Bovine Lactoferrin, a vital alternative to traditional diverticulitis treatment
Those of us who have diverticulitis know that it is an inflammatory infection in the intestines. The infection takes place in a distended area of the intestine known as a diverticulum (think of this as a very, very small appendix) where digested food can become lodged and not excreted by the normal function of the intestines. The result is that one or more types of bacteria proliferate in the trapped space, an acute infection develops, acute pain follows and medical treatment becomes absolutely necessary. Typical treatment usually consists of high doses of antibiotics. Of the roughly 3 million Americans with diverticulitis approximately 62,000 are forced to undergo surgical resection to remove damaged and frequently perforated tissue. These people are still at high risk of recurrence and quite possibly additional surgical intervention.
Sadly, once an individual experiences diverticulitis, they are likely to experience it again. For many people it becomes a chronic recurrent disease. While antibiotics can kill the bad actors causing the infection, acute pain can persist for weeks or even months as the body’s immune system continues to attack remnants of the dead bacteria, or bacterial endotoxin. Additionally, the antibiotics used to thwart the infection kill off the healthy bacteria that are essential for good gut health. This is likely paving the way for recurrent infection. Probiotics such as yogurt and Kefir are helpful, but probably inadequate in restoring a healthy microbiome after antibiotic treatment.
So then, what’s there to do? Lactoferrin for Prevention of NEC and Diverticulitis
Bovine lactoferrin, a protein that occurs naturally in cow’s milk, is currently being studied in large, multicenter, multinational trials in low birth weight, premature infants. The ultimate goals are prevention and successful treatment of two conditions known as Necrotizing Enterocolitis and Late Onset Sepsis (NEC). NEC is a devastating infection of the intestines most commonly present in premature infants. Because the infants’ intestines are not fully developed, they are more vulnerable to infection. Like treatment for diverticulitis, high dose antibiotics are administered in an attempt to control the infection. Surgical resection of the intestine is frequently attempted to remove necrotic tissue (can you imagine that surgery on an infant that weighs 1 pound?).
Sepsis commonly occurs when the infection cannot be controlled and moves to the blood. It is heartbreaking and alarming to know that roughly 50,000 babies die each year in the US from this condition.
My friend and colleague Professor Michael Sherman (who we most sadly lost in 2017) was a leader in the thinking and research about the role of lactoferrin for the prevention of NEC. His exemplary career and contributions to Neonatology deserve our continued recognition. At least one emerging US biopharmaceutical company was influenced by Professor Sherman and his thinking in this area. They may have the opportunity to complete development of bovine lactoferrin, seek and receive FDA approval, and completely change the treatment paradigm in vulnerable infants. We hope that they do.
It was in conversation with Professor Sherman that I first heard of the parallels between NEC in premature infants and diverticulitis in adults.
From our conversations* we now understand that both diseases are infections of the intestine due to under-formed, malformed or weakened tissue. Both diseases are treated with antibiotics which may control infection but have no effect on preventing a recurrence. Damage will continue in both diseases even after resolution of infection due to the presence of bacterial endotoxin on and in the intestinal wall over which antibiotics have no effect. This is most certainly the source of continued post-infection pain in adults with diverticulitis. Many have studied and explained the ability of lactoferrin to kill pathogenic bacteria. But Michael Sherman was perhaps the first and certainly the most clear in describing the importance of lactoferrin in clearing residual endotoxin after infection has subsided: bovine lactoferrin has two endotoxin binding sites which grab the bad bacteria and take it out with waste. Removing it allows the immune system to calm down. The purest forms of bovine lactoferrin make this process more effective. This is why Epiphany Therapeutics puts in the effort to provide the purest form of bovine lactoferrin, free of bacterial endotoxin.
Research on the effectiveness of bovine lactoferrin will continue, but if you would like to learn more about the effectiveness of bovine lactoferrin, take a look at our testimonials page.
*The FDA has not reviewed or ruled on any of the statements below. He is not with us to confirm the language, and FDA has not reviewed either his language or my representation of it.