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Ahuja K, Issa CJ, Nedorost ST, Lio PA. Is Food-Triggered Atopic Dermatitis a Form of Systemic Contact Dermatitis? Clin Rev Allergy Immunol 2024; 66:1-13. [PMID: 38285165 DOI: 10.1007/s12016-023-08977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/30/2024]
Abstract
Food allergy in atopic dermatitis is mediated by complex immune interactions between genetics, diet, environment, and the microbiome. When contact between inflamed skin and food antigens occurs, contact hypersensitivity can develop. Consequently, systemic contact dermatitis (SCD) can occur after ingestion of allergenic foods or food additives in the setting of a Th2 response with CLA-positive T cells, triggering dermatitis where skin resident memory lymphocytes reside. This phenomenon explains food-triggered dermatitis. Atopy patch tests (APTs) detect sensitization to food proteins responsible for SCD, which in turn can be confirmed by oral food challenge with delayed interpretation. We summarize the literature on using APTs to identify foods for oral challenge with dermatitis as an outcome. In dermatitis patients at risk for Th2 skewing based on a history of childhood-onset flexural dermatitis, shared decision-making should include a discussion of identifying and avoiding food and food additive triggers, as well as identifying and avoiding all contact allergens, prior to initiation of systemic therapy for dermatitis.
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Affiliation(s)
- Kripa Ahuja
- Eastern Virginia Medical School, Norfolk, USA.
| | - Christopher J Issa
- Oakland University William Beaumont School of Medicine, Rochester, USA
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susan T Nedorost
- Dermatologists of the Central States, Case Western Reserve University, Columbus, OH, USA
| | - Peter A Lio
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Bradley CW, Mauldin EA, Morris DO. A review of cutaneous hypersensitivity reactions in dogs: A diagnostician's guide to allergy. Vet Pathol 2023; 60:783-795. [PMID: 37515434 DOI: 10.1177/03009858231189298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Allergic dermatoses are common in people and domestic animals. Resultant lesions are routinely biopsied and submitted for histological examination to confirm a diagnosis or rule out diseases with overlapping or atypical clinical features. Diagnostic pathologists and clinicians are often faced with the difficult task of determining whether an allergic reaction pattern is present on both the microscopic and macroscopic levels and correlating histopathologic findings with clinical and historical data to achieve a precise clinical diagnosis. The bulk of the current veterinary literature on allergic dermatoses focuses on atopic dermatitis in dogs, distantly followed by cats, horses, and other animals. The objectives of this review are to demonstrate the key histopathologic and clinical diagnostic features of the various allergy-mediated reaction patterns, and to provide diagnosticians with a practical guide for clinicopathological correlations. Current concepts in the pathophysiology of immediate hypersensitivity reactions, with a focus on atopic dermatitis, are discussed. Points of potential histopathologic overlap between the "classic" allergic reaction pattern and less common inflammatory, predominately eosinophilic, conditions that may mimic this pattern will be discussed with the goal of highlighting the critical need for collaboration between pathologists and clinicians in furthering patient care.
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Sissoko NDN, Chen W, Wang C, Wu Y, Zheng X, Dong X, Lib M, Yang H. Associations between functional constipation and non-IgE-mediated food allergy in infants and children. Allergol Immunopathol (Madr) 2023; 51:163-173. [PMID: 37169574 DOI: 10.15586/aei.v51i3.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 12/28/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND The non-IgE-mediated food allergy (non-IgE-FA) is less prevalent than IgE-mediated food allergy, and their relationship with functional constipation (FC) needs to be clarified. METHODS A total of 305 infants and children with constipation treated in the Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, from July 2020 to December 2021 were included in this study. Four cases with organic lesions were excluded. Among 301 diagnosed with FC, according to ROME IV criteria, 81 cases with allergy-related indicators were further evaluated for food allergy by food-specific IgG antibody test, allergen- specific IgE antibody detection, skin prick test, and food avoidance and reintroduction. RESULTS A total of 45 cases with FC were diagnosed with food allergy, and the incidence rate was 15%. Among the 45 patients, 35 cases (77.8%) had FC with non-IgE-FA. The main clinical symptoms or signs included anal fissure, abdominal pain, and pain during defecation. The most prevalent allergic foods were cow's milk, eggs, fish, and shrimp. Ten (22.2%) cases reported FC with mixed food allergy, including both non-IgE-mediated and IgE-mediated food allergy. This study focused on non-IgE-mediated food allergy-related FC. CONCLUSION Our results showed that the incidence of food allergy in infants and children with FC was 15%, which was mainly mediated by non-IgE-FA. The main clinical symptoms or signs in these cases included anal fissure, abdominal pain, and pain during defecation, and the main allergens included milk, eggs, fish, and shrimp.
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Affiliation(s)
- N'bamori Dite Naba Sissoko
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wenxin Chen
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chenhui Wang
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yanling Wu
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xinguo Zheng
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xueting Dong
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mei Lib
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, ChinaNursing Department, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hui Yang
- Department of Pediatric Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China;
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Hardy J, Gajanayake I. Diagnosis and management of adverse food reactions in dogs and cats. IN PRACTICE 2022. [DOI: 10.1002/inpr.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Possebom J, Cruz A, Gmyterco VC, de Farias MR. Combined prick and patch tests for diagnosis of food hypersensitivity in dogs with chronic pruritus. Vet Dermatol 2022; 33:124-e36. [PMID: 35014738 DOI: 10.1111/vde.13055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/17/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Juliane Possebom
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
| | - Ariane Cruz
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
| | - Vanessa Cunningham Gmyterco
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
| | - Marconi Rodrigues de Farias
- Programa de Pós-Graduação em Ciência Animal, Escola de Ciências da Vida, Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, 80215-901, Brazil
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Pinto CFD, Bortolo M, Marx FR, Trevizan L. Characterisation of spray dried hydrolysed chicken liver powder: effects on palatability and digestibility when included as single source of animal protein in dog diets. ITALIAN JOURNAL OF ANIMAL SCIENCE 2021. [DOI: 10.1080/1828051x.2021.1993091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | - Luciano Trevizan
- Animal Science Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Baumann SA, Fritz C, Mueller RS. Food antigen-specific IgE in dogs with suspected food hypersensitivity. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2020; 48:395-402. [PMID: 33276389 DOI: 10.1055/a-1274-9210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Knowledge of cross-reactions in food-sensitive dogs will influence the choice of elimination diets and the long-term management of those patients. The objective of this study was to evaluate food allergen-specific IgE tests of suspected allergic dogs for concurrent positive reactions as possible evidence for cross reactions between allergens. MATERIAL AND METHODS Results of serum IgE tests from 760 suspected allergic dogs submitted to 2 laboratories were evaluated statistically. After the tested allergens were grouped by their phylogenetic relationship, odds ratios as well as a sensitivity analysis of the odds ratios were performed to evaluate if concurrent positive IgE results to 2 allergens occurred more often than expected. RESULTS Within related allergen pairs 27% (laboratory 1) and 72% (laboratory 2) of the pairs could be considered as associated. For the unrelated allergen pairs only 6.8% and 10.6% of the analyzed pairs were considered associated respectively. Strong correlations were shown in the group of ruminant allergens, especially beef and lamb, and grain allergens. High rates of concurrent reactions were also detected in the poultry group, especially between chicken and duck, as well as between pork and ruminant allergens, and soy and grain allergens. CONCLUSION As our results showed not only correlations within related but also between non-related allergens, the possible relevance of carbohydrate moieties as well as panallergens for canine hypersensitivities warrants further study. Further investigations are necessary to distinguish co-sensitization from cross-reactions and determine the clinical relevance of food-specific IgE reactivity. CLINICAL RELEVANCE Due to possible cross reactivity related allergens, especially beef and lamb as well as grain allergens, should not be used for an elimination diet to avoid false results.
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Affiliation(s)
- Sandra A Baumann
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University
| | | | - Ralf S Mueller
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University
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Kröger S, Heide C, Zentek J. Evaluation of an extruded diet for adult dogs containing larvae meal from the Black soldier fly (Hermetia illucens). Anim Feed Sci Technol 2020. [DOI: 10.1016/j.anifeedsci.2020.114699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Detection of allergen-specific antibody-secreting cells in dogs by ELISPOT. Vet Immunol Immunopathol 2020; 228:110101. [PMID: 32861056 DOI: 10.1016/j.vetimm.2020.110101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 07/26/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022]
Abstract
Current laboratory tests are unable to distinguish healthy from allergic dogs. Unlike serum antibody responses, circulating antibody-secreting cells (ASC) are temporarily induced after each contact with the antigen. These ASC can be identified using ELISPOT and the observation of allergen-specific ASC might correlate with the causative allergens in dogs with an allergic dermatitis. In this study, blood was sampled from six privately-owned allergic dogs and six non-allergic laboratory beagles to determine the frequency of circulating allergen-specific ASC for common allergens. Blood IgE+, IgA + and IgG + cells were magnetically isolated to determine the number of allergen-specific ASC with ELISPOT for Dermatophagoides farinae, Dermatophagoides pteronyssinus, Alternaria alternata, birch, timothy grass, wheat, cow's milk, bovine, chicken and lamb meat. For IgA and IgG, allergen-specific spots were observed, however for IgE, no spots were detected for any of the allergens. ELISPOT could not differentiate allergic from non-allergic dogs. When the responses to the different allergens were compared, more IgA ASC for D. pteronyssinus were observed compared to some of the other allergens which was statistically significant for the non-allergic dogs and approached significance in the allergic dogs. These findings indicate that ELISPOT can be used to identify circulating allergen-specific IgA- and IgG-secreting cells. The technique did however not detect allergen-specific IgE ASC and was unable to distinguish allergic from non-allergic dogs. Only a small number of studies have studied allergen-specific IgA in dogs. The finding that dogs have higher numbers of D. pteronyssinus-specific IgA ASC points out that apart from IgE and IgG, it might be interesting to include IgA measurements for certain allergens to analyse the complete spectrum of both the protective and pro-allergic antibody responses.
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Lam ATH, Johnson LN, Heinze CR. Assessment of the clinical accuracy of serum and saliva assays for identification of adverse food reaction in dogs without clinical signs of disease. J Am Vet Med Assoc 2020; 255:812-816. [PMID: 31517577 DOI: 10.2460/javma.255.7.812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the clinical accuracy of 2 serum-based assays and 1 saliva-based assay for detection of adverse food reaction (AFR) in dogs without clinical signs of disease. ANIMALS 30 healthy client-owned dogs. PROCEDURES Dog owners completed an online survey to collect comprehensive information about their pets' diet history. From each dog, serum and saliva samples were obtained and submitted for AFR testing by means of 3 assays that assessed the immunoglobulin response to 24 foods. Assays A and B measured food allergen-specific IgE concentrations in serum, whereas assay C measured food allergen-specific IgA and IgM concentrations in saliva. Descriptive data were generated, and Fisher exact tests were used to assess the respective associations between positive test results and specific food ingredients to which dogs were exposed. RESULTS Assays A, B, and C yielded positive results for 26, 18, and 30 dogs, respectively. All dogs had positive results for at least 1 assay. The median (range) number of foods or ingredients to which dogs tested positive was 10.5 (0 to 24) for assay A, 1 (0 to 13) for assay B, and 12.5 (4 to 22; IgM) and 3 (0 to 24; IgA) for assay C. Positive test results were not significantly associated with prior food exposure. CONCLUSIONS AND CLINICAL RELEVANCE Saliva and serum assays for AFR often yielded positive results for apparently healthy dogs and are not recommended for clinical use. Elimination diet trials remain the gold standard for diagnosis of AFR in dogs.
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Mimura T, Noma H, Mizota A. Specific Dog Allergen Immunoglobulin G Antibodies in Patients with Allergic Conjunctivitis. Open Ophthalmol J 2019. [DOI: 10.2174/1874364101913010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The purpose of the study was to examine the role of total tear IgE, and specific serum dog IgG and IgE antibodies on the severity of allergic conjunctivitis.
Methods:
This study enrolled healthy subjects (control group, N=13), the patients with seasonal allergic conjunctivitis (seasonal group, N=13), and patients with perennial allergic conjunctivitis (perennial group, N=13). Skin prick test, tear IgE level, and serum specific dog IgE and IgG levels were examined. The severity of allergic conjunctivitis using a grading score (0-30) was also examined.
Results:
The levels of serum dog-specific IgE and IgG, and total tear IgE of the seasonal and perennial groups were higher as compared to those of the control group (all p<0.05). The levels of serum dog-specific IgG of the perennial group were higher than those of the seasonal group (0.4 ± 0.6 vs. 0.0 ± 0.0). Multivariate analysis confirmed that the skin prick test result for dog allergen was related to the serum dog-specific IgG levels, but not IgE levels (p<0.01). The severity of allergic conjunctivitis was related to the serum level of dog-specific IgG antibodies (p<0.01).
Conclusion:
It was concluded that dog-specific IgG antibodies level may be associated with the severity of dog-related perennial allergic conjunctivitis.
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Pootongkam S, Havele SA, Orillaza H, Silver E, Rowland DY, Nedorost ST. Atopy patch tests may identify patients at risk for systemic contact dermatitis. IMMUNITY INFLAMMATION AND DISEASE 2019; 8:24-29. [PMID: 31823526 PMCID: PMC7016841 DOI: 10.1002/iid3.280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/14/2019] [Accepted: 11/20/2019] [Indexed: 01/13/2023]
Abstract
Background A subset of patients with positive patch tests demonstrates systemic contact dermatitis (SCD) upon ingestion or inhalation of the allergen. Concern has been raised about the use of patch tests for protein allergens (APTs) to detect SCD in atopic dermatitis (AD) patients. Methods We present atopy patch test (APT) data for 97 people. We reviewed APTs and tests for antigen‐specific immunoglobulin E (IgE) to the same allergen in pediatric AD patients. We compared the frequency of APTs as a function of age in AD patients. To study the irritancy potential of APTs, we prospectively tested consenting non‐AD dermatitis patients undergoing evaluation for allergic contact dermatitis and healthy controls to an APT panel. Results APT demonstrated fewer positive results than serum‐specific IgE or skin prick tests to the same allergen. Positive APT to food was more common in children under 3 years, whereas positive APT to aeroallergens were more common in teens and adults. Only positive APTs to dust mite were significantly more common positive in subjects without AD. Conclusion Our aggregate findings suggest that most APTs, but not dust mite, behave like conventional patch tests to low‐potency allergens. They are more likely to be positive in patients with chronically inflamed skin and to identify allergens that cause SCD. The higher prevalence of APT positivity to foods in young children is consistent with food allergy as a trigger of AD (also known as SCD) being more common in children than adults. Positive APTs define patients who may have SCD; negative APTs may guide elimination diets.
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Affiliation(s)
- Suwimon Pootongkam
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Sonia A Havele
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Hanna Orillaza
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Eli Silver
- Division of Allergy and Immunology, University Hospitals Cleveland, Cleveland, Ohio
| | - Douglas Y Rowland
- Department of Population and Quantitative Health Sciences (PQHS), Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Susan T Nedorost
- Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.,Department of Population and Quantitative Health Sciences (PQHS), Case Western Reserve University School of Medicine, Cleveland, Ohio
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Pucheu-Haston CM, Mougeot I. Serum IgE and IgG responses to dietary antigens in dogs with and without cutaneous adverse food reactions. Vet Dermatol 2019; 31:116-127. [PMID: 31749195 DOI: 10.1111/vde.12810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND It is suspected that many canine cutaneous adverse food reactions (CAFR) are true immunological hypersensitivities; however, few specific dietary allergens have been identified. OBJECTIVE To compare serum immunoglobulin (Ig)E and IgG reactivity to specific food antigens in privately owned dogs with and without CAFR. ANIMALS Eighteen adult dogs with nonseasonal pruritus recruited from a hospital population. METHODS AND MATERIALS Dogs were fed an extensively hydrolysed poultry-based diet exclusively for 12 weeks. Serum was collected at the beginning of the trial. Canine atopic dermatitis extent and severity index and pruritus Visual Analog Scale scoring were performed at the beginning and end of the trial. Immunoblotting was performed to identify IgE and/or IgG binding to specific proteins in beef, egg, milk, chicken, pork, soy and wheat extracts. RESULTS A CAFR (defined as an unequivocal relapse of pruritus after dietary challenge) was diagnosed in 10 dogs, with 60% relapsing when fed chicken-based diets. Binding of subjects' IgG to almost all proteins in all extracts was seen regardless of reported dietary history. Few proteins were exclusively or predominantly bound by IgE in CAFR dogs. Exceptions included a 42 kDa band (chicken), a 52 kDa band (beef), a 46 kDa band (beef and milk) and a poorly defined high molecular weight protein or proteins (beef and milk). CONCLUSION This study demonstrated three protein bands and a poorly defined band predominantly recognized by sera from dogs with CAFR relative to non-CAFR dog sera. Almost all proteins were bound by IgG in all dogs, suggesting prior exposure to unreported foods.
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Affiliation(s)
- Cherie M Pucheu-Haston
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - Isabelle Mougeot
- CanCog Technologies, 120 Carlton Street, Toronto, Ontario, Canada, M5A 4K2
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Kathrani A, Hall E. A preliminary study assessing cytokine production following ex vivo stimulation of whole blood with diet in dogs with chronic enteropathy. BMC Vet Res 2019; 15:185. [PMID: 31164117 PMCID: PMC6549371 DOI: 10.1186/s12917-019-1940-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 05/29/2019] [Indexed: 01/08/2023] Open
Abstract
Background Ex vivo whole blood stimulation assays (WBSA) have been used to characterize the cytokine response to diet in cats. The present study aimed to use this assay to determine the cytokine response to diets being fed at the time of diagnosis to dogs with chronic enteropathy (CE) and to compare this to a control group of dogs presented for non-gastrointestinal (GI) causes. Results Dogs with chronic GI signs and dogs presented for non-GI causes were prospectively recruited. For each case, residual blood following diagnostic sampling was placed into heparin. WBSAs were performed using crude extracts of the diet currently being fed and provided by the owner. Supernatants were collected and analyzed for tumor necrosis factor (TNF)-alpha, interleukin (IL)-10 and IL-4 using an enzyme-linked immunosorbent assay. The case group consisted of 22 dogs with CE diagnosed on histopathology of GI biopsy and 9 with suspected CE. The non-GI group consisted of 18 dogs. Of the diets being fed at or prior to diagnosis, hydrolyzed protein diets elicited significantly lower IL-10 and TNF-alpha concentrations compared to commercial intact protein diets in dogs with confirmed or suspected CE (P-value 0.004 and < 0.001, respectively). Six out of 15 dogs with detectable IL-4 concentrations in the confirmed CE group had IL-4 to IL-10 ratios that exceeded the 95% confidence interval (CI) of the mean of the non-GI group (non-GI: 95% CI of IL-4:IL-10 = 0.64–2.71; confirmed CE: IL-4:IL-10 in 6 dogs = mean 22.40, range 2.77–89.11). Conclusions Hydrolyzed protein diets elicited a significantly reduced cytokine response when incubated with patient whole blood ex vivo compared to commercial intact protein diets in dogs with CE. The IL-4 to IL-10 ratio as a marker of dietary responsiveness warrants further investigation, together with assessment of the cytokine response to diet at the intestinal mucosal surface.
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Affiliation(s)
- Aarti Kathrani
- Present address: Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK.
| | - Edward Hall
- Langford Vets, Langford House, Langford, Bristol, BS40 5DU, UK
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Testing for food-specific antibodies in saliva and blood of food allergic and healthy dogs. Vet J 2019; 245:1-6. [DOI: 10.1016/j.tvjl.2018.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 08/08/2018] [Accepted: 12/08/2018] [Indexed: 11/20/2022]
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Mueller RS, Olivry T. Critically appraised topic on adverse food reactions of companion animals (6): prevalence of noncutaneous manifestations of adverse food reactions in dogs and cats. BMC Vet Res 2018; 14:341. [PMID: 30419909 PMCID: PMC6233561 DOI: 10.1186/s12917-018-1656-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many reports describe the cutaneous signs of adverse food reactions (AFR) in the dog and cat. However, various non-cutaneous clinical signs are less well described. Our objective was to systematically evaluate these non-cutaneous signs of AFR in small animals. RESULTS We searched two databases (MEDLINE and Web of Science) for pertinent references on non-cutaneous signs of adverse food reactions. Among 117 and 764 articles found in the MEDLINE and Web of Science databases, respectively, we selected 47 articles that reported data related to non-cutaneous clinical signs of AFR. Gastrointestinal signs, symmetrical lupoid onychitis, conjunctivitis, sneezing, and anaphylaxis were reported to be associated with AFR in dogs and gastrointestinal and respiratory signs, conjunctivitis, and hyperactive behaviour in cats. In Border terriers with paroxysmal gluten-sensitive dyskinesia, an underlying AFR should be considered. Of these clinical signs diarrhoea and frequent defecation were most frequently reported to be diet-responsive in dogs; in the cat, these were vomiting and diarrhoea. CONCLUSIONS An elimination diet should be considered early in the work-up of dogs and cats with chronic vomiting and diarrhoea. Other non-cutaneous signs occur less commonly because of AFRs.
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Affiliation(s)
- Ralf S. Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607 USA
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Coyner K, Schick A. Hair and saliva test fails to identify allergies in dogs. J Small Anim Pract 2018; 60:121-125. [PMID: 30371955 DOI: 10.1111/jsap.12952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/05/2018] [Accepted: 09/17/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Several companies offer saliva and/or hair tests for food and environmental allergies in companion animals, but provide no validation of test accuracy. We examined one such hair and saliva allergy test to determine whether it could reliably differentiate between a normal dog and an allergic dog, and to examine test repeatability. MATERIALS AND METHODS Ten fur and saliva samples were submitted from a known allergic dog and a normal, non-allergic dog. Five fake fur samples and water were also submitted to determine whether the test could differentiate between a real dog and toy animal. The company performed testing for 128 food and environmental allergens. Statistical analyses were performed to determine whether the response distribution differed significantly between dogs, using the Pearson chi-square coefficient, as well as to determine test-retest reliability by calculating Cohen's kappa for each allergen. RESULTS The distribution of test results from samples obtained from allergic, non-allergic or fake dogs was not different from that expected due to random chance. Test-retest reproducibility was poor to slight. CLINICAL SIGNIFICANCE Hair and saliva testing should not be used to diagnose allergies and is not a substitute for veterinary-directed allergy evaluation and diagnostics.
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Affiliation(s)
- K Coyner
- Dermatology Clinic for Animals, Lacey, Washington 98516 USA
| | - A Schick
- Dermatology for Animals, Gilbert, Arizona 85234 USA
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Gedon NKY, Mueller RS. Atopic dermatitis in cats and dogs: a difficult disease for animals and owners. Clin Transl Allergy 2018; 8:41. [PMID: 30323921 PMCID: PMC6172809 DOI: 10.1186/s13601-018-0228-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/10/2018] [Indexed: 12/13/2022] Open
Abstract
The purpose of this review article is to give an overview of atopic dermatitis in companion animals and of recent developments including knowledge on immunological background, novel treatment options and difficulties in disease management. The prevalence of hypersensitivities seems to be increasing. The pathogenetic mechanisms are not fully understood, yet multiple gene abnormalities and altered immunological processes are involved. In dogs and cats, the diagnosis of atopic dermatitis is based on history, clinical examination and exclusion of other differential diagnoses. Intradermal testing or testing for serum allergen-specific Immunoglobulin E is only used to identify allergens for inclusion in the extract for allergen immunotherapy. Symptomatic therapy includes glucocorticoids, ciclosporin, essential fatty acids and antihistamines. A selective janus kinase 1 inhibitor and a caninized monoclonal interleukin-31 antibody are the newest options for symptomatic treatment, although longterm effects still need to be assessed. The chronic and often severe nature of the disease, the costly diagnostic workup, frequent clinical flares and lifelong treatment are challenging for owners, pets and veterinarians. Patience and excellent communication skills are needed to achieve a good owner compliance and satisfactory clinical outcome for the animal.
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Affiliation(s)
- Natalie Katharina Yvonne Gedon
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstraße 13, 80539 Munich, Germany
| | - Ralf Steffen Mueller
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstraße 13, 80539 Munich, Germany
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Mueller R, Unterer S. Adverse food reactions: Pathogenesis, clinical signs, diagnosis and alternatives to elimination diets. Vet J 2018; 236:89-95. [DOI: 10.1016/j.tvjl.2018.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 02/06/2023]
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20
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Maina E, Matricoti I, Noli C. An assessment of a Western blot method for the investigation of canine cutaneous adverse food reactions. Vet Dermatol 2018; 29:217-e78. [DOI: 10.1111/vde.12536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Elisa Maina
- Laboratory of Immunology; Ghent University of Veterinary Medicine; Salisburylaan 133 Merelbeke 9820 Belgium
| | - Irina Matricoti
- Servizi Dermatologici Veterinari; Via Santo Stefano 168 Bologna 40125 Italy
| | - Chiara Noli
- Servizi Dermatologici Veterinari; Strada Bedale della Ressia 2 Peveragno 12016 Italy
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21
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Pali‐Schöll I, De Lucia M, Jackson H, Janda J, Mueller RS, Jensen‐Jarolim E. Comparing immediate-type food allergy in humans and companion animals-revealing unmet needs. Allergy 2017; 72:1643-1656. [PMID: 28394404 DOI: 10.1111/all.13179] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 12/15/2022]
Abstract
Adverse food reactions occur in human as well as veterinary patients. Systematic comparison may lead to improved recommendations for prevention and treatment in both. In this position paper, we summarize the current knowledge on immediate-type food allergy vs other food adverse reactions in companion animals, and compare this to the human situation. While the prevalence of food allergy in humans has been well studied for some allergens, this remains to be investigated for animal patients, where owner-reported as well as veterinarian-diagnosed food adverse reactions are on the increase. The characteristics of the disease in humans vs dogs, cats, and horses are most often caused by similar, but sometimes species-dependent different pathophysiological mechanisms, prompting the specific clinical symptoms, diagnoses, and treatments. Furthermore, little is known about the allergen molecules causative for type I food allergy in animals, which, like in human patients, could represent predictive biomarkers for risk evaluation. The definite diagnosis of food allergy relies-as in humans-on elimination diet and provocation tests. Besides allergen avoidance in daily practice, novel treatment options and tolerization strategies are underway. Taken together, numerous knowledge gaps were identified in veterinary food allergy, which need to be filled by systematic comparative studies.
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Affiliation(s)
- I. Pali‐Schöll
- Comparative Medicine The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna Medical University of Vienna and University of Vienna Vienna Austria
| | - M. De Lucia
- Clinica Veterinaria Privata San Marco Padova Italy
| | - H. Jackson
- Dermatology Referral Services LTD Glasgow Scotland UK
| | - J. Janda
- Faculty of Science Charles University Prague Czech Republic
| | - R. S. Mueller
- Centre for Clinical Veterinary Medicine Ludwig Maximilian University Munich Munich Germany
| | - E. Jensen‐Jarolim
- Comparative Medicine The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna Medical University of Vienna and University of Vienna Vienna Austria
- Institute of Pathophysiology and Allergy Research Center of Pathophysiology Infectiology and Immunology Medical University of Vienna Vienna Austria
- Allergy Care Allergy Diagnosis and Study Center Vienna Austria
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Mueller RS, Olivry T. Critically appraised topic on adverse food reactions of companion animals (4): can we diagnose adverse food reactions in dogs and cats with in vivo or in vitro tests? BMC Vet Res 2017; 13:275. [PMID: 28854915 PMCID: PMC5577833 DOI: 10.1186/s12917-017-1142-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 07/14/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The gold standard to diagnose adverse food reactions (AFRs) in the dog and cat is currently an elimination diet with subsequent provocation trials. However, those trials are inconvenient and client compliance can be low. Our objective was to systematically review the literature to evaluate in vivo and in vitro tests used to diagnose AFR in small animals. RESULTS We searched three databases (CAB Abstracts, MEDLINE and Web of Science) for pertinent references on September 16, 2016. Among 71, 544 and 41 articles found in the CAB Abstract, MEDLINE and Web of Science databases, respectively, we selected 22 articles and abstracts from conference proceedings that reported data usable for evaluation of tests for AFR. Serum tests for food-specific IgE and IgG, intradermal testing with food antigens, lymphocyte proliferation tests, fecal food-specific IgE, patch, gastroscopic, and colonoscopic testing were evaluated. CONCLUSIONS Testing for serum food-specific IgE and IgG showed low repeatability and, in dogs, a highly variable accuracy. In cats, the accuracy of testing for food-specific IgE was low. Lymphocyte proliferation tests were more frequently positive and more accurate in animals with AFR, but, as they are more difficult to perform, they remain currently a research tool. All other reported tests were only evaluated by individual studies with small numbers of animals. Negative patch test reactions have a very high negative predictability in dogs and could enable a choice of ingredients for the elimination diet in selected patients. Gastroscopic and colonoscopic testing as well as food-specific fecal IgE or food-specific serum IgG measurements appear less useful. Currently, the best diagnostic procedure to identify AFRs in small animals remains an elimination diet with subsequent provocation trials.
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Affiliation(s)
- Ralf S Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539, Munich, Germany.
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
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Johansen C, Mariani C, Mueller RS. Evaluation of canine adverse food reactions by patch testing with single proteins, single carbohydrates and commercial foods. Vet Dermatol 2017; 28:473-e109. [PMID: 28544017 DOI: 10.1111/vde.12455] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adverse food reaction (AFR) is an important differential diagnosis for the pruritic dog. It is usually diagnosed by feeding an elimination diet with a novel protein and carbohydrate source for eight weeks followed by subsequent food provocation. A previous study demonstrated that patch testing dogs with foods had a high sensitivity and negative predictability for selection of elimination diet ingredients. HYPOTHESIS/OBJECTIVES The aim of this study was to investigate patch testing with proteins, carbohydrates and dry commercial dog food in dogs to determine whether there was value in patch testing to aid the diagnosis of canine adverse food reaction. METHODS Twenty five privately owned dogs, with confirmed AFR, underwent provocation trials with selected food antigens and patch testing. RESULTS For proteins, carbohydrates and dry dog food the sensitivity of patch testing was 100%, 70% and 22.2%, respectively; the negative predictive values of patch testing were 100%, 79% and 72%. The positive predictive values of patch testing for proteins and carbohydrates were 75% and 74%, respectively. CONCLUSION AND CLINICAL IMPORTANCE This study confirmed that patch testing may be useful for the selection of a suitable protein source for an elimination diet in dogs with suspected AFR, but not as a diagnostic tool for canine AFR. Results for proteins are more reliable than for carbohydrates and the majority of positive patch test reactions were observed with raw protein. Patch testing with commercial dog food does not seem to be useful.
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Affiliation(s)
- Cornelia Johansen
- Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstr. 13, Munich, 80539, Germany
| | | | - Ralf S Mueller
- Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstr. 13, Munich, 80539, Germany
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24
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Measurement of allergen-specific IgG in serum is of limited value for the management of dogs diagnosed with cutaneous adverse food reactions. Vet J 2017; 220:111-116. [DOI: 10.1016/j.tvjl.2017.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/10/2017] [Accepted: 01/11/2017] [Indexed: 11/21/2022]
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25
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Favrot C, Linek M, Fontaine J, Beco L, Rostaher A, Fischer N, Couturier N, Jacquenet S, Bihain BE. Western blot analysis of sera from dogs with suspected food allergy. Vet Dermatol 2017; 28:189-e42. [DOI: 10.1111/vde.12412] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Claude Favrot
- Clinic for Small Animal Internal Medicine; University of Zurich; Winterthurerstrasse 204 CH-8057 Zürich Switzerland
| | - Monika Linek
- Tieraerztliche Spezialisten; Rodigallee 85 D-22043 Hamburg Germany
| | - Jacques Fontaine
- Clinique Vétérinaire; 425 Brugmann Avenue, B-1180 Bruxelles Belgium
| | - Luc Beco
- Cabinet Vétérinaire; 104 Reine Astrid Avenue, B-4900 Spa Belgium
| | - Ana Rostaher
- Clinic for Small Animal Internal Medicine; University of Zurich; Winterthurerstrasse 204 CH-8057 Zürich Switzerland
| | - Nina Fischer
- Clinic for Small Animal Internal Medicine; University of Zurich; Winterthurerstrasse 204 CH-8057 Zürich Switzerland
| | - Nicolas Couturier
- Genclis SA; 15 rue du Bois de la Champelle 54500 Vandœuvre-lès-Nancy France
| | - Sandrine Jacquenet
- Genclis SA; 15 rue du Bois de la Champelle 54500 Vandœuvre-lès-Nancy France
| | - Bernard E. Bihain
- Genclis SA; 15 rue du Bois de la Champelle 54500 Vandœuvre-lès-Nancy France
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26
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Pali-Schöll I, Herrmann I, Jensen-Jarolim E, Iben C. Allergies, with Focus on Food Allergies, in Humans and Their Animals. Comp Med 2017. [DOI: 10.1007/978-3-319-47007-8_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Lavergne SN. In Vitro Research Tools in the Field of Human Immediate Drug Hypersensitivity and Their Present Use in Small Animal Veterinary Medicine. Vet Sci 2016; 4:E1. [PMID: 29056660 PMCID: PMC5606612 DOI: 10.3390/vetsci4010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/23/2016] [Accepted: 12/13/2016] [Indexed: 12/18/2022] Open
Abstract
Drug hypersensitivity reactions (DHR) are immune-mediated idiosyncratic adverse drug events. Type I DHR are often referred to as "immediate" and involve B lymphocyte-secreted IgE that bind to the membrane of basophils and mast cells, inducing their degranulation. This review presents various in vitro tests that were developed in the field of human type I HS and implemented as clinical diagnostic tools in human cases of immediate DHR. The respective strengths and weaknesses of each test will be discussed in parallel of validation data such as specificity and sensitivity whenever available. Some of them have also been used as diagnostic tools in veterinary medicine, but not in cases of immediate DHR. Most of these diagnostic tools can be categorized into humoral and cellular tests. The former tests measure serum concentrations of factors, such as histamine, tryptase, and drug-specific IgE. The latter assays quantify markers of drug-induced basophil activation or drug-specific lymphocyte proliferation. Pharmacogenetic markers have also been investigated in immediate DHR, but not as extensively as in non-immediate ones. Throughout, practical aspects and limitations of the tests, as well as sensitivity and specificity parameters, will be presented. In addition, the experience of veterinary medicine with these diagnostic tools will be summarized. However, to date, none of them has ever been reported in a veterinary case of type I DHR.
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Affiliation(s)
- Sidonie N. Lavergne
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois-Urbana-Champaign, 2001 South Lincoln Av, Urbana, IL 61802, USA.
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28
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IgE reactivity to hen egg white allergens in dogs with cutaneous adverse food reactions. Vet Immunol Immunopathol 2016; 177:52-7. [DOI: 10.1016/j.vetimm.2016.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 05/24/2016] [Accepted: 06/15/2016] [Indexed: 01/19/2023]
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Maina E, Cox E. A double blind, randomized, placebo controlled trial of the efficacy, quality of life and safety of food allergen‐specific sublingual immunotherapy in client owned dogs with adverse food reactions: a small pilot study. Vet Dermatol 2016; 27:361-e91. [DOI: 10.1111/vde.12358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Elisa Maina
- Laboratory of Immunology Ghent University of Veterinary Medicine Salisburylaan 133 Merelbeke 9820 Belgium
| | - Eric Cox
- Laboratory of Immunology Ghent University of Veterinary Medicine Salisburylaan 133 Merelbeke 9820 Belgium
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30
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Bexley J, Nuttall TJ, Hammerberg B, Halliwell RE. Co-sensitization and cross-reactivity between related and unrelated food allergens in dogs - a serological study. Vet Dermatol 2016; 28:31-e7. [DOI: 10.1111/vde.12335] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Jennifer Bexley
- Avacta Animal Health; Unit 706, Avenue E West, Thorp Arch Estate Wetherby LS23 7GA UK
| | - Timothy J. Nuttall
- Royal (Dick) School of Veterinary Studies; University of Edinburgh; Easter Bush Campus Edinburgh EH25 9RG UK
| | - Bruce Hammerberg
- College of Veterinary Medicine; North Carolina State University; 1060 William Moore Drive Raleigh NC 27607 USA
| | - Richard E. Halliwell
- Royal (Dick) School of Veterinary Studies; University of Edinburgh; Easter Bush Campus Edinburgh EH25 9RG UK
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Koch T, Mueller RS, Dobenecker B, Fischer A. Cutaneous Adverse Drug Reactions in Dogs Treated with Antiepileptic Drugs. Front Vet Sci 2016; 3:27. [PMID: 27148543 PMCID: PMC4830846 DOI: 10.3389/fvets.2016.00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Abstract
Epilepsy is one of the most common neurologic disorders in dogs and life-long treatment with antiepileptic drugs (AED) is frequently required. Adverse events of AED targeting the skin are only rarely reported in veterinary medicine and the true incidence and spectrum of cutaneous reactions in epileptic dogs remains unknown. In this study, we hypothesized that cutaneous reactions commonly occur in epileptic dogs and are related to AED treatment. A retrospective case review of 185 dogs treated for epilepsy identified 20.0% with simultaneous appearance of dermatologic signs. In a subsequent prospective case investigation (n = 137), we identified newly appearing or distinct worsening of skin lesions following initiation of AED therapy in 10.9% of dogs treated for epilepsy (95% CI 6.8–17.7%). Cutaneous lesions were classified as probably drug-induced in 40.0% of these cases. Patch testing and intradermal testing were further investigated as potential diagnostic methods to confirm AED hypersensitivity. They were of high specificity but sensitivity and positive predictive value appeared inappropriate to recommend their routine use in clinical practice.
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Affiliation(s)
- Tina Koch
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, Ludwig Maximilian University Munich , Munich , Germany
| | - Ralf S Mueller
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, Ludwig Maximilian University Munich , Munich , Germany
| | - Britta Dobenecker
- Department of Veterinary Sciences, Ludwig Maximilian University Munich , Munich , Germany
| | - Andrea Fischer
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, Ludwig Maximilian University Munich , Munich , Germany
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32
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Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. Vet J 2015; 207:29-37. [PMID: 26586215 DOI: 10.1016/j.tvjl.2015.09.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 08/24/2015] [Accepted: 09/11/2015] [Indexed: 01/08/2023]
Abstract
Canine atopic dermatitis is a common skin disease seen in veterinary clinical practice. Several factors appear to contribute to the cutaneous inflammation and pruritus. The therapeutic strategy should focus on control of those factors that can be identified and for which interventional measures are feasible; these include ectoparasites, bacterial/fungal infection and dietary hypersensitivity. Ectoparasites, particularly fleas, are not the cause of atopic dermatitis, but they are a confounding factor, which can exacerbate pruritus, and preventative measures are therefore indicated. Bacterial and yeast infections are frequently associated with atopic dermatitis and initial systemic and/or topical therapy should be considered, followed by regular topical treatment for preventing relapse. Concurrent dietary hypersensitivity should be investigated by undertaking an elimination/provocation trial, followed by feeding of a hypoallergenic diet where appropriate. Depending on the severity of the clinical signs of atopic dermatitis and the willingness and expectations of owners, symptomatic treatment and/or specific interventional therapy for environmental allergy (allergen avoidance, allergen-specific immunotherapy) may be implemented. Symptomatic treatment includes use of glucocorticoids (systemically or topically), ciclosporin and oclacitinib. Other treatment modalities of lower or less proven efficacy include antihistamines, dextromethorphan, fatty acids, feline interferon-omega, misoprostol, pentoxifylline, specific serotonin re-uptake inhibitors and tricyclic antidepressant drugs. The therapeutic approach should be reviewed at regular intervals and tailored to the individual's needs. A successful long-term outcome can usually be achieved by combining the various treatment approaches in a way that maximises their benefits and minimises their drawbacks.
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Affiliation(s)
- Manolis N Saridomichelakis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, Karditsa GR-43100, Greece.
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA; Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC 27606, USA
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Olivry T, DeBoer DJ, Favrot C, Jackson HA, Mueller RS, Nuttall T, Prélaud P. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Vet Res 2015; 11:210. [PMID: 26276051 PMCID: PMC4537558 DOI: 10.1186/s12917-015-0514-6] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 07/30/2015] [Indexed: 12/11/2022] Open
Abstract
Background In 2010, the International Task Force on Canine Atopic Dermatitis (now International Committee on Allergic Diseases of Animals, ICADA) published the first consensus guidelines for the treatment of atopic dermatitis (AD) in dogs. This is the first 5-year minor update of this document. Results The treatment of acute flares of AD should involve the search for, and then elimination of, the cause of the flares, bathing with mild shampoos, and controlling pruritus and skin lesions with interventions that include topical and/or oral glucocorticoids or oclacitinib. For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care; this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic pruritus and skin lesions are topical and oral glucocorticoids, oral ciclosporin, oral oclacitinib, and, where available, injectable recombinant interferons. Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are the only interventions likely to prevent or delay the recurrence of flares of AD. Conclusions This first 5-year minor update of the international consensus guidelines for treatment of AD in dogs further establishes that the treatment of this disease is multifaceted, and that interventions should be combined for a proven (or likely) optimal benefit. Importantly, treatment plans are likely to vary between dogs and, for the same dog, between times when the disease is at different stages. Electronic supplementary material The online version of this article (doi:10.1186/s12917-015-0514-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, 27606, NC, USA.
| | - Douglas J DeBoer
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, 53706, WI, USA
| | - Claude Favrot
- Clinic for Small Animal Internal Medicine, Dermatology Department, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland
| | - Hilary A Jackson
- Dermatology Referral Services LTD, 528 Paisley Road West, Glasgow, Scotland, G51 1RN, UK
| | - Ralf S Mueller
- Medizinische Kleintierklinik, Centre for Clinical Veterinary Medicine, Ludwig-Maximilian University, Veterinärstrasse 13, 80539, Munich, Germany
| | - Tim Nuttall
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Campus, Roslin, Scotland, EH25 9RG, UK
| | - Pascal Prélaud
- Clinique Advetia, 5 rue Dubrunfaut, Paris, 75012, France
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Jang HM, Yeo GS, Kim JH, Hwang CY, Hyun JE, Kim SS, Kang YH, Jung DI. Prevalence of serum allergen-specific immunoglobulin E for canine atopic dermatitis in Korea. J Biomed Res 2014. [DOI: 10.12729/jbr.2014.15.4.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Miyama A, Mimura T, Noma H, Goto M, Kamei Y, Kondo A, Saito Y, Okuma H, Matsubara M. Specific IgG for cat allergens in patients with allergic conjunctivitis. Int Ophthalmol 2014; 35:575-86. [PMID: 25189683 DOI: 10.1007/s10792-014-9987-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 08/07/2014] [Indexed: 10/24/2022]
Abstract
Immunoglobulin G (IgG) antibodies are involved in type II and type III hypersensitivity. We evaluated the relation between perennial allergic conjunctivitis and serum levels of specific IgG for cat allergens. A prospective study was conducted in patients with seasonal allergic conjunctivitis (seasonal group, n = 10), patients with perennial allergic conjunctivitis (perennial group, n = 10), and healthy control subjects (control group, n = 10). Serum levels of specific IgE and IgG for cat allergens and total tear IgE were measured, and a skin prick test was also performed. In addition, a severity score associated with allergic conjunctivitis was calculated (0-30). The positive rates and scores of for total tear IgE, serum cat-specific IgE, and serum cat-specific IgG were all higher in the seasonal and perennial groups than in the control group (all p < 0.05). Serum cat-specific IgG levels were higher in the perennial group than in the seasonal group (p = 0.0156), but there was no significant difference in the grade of cat-specific IgE between the two groups (p = 0.3008). On multivariate analysis, the mean wheal diameter for cat allergen was associated with the serum level of cat-specific IgG (not IgE) in all patients [odds ratio (OR) = 31.979, p < 0.0001]. Multivariate analysis revealed that the total objective score was strongly associated with serum cat-specific IgG (OR = 23.015, p < 0.0001). These findings suggest that specific IgG antibodies may be involved in perennial allergic symptoms caused by indoor allergens such as cat allergens.
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Affiliation(s)
- Anri Miyama
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
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Hardy JI, Hendricks A, Loeffler A, Chang YM, Verheyen KL, Garden OA, Bond R. Food-specific serum IgE and IgG reactivity in dogs with and without skin disease: lack of correlation between laboratories. Vet Dermatol 2014; 25:447-e70. [PMID: 24890097 DOI: 10.1111/vde.12137] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite conflicting data on their utility and no reports on interlaboratory reproducibility, serum food-specific antibodies are commonly assayed in first-opinion canine practice. HYPOTHESIS/OBJECTIVES To determine both the variability of test results between two laboratories and the frequencies and magnitudes of food reactivity in dogs of different disease status. ANIMALS Sera were obtained from eight dogs with cutaneous adverse food reaction (Group A), 22 with nonfood-induced atopic dermatitis (Group B), 30 with an allergic/inflammatory phenotype (Group C), 12 with miscellaneous skin diseases (Group D) and nine healthy dogs (Group E). METHODS Paired sera were submitted to two laboratories (A and B) for assays of food-specific IgE and IgG antibodies. RESULTS Numbers of positive IgE and IgG tests determined by each laboratory in Groups A, B, D and E were comparable (Group C not included). Significant differences in the magnitude of IgE reactivity between groups for each allergen were seen only for lamb (Laboratory A, P = 0.003); lamb reactivity in Group D exceeded Group E (P = 0.004) but was comparable between all other groups. Agreement (kappa statistic) between the two laboratories' tests was 'moderate' for one antigen (potato IgE), 'fair' for four (corn IgE, rice IgE and IgG and soya bean IgG), 'slight' for eight (six IgE and two IgG) and 'less than chance' for the remaining six antigens (three IgE and three IgG). CONCLUSIONS AND CLINICAL IMPORTANCE These laboratories' tests appear to have dubious predictive clinical utility because they neither correlate nor distinguish between dogs of different disease status.
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Affiliation(s)
- Jonathan I Hardy
- Department of Clinical Science and Services and, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK
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Olivry T, Linder KE, Paps JS, Bizikova P, Dunston S, Donne N, Mondoulet L. Validation of a novel epicutaneous delivery system for patch testing of house dust mite-hypersensitive dogs. Vet Dermatol 2012; 23:525-e106. [PMID: 23050930 DOI: 10.1111/j.1365-3164.2012.01111.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patch tests with allergens are used for the evaluation of cellular hypersensitivity to food and environmental allergens in dogs and humans with atopic dermatitis. Viaskin is a novel allergen epicutaneous delivery system that enhances epidermal allergen capture by immune cells. OBJECTIVES To compare the use of Viaskin and Finn chamber patch tests in dogs hypersensitive to mite allergens. METHODS Empty control or Dermatophagoides farinae house dust mite-containing Viaskin or Finn chamber patches were applied to the thoracic skin of six mite-hypersensitive Maltese-beagle crossbred atopic dogs. Lesions were graded 49 and 72 h after patch test application, and skin biopsies were collected after 72 h. Overall microscopic inflammation, eosinophil and T-lymphocyte infiltrations were scored. RESULTS Positive macroscopic patch test reactions developed at five of six Viaskin application sites and four of six Finn chamber application sites. Median microscopic epidermal and dermal inflammation, as well as eosinophil and CD3 T-lymphocyte dermal scores were always higher in biopsies collected at Viaskin than at Finn chamber sites. Microscopic inflammation scores were significantly higher after mite allergen-containing Viaskin compared with empty patches, but this was not the case for mite-containing Finn chambers compared with control chambers. Scores obtained using Viaskin were not significantly different from those obtained using Finn chambers. Macroscopic and microscopic scores were significantly correlated. CONCLUSIONS AND CLINICAL IMPORTANCE In mite-allergic dogs, Viaskin epicutaneous delivery systems appear to induce stronger allergen-specific inflammation than currently used Finn chamber patch tests. Consequently, Viaskin patches might offer a better alternative for screening cellular hypersensitivity to food and environmental allergens.
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Affiliation(s)
- Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine Center, North Carolina State University, Raleigh, NC 27607, USA.
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