Human recombinant lactoferrin for sepsis: Too good to be true?

摘要

In this issue of Critical Care Medicine, Guntupalli et al (1) report the clinical trial results of the initial phase 2 trial with orally administered, human recombinant lactoferrin (talac-toferrin) in adult patients with severe sepsis. Despite the complicating factor of mislabeled doses for a subset of patients, analysis of the data revealed a truly remarkable finding with a 12.5% absolute risk reduction in all-cause mortality in the talactoferrin group compared with the placebo group. This beneficial effect size in this study appeared to be more pronounced in the most severely illl patients and was effective in most subgroups, with the notable exceptions of patients septic from intra-abdominal infection and female patients. Given the protean roles that lactoferrin plays in host immune and inflammatory responses (2), finding a potential use in adult sepsis is perhaps not surprising.