Lactoferrin, a unique and powerful friend for good health

Dr Traj Nibber, CEO and Director of Research at AOR has a wealth of experience and knowledge in the field of nutritional science and supplementation. We have asked him for his expert opinion on a number of nutrients, to feature in our blog. We hope you enjoy these insights and overviews of some key nutrients.

In this blog he talks about the nutrient Lactoferrin.

Lactoferrin (Lf) is a small molecule as far as proteins go. Its structure is like a spring that coils onto itself and is able to trap and hold minerals within its many folds. This is a unique property as we shall see. Lactoferrin is abundant in mothers’ milk, especially the first milk or colostrum that helps protect the newborn but is also present in other bodily fluids like tears, saliva, sweat, urine etc., signifying its importance as a valuable defence molecule.

Lactoferrin plays an important role in a wide range of diseases including in anaemia, as an antioxidant, anti-inflammatory, and anti-microbial with gut modifying microbiome properties. Let us discuss each of these categories.

Anaemia:

Lactoferrin has this huge capacity to bind and trap different metal ions but particularly iron. Because of this unique feature, Lf helps maintain and balance levels of iron in the body. This is important since too little iron can cause anaemia, which is reduced number of red blood cells and/or the oxygen carrying capacity of haemoglobin. Approximately 40% of pregnant women are anemic, and a similar number of pre-school aged children. On the other hand, if the iron levels are too high then this can cause oxidative stress. Where the body is put under pressure from within.

Due to this unique ability to trap iron, Lf helps improve serum iron and haemoglobin levels. In several human studies, Lf has been shown to increase iron levels similar to iron supplements that doctors prescribe for Iron deficiency anaemia (IDA), like ferrous sulphate or gluconate. Majority of these studies have shown that Lf either shows similar or better benefits to iron supplementation and with fewer side effects like stomach upset and constipation. In fact, a recent review confirms Lf as the drug of choice for IDA during pregnancy (Abu Hashim et-al, 2017).

Antimicrobial activity:

Lf is active against a whole range of pathogenic (bad organisms) including bacteria, viruses, fungi, and parasites.  Due to its unique aspect of entrapping iron, iron becomes less available to microorganisms which thrive on iron to grow. By withholding iron, pathogens are literally starved and less likely to grow and spread.

Other mechanisms by which Lf fights off various pathogenic organisms includes:

  • Lf binds with the microorganisms’ cell membrane by puncturing holes and weakening the membrane and causing it to leak and self-destruct.
  • Preventing adhesion of the microorganisms within the body especially in the gastrointestinal tract which is the major site of harbouring organisms.
  • Preventing biofilm formation which acts as a shield for the pathogen which is responsible for resistance against antibiotics and anti-viral medications.

Furthermore, several studies have shown that Lf reduces other bacteria like Helicobacter pylori, and fungi like Candida albicans infections.

Lf has also been shown to be active against a range of viruses like Herpes simplex virus, Cytomegalovirus, Human hepatitis B and C viruses and possibly other viruses like SARS and HIV.

A recent Italian study showed that Lf could counteract the coronavirus infection and the associated inflammation. The researchers found that Lf helped with clearance of the virus and help with the recovery. The researchers concluded that Lf can be used as a safe and efficacious natural agent to prevent and treat COVID-19 infection.

Decreasing risk of sepsis especially in the neonates.

Babies born pre-term are at risk of infections because their immune system hasn’t fully developed. One such condition is called necrotising enterocolitis (NEC) which not only causes damage to the gut of the baby, but as a result causes inflammation and sepsis. Lactoferrin has been shown to prevent such conditions. Part of this benefit may also be due to Lf acting as a pre-biotic or food for the good bacteria so they can nourish and flourish while competing against the bad or pathogenic bacteria.

AOR has been instrumental in three such studies with Montreal University and Queens university, as well with an ongoing multi-centre study in 5 different hospitals in Canada with university of Toronto.

Anti-inflammatory action:

Several studies have indicated that Lf acts as an immune modulator by both helping the immune system to mature fully especially in the newborn, infants and children but also in the immune compromised population e.g. HIV, transplant patients taking immunosuppressive drugs like cyclosporin, and in seniors who have weakened immune system. Lf supresses the common inflammatory mediators like NF-kB and acting at the nuclear levels by turning off the various pro-inflammatory genes.

Other effects:

Lf has been looked at the following:

  • Reducing obesity
  • Bone Health
  • Dry eyes
  • Skin health especially dermatitis

Conclusion

Lf has been studied for over sixty years and has been shown to be a natural immune enhancer acting in a unique manner in denying pathogens the vital iron they need as food. Lf is also an excellent supplement for gut health by promoting growth of beneficial bacteria like Akkermansia at the expense of pathogenic bacteria. Finally, Lf is a safe ingredient widely used in infant formulas but also in enhancing immunity and gut health in adults.

References:

Supreti F “Lactoferrin from Bovine Milk: A protective role for life” Nutrients 2020, 12: 2562-2587

Wang B et-al, “Lactoferrin: Structure, function, denaturation and digestion”. Crit Rev. Food Sci. 2019, 59: 580-596

Abu Hashim, H et-al, “Lactoferrin or ferrous salts for iron deficiency anemia in pregnancy: A meta-analysis of randomized trials” Eur J Obstet. Gynecol. Reprod. Biol. 2017, 219: 45-52

Sharma D et-al, “Role of lactoferrin in neonatal care: A systemic review” J Matern. Fetal neonatal Med, 2017, 30: 1920-1932

Orisi, N, “The antimicrobial activity of lactoferrin” Biometals, 2004, 17: 189-196

Giansanti, F et-al, “Lactoferrin from Milk: Nutraceutical and Pharmacological properties” 2016, 9: 61-69

Fernandes KE et-al, “The antifungal activity of lactoferrin and its derived peptides: Mechanisms of action and synergy with drugs against fungal pathogens” Front Microbiol, 2017, 8: 2-11

Campione E, et-al “Lactoferrin as Protective Natural Barrier of Respiratory and Intestinal Mucosa against Coronavirus Infection and Inflammation”. Int J Mol Sci. 2020 Jul 11;21(14):4903. doi: 10.3390/ijms21144903. PMID: 32664543; PMCID: PMC7402319. https://pubmed.ncbi.nlm.nih.gov/32664543/

Campione, E, et al, “Pleiotropic effect of Lactoferrin in the prevention and treatment of COVID-19 infection: randomized clinical trial, in vitro and in silico preliminary evidence” bioRxiv 2020.08.11.244996; doi: https://doi.org/10.1101/2020.08.11.244996 https://www.biorxiv.org/content/10.1101/2020.08.11.244996v3

Asztalos E et-al, “Lactoferrin infant feeding trial Canada (LIFT): protocol for a randomized trail of adding lactoferrin to feeds of very-low-birth-weight preterm infants” BMC Pediatrics 2020, 20: 40

Grzywacz K et-al, “Bovine lactoferrin supplementation does not disrupt microbiota development in preterm infants receiving probiotics”, j Pediatric Gastro. Nutrition, 2020, 7:216-222

Muscedere J et-al, “Prevention of nosocomial infections in critically ill patients with lactoferrin: A randomised double-blind, placebo-controlled study”. Critical Care Medicine, 2018;46:1450-1456