Oral Lactoferrin Supplementation during Induction Chemotherapy Promotes Gut Microbiome Eubiosis in Pediatric Patients with Hematologic Malignancies

Induction chemotherapy is the first-line treatment for pediatric patients with hematologic malignancies. However, several complications may arise, mainly infections and febrile neutropenia, with a strong impact on patient morbidity and mortality. Such complications have been shown to be closely rela...

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Published inPharmaceutics Vol. 14; no. 8; p. 1705
Main Authors D’Amico, Federica, Decembrino, Nunzia, Muratore, Edoardo, Turroni, Silvia, Muggeo, Paola, Mura, Rosamaria, Perruccio, Katia, Vitale, Virginia, Zecca, Marco, Prete, Arcangelo, Venturelli, Francesco, Leardini, Davide, Brigidi, Patrizia, Masetti, Riccardo, Cesaro, Simone, Zama, Daniele
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 01.08.2022
MDPI
Subjects
Antibiotics
Blood diseases
Cancer
Cancer therapies
Care and treatment
Chemotherapy
Children
Clinical trials
Composition
Diagnosis
Dosage and administration
eubiosis
gut microbiota
Health aspects
hematologic malignancies
Immunotherapy
lactoferrin
Lactoferrins
Leukemia
Microbiota (Symbiotic organisms)
Mortality
Neutropenia
oral supplementation
Patient outcomes
Patients
Pediatrics
Italy
United States > US
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Summary:Induction chemotherapy is the first-line treatment for pediatric patients with hematologic malignancies. However, several complications may arise, mainly infections and febrile neutropenia, with a strong impact on patient morbidity and mortality. Such complications have been shown to be closely related to alterations of the gut microbiome (GM), making the design of strategies to foster its eubiosis of utmost clinical importance. Here, we evaluated the impact of oral supplementation of lactoferrin (LF), a glycoprotein endowed with anti-inflammatory, immunomodulatory and antimicrobial activities, on GM dynamics in pediatric oncohematologic patients during induction chemotherapy. Specifically, we conducted a double blind, placebo-controlled trial in which GM was profiled through 16S rRNA gene sequencing before and after two weeks of oral supplementation with LF or placebo. LF was safely administered with no adverse effects and promoted GM homeostasis by favoring the maintenance of diversity and preventing the bloom of pathobionts (e.g., Enterococcus). LF could, therefore, be a promising adjunct to current therapeutic strategies in these fragile individuals to reduce the risk of GM-related complications.
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These authors contributed equally to this work.
ISSN:1999-4923
1999-4923
DOI:10.3390/pharmaceutics14081705