by Henry I. Miller
June 26, 2006

Who among us hasn't experienced a touch of the trots from stomach flu or food poisoning? For those of us fortunate enough to live in an industrialized country with ready access to health care, diarrhea is little more than a nuisance, most often involving some discomfort and bloating, and a day or two off from school or work; but in the developing world it can be deadly. In sub-Saharan Africa and parts of Latin America and Asia with poor access to health care, clean water, and other resources, diarrhea is the number-two infectious killer of children under the age of five (surpassed only by respiratory diseases), accounting for two million deaths a year.

However, thanks to a simple but ingenious innovation by a California company, those numbers may soon be a relic of the past, like the mortality from smallpox and bubonic plague—if we don't let naysayers and special interests get in the way.

Since the 1960's the standard of care for childhood diarrhea in the developing world has been the World Health Organization's formulation of rehydration solution, a glucose-based, high-sodium liquid that is administered orally. This low-tech product was revolutionary. It saved countless lives and reduced the need for costly (and often unavailable) hospital stays and intravenous rehydration. However, this product did nothing to lessen the severity or duration of the condition, which over time leads to malnutrition, anemia and other chronic health risks. Other approaches to treatments and preventive measures—including changes in public policy, improvement of water treatment and the development of vaccines—have not yielded significant, cost-effective results.

The solution (literally and figuratively) may be an ingenious, affordable innovation from Ventria Bioscience that combines high- and low-tech. It is an improvement on current oral rehydration that could be a veritable Holy Grail: two human proteins produced inexpensively in rice that radically improve the effectiveness of rehydration solutions.

It has been known for decades that breastfed children get sick with diarrhea and other infections less often than those fed with formula. Recent research done in Peru has shown that fortifying oral rehydration solution with two of the primary protective proteins in breast milk, lactoferrin and lysozyme, lessens the duration of diarrhea and reduces the rate of recurrence. Although the availability of an oral rehydration solution that lowers the severity, duration and recurrence of diarrhea would be of modest benefit to those of us in the developed world, it could be a near-miraculous advance in the developing world.

Ventria partnered with researchers at the University of California, Davis, and at a leading children's hospital and a nutrition institute in Lima, Peru, to test the effects of adding human lactoferrin and lysozyme to a rice-based oral rehydration solution (which provides more nutrition and tastes better to kids than glucose-based oral rehydration solution, so they're more likely to drink it).

The researchers found that when lactoferrin and lysozyme are added to rice-based oral rehydration solution, the duration of children's illness is cut from more than five days to three and two-thirds. This improvement is thought to be caused by the antimicrobial effect of lysozyme, which has long been known to be one of the primary protective proteins in breast milk. Moreover, over the twelve-month follow-up period, the children who had received the lactoferrin and lysozyme had less than half the recurrence rate of diarrhea (eight percent versus eighteen percent in the controls). This effect is probably caused by lactoferrin, which promotes repair of the cells of the intestinal mucosa damaged by diarrhea.

These developments represent significant progress in managing diarrhea and keeping it from becoming a chronic, recurring health risk.

What makes this approach feasible is Ventria's invention of a method to produce human lactoferrin and lysozyme in genetically modified rice, a process dubbed "biopharming." This is an inexpensive and ingenious way to synthesize the huge quantities of the proteins that will be necessary. (In effect, the rice plants' inputs are carbon dioxide, water and the sun's energy.)

Sounds like a great success for Ventria and end of story, right? Not by a long shot. Virtually every biotech breakthrough brings the creeps out of the woodwork, and this one is no exception. One radical biotech opponent remonstrated, "The chance this will contaminate traditionally grown crops is great. This is a very risky business."

Rubbish.

Rice is self-pollinating, so outcrossing—interbreeding with other rice varieties—is virtually impossible. But even in a worst case, "contaminate traditionally grown crops" with what? With two human proteins normally present in tears, breast milk and saliva? Contamination, indeed!

Equally shameful was the comment of Bob Papanos of the U.S. Rice Producers Association: "We just want [Ventria] to go away," he said. "This little company could cause major problems." The truth is that it is the Luddite rice producers themselves who are causing major problems by their willingness to let the antagonism toward biotechnology by foreign importers of American rice interfere with the development of life-saving new products.

Biopharming has brought us to the verge of a safe, affordable solution to one of the developing world's most pressing health problems. It will be the first of many to come—if only we can keep the troglodytes at bay.