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Kasper B, Boehm T, Wittenstein N, Mueller RS. Cross-reactive carbohydrate determinants in atopic and healthy dogs and their influence on allergy test specificity. Vet Rec 2023; 193:e3308. [PMID: 37614212 DOI: 10.1002/vetr.3308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND The selection of allergens for immunotherapy in atopic dogs is often based on serum allergy testing. Cross-reactive carbohydrate determinants (CCDs) are common structures in plant and insect allergens that reportedly induce polysensitisation, reduce agreement between intradermal and serum tests and complicate allergen selection. METHODS Thirty-four dogs with diagnosed atopic dermatitis and 10 healthy dogs were included in the study. An intradermal test was conducted in atopic dogs, and serum samples from allergic and healthy dogs were analysed for allergen-specific immunoglobulin E (IgE) before and after inhibition of detectable anti-CCD-IgE antibodies. RESULTS Anti-CCD-IgE antibodies were not found in any of the healthy dogs and no polysensitisation to plant and insect allergens was detected. The agreement between intradermal and serum allergy test results in the atopic dogs with anti-CCD-IgE antibodies improved from slight to fair after blocking the anti-CCD-IgE antibodies. In addition, blocking clearly reduced polysensitisation to plant allergens but not to acarid allergens. LIMITATIONS Only a limited number of healthy dogs were tested in this study. A gold standard for determining the clinical relevance of IgE sensitisation does not exist. CONCLUSION Inhibition of anti-CCD-IgE antibodies seems to be of importance to improve serum test specificity for allergen-specific IgE in atopic dogs in relation to intradermal allergy testing.
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Affiliation(s)
- Bettina Kasper
- Center of Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | - Teresa Boehm
- Center of Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | | | - Ralf S Mueller
- Center of Clinical Veterinary Medicine, LMU Munich, Munich, Germany
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Shaw SC. Blocking cross-reactive carbohydrate determinant-specific IgE improves serum allergy testing reliability in atopic dogs. Vet Rec 2023; 193:407-409. [PMID: 37975475 DOI: 10.1002/vetr.3693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Stephen C Shaw
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
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Hopke K, Coleman M, Kneese E, Dominguez B, Diesel A, Patterson A. Prevalence of serum immunoglobulin E against cross‐reactive carbohydrate determinants in allergic and nonallergic horses, and its impact on polysensitisation in serum allergen tests. Vet Dermatol 2022; 33:338-e79. [DOI: 10.1111/vde.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Kaitlin Hopke
- Department of Small Animal Clinical Sciences College of Veterinary Medicine, Texas A&M University TX USA
| | - Michelle Coleman
- Large Animal Clinical Sciences College of Veterinary Medicine, Texas A&M University TX USA
| | - Eric Kneese
- Large Animal Clinical Sciences College of Veterinary Medicine, Texas A&M University TX USA
| | - Brandon Dominguez
- Large Animal Clinical Sciences College of Veterinary Medicine, Texas A&M University TX USA
| | - Alison Diesel
- Department of Small Animal Clinical Sciences College of Veterinary Medicine, Texas A&M University TX USA
| | - Adam Patterson
- Department of Small Animal Clinical Sciences College of Veterinary Medicine, Texas A&M University TX USA
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Atopic Dermatitis in Domestic Animals: What Our Current Understanding Is and How This Applies to Clinical Practice. Vet Sci 2021; 8:vetsci8070124. [PMID: 34357916 PMCID: PMC8310319 DOI: 10.3390/vetsci8070124] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 12/18/2022] Open
Abstract
Atopic dermatitis is a clinical syndrome that affects both people and animals. Dogs closely mimic the complexity of the human skin disease, and much progress has been made in recent years in terms of our understanding of the role of skin impairment and the identification of new treatments. Cats and horses also develop atopic syndromes which include both cutaneous and respiratory signs, yet studies in these species are lagging. It is now recognized that atopic dermatitis is not a single disease but a multifaceted clinical syndrome with different pathways in various subgroups of patients. Appreciating this complexity is clinically relevant as we develop more targeted treatments which may work well in some patients but not in others. Different phenotypes of atopic dermatitis have been described in dogs, and it is possible that phenotypes related to breed and age may exist in other animals similar to how they are described in people. The awareness of different mechanisms of disease leads to the desire to correlate different phenotypes with specific biomarkers and responses to treatment. In this review, the current understanding and updated information on atopic syndrome in animals are described, highlighting opportunities for further studies in the future.
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Canning P, Brame B, Stefanovski D, Lee KW, Cain CL, Rook K, Morris DO. Multivariable analysis of the influence of cross-reactive carbohydrate determinant inhibition and other factors on intradermal and serological allergen test results: a prospective, multicentre study. Vet Dermatol 2021; 32:347-e96. [PMID: 34105194 DOI: 10.1111/vde.12974] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/27/2021] [Accepted: 02/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Serological allergen testing (SAT) is used widely to formulate allergen-specific immunotherapy for atopic dogs. Serum immunoglobulin (Ig)E specific for cross-reactive carbohydrate determinants (CCD) can produce false-positive reactions, creating discrepancy between SAT and intradermal allergen test (IDAT) results. OBJECTIVES The primary objective was to determine if inhibition of anti-CCD IgE in a commercial assay improved correlation with IDAT. The secondary objective was to assess the influence of dog- and clinic-specific factors, environmental factors, putative allergen exposure and prior medications on intradermal and SAT reactivity. ANIMALS Two-hundred and eleven client-owned dogs were enrolled from eight North American dermatology specialty practices. METHODS AND MATERIALS Collection of serum samples and IDAT were performed on the same day. Sera were assayed for detection of IgE specific to 25 allergens, before and after treatment with a proprietary inhibitor of anti-CCD IgE. Data for each dog were collected via a questionnaire filled out by veterinary personnel. RESULTS The correlation between the testing modalities was fair before (Spearman's rho, ρ = 0.2092) and after (ρ = 0.3042) inhibition of anti-CCD IgE. Ciclosporin dose (P = 0.003), independent of duration of use, and duration of lokivetmab use (P = 0.001), independent of dose administered, were associated with statistically significant decreases in IgE concentrations across all allergen types. CONCLUSIONS AND CLINICAL RELEVANCE Contrary to previous reports, this study demonstrated unchanged correlation between SAT and IDAT after inhibition of anti-CCD IgE. Ciclosporin dose and lokivetmab treatment duration may have unexplored effects on IgE concentration during SAT.
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Affiliation(s)
- Peter Canning
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA, 19104, USA
| | - Bailey Brame
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA, 19104, USA
| | - Darko Stefanovski
- Department of Clinical Studies - New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 W Street Road, Kennett Square, PA, 19348, USA
| | - Kenneth W Lee
- Stallergenes Greer Laboratories, 639 Nuway Circle, Lenoir, NC, 28645, USA
| | - Christine L Cain
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA, 19104, USA
| | - Katherine Rook
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA, 19104, USA
| | - Daniel O Morris
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA, 19104, USA
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Mohammaddavoodi A, Christian M, Müller E, Panakova L, Burgener I, Wagner R. Prevalence of immunoglobulin E against cross-reactive carbohydrate determinants and the impact of a blocker in canine sera. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:272-277. [PMID: 34005830 DOI: 10.1055/a-1442-3928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Cross-reactive carbohydrate determinants (CCD) cause multiple positive results in seasonal in vitro allergy tests. False positive/clinically irrelevant results have been identified due to the binding of immunoglobulin E against CCD (anti-CCD IgE) when testing for pollen allergens. The aim of this study was to investigate the prevalence of polysensitised serum samples and evaluate the impact of a CCD inhibitor/blocker in seasonal allergy test results. MATERIAL AND METHODS A total of 4614 canine serum samples, submitted from July 2017 to June 2018 for seasonal in vitro allergy test via ELISA Fc-Ε receptor technology, were studied. Samples were grouped into polysensitised (group A) and non-polysensitised (group B). Polysensitised samples were retested after adding a modified glycoprotein plant extract (blocker). To determine the impact of the blocker for each allergen, results prior and post blocking were investigated in 96 randomly selected samples. RESULTS Polysensitisation to seasonal allergens was diagnosed in 818 (17.7 %) serum samples. The blocker eliminated the binding of anti-CCD IgE to allergen extracts (49 %) or suppressed the reaction classes (40 %) which are indicative of the presence of clinically relevant IgE. Negative reactions after blocking were less common when testing for antibodies against a mixture of 6-grass mix (29 %), rye (22 %), and sheep sorrel (20 %) in comparison to nettle (82 %), willow (70 %), birch-hazel (65 %), mugwort-ragweed (63 %) and English plantain (57 %). CONCLUSION AND CLINICAL RELEVANCE Blocking should be used in the case of polysensitized results to improve the quality of seasonal in vitro allergy tests and avoid the use of allergen-specific immunotherapy (ASIT) for clinically irrelevant allergens.
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Affiliation(s)
| | - Maria Christian
- Laboklin laboratory for clinical diagnostics GMBH & CO. KG, Bad Kissingen, Germany
| | - Elisabeth Müller
- Laboklin laboratory for clinical diagnostics GMBH & CO. KG, Bad Kissingen, Germany
| | - Lucia Panakova
- Clinic of Internal Medicine Small Animals, Department for Companion Animals and Horses, Vetmeduni Vienna, Vienna, Austria
| | - Iwan Burgener
- Clinic of Internal Medicine Small Animals, Department for Companion Animals and Horses, Vetmeduni Vienna, Vienna, Austria
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Enck KM, Lee KW, McKinney BH, Blankenship KD, Montesano C. Detection and inhibition of IgE antibodies reactive with cross-reactive carbohydrate determinants in an ELISA for allergen-specific IgE in horses. Vet Dermatol 2021; 32:685-e184. [PMID: 33956389 DOI: 10.1111/vde.12963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND It has been demonstrated that immunoglobulin (Ig)E specific for cross-reactive carbohydrate determinants (CCD) is present in the serum of sensitized humans, dogs and cats, and that these CCD-specific antibodies might confound serological testing. HYPOTHESIS/OBJECTIVE The objective was to determine whether or not CCD-reactive antibodies occur in horses and to investigate the prevalence of CCD-reactive IgE antibodies in equine sera using a monoclonal cocktail-based enzyme-linked immunosorbent assay designed to detect allergen-specific IgE in horses, and to evaluate a means for successful inhibition of these CCD. METHODS AND MATERIALS Sera from 28 horses suspected of clinical allergy were evaluated, with and without a proprietary inhibitor which contains carbohydrates derived from bromelain (BROM-CCD), using a panel of 72 allergens that include 15 grasses, 17 trees, nine weeds, five mites, 12 fungi, 12 insects and two environmental allergens. RESULTS Twenty-five samples were shown to be reactive to at least one of the allergens, and 15 were reactive to 10 allergens or more. BROM-CCD had minimal effect on the mite reactivity in any of the positive samples; however, substantial inhibition for pollen allergens (trees, grasses and weeds) was demonstrable. Reduction in signal to pollens ranged from 20% to 100% for samples that were inhibited by CCD-BROM. CONCLUSIONS AND CLINICAL IMPORTANCE These results demonstrate that CCD-reactive IgE antibodies are evident in horses and that BROM-CCD can be effective in reducing reactions with these irrelevant carbohydrates and will likely yield a more accurate in vitro allergen reactivity profile for selection of allergens included in an immunotherapeutic regime.
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Affiliation(s)
- Kevin M Enck
- Stallergenes Greer, 639 Nuway Circle, Lenoir, NC, USA
| | - Kenneth W Lee
- Stallergenes Greer, 639 Nuway Circle, Lenoir, NC, USA
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Mohammaddavoodi A, Panakova L, Christian M, Burgener I, Müller E, Wagner R. [Prevalance of immunoglobulin E against cross-reactive carbohydrate determinants (CCD) and impact of a blocker in seasonal allergy tests]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2020; 48:404-409. [PMID: 33276390 DOI: 10.1055/a-1274-9188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Cross-reactive carbohydrate determinants (CCD) cause false positive/clinically irrelevant results in seasonal in vitro allergy tests due to the binding of immunoglobulin IgE against CCD (anti-CCD IgE).There is no study regarding the presence of this phenomen in cats. The aim of this study was to investigate the prevalence of polysensitization in serum samples and evaluate the impact of a CCD inhibitor/blocker in multi-positive seasonal allergy test results in cats. MATERIALS AND METHODS A total of 472 feline sera, submitted from July 2017 to June 2018 for seasonal in vitro allergy test via ELISA Fc-Ε receptor technology, were studied. Samples were grouped into polysensitized (group A) and non-polysensitized (group B). Polysensitized samples (A) were retested after adding a modified glycoprotein plants extract (blocker). To determine the impact of the blocking to each allergen, the results in 48 randomly selected samples in cats prior- and post-blocking were investigated. RESULTS Polysensitization to seasonal allergens was diagnosed in 137 (29 %) samples. No discrepancy in presence of polysensitization was seen in different seasons. Blocking eliminated the binding of anti-CCD IgE and produced either negative test results (49 %) or a decrease of 1-4 reaction classes (41 %) which is indicative of the simultaneous presence of clinically relevant allergen specific IgE. Total negative reactions after blocking were less common in 6-grass mix (31 %), rye (23 %) and sheep sorrel (25 %) in comparison to willow und birch-hazel (67 %), mugwort-ragweed und nettle (65 %), as well as English plantain (54 %). CONCLUSION AND CLINICAL RELEVANCE In order to improve the quality of seasonal in vitro allergy test, blocking should be employed in cases of polysensitized results resulting in an avoidance of the administration of non-offending allergens during allergen-specific immunotherapy (ASIT).
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Affiliation(s)
| | - Lucia Panakova
- Klinik für Interne Medizin Kleintiere, Department für Kleintiere und Pferde der Veterinärmedizinischen Universität Wien
| | | | - Iwan Burgener
- Klinik für Interne Medizin Kleintiere, Department für Kleintiere und Pferde der Veterinärmedizinischen Universität Wien
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Lee KW, McKinney BH, Blankenship KD, Morris DO. Detection and Inhibition of IgE for cross-reactive carbohydrate determinants evident in an enzyme-linked immunosorbent assay for detection of allergen-specific IgE in the sera of dogs and cats. Vet Dermatol 2020; 31:439-e116. [PMID: 32975354 PMCID: PMC7756665 DOI: 10.1111/vde.12904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND It has been demonstrated recently that immunoglobulin (Ig)E specific for cross-reactive carbohydrate determinants (CCD) is present in the serum of allergen-sensitized dogs and cats, and that these CCD-specific antibodies might confound serological testing. HYPOTHESIS/OBJECTIVE The objective was to document the prevalence of CCD detectable in a monoclonal cocktail-based enzyme-linked immunosorbent assay designed for the detection of allergen-specific IgE in the sera of dogs and cats, and to define a means for successful inhibition of these CCD. METHODS AND MATERIALS The incidence of reactivity to bromelain and a commercially available inhibitor of carbohydrate-specific antibodies (RIDA-CCD) was evaluated in 100 dog sera samples before and after inhibition with RIDA-CCD and a proprietary inhibitor containing carbohydrates derived from bromelain (BROM-CCD). Subsequently, sera from 600 dogs and 600 cats were evaluated using a serum diluent with and without BROM-CCD. RESULTS Both the RIDA-CCD and BROM-CCD inhibitors demonstrated successful reduction of CCD reactivity, although a more efficient profile of inhibition was evident with BROM-CCD. Mite reactivity in dog and cat sera was largely unaffected; however, substantial inhibition for pollen allergens (trees, grasses and weeds) was shown. After BROM-CCD inhibition, 1% of canine samples and 13% of feline samples were rendered completely negative for allergen reactivity. CONCLUSIONS AND CLINICAL IMPORTANCE The results demonstrate that BROM-CCD is effective in reducing reactions with irrelevant carbohydrates, and that inhibition of CCD reactivity might substantially alter the outcome of the in vitro reactivity profile used for selection of allergens to be included in an immunotherapeutic regime.
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Affiliation(s)
| | | | | | - Daniel O. Morris
- School of Veterinary MedicineUniversity of Pennsylvania3900 Spruce StPhiladelphiaPA19104USA
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