Bovine Lactoferrin prevents invasive fungal infections in very low birth weight infants: a randomized controlled trials

Giovanni Corsello, Paolo Manzoni, Matteo Rinaldi, Daniele Farina, Silvia Cattani, Lidia Decembrino, Rosario Magaldi, Michele Quercia, Federica Vagnarelli, Nicola Laforgia, Lina Bollani, Ilaria Stolfi, Milena Maule, Luigi Memo, Mauro Stronati, Pasqua M. Betta, Michael Mostert, Hubert Messner, Elena Gallo, Fabio MoscaMario G. Romeo

Risultato della ricerca: Articlepeer review

110 Citazioni (Scopus)

Abstract

BACKGROUND: Lactoferrin is a mammalian milk glycoprotein involved in innate immunity. Recent data show that bovine lactoferrin (bLF) prevents late-onset sepsis in preterm very low birth weight (VLBW) neonates. METHODS: This is a secondary analysis of data from a multicenter randomized controlled trial where preterm VLBW neonates randomly received bLF (100 mg/day; group A1), bLF + Lactobacillus rhamnosus GG (106 colony-forming units per day; group A2), or placebo (group B) for 6 weeks. Here we analyze the incidence rates of fungal colonization, invasive fungal infection (IFI), and rate of progression from colonization to infection in all groups. RESULTS: This study included 472 neonates whose clinical, nutritional, and demographical characteristics were similar. Overall, the incidence of fungal colonization was comparable (17.6%, 16.6%, and 18.5% in A1, A2, and B, respectively; P = .89 [A1] and .77 [A2]). In contrast, IFIs were significantly decreased in A1 and A2 (0.7% and 2.0%, respectively) compared with B (7.7%; P = .002 [A1] and .02 [A2]), and this was significantly true both in <1000 g (0.9% [A1] and 5.6% [A2], vs 15.0%) and in 1001 to 1500 g infants (0% and 0% vs 3.7%). The progression rate colonization-infection was significantly lower in the bLF groups: 3.7% (A1) and 12% (A2), vs 41.9%; P < .001 (A1) and P = .02 (A2). No IFI-attributable deaths occurred in the treatment groups, versus 2 in placebo. No adverse effects or intolerances occurred. CONCLUSIONS: Prophylactic oral administration of bLF reduces the incidence of IFI in preterm VLBW neonates. No effect is seen on colonization. The protective effect on IFI is likely due to limitation of ability of fungal colonies to progress toward invasion and systemic disease in colonized infants
Lingua originaleEnglish
pagine (da-a)116-123
Numero di pagine8
RivistaPediatrics
Volume129
Stato di pubblicazionePublished - 2012

All Science Journal Classification (ASJC) codes

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