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About the Authors:
Fulton P. Rivera
* E-mail: [email protected]
Affiliations Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, Laboratorio de Fisiopatogenia, Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
Anicia M. Medina
Affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
Sandra Bezada
Affiliation: Laboratorio de Farmacología, Facultad de Farmacia y Bioquímica, Universidad Nacional Mayor de San Marcos, Lima, Peru
Roberto Valencia
Affiliation: Facultad de Veterinaria y Zootecnia, Universidad Peruana Cayetano Heredia, Lima, Peru
María Bernal
Affiliation: Department of Bacteriology, U.S. Naval Medical Research Unit SIX, Lima, Peru
Rina Meza
Affiliation: Department of Bacteriology, U.S. Naval Medical Research Unit SIX, Lima, Peru
Ryan C. Maves
Affiliations Department of Bacteriology, U.S. Naval Medical Research Unit SIX, Lima, Peru, Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, California, United States of America
Theresa J. Ochoa
Affiliations Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru, Center for Infectious Diseases, University of Texas School of Public Health, Houston, Texas, United States of America
Introduction
Diarrheal disease due to enteric infection is a major cause of death among children under five years of age, especially in developing countries. Enterotoxigenic bacteria are responsible for a large proportion of these diseases. Among the enterotoxin-producing bacteria, Vibrio cholerae causes the most severe disease, while enterotoxigenic Escherichia coli (ETEC) is responsible for the largest number cases. ETEC is also a major cause of diarrhea in adult travelers from industrialized countries to the developing world. The major virulence factors of these bacteria are their homologous enterotoxins, cholera toxin (CT) and heat-labile enterotoxin (LT), respectively. These toxins are examples of bacterial AB5 toxins, consisting of one enzymatically active A subunit (CTA or LTA) that assemble with five B subunits (CTB or LTB) which are responsible for the toxins’ binding properties [1].
Breastfeeding has been identified as one of the most effective interventions to prevent pediatric diarrhea as well as all-cause mortality [2]. Lactoferrin is a major nonimmune milk factor that has been thought to be important in protecting infants from intestinal infections. It is an iron-binding 78-kDa glycoprotein that is resistant to proteolytic enzymes [3], [4], [5], [6]. Lactoferrin is produced not only...