Venkatesh Mohan, Abrams Steven
Department of Pediatrics, Section of Neonatology, Texas Children's Hospital & Baylor College of Medicine, Houston, TX 77030, USA.
Expert Rev Anti Infect Ther. 2009 Jun;7(5):515-25. doi: 10.1586/eri.09.25.
Despite the use of potent antimicrobials, neonatal sepsis and necrotizing enterocolitis are associated with significant mortality and morbidity. The emergence of microbial antibiotic resistance is a grave concern. Inflammation secondary to sepsis and necrotizing enterocolitis increases pulmonary and cerebral morbidity. New strategies that target inflammation and reduce the emergence of antibiotic resistance are urgently needed. Lactoferrin has broad-spectrum antimicrobial and immunomodulatory activities. In animal models of colitis, lactoferrin reduces inflammatory injury. Lactoferrin also induces the receptor-mediated proliferation and differentiation of intestinal cells. A randomized, controlled trial of lactoferrin in premature neonates to prevent late-onset sepsis is currently in progress. Lactoferrin is a promising agent in the prevention of neonatal sepsis and necrotizing enterocolitis but needs further evaluation to confirm its safety, tolerability and efficacy.
尽管使用了强效抗菌药物,但新生儿败血症和坏死性小肠结肠炎仍伴有显著的死亡率和发病率。微生物抗生素耐药性的出现是一个严重问题。败血症和坏死性小肠结肠炎继发的炎症会增加肺部和脑部的发病率。迫切需要针对炎症并减少抗生素耐药性出现的新策略。乳铁蛋白具有广谱抗菌和免疫调节活性。在结肠炎动物模型中,乳铁蛋白可减轻炎症损伤。乳铁蛋白还可诱导受体介导的肠道细胞增殖和分化。目前正在进行一项关于乳铁蛋白预防早产儿晚发性败血症的随机对照试验。乳铁蛋白在预防新生儿败血症和坏死性小肠结肠炎方面是一种有前景的药物,但需要进一步评估以确认其安全性、耐受性和有效性。