Professor Resia Pretorious is a physiologist from the Department of Physiological Sciences at the University of Stellenbosch, a prestigious university town near Cape Town. Her research interests are abnormal blood clotting and discovering circulating inflammatory molecules that cause blood to clot faster. Recently, she’s also turned her attention to Covid-19 and the reasons for abnormal clotting in this condition, together with one of her longstanding collaborators, Professor Douglas Kell from the University of Liverpool. Together they’ve been interested in nutraceuticals that may treat abnormal clotting in inflammatory diseases and this research lead them to the molecule at the heart of Leapfrog Remedies: Lactoferrin. Last year they published the paper The Biology of Lactoferrin, an Iron-Binding Protein That Can Help Defend Against Viruses and Bacteria (Frontiers in Immunology).
Resia, what is your elevator pitch on Lactoferrin?
Lactoferrin is a nutrient classically found in mammalian milk and inside blood cells called neutrophils. However, it can also be taken as a supplement usually from cow’s milk, known as bovine lactoferrin. Bovine lactoferrin is also deemed a “Generally Recognized as Safe” substance by the Food and Drug Administration in the USA and Europe’s EFSA. Lactoferrin is also known as Lactotransferrin and it has recently come under the spotlight, particularly with regards to the coronavirus pandemic. It binds iron in circulation and is transferred via a variety of receptors between cells and the circulation. Receptors are the little gatekeeper doors on cells that assist molecules to enter into cells.
What is Lactoferrin’s role in the body?
Lactoferrin is known for its iron-binding capabilities, also known as iron chelating properties. Lactoferrin has a two lobular structure: it binds one ferric iron atom in each of its two lobes, and an important attribute is that it does not release its iron. It therefore prevents oxidative stress in the body. Too much iron in circulation is a source of oxidative stress and inflammation. Lactoferrin also has important immunological properties, and is both anti-bacterial and anti-viral.
How is Lactoferrin unique and special?
One of the most well-known and interesting characteristics of lactoferrin is that it is anti-bacterial, anti-viral, anti-fungal, anti-inflammatory, and anti-carcinogenic. Microbes use iron to feed on and when iron is too high in circulation, it is a perfect breeding ground for microbes. Lactoferrin therefore has an important mechanism and ability to limit iron availability to microbes and is one of its crucial anti-microbial properties.
How else can it protect against viruses and bacteria?
Lactoferrin is known to interfere with some of the receptors used by coronaviruses to enter into cells and therefore lactoferrin as supplement may potentially contribute to the prevention and also perhaps treatment of acute COVID-19 infections. So essentially, in COVID-19 infection, lactoferrin may have a role to play in sequestering iron and even other inflammatory molecules that are severely increased in the circulation of patients. Lactoferrin can also possibly assist by occupying receptors on cells that prevent the virus to attach to the cells and then replicate inside the cells of the body.
There are several new trials that have begun over the last 18 months, initiated because of Covid. Can you tell us about some of them?
There are lots of exciting things happening in this space, and I am happy that more interest in lactoferrin has been shown by clinicians too. There was a trial initiation posted on ClinicalTrials.gov with title Lactoferrin for Prevention of COVID-19 in Health Care Workers. This trial starting date was August 2020. Bovine lactoferrin was given at a 600 mg daily dose for 12 weeks to 336 doctors and nurses at a hospital in Peru. There is also another trial on with the title Lactoferrin in Covid-19 Hospitalized Patients that was first posted 19 April 2021, in Italy. And then Elena Campione from Tor Vergata University Hospital, Department of Systems Medicine, in Rome and her co-workers posted a pre-print with the title: Lactoferrin as potential supplementary nutraceutical agent in COVID-19 patients: in vitro and in vivo preliminary evidences. The authors report that Bovine Lactoferrin-supplemented COVID-19 patients showed significant fast clinical symptoms recovery than standard of care-treated and non-treated COVID-19 patients.
Following on from the research you conducted for your own review, what is the therapeutic potential of lactoferrin?
I think it is an important nutraceutical, not only during the COVID-19 pandemic, but in general. Too much iron is directly linked to oxidative stress and systemic inflammation and is one of the hallmarks of many inflammatory diseases. Examples are type 2 diabetes, rheumatoid arthritis and even neuroinflammatory conditions like Parkinson’s and Alzheimer’s disease. Lactoferrin potentially has the ability to support the body to remove too much iron from circulation.