Villavicencio Aasith, Rueda Maria S, Turin Christie G, Ochoa Theresa J
a Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima 31, Peru.
b Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
Biochem Cell Biol. 2017 Feb;95(1):12-21. doi: 10.1139/bcb-2016-0060. Epub 2016 Aug 4.
Lactoferrin (LF) is a breast milk glycoprotein with antimicrobial and anti-inflammatory effects. Its beneficial properties in infants, especially in those born preterm, are currently being studied in clinical trials. However, the maternal and nursing infant factors that may affect LF concentration in breast milk are still not clear. We conducted a systematic review to investigate the factors that may affect the concentration of LF in breast milk. We used a 2-step approach to identify the eligible studies according to inclusion/exclusion criteria, and to determine which studies would be considered. We included 70 qualified articles from 29 countries with publication dates ranging from 1976 to 2015. We described the correlation between LF concentration in breast milk and lactation stage; 10 maternal factors, such as race, parity, among others; and 2 infant factors: infections and prematurity. Colostrum has the highest LF levels, but they decrease with days postpartum. No other factor has been consistently associated with LF concentration. A major limitation of the majority of the published studies is the small sample size and the different methods used to measure LF concentration. Therefore, there is a need for large, multicenter studies with standardized study design, sample collection, and LF measurement methods to identify clinically significant factors associated with LF expression in breast milk, which will help promote exclusive breastfeeding in preterm infants.
乳铁蛋白（LF）是一种具有抗菌和抗炎作用的母乳糖蛋白。目前正在临床试验中研究其对婴儿，尤其是早产儿的有益特性。然而，可能影响母乳中LF浓度的母体和哺乳婴儿因素仍不清楚。我们进行了一项系统综述，以调查可能影响母乳中LF浓度的因素。我们采用两步法根据纳入/排除标准确定符合条件的研究，并确定哪些研究将被纳入。我们纳入了来自29个国家的70篇合格文章，发表日期从1976年到2015年。我们描述了母乳中LF浓度与泌乳阶段之间的相关性；10个母体因素，如种族、胎次等；以及2个婴儿因素：感染和早产。初乳中LF水平最高，但会随着产后天数的增加而下降。没有其他因素一直与LF浓度相关。大多数已发表研究的一个主要局限性是样本量小以及测量LF浓度的方法不同。因此，需要进行大规模、多中心研究，采用标准化的研究设计、样本采集和LF测量方法，以确定与母乳中LF表达相关的具有临床意义的因素，这将有助于促进早产儿的纯母乳喂养。
