Introduction:
Colostrum is a type of milk a mother produces in the first few days after birth. Human mothers and many mammals, including cows, produce it. Bovine colostrum (BC), like human colostrum, contains specific nutrients, including proteins, fats, vitamins, and minerals, to provide passive immunity to newborn calves until they can develop immunity. BC contains protein, whey > casein, β-Lactoglobulin, α-Lactalbumin, IgG1, IgG2, IgA, IgM, Lactoferrin, IGF-1, IGF-2, TGF- β1, TGF - β2, Lysozyme, Lactoperoxidase, Lactose, Oligosaccharides, Lipids, Minerals, and Vitamins B12, B2, A, D, and E.[1] Due to its function of boosting the immune system, BC is starting to become the spotlight for possibly protecting humans and bolstering their immune systems. We found commercially available BC products that are endorsed to help prevent flu, COVID-19, and other upper respiratory tract infections (URI).[2-6]
Methods:
We used all the research papers that were listed on the “ARMRATM BC research” page under the “Bovine Colostrum's Effectiveness Against Influenza: Studies Comparing Colostrum to Flu Vaccines and its Potential in Upper Respiratory Infection Support and Recovery (1-9)” section. On Pubmed, we searched using MeSH* and regular** search for BC and influenza. We also Googled “Nature” journal papers on BC only. Based on all these search results, we came across 8, 10, and 2 articles, respectively. Out of these articles, eight had conflicts of interest or had funding from companies that produced or had ties to the production/patent of BC, yet they were used in this paper.
Results:
Two clinical studies done by some of the same authors tested the effects of BC on preschool students aged 4-7 years old and medical/health science students.[2,3] These authors have declared a conflict of interest due to a financial relationship with a BC manufacturer. Methods used were similar where they had two groups (BC vs placebo), and they used self-reporting online surveys to obtain data. Their results suggested that there was a significantly lower incidence of self-reported flu-like symptoms in the BC group as compared to placebo. Additionally, it is important to take note that in the paper with medical/health science students, the students with “severe symptoms” were not included in the dataset, assuming that they either are “reporting recklessly” or “do not fit the definition of a young, healthy individual” even though they obtained these students’ past medical history before selecting them.[2]
Another study that has been widely cited in almost all BC research studies was by Cesarone, 2007.[7] They studied normal and high-risk populations (severe cardiovascular and pulmonary diseases) by dividing them into BC, BC+flu vaccine, the flu vaccine only, and control groups (excluded for the high-risk group). This study was not blinded and used commercially available BC of 400mg and self-reported surveys to obtain data. Their data was also statistically significant for a reduction in flu symptoms in the BC and BC+flu vaccine groups as compared to the other two groups. However, while calculating the intention-to-treat analysis, they added the dropouts to the patients with flu-like symptoms before calculating the differences. Further, they did not use any diagnostic tool to check if the patients were infected with flu or another URI.[7]
Finally, one last non-blinded study included the analysis of BC as a treatment measure for COVID-19 patients.[5] Adult patients hospitalized for COVID-19 were selected and were separated into mild, moderate, and severe symptoms. Each of these was further separated into BC and control groups. Subjective symptoms such as appetite, muscle weakness, headache, cough, fatigue, and loss of sense of taste and smell were evaluated. Objective measures such as O2 mask and CRP levels were also obtained. For all three groups, subjective symptoms were statistically significantly less for the BC group than the control group. However, the CRP levels were not significant for moderate and severe groups.[5]
Discussion/Conclusion:
BC has historically been used to supply the needed immune structure to newborns due to immature immune systems for the first six months of their life. It is important to understand that in a healthy individual, supplying these immunological components might not be as helpful as in patients with low immune function. Our current influenza vaccine works in a way to expose our immune system to viral antigenic particles that our immune system uses as a prototype to create antibodies using an antibody diversity system. Using this knowledge, one study looked at hyperimmunized bovine colostrum as a way to provide immunity to immunocompromised patients or newborns who do not have access to breast milk.[8]
To understand the use of commercially available (non-hyperimmune) BC as a prophylactic supplement for influenza or other URIs, there needs to be more basic science research on it to look closely at the molecular pathway. It is widely known that cytotoxic T cells (CTL), Natural Killer (NK) cells, and antiviral macrophages particularly work in cohesion to recognize and kill virus-infected cells.[9] However, when looking at the basic science research with non-hyperimmune BC, one study shows an increase in IL-12, which activates CTL and NK cells. However, it does not affect INF-γ, which activates macrophages.[10,11] Another study showed activation of IL-8 (activates neutrophils), IP-10 (functions in tumor regulation, promotion, and angiostasis), and MIP-1α (functions in wound healing and inhibiting stem cells).[12-14]
Finally, based on the clinical results above of BC, it can be said that subjective reporting of the study with non-blinded participants will yield biased results. There needs to be a better study design with a randomized, double-blinded study, with objective measures such as CRP levels, Chest CT (for treatment studies), and respiratory panel diagnostic tests for patients with flu-like symptoms. Since hyperimmunized BC has been used as a means to prevent Rotavirus in children, there seems to be promise in the use of hyperimmunized BC products for the prevention of influenza or COVID-19. However, using non-immunized BC products would most likely benefit immunocompromised patients rather than healthy adults with normal functioning immune systems. There needs to be more research on commercially available BC to sway the decision in the other direction.
References:
1. Duman H, Karav S. Bovine colostrum and its potential contributions for treatment and prevention of COVID-19. Front Immunol. 2023;14:1214514.
2. Baśkiewicz-Hałasa M, Stachowska E, Grochans E, et al. Moderate Dose Bovine Colostrum Supplementation in Prevention of Upper Respiratory Tract Infections in Medical University Students: A Randomized, Triple Blind, Placebo-Controlled Trial. Nutrients. Apr 16 2023;15(8).
3. Hałasa M, Skonieczna-Żydecka K, Machaliński B, Bühner L, Baśkiewicz-Hałasa M. Six Weeks of Supplementation with Bovine Colostrum Effectively Reduces URTIs Symptoms Frequency and Gravity for Up to 20 Weeks in Pre-School Children. Nutrients. Aug 18 2023;15(16).
4. Batista da Silva Galdino A, do Nascimento Rangel AH, Buttar HS, et al. Bovine colostrum: benefits for the human respiratory system and potential contributions for clinical management of COVID-19. Food and Agricultural Immunology. 2021/01/01 2021;32(1):143-162.
5. Khartode S. Early Recovery of COVID-19 Patients by Using Immunoglobulins Present in Cow Colostrum Food Supplement-A Clinical Study. Journal of Research in Medical and Dental Science. 2021;9(3):186-198.
6. Li J, Xu Y-W, Jiang J-J, Song Q-K. Bovine colostrum and product intervention associated with relief of childhood infectious diarrhea. Scientific Reports. 2019/02/28 2019;9(1):3093.
7. Cesarone MR, Belcaro G, Di Renzo A, et al. Prevention of influenza episodes with colostrum compared with vaccination in healthy and high-risk cardiovascular subjects: the epidemiologic study in San Valentino. Clin Appl Thromb Hemost. Apr 2007;13(2):130-136.
8. Ng WC, Wong V, Muller B, Rawlin G, Brown LE. Prevention and treatment of influenza with hyperimmune bovine colostrum antibody. PLoS One. Oct 26 2010;5(10):e13622.
9. Chapter 50. Immune Defenses. In: Baron S, ed. Medical Microbiology. Galveston (TX): University of Texas Medical Branch at Galveston Copyright © 1996, The University of Texas Medical Branch at Galveston.; 1996.
10. Biswas P, Vecchi A, Mantegani P, Mantelli B, Fortis C, Lazzarin A. Immunomodulatory effects of bovine colostrum in human peripheral blood mononuclear cells. New Microbiol. Oct 2007;30(4):447-454.
11. Lacy P. Chapter 12 - Eosinophil Cytokines in Allergy. In: Foti M, Locati M, eds. Cytokine Effector Functions in Tissues: Academic Press; 2017:173-218.
12. Jensen GS. Biological Activities of a Novel Bovine Colostrum-Based Proprietary Concentrate, ARMRA, at the Cellular Level. . n.d.
13. Madhurantakam S, Lee ZJ, Naqvi A, Prasad S. Importance of IP-10 as a biomarker of host immune response: Critical perspective as a target for biosensing. Current Research in Biotechnology. 2023/01/01/ 2023;5:100130.
14. Bhavsar I, Miller CS, Al-Sabbagh M. Macrophage Inflammatory Protein-1 Alpha (MIP-1 alpha)/CCL3: As a Biomarker.
*MeSH terms searched were:
- (( "Influenza, Human/pathology"[Mesh] OR "Influenza, Human/physiopathology"[Mesh] OR "Influenza, Human/prevention and control"[Mesh] OR "Influenza, Human/therapy"[Mesh] OR "Influenza, Human/virology"[Mesh] ) AND "Bovine Colostrum")
- "Influenza, Human/prevention and control"[Mesh] AND "Bovine Colostrum"
**Regular terms searched were:
- ("Influenza" AND "Bovine Colostrum")
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