Colostrum Therapy for Human Gastrointestinal Health and Disease
Abstract
:1. Introduction
2. The Mucosal Barrier in the Gut
- The gastric acid barrier limiting access to the intestine;
- The epithelium, a single cell monolayer joined by tight junctions and other cell adhesion structures [22], and which is continuously replaced from the crypts;
- Intra-epithelial lymphocytes (IELs), a group of resident lymphocytes;
- Lymphocytes and macrophages in the lamina propria, which circulate to mesenteric lymph nodes and provide anamnestic immunity;
- Downstream, the macrophage (Kupffer cell) compartment of the liver provides a barrier against pathogens and pathogen-associated molecular patterns (PAMPs), which escape the first four elements of the barrier listed above. This will not be discussed further;
- The microbiota, which confers resistance to extraneous colonization.
3. Gastrointestinal Repair Mechanisms
4. Clinical Applications: Colostrum as Therapy
4.1. NSAID-Induced Gastrointestinal Injury
4.2. Inflammatory Bowel Disease (IBD)
4.3. Infectious Diarrhea
4.4. Short Bowel Syndrome; Intestinal Failure
4.5. Necrotizing Enterocolitis
4.6. Intestinal Consequences of Cancer Treatment
4.7. Use of BC in Combination with Other Nutraceuticals
4.8. Other Conditions
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
References
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First Author | Country | Study Population | Year | Number of Participants (Human Studies Only) | Conclusion |
---|---|---|---|---|---|
NSAID-Induced Gut Injury | |||||
Playford et al. [37] | UK | Animal (Mice) | 1999 | Colostrum preparation has major beneficial effects in preventing NSAID-induced gut injury | |
Kim et al. [38] | Korea | Animal (rats) | 2005 | BC ameliorated NSAID-induced intestinal damage and bacterial translocation, especially when combined with glutamine | |
Cairangzhuoma et al. [39] | Japan | Animal (mice) | 2013 | Late BC aids in recovery and inhibition of NSAID-induced small intestinal injury in mouse model | |
Playford et al. [40] | UK | RCT (cross over) | 2001 | Acute effect, 7; long-term, 22 | Compared to indomethacin alone, BC reduced the impact of indomethacin on gut permeability only in the short term |
Inflammatory Bowel Disease | |||||
Kanwar et al. [41] | New Zealand | Animal (mice) | 2016 | Bovine milk components attenuated the severity of DSS-induced colitis in mice with differing effectiveness against specific disease parameters | |
Filipescu et al. [42] | Italy | Animal (mice) | 2018 | Pre-treatment of mice with BC reduces TNBS-induced intestinal damage | |
Spalinger et al. [43] | Switzerland | Animal (mice) | 2019 | Hyperimmune BC reduces intestinal inflammation by increasing Treg cell induction while decreasing accumulation of pathogenic T cells | |
Playford et al. [44] | UK | Animal (mice) | 2020 | Combination of BC and egg synergistically reduced indomethacin and DSS-induced gut damage | |
Menchetti et al. [45] | Italy | Animal (mice) | 2020 | Pre-treatment with BC modulates the expression of genes and the count of microbes involved in the etiopathogenesis of colitis | |
Khan et al. [46] | UK | RCT | 2002 | 14 | Mesalazine and BC enema improved symptoms in patients with left sided colitis compared to mesalazine with placebo |
Infectious Diarrhea | |||||
Choudhry et al. [47] | UK | Cell culture model of microbial translocation | 2020 | BC reduced enteropathogen-mediated damage in Caco-2 cells | |
Li et al. [48] | China | Meta-analysis | 2019 | BC products were effective in controlling clinical symptoms and pathogenic agents in children with infectious diarrhea | |
Barakat et al. [49] | Egypt | RCT | 2020 | 160 | BC is effective in the treatment of acute diarrhea and can be considered as adjuvant therapy in both viral and bacterial diarrhea to prevent diarrhea-related complications |
Gaensbauer et al. [50] | Guatemala | RCT | 2017 | 301 | A BC and hen’s egg derived feed reduced acute non-bloody diarrheal duration in children in a subgroup with an identified pathogen; the primary outcome was not met |
Saad et al. [51] | Open multicentric, noncomparative | 2016 | 160 | BC was effective in reducing the number of episodes of URTI and diarrhea in children | |
Otto et al. [52] | Poland | RCT | 2011 | 90 | Hyperimmune BC is effective in protecting adult volunteers against diarrhea caused by ETEC |
Kaducu et al. [53] | Uganda | RCT | 2011 | 87 | Addition of BC-based supplement is effective in treatment of HIV-associated diarrhea in adults |
Eslamian et al. [54] | RCT | 2019 | 70 | BC supplementation may have beneficial effects on intestinal permeability and gastrointestinal complications in ICU-hospitalized patients | |
Bierut et al. [55] | Malawi | RCT | 2021 | 267 | Addition of BC and egg to complementary feeding in Malawian infants resulted in less linear growth faltering. Episodes of diarrhea and β-diversity of the 16S configuration of fecal microbiota did not differ between the treatment group and controls |
Short Bowel Syndrome | |||||
Paris et al. [56] | Australia | Animal (piglets) | 2004 | A polymeric infant formula supplemented with BC given to pig model of SBS was associated with significant increase in plasma GLP-2, suggesting the role of GLP-2 in intestinal adaptation post resection | |
Nagy et al. [57] | Animal (piglets) | 2004 | In pig model of SBS, supplementation with colostrum protein concentrate resulted in normal weight gain and features of enhanced morphologic adaptation | ||
Pereira-Fantini et al. [58] | Australia | Animal (piglets) | 2008 | Following bowel resection, colostrum protein concentrate significantly increased circulating levels of IGF-1 and IGFBPs | |
Aunsholt et al. [59] | Denmark | Animal (piglets) | 2018 | Parenteral nutrition (PN) with minimal enteral nutrition with BC or formula induced similar intestinal adaption after resection | |
Aunsholt et al. [60] | Denmark | RCT (crossover) | 2012 | 9 | Inclusion of bovine colostrum to the diet did not improve intestinal function |
Lund et al. [61] | Denmark | RCT | 2012 | 12 | BC did not significantly improve intestinal absorption, body composition, or functional tests compared with the control |
Necrotizing Enterocolitis | |||||
Jensen et al. [62] | Denmark | Animal (piglets) | 2013 | BC and human milk are both superior to formula in stimulating gut structure, function, and NEC resistance in preterm piglets | |
Li et al. [63] | Denmark | Animal (piglets) | 2014 | The maturational and protective effects on the immature intestine decreased in the order BC > mature bovine milk >whole milk powder, but all three were markedly better than formula | |
Støy et al. [64] | Animal (piglets) | 2014 | Bovine colostrum restores intestinal function after initial formula-induced inflammation in preterm pigs | ||
Seigel et al. [65] | USA | Retrospective cohort | 2013 | 369 | Initiating oropharyngeal COL in ELBW infants in the first 2 postnatal days appears feasible and safe and may be nutritionally beneficial |
Balachandran et al. [66] | India | RCT | 2017 | 86 | The use of prophylactic enteral BC in VLBW infants showed a trend toward increased stool IL-6 and features of NEC; there were no clinical benefits |
Nasuf et al. [67] | Systematic review | 2018 | Limited available evidence currently suggests that oropharyngeal administration of mother’s colostrum starting within the first 48 h of life does not reduce the risk of NEC, late-onset infection, or death until discharge in preterm infants, including very preterm, VLBW infants | ||
ELFIN trial investigators group [68] | RCT | 2019 | 2203 | Enteral supplementation with bovine lactoferrin (derived from milk) did not reduce the risk of late-onset infection in very preterm infants | |
Tao et al. [69] | Meta-analysis of RCTs | 2020 | BC does not reduce the incidences of NEC, late onset sepsis, and death in preterm infants, but there is a trend toward a positive effect | ||
Sharma et al. [70] | India | RCT | 2020 | 117 | There was no significant reduction in the incidence of NEC in the BC group but there was significant reduction of 7 days of hospital stay in the BC group |
Sadeghirad et al. [71] | Meta-analysis | 2018 | Bovine or human colostrum has no effect on severe NEC, mortality, culture-proven sepsis, feed intolerance, or length of stay |
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Chandwe, K.; Kelly, P. Colostrum Therapy for Human Gastrointestinal Health and Disease. Nutrients 2021, 13, 1956. https://doi.org/10.3390/nu13061956
Chandwe K, Kelly P. Colostrum Therapy for Human Gastrointestinal Health and Disease. Nutrients. 2021; 13(6):1956. https://doi.org/10.3390/nu13061956
Chicago/Turabian StyleChandwe, Kanta, and Paul Kelly. 2021. "Colostrum Therapy for Human Gastrointestinal Health and Disease" Nutrients 13, no. 6: 1956. https://doi.org/10.3390/nu13061956