Download PDF
CC BY 4.0 · Journal of Child Science 2021; 11(01): e199-e204
DOI: 10.1055/s-0041-1731073
Original Article

Lactoferrin Efficacy versus Ferrous Sulfate in Treatment of Children with Iron Deficiency Anemia

Osama Mahmoud El-Asheer 
1   Pediatric Department, Faculty of Medicine, Assiut University, Asyut, Egypt
,
Ahmed Gaber Ahmed
1   Pediatric Department, Faculty of Medicine, Assiut University, Asyut, Egypt
,
Zainab AbdelAal Abdel Hafez
2   Clinical Pathology Department, Faculty of Medicine, Assiut University, Asyut, Egypt
,
Marwa AbdelHafiz Dahpy 
3   Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Assiut University, Asyut, Egypt
,
Amal AbdElSalam Soliman
1   Pediatric Department, Faculty of Medicine, Assiut University, Asyut, Egypt
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Lactoferrin (LF) is an iron-binding globular glycoprotein that is structurally and chemically similar to serum transferrin. Many studies have been done to evaluate the effect of oral LF administration on iron deficiency anemia (IDA) with controversial results. This study was designed to compare the efficacy of LF versus oral ferrous sulfate (OFS) therapy in the treatment of children with IDA. A significant increase in mean hemoglobin and serum iron concentrations was noted in the group that received oral bovine LF (11.06 ± 0.96 and 42.79 ± 6.14, respectively) versus the group that received OFS (10.24 ± 0.57 and 28.94 ± 5.05, respectively, with p < 0.001 for each) after 30 days of the treatment with fewer side effects (9.3 vs. 33.3% with p = 0.043). Oral bovine LF is a more effective and safer alternative in treating iron deficiency and IDA compared with OFS with clinical benefits of fewer side effects and better patient compliance.

Keywords

Iron - iron deficiency anemia - lactoferrin - ferrous sulfate - hemoglobin

Authors' Contributions

All authors read and approved the final manuscript. O.M.E. designed the study, evaluated the patients, collected, analyzed, and interpreted the data. O.M.E., A.G.A., and A.A.S. contributed to the conception and design of the study, literature search, and manuscript review. M.A.D. contributed to the biochemical laboratory assessment, interpretation of data analysis, manuscript writing, and review. All authors helped in revising and approving the manuscript.


Ethical Approval and Consent to Participate

The study was approved by the Ethics Committee of the Faculty of Medicine, Assiut University (IRB no: 17100915). Verbal informed consents were taken from parents with explanation of benefits of the study, risks expected, and suggested treatment for each case. As the manuscript does not contain any kind of content which can reveal patient's identity, so written informed consent was not taken from the guardians.




Publication History

Received: 07 December 2020

Accepted: 26 March 2021

Article published online:
20 July 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Özdemir N. Iron deficiency anemia from diagnosis to treatment in children. Turk Pediatri Ars 2015; 50 (01) 11-19
    CrossrefPubMedGoogle Scholar
  • 2 Al Ghwass MM, Halawa EF, Sabry SM, Ahmed D. Iron deficiency anemia in an Egyptian pediatric population: a cross-sectional study. Ann Afr Med 2015; 14 (01) 25-31
    CrossrefPubMedGoogle Scholar
  • 3 Roganović J, Starinac K. 2018. Iron deficiency Anemia in children, In: Jesmine Khan, eds. Current Topics of Anemia. Croatia: InTech open, Janeza Trdine; 47-71
  • 4 Camaschella C. Iron deficiency: new insights into diagnosis and treatment. Hematology (Am Soc Hematol Educ Program) 2015; 2015 (01) 8-13
    CrossrefPubMedGoogle Scholar
  • 5 Jiang R, Lönnerdal B. Cloning and characterization of the human lactoferrin receptor gene promoter. Biometals 2018; 31 (03) 357-368
    CrossrefPubMedGoogle Scholar
  • 6 Rosa L, Cutone A, Lepanto MS, Paesano R, Valenti P. Lactoferrin: a natural glycoprotein involved in iron and inflammatory homeostasis. Int J Mol Sci 2017; 18 (09) 1985
    CrossrefPubMedGoogle Scholar
  • 7 Superti F. Lactoferrin from bovine milk: a protective companion for life. Nutrients 2020; 12 (09) 2562
    CrossrefPubMedGoogle Scholar
  • 8 Wang B, Timilsena YP, Blanch E, Adhikari B. Lactoferrin: structure, function, denaturation and digestion. Crit Rev Food Sci Nutr 2019; 59 (04) 580-596
    CrossrefPubMedGoogle Scholar
  • 9 Russo G, Guardabasso V, Romano F. et al. Monitoring oral iron therapy in children with iron deficiency anemia: an observational, prospective, multicenter study of AIEOP patients (Associazione Italiana Emato-Oncologia Pediatrica). Ann Hematol 2020; 99 (03) 413-420
    CrossrefPubMedGoogle Scholar
  • 10 Adamson JW. Iron deficiency and other hypoproliferative anemias. In: Fauci AS, Braunwald E, Kasper DL. et al, eds. Harrison's Principles of Internal Medicine. New York, NY: McGraw-Hill; 2008: 628-634
    Google Scholar
  • 11 El-Khawaga A, Abdelmaksoud H. Effect of lactoferrin supplementation on iron deficiency anemia in primary school children. Int J Med Arts 2019; 1 (01) 48-52
    PubMedGoogle Scholar
  • 12 Taruni R. A Comparative Study to Evaluate the Efficacy of Oral Lactoferrin Fortified Bovine Colostrum with Oral Iron in the treatment of Iron Deficiency Anemia [Doctoral dissertation]. Chennai, India: Kilpauk Medical College; 2015
    Google Scholar
  • 13 Paesano R, Berlutti F, Pietropaoli M, Goolsbee W, Pacifici E, Valenti P. Lactoferrin efficacy versus ferrous sulfate in curing iron disorders in pregnant and non-pregnant women. Int J Immunopathol Pharmacol 2010; 23 (02) 577-587
    CrossrefPubMedGoogle Scholar
  • 14 Parodi E, Giraudo MT, Davitto M. et al. Reticulocyte parameters: markers of early response to oral treatment in children with severe iron-deficiency anemia. J Pediatr Hematol Oncol 2012; 34 (06) e249-e252
    CrossrefPubMedGoogle Scholar
  • 15 Saha L, Pandhi P, Gopalan S, Malhotra S, Saha PK. Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women. MedGenMed 2007; 9 (01) 1
    PubMedGoogle Scholar
  • 16 Embleton ND, Berrington JE, McGuire W, Stewart CJ, Cummings SP. Lactoferrin: antimicrobial activity and therapeutic potential. Semin Fetal Neonatal Med 2013; 18 (03) 143-149
    CrossrefPubMedGoogle Scholar
  • 17 Wada Y, Lönnerdal B. Bioactive peptides derived from human milk proteins--mechanisms of action. J Nutr Biochem 2014; 25 (05) 503-514
    CrossrefPubMedGoogle Scholar
  • 18 Oda H, Wakabayashi H, Yamauchi K, Abe F. Lactoferrin and bifidobacteria. Biometals 2014; 27 (05) 915-922
    CrossrefPubMedGoogle Scholar