1
|
Cain CL, White E, Citron LE, Zheng Q, Morris DO, Grice EA, Bradley CW. Longitudinal evaluation of the cutaneous and rectal microbiota of German shepherd dogs with perianal fistulas undergoing therapy with ciclosporin and ketoconazole. Vet Dermatol 2024; 35:375-385. [PMID: 38616572 DOI: 10.1111/vde.13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/18/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Perianal fistulas are painful ulcers or sinus tracts that disproportionately affect German shepherd dogs and are proposed as a spontaneous animal model of fistulising Crohn's disease. OBJECTIVES To characterise the rectal and cutaneous microbiota in German shepherd dogs with perianal fistulas and to investigate longitudinal shifts with lesion resolution during immunomodulatory therapy. ANIMALS Eleven German shepherd dogs with perianal fistulas and 15 healthy German shepherd dogs. MATERIALS AND METHODS Affected dogs were evaluated and swabbed at three visits, 30 days apart, while undergoing treatment with ciclosporin and ketoconazole. Healthy German shepherd dogs were contemporaneously sampled. Sites included the rectum, perianal skin and axilla. The microbiome was evaluated following sequencing of the V4 hypervariable region of the 16S ribosomal RNA (rRNA) gene. RESULTS Alpha diversity was not significantly different between healthy and affected dogs at each of the three body sites (p > 0.5), yet rectal and perianal beta diversities from affected dogs differed significantly from those of healthy dogs at Day 0 (p = 0.004). Rectal and perianal relative abundance of Prevotella spp. increased and perianal Staphylococcus spp. relative abundance decreased in affected dogs over time, coincident with lesion resolution. CONCLUSIONS AND CLINICAL RELEVANCE Changes in lesional cutaneous and rectal microbiota occur in German shepherd dogs with perianal fistulas and shift over time with lesion resolution during immunomodulatory therapy. Further investigations of the role of cutaneous and enteric microbiota in the pathogenesis of perianal fistulas, and whether manipulation of microbial populations may ameliorate disease, are needed.
Collapse
Affiliation(s)
- Christine L Cain
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ellen White
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lindsey E Citron
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Qi Zheng
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel O Morris
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth A Grice
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Charles W Bradley
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
2
|
The Intersection of Human and Veterinary Medicine-A Possible Direction towards the Improvement of Cell Therapy Protocols in the Treatment of Perianal Fistulas. Int J Mol Sci 2022; 23:ijms232213917. [PMID: 36430390 PMCID: PMC9696944 DOI: 10.3390/ijms232213917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
The effective treatment of perianal fistulizing Crohn's disease is still a challenge. Local administration of mesenchymal stromal cells (MSCs) is becoming a part of accepted treatment options. However, as a fledgling technique, it still can be optimized. A new trend in translational research, which is in line with "One Health" approach, bases on exploiting parallels between naturally occurring diseases affecting humans and companion animals. Canine anal furunculosis (AF) has been indicated as condition analogous to human perianal Crohn's disease (pCD). This narrative review provides the first comprehensive comparative analysis of these two diseases based on the published data. The paper also outlines the molecular mechanisms of action of MSCs which are likely to have a role in modulating the perianal fistula niche in humans, and refers them to the current knowledge on the immunomodulatory properties of canine MSCs. Generally, the pathogenesis of both diseases shares main determinants such as the presence of genetic predispositions, dysregulation of immune response and the relation to intestine microbiota. However, we also identified many aspects which should be further specified, such as determining the frequency of true fistulas formation in AF patients, elucidating the role of TNF and Th17 pathway in the pathogenesis of AF, or clarifying the role of epithelial-to-mesenchymal transition phenomenon in the formation of canine fistulae. Nevertheless, the available data support the hypothesis that the results from testing cell therapies in dogs with anal furunculosis have a significant translational value in optimizing MSC transplants procedures in pCD patients.
Collapse
|
3
|
|
4
|
Bachtel JC, Pendergraft JS, Rosychuk RAW, Gustafson DL, Hansen RJ, Lunghofer PJ. Comparison of the stability and pharmacokinetics in dogs of modified ciclosporin capsules stored at −20°C and room temperature. Vet Dermatol 2015; 26:228-e50. [PMID: 26178603 DOI: 10.1111/vde.12222] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Jeremy C. Bachtel
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Jennifer S. Pendergraft
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Rodney A. W. Rosychuk
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Daniel L. Gustafson
- Pharmacology Core; University of Colorado Comprehensive Cancer Center; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Ryan J. Hansen
- Pharmacology Core; University of Colorado Comprehensive Cancer Center; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| | - Paul J. Lunghofer
- Pharmacology Core; University of Colorado Comprehensive Cancer Center; Colorado State University; 300 West Drake Road Fort Collins CO 80525 USA
| |
Collapse
|
5
|
Abstract
Ciclosporin is a lipophilic cyclic polypeptide with powerful immunosuppressive and immunomodulatory properties that has been used in veterinary medicine for two decades. It is a calcineurin inhibitor whose principal mode of action is to inhibit T cell activation. The drug is principally absorbed from the small intestine and is metabolised in the intestine and liver by the cytochrome P450 enzyme system. Ciclosporin is known to interact with a wide range of pharmacological agents. Numerous studies have demonstrated good efficacy for the management of canine atopic dermatitis and this has been a licensed indication since 2003. In addition to the treatment of atopic dermatitis, it has been used as an aid in the management of numerous other dermatological conditions in animals including perianal fistulation, sebaceous adenitis, pododermatitis, chronic otitis externa and pemphigus foliaceus. This article reviews the mode of action, pharmacokinetics, indications for use and efficacy of ciclosporin in veterinary dermatology.
Collapse
Affiliation(s)
- Peter Forsythe
- The Dermatology Referral Service, 528 Paisley Road West, Glasgow G51 1RN, UK
| | | |
Collapse
|
6
|
Rosenberg A, Rosenkrantz W, Griffin C, Angus J, Keys D. Evaluation of azithromycin in systemic and toothpaste forms for the treatment of ciclosporin-associated gingival overgrowth in dogs. Vet Dermatol 2013; 24:337-45, e74-5. [PMID: 23668859 DOI: 10.1111/vde.12033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Gingival overgrowth is an adverse effect of ciclosporin therapy. Azithromycin (AZI) in capsule and toothpaste form is an effective treatment for ciclosporin-associated gingival overgrowth (CsAGO) in humans. HYPOTHESIS/OBJECTIVES To evaluate AZI in a systemic and a toothpaste form for the treatment of CsAGO in dogs. The secondary objective was to determine which treatment is more effective. ANIMALS Thirty-six client-owned dogs with CsAGO. METHODS Dogs were randomly assigned to the following four groups: AZI capsule; AZI toothpaste; placebo capsule; and placebo toothpaste. Treatments were for 4 weeks, and measurements of gingival sulcus depth, tooth length and subjective global scores were taken at weeks 0, 2, 4 and 8. The AZI dose was 10 mg/kg daily, and brushing (8.5% AZI) was once daily. RESULTS There was a significant decrease in gingival sulcus depth for the AZI capsule group at week 8 and for the AZI toothpaste group at weeks 2, 4 and 8. The mean decrease in gingival sulcus depth was significantly greater in active versus placebo groups (P = 0.0356). The tooth length and subjective global scores were not significantly different for any groups. Gastrointestinal adverse events occurred in all groups, but more frequently in the AZI capsule group. CONCLUSIONS AND CLINICAL IMPORTANCE Azithromycin improved CsAGO in only one measured parameter, gingival sulcus depth. Only one dog in the AZI capsule group had complete resolution of CsAGO. Further studies are warranted. Azithromycin capsules were associated with the most gastrointestinal adverse effects.
Collapse
Affiliation(s)
- Andrew Rosenberg
- Animal Dermatology Clinic, 2965 Edinger Avenue, Tustin, CA 92780, USA.
| | | | | | | | | |
Collapse
|
7
|
Archer TM, Boothe DM, Langston VC, Fellman CL, Lunsford KV, Mackin AJ. Oral cyclosporine treatment in dogs: a review of the literature. J Vet Intern Med 2013; 28:1-20. [PMID: 24341787 PMCID: PMC4895546 DOI: 10.1111/jvim.12265] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/02/2013] [Accepted: 10/28/2013] [Indexed: 11/30/2022] Open
Abstract
Cyclosporine is an immunomodulatory drug used to treat an increasing spectrum of diseases in dogs. Cyclosporine is a calcineurin inhibitor, ultimately exerting its inhibitory effects on T-lymphocytes by decreasing production of cytokines, such as interleukin-2. Although, in the United States, oral cyclosporine is approved in dogs only for treatment of atopic dermatitis, there are many other indications for its use. Cyclosporine is available in 2 oral formulations: the original oil-based formulation and the more commonly used ultramicronized emulsion that facilitates oral absorption. Ultramicronized cyclosporine is available as an approved animal product, and human proprietary and generic preparations are also available. Bioavailability of the different formulations in dogs is likely to vary among the preparations. Cyclosporine is associated with a large number of drug interactions that can also influence blood cyclosporine concentrations. Therapeutic drug monitoring (TDM) can be used to assist in attaining consistent plasma cyclosporine concentrations despite the effects of varying bioavailability and drug interactions. TDM can facilitate therapeutic success by guiding dose adjustments on an individualized basis, and is recommended in cases that do not respond to initial oral dosing, or during treatment of severe, life-threatening diseases for which a trial-and-error approach to dose adjustment is too risky. Pharmacodynamic assays that evaluate individual patient immune responses to cyclosporine can be used to augment information provided by TDM.
Collapse
Affiliation(s)
- T M Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
| | | | | | | | | | | |
Collapse
|
8
|
Abstract
Cyclosporine is an immunomodulatory medication that is efficacious and approved for atopic dermatitis in dogs and allergic dermatitis in cats; it has also been used to successfully manage a variety of immune-mediated dermatoses in dogs and cats. This article reviews the use of cyclosporine in veterinary dermatology including its mechanism of action, pharmacokinetics, drug interactions, side effects, and relevant clinical updates. Dermatologic indications including atopic/allergic dermatitis, perianal fistulas, sebaceous adenitis, and other immune-mediated skin diseases are discussed.
Collapse
|
9
|
Kovalik M, Thoday KL, van den Broek AHM. The use of ciclosporin A in veterinary dermatology. Vet J 2012; 193:317-25. [PMID: 22609151 DOI: 10.1016/j.tvjl.2012.03.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 03/14/2012] [Accepted: 03/29/2012] [Indexed: 11/18/2022]
Abstract
Ciclosporin A (CsA) has potent immunosuppressive and immunomodulatory activity that has been exploited in human medicine to prevent the rejection of transplanted organs and to manage atopic dermatitis and psoriasis. Over the past decade, CsA has been employed more frequently in veterinary dermatology and its value in the management of several canine and feline dermatoses is now well established. CsA inhibits calcineurin phosphatase, suppressing T cell activation and the synthesis of T cell cytokines consequently impairing the activity of B cells, antigen-presenting cells, mast cells, basophils and eosinophils. The pharmacokinetics of CsA are similar in humans, dogs and cats and the drug has a wide safety margin in dogs, cats and rabbits. Adverse effects, principally transient vomiting and soft faeces/diarrhoea, may be seen shortly after instituting treatment but often resolve despite continuing treatment. Gingival hyperplasia and cutaneous effects such as hirsutism may occur after prolonged treatment.
Collapse
Affiliation(s)
- Marcel Kovalik
- The University of Edinburgh, Division of Veterinary Clinical Sciences, Dermatology Unit, The Royal (Dick) School of Veterinary Studies, The Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, Scotland, UK.
| | | | | |
Collapse
|
10
|
Archer TM, Fellman CL, Stokes JV, Pinchuk LM, Lunsford KV, Pruett SB, Langston VC, Mackin AJ. Pharmacodynamic monitoring of canine T-cell cytokine responses to oral cyclosporine. J Vet Intern Med 2011; 25:1391-7. [PMID: 22092633 DOI: 10.1111/j.1939-1676.2011.00797.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 07/01/2011] [Accepted: 08/09/2011] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Pharmacodynamic assays measure the immunosuppressive effects of cyclosporine on T-cells and offer an alternative assessment of efficacy in individual patients. OBJECTIVE To assess the immunosuppressive effects of high and low dosage cyclosporine on canine T-cells and to develop a novel testing system for individualized dose adjustment. ANIMALS Seven healthy female Walker hounds. METHODS Experimental study using a paired comparison design. Flow cytometry was used to measure T-cell expression of IL-2, IL-4, and IFN-γ. Cytokine expression 8 days after oral administration of high and low dosages of cyclosporine was compared to baseline and washout values, respectively. The high dosage was initially 10 mg/kg q12h and was then adjusted to attain established immunosuppressive trough blood drug concentrations (>600 ng/mL). The low dosage was 5 mg/kg q24h. RESULTS High dosage cyclosporine resulted in significant decreases in IL-2 and IFN-γ expression (P = .0156, P = .0156), but not IL-4 expression (P = .2188). Low dosage cyclosporine was associated with a significant decrease in IFN-γ expression (P = .0156), while IL-2 expression was not affected (P = .1094). CONCLUSIONS AND CLINICAL IMPORTANCE T-cell function is suppressed at trough blood drug concentrations exceeding 600 ng/mL, and is at least partially suppressed in some dogs at low dosages. Direct evaluation of T-cell function could be an effective, more sensitive alternative to measuring blood drug concentrations for monitoring immunosuppressive therapy.
Collapse
Affiliation(s)
- T M Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762, USA.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
The use of cyclosporine-A in dogs with chronic osteoarthritis: a pilot study. Vet Comp Orthop Traumatol 2011; 24:285-8. [PMID: 21597647 DOI: 10.3415/vcot-10-07-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 04/10/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the efficacy of cyclosporine-A in dogs with radiographic and physical evidence of chronic stifle osteoarthritis. MATERIALS AND METHODS Ten hound-type dogs with osteoarthritis induced by surgical transection of a cranial cruciate ligament followed by immediate stabilization of the stifle four years prior to study start were randomized to two groups. Cyclosporine-A was administered orally once daily at 5 mg/kg to one group for one month while the other group served as control. After a two week wash-out period during which the animals were not treated, and the degree of lameness was allowed to return to baseline, the treatments were switched so that the second group received treatment with cyclosporine-A and the first group served as control. Ground reaction forces were measured using a force platform in all animals at day zero and then every two weeks until the end of the study. RESULTS Cyclosporine-A did not alter the degree of lameness based on assessment of ground reaction forces. CONCLUSIONS At a dose of 5 mg/kg/day for 28 days, cyclosporine-A was not effective in decreasing lameness of dogs with chronic osteoarthritis induced by surgical transection of the cranial cruciate ligament.
Collapse
|
12
|
Stanley BJ, Hauptman JG. Long-term prospective evaluation of topically applied 0.1% tacrolimus ointment for treatment of perianal sinuses in dogs. J Am Vet Med Assoc 2009; 235:397-404. [DOI: 10.2460/javma.235.4.397] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
13
|
Behr S, Llabrés-Días FJL, Radaelli ST. Treatment of meningoencephalitis of unknown origin in a dog. Vet Rec 2009; 164:627-9. [DOI: 10.1136/vr.164.20.627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- S. Behr
- Manor Farm Business Park Higham Gobian Hertfordshire SG5 3HR
| | | | - S. T. Radaelli
- Manor Farm Business Park Higham Gobian Hertfordshire SG5 3HR
| |
Collapse
|
14
|
Tivers MS, Catchpole B, Gregory SP, House AK. Interleukin-2 and interferon-gamma mRNA expression in canine anal furunculosis lesions and the effect of ciclosporin therapy. Vet Immunol Immunopathol 2008; 125:31-6. [DOI: 10.1016/j.vetimm.2008.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Revised: 04/09/2008] [Accepted: 04/22/2008] [Indexed: 01/16/2023]
|
15
|
NAM HYUNSOOK, MCANULTY JONATHONF, KWAK HOHYUN, YOON BYUNGI, HYUN CHANGBAIG, KIM WANHEE, WOO HEUNGMYONG. Gingival Overgrowth in Dogs Associated with Clinically Relevant Cyclosporine Blood Levels: Observations in a Canine Renal Transplantation Model. Vet Surg 2008; 37:247-53. [DOI: 10.1111/j.1532-950x.2008.00373.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|