TREATMENT AND PREVENTION OF INFECTIONS, INFLAMMATIONS AND/OR TUMOURS WITH LACTOFERRIN AND/OR LACTOFERRICIN

Abstract: The present invention relates to a pharmaceutical composition comprising lactoferrin and/or lactoferricin for treatment and/or prevention of infections, inflammations and/or tumours, to the use of lactoferrin and lactoferricin in the production of a pharmaceutical composition for treatment and/or prevention of infections, inflammmations and tumours, and to a method for treatment and/or prevention of infections, inflammations and/or tumours comprising administration of lactoferrin and/or lactoferricin. The invention is particularly well suited for treatment and/or prevention of urinary tract infections and colitis. The lactoferrin and/or lactoferricin according to the present invention is preferably orally administered. Furthermore, the composition comprising lactoferrin and/or lactoferricin may be included in an infant formula food.

Description: TREATMENT AND PREVENTION OF INFECTIONS, INFLAMMATIONS AND/OR TUMOURS WITH LACTOFERRIN AND/OR LACTOFERRICIN FIELD OF THE INVENTION The present invention relates to a pharmaceutical composition comprising lactoferrin and/or lactoferricin for treatment and/or prevention of infections, inflamma- tions and/or tumours, to the use of lactoferrin and lactoferricin in the production of a pharmaceutical composition for treatment and/or prevention of infections, inflammations and tumours, and to a method for treatment and/or prevention of infections, inflammations and/or tu- mours comprising administration of lactoferrin and/or lactoferricin. BACKGROUND OF THE INVENTION It is known that human milk in several ways is anti- inflammatory. Goldman et al. pointed out that human milk is poor in initiators and mediators of inflammation but rich in anti-inflammatory agents (see Goldman A. S., et al., Anti-inflammatory properties of human milk, Acta Paediatr. Scand. 75 : 689-695, ' 1986) . Human milk contains several soluble anti-infective components, such as specific secretory IgA (SIgA) antibodies and non-specific components, including lactoferrin (LF) (see e.g. Hanson L. A., et al., Protective factors in milk and the development of the immune system, Pediatrics 75:172-176, 1983) . Lactoferrin is a single chain metalbinding glycopro- tein with a molecular weight of 77 kd. It occurs in three isoforms: LF-α, LF-β, and LF-γ. These three variants have the same physical, chemical and antigenic characteris- tics, but differ in their functional properties. The iron-binding lactoferrin is also present in specific granules of polymorphonuclear leucocytes and in other exocrine secretions than milk such as saliva, tears and bronchial mucus, as well as cervical secretion, amni- otic fluid, decidua, and trophoblasts (see e.g. Montreuil J., et al., Isolement d'une lactosiderophiline du lait de femme, CR Acad. Sci. Paris 250 D: 1736-37, 1960; Montreuil J., et al., Preparation et proprietes de la lactosiderophiline (lactotransferrine) du fait de femme, Biochim. Biophys. Acta 45:413-421, 1960; and Masson P. L., et al., Lactoferrin an ironbinding protein neutrophilic leucocytes, J. Exp. Med. 130:643-656, 1969). Lactoferrin is associated with host defense at mucosal surfaces through its antibacterial and iron-binding properties. Human lactoferrin is found in colostrum and mature milk at levels of 2-5 g/1. Bovine lactoferrin shares 68% and 64% amino acid identity with human lactoferrin and murine lactoferrin, respectively. Lactoferricin is a pepsin-cleaved fragment of human and bovine lactoferrin. It has recently been found to contain the structural domain responsible for the bactericidal properties of lactoferrin (see e.g. Bellamy W., et al., Identification of the bactericidal domain of lac- toferrin, Biochim. Biophys. Acta 1121:130-136, 1992, and Bellamy W., et al., Antibacterial spectrum of lactoferricin B, a potent bactericidal peptide derived from the N-terminal region of bovine lactoferrin, J. Appl. Bact. 73:472-479, 1992). Lactoferrin receptors are found on many types of cells including monocytes and macrophages (Broxmeyer H. E., et al., Specificity and modulation of the action of lactoferrin, a negative feedback regulator of myelopoi- esis, Blood 55:324-333, 1980), lectin-stimulated human peripheral blood lymphocytes (Mazurier J., et al., Expression of human lactotransferrin receptors in phytohe- magglutinin-stimulated human peripheral blood lymphocytes. Isolation of the receptors by anti-ligand-affinity chromatography, Eur. J. Biochem. 179:481-487, 1989), brush-border cells (Hu W. L., et al., Lactotransferrin receptor of mouse small-intestinal brush border. Binding characteristics of membrane-bound and Triton X-100- solubilized forms, Biochem. J. 249:435-441, 1988; Cox T. M., et al., Iron-binding proteins and influx of iron across the duodenal brush border. Evidence for specific lactotransferrin receptors in the human intestine. Bio- chim. Biophys. Acta 588:120-128, 1979; Mazurier J., et al., Visualization of lactotransferrin brush-border receptors by ligand-blotting. Biochim. Biophys. Acta 821:453-460, 1985; and Wei-Lu Hu, et al., Isolation and partial characterization of a lactotransferrin receptor from mouse intestinal brush-border, Biochemistry 29:535- 540, 1990), tumor cell lines, e.g. HT-29, HL-60, K562, (see e.g. Roiron D., et al., Lactoferrin-binding sites at the surface of HT29-D4 cells. Comparison with transfer- rin. Eur. J. Biochem. 186:367-373, 1989; Miyazawa K., et al . , Effect on lactoferrin binding to monocyte/macro- phage-differentiated HL-60 cells. J Immunol. 146:723-729, 1991; and Yamada Y., et al., Lactoferrin binding by leukemia cell lines, Blood 70:264-270, 1987). In addition to the role of lactoferrin as an essen- tial growth factor for both human B- and T-lymphocytic cell lines (see e.g. Hashizume S., et al., Identification of lactoferrin as an essential growth factor for human lymphocytic cell lines in serum-free medium, Biochem. Biophys. Acta 763:377-382, 1983) and as an inducer of growth of HT-29 cells (see e.g. Anuric M., et al., Effect of lactoferrin on the growth of a human colon adenocarci- noma cell line - comparison with transferrin. In Vitro 20:543-548, 1984), lactoferrin is a negative regulator of myelopoiesis (see e.g. Broxmeyer H. E., et al . , Specific- ity and modulation of the action of lactoferrin, a negative feedback regulator of myelopoiesis, Blood 55:324- 333, 1980, and Gentile P., et al., Suppression of mouse myelopoesis by administration of human lactoferrin in vivo and the comparative action of human transferrin, Blood 61:982-993, 1983). This latter function is mediated through suppression of IL-1 and GM-CSF release from ono- cytes and macrophages (see e.g. Broxmeyer H. E., et al., Lactoferrin acts on I-A and I-E/C antigen subpopulations of mouse peritoneal macrophages in the absence of T lymphocytes and other cell types to inhibit production of granulocyte-macrophage colony stimulatory factors "in vi- tro", J. Immunol. 133:306-314, 1984, and Zucali J. R. , et al., Lactoferrin decreases monocyte-induced fibroblast production of myeloid colony-stimulating activity by suppressing monocyte release of interleukin-1, Blood 74:1531-1536, 1989). After binding of bacterial lipopolysaccharides (LPS) to macrophages, T-cells and cultured human monocytes, these cells synthesize tumor necrosis factor-α (TNF-α) , interleukin-1 (IL-1), interleukin-6 (IL-6), and colony- stimulating factor (CSF) (see e.g. Arai K. , et al., Cy- tokines: coordinators of immune and inflammatory responses, Ann. Rev. Biochem. 59:783-836, 1990; Hirano T., et al., Biological and clinical aspects of interleukin 6, Immunol. Today 11:443-449, 1990; and Shalaby M. R., et al., Endotoxin, tumor necrosis factor-α and interleukin-1 induce interleukin-6 production "in vivo", Clin. Immunol. Immunopath. 53:488-498, 1989). Cells participating in the inflammatory response carry several different LPS-binding receptors (Lei M-G., et al . , Specific endotoxic lipopoly- saccharide-binding proteins on murine splenocytes. II. Membrane localization and binding characteristics, J. Immunol. 141:1006-1011, 1988 and Couturier C, et al., Binding sites for endotoxin (LPS) on human monocytes, J. Immunol. 147:1899-1904, 19 ' 91) . Such cells also have receptors for lactoferrin. An interaction between LPS and lactoferrin has been observed, the complex being bound to the cells also via LPS receptors (see Miyazawa K. , et al., Effect on lactoferrin binding to monocyte/macro- phage-differentiated HL-60 cells. J Immunol. 146:723-729, 1991) . Recently, it was showed that lactoferrin exerted an inhibitory effect on the production of IL-1 and TNF-α in LPS stimulated monocytes (see Crouch P. M. , et al., Regulation of cytokine release from mononuclear cells by the iron-binding protein lactoferrin, Blood 80:235-240, 1992) . It has earlier been shown (see Mattsby-Baltzer I. et al., Lactoferrin or a fragment thereof inhibits the endo- toxin-induced interleukin-6 response in human monocytic cells, Pediactric Research 40:257-262, 1996) that human and bovine lactoferrin as well as bovine lactoferricin suppress LPS-induced IL-6 response when added to fresh monocytes or cultured monocytic cells. Human lactoferrin has also been reported to suppress TNF-α induced IL-6 response when added to fresh monocytes or cultured monocytic cells. According to the present invention it has now been found that lactoferrin and lactoferricin have an in vivo effect on all kinds of inflammation, i.e. not only when IL-6 is involved, as well as on infections, such as urinary tract infection, and tumours. DESCRIPTION OF THE INVENTION Thus, an object of the present invention is to provide a pharmaceutical composition for treatment and/or prevention of infections, inflammations and/or tumours comprising an effective amount of lactoferrin and/or lactoferricin. Another object of the present invention is use of lactoferrin and/or lactoferricin in the production of a pharmaceutical composition for treatment and/or prevention of infections, inflammations and/or tumours. A third object of the present invention is to pro- vide a method for treatment and/or prevention of infections, inflammations and/or tumours by administration of an effective amount of lactoferrin and/or lactoferricin. The characterising features of the invention will be evident from the following description and the appended claims. In order to treat a patient, suffering from an infection, an inflammation or a tumour, with the pharmaceu- tical composition according to the invention, the pharmaceutical composition, comprising an effective amount of lactoferrin and/or lactoferricin, is preferably administered systemically, and most preferably orally. The infections treatable with the pharmaceutical composition according to the present inventions include infections caused by all kinds of pathogens, such as bacteria, viruses, fungi, etc. Inflammation is a phenomenon marked by abnormal "redness" and swelling of tissues and organs, pain and heat in affected areas, capillary dilation, leucocyte infiltration, etc. Inflammation is primarily caused by exposure to bacterial and other noxious agents and physical injury. Inflammation is mediated by a variety of cytoki- nes and other chemical signals. These mediators of inflammation include tumor necrosis factor-α (TNF-α) , in- terleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and various colony-stimulating factors (CSFs) . As used herein, "treatment" refers to preventing, curing, reversing, attenuating, alleviating, minimizing, suppressing or halting the deleterious effects of a disease state, disease progression or other abnormal condition, including urinary tract infections. "Prevention" refers to minimizing, reducing or sup- pressing the risk of developing a disease state or progression or other abnormal or deleterious conditions. A "patient" is a subject at risk for or suffering from a disease state, disease progression or other abnormal or deleterious condition. An "effective amount" is an amount sufficient to treat or prevent a disease state, disease progression or other abnormal or deleterious condition. "Systemic administration" can be undertaken by oral, nasal, intravenous, intraartery, intracavitary, intramus- cular, subcutaneous, transdermal, suppositories (including rectal) or other routes known to those of skill in the art. Preferably, the pharmaceutical composi- tion according to the present invention is formulated for oral administration. The lactoferrin and lactoferricin used according to the present invention can e.g. be obtained through isola- tion and purification from natural sources, such as human milk, through use of genetic engineering techniques, such as recombinant expression or direct production in genetically altered animals, or through chemical synthesis. The lactoferricin can also be obtained by enzymatic degrada- tion of lactoferrin (hydrolysate) . The lactoferrin used according to the present invention is preferably human lactoferrin or bovine lactoferrin, and it is preferably administered as a hydrolysate. The lactoferricin used according to the present in- vention is preferably human lactoferricin or bovine lactoferricin. The pharmaceutical composition comprising lactoferrin and/or lactoferricin according to the present invention is particularly well suited for treatment and/or prevention of urinary tract infection and colitis, but several other inflammatory and infectious diseases are also treatable according to the present invention, such as inflammatory bowel diseases, rheumatoid arthritis, conditions caused by the virus HIV-1, conditions caused by the virus CMV, and conditions caused by the fungus Candida albicans. The pharmaceutical composition according to the present invention is also well suited for preventive medical care by reducing the risk of developing urinary tract in- fection or other inflammatory or infectious diseases in patients with an increased risk of attracting such complications . The pharmaceutical composition according to the present invention may also comprise other components, such as pharmaceutically acceptable carriers, vehicles, preservatives, lubricators etc., which is well known to persons skilled in the art. According to the present invention it is also possible to include lactoferrin and/or lactoferricin, in an effective amount, in any kind of food or beverage intended to reduce infections and/or inflammations in pa- tients running an increased risk of such conditions due to an underlying disease or a medical treatment. According to the present invention it is also possible to include lactoferrin and/or lactoferricin, in an effective amount, in an infant formula food intended to inhibit harmful effects of bacteria, such as weight loss caused by inflammation induced by bacteria, viruses or fungi in infants. EXAMPLES The invention will now be further explained in the following examples. These examples are only intended to illustrate the invention and should in no way be considered to limit the scope of the invention. In the examples reference is made to the accompany- ing drawings on which: Fig. 1 a - d illustrate bacterial recovery from the kidney (a and b) and bladder (c and d) , respectively, of C3H/Tif and C3H/HeN mice infected with E. coli in the urinary tract and perorally given human lactoferrin (LF hum) , bovine lactoferrin (LF bov) , or PBS, 30 min after the injection of bacteria. The samples represented by symbols below the line were culture negative. Fig. 2 a and b illustrate the kinetics of the urinary leucocyte influx in E. coli infected C3H/Tif and C3H/HeN mice treated with human lactoferrin (LF hum), bovine lactoferrin (LF bov), or PBS. Fig. 3 a and b illustrate the kinetics of the urinary IL- 6 response in E. coli infected C3H/Tif and C3H/HeN mice treated with human lactoferrin (LF hum) , bovine lactoferrin (LF bov) , or PBS, 30 min after the injection of bacteria. Fig. 4 illustrates the serum IL-6 response 24 h after experimentally induced urinary tract infection in C3H/Tif and C3H/HeN mice treated with human lactoferrin (LF hum) , bovine lactoferrin (LF bov) , or PBS, 30 min after the injection of bacteria. Fig. 5 illustrates the cytokine concentration in serum from mice with experimentally induced colitis after treatment with bovine lactoferrin (LF bov) compared to a control group not receiving lac- toferrin. Example 1: Treatment of urinary tract infection in mice by oral administration of human lactoferrin The antibacterial and anti-inflammatory properties of lactoferrin were explored by studying the effects of lactoferrin given to mice (C3H/Tif and C3H/HeN) with experimentally induced urinary tract infection (UTI) . In order to induce urinary tract infection (UTI) in the mice, the animals were injected with 100 μl of a bac- terial solution containing 2xl0 9 E. coli-bacteria/ml diluted with phosphate-buffered saline (PBS) directly into the bladder via a catheter according to Svanborg-Eden et al (see C. Svanborg-Eden et al Infect. Immun. 55:1224- 1232, 1987). A solution containing 10 mg/ml of either human lactoferrin, bovine lactoferrin, or bovine lactoferricin was orally administered (50 μl) to the mice 30 min after the instillation of bacteria. Urine samples from the mice were collected 0, 2, 5, and 24 hours after infection. 50 μl of each of the undiluted urine samples were cultured. The number of leucocytes in uncentrifuged urine was analyzed for each sample. The remaining urine from each animal at each sampling time was centrifuged and saved for IL-6 analysis. After 24 h the mice were bled and killed. The bladder and kidneys were taken out aseptically. The organs were homogenized, and serial dilutions thereof (bladder 1/1, 1/10, kidneys 1/1, 1/10, 1/100, 1/1000) were cultured on Drigalsky plates. The results are illustrated below in Table 1 and in Figures 1-4. when four comparisons are made with one group, a significant p value should be adjusted to p<0.025 t illustrates a significant increase in the treatment group compared to the infected but untreated control group. I illustrates a significant decrease in the treatment group compared to the infected but untreated control group. The data shown in Table 1 clearly shows the effect of the treatment with lactoferrin and lactoferricin. From the table and the figures it is evident that orally administered lactoferrin (both human and bovine) significantly decreased the number of bacteria in the urinary tract of the infected mice, compared to the control group. In Figures 2 a and b the kinetics of the urinary leucocyte influx is illustrated (** in Figure 2 a signi- fies p<0.01, Mann-Whitney test), and in Figure 3 a and b the IL-6 response in urine is illustrated (* in these figures signifies p<0.05, Mann-Whitney test). These figures clearly shows that the local inflammatory response was reduced after 24 h. The systemic cytokine response, viz. IL-6 response in serum, after 24 h is illustrated in Figure 4, and this response was also reduced in the lactoferrin treated animals. In conclusion these results demonstrate that oral administration of lactoferrin or lactoferricin is sys- temically effective by preventing infection and inflammation in the urinary tract by an as yet unidentified mechanism. Example 2: Treatment of experimental colitis by oral administration of human lactoferrin Acute colitis was induced in C57BI/6J mice by giving 5% dextransulphate in the drinking water for 6 days. Human lactoferrin was orally given to ten mice twice a day in a dose of 1 mg/mouse, starting from day 3 of the experiment. Two control groups (in total 17 mice) were given the same volume of drinking water or bovine serum albumin (BSA) (2 mg per mouse and day) . 30% of the mice in the lactoferrin treated group presented gross rectal bleeding on day 5 and 6 compared to 100% in the control group (p = 0.0007, Fischer's test). Moreover, the colon length was significantly reduced in the control groups compared with the lactoferrin treated group, indicating a more advanced inflammation of the colon tissue in the controls (p = 0.041, Mann-Whitney test). High concentrations of lactoferrin were found in serum of the lactofer- rin treated group. In an other experiment using 3% dextransulphate the systemic TNF-α response was reduced in the lactoferrin treated mice after 10 days (p < 0.0006). The result is illustrated in Figure 5. In summary, the results demonstrate that oral administration of LF reduces some of the clinical symptoms of experimental colitis.

Claims: CLAIMS 1. A pharmaceutical composition for treatment and/or prevention of infections, inflammations and/or tumours comprising an effective amount of lactoferrin and/or lactoferricin. 2. A pharmaceutical composition according to claim 1 intended for oral administration. 3. A pharmaceutical composition according to claim 1 or claim 2, intended for treatment and/or prevention of urinary tract infection. 4. A pharmaceutical composition according to claim 1 or claim 2, intended for treatment and/or prevention of colitis . 5. A pharmaceutical composition according to any one of claims 1-4, wherein the lactoferrin and/or the lactoferricin is derived from a human or bovine source. 6. A pharmaceutical composition according to any one of claims 1-5, wherein the lactoferrin is included in the pharmaceutical composition as a hydrolysate. 7. An infant formula food comprising the pharmaceutical composition according to any one of claims 1-6. 8. Use of lactoferrin and/or lactoferricin in the production of a pharmaceutical composition for treatment and/or prevention of infections, inflammations and/or tu- ours. 9. Use of lactoferrin and/or lactoferricin according to claim 8, wherein the pharmaceutical composition is intended for oral administration. 10. Use of lactoferrin and/or lactoferricin accord- ing to claim 8 or claim 9, wherein the pharmaceutical composition is intended for treatment and/or prevention of urinary tract infection. 11. Use of lactoferrin and/or lactoferricin according to claim 8 or claim 9, wherein the pharmaceutical composition is intended for treatment and/or prevention of colitis. 12. Use of lactoferrin and/or lactoferricin according to any one of claims 8-11, wherein the lactoferrin and/or the lactoferricin is derived from a human or bovine source. 13. Use of lactoferrin according to any one of claims 8-12, wherein the lactoferrin is included in the pharmaceutical composition as a hydrolysate. 14. Use of lactoferrin and/or lactoferricin according to any one of claims 8-13, wherein the pharmaceutical composition constitutes or is included in an infant formula food. 15. A method for treatment and/or prevention of infections, inflammations and/or tumours whereby an effective amount of a substance chosen from the group consist- ing of lactoferrin and lactoferricin is administered to a patient. 16. A method according to claim 15, wherein the substance is orally administered. 17. A method according to claim 15 or claim 16, used for treatment and/or prevention of urinary tract infection. 18. A method according to claim 15 or claim 16, used for treatment and/or prevention of colitis. 19. A method according to any one of claims 15-18, wherein the lactoferrin and/or the lactoferricin is derived from a human or bovine source. 20. A method according to any one of claims 15-19, wherein the lactoferrin is used in the form of a hydrolysate. 21. A method according to any one of claims 15-20, wherein the substance is included in an infant formula food.

Inventors: HANSON LARS AA, MATTSBY-BALTZER INGER, MOTAS CECILIA, HANSON, LARS, AA, MATTSBY-BALTZER, INGER, MOTAS, CECILIA
Applicants: HANSON LARS AA, HOLDINGBOLAGET VID GOETEBORGS, MATTSBY BALTZER INGER, MOTAS CECILIA, HANSON, LARS, AA, HOLDINGBOLAGET VID GOETEBORGS UNIVERSITET AB, MATTSBY-BALTZER, INGER, MOTAS, CECILIA
Application year: 1997
Main classification: A61K38
IPC codes: A23L1, A61K38, A61P1, A61P29, A61P31, A61P35