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Hart KA, Kimura S. Pharmacologic Interventions to Immunologic and Immune-Mediated Conditions in Horses. Vet Clin North Am Equine Pract 2024; 40:307-339. [PMID: 38852015 DOI: 10.1016/j.cveq.2024.04.007] [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: 06/10/2024] Open
Abstract
Immunomodulators can stimulate, suppress, or regulate one or many aspects of the immune response. Use of a variety of immunostimulants, immunosuppressors, and anti-inflammatory drugs are described in horses, but the evidence supporting their efficacy is variable. Corticosteroids and nonsteroidal anti-inflammatory drugs are the best characterized immunomodulators in horses, but further study is needed to fully define their ideal dosing protocols and indications and to characterize the efficacy of other immunomodulators in equine medicine.
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Affiliation(s)
- Kelsey A Hart
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, USA.
| | - Shune Kimura
- Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, USA
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2
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Marsella R. Autoimmune Dermatopathies of Horses. Vet Clin North Am Equine Pract 2024; 40:237-251. [PMID: 38821844 DOI: 10.1016/j.cveq.2024.04.001] [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: 06/02/2024] Open
Abstract
Autoimmune dermatopathies are not common in horses. These autoimmune diseases can be idiopathic or triggered by an antigen such as drugs, vaccines, or neoplasia. The most common one is pemphigus foliaceus, which manifests as a pustular, crusting eruption. Other more common pustular diseases should be ruled out before considering pemphigus. Vasculitis is relatively common in horses and can be triggered by a variety of antigenic stimulations. Systemic lupus and true idiopathic autoimmune vasculitis are very rare in horses. Every effort should be made to reach a final diagnosis, as the prognosis for true idiopathic autoimmune skin diseases is poor.
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Affiliation(s)
- Rosanna Marsella
- Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Room VC-34, Gainesville, FL 32610, USA.
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3
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Bozorgmanesh R. Immune-mediated Equine Vasculopathies. Vet Clin North Am Equine Pract 2024; 40:253-261. [PMID: 38789348 DOI: 10.1016/j.cveq.2024.04.002] [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: 05/26/2024] Open
Abstract
Immune-mediated vasculopathies occur secondary to infection or another noninfectious stimulus. Potential triggers include heterologous antigens including viruses, injected proteins and drugs; or auto-antigens including immunoglobulins or other endogenous proteins. Although these conditions are rare in horses, immune-mediated vasculopathies can cause considerable morbidity, with variable clinical signs depending on severity and organ system affected. Examples include purpura hemorrhagica, systemic lupus erythematosus, drug-induced vasculitis, paraneoplastic vasculitis, and idiopathic immune-mediated vasculitis. Diagnosis is presumptive or based on histopathology of skin biopsies if cutaneous signs are present. Treatment relies on removing the inciting cause, immunosuppression, and supportive care.
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Affiliation(s)
- Rana Bozorgmanesh
- UC Davis, UC Davis Veterinary Medical Teaching Hospital, Large Animal Clinic, 1 Garrod Drive, Davis, CA 95616, USA.
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4
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Burroughs DL, Lorch G, Guo Y, Hill K, Schroeder EL, Cole LK, Phelps MA. Noncompartmental pharmacokinetics of three intravenous mycophenolate mofetil concentrations in healthy Standardbred mares. Vet Dermatol 2022; 34:222-234. [PMID: 35929548 DOI: 10.1111/vde.13109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/10/2022] [Accepted: 05/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mycophenolate mofetil (MMF) is the prodrug of mycophenolic acid (MPA) which acts as an immunosuppressive agent. During the biotransformation of MMF to MPA, additional metabolites including MPA phenol glucuronide (MPAG), MPA acyl glucuronide (AcMPAG) and MPA phenol glucoside (MPG) are formed. OBJECTIVE To define the noncompartmental pharmacokinetic (PK) parameters of three single doses of intravenous (i.v.) MMF and its downstream metabolites in healthy horses. ANIMALS Six healthy Standardbred mares. MATERIALS AND METHODS Generic MMF (Par Pharmaceuticals; Chestnut Ridge, NY, USA) was reconstituted and administered as a single i.v. bolus at 1.0 mg/kg, 5.0 mg/kg and 10.0 mg/kg with an eight day washout between treatments. Blood samples were collected immediately before MMF administration and over 24 h. A liquid chromatography-tandem mass spectrometry assay was developed following FDA guidance to determine plasma MMF, MPA, MPAG, AcMPAG and MPG concentrations. Plasma concentrations were analysed independently, followed by calculation of geometric mean and coefficient of variation. RESULTS Noncompartmental PK parameters were determined for MMF and all metabolites at all doses. MMF was rapidly converted to MPA in all horses. Each incremental dose of MMF resulted in increases in Cmax and AUCinf _obs for MPA and the three additional metabolites. Within the 10-fold dose range, the increase in Cmax and AUCinf _obs for MMF and its metabolites was nonlinear. CONCLUSIONS AND CLINICAL RELEVANCE Horses biotransform MMF into MPA, MPAG, AcMPAG and MPG via the glucuronidation and glucosidation clearance pathways. Equine reference PK profiles for MPA and the metabolites, MPAG, AcMPAG and MPG were established.
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Affiliation(s)
- Dylan L Burroughs
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Gwendolen Lorch
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Yizhen Guo
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Kasey Hill
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Eric L Schroeder
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Lynette K Cole
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Mitch A Phelps
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, USA
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5
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White SD, Affolter VK, Molinaro AM, Depenbrock SM, Chigerwe M, Heller MC, Rowe JD. Skin disease in goats (
Capra aegagrus hircus
): a retrospective study of 358 cases at a university veterinary teaching hospital (1988–2020). Vet Dermatol 2021; 33:227-e64. [DOI: 10.1111/vde.13052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/26/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Stephen D. White
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California Davis CA 95616 USA
| | - Verena K. Affolter
- Department of Pathology, Microbiology & Immunology School of Veterinary Medicine University of California Davis CA 95616 USA
| | - Annette M. Molinaro
- Department of Neurological Surgery University of California San Francisco CA 94143 USA
| | - Sarah M. Depenbrock
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California Davis CA 95616 USA
| | - Munashe Chigerwe
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California Davis CA 95616 USA
| | - Meera C. Heller
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California Davis CA 95616 USA
| | - Joan Dean Rowe
- Department of Population Health & Reproduction School of Veterinary Medicine University of California Davis CA 95616 USA
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6
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Curtiss JB, Lewis M, Mitchell EP. Pemphigus foliaceus in Arabian oryx ( Oryx leucoryx). Vet Pathol 2021; 58:1142-1146. [PMID: 34318735 DOI: 10.1177/03009858211030532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pemphigus foliaceus (PF) is an autoimmune acantholytic skin disease described in humans, dogs, cats, horses, goats, and sheep. From 2003 to 2016, six Arabian oryx (Oryx leucoryx) at the National Zoological Garden in Pretoria, South Africa, developed progressive, bilaterally symmetrical, hyperkeratotic skin lesions and pustules consistent with PF. Lesions were similar to those observed in domestic animals and primarily affected the pinnae, face and nasal planum, distal legs, and tail tip. Histological evaluation of suspect PF skin lesions in affected animals, evaluation of medical records for treatments received, causative agents in the diet and environment, and special stains for infectious organisms yielded no consistent inciting cause. The Arabian oryx is a species highly adapted to arid environments of the desert and has recently survived from a severe genetic bottleneck; both of these factors may have contributed to the development of PF in these animals.
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Affiliation(s)
- Jeffrey B Curtiss
- Zoological Pathology Program, University of Illinois at Urbana-Champaign, Chicago, IL, USA
| | - Michelle Lewis
- National Zoological Garden, South African National Biodiversity Institute, Pretoria, South Africa.,Paraclinical Sciences and Centre for Veterinary Wildlife Studies, University of Pretoria, Onderstepoort, South Africa
| | - Emily P Mitchell
- National Zoological Garden, South African National Biodiversity Institute, Pretoria, South Africa.,Paraclinical Sciences and Centre for Veterinary Wildlife Studies, University of Pretoria, Onderstepoort, South Africa
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7
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Zhou Z, Corner S, Petersen A, Rosser E, Noland EL. Clinical presentation, treatment and outcome in dogs with pemphigus foliaceus with and without vasculopathic lesions: an evaluation of 41 cases. Vet Dermatol 2021; 32:503-e139. [PMID: 34189786 DOI: 10.1111/vde.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/14/2021] [Accepted: 04/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Concurrent vasculopathic lesions in dogs with pemphigus foliaceus (PF) have been observed anecdotally yet not reported in the literature. Any association with prognosis is unclear. HYPOTHESIS/OBJECTIVES To compare clinical features and outcome of PF in dogs with and without vasculopathic lesions. ANIMALS Archived, formalin-fixed, paraffin-embedded biopsy samples of 41 dogs with PF. METHODS AND MATERIALS Archived, formalin-fixed, paraffin-embedded biopsy samples with a histological diagnosis of PF were selected and re-evaluated independently. Dogs were assigned to groups following histological evaluation: Group 1 (no vasculopathic lesions) and Group 2 (vasculopathic lesions present). Group 2 was subdivided into Group 2a (vasculopathic lesions without vasculitis - i.e. vasculopathy) and Group 2b (overt vasculitis). Medical records from identified cases were reviewed retrospectively for data on clinical presentation, treatment and outcome. RESULTS Time to remission was longer in Group 2b (93.8 days) compared to Group 1 (41.8 days) (P = 0.047). Dogs in groups 2a and 2b were more likely to have systemic signs of illness at presentation (P = 0.028 and P = 0.032, respectively) compared to Group 1. Dogs in Group 2b were more likely to have adverse effects associated with treatment than dogs in Group 1 (P = 0.004). There were no significant differences in lesion type, distribution, rates of remission, recurrence or corticosteroid dosage between groups. CONCLUSIONS AND CLINICAL IMPORTANCE Dogs with PF and concurrent vasculitis took longer to achieve remission and were more likely to have systemic signs of illness or adverse effects associated with treatment than dogs with PF without concurrent vasculopathic lesions.
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Affiliation(s)
- Zijin Zhou
- Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA
| | - Sarah Corner
- Veterinary Diagnostic Laboratory, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA
| | - Annette Petersen
- Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA
| | - Edmund Rosser
- Small Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA
| | - Erica L Noland
- Pathobiology & Diagnostic Investigation, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA
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8
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Knych HK, McKemie DS, Kanarr KL, White SD. Pharmacokinetics of mycophenolate mofetil following single-dose intravenous and single- and multiple-dose oral administration and clinicopathologic effects of mycophenolate mofetil following long-term oral administration in healthy horses. Am J Vet Res 2021; 82:502-509. [PMID: 34032479 DOI: 10.2460/ajvr.82.6.502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize the pharmacokinetics of mycophenolate mofetil (MMF) following single-dose IV or PO administration, characterize the pharmacokinetics of MMF following long-term PO administration, and describe the clinicopathologic effects of long-term MMF administration in horses. ANIMALS 12 healthy adult horses. PROCEDURES In phase 1, 6 horses received a single IV (2.5 mg/kg) or PO (5 mg/kg) dose of MMF in a randomized balanced crossover assessment (≥ 2-week interval between administrations). In phase 2, 6 other horses received MMF for 60 days (5 mg/kg, PO, q 24 h for 30 days and then 5 mg/kg, PO, q 48 h for an additional 30 days). RESULTS Following IV (single-dose) or PO (single- or multiple-dose) administration, MMF was rapidly converted to mycophenolic acid. For single-dose PO administration, mean ± SD maximum plasma mycophenolic acid concentration was 1,778.3 ± 441.5 ng/mL at 0.71 ± 0.29 hours. For single-dose IV administration, mean systemic clearance and volume of distribution at steady state were 0.689 ± 0.194 L/h/kg and 1.57 ± 0.626 L/kg, respectively. Following single doses, mean terminal half-life was 3.99 ± 0.865 hours for IV administration and 4.02 ± 1.01 hours for PO administration. The accumulation index following long-term PO administration was 1.0 ± 0.002, and the terminal half-life was 4.59 ± 1.25 hours following the final dose on day 60. None of the horses developed abnormal clinical signs or had any consistently abnormal clinicopathologic findings. CONCLUSIONS AND CLINICAL RELEVANCE Further investigation of the clinical efficacy of long-term MMF treatment of horses with autoimmune diseases is warranted.
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Ehrmann C, Hartung S, Hirz M, Fey K. [Therapy of bullous pemphigoid in a Warmblood gelding]. TIERARZTLICHE PRAXIS. AUSGABE G, GROSSTIERE/NUTZTIERE 2021; 49:139-144. [PMID: 33902144 DOI: 10.1055/a-1395-6307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A 15-year-old Warmblood gelding was presented with multiple large, ulcerative, and crusty dermal lesions that had been existing for 4 years. Histopathology of a skin biopsy revealed cleft formation at the dermal-epidermal junction beneath the basal cells and above the basement membrane leading to the diagnosis of bullous pemphigoid. Immunosuppressive therapy with dexamethasone and azathioprine was initiated and after 14 weeks full remission of the ulcers was achieved. Scar tissue formation was evident in the areas of the formerly affected lesions. Following medication tapering over a period of 5 months, long-term therapy was continued with a maintenance dose of 0.5 mg/kg azathioprine daily. The ulcerative lesions recurred after 63 weeks of disease stabilization. Additionally, adverse drug reactions (acute laminitis and increased susceptibility to infections) were evident and the gelding was euthanized due to animal welfare considerations.
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Affiliation(s)
- Carolin Ehrmann
- Klinik für Pferde, Innere Medizin, Justus-Liebig-Universität Gießen
| | - Svenja Hartung
- Institut für Veterinär-Pathologie, Justus-Liebig-Universität Gießen
| | - Manuela Hirz
- Institut für Veterinär-Pathologie, Justus-Liebig-Universität Gießen
| | - Kerstin Fey
- Klinik für Pferde, Innere Medizin, Justus-Liebig-Universität Gießen
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10
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Cabezas J, Rojas D, Wong Y, Telleria F, Manriquez J, Mançanares ACF, Rodriguez-Alvarez LL, Castro FO. In vitro preconditioning of equine adipose mesenchymal stem cells with prostaglandin E 2, substance P and their combination changes the cellular protein secretomics and improves their immunomodulatory competence without compromising stemness. Vet Immunol Immunopathol 2020; 228:110100. [PMID: 32871408 DOI: 10.1016/j.vetimm.2020.110100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 02/06/2023]
Abstract
Mesenchymal stem cells (MSC) are modern tools in regenerative therapies of humans and animals owed to their immunomodulatory properties, which are activated in a pro-inflammatory environment. Different preconditioning strategies had been devised to enhance the immunomodulatory properties of MSC. In this research, we evaluated the immunological attributes of equine adipose MSC (eAMSC) before and after preconditioning in vitro with prostaglandin E2 (PGE2), substance P (SP), their combination and IFNγ. PGE2/SP was the best combination to keep or enhance the mesodermal lineage differentiation of eAMSC. Alongside with this, preconditioning of eMSC with PGE2 and SP did not affect expression of stemness MSC surface phenotype: CD90+, CD44+, MHC class I+, MHC class II- and CD45-, assessed by cytometry. Both naïve and preconditioned eAMSC expressed genes related with immune properties, such as MHC-I, PTGES, IL6, IL1A, TNFα and IL8 assessed by qPCR. Only TNFα was under expressed in treated cells, while the other markers were either overexpressed or not changed. In no cases MHC-II expression was detected. The antiproliferative effect of preconditioned eAMSC exposed to activated peripheral blood mononuclear cells (PBMC) showed that SP treatment significantly inhibited proliferation of LPS stimulated PBMC. When eAMSC were stimulated with Poly I:C, all the treatments significantly inhibited proliferation of stimulated PBMC (p < 0.05). Direct contact (coculture) between the preconditioned eAMSC and PBMC, induced a shift of significantly more (CD4/CD25/FOXP3)+ T-regulatory PBMC than naïve eAMSC. In the experiments of this research, we investigated the secreted proteomic profile of naïve and preconditioned eAMSC, 42 up-regulated and 40 down-regulated proteins were found in the proteomic assay. Our proteomic data revealed profound changes in the secretory pattern of MSC exposed to different treatments, compared to naïve eAMSC as well as among treatments. In overall, compared to naïve cells, the protein profile of preconditioned cells resembled the mesenchymal-epithelial transition (MET). Here we showed that the combined use of PGE2 and SP provoked in overall the highest expression of anti-inflammatory markers as well as lead to an increased acquisition of a T-regulatory phenotype in preconditioned eAMSC without affecting their "stemness".
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Affiliation(s)
- J Cabezas
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Science, Department of Animal Science, Laboratorio de Biotecnología Animal, Chile.
| | - D Rojas
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Sciences, Department of Animal Pathology, Chile.
| | - Y Wong
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Science, Department of Animal Science, Laboratorio de Biotecnología Animal, Chile.
| | - F Telleria
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Science, Department of Animal Science, Laboratorio de Biotecnología Animal, Chile.
| | - J Manriquez
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Science, Department of Animal Science, Laboratorio de Biotecnología Animal, Chile.
| | - A C F Mançanares
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Science, Department of Animal Science, Laboratorio de Biotecnología Animal, Chile.
| | - L L Rodriguez-Alvarez
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Science, Department of Animal Science, Laboratorio de Biotecnología Animal, Chile.
| | - F O Castro
- Universidad de Concepción, Campus Chillan, Faculty of Veterinary Science, Department of Animal Science, Laboratorio de Biotecnología Animal, Chile.
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11
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Piccione ML, Layne EA, Shaw GC. Pemphigus foliaceus in two pet Nigerian Dwarf goats. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Two male Nigerian Dwarf pet goats from a group of three living in rural southern Wisconsin, USA, presented at the same time with an eight-month history of pruritus and marked crusting on head, axillae and inguinal regions. Parasite investigations were negative, and there was no response to antiparasitic treatment. Fungal and bacterial cultures did not reveal a cause. Histopathology was consistent with a diagnosis of pemphigus foliaceus, and goats were treated with immunosuppressive doses of injectable dexamethasone sodium phosphate. After six weeks of treatment, clinical remission was achieved, and immunosuppressive therapy was continued. Three months later, goat 2 developed presumptive viral pneumonia; necropsy reported presumptive caprine arthritis encephalitis virus. One year into treatment, goat 1 developed similar clinical signs and was euthanased. In goats, pemphigus foliaceus is rare and can be treated using glucocorticoids, but as in other species, chronic immunosuppression increases susceptibility to infections.
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12
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Rostang A, Desjardins I, Espana B, Panzuti P, Berny P, Prouillac C, Pin D. Pharmacokinetics of low-dose methotrexate in horses. J Vet Pharmacol Ther 2020; 43:461-469. [PMID: 32216109 DOI: 10.1111/jvp.12857] [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: 11/13/2019] [Revised: 02/10/2020] [Accepted: 02/28/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to investigate both the pharmacokinetic behavior and tolerance of methotrexate (MTX) in horses to design a specific dosing regimen as a new immunomodulatory drug for long-term treatment. To determine the primary plasma pharmacokinetic variables after single intravenous, subcutaneous or oral administration, six horses were administered 0.3 mg/kg MTX in a crossover design study. After a 10-week washout, MTX was administered subcutaneously to three of the six previously treated horses at a dose of 0.3 mg/kg once per week for 3 months. In both studies, MTX and metabolite concentrations were measured using LC-MS/MS. The absolute bioavailability of MTX was 73% following subcutaneous administration but less than 1% following oral administration. The plasma clearance was 1.54 ml min-1 kg-1 (extraction ratio = 2%). After 24 hr, plasma concentrations were below the LOQ. No adverse effects were noted except for a moderate reversible elevation in liver enzymes (GLDH). With regards to the main metabolites of MTX, very low concentrations of 7-hydroxy-MTX were found, whereas polyglutamated forms (mainly short chains) were found in red blood cells. A subcutaneous dose of 0.2 mg kg-1 week-1 may be safe and relevant in horses, although this has yet to be clinically confirmed.
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Affiliation(s)
- Antoine Rostang
- Université de Lyon, VetAgro Sup, UPSP ICE 'Interactions Cellules Environnement', Marcy l'Etoile, France
| | - Isabelle Desjardins
- Université de Lyon, VetAgro Sup, UPSP ICE 'Interactions Cellules Environnement', Marcy l'Etoile, France
| | - Bernadette Espana
- Université de Lyon, VetAgro Sup, UPSP ICE 'Interactions Cellules Environnement', Marcy l'Etoile, France
| | - Pauline Panzuti
- Université de Lyon, VetAgro Sup, UPSP ICE 'Interactions Cellules Environnement', Marcy l'Etoile, France
| | - Philippe Berny
- Université de Lyon, VetAgro Sup, UPSP ICE 'Interactions Cellules Environnement', Marcy l'Etoile, France
| | - Caroline Prouillac
- Université de Lyon, VetAgro Sup, UPSP ICE 'Interactions Cellules Environnement', Marcy l'Etoile, France
| | - Didier Pin
- Université de Lyon, VetAgro Sup, UPSP ICE 'Interactions Cellules Environnement', Marcy l'Etoile, France
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13
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Curnow B. Diagnosis and management of the itchy horse. IN PRACTICE 2020. [DOI: 10.1136/inp.l6929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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14
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Potter K, Stevens K, Menzies-Gow N. Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids. Vet Rec 2019; 185:82. [DOI: 10.1136/vr.105378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/15/2019] [Accepted: 05/15/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Katya Potter
- Department of Clinical Sciences and Services; Royal Veterinary College; North Mymms Hertfordshire UK
| | - Kim Stevens
- Department of Pathobiology and Population Sciences; Royal Veterinary College; North Mymms Hertfordshire UK
| | - Nicola Menzies-Gow
- Department of Clinical Sciences and Services; Royal Veterinary College; North Mymms Hertfordshire UK
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15
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White SD, Bourdeau PJ, Brément T, Vandenabeele SI, Haspeslagh M, Bruet V, Sloet van Oldruitenborgh‐Oosterbaan MM. Skin disease in donkeys (Equus asinus): a retrospective study from four veterinary schools. Vet Dermatol 2019; 30:247-e76. [DOI: 10.1111/vde.12733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Stephen D. White
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California 944, Garrod Dr Davis CA 95616 USA
| | - Patrick J. Bourdeau
- Dermatology, Parasitology and Mycology Unit Ecole Nationale Vétérinaire Agroalimentaire et de l'Alimentation Nantes‐Atlantique: ONIRIS Route de Gachet 44307 Nantes France
| | - Thomas Brément
- Dermatology, Parasitology and Mycology Unit Ecole Nationale Vétérinaire Agroalimentaire et de l'Alimentation Nantes‐Atlantique: ONIRIS Route de Gachet 44307 Nantes France
| | - Sophie I. Vandenabeele
- Department of Medicine and Clinical Biology of Small Animals Faculty of Veterinary Medicine Ghent University Salisburylaan 133 9820 Merelbeke Belgium
| | - Maarten Haspeslagh
- Department of Surgery and Anaesthesiology of Domestic Animals Faculty of Veterinary Medicine Ghent University Salisburylaan 133 9820 Merelbeke Belgium
| | - Vincent Bruet
- Dermatology, Parasitology and Mycology Unit Ecole Nationale Vétérinaire Agroalimentaire et de l'Alimentation Nantes‐Atlantique: ONIRIS Route de Gachet 44307 Nantes France
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16
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Jordan TJ, Affolter VK, Outerbridge CA, Goodale EC, White SD. Clinicopathological findings and clinical outcomes in 49 cases of feline pemphigus foliaceus examined in Northern California, USA (1987–2017). Vet Dermatol 2019; 30:209-e65. [DOI: 10.1111/vde.12731] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Tyler J.M. Jordan
- William R. Pritchard Veterinary Medical Teaching Hospital School of Veterinary Medicine University of California, Davis 1 Garrod Drive Davis CA 95616 USA
| | - Verena K. Affolter
- Department of Pathology, Microbiology and Immunology School of Veterinary Medicine University of California, Davis One Shields Avenue Davis CA 95616 USA
| | - Catherine A. Outerbridge
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California, Davis One Shields Avenue Davis CA 95616 USA
| | - Elizabeth C. Goodale
- Yu of Guelph Veterinary Dermatology Guelph Veterinary Specialty Hospital 1460 Gordon Street South Guelph Ontario Canada N1L 1C8
| | - Stephen D. White
- Department of Medicine and Epidemiology School of Veterinary Medicine University of California, Davis One Shields Avenue Davis CA 95616 USA
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Wotman KL, Johnson AL. Ocular Manifestations of Systemic Disease in the Horse. Vet Clin North Am Equine Pract 2017; 33:563-582. [PMID: 29103562 DOI: 10.1016/j.cveq.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Many systemic diseases have ocular manifestations. In some cases, ocular abnormalities are the most obvious or first recognized sign of disease that prompts veterinary evaluation. In other cases, the systemic disease leads to secondary ocular changes that might lead to loss of vision or globe if not addressed. Therefore, recognition of ocular abnormalities that might result from systemic diseases is an essential skill for the equine practitioner. This article provides practitioners with information regarding the most common systemic diseases of horses in North America that have ocular manifestations, organized by ocular signs.
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Affiliation(s)
- Kathryn L Wotman
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake, Fort Collins, CO 80523-1678, USA.
| | - Amy L Johnson
- Department of Clinical Sciences, Clinical Studies - New Bolton Center, University of Pennsylvania School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA 19348, USA
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Leclere M. Corticosteroids and Immune Suppressive Therapies in Horses. Vet Clin North Am Equine Pract 2017; 33:17-27. [PMID: 28325178 DOI: 10.1016/j.cveq.2016.11.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Immune suppressive therapies target exaggerated and deleterious responses of the immune system. Triggered by exogenous or endogenous factors, these improper responses can lead to immune or inflammatory manifestations, such as urticaria, equine asthma, or autoimmune and immune-mediated diseases. Glucocorticoids are the most commonly used immune suppressive drugs and the only ones supported by robust evidence of clinical efficacy in equine medicine. In some conditions, combining glucocorticoids with other pharmacologic and nonpharmacologic treatments, such as azathioprine, antihistamine, bronchodilators, environmental management, or desensitization, can help to decrease dosages and associated side effects.
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Affiliation(s)
- Mathilde Leclere
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, 3200 Sicotte, St-Hyacinthe, Quebec J2S 7C6, Canada.
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Mora Pereira M, Groover E, Wooldridge A, Caldwell F. Review of glucocorticoid therapy in horses. Part 2: Clinical use of systemic glucocorticoids in horses. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M. Mora Pereira
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - E. Groover
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - A. Wooldridge
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - F. Caldwell
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
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20
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Jordan VJ, Ireland JL, Rendle DI. Does oral prednisolone treatment increase the incidence of acute laminitis? Equine Vet J 2016; 49:19-25. [PMID: 26713748 DOI: 10.1111/evj.12565] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 12/17/2015] [Indexed: 01/11/2023]
Abstract
REASONS FOR PERFORMING STUDY It is accepted among equine practitioners that glucocorticoid treatment is a risk factor for the development of laminitis. However, there is little published evidence of a link between glucocorticoids and laminitis. OBJECTIVES To determine whether horses receiving oral prednisolone are at increased risk of laminitis. STUDY DESIGN Retrospective case-control study. METHODS Clinical records of horses registered with the ambulatory service at Liphook Equine Hospital between January 2001 and November 2014 were reviewed retrospectively to identify horses that had received treatment with oral prednisolone. For each treated horse, 2 time-matched controls that received veterinary attention but were not treated with prednisolone were selected. Incidence of laminitis was compared between the 2 groups and factors associated with laminitis were assessed using Cox regression analysis. RESULTS Of the 416 horses treated with prednisolone, 16 (3.8%) were diagnosed with laminitis subsequent to the initiation of prednisolone treatment with an overall incidence of 2.60 (95% CI 1.49-4.22) cases per 100 horse-years at risk. A total of 7 horses (1.7%) developed laminitis during the course of their treatment and 3 (0.7%) of the horses treated with prednisolone were ultimately subjected to euthanasia as a result of laminitis. A total of 46 (5.7%), of the 814 time-matched control horses were diagnosed with laminitis during the study period with an overall incidence of 3.46 (95% CI 2.54-4.62) cases per 100 horse-years at risk. Of these, 12 (1.5%) were subjected to euthanasia as a result of laminitis. There were no significant differences in the overall laminitis incidence rate (P = 0.8), incidence rate during prednisolone treatment (P = 0.09), or probability of laminitis (P = 0.3) between the 2 groups. Mean survival time was greater in the prednisolone than the control group. Equine metabolic syndrome and increasing age were associated with increased risk of laminitis. CONCLUSIONS Administration of oral prednisolone did not increase the risk of laminitis.
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Affiliation(s)
- V J Jordan
- Liphook Equine Hospital, Liphook, Hampshire, UK
| | - J L Ireland
- The Animal Health Trust, Newmarket, Suffolk, UK
| | - D I Rendle
- Rainbow Equine Hospital, Rainbow Farm, Old Malton, North Yorkshire, UK
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22
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Affiliation(s)
- S. D. White
- Department of Medicine and Epidemiology; School of Veterinary Medicine; University of California; Davis USA
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Abstract
Pemphigus foliaceus is the most common autoimmune skin disease in horses and is associated with the production of autoantibodies directed against surface proteins of the keratinocyte. Pemphigus vulgaris is a rare autoimmune skin disease in horses. Systemic lupus erythematosus and cutaneous lupus erythematosus are recognized in horses and both are rare. Bullous pemphigoid is a rare autoimmune disease in horses caused by immunologic attack of the basement membrane zone by autoantibodies. Erythema muliforme is an immunologic reaction in the skin in which keratinocyte cell death is the prominent change seen on biopsy. Purpura hemorrhagica is thought analogous to nonthrombocytopenic purpura in humans.
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Affiliation(s)
- Wayne Rosenkrantz
- Animal Dermatology Clinic, 2965 Edinger Avenue, Tustin, CA 92780, USA.
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Winfield LD, White SD, Affolter VK, Renier AC, Dawson D, Olivry T, Outerbridge CA, Wang YH, Iyori K, Nishifuji K. Pemphigus vulgaris in a Welsh pony stallion: case report and demonstration of antidesmoglein autoantibodies. Vet Dermatol 2013; 24:269-e60. [DOI: 10.1111/vde.12002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2012] [Indexed: 12/31/2022]
Affiliation(s)
- Laramie D. Winfield
- William R. Pritchard Veterinary Medical Teaching Hospital; University of California; Davis; CA; USA
| | - Stephen D. White
- Department of Medicine and Epidemiology; University of California; Davis; CA; USA
| | - Verena K. Affolter
- Department of Pathology; Microbiology and Immunology; University of California; Davis; CA; USA
| | - Anna C. Renier
- William R. Pritchard Veterinary Medical Teaching Hospital; University of California; Davis; CA; USA
| | - Dominic Dawson
- William R. Pritchard Veterinary Medical Teaching Hospital; University of California; Davis; CA; USA
| | - Thierry Olivry
- Department of Clinical Sciences; College of Veterinary Medicine & Center for Comparative Medicine and Translational Research; North Carolina State University; Raleigh; NC; USA
| | | | - Yu Hsuan Wang
- Department of Veterinary Medicine; Tokyo University of Agriculture and Technology; 3-5-8 Saiwai-cho; Fuchu; Tokyo; 183-8509; Japan
| | - Keita Iyori
- Department of Veterinary Medicine; Tokyo University of Agriculture and Technology; 3-5-8 Saiwai-cho; Fuchu; Tokyo; 183-8509; Japan
| | - Koji Nishifuji
- Department of Veterinary Medicine; Tokyo University of Agriculture and Technology; 3-5-8 Saiwai-cho; Fuchu; Tokyo; 183-8509; Japan
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25
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Cornish J, Highland M. Successful treatment of juvenile pemphigus foliaceus in a Nigerian Dwarf goat. J Am Vet Med Assoc 2010; 236:674-6. [DOI: 10.2460/javma.236.6.674] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Brenner DJ, Stokking L, Donovan TA, Lamberski N. Pemphigus foliaceus in a Barbary sheep (Ammotragus lervia
). Vet Rec 2009; 165:509-10. [DOI: 10.1136/vr.165.17.509] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- D. J. Brenner
- Department of Animal Health; Denver Zoo, 2300 Steele Street Denver CO 80205-5735 USA
| | - L. Stokking
- Veterinary Specialty Hospital; 10435 Sorrento Valley Road San Diego CA 92121 USA
| | - T. A. Donovan
- The Animal Medical Center; 510 East 62nd Street New York NY 10065 USA
| | - N. Lamberski
- San Diego Wild Animal Park, 15500 San Pasqual Valley Road Escondido CA 92027-7017 USA
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White SD, Affolter VK, Dewey J, Kass PH, Outerbridge C, Ihrke PJ. Cutaneous vasculitis in equines: a retrospective study of 72 cases. Vet Dermatol 2009; 20:600-6. [DOI: 10.1111/j.1365-3164.2009.00827.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Oliveira Filho J, Gonçalves R, Chiacchio S, Amorim R, Conceição L, Borges A. Pênfigo foliáceo em eqüino: relato de caso. ARQ BRAS MED VET ZOO 2007. [DOI: 10.1590/s0102-09352007000500007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Diagnosticou-se pênfigo foliáceo em um eqüino macho, castrado, quatro anos de idade da raça Árabe apresentando dermatite generalizada caracterizada por placas escamo-crostosas e presença de dermatite pustular acantolítica subcorneal.
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Abstract
In humans, the pemphigus denomination encompasses a group of autoimmune blistering skin diseases with intraepidermal separation resulting from cell-cell detachment by acantholysis. Entities are classified based on the level of blistering in the epidermis, and both superficial (pemphigus foliaceus, IgA pemphigus) and deep (pemphigus vulgaris, pemphigus vegetans and paraneoplastic pemphigus) variants are recognized. In domestic animals, subsets of pemphigus have been recognized since the mid-1970s, and the disease classification resembles that used for human patients. This article reviews up-to-date knowledge on the epidemiology, clinical signs, histopathology, immunopathology and treatment outcome of superficial pemphigus in domestic animals. Detailed information on canine, feline, equine and caprine pemphigus foliaceus, canine and feline pemphigus erythematosus and canine panepidermal pustular pemphigus is provided.
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Affiliation(s)
- Thierry Olivry
- Center for Comparative Medicine and Translational Research and Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
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30
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Miragliotta V, Donadio E, Felicioli A, Podestà A, Ricciardi MP, Ceccardi S, Abramo F. Immunolocalisation of desmoglein-1 in equine muzzle skin. Equine Vet J 2006; 38:485-7. [PMID: 16986611 DOI: 10.2746/042516406778400592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- V Miragliotta
- Department of Veterinary Anatomy, Biochemistry and Physiology, University of Pisa, Italy
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White SD. Advances in Equine Atopic Dermatitis, Serologic and Intradermal Allergy Testing. ACTA ACUST UNITED AC 2005. [DOI: 10.1053/j.ctep.2005.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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White SD, Maxwell LK, Szabo NJ, Hawkins JL, Kollias-Baker C. Pharmacokinetics of azathioprine following single-dose intravenous and oral administration and effects of azathioprine following chronic oral administration in horses. Am J Vet Res 2005; 66:1578-83. [PMID: 16261832 DOI: 10.2460/ajvr.2005.66.1578] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine pharmacokinetics of azathioprine (AZA) and clinical, hematologic, and serologic effects of i.v. and oral administration of AZA in horses. ANIMALS 6 horses. PROCEDURE In study phase 1, a single dose of AZA was administered i.v. (1.5 mg/kg) or orally (3.0 mg/kg) to 6 horses, with at least 1 week between treatments. Blood samples were collected for AZA and 6-mercaptopurine (6-MP) analysis 1 hour before and at predetermined time points up to 4 hours after AZA administration. In study phase 2, AZA was administered orally (3 mg/kg) every 24 hours for 30 days and then every 48 hours for 30 days. Throughout study phase 2, blood samples were collected for CBC determination and serum biochemical analysis. RESULTS Plasma concentrations of AZA and its metabolite, 6-MP decreased rapidly from plasma following i.v. administration of AZA, consistent with the short mean elimination half-life of 1.8 minutes. Oral bioavailability of AZA was low, ranging from 1% to 7%. No horses had abnormalities on CBC determination or serum biochemical analysis, other than 1 horse that was lymphopenic on day 5 and 26 of daily treatment. This horse developed facial alopecia from which 1 colony of a Trichophyton sp was cultured; alopecia resolved within 1 month after the study ended. CONCLUSIONS AND CLINICAL RELEVANCE Overall, no adverse effects were observed with long-term oral administration of AZA to horses, although 1 horse did have possible evidence of immunosuppression with chronic treatment. Further investigation of the clinical efficacy of AZA in the treatment of autoimmune diseases in horses is warranted.
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Affiliation(s)
- Stephen D White
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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