Imperial College London
Alternate

Emeritus ProfessorJohnWarner

Faculty of Medicine, National Heart & Lung Institute

Emeritus in Paediatrics
 
 
 
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Contact

 

j.o.warner

 
 
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Location

 

246Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Khaleva:2019:10.1111/cea.13409,
author = {Khaleva, E and Gridneva, Z and Geddes, DT and Oddy, WH and Colicino, S and Blyuss, O and Boyle, R and Warner, J and Munblit, D},
doi = {10.1111/cea.13409},
journal = {Clinical and Experimental Allergy},
pages = {1201--1213},
title = {Transforming growth factor beta in human milk and allergic outcomes in children: A systematic review},
url = {http://dx.doi.org/10.1111/cea.13409},
volume = {49},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Human milk (HM) transforming growth factor beta (TGF-β) is critical for inflammation regulation and oral tolerance promotion. Previous reports suggested that variations in HM TGF-β levels are associated with allergic outcomes. OBJECTIVE: We undertook a systematic review (PROSPERO 2017 CRD42017069920) to reassess the evidence on the relationships between HM TGF-β and allergic outcomes in children. METHODS: Electronic bibliographic databases (MEDLINE, EMBASE, Cochrane Library) were systematically searched. Two independent reviewers screened reference lists, extracted the data and assessed risk of bias using the National Institute for Clinical Excellence methodological checklist. RESULTS: A total of 21 studies were identified. Sixteen studies assessed relationships between HM TGF-β and risk of eczema; 14, allergic sensitisation; 9, wheezing/asthma; 6, food allergy; 3, allergic rhinitis/conjunctivitis. Five cohorts (5/18, 28%) reported a protective effect of TGF-β1, while 3 (3/10, 30%) suggested increased risk of allergic outcomes development and 1 (1/10, 10%), a protective effect of TGF-β2 on eczema. Meta-analysis was not possible due to significant heterogeneity in methodology, age of outcome assessment and differing statistical approaches. 71% (15/21) of studies carried a high risk of bias. CONCLUSION AND CLINICAL RELEVANCE: In contrast with previous findings we did not find strong evidence of associations between HM TGF-β and allergic outcomes. Differences in studies' methodology and outcomes do not allow unconditional rejection or acceptance of the hypothesis that HM TGF-β influences the risk of allergy development. Future studies on diverse populations employing standardised methods, accurate phenotyping of outcomes and evaluation of the effect of TGF-β in combination with other HM immune markers, microbiome and oligosaccharides are required.
AU  - Khaleva,E
AU  - Gridneva,Z
AU  - Geddes,DT
AU  - Oddy,WH
AU  - Colicino,S
AU  - Blyuss,O
AU  - Boyle,R
AU  - Warner,J
AU  - Munblit,D
DO  - 10.1111/cea.13409
EP  - 1213
PY  - 2019///
SN  - 0954-7894
SP  - 1201
TI  - Transforming growth factor beta in human milk and allergic outcomes in children: A systematic review
T2  - Clinical and Experimental Allergy
UR  - http://dx.doi.org/10.1111/cea.13409
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31058363
UR  - http://hdl.handle.net/10044/1/70139
VL  - 49
ER  -
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