Clinical applications of bioactive milk components

Abstract

Milk represents a unique resource for translational medicine: It contains a rich pool of biologically active molecules with demonstrated clinical benefits. The ongoing characterization of the mechanistic process through which milk components promote development and immunity has revealed numerous milk-derived compounds with potential applications as clinical therapies in infectious and inflammatory disease, cancer, and other conditions. Lactoferrin is an effective antimicrobial and antiviral agent in high-risk patient populations and a potentially potent adjuvant to chemotherapy in lung cancer. Enteric nutrition formulas supplemented with transforming growth factor β, a milk cytokine, have been shown to promote remission in pediatric Crohn's disease. A number of milk glycans, including human milk oligosaccharides, show promise in preclinical studies as antimicrobial and anti-inflammatory agents. While active preclinical investigations of human milk may soon result in large-scale production of human milk molecules, bovine milk components in many instances represent a practical source of bioactive milk compounds for use in clinical trials. This review summarizes current efforts to translate the compounds derived from human and bovine milk into effective clinical therapies. These efforts suggest a common pathway for the translation of milk-derived compounds into clinical applications.

Figure 1

Diagram illustrating the wide range of applications for bioactive milk compounds in the treatment of human disease. Molecules undergoing preclinical evaluation are listed on the left side of the diagram underneath each disease model or clinical application under consideration. Milk components undergoing active clinical evaluation or currently in clinical use are listed on the right side of the diagram underneath each human disease in which clinical efficacy has been demonstrated. Abbreviations: GAG, glycosaminoglycan; HAMLET, human α-lactalbumin made lethal to tumor cells; HMO, human milk oligosaccharide; IBD, inflammatory bowel disease; NEC, necrotizing enterocolitis; PRP, proline-rich polypeptide; sIgA, soluble immunoglobulin A.