for improving self-reported TSA among patients receiving chemotherapy.

Dysgeusia in Patients with Breast Cancer Treated with Chemotherapy—A Narrative Review

“…The salty taste is the one affected most frequently, while bitter and metallic tastes are also frequently reported as CT side effects. This may be due to different reasons, such as the presence of metallic- or bitter-tasting components in the structure of the drugs reaching the taste receptors by diffusion through capillaries (e.g., platinum contained in cisplatin and carboplatin drugs) [ 5 , 35 , 36 ], the production of carbonyls by the lipid peroxidation of oral epithelial cells causing metallic taste sensations [ 5 ], and the reduced threshold for metals described in cancer patients undergoing CT [ 35 ]. The iron-containing compounds in red meat can exacerbate these impaired sensations, explaining why many cancer patients experience a bitter or metallic taste during its consumption and prefer the use of plastic instead of metal cutlery and utensils during meals [ 35 ].…”

“…The authors reported an increased expression of salivary immune proteins at proteomic analysis, which are associated with taste bud growth, neutral signal transduction, and taste threshold recovery [ 78 ]. Lactoferrin supplementation (750 mg daily for 30 days) was successfully reported to improve taste scores by 1.9 points (similar score 0–10, based on nine questions on taste changes, p = 0.001) among 26 cancer patients (five patients with BC) receiving CT in a single arm pilot trial [ 36 ].…”

No Smell, No Taste—Dealing With a “Senseless” Phase of the Pandemic

“…Possibly, this can be reversed through LF intervention 69 . In a recent human clinical study (n = 26), LF supplementation (750 mg/d) for 30 days showed effective improvement in subjective taste and smell perception of cancer patients 70 …”