Bovine colostrum: A treatment for infectious emergencies and the immunosupressed?

Students of both neonatology and veterinary ­science are well aware of the powerful nutritional components of colostrum.

Defined as the first milk produced by, in the context of bovine colostrum, a lactating dairy cow in the immediate period after the birth of a calf, colostrum is “super-rich” in multiple immunoglobulins that protect the neonate from environmental pathogens.¹ Production of this antibody-dense substance, also known as “foremilk,” 
confers passive immunity on the newborn.² The lactating mother will generate this milk for two to four days after delivery.²

Background


Bovine colostrum is particularly rich in immunoglobulin A (IgA) and the antimicrobial peptides lactoferrin and lactoperoxidase.² Before the discovery of penicillin, bovine colostrum was used to treat various infectious processes in humans.² While human colostrum is rich in nutrients, bovine colostrum contains nearly three times the energy and fat and five times the protein.² Bovine colostrum is being studied as a wound-healing agent, an antimicrobial, and an anticancer therapy.² 



Science


Bovine colostrum appears to be especially useful in inflammatory conditions and gastric infections. In a small clinical study to determine the extent of immune response in humans when supplemented with this agent, 18 healthy volunteers were randomized to either bovine colostrum or placebo and then inoculated with an attenuated Salmonella typhi vaccine.³

After eight days, serum studies were conducted and analyzed for immune globulin concentrations. When compared with baseline, participants in the bovine colostrum group showed a 150% increase in IgA and a 246% increase in IgG.³ 


In a study of adults suffering from ulcerative colitis, participants with mild to severe distal colitis were randomized to either placebo or bovine colostrum for a four-week period.⁴ Results were based on self-report of disease symptoms based on the validated Powell-Tuck scoring tool and histologic mucosal changes obtained during sigmoidoscopy.

At the end of the one-month period, participants randomized to the colostrum product showed a mean reduction in symptoms of nearly three points whereas the placebo participants experienced an increase in symptoms of 0.5 points. Histology findings demonstrated a greater than 50% reduction in mucosal damage in the colostrum group and no change with placebo. 


Bovine colostrum has also been studied for its effect on two other common enteric pathogens, Clostridium difficile and Escherichia coli. C. difficile infections are common but have lead to significant morbidity and mortality, with death rates approaching 17% and hospitalization stays increased by nearly four days.⁵ With the significant increases in IgM and IgA found with colostrum use, researchers have noted a toxin-neutralizing activity against this bacterium. 


Bovine colostrum has been studied as a potential adjunctive therapy for victims of E. coli. In calves, the method of action of bovine colostrum against such bacteria appears to be multifaceted.⁶ Through its immune-enhancing actions, colostrum inhibits the ability of E. coli to attach to the mucosal lining of the intestine, thereby rendering the bacterium unable to lyse and release its deadly endotoxin. 


Finally, colostrum has also been studied as a preventive agent for upper-respiratory-tract infections (URTIs). Having determined that respiratory tract mucosal IgA concentrations play a large role in susceptibility to infection, researchers examined self-report diaries of 174 healthy men.⁷

These participants had been randomized to daily consumption of either bovine colostrum or placebo and recorded daily symptoms scores typically associated with URTI. At the end of eight weeks, the treatment group reported 16% fewer URTI symptoms than did the placebo group; duration of symptoms did not change. 



Safety, interactions 


Bovine colostrum is very well tolerated, and only those with a known milk allergy should avoid its use. No herb or drug interactions have been reported. Use should be avoided in areas in which bovine spongiform encephalopathy (mad cow disease) has been reported.



How supplied, dose, cost


There are no well-established dosing guidelines for bovine colostrum. One source recommends 
10 g to 20 g of colostrum daily for 10 days for treating infectious diarrhea.⁸ Colostrum supplements may be found in a variety of forms including powder-filled capsules and concentrated liquids.

Pasteurization of all dairy products is recommended and has been shown to have little effect on the immune globulin content of colostrum when performed commercially.⁹ A one-month supply of capsules costs about $50.



Summary


For patients suffering from acute infectious emergencies or those with other forms of immune weaknesses, bovine colostrum seems to be worth its cost. With no known interactions, colostrum can be recommended without fear of hidden dangers when used with other treatments. 


From the January 01, 2014 Issue of Clinical Advisor