Canine atopic dermatitis: detailed guidelines for diagnosis and allergen identification

Is Vitamin D3 a Worthy Supplement Protecting against Secondary Infections in Dogs with Atopic Dermatitis?

Canine atopic dermatitis (CAD) is a common, chronic, inflammatory skin disease in dogs worldwide. This disease often predisposes for secondary organisms overgrowth and skin infections with pathogens, such as Staphylococcus pseudintermedius and Malassezia pachydermatis. Unfortunately, the causes of this disease in both humans and animals are not fully understood; therefore, the only possible option is a lifelong, symptomatic treatment. The management of CAD is mainly based on limiting contact with allergens and antipruritic therapy, most often with glucocorticoids and antihistamines. A serious problem in this situation is the fact, that long-term administration of glucocorticoids leads to side effects like polyuria, alopecia, increased susceptibility to infection, muscle atrophy, and many others. For this reason, great emphasis is placed on the development of replacement and supportive therapies. It is a well-documented fact that reduced concentrations of serum vitamin D3 contribute to the severity of atopic dermatitis symptoms in humans. Moreover, unlike the most commonly used therapeutic methods, of which the main goal is to ameliorate inflammation and pruritus, namely the symptoms of AD, vitamin D3 supplementation affects some underlying factors of this disease. Therefore, in this review, we summarize the current state of knowledge regarding the role of vitamin D3 in CAD, its protective effect against secondary bacterial and fungal infections, and the potential of its supplementation in dogs.

Characterization of the oral and fecal microbiota associated with atopic dermatitis in dogs selected from a purebred Shiba Inu colony

Atopic dermatitis (AD) is a chronic and relapsing multifactorial inflammatory skin disease that also affects dogs. The oral and gut microbiota are associated with many disorders, including allergy. Few studies have addressed the oral and gut microbiota in dogs, although the skin microbiota has been studied relatively well in these animals. Here, we studied the AD-associated oral and gut microbiota in 16 healthy and nine AD dogs from a purebred Shiba Inu colony. We found that the diversity of the oral microbiota was significantly different among the dogs, whereas no significant difference was observed in the gut microbiota. Moreover, a differential abundance analysis detected the Family_XIII_AD3011_group (Anaerovoracaceae) in the gut microbiota of AD dogs; however, no bacterial taxa were detected in the oral microbiota. Third, the comparison of the microbial co-occurrence patterns between AD and healthy dogs identified differential networks in which the bacteria in the oral microbiota that were most strongly associated with AD were related with human periodontitis, whereas those in the gut microbiota were related with dysbiosis and gut inflammation. These results suggest that AD can alter the oral and gut microbiota in dogs.

Efficacy of Antimicrobial Treatment in Dogs with Atopic Dermatitis: An Observational Study

There is a shortage of studies reporting the efficacy of antimicrobial treatment of dogs with atopic dermatitis (AD) and skin infections (SIs). The aim of this study was to evaluate the change in the severity of skin lesions and pruritus, and the overall efficacy of antimicrobial treatment, in dogs with AD and bacterial overgrowth/infection and/or Malassezia dermatitis. A total of 20 dogs with AD and SIs were prospectively enrolled (group A) and they were examined before and after the administration of systemic antimicrobials that resulted in the resolution of SIs. In addition, 19 dogs fulfilling the same inclusion criteria and treated with systemic, with or without topical antimicrobials, were included retrospectively (group B). Since there were no major differences between the groups, their results were combined. The severity of skin lesions decreased significantly, by 30% based on Canine Atopic Dermatitis Extent and Severity Index-4 (CADESI-4), by 28.1% based on the erythema domain of CADESI-4 and based on owner’s global assessment of the severity of skin lesions. Pruritus decreased significantly, by 34.7% based on the Pruritus Visual Analogue Scale (PVAS). The efficacy of antimicrobial treatment was assessed as good to excellent by the investigator and the owner in 55% and 60% of the dogs, respectively. Despite the significant improvement, there was high variability in the response to treatment among dogs. Further studies are needed to find factors that determine the response to antimicrobial treatment in dogs with AD and SIs.

Snail Mucus Filtrate Reduces Inflammation in Canine Progenitor Epidermal Keratinocytes (CPEK)

Simple Summary

Canine atopic dermatitis (cAD) is a clinical syndrome characterized by inflammatory and allergic manifestations. Recent studies have demonstrated that cAD has many common characteristics with human AD and this assertion is derived from the assumption that domestic dogs share the environment with their owners. Several therapeutic approaches can be used in the management of cAD; in our research, we used the mucus secreted by Helix aspersa Muller. To clarify the development of cAD, we employed cell lines of canine epidermal keratinocytes (CPEK). Our results highlight the anti-inflammatory capacity of mucus in reducing the inflammatory process produced during cAD.

Abstract

Atopic dermatitis (AD) is an inflammatory and allergic disease, whose multifactorial etiopathogenesis is the consequence of the link between the genetic, immunological and environmental components. The complexity and difficulty in understanding the causes that trigger or exacerbate this pathology makes it difficult, once diagnosed, to proceed with a targeted and effective therapeutic process. Today, the new frontiers of research look to natural and innovative treatments to counteract the different manifestations of dermatitis. From this point of view, the mucus secreted by Helix aspersa Muller has proven, since ancient times, to be able to neutralize skin diseases. To study canine atopic dermatitis (cAD), we used cell lines of canine epidermal keratinocytes (CPEK) that are optimal to understand the biological reactivity of keratinocytes in vitro. The data obtained from our study demonstrate the anti-inflammatory capacity of snail secretion filtrate (SSF) in counteracting the production of proinflammatory cytokines produced during cAD, highlighting the opportunities for further studies to be able to identify new, natural and safe treatments for cAD and to open new frontiers for veterinarians and owners.

Cytokine and Lymphocyte Profiles in Dogs with Atopic Dermatitis after Allergen-Specific Immunotherapy

Canine atopic dermatitis (cAD) is a chronic and recurrent inflammatory and pruritic skin disease in dogs. Currently, allergen-specific immunotherapy (ASIT) is the only identified disease-modifying intervention for allergic diseases. It decreases the symptoms triggered by allergens and prevents recurrence of the disease in the long-term. The aim of our research was to determine how immunotherapy changes the proportion of lymphocyte subsets in dog peripheral blood and the levels of cytokines secreted by these cells during therapy. ASIT was applied for 6 months. Blood samples for further analyses were collected from patients in the third and sixth month of immunotherapy. Six out of seven dogs receiving ASIT showed a positive effect. A reduction in cytokine levels (IL-13, TNF-α) in peripheral blood of cAD patients and changes in the number of specific T cell subpopulations—reduction of Tc cells (CD8+) and increase of activated T cells (CD3+CD25+)—confirmed the beneficial effect of the applied ASIT. In addition, a significantly higher percentage of Treg cells (CD4+CD25+FOXP3+) was noted in cAD patients before treatment compared to healthy dogs. After 3 months of therapy, the percentage of Tregs significantly decreased, and after 6 months, it increased significantly again.

Enhanced In Vitro Expression of Filaggrin and Antimicrobial Peptides Following Application of Glycosaminoglycans and a Sphingomyelin-Rich Lipid Extract

Filaggrin is an epidermal protein involved in skin barrier formation and hydration, whose expression is altered in canine atopic dermatitis (CAD). CAD patients also present an abnormal immune response with an altered expression of antimicrobial peptides (AMPs), such as β-defensins and cathelicidins. Sphingolipids and glycosaminoglycans (GAGs) have been reported to improve the skin barrier in several animal species, including dogs. Our objective was to evaluate the in vitro effects of a sphingomyelin-rich lipid extract (LE), a hyaluronic acid-rich GAG matrix, and their combination, on the expression of filaggrin and human β-defensin 2 (hBD-2). Filaggrin expression was quantified in a reconstructed human epidermis (RHE), and hBD-2 in normal human epidermal keratinocyte (NHEK) cultures. LE and GAGs were tested at 0.02 mg/mL, with or without adding a cytokine mix. A significant increase in mean hBD-2, compared to the control (99 pg/mL) was achieved with LE (138 pg/mL) and LE+GAGs (165 pg/mL). Filaggrin increased with GAGs (202% ± 83) and LE (193% ± 44) vs. the stimulated control, but this difference was statistically significant (p < 0.05) only with LE+GAGs (210% ± 39). In conclusion, the tested GAGs and LE enhance filaggrin and AMP expression in vitro, which might benefit CAD patients if applied in vivo.

THE USE OF INTRADERMAL SKIN TESTING AND HYPOSENSITIZATION INJECTIONS TO CONTROL SEASONAL DERMATITIS IN GREATER ONE-HORNED RHINOCEROSES (RHINOCEROS UNICORNIS)

Allergic dermatitis was diagnosed in a 25-yr-old female greater one-horned rhinoceros (Rhinoceros unicornis) and her 6-yr-old female offspring by skin biopsy, intradermal skin testing (IDST), and allergen-specific serum IgE testing. Dam and offspring presented with seasonal, erosive, and ulcerative dermatitis affecting the face, legs, and trunk starting at 6 and 2 yr of age, respectively. IDST was performed at the caudal pinnal base using 61 regionally specific allergens. Specific serum allergen responses were detected using Heska's Equine ALLERCEPT^® Allergen Panel. Histopathology of the lesions was consistent with an allergic etiology. Injectable allergen-specific immunotherapy was initiated in both animals and within 6 to 18 mon after commencing hyposensitization clinical improvement was noted. This report documents a repeatable methodology for IDST and serological allergen testing for use in rhinoceroses. The hyposensitization protocol detailed here can help guide future treatment protocols.

Efficacy of subcutaneous allergen immunotherapy in atopic dogs: A retrospective study of 664 cases

Background

Canine atopic dermatitis (cAD) is an allergic skin disease affecting approximately 10% of dogs. allergen‐specific immunotherapy (ASIT) is currently the only treatment option able to induce tolerance to the causative allergens.

Objective

To retrospectively establish the efficacy of ASIT in atopic dogs.

Animals

Client‐owned (n  = 664) dogs with cAD presented between 2008 and 2018 to two dermatology referral clinics.

Materials and Methods

Clinical records of atopic dogs were reviewed to obtain information including the results of the intradermal skin test and/or allergen‐specific immunoglobulin (Ig)E serological results, the allergens included in the ASIT, concurrent symptomatic medications, and ASIT efficacy after at least 9 months.

Results

Excellent (ASIT alone controlled clinical signs), good (≥50% reduction of clinical signs) and poor (<50% improvement) responses were seen in 31.5%, 28.5% and 40.1% of the dogs, respectively. No significant differences in efficacy were associated with breed, sex, age at initiation of ASIT, type of allergens in ASIT, and between clinics. Dogs re‐examined regularly responded significantly better to ASIT than dogs that did not (>50% improvement in 69.3% and 55.4% of the dogs, respectively). Dogs treated with ASIT and concomitant systemic glucocorticoids showed a significantly poorer response (success rate of >50% improvement of 38.5%).

Conclusions and clinical importance

In 59.9% of atopic dogs, subcutaneous ASIT can improve clinical signs by ≥50%. The beneficial effect of ASIT is higher if dogs are re‐examined regularly and if systemic long‐term corticosteroids are avoided, at least during the first 9 months of ASIT.

The effect of a mixed cannabidiol and cannabidiolic acid based oil on client‐owned dogs with atopic dermatitis

Background

Cannabidiol (CBD) and cannabidiolic acid (CBDA) are reported to have antinociceptive, immunomodulatory and anti‐inflammatory actions.

Objectives

To determine if CBD/CBDA is an effective therapy for canine atopic dermatitis (cAD).

Animals

Thirty‐two privately owned dogs with cAD.

Materials and methods

Prospective, randomised, double‐blinded, placebo‐controlled study. Concurrent therapies were allowed if remained unchanged. Dogs were randomly assigned to receive either 2 mg/kg of an equal mix of CBD/CBDA (n = 17) or placebo for 4 weeks. On Day (D)0, D14 and D28, Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI‐04) and pruritus Visual Analog Scale (pVAS) scores were determined by investigators and owners, respectively. Complete blood count, serum biochemistry profiles and cytokine bioassays were performed on serum collected on D0 and D28.

Results

There was no significant difference in CADESI‐04 from D0 to D14 (p  = 0.42) or D28 (p  = 0.51) in either group. pVAS scores were significantly lower for the treatment group at D14 (p  = 0.04) and D28 (p  = 0.01) and a significant change in pVAS from baseline was seen at D14 (p  = 0.04) and not D28 (p  = 0.054) between groups. There was no significant difference in serum levels of interleukin (IL)‐6, IL‐8, monocyte chemoattractant protein ‐ 1, IL‐31 or IL‐34 between groups at D0 or D28. Elevated alkaline phosphatase was observed in four of 17 treatment group dogs.

Conclusions and clinical relevance

CBD/CBDA as an adjunct therapy decreased pruritus, and not skin lesions associated with cAD in dogs.

The effects of oclacitinib treatment on antimicrobial usage in allergic dogs in primary practice: an Australia wide case-control study

BACKGROUND

Canine allergic dermatitis is a common diagnosis in veterinary practices which can lead to secondary infections requiring treatment with antimicrobials. A previous study suggested that dogs treated with oclacitinib in an Australian referral hospital required fewer courses of antimicrobial therapy compared to dogs receiving other anti-pruritic treatments. This study aimed to quantify the effect of oclacitinib treatment on the use of antimicrobials and other therapies in general practice veterinary clinics across Australia. A retrospective case-controlled review of patient records was designed to investigate the number of courses of antimicrobials and other therapies in dogs that received oclacitinib (Apoquel®), compared with those who received an anti-pruritic treatment that was not oclacitinib.

RESULTS

The target population included canine patients with a presumptive diagnosis of allergic dermatitis presenting between 2008 and 2018 to general practices contributing to the VetCompass Australia database. Patient records of interest were identified using search terms relating to allergic dermatitis, resulting in over 700,000 observations. Multivariable logistic regression models were developed to determine whether cases were prescribed fewer antimicrobial courses than controls, after adjusting for the presence of concurrent skin infections or infectious agents in ears. Our results indicate that fewer antimicrobial courses were prescribed in the cases compared to the controls. After adjusting for the concurrent skin infections, there was a significant reduction in the use of cefovecin [OR:0.62(0.39-0.98), P = 0.043], chlorhexidine [OR:0.57(0.42-0.77), P < 0.001], neomycin [OR:0.4(0.28-0.56), P < 0.001] and amoxycillin clavulanic acid (AMC) [OR: 0.55(0.39-0.78), P = 0.001] in cases compared to controls.

CONCLUSION

This study demonstrates a potential sparing effect of oclacitinib on the prescription of antimicrobials for the treatment of allergic skin diseases in dogs. This information may assist in the planning of treatment for canine allergic dermatitis, with consideration for antimicrobial stewardship.

A 3-Year Case Report on an Atopic Patient with a Caninised Monoclonal Antibody Treatment

A 6-year-old, male, neutered, English Mastiff dog was presented for a second opinion due to chronic pruritus. The patient had been on methylprednisolone and chlorphenamine for four years. The diagnostic investigations included: swabs for bacterial and mycology culture, hair plugs for dermatophyte culture, acetate tape strips and deep skin scrapes, skin biopsies for dermatohistopathology, biochemistry, haematology, endocrinology, serology for canine scabies using enzyme-linked immunosorbent assay (ELISA) testing and serology for allergen specific IgE antibodies. The history and the diagnostics confirmed the diagnosis of canine atopic dermatitis. This case report details the treatment with lokivetmab, which is a caninised monoclonal antibody drug. At periods of flare ups, additional treatments were prescribed, such as systemic glucocorticoids and oclacitinib in order to manage the clinical signs. The treatment showed good response to the overall treatment management during the three year period of this atopic patient.

Polyopes affinis Suppressed IFN-γ- and TNF-α-Induced Inflammation in Human Keratinocytes via Down-Regulation of the NF-κB and STAT1 Pathways

Polyopes affinis is a red algal species commonly found on the South coast and near Jeju Island, Korea. This study aimed to determine whether P. affinis extracts can inhibit the pathogenesis of T-helper-2 (Th2)-mediated inflammation in a human keratinocyte cell line of atopic dermatitis (AD). Cells were incubated with 10 ng/mL of interferon gamma (IFN-γ) and 10 ng/mL of tumor necrosis factor-alpha (TNF-α) at various concentrations of PAB (10, 30, and 60 µg/mL) and PAA (100, 500, and 1000 µg/mL) extracts. A gene-ontology (GO)-enrichment analysis revealed that PAB significantly enriched the genes associated with biological processes such as cell adhesion, immune response, inflammation, and chemokine-mediated pathways. PAB suppressed the expression of the secretory proteins and mRNAs that are associated with the thymus and the production of activation-regulated chemokines (TARC/CCL17) and macrophage-derived chemokines (MDC/CCL22). The effect of the extract on mitogen-activated protein kinases (MAPKs) was related to its inhibition of TARC/CCL17 and MDC/CCL22 production by blocking NF-κB and STAT1 activation. These results suggest that seaweed extract may improve AD by regulating pro-inflammatory chemokines. In conclusion, we first confirmed the existence of phloroglucinol, a polyphenol formed from a precursor called phlorotannin, which is present in PAB, and this result proved the possibility of PAB being used as a treatment for AD.

Allergy to Fungi in Veterinary Medicine: Alternaria, Dermatophytes and Malassezia Pay the Bill!

The fungal kingdom comprises ubiquitous forms of life with 1.5 billion years, mostly phytopathogenic and commensals for humans and animals. However, in the presence of immune disorders, fungi may cause disease by intoxicating, infecting or sensitizing with allergy. Species from the genera Alternaria, Aspergillus and Malassezia, as well as dermatophytes from the genera Microsporum, Trichophyton and Epidermophyton, are the most commonly implicated in veterinary medicine. Alternaria and Malassezia stand as the most commonly associated with either allergy or infection in animals, immediately followed by Aspergillus, while dermatophytes are usually associated with the ringworm skin infection. By aiming at the relevance of fungi in veterinary allergy it was concluded that further research is still needed, especially in the veterinary field.

Combined prick and patch tests for diagnosis of food hypersensitivity in dogs with chronic pruritus

BACKGROUND

Previous studies have shown that patch testing with food extracts can assist formulation of elimination diets (ED) in human patients with suspected adverse food reactions (AFR). Little is known about the use of these tests in dogs.

OBJECTIVES

To evaluate the effectiveness of a combination of prick and patch testing in current protocols, and food challenge (FC) tests in dogs with AFR.

METHODS AND MATERIALS

Prick and patch tests were performed on 21 dogs with chronic, nonseasonal pruritus. Dogs then were fed an ED formulated on the basis of the results. All dogs with improved clinical signs then were challenged with a food to which there had been a positive reaction in the tests. Six dogs subsequently were challenged with a food to which they had been negative on testing. Pruritus Visual Analog Scale (pVAS) and Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) were evaluated on Day (D)0, D30 and D60 of the ED. Sensitivity (SE), specificity (SP), positive (PPV) and negative (NPV) predictive values, and the Kappa (κ)value were calculated.

RESULTS

Of the 21 dogs, there was a significant mean improvement in pVAS and CADESI-04 scores in 16 (76%) dogs after D30 (P < 0.01) and D60 (P < 0.01) of the ED. There were no statistical differences between D30 and D60. The combination of tests had SE, SP, PPV, NPV and κ values of 80%, 66.7%, 66.7%, 80% and -0.17, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

The combination of prick and patch testing reached high values of SE and NPV. A diagnosis of AFR was made in 76% of the dogs, and test results were useful for the selection of an ED.

THE USE OF INTRADERMAL ALLERGY TESTING FOR ALLERGIC DERMATITIS IN PTEROPID BATS AND TREATMENT WITH ALLERGEN SPECIFIC IMMUNOTHERAPY: A CASE SERIES

This case series describes the diagnosis of allergic dermatitis and management with allergen-specific immunotherapy (ASIT) based on intradermal allergy testing (IDAT) and adjunctive medical therapy in six pteropid bats; five large flying foxes (Pteropus vampyrus); and one variable flying fox (Pteropus hypomelanus). The cases ranged from 2 to 15 yr of age at the time of presentation. Clinical signs varied between individuals and included moist ulcerative cutaneous lesions in nonhaired skin, blepharoconjunctivitis, alopecia, and pruritus. All bats underwent IDAT under general anesthesia, and reactive allergens included a mixture of grasses, trees, weeds, and biting insects. Three of the six cases (50%) had reformulation of the ASIT before control of clinical signs was seen, and two bats were treated with the addition of oclacitinib (Apoquel). Severe adverse effects were not identified; however, one bat had self-limiting swelling at the immunotherapy injection site. All six cases showed improvement of clinical signs and perceived comfort level, including in subsequent allergy seasons.

Determination of the efficacy rate and time-to-efficacy of subcutaneous immunotherapy in dogs with atopic dermatitis

BACKGROUND

Allergen-specific immunotherapy (ASIT) is reported to have a success rate of 50-70% when given for up to 12 months to dogs with atopic dermatitis (AD). How soon ASIT is clinically effective is unclear.

OBJECTIVES

To compare the efficacy rate (ER) and time-to-efficacy (TTE) of various types of subcutaneous immunotherapy (SCIT) administered using conventional dosing regimens using the methodology of a critically appraised topic.

METHODS AND MATERIALS

Three databases were searched to extract information on the ER and TTE of SCIT in dogs with AD. Herein, "efficacy" was defined as a ≥50% reduction in pruritus and/or skin lesions, and the TTE as the time needed to achieve such a reduction.

RESULTS

We selected 12 publications including 194 dogs. The ER was significantly higher with the polymerised allergoids coupled with nonoxidized mannan than for the "classic" aqueous and alum-precipitated SCIT types. A TTE of three months or shorter was seen in a significantly higher proportion of dogs receiving mannan-couple allergoids, pullulan-conjugated Der f 2 or tyrosine-adjuvanted than aqueous or alum-precipitated SCIT; with the latter two formulations, the TTE might be nine months or longer in ≤20% of atopic dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

In spite of the low number of articles available for review and small number of enrolled dogs, novel SCIT regimens appear to have a faster - and possibly higher - efficacy than the currently available aqueous or alum-precipitated formulations. A standardisation of outcome measures for ASIT clearly is needed to allow a more meaningful comparison between SCIT types.

Efficacy of olanexidine gluconate in canine superficial pyoderma: a randomised, single-blinded controlled trial

BACKGROUND

Topical treatments can be beneficial for managing canine superficial pyoderma. A novel antiseptic agent, olanexidine gluconate, has become available recently for use in humans, and its efficacy for canine pyoderma as topical therapy is unknown.

OBJECTIVE

The antimicrobial effect of olanexidine was evaluated using minimal inhibitory concentration (MIC) towards Staphylococcus pseudintermedius. Furthermore, its clinical efficacy in canine superficial pyoderma was assessed in a randomized, single-blinded study.

ANIMALS

Twenty-eight client-owned dogs with atopic dermatitis and superficial pyoderma.

METHODS AND MATERIALS

The MIC of olanexidine was determined for S. pseudintermedius isolates (n=73) by serial dilution of 96-well broth microdilution method. Regarding the clinical trial, all recruited dogs were randomized into two groups; one treated with 1.5% olanexidine spray once daily and the other with a 3% chlorhexidine shampoo once a week for 2 times, respectively. Clinical assessment was performed at days 0 and 14 according to the guidelines of the Japanese Society of Antimicrobials for Animals.

RESULTS

The MIC values for methicillin-resistant S. pseudintermedius (MRSP) and methicillin-sensitive S. pseudintermedius (MSSP) were 0.23 μg/ml and 0.24 μg/ml (P =0.9), respectively. In clinical trial, olanexidine and chlorhexidine showed substantial improvement in clinical presentation compared to the baseline.

CONCLUSIONS AND CLINICAL IMPORTANCE

Olanexidine showed comparable efficacy to chlorhexidine (P=0.73). Moreover, the MIC against S. pseudintermedius indicated high bactericidal activity, which was supported by the topical effectiveness of olanexidine.

Randomized, double-blind, placebo-controlled clinical trial measuring the effect of a dietetic food on dermatologic scoring and pruritus in dogs with atopic dermatitis

Background

Canine atopic dermatitis (AD) is a common condition that often requires multimodal therapy. Including a diet in the multimodal management of AD may reduce medication doses, saving pet owners money and reducing side effects. The objective of this randomized, double-blind, placebo-controlled clinical trial was to determine if a diet fortified in antioxidants, polyphenols, and omega-3 fatty acids can reduce the clinical signs of AD. Forty client-owned dogs with AD were enrolled in the study and assigned to either an enriched diet (diet B) or control diet (diet A) for 60-days. CADESI-4 index scores and owner-reported pruritus scores were measured periodically.

Results

Total CADESI-4 index scores for dogs eating diet B were lower on day 60 compared to baseline (P = 0.003). There was no statistical difference in scores for dogs eating diet A over a 60-day period. Diet B dogs had 25 and 49% reductions in CADESI-4 index scores on days 30 and 60, respectively (P = 0.0007) while diet A had no change over the study period. When comparing the percent change in owner-reported pruritus scores, diet B also performed better than diet A. By day 60, owners feeding diet B to their dogs reported a significant reduction (P < 0.0001) of 46.4% in itching, while those on diet A reported a 26.8% reduction, which was not statistically significant (P = 0.08).

Conclusions

These study results demonstrate feeding a diet enriched with ingredients to improve skin health and reduce inflammation improves the clinical signs of AD in dogs.

Immunomodulatory effect of long-term oclacitinib maleate therapy in dogs with atopic dermatitis

BACKGROUND

Canine atopic dermatitis (cAD) is a chronic disease characterised by hypersensitivity to environmental allergens. Oclacitinib maleate selectively inhibits pro-inflammatory mediators associated with cAD. However, the impact of chronic oclacitinib use on immunocompetence requires further investigation.

OBJECTIVES

Herein, we examined the potential immunomodulatory effects of prolonged oclacitinib treatment in dogs.

ANIMALS

Thirteen privately owned dogs with cAD, treated with 0.4-0.6 mg/kg oclacitinib for 12 months.

METHODS AND MATERIALS

Pruritus level was evaluated using a pruritus Visual Analog Scale (pVAS) and the canine atopic dermatitis extent and severity index, 4^th iteration (CADESI IV). Peripheral blood samples were collected for routine laboratory assays and lymphocyte subtypes were analysed using flow cytometry. Antigen-specific intracellular cytokine production from CD4+ and CD8+ T lymphocytes was analysed following in vitro stimulation by Dermatophagoides farinae antigens.

RESULTS

Oclacitinib treatment significantly reduced pVAS and CADESI-04 scores, by 51% and 86.7%, respectively. Flow cytometric analysis revealed increased CD4+ and CD14+ lymphocyte populations. The cytokine profile at 360 days after treatment initiation was similar to that before treatment and was not associated with clinical relapse.

CONCLUSION

Oclacitinib, when administered at the currently labelled dose for one year, is associated with a significant increase in circulating CD4+ T cells, but does not alter cytokine production from antigen-stimulated T cells. The results reported do not support evidence for immunosuppression mediated by the mechanisms evaluated in this study.

A double-blinded placebo-controlled evaluation of adipose-derived mesenchymal stem cells in treatment of canine atopic dermatitis

Mesenchymal stem cells (MSCs) have emerged as a new therapy for various immune-mediated inflammatory diseases. In this study we perform the first double-blinded, placebo-controlled evaluation of the efficacy of adipose-derived allogenic canine MSCs for the treatment of canine atopic dermatitis (cAD). Enrolled canine patients were randomly divided into placebo (PBS saline), low-dose (5 × 10⁵ cells/kg), and high-dose (5 × 10⁶ cells/kg) treatment groups. Each patient received three subcutaneous MSCs treatments or PBS saline at four-week intervals with injections at five sites. Patients were monitored by physical exams, pruritus visual analog scales (PVAS) signed by the primary caretaker, canine atopic dermatitis extent and severity index-4 (CADESI-4) scores by two veterinarians, and complete blood count and serum chemistry analysis along with laboratory analysis for potential biomarkers. Patients were kept off any immune-modulating drugs during the study period, and oral antibiotics and topicals were used for managing pruritus and secondary infections. The PVAS scores and the serum miR-483 levels were significantly lower in the high dose group compared to the placebo group at day90 post first-treatment. The CADESI-4 scores of the high dose group also showed downward trends. No severe adverse effects were observed in any patient in this study. The high dose MSC treatment is efficacious in alleviating the clinical signs of cAD until 30 days after the last subcutaneous administration of MSCs, and miRNA-483 may be a reliable prognostic biomarker for cAD. The MSCs efficacy and potential biomarkers should be further explored by a larger scale clinical trial.

Clinical relevance of intradermal test results in atopic dogs

TOPIC AND AIMS

Canine atopic dermatitis (AD) is an inflammatory and pruritic skin disease and in most cases associated with IgE antibodies against environmental allergens. To date, the only causative therapeutic option is allergen immunotherapy (AIT). Offending allergens for AIT can be identified by intradermal testing (IDT) or serum allergen-specific IgE testing. The aim of the study was to evaluate positive IDT results considering the atopic dogs' clinical history.

MATERIAL AND METHODS

An IDT was performed on 48 atopic dogs and their owners completed a detailed questionnaire about the seasonal course of their pruritus. Results of IDT were correlated with the seasonal occurrence of pruritus.

RESULTS

The most common positive IDT reactions were observed to mite allergens (33.3-62.5 %). Prevalence of positive reactions to individual tree, grass and weed pollen ranged between 8.3 % and 25 %. Moulds and epithelial allergens produced positive reactions in only 0-6.3 %. A correlation between positive IDT reactions and course of pruritus could neither be found for perennial nor for seasonal allergens.

CONCLUSION

The evaluation of IDT reactions may not be an optimal method for identification of clinically relevant allergens in canine AD.

CLINICAL RELEVANCE

The results of this study emphasise the importance of considering clinical history in addition to allergy test results in the formulation of an allergen extract for desensitisation.

Effects of Feeding a Hypoallergenic Diet with a Nutraceutical on Fecal Dysbiosis Index and Clinical Manifestations of Canine Atopic Dermatitis

Simple Summary

The prevalence of canine atopic dermatitis in developed countries has been growing constantly over the last few decades. Genetic predisposition represents only part of the problem, and environmental factors are believed to be an important boost to the rapid rise in atopic dogs. Although a complete understanding of the gut–skin axis has not yet been achieved, a growing number of studies demonstrate a close relationship between gastrointestinal imbalance and skin diseases. The aim of this study was to assess the effect of a nutraceutical product on the Dysbiotic Index and skin lesions of atopic dogs.

Abstract

Background: an imbalance of the intestinal microbiota can cause health problems in the gastrointestinal tract and in other organs. Canine Atopic Dermatitis (CAD) is a genetically predisposed, inflammatory and pruritic allergic skin disease with multifactorial etiology and multimodal treatment. The aim of this study was to assess the effect of a nutraceutical product on Dysbiotic Index (DI) and the skin lesions of atopic dogs. Methods: a nutraceutical product was administered to 32 dogs with CAD. The product was associated with a standardized hypoallergenic diet for 60 days; the dietary regimen continued for 120 days, while ongoing therapies remained unchanged. Values of Visual Analogic Scale (VAS), Canine Atopic Dermatitis Lesional Index (CADLI) and DI were evaluated on day 0, 60, 120. Results: all the 32 dogs showed a statistically significant decrease (p < 0.001) to V60 of VAS and CADLI, which persisted and increased to V120 when diet alone was continued. The decrease in the DI value was also statistically significant (p < 0.001). Conclusion: the intake of nutraceutical associated with diet resulted in a decrease in the index of intestinal dysbiosis, with an improvement in the subjective severity of cutaneous lesions.

Circulating Galectin-3 Evaluation in Dogs With Cardiac and Non-cardiac Diseases

Galectin-3 is involved in important biological functions such as fibrogenesis and inflammation. Notably, it is associated with various diseases and plays a major role in cardiac inflammation and fibrosis. Although heart diseases are relatively common in dogs, a few studies have analyzed the circulating galectin-3 concentration in dogs with various heart diseases, including myxomatous mitral valve disease, patent ductus arteriosus, and pulmonic stenosis. The aims of the present study were to evaluate the effect of heart disease on circulating galectin-3 levels in dogs, and also to evaluate the correlation between galectin-3 concentration and conventional echocardiographic indices along with N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration in dogs with heart diseases. The medical records and archived serum samples of 107 dogs were evaluated retrospectively. In total, 107 dogs were classified into healthy dogs (n = 8), cardiac disease (n = 26), and non-cardiac disease groups (n = 73). The circulatory galectin-3 levels were analyzed using a commercially available canine-specific galectin-3 enzyme-linked immunosorbent assay kit. This study demonstrated that dogs with heart, endocrine, and dermatologic diseases had significantly higher galectin-3 levels than healthy dogs (p = 0.009, p = 0.007, and p = 0.026, respectively). Among dogs with heart diseases, dogs with concentric cardiomyopathy had significantly increased circulatory galectin-3 levels compared with healthy dogs (p = 0.028). E'/A' had a positive association with galectin-3 levels among conventional echocardiographic indices. Moreover, the galectin-3 concentration could predict diastolic dysfunction. In dogs with myxomatous mitral valve disease, a significantly positive correlation was revealed between galectin-3 levels and NT-proBNP levels (p = 0.007). Overall, this study demonstrates that circulatory galectin-3 levels increase in dogs with heart, endocrine, and dermatologic diseases. Moreover, this study demonstrates that galectin-3 concentration could be helpful to evaluate cardiac remodeling and diastolic function. Further large-scale research is required to evaluate the role of circulating galectin-3 in dogs with heart diseases.

The upper epidermis of atopic dogs is altered at the functional and structural levels

BACKGROUND

The pathogenesis of human atopic dermatitis (AD) is complex. Like humans, dogs develop spontaneous AD so this species could be a useful model of study. However, AD has been less characterised in dogs than in humans.

OBJECTIVES

To compare the epidermis of normal and spontaneously atopic dogs at the functional and structural levels.

ANIMALS

Six healthy and five atopic laboratory Beagle dogs.

METHODS AND MATERIALS

Dogs were clinically characterised by general examination, Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) evaluation and trans-epidermal water loss (TWEL) measurement. Skin biopsies were taken from healthy skin from normal dogs and on nonlesional and lesional skin from atopic dogs. Samples were analysed using transmission electron microscopy (TEM). Cornified envelopes were extracted and examined for their visual aspects (smooth versus ruffled).

RESULTS

CADESI-04 and TWEL were significantly higher in atopic dogs. Healthy and nonlesional skin could be distinguished from lesional skin by histopathological evaluation. TEM examination revealed abnormal morphology of the stratum corneum (SC) in atopic skin. The SC compactum corneocyte layer was larger. Thicker and wrinkled corneocytes were more prominent (P = 0.005) in the lesional skin. Similar changes were observed in the nonlesional skin, but less pronounced. The proportion of immature ruffled envelopes was increased in atopic samples (P < 0.05), both from lesional and nonlesional areas.

CONCLUSIONS

The morphology of the SC was altered in the lesional and apparently nonlesional skin of spontaneously atopic dogs.

Dogs' Microbiome From Tip to Toe

Microbiota and microbiome, which refers, respectively, to the microorganisms and conjoint of microorganisms and genes are known to live in symbiosis with hosts, being implicated in health and disease. The advancements and cost reduction associated with high-throughput sequencing techniques have allowed expanding the knowledge of microbial communities in several species, including dogs. Throughout their body, dogs harbor distinct microbial communities according to the location (e.g., skin, ear canal, conjunctiva, respiratory tract, genitourinary tract, gut), which have been a target of study mostly in the last couple of years. Although there might be a core microbiota for different body sites, shared by dogs, it is likely influenced by intrinsic factors such as age, breed, and sex, but also by extrinsic factors such as the environment (e.g., lifestyle, urban vs rural), and diet. It starts to become clear that some medical conditions are mediated by alterations in microbiota namely dysbiosis. Moreover, understanding microbial colonization and function can be used to prevent medical conditions, for instance, modulation of gut microbiota of puppies is more effective to ensure a healthy gut than interventions in adults. This paper gathers current knowledge of dogs' microbial communities, exploring their function, implications in the development of diseases, and potential interactions among communities while providing hints for further research.

An international seroprevalence survey of the IgE sensitisation to the Dermatophagoides farinae house dust mite and two of its major allergens (Der f 2, Zen 1) in atopic dogs

BACKGROUND

Dogs with atopic dermatitis are often immunoglobulin (Ig)E-sensitised to Dermatophagoides farinae (Df) house dust mites, yet limited data exist on the sensitisation rates to the individual Df allergens, Der f 2 and Zen 1.

OBJECTIVES

To determine the IgE sensitisation rates to Df, Der f 2 and Zen 1 in atopic dogs from geographically diverse countries.

ANIMALS

Serum was collected from 32 laboratory dogs in Japan, and 837 atopic dogs from 11 countries from five continents: Asia (Japan, Thailand, Taiwan), Europe (Italy, Latvia, the Netherlands, UK), North America (USA), South America (Argentina, Brazil) and Africa (South Africa).

METHODS AND MATERIALS

We determined Df-, Der f 2- and Zen 1-specific IgE levels by ELISA. Correlations between the IgE values for these three allergens were calculated.

RESULTS

The IgE seropositivity rates for Df varied between 74% (Argentina) and 100% (the Netherlands, Thailand, South Africa), those for Der f 2 between 12% (Argentina) and 88% (South Africa), and for Zen 1 between 70% (Argentina) and 100% (the Netherlands). Apart from the especially low seropositivity rate for Der f 2-specific IgE in Argentina, the percentage of IgE sensitisation varied little between countries. There was significant correlation between the IgE levels to these three allergens which was highest between Df and Zen 1, and lowest between Zen 1 and Der f 2.

CONCLUSIONS AND CLINICAL RELEVANCE

The IgE sensitisation to Df is geographically widespread. Der f 2 and Zen 1 are major allergens for dogs in almost all countries where this was evaluated.

Weekly topical therapy based on plant extracts combined with lokivetmab in canine atopic dermatitis

BACKGROUND

Lokivetmab is an effective treatment for atopic dermatitis (AD) in dogs. The aim of this prospective study was to determine if topical products containing plant extracts could enhance the clinical efficacy of lokivetmab.

ANIMALS

Thirty atopic dogs were included.

METHODS AND MATERIALS

Dogs were allocated randomly to be treated either with a single injection of lokivetmab (mean dose 1.34 mg/kg; Group A) or to a single injection (mean dose 1.28 mg/kg) coupled with a weekly topical treatment using a shampoo and a spot-on specifically designed to improve skin barrier defect (Group B). Clinical parameters evaluated included pruritus (pruritus Visual Analog Scale) and skin lesions (Canine Atopic Dermatitis Lesion Index, CADLI); cosmetic evaluation, and owner and investigator global assessment of efficacy (OGATE) also were carried out. Dogs were re-examined after 10, 17 and 31 days, and until a clinical relapse occurred.

RESULTS

An improvement was noted for all dogs, with scores being significantly better in dogs in Group B than in those in Group A; after 10 days for cosmetic evaluation, 17 days for pruritus (P = 0.039) and OGATE, and 31 days for CADLI (P = 0.043). A longer-lasting remission was noted in Group B compared to Group A; dogs receiving the combined treatment showed an extended time to flare compared to dogs treated with lokivetmab alone (P = 0.012).

CONCLUSIONS AND CLINICAL IMPORTANCE

This study suggests that combining lokivetmab with topical therapies designed to repair the skin barrier potentially have value in the treatment of AD in dogs.

Survey of cytokines on ocular surfaces of atopic dogs by multiplex analysis using two sampling methods - a pilot study

BACKGROUND

Conjunctivitis in atopic dogs has already been described yet is rarely observed, and likely underdiagnosed in practice.

OBJECTIVES

To assay various cytokines in tears and conjunctivae from atopic and normal dogs, and to compare canine atopic dermatitis-associated conjunctivitis with controls.

ANIMALS

Ten atopic and ten normal client-owned dogs.

METHODS AND MATERIALS

Ocular surfaces were sampled bilaterally in a prospective study, using two different methods. Tear samples were obtained with a sterile swab previously moistened with saline solution (method A). Conjunctival impressions were obtained with a conjunctival impression device (method B). For each sample, the concentrations of a panel of 13 cytokines were measured by multiplex analyses. CADESI-4, pruritus (PS) and conjunctival (CS) scores were determined.

RESULTS

Among the measured cytokines, only granulocyte-macrophage colony-stimulating factor (GM-CSF), keratinocyte-derived chemokine (KC)-like and interleukin (IL)-8 were above the limit of quantification in most samples. Absolute amounts of each cytokine were always higher in samples obtained with method A than with method B. GM-CSF amounts were lower in atopic dogs (method A, P=0.02; method B, P=0.0005). KC levels were higher in atopic dogs, yet the differences were not significant. IL-8 amounts were higher in atopic dogs (method A, P=0.0003; method B, P=0.006).

CONCLUSIONS AND CLINICAL RELEVANCE

Regardless of the method, these preliminary results suggest an overexpression of IL-8 in conjunctivae and tears of atopic dogs despite subtle conjunctival symptoms. As IL-8 is commonly found in many inflammatory conditions, further studies are needed to determine its specificity in atopic conjunctivitis.

Clinical effects of 2 commercially available diets on canine atopic dermatitis

OBJECTIVE

Canine atopic dermatitis (CAD) is a common skin disease in dogs. Prior studies were able to determine beneficial effects of essential fatty acids (EFA) on the clinical signs of CAD. The aim of this study was set to evaluate the effects of a newly designed, EFA-enriched diet on the clinical signs of CAD compared to another EFA-enriched diet.

MATERIALS AND METHODS

In this prospective, randomized, double-blinded study, 31 privately owned dogs with atopic dermatitis received either the control diet (diet A, Hill's Prescription Diet™ d/d™ Salmon & Rice, n = 17) or the test diet (diet B, Veterinary HPM™ Dermatology Support D1, Virbac, n = 14) for 12 weeks. At the beginning of the study as well as after 4, 8 and 12 weeks, skin lesions and pruritus were evaluated via validated scores and the administered medication was documented. At the same time, the dogs' coat quality was evaluated via a distinct scoring system. In both groups, a total of 7 dogs each completed the entire study.

RESULTS

After 12 weeks, there was a mild improvement in lesion scores, pruritus and coat quality with both diets.

CLINICAL RELEVANCE

In this study, both diets improved the patients' skin lesions pruritus and coat quality.

Atopic Dermatitis in Domestic Animals: What Our Current Understanding Is and How This Applies to Clinical Practice

Atopic dermatitis is a clinical syndrome that affects both people and animals. Dogs closely mimic the complexity of the human skin disease, and much progress has been made in recent years in terms of our understanding of the role of skin impairment and the identification of new treatments. Cats and horses also develop atopic syndromes which include both cutaneous and respiratory signs, yet studies in these species are lagging. It is now recognized that atopic dermatitis is not a single disease but a multifaceted clinical syndrome with different pathways in various subgroups of patients. Appreciating this complexity is clinically relevant as we develop more targeted treatments which may work well in some patients but not in others. Different phenotypes of atopic dermatitis have been described in dogs, and it is possible that phenotypes related to breed and age may exist in other animals similar to how they are described in people. The awareness of different mechanisms of disease leads to the desire to correlate different phenotypes with specific biomarkers and responses to treatment. In this review, the current understanding and updated information on atopic syndrome in animals are described, highlighting opportunities for further studies in the future.

Insect Protein-Based Diet as Potential Risk of Allergy in Dogs

Before insects can be used widely as an alternative source of dietary protein, their allerginicity should be investigated. Therefore, the aim of our study was to assess the potential adverse reactions of the immune system of dogs against Tenebrio molitor proteins. Dogs sensitised to storage mites T. putrescentiae and A. siro were included. Clinically healthy and clinically allergic dogs were compared. Proteins were extracted from mealworm larvae and their digestibility determined by in vitro incubation with digestive proteases. Mealworm protein extracts and digests were analysed by SDS-PAGE. Canine sera tested for the presence of mite-specific IgEs were used for subsequent Western blotting. LC-MS/MS analysis was used to identify mealworm proteins and their allergenic potential was predicted with the AllermatchTM tool. The binding of canine sera IgEs to mealworm proteins was confirmed; however, the differences between the two groups of dogs were not significant. Moreover, no clear correlation was found between sensitisation to storage mites and clinical status of the dogs. Altogether, 17 different proteins were identified, including tropomyosin, α-amylase, and Tm-E1a cuticular protein that are known cross-reacting IgE-binding allergens. Our results suggest that dogs allergic to mites may clinically express also the cross-reactivity with mealworm proteins.

Ovalicin attenuates atopic dermatitis symptoms by inhibiting IL-31 signaling and intracellular calcium influx

Atopic dermatitis (AD) is a common skin disorder difficult to be treated with medication. This study investigated the potential of ovalicin extracted from Cordyceps militaris for the treatment of AD using in vitro and in vivo models. We found that, in canine macrophage cell line DH82, lipopolysaccharide (LPS) upregulated the expression of genes associated with inflammation and pruritic responses through activating calcium and interleukin-31 (IL-31) signaling, and the upregulation could be suppressed by ovalicin, with an effect significantly stronger than dexamethasone. Ovalicin also reduced the expression of IL-31 downstream genes, including JAK2 (Janus kinase 2), TRPV1 (transient receptor potential vanilloid receptor-1), and HRH2 (histamine receptor H2). Ovalicin significantly alleviated the allergic symptoms in the AD mouse model. Histologically, the number of macrophages and mast cells infiltrated in the dermis was significantly reduced by ovalicin treatment. In the skin tissue of AD mice, reduction of IL-31 receptor was observed in the ovalicin treated group compared to the group without ovalicin treatment. To our knowledge, this is the first study to elucidate the anti-atopic mechanism of ovalicin, which could be an alternative to steroidal drugs commonly used for AD treatment.

Multivariable analysis of the influence of cross-reactive carbohydrate determinant inhibition and other factors on intradermal and serological allergen test results: a prospective, multicentre study

BACKGROUND

Serological allergen testing (SAT) is used widely to formulate allergen-specific immunotherapy for atopic dogs. Serum immunoglobulin (Ig)E specific for cross-reactive carbohydrate determinants (CCD) can produce false-positive reactions, creating discrepancy between SAT and intradermal allergen test (IDAT) results.

OBJECTIVES

The primary objective was to determine if inhibition of anti-CCD IgE in a commercial assay improved correlation with IDAT. The secondary objective was to assess the influence of dog- and clinic-specific factors, environmental factors, putative allergen exposure and prior medications on intradermal and SAT reactivity.

ANIMALS

Two-hundred and eleven client-owned dogs were enrolled from eight North American dermatology specialty practices.

METHODS AND MATERIALS

Collection of serum samples and IDAT were performed on the same day. Sera were assayed for detection of IgE specific to 25 allergens, before and after treatment with a proprietary inhibitor of anti-CCD IgE. Data for each dog were collected via a questionnaire filled out by veterinary personnel.

RESULTS

The correlation between the testing modalities was fair before (Spearman's rho, ρ = 0.2092) and after (ρ = 0.3042) inhibition of anti-CCD IgE. Ciclosporin dose (P = 0.003), independent of duration of use, and duration of lokivetmab use (P = 0.001), independent of dose administered, were associated with statistically significant decreases in IgE concentrations across all allergen types.

CONCLUSIONS AND CLINICAL RELEVANCE

Contrary to previous reports, this study demonstrated unchanged correlation between SAT and IDAT after inhibition of anti-CCD IgE. Ciclosporin dose and lokivetmab treatment duration may have unexplored effects on IgE concentration during SAT.

Cutaneous microRNA expression in healthy Labrador and Golden retrievers and retrievers with allergic and inflammatory skin diseases

BACKGROUND

MicroRNAs (miRNA) are short, single-stranded RNA molecules that regulate gene expression in a post-transcriptional manner. Their expression is proposed to be tissue-specific and alterations in miRNA expression have been detected in many diseases.

OBJECTIVE

To compare miRNA expression in the skin of healthy Labrador and golden retrievers, and those with allergic and nonallergic dermatitis.

METHODS AND MATERIALS

Formalin-fixed and paraffin-embedded (FFPE) skin specimens from seven healthy Labrador and golden retrievers, and seven dogs with allergic skin disease were collected. A further mixed nonallergic inflammation group consisted of samples from five dogs with fungal infection, demodicosis and mast cell tumours. Total RNA was extracted and miRNA primer assays for 18 target miRNAs (miR-142, miR-363, miR-18b, miR-451, miR-146a, miR-124, miR-409, miR-193b, miR-223, miR-215, miR-155, miR-423a, miR-143, miR-1839, miR-21, miR-34b, miR-146b and miR-202) were performed, with RNU6-2 and SNORD95 as miRNAs for normalisation. The selection of miRNAs for investigation was based on reported data and a pilot study evaluating miRNA extraction from FFPE tissue specimens.

RESULTS

In the two dogs with mast cell tumours, miRNA expression was undetermined for most miRNAs, so both were excluded from analysis. Although there were differences in the miRNA expression between healthy and inflamed skin, allergic and nonallergic inflammation showed similar expression patterns.

CONCLUSION AND CLINICAL RELEVANCE

Although the number of included dogs was small, based on this study, none of the evaluated miRNAs allowed differentiation of allergic dermatitis from other inflammatory skin diseases in retriever dogs.

Prevalence of immunoglobulin E against cross-reactive carbohydrate determinants and the impact of a blocker in canine sera

OBJECTIVE

 Cross-reactive carbohydrate determinants (CCD) cause multiple positive results in seasonal in vitro allergy tests. False positive/clinically irrelevant results have been identified due to the binding of immunoglobulin E against CCD (anti-CCD IgE) when testing for pollen allergens. The aim of this study was to investigate the prevalence of polysensitised serum samples and evaluate the impact of a CCD inhibitor/blocker in seasonal allergy test results.

MATERIAL AND METHODS

 A total of 4614 canine serum samples, submitted from July 2017 to June 2018 for seasonal in vitro allergy test via ELISA Fc-Ε receptor technology, were studied. Samples were grouped into polysensitised (group A) and non-polysensitised (group B). Polysensitised samples were retested after adding a modified glycoprotein plant extract (blocker). To determine the impact of the blocker for each allergen, results prior and post blocking were investigated in 96 randomly selected samples.

RESULTS

 Polysensitisation to seasonal allergens was diagnosed in 818 (17.7 %) serum samples. The blocker eliminated the binding of anti-CCD IgE to allergen extracts (49 %) or suppressed the reaction classes (40 %) which are indicative of the presence of clinically relevant IgE. Negative reactions after blocking were less common when testing for antibodies against a mixture of 6-grass mix (29 %), rye (22 %), and sheep sorrel (20 %) in comparison to nettle (82 %), willow (70 %), birch-hazel (65 %), mugwort-ragweed (63 %) and English plantain (57 %).

CONCLUSION AND CLINICAL RELEVANCE

 Blocking should be used in the case of polysensitized results to improve the quality of seasonal in vitro allergy tests and avoid the use of allergen-specific immunotherapy (ASIT) for clinically irrelevant allergens.

Allergen components of Dermatophagoides farinae recognised by serum immunoglobulin (Ig)E in Thai dogs with atopic dermatitis

BACKGROUND

Dermatophagoides farinae (Der f) is a common allergen in dogs with atopic dermatitis (AD). However, the relevant components of Der f require further investigation.

OBJECTIVES

We aimed to provide data on the immunoglobulin (Ig)E-binding specific components of Der f for further diagnostic and therapeutic applications.

ANIMALS

Serum samples were collected from five healthy, nine Der f-allergic atopic and seven non-Der f-allergic atopic dogs identified based on an intradermal skin test.

METHODS AND MATERIALS

We explored the component profiles of Der f extracts through 2D gel electrophoresis and IgE immunoblotting. The IgE-binding components in both groups of atopic dogs were analysed by mass spectrometry.

RESULTS

The majority of Der f-allergic atopic dogs recognised Der f Alternaria alternata allergen 10 (Der f Alt a 10), elongation factor 1-alpha (EF1-α), gelsolin-like allergen Der f 16, Der f 28 and Der f 2. Der f 3, Der f 10, Der f 20 and Der f 32 were recognised as minor allergens. Alpha-enolase, serine protease, arginine kinase and a few hypothetical proteins were recognised components in both groups of atopic dogs. Unexpectedly, Der f 15 (chitinase) was found to be a minor component.

CONCLUSIONS AND CLINICAL IMPORTANCE

Multiple IgE-binding allergens of Der f were identified in Thai atopic dogs. We propose that the specific antigen set that is bound by IgE, comprising Der f Alt a 10, EF1-α, gelsolin-like Der f 16, Der f 28 and Der f 2, could be used for future diagnostics and immunotherapy platforms.

Description and comparison of the skin and ear canal microbiota of non-allergic and allergic German shepherd dogs using next generation sequencing

Atopic dermatitis is one of the most common skin diseases in dogs. Pathogenesis is complex and incompletely understood. Skin colonizing bacteria likely play an important role in the severity of this disease. Studying the canine skin microbiota using traditional microbiological methods has many limitations which can be overcome by molecular procedures. The aim of this study was to describe the bacterial microbiota of the skin and ear canals of healthy non-allergic and allergic German shepherd dogs (GSDs) without acute flare or concurrent skin infection and to compare both. Bacterial 16S rRNA gene amplicon sequence data revealed no differences of bacterial community patterns between the different body sites (axilla, front dorsal interdigital skin, groin, and ear canals) in non-allergic dogs. The microbiota at the different body sites of non-allergic GSDs showed no significant differences. Only for the samples obtained from the axilla the bacterial microbiota of allergic dogs was characterized by a lower species richness compared to that of non-allergic dogs and the bacterial community composition of the skin and ear canals of allergic dogs showed body site specific differences compared to non-allergic dogs. Actinobacteria was the most abundant phylum identified from the non-allergic dogs and Proteobacteria from allergic dogs. Macrococcus spp. were more abundant on non-allergic skin while Sphingomonas spp. were more abundant on the allergic skin. Forward step redundancy analysis of metadata indicated that the household the dogs came from had the strongest impact on the composition of the skin microbiome followed by sex, host health status and body site.

Evaluation of the cutaneous expression of IL-17, IL-22, IL-31, and their receptors in canine atopic dermatitis

Interleukins (IL)-17, IL-22, and IL-31 play roles in human atopic dermatitis (AD), but scant information is available on canine AD. Histopathological assessment for interleukin expression is a challenge due to a lack of canine specific antibodies. To evaluate the mRNA and protein expression of IL-17 and IL-22, and mRNA expression of IL-31 and their receptors in the skin of healthy and atopic dogs, seventeen atopic (10 with and 7 without an active infection) and 13 healthy privately owned dogs were sampled. RNAscope® In situ hybridization (ISH) for IL-17, IL-22, IL-31, and their receptors was performed on archived canine skin samples. Simultaneously, indirect immunofluorescence (IIF) was performed for IL-17 and IL-22. RNAscope® ISH probes were validated by RT-PCR and RNAscope® ISH on cytospin preparations of peripheral blood mononuclear cells from atopic dogs. IL-17, IL-22, IL-31, and their receptors were successfully detected by RNAscope® ISH and by IIF (IL-17 and IL-22) in both atopic and healthy canine skin. There was no significant difference in the expression of interleukins and their receptors between healthy and atopic skin with or without active infection. Data from both methodologies were similar. The role and the relationship among those proteins in atopic skin is unclear from this study results. Data from IIF and ISH were overlapping and support each other. Fresh skin samples taken at different times during the development of atopic dermatitis might better assess the role that interleukins and their receptors play in AD.

Preliminary evaluation of two bathing methods for the management of Malassezia overgrowth in dogs with atopic dermatitis

BACKGROUND

Antifungal shampoos are widely used for canine Malassezia dermatitis. Few studies have evaluated effective bathing methods for atopic dogs with Malassezia overgrowth.

OBJECTIVES

To evaluate the efficacy of an emollient bathing product (AFLOAT VET) and 2% miconazole/2% chlorhexidine shampoo (2% MIC/CHX) in atopic dogs, and to evaluate the influence on skin barrier function of both products in healthy dogs.

ANIMALS

Sixteen atopic dogs with secondary Malassezia overgrowth and 11 healthy dogs.

METHODS AND MATERIALS

This study was a randomized, single-blinded trial. The dogs were randomly treated with either emollient bathing or 2% MIC/CHX, twice weekly for four weeks. Clinical assessment used the Canine Atopic Dermatitis Extent and Severity Index, 4^th iteration (CADESI-04), pruritus Visual Analog Scale (pVAS), and cytological evaluation of yeast numbers at Day (D)0, D14 and D28. Skin barrier function was determined by measuring transepidermal water loss (TEWL) after a single bathing procedure with each product in the healthy dogs.

RESULTS

The pVAS scores and yeast counts were significantly reduced on D28 compared with D0 in both groups (P < 0.05). CADESI-04 was significantly decreased on D28 in the emollient bathing group (P = 0.003). There were no significant differences in each endpoint score between the groups. In healthy dogs, TEWL was significantly increased after bathing in both groups (P < 0.01).

CONCLUSION

An emollient bathing product can be effective for Malassezia overgrowth in dogs with atopic dermatitis. Bathing with shampoo products might affect skin barrier function even when using an emollient product.

Results of food challenge in dogs with cutaneous adverse food reactions

BACKGROUND

Elimination diet trials and food challenge tests remain the gold standard for diagnosing cutaneous adverse food reaction (CAFR) in dogs. However, food challenge tests are difficult to perform owing to a lack of definite information on expected clinical signs and the time frame within which they develop after challenge.

OBJECTIVES

To report the results of the food challenge test carried out in client-owned dogs under observation.

METHODS AND MATERIALS

A retrospective evaluation of the medical records of dogs presenting with pruritus was performed. Skin infections and/or parasites were treated before inclusion in the study. Dogs that underwent an elimination diet with clinical improvement and relapse with food challenge tests were included in this study. A pruritus Visual Analog scale score was recorded as an index of pruritus before and at the end of the elimination diet trial before challenge. The onset of time to relapse of clinical signs and the body sites affected after food challenge testing were recorded by the owners.

RESULTS

We examined the medical records of 310 dogs with pruritus. Of these, 46 dogs with a diagnosis of CAFR were enrolled in this study. Significant clinical improvement was observed after the elimination diet trial (P < 0.0001). All dogs exhibited pruritus, and none exhibited anaphylaxis after food challenge testing. Among these dogs, 60.9% developed pruritus within 12 h of food challenge. Notably, 23.9% of the dogs developed pruritus within 3-6 h. The limbs exhibited the highest frequency of pruritus (56.5%), followed by the face (26.1%).

CONCLUSIONS AND CLINICAL RELEVANCE

This study is the first to report details of the time to onset of clinical signs and body site affected after food challenge testing in dogs. These results will assist veterinarians and dog owners in the decision-making process regarding food challenge testing.

The Association Between the Use of Oclacitinib and Antibacterial Therapy in Dogs With Allergic Dermatitis: A Retrospective Case-Control Study

Background: Canine allergic dermatitis, including atopic dermatitis, often requires antibacterial therapy for concurrent infections. Oclacitinib is indicated for treatment of pruritus associated with allergic dermatitis and the clinical manifestations of atopic dermatitis in dogs aged ≥12 months.

Hypothesis/Objectives: We aimed to determine if there was a quantitative difference in antibacterial use by dogs with allergic dermatitis receiving oclacitinib vs. other anti-pruritic therapies and before vs. after oclacitinib.

Animals: In this retrospective case-control study, cases (n = 58) included dogs suffering from allergic dermatitis aged ≥12 months receiving oclacitinib and controls (n = 205) were counterpart dogs treated with other anti-pruritic therapies.

Methods: Clinical histories of dogs with allergic dermatitis were collected from a small animal university hospital. Multivariable logistic regression models were developed adjusting for underlying skin or ear conditions to determine whether cases were prescribed fewer antibacterials than controls.

Results: The odds of systemic antibacterial usage were lower in cases vs. controls [odds ratio (OR): 0.29 (95% confidence interval 0.12–0.71); P = 0.007]. The odds of amoxycillin clavulanic acid usage (12.5–25 mg/kg orally every 12 h) was lower in cases vs. controls [OR: 0.08 (0.01–0.71); P = 0.024]. Topical antibacterial drug use was reduced overall; however, only the odds of neomycin use was lower in cases vs. controls [OR: 0.3 (0.1–0.89); P = 0.029]. Cases had higher odds of experiencing improvements in allergic dermatitis categories vs. controls [OR: 7.89 (3.26–19.13); P < 0.001].

Conclusions and Clinical Importance: Our results suggest that use of oclacitinib to treat allergic dermatitis in dogs is associated with less antibacterial use than other anti-pruritic therapies.

Sensitivity and specificity of a shortened elimination diet protocol for the diagnosis of food-induced atopic dermatitis (FIAD)

BACKGROUND

The gold standard to diagnose food allergy in dogs is an eight week elimination diet trial (EDT) followed by a re-challenge. A recent study demonstrated that a shorter EDT is possible if prednisolone is administered initially.

HYPOTHESIS/OBJECTIVES

The goal was to evaluate the sensitivity and specificity of the EDT based on the number of relapses after prednisolone discontinuation. In addition, the aim was to determine whether the initial treatment length or the replacement of prednisolone with oclacitinib would influence the outcome.

ANIMALS

Eighty-seven dogs with atopic dermatitis.

METHODS AND MATERIALS

Dogs were fed an elimination diet and treated with either prednisolone or oclacitinib for two to three weeks. Relapsing dogs were treated a second time. In the absence of a relapse after two weeks off medication, dogs then were challenged. Dogs never achieving two weeks off treatment without relapse received the regular EDT.

RESULTS

Fifty-eight of 87 dogs completed the study. Thirty-nine of 58 dogs received prednisolone; 21 of these were diagnosed with FIAD and had no relapse (n = 14), one relapse (n = 6) or two relapses (n = 1). Nineteen of 58 dogs received oclacitinib; 11 of these were deemed food-allergic and had no relapse (n = 7) or two relapses (n = 4). The initial treatment duration did not influence the outcome. The threshold of one relapse or less for the diagnosis of FIAD was associated with a sensitivity of 95% for prednisolone and 63% for oclacitinib. The specificity was 100% for both drugs.

CONCLUSION AND CLINICAL IMPORTANCE

Initial prednisolone or oclacitinib use in EDT shortens the time to diagnosis of FIAD.

Evaluation of sensitization to the crude extract of Dermatophagoides farinae and its derived allergens, Der f 2 and Zen 1, in dogs with atopic dermatitis in Southern Brazil

BACKGROUND

Atopic dermatitis is associated with the production of IgE antibodies against environmental allergens and allergens of the house dust miteDermatophagoides farinae are frequently implicated in the disease.

OBJECTIVES

We aimed to observe the allergen-specific IgE against crudeD. farinae, Der f 2 and Zen 1 in dogs with atopic dermatitis and report if these dogs are in contact with material that could shelter mite allergens.

METHODS

100 dogs with clinical diagnosis of atopic dermatitis were included after exclusion of other forms of pruritic skin disease and dogs that already received specific or non-specific immunotherapy. These dogs were of different breeds and ages and they were presented at a veterinary teaching hospital and a private service of veterinary dermatology, both located in Curitiba, Southern Brazil. At the time of anamnesis, some questions were applied to know the possibility of these dogs having had contact with furniture and textile material which could shelter house dust mites. Sera samples were obtained and further analyzed by ELISA assay to measure serum IgE levels against these allergens with an established cut-off of 0.200 IgE optical density.

RESULTS

The allergen-specific IgE positivity against crudeD. farinae (92 %) and Zen 1 (77 %) was higher than Der f 2 (56 %). There was a correlation in sensitization to crude D. farinae and Zen 1 that was not observed between crude D. farinae and Der f 2 and Der f 2 and Zen 1. The sensitization to D. farinae and its allergens was associated with an unrestricted exposition to furniture and textile material. CONCLUSION & CLINICAL RELEVANCE: dogs with atopic dermatitis are frequently sensitized to D. farinae and its allergens, Der f 2 and Zen 1, may be considered major allergens in these dogs. Zen 1 may be the main allergen responsible for the sensitization to crude D. farinae.

Immunoglobulin G1 subclass responses can be used to detect specific allergy to the house dust mites Dermatophagoides farinae and Dermatophagoides pteronyssinus in atopic dogs

BACKGROUND

In dogs with atopic dermatitis, intradermal testing (IDT) or allergen specific IgE serological testing are routinely employed to identify causative allergens. These allergens can then be used for allergen-specific immunotherapy and allergy management. The clinical relevance of this testing is affected by the source of allergen, and other biomarkers that are more related to specific allergens still need to be identified. The aim of this study was to investigate levels of specific IgE, total IgG, and IgG1 and IgG2 subclasses against the local house dust mites (HDM) Dermatophagoides farinae (DF) and D. pteronyssinus (DP) as biomarkers by using in-house ELISAs in healthy (n = 33) and atopic dogs (AD) (n = 44) that were either positive or negative by IDT to HDM.

RESULTS

Being over 3 years of age was a risk factor for AD (Odds Ratio (OD) = 4.10, 95% Confidence interval (CI) 1.57-10.75, p = 0.0049), but there was no relation to IDT outcomes (OR = 0.9091, 95% CI 0.22-3.74, p = 1.00). High levels of all antibody isotypes (IgE, IgG, IgG1 and IgG2) against HDM were found in aged healthy dogs (> 3 years old). In AD, HDM-IgE and IgG1 levels were higher in dogs that were IDT positive to HDM than in IDT negative animals. Levels of IgE and IgG1 could be used to distinguish the specific allergens, whereas total IgG and IgG2 levels were not different between IDT-positive and IDT-negative AD. By the receiver operating characteristic curve at a false-positive rate = 0.10, both IgE and IgG1 showed better sensitivity than IgG and IgG2. Similar to IgE, serum IgG1 concentration was also relevant to IDT outcomes.

CONCLUSIONS

Our in-house ELISAs coated with local HDM were useful for evaluating antibody levels, and we propose use of the HDM-specific IgG1 subclass as a biomarker to detect HDM specific allergens in AD, potentially together with an IgE based platform.

Detection of Serum Allergen-Specific IgE in Atopic Dogs Tested in Northern Italy: Preliminary Study

Canine atopic dermatitis (CAD) is a pruritic allergic skin disease associated with IgE-mediated hypersensitivity. IgE is detected using Serum Allergen-Specific IgE test (SAT) in order to identify allergens. The present study aims to identify the environmental allergens in atopic dogs living in Northern Italy using SAT. The screening SAT (sSAT), using a monoclonal antibody cocktail-based ELISA to identify indoor and outdoor allergens, was performed. In all positive samples, an anti-IgE monoclonal antibody ELISA test was performed to extend panel of allergens. Out of 117 selected dogs, 69 were included in the study; 71% were positive and 29% were negative to sSAT. Among the 49 positive sSAT, 53% were positive for both indoor and outdoor, 38.8% only for indoor, and 8.2% only for outdoor allergens. This is the first study on the frequency of allergens involved in CAD in Italy using SAT. IgE hypersensitivity in atopic dogs of Northern Italy is usually associated with indoor allergens, primarily house dust mites. Among the outdoor allergens, an important role was played by Rumex acetosa. Polysensitization also commonly occurs. Therefore, since the numerous factors affect the IgE positivity in CAD, specific panels for geographical areas should be considered and re-evaluated at time intervals.