New research shows affordable dairy by-product could help to treat acute malnutrition in children
Intro
A new study, published today in Nature Communications, has examined the effect of novel therapies for children with severe malnutrition associated with gut damage (enteropathy).
The paper, entitled Malnutrition enteropathy in Zambian and Zimbabwean children with severe acute malnutrition, is an international collaboration involving centres in the UK, Zambia and Zimbabwe.
Main
There have been few new treatments developed over the last three decades, despite 17 million annual worldwide cases of severe acute malnutrition, resulting in high mortality rates of children hospitalised. Malnutrition underlies almost half of child deaths globally and in many of these cases the intestine is severely damaged, further limiting the ability of the person to absorb nutrients.
The paper trialled four treatments against a normal WHO standard care control group to reduce inflammation and enhance repair of the gut lining. These comprised bovine colostrum, which is the milk produced for the first few days after calving and is rich in antimicrobial and repair factors, a non-absorbable steroid (budesonide) used in inflammatory bowel disease, N-acetyl glucosamine which may help gut repair and Teduglutide (synthetic human glucagon-like peptide 2) which has been shown to improve nutrient absorption by stimulating intestinal growth in patients with intestinal failure.
The results demonstrated positive effects of all four test products on gut and blood markers of inflammation with Teduglutide and bovine colostrum also showing positive effects on gut regeneration.
University of West London (UWL) Professor Raymond Playford, a clinician scientist and clinical gastroenterologist who is a world-leading expert in the study of bovine colostrum and a co-investigator on the present study, stated:
These are exciting initial results providing further evidence for the potential benefit of bovine colostrum for the prevention and treatment of gut disease, and could be an affordable, accessible and sustainable treatment.
Bovine colostrum is a side product of the dairy industry, where any excess colostrum (that the suckling calf does not require) is collected and pasteurised in a similar way to standard milk.
The effects of bovine colostrum are likely to be caused by a combination of anti-microbial, anti-inflammatory and growth reparative molecules that it contains.
Its benefits have been recognised for thousands of years in situations such as Ayurvedic medicine and is in keeping with other clinical trials from our group demonstrating efficacy in inflammatory bowel disease and exercise induced increases in gut permeability.
The finding that it stimulated gut regeneration is especially encouraging, this was also seen with Teduglutide but in contrast to bovine colostrum, has the disadvantage of high cost and requiring to be injected rather than taken orally.
Professor Playford has been working in the field of nutraceuticals (food as medicine) for 25 years, using both laboratory studies and human clinical trials to research gut health. Playford’s research suggests bovine colostrum could have revolutionary benefits for gut health and repair.
This study follows a paper published by him in December 2022 for the University of West London, which examined the feasibility of providing bovine colostrum to young children with Crohn's disease, an incurable, chronic inflammatory bowel condition, which showed a high rate of acceptability and compliance even when taken for several months.
Professor Paul Kelly, at Queen Mary University of London and principal investigator on the current study, stated:
Our findings, which were underpinned by a UK Medical Research Council Grant, support the safety of these medications for this indication and we plan to follow up with additional trials of giving these compounds in combination therapies as well as detailed examination of mechanistic processes.
I am grateful to all the researchers, clinical staff and especially the parents of these children that have provided insight into novel approaches to treat a potentially fatal condition of global significance.
The paper, published today in the prestigious research journal Nature Communications, coincides with the launch of UWL’s new School of Medicine and Biosciences today, 17 April.
End
About the study
The trial, entitled "The Therapeutic Approaches to Malnutrition Enteropathy (TAME)", tested the hypothesis that one or more of these therapies could reduce the severity of malnutrition enteropathy in children with severe acute malnutrition (SAM).
The study was conducted using a randomised-controlled clinical trial protocol involving 125 children with severe acute malnutrition. Each subject received two weeks of their allocated treatment, with subjects being recruited in the Children’s Hospital of University Teaching Hospital, Lusaka, and Sally Mugabe Hospital, Harare.
Figure A: Subjects who received the standard (control group) treatment did not show signs of recovery of the finger-like villi that should be present in the small intestine.
Figure B: Subjects who received the bovine colostrum showed signs of regeneration of the finger-like villi, which are important in improving nutrient absorption.
Professor Raymond Playford
Raymond Playford is a clinician scientist who serves as a Professor of Molecular Medicine at UWL and as adjunct Professor at University College, Cork. He is also Chairman of the Herbal Medicines Advisory Committee of the MHRA, a member of the Policy and Education Advisory Committee of the General Osteopathy Council and a visiting Consultant Gastroenterologist at St Georges NHS Trust. Professor Playford received a medical degree from St Bartholomew's Medical School and obtained both a PhD and a DSc.
He is a Fellow of the Academy of Medical Science and has published over 150 original scientific and clinical papers and received several awards for his research.