Passive immunotherapy using chicken egg yolk antibody (IgY) against diarrheagenic E. coli: A systematic review and meta-analysis

Animal diarrhea due to diarrheagenic Escherichia coli (E. coli) has been a major concern in the field of livestock farming leading to a severe loss of domesticated animals. This systematic review aims to analyze medical shreds of evidence available in the literature and to discover the effect of IgY in treatment and protection against E. coli diarrhea.Research reports that aimed to evaluate the effect of IgY against E. coli diarrhea were searched and collected from several databases (Science Direct, Springer link, Wiley, T&F). The collected studies were screened based on the inclusion criteria. 19 studies were identified and included in the meta-analysis. The pooled relative risk ratios were calculated for the studies and found to be statistically significant to support the therapeutic effect of IgY against E. coli diarrhea but the 95% confidence interval of a majority of studies includes a relative risk of 1. This variability between the effect of IgY in the overall estimate and individual studies accounts due to the presence of methodological heterogeneity. In addition, subgroup analysis revealed the grounds for heterogeneity.This systematic review and meta-analysis provide concrete evidence for the favorable effect of IgY as a prophylactic and therapeutic modality against E. coli diarrhea. Yet, more research pieces of evidence with standardized animal studies aimed to utilize IgY against E. coli are vital. Further studies and trials on human subjects could open new perspectives in the application IgY as a therapeutic agent.