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Marsella R, White S, Fadok VA, Wilson D, Mueller R, Outerbridge C, Rosenkrantz W. Equine allergic skin diseases: Clinical consensus guidelines of the World Association for Veterinary Dermatology. Vet Dermatol 2023; 34:175-208. [PMID: 37154488 DOI: 10.1111/vde.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Allergic skin diseases are common in horses worldwide. The most common causes are insect bites and environmental allergens. OBJECTIVES To review the current literature and provide consensus on pathogenesis, diagnosis, treatment and prevention. MATERIALS AND METHODS The authors reviewed the literature up to November 2022. Results were presented at North America Veterinary Dermatology Forum (2021) and European Veterinary Dermatology Congress (2021). The report was available to member organisations of the World Association for Veterinary Dermatology for feedback. CONCLUSIONS AND CLINICAL RELEVANCE Insect bite hypersensitivity (IBH) is the best characterised allergic skin disease. An immunoglobulin (Ig)E response against Culicoides salivary antigens is widely documented. Genetics and environmental factors play important roles. Tests with high sensitivity and specificity are lacking, and diagnosis of IBH is based on clinical signs, seasonality and response to insect control. Eosinophils, interleukin (IL)-5 and IL-31 are explored as therapeutic targets. Presently, the most effective treatment is insect avoidance. Existing evidence does not support allergen-specific immunotherapy (ASIT) using commercially available extracts of Culicoides. Hypersensitivity to environmental allergens (atopic dermatitis) is the next most common allergy. A role for IgE is supported by serological investigation, skin test studies and positive response to ASIT. Prospective, controlled, randomised studies are limited, and treatment relies largely on glucocorticoids, antihistamines and ASIT based on retrospective studies. Foods are known triggers for urticaria, yet their role in pruritic dermatitis is unknown. Recurrent urticaria is common in horses, yet our understanding is limited and focussed on IgE and T-helper 2 cell response. Prospective, controlled studies on treatments for urticaria are lacking. Glucocorticoids and antihistamines are primary reported treatments.
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Affiliation(s)
- R Marsella
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - S White
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - V A Fadok
- Zoetis, US PET CARE, Bellaire, Texas, USA
| | - D Wilson
- School of Clinical Veterinary Sciences, University of Bristol, Bristol, UK
| | - R Mueller
- Medizinische Keleintierklinik, Zentrum für klinische Tiermedizin, LMU, Munich, Germany
| | - C Outerbridge
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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White SD. Approach to the pruritic horse. J Am Vet Med Assoc 2023; 261:S66-S74. [PMID: 36638000 DOI: 10.2460/javma.22.10.0444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/05/2022] [Indexed: 01/14/2023]
Abstract
Pruritus in the horse may be due to several causes, the most common being a hypersensitivity response to salivary proteins in the Culicoides genera, which may coexist with atopic dermatitis, also known as an environmental allergy to pollens, molds, dust, storage mites, etc. Less common etiologies are food allergy and contact allergy, the latter often caused by owners applying various products to the skin. Other ectoparasites, such as Chorioptes mites, may also initiate pruritus. Secondary bacterial infections (usually Staphylococcus spp) may be pruritic in and of themselves. This article reviews the questions that need to be asked of owners to obtain a relevant history, always important for any organ system, but perhaps none more so than the skin. The various clinical findings such as alopecia and crusts and their location on the horse, diagnostic methods such as intradermal or serum testing for allergies, and subsequent hyposensitization are also discussed. Therapeutic options currently available for the potential underlying diseases, in particular for the hypersensitivity reactions to Culicoides spp or environmental allergens, are reviewed with the studies of hyposensitization over the last 40 years, as well as medications that may be effective. While the most common causes of pruritus in the horse are known, the current understanding of the pathophysiology still needs to be investigated, and consequently, the most effective treatments for those causes need to be improved. Newer research is discussed that may eventually add to the diagnostic and therapeutic options currently available for the pruritic horse.
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Affiliation(s)
- Stephen D. White
- School of Veterinary Medicine, University of California-Davis, Davis, CA
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van Damme CMM, van den Broek J, Sloet van Oldruitenborgh-Oosterbaan MM. Discrepancies in the bilateral intradermal test and serum tests in atopic horses. Vet Dermatol 2020; 31:390-e104. [PMID: 32743929 PMCID: PMC7589420 DOI: 10.1111/vde.12871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2020] [Indexed: 11/30/2022]
Abstract
Background In equine atopic patients intradermal testing (IDT) and immunoglobulin (Ig)E serology are used frequently. There is little evidence regarding the reproducibility of the IDT and IgE serology in horses. Objectives To compare the results of a simultaneously performed IDT on the left and right side of the neck in atopic horses, and to compare these results with allergen‐specific IgE serology. Animals Ten equine patients from a university hospital population with chronic urticaria and/or pruritus. Methods and materials The IDT was performed using 16 allergens and the results were evaluated after 30 min, 1, 4 and 24 h. Thirteen allergens also were analysed in duplicate with two monoclonal allergen‐specific IgE enzyme‐linked immunosorbent assays (ELISA). Results Good agreement (Kappa > 0.6) between left and right IDT was found only for Dermatophagoides farinae, Lepidoglyphus destructor, birch pollen mixture and perennial rye at 30 min, birch pollen mixture at 1 h, and Acarus siro and nettle and common mugwort mixture at 4 h. The bilateral comparison of the other allergens and even the same allergens at other time points showed little or no concordance between left and right IDT. The interlaboratory comparison between both ELISAs, and the comparison between the ELISAs and IDT, showed a good agreement for two of 13 allergens: D. farinae and Dermatophagoides pteronyssinus. Conclusions and clinical importance Based on these preliminary data, IDT and IgE serological test results should be interpreted with great care and further studies are needed to indicate the clinical relevance of these findings.
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Affiliation(s)
- Catharina M M van Damme
- Department Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht NL, 3584 CM, The Netherlands
| | - Jan van den Broek
- Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, Utrecht NL, 3584 CM, The Netherlands
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Wilkołek P, Szczepanik M, Sitkowski W, Rodzik B, Pluta M, Taszkun I, Gołyński M. Evaluation of multiple allergen simultaneous (sIgE) testing compared to intradermal testing in the etiological diagnosis of atopic dermatitis in horses. J Vet Sci 2020; 20:e60. [PMID: 31775187 PMCID: PMC6883192 DOI: 10.4142/jvs.2019.20.e60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/06/2019] [Accepted: 09/04/2019] [Indexed: 11/20/2022] Open
Abstract
Although intradermal testing (IDT) is commonly used in the etiological diagnosis of allergies, in vitro testing for specific IgE (sIgE) is an attractive alternative. Currently, new laboratory techniques in veterinary allergological practice, including multiple allergen simultaneous tests (MASTs), gradually supersede in vivo tests. Both, serological (sIgE) and IDTs in fourteen atopic Malopolski horses were performed. Correlation and agreement between test results were evaluated. Receiver operating characteristic analysis showed that sIgE to Acarus siro had the best diagnostic performance (Area under the ROC curve [AUC] = 0.969), followed by Dermatophagoides pteronyssinus (AUC = 0.844), Dermatophagoides farinae (AUC = 0.813) and Tyrophagus putrescentiae (AUC = 0.803). A significant positive correlation between IDT and MAST was found for A. siro (rS = 0.870; p = 0.00005), and D. farinae (rS = 0.657; p = 0.011). There was significant moderate agreement for 2 of 5 allergens, A. siro (κ = 0.569) and D. farinae (κ = 0.485) in semiquantitative assessment and significant fair to substantial agreement for 3 of 5 allergens, D. pteronyssinus (κ = 0.689), A. siro (κ = 0.569), D. farinae (κ = 0.432) in dichotomic assessment. Sensitivity ranged from 44% to 89%, depending on the allergen, while specificity was significantly higher for all allergens in MAST (60%–100%); the mean accuracy was 73% (manufacturer cut-off) and 77.4% (optimal cut-off) based on the Youden index. Compared with IDT, serological MAST showed good detection performance for 60% allergen sIgE in dichotomic assessment with substantial diagnostic capability, but careful clinical interpretation is needed for some allergens.
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Affiliation(s)
- Piotr Wilkołek
- Sub-Department of Clinical Diagnostics and Veterinary Dermatology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-612 Lublin, Poland.
| | - Marcin Szczepanik
- Sub-Department of Clinical Diagnostics and Veterinary Dermatology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-612 Lublin, Poland
| | - Wiesław Sitkowski
- Sub-Department of Clinical Diagnostics and Veterinary Dermatology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-612 Lublin, Poland
| | - Beata Rodzik
- Institute of Mathematics, Marie Curie-Skłodowska University, 20-031 Lublin, Poland
| | - Michał Pluta
- Equine Breeding and Management Unit, Department of Biology and Animal Breeding, University of Life Sciences in Lublin, 20-950 Lublin, Poland
| | - Iwona Taszkun
- Sub-Department of Clinical Diagnostics and Veterinary Dermatology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-612 Lublin, Poland
| | - Marcin Gołyński
- Nicolaus Copernicus University in Torun, Faculty of Biological and Veterinary Sciences, 87-100 Torun, Poland
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Forsyth J, Halliwell RE, Harrand R. Co-reactivity between related and unrelated environmental allergens in equine allergen-specific IgE serology testing in the UK. Vet Dermatol 2019; 30:544-e165. [PMID: 31464011 DOI: 10.1111/vde.12786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Identification of environmental allergens in horses with allergic disease facilitates allergen avoidance and targeted immunotherapy. HYPOTHESIS/OBJECTIVES To evaluate allergenic co-reactivity between 44 environmental allergens. ANIMALS Horses with suspected allergic disease (n = 344) whose sera were submitted for environmental allergen testing. METHODS AND MATERIALS Allergen-specific IgE serological assays were performed using 44 allergens divided into six taxonomically related groups: house dust/storage mites, moulds, insects, grass, tree and weed pollens. Using pairwise comparisons, odds ratios (ORs) were calculated for each environmental pair to determine if there was increased or decreased likelihood of a positive result for one allergen, given a positive result to another. The OR significance was set (using Holm-Bonferroni correction) at P < 0.00006 for all horses (n = 344) and P < 0.00005 for horses with at least one positive reaction (n = 239). Using one-way ANOVA with Tukey's post hoc tests (significance at P < 0.05), differences in mean log e ORs between three groups, taxonomically related allergens with a statistically significant association (related-associated), related allergens lacking a significant association (related-nonassociated) and unrelated allergens were tested. RESULTS Statistically significant associations were found between both related and unrelated allergen pairs, the former being more frequent. For all horses (n = 344) and horses with at least one positive reaction (n = 239), co-reactivity ranged from 100% (grasses) to 0% (moulds). The weeds group was exceptional in having more co-reactions with another group (grasses). CONCLUSIONS AND CLINICAL IMPORTANCE Co-reactivity was shown within and between certain related allergen groups. Further studies are required to determine whether this is the result of antigenic cross-reactivity.
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Affiliation(s)
- Johanna Forsyth
- Avacta Animal Health, Unit 651, Street 5, Thorp Arch Estate, Wetherby, Yorkshire, LS23 7FZ, UK
| | - Richard E Halliwell
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Edinburgh, EH25 9RG, UK
| | - Robert Harrand
- Avacta Animal Health, Unit 651, Street 5, Thorp Arch Estate, Wetherby, Yorkshire, LS23 7FZ, UK
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Loeffler A, Herrick D, Allen S, Littlewood JD. Long-term management of horses with atopic dermatitis in southeastern England: a retrospective questionnaire study of owners' perceptions. Vet Dermatol 2018; 29:526-e176. [PMID: 30175879 DOI: 10.1111/vde.12685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Allergic pruritus and urticaria in the horse are challenging for veterinarians and owners; little is known about their long-term management. OBJECTIVES To summarize intradermal allergen test results (IDT), and to assess owners' perceptions of skin disease and the effects of medical treatment and management changes in their atopic horses over time. ANIMALS Eighty two horses with atopic dermatitis in southeastern England between 2006 and 2011. METHODS AND MATERIALS The IDT results were reviewed retrospectively. Owners completed telephone questionnaires on skin changes, medication, effect of allergen-specific immunotherapy (ASIT) and management. RESULTS Sixty one owners (74.4%) could be contacted, an average of 5.9 years (range 28-88 months) after IDT; of those, three could not be enrolled. Of the 58 remaining horses, eleven (19%) were deceased at the time of owner interview, including four (6.9%) euthanized due to uncontrollable skin disease. The remaining 47 owners reported that the signs of skin disease had not been seen for at least two years in 18 horses (38.3%), including two that only flared with known triggers. Twenty nine horses (61.7%) still required medication to control skin disease although 25 (53.2%) required less since testing. Owners reported benefit from ASIT in nine of 14 horses (64.3%) from glucocorticoids in 33 of 35 (94.3%) and from antihistamines in 17 of 28 (60.7%). Specific management changes were implemented for 22 horses and reported as beneficial in nine of 22 (40.9%). CONCLUSIONS Equine atopic dermatitis may not always be chronic, but severe cases appear difficult to control. IDT may help to formulate ASIT and can help to guide management changes.
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Affiliation(s)
- Anette Loeffler
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Desiree Herrick
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Serena Allen
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
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Einhorn L, Hofstetter G, Brandt S, Hainisch EK, Fukuda I, Kusano K, Scheynius A, Mittermann I, Resch-Marat Y, Vrtala S, Valenta R, Marti E, Rhyner C, Crameri R, Satoh R, Teshima R, Tanaka A, Sato H, Matsuda H, Pali-Schöll I, Jensen-Jarolim E. Molecular allergen profiling in horses by microarray reveals Fag e 2 from buckwheat as a frequent sensitizer. Allergy 2018; 73:1436-1446. [PMID: 29350763 PMCID: PMC6032949 DOI: 10.1111/all.13417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 12/13/2022]
Abstract
Background Companion animals are also affected by IgE‐mediated allergies, but the eliciting molecules are largely unknown. We aimed at refining an allergen microarray to explore sensitization in horses and compare it to the human IgE reactivity profiles. Methods Custom‐designed allergen microarray was produced on the basis of the ImmunoCAP ISAC technology containing 131 allergens. Sera from 51 horses derived from Europe or Japan were tested for specific IgE reactivity. The included horse patients were diagnosed for eczema due to insect bite hypersensitivity, chronic coughing, recurrent airway obstruction and urticaria or were clinically asymptomatic. Results Horses showed individual IgE‐binding patterns irrespective of their health status, indicating sensitization. In contrast to European and Japanese human sensitization patterns, frequently recognized allergens were Aln g 1 from alder and Cyn d 1 from Bermuda grass, likely due to specific respiratory exposure around paddocks and near the ground. The most prevalent allergen for 72.5% of the tested horses (37/51) was the 2S‐albumin Fag e 2 from buckwheat, which recently gained importance not only in human but also in horse diet. Conclusion In line with the One Health concept, covering human health, animal health and environmental health, allergen microarrays provide novel information on the allergen sensitization patterns of the companion animals around us, which may form a basis for allergen‐specific preventive and therapeutic concepts.
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Affiliation(s)
- L. Einhorn
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - G. Hofstetter
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
| | - S. Brandt
- Research Group Oncology; Equine Clinic; University of Veterinary Medicine Vienna; Vienna Austria
| | - E. K. Hainisch
- Research Group Oncology; Equine Clinic; University of Veterinary Medicine Vienna; Vienna Austria
| | - I. Fukuda
- Racehorse Hospital; Miho Training Center; Japan Racing Association; Mikoma Japan
| | - K. Kusano
- Racehorse Hospital; Miho Training Center; Japan Racing Association; Mikoma Japan
| | - A. Scheynius
- Science for Life Laboratory; Department of Clinical Science and Education; Karolinska Institutet, and Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
| | - I. Mittermann
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - Y. Resch-Marat
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - S. Vrtala
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - R. Valenta
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - E. Marti
- Department of Clinical Research and Veterinary Public Health; Vetsuisse Faculty; University of Bern; Bern Switzerland
| | - C. Rhyner
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - R. Crameri
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - R. Satoh
- Division of Food Function Research; Food Research Institute; National Agriculture and Food Research Organization; Tsukuba Japan
| | - R. Teshima
- National Institute of Health Sciences; Tokyo Japan
| | - A. Tanaka
- Laboratory of Comparative Animal Medicine; Division of Animal Life Science; Tokyo University of Agriculture and Technology; Fuchu Japan
| | - H. Sato
- Laboratory of Veterinary Molecular Pathology and Therapeutics; Division of Animal Life Science; Tokyo University of Agriculture and Technology; Fuchu Japan
| | - H. Matsuda
- Laboratory of Veterinary Molecular Pathology and Therapeutics; Division of Animal Life Science; Tokyo University of Agriculture and Technology; Fuchu Japan
| | - I. Pali-Schöll
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - E. Jensen-Jarolim
- The interuniversity Messerli Research Institute; University of Veterinary Medicine Vienna; Medical University Vienna and University Vienna; Vienna Austria
- Institute of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
- AllergyCare; Allergy Diagnosis and Study Center; Vienna Austria
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Abstract
Allergic diseases in animals are increasingly gaining importance in veterinary practice and as research models. For intradermal testing and allergen immunotherapy, a good knowledge of relevant allergens for the individual species is of great importance. Currently, the knowledge about relevant veterinary allergens is based on sensitization rates identified by intradermal testing or serum testing for allergen-specific IgE; crude extracts are the basis for most evaluations. Only a few studies provide evidence about the molecular structure of (particularly) dust mite, insect and mould allergens in dogs and horses, respectively. In those species, some major allergens differ from those in humans. This position paper summarizes the current knowledge about relevant allergens in dogs, cats and horses.
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Affiliation(s)
- R S Mueller
- Centre for Clinical Veterinary Medicine, Ludwig Maximilian University Munich, Munich, Germany
| | - J Janda
- Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic
| | - E Jensen-Jarolim
- Comparative Medicine, Messerli Research-Institute, University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
| | - C Rhyner
- Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| | - E Marti
- Department of Clinical Research and Veterinary Public Health, University of Bern, Bern, Switzerland
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Roberts HA, Hurcombe SDA, Hillier A, Lorch G. Equine intradermal test threshold concentrations for house dust mite and storage mite allergens and identification of stable acari fauna. Vet Dermatol 2014; 25:124-34, e35-6. [PMID: 24800265 DOI: 10.1111/vde.12113] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND House dust mite (HDM) and storage mite (SM) stable fauna and their associated equine intradermal test (IDT) threshold concentrations (TCs) for the midwestern region of the USA are unknown. HYPOTHESIS/OBJECTIVES To determine IDT TCs and serum IgE concentrations for two HDM and three SM species in clinically normal horses over two seasons, and to identify the mite taxa and habitats in a stable. ANIMALS Thirty-eight clinically normal horses. METHODS Threshold concentrations for HDMs and SMs were determined using IDT subjective measurements and a statistical model. An enzyme-linked immunosorbent assay was used to quantify serum IgE concentrations for the same mite species. A modified flotation method was used to identify morphologically HDMs and SMs. RESULTS Subjective IDT TCs were as follows: 1:80,000 w/v for Dermatophagoides farinae in both seasons; 1:80,000 w/v in spring and 1:160,000 w/v in late summer for Dermatophagoides pteronyssinus; 1:40,000 w/v in spring and 1:20,000 w/v in late summer for Acarus siro; 1:20,000 w/v for Lepidoglyphus destructor in both seasons; and 1:20,000 w/v in spring and 1:10,000 w/v in late summer for Tyrophagus putrescentiae. Statistically significant associations for increased serum IgE and a positive IDT reaction were evident for D. farinae in the spring and D. pteronyssinus in both seasons. One mite from all four genera specific to this study was identified; however,two HDM and A. siro species were not detected.Conclusions and clinical importance – This study established HDM and SM IDT dilution concentrations for the horses in this region. Exposure to diverse acaridae fauna may contribute to the pathogenesis of equine allergic disease.
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Stepnik CT, Outerbridge CA, White SD, Kass PH. Equine atopic skin disease and response to allergen-specific immunotherapy: a retrospective study at the University of California-Davis (1991-2008). Vet Dermatol 2011; 23:29-35, e7. [PMID: 21777308 DOI: 10.1111/j.1365-3164.2011.01001.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This retrospective study reports on the clinical presentation of equine atopic skin disease and evaluates response to treatment with allergen-specific immunotherapy (ASIT) based on intradermal testing and/or serum testing. Computerized medical records from January 1991 to December 2008 yielded 54 horses included in the study. Presenting clinical signs (CS) included urticaria (n=28), pruritus (n=8) or both (n=18). Forty-one of 54 horses received ASIT, and response to ASIT (n=32) was evaluated via telephone survey. Eighty-four per cent (n=27) of owners reported that ASIT reduced their horse's CS; 59% (n=19) were able to manage CS by ASIT alone. Three horses (9%) were managed with ASIT in combination with doxepin and discontinued use of corticosteroids. There was no statistical significance between type of test performed and reported success of ASIT (χ(2) analysis, P=0.53). Ninety-three per cent (n=30) of owners reported use of antipruritic medications prior to starting ASIT; 57% (n=17) of these owners reported discontinuing those medications due to success of ASIT. Adverse effects were limited to swelling at the injection site, seen in 16% (n=5). Seventy-five per cent (n=24) of owners elected to discontinue ASIT after 6 months to 8 years (mean 2.2 years): 15 due to resolution of CS, six due to persistent CS, two because the horse was sold, and one due to cost. Ten owners reported no recurrence of CS after discontinuing ASIT; five had recurrence within a median of 2 years of discontinuing ASIT (range 1-12 years). Allergen-specific immunotherapy is a safe and effective way to manage equine atopic skin disease.
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Affiliation(s)
- Casey T Stepnik
- Department of Medicine, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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