Systemic and mucosal levels of lactoferrin in very low birth weight infants supplemented with bovine lactoferrin.
Lactoferrin supplementation may help prevent infections in preterm infants but efficacy has varied with different dosing and products. We assessed the absorption and excretion of bovine lactoferrin (bLF) in thirty-one infants receiving 100, 200, or 300 mg/kg/day of enteral bLF for 30 days. BLF and human lactoferrin (hLF) in infant saliva, blood, urine, and stool and expressed or donor breast milk (EBM, DBM) collected before treatment initiation, study day 22, and one week after treatment cessation were measured by ELISA. During treatment, BLF was absorbed from the gastrointestinal tract, detected in plasma, saliva, and urine, and excreted in stool. Saliva and stool bLF levels began to decline within 12 hours after dosing and bLF was undetectable in all samples one week after treatment. HLF concentrations exceeded bLF across sample types and timepoints. Infants receiving EBM demonstrated higher saliva and stool hLF levels than DBM patients. Neither bLF nor hLF levels varied by patient characteristics, bLF dosage, or infection status. This is the first study demonstrating bLF absorption into the bloodstream and distribution to saliva and urine in preterm infants. Future studies should further explore lactoferrin pharmacokinetics as higher and more frequent dosing may improve the clinical benefit of lactoferrin supplementation.
Itell, HL; Berenz, A; Mangan, RJ; Permar, SR; Kaufman, DA
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