乳铁蛋白在口服营养补充剂（ONS）中对感染导致发育不良儿童的白细胞介素-6和白细胞介素-10的影响。

Effect of lactoferrin in oral nutrition supplement (ONS) towards IL-6 and IL-10 in failure to thrive children with infection.

作者信息

Widjaja Nur Aisiyah, Hamidah Azizah, Purnomo Marissa Tulus, Ardianah Eva

机构信息

Child Health, Airlangga University, Surabaya, East Java, 60286, Indonesia.

出版信息

F1000Res. 2023 Dec 19;12:897. doi: 10.12688/f1000research.130176.3. eCollection 2023.

DOI:10.12688/f1000research.130176.3

PMID:38434639

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10904948/

Abstract

BACKGROUND

Growth failure due to infection in children is a major health problem throughout the world. It provokes a systemic immune response, with increased interleukin (IL)-6 and reduced IL-10. Lactoferrin (Lf) is a multifunctional iron-binding protein that can be found in whey protein inside formula milk such as oral nutrition supplement (ONS), which is able to upregulate anti-inflammatory cytokines (IL-10) and modulate pro-inflammatory cytokines. We conducted this study to investigate the effect of Lf supplementation in ONS on IL-6 and IL-10 levels in children with failure to thrive and infection.

METHODS

We performed a quasi-experimental pre- and post-study in children aged 12-60 months old with failure to thrive due to infectious illness. The subjects received 400 ml of oral nutritional supplements (ONS, 1 ml equivalent to 1 kcal) each day for 90 days, and their parents received dietary advice and medication based on the underlying illness. Blood was drawn to measure IL-6 and IL-10 before and after the intervention.

RESULTS

There were 75 subjects recruited and divided into group-1 and group-2 based on age. The incidence of undernutrition was 37.33%. Lf in ONS intervention improved body weight and body length. Lf also reduced IL-6, although there was not a significant difference before and after the intervention. However, the IL-6 reduction was significantly higher in subjects with undernutrition compared with subjects with weight faltering. Pre-intervention IL-6 levels were higher in children with stunting than in children with normal stature. There was a greater change in IL-6 in children with severe stunting than in children with normal stature or stunting. IL-10 was significantly reduced after the intervention.

CONCLUSIONS

In addition to improving body weight and length, Lf supplementation in ONS improved immune response homeostasis by balancing IL-6 and IL-10 levels and by improving the IL-6/IL-10 ratio.ClinicalTrials.gov number ID: NCT05289674, dated May 3 2022.

摘要

背景

儿童因感染导致生长发育迟缓是全球主要的健康问题。它会引发全身免疫反应，导致白细胞介素（IL）-6升高和IL-10降低。乳铁蛋白（Lf）是一种多功能铁结合蛋白，可在配方奶（如口服营养补充剂（ONS））中的乳清蛋白中找到，它能够上调抗炎细胞因子（IL-10）并调节促炎细胞因子。我们开展这项研究以调查在ONS中补充Lf对发育迟缓且伴有感染的儿童IL-6和IL-10水平的影响。

方法

我们对12至60个月因感染性疾病导致发育迟缓的儿童进行了一项准实验性前后对照研究。受试者每天接受400毫升口服营养补充剂（ONS，1毫升相当于1千卡），持续90天，其父母根据潜在疾病接受饮食建议和药物治疗。在干预前后采集血液以测量IL-6和IL-10。

结果

共招募了75名受试者，并根据年龄分为1组和2组。营养不良发生率为37.33%。ONS干预中的Lf改善了体重和身长。Lf也降低了IL-6，尽管干预前后没有显著差异。然而，与体重增长缓慢的受试者相比，营养不良受试者的IL-6降低更为显著。发育迟缓儿童的干预前IL-6水平高于正常身高儿童。重度发育迟缓儿童的IL-6变化大于正常身高或发育迟缓儿童。干预后IL-10显著降低。