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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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2
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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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Marteles D, Odriozola L, Verde MT, Conde T, Fernández A. Assessment of serum allergen-specific IgE levels in horses with seasonal allergic dermatitis and recurrent airway obstruction in Spain. Acta Vet Hung 2019; 67:11-21. [PMID: 30922098 DOI: 10.1556/004.2019.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Allergic conditions are prevalent equine diseases that can be diagnosed by clinical examination alone, but definitive diagnosis is more likely with laboratory testing. The ELISA Allercept© test was used to analyse the serum samples of 73 horses with allergic diseases. Sixty-one horses (83.5%) had allergen-specific IgE levels ≥ 150 ELISA Units (EU), the cut-off defined by the assay. Fifty-four horses had allergic dermatitis (AD) with high IgE levels to Tyrophagus putrescentiae (51.9%), Rumex crispus (48.1%), Tabanus (46.3%) and Dermatophagoides farinae/ D. pteronyssinus (40.7%). Seven horses with recurrent airway obstruction (RAO) had a high prevalence of T. putrescentiae (85.7%), followed by that of Acarus siro (57.1%) and D. farinae/D. pteronyssinus (57.1%). Horses affected with RAO had more positive reactions to mites (2.22 ± 0.84) than did horses with AD (1.51 ± 0.61, P < 0.05). A strong correlation of serum allergen-specific IgE level was found between Culex tarsalis and Stomoxys (r = 0.943) and between Dactylis glomerata and both Secale cereale (r = 0.79) and R. crispus (r = 0.696). These results indicate that among horses with allergic diseases in Spain, ELISA tests demonstrated a high prevalence of serum allergen-specific IgE in response to mites. Our study emphasises the importance of laboratory testing and updating allergy panels to improve the likelihood of a definitive diagnosis and the identification of allergens that should be included in allergic disease treatment.
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Affiliation(s)
- Diana Marteles
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Laura Odriozola
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013 Zaragoza, Spain
| | - María Teresa Verde
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Tomás Conde
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013 Zaragoza, Spain
| | - Antonio Fernández
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Miguel Servet 177, 50013 Zaragoza, Spain
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Abrams SB, Brock GN, Palettas M, Bolner ML, Moore-Sowers T, Plunkett GA, Cole LK, Diaz SF, Lorch G. An evaluation of veterinary allergen extract content and resultant canine intradermal threshold concentrations. Vet Dermatol 2018; 29:496-e167. [DOI: 10.1111/vde.12686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Stephanie B. Abrams
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; 601 Vernon L. Tharp St. Columbus OH 43210 USA
| | - Guy N. Brock
- Center for Biostatistics; Department of Biomedical Informatics; The Ohio State University; 1800 Cannon Dr. Columbus OH 43210 USA
| | - Marilly Palettas
- Center for Biostatistics; Department of Biomedical Informatics; The Ohio State University; 1800 Cannon Dr. Columbus OH 43210 USA
| | | | | | | | - Lynette K. Cole
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; 601 Vernon L. Tharp St. Columbus OH 43210 USA
| | - Sandra F. Diaz
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; 601 Vernon L. Tharp St. Columbus OH 43210 USA
| | - Gwendolen Lorch
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; 601 Vernon L. Tharp St. Columbus OH 43210 USA
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Lane MJ, Pucheu-Haston CM, Kearney MT, Woodward M. Determination of irritant threshold concentrations of multiple tree, grass, weed and mould allergens for intradermal testing of horses residing in the southern USA. Vet Dermatol 2017; 28:604-e147. [PMID: 28722254 DOI: 10.1111/vde.12472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Appropriate allergen threshold concentrations (TCs) for intradermal testing (IDT) have not been established in horses for many pollen and mould allergens. OBJECTIVES To determine the TCs in non-allergic horses and describe the frequency of late phase reactions for 26 allergens, including trees, grasses, weeds and moulds in horses residing in the southern Unites States. ANIMALS Twenty four clinically normal horses in the southern United States. METHODS Threshold concentrations for different allergens were determined using IDT subjective measurements at 30 minutes. Delayed reactions were evaluated at 4 and 24 h. RESULTS Threshold concentrations (all PNU/mL) were established for eight tree allergens (black willow 1,000, box elder 1,000, live oak 1,000, pecan 2,000, white ash 4,000, red oak 4,000, red mulberry 2,000 and green ash 2,000); two grass allergens (Johnson grass 250 PNU/mL and Kentucky blue grass 500 PNU/mL); two weeds (carelessweed 1,000 PNU/mL, great ragweed 500 PNU/mL) and one mould (Curvularia 8,000 PNU/mL). The TC was not determined due to excessive reactivity at the lowest concentration tested (1,000 PNU/mL) for bahia and perennial rye grass. Eleven other allergens did not meet the criteria to establish a TC when evaluated at 30 min due to lack of positive reactions. Multiple allergens caused positive reactions in ≥10% of horses at 4 h. Reactions at 24 h were rare with the exception of one horse. CONCLUSIONS AND CLINICAL IMPORTANCE This study identified intradermal TC for multiple pollen and mould allergens in horses. These values may prove useful for optimizing allergen concentrations for IDT of allergic horses.
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Affiliation(s)
- Martha J Lane
- Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - Cherie M Pucheu-Haston
- Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - Michael T Kearney
- Pathobiological Sciences, Louisiana State University School of Veterinary Medicine, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - Michelle Woodward
- Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Skip Bertman Drive, Baton Rouge, LA, 70803, USA
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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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9
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Bieber T. Insights into immunoglobulin E-mediated late-phase reactions in dogs. Vet Dermatol 2014; 25:305-6. [PMID: 25124176 DOI: 10.1111/vde.12172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany.
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