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Martini F, Rostaher A, Favrot C, Fischer NM. Open trial of recombinant Der f 2 pullulan-conjugated immunotherapy in cats. Vet Dermatol 2024; 35:175-183. [PMID: 38073305 DOI: 10.1111/vde.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 08/26/2023] [Accepted: 11/20/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Allermmune HDM (Zenoaq) is a recombinant Dermatophagoides farinae 2 (Der f 2) pullulan-based immunotherapy vaccine whose efficacy on house dust mite allergic dogs has been demonstrated. There is no published information on its use in cats. OBJECTIVES The objective of the study was to evaluate the safety and short-term effects of Allermmune HDM in Dermatophagoides farinae (Df)-sensitised cats. MATERIALS AND METHODS Eleven cats diagnosed with atopic skin syndrome received Allermmune weekly for six weeks then monthly for three months (total duration 18 weeks). On Weeks 0, 6 and 18 clinical lesions were assessed by the Feline Dermatitis Extent and Severity Index (FEDESI); owners assessed pruritus with a 10-cm Visual Analog Scale (pVAS). Concurrent medication use was recorded. The allergen-specific immunoglobulin (Ig)E were measured before study inclusion with a commercial serological assay. RESULTS There were no evident adverse effects. FEDESI and pVAS improved significantly after six weeks (p = 0.001 and p = 0.01, respectively). The pretreatment Df-specific IgE levels were significantly higher in the cats with improved clinical scores than in the cats with no clinical score change (p = 0.009). CONCLUSIONS AND CLINICAL RELEVANCE Allermmune HDM may be safe in cats and has the potential to alleviate signs of atopic skin syndrome. Allergen-specific IgE levels may represent an efficacy marker. Controlled studies of longer duration and larger sample size are worth pursuing.
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Affiliation(s)
- Franco Martini
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ana Rostaher
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Claude Favrot
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Nina M Fischer
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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2
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van Amersfort K, Vernooij JCM, van der Lee A. Efficacy of short-term combination of intralymphatic allergen immunotherapy and lokivetmab treatment in canine atopic dermatitis: A double-blinded, controlled, randomised study. Vet Dermatol 2023; 34:373-384. [PMID: 37186491 DOI: 10.1111/vde.13165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Allergen-specific immunotherapy (ASIT) is an effective therapy for canine atopic dermatitis (cAD). Intralymphatic immunotherapy (ILIT) is potentially beneficial in decreasing time to clinical effectiveness. OBJECTIVE To compare clinical efficacy of six monthly ILIT injections combined with three monthly injections of lokivetmab (LVM) with monthly LVM monotherapy at Day (D)168. To monitor dogs treated with ILIT for an additional six months of subcutaneous immunotherapy (SCIT). ANIMALS Thirty-six client-owned dogs with cAD. MATERIALS AND METHODS In this double-blinded, randomised study, dogs received either six monthly injections of ILIT combined with three monthly LVM injections (ILIT group) or six monthly LVM injections (LVM group). Monthly evaluations with pruritus Visual Analogue Scale (pVAS), Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and medication scores (MS) were undertaken. Owners completed a Quality of Life (QoL) questionnaire. Treatment success was predefined as ≥50% reduction in pVAS and CADESI-04 score ≤ 10. After D168, the ILIT group continued with SCIT until subjective assessment at 12 months. RESULTS The treatment benchmark at D168 was achieved by 11.1% of the ILIT group and 11.8% of LVM group. A significant decrease in mean pVAS and CADESI scores was observed in both groups (p < 0.001). The ILIT group had a trend towards higher MS compared to LVM. QoL was better in LVM (p = 0.01). At 12 months subjective good-to-excellent response in 77.8% of dogs in the ILIT/SCIT group was seen. CONCLUSION AND CLINICAL RELEVANCE The efficacy of this ILIT protocol was comparable with LVM monotherapy at six months. When ILIT was continued with SCIT, a favourable response was seen.
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Affiliation(s)
- Kelly van Amersfort
- IVC Evidensia Netherlands, Evidensia Dierenziekenhuis Arnhem, Arnhem, the Netherlands
| | | | - Annette van der Lee
- IVC Evidensia Netherlands, Evidensia Dierenziekenhuis Arnhem, Arnhem, the Netherlands
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Kotnik T. Quality of Life of Allergic Dogs Treated with Allergen-Specific Immunotherapy-A Retrospective Study. Vet Sci 2023; 10:vetsci10020072. [PMID: 36851376 PMCID: PMC9965114 DOI: 10.3390/vetsci10020072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The quality of life (QoL) of dogs with canine atopic dermatitis (CAD) treated with allergen-specific immunotherapy (ASIT) was studied to determine whether the QoL of dogs treated with ASIT (AG) improved compared with dogs not treated with ASIT (CG). METHODS The power of the study was calculated in advance assuming that the AG would assess QoL 20% better than the CG. The CG consisted of 21 dogs with CAD and the AG of 46 dogs with CAD. Validated QoL1 (pre-treatment) and QoL2 (post-treatment) questionnaires were emailed to owners. RESULTS AG dogs were significantly less disturbed during mealtimes (i.e., had better appetites and scratched less during mealtimes) and caused significantly less physical discomfort to their owners (due to unpleasant odor, the impression of a dirty apartment) than CG dogs. Owners of dogs treated with ASIT were able to significantly improve their daily activities (leisure, vacation, walks, work, hunting), significantly reduce their expenses (treatment costs, veterinary costs), feel significantly less emotional distress (less guilt, powerlessness, sadness, regret, fear, anger, disgust, rage, frustration), and experience less influence on relationships with family members and friends compared to owners of dogs not treated with ASIT. CONCLUSIONS According to our results, the quality of life of dogs treated with ASIT and their owners seemed to improve significantly.
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Affiliation(s)
- Tina Kotnik
- Small Animal Clinic, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
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Fennis EEM, Damme CMM, Schlotter YM, Sinke JD, Leistra MHG, Bartels RT, Broere F. Efficacy of subcutaneous allergen immunotherapy in atopic dogs: A retrospective study of 664 cases. Vet Dermatol 2022; 33:321-e75. [PMID: 35635279 PMCID: PMC9544551 DOI: 10.1111/vde.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/20/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
Background Canine atopic dermatitis (cAD) is an allergic skin disease affecting approximately 10% of dogs. allergen‐specific immunotherapy (ASIT) is currently the only treatment option able to induce tolerance to the causative allergens. Objective To retrospectively establish the efficacy of ASIT in atopic dogs. Animals Client‐owned (n = 664) dogs with cAD presented between 2008 and 2018 to two dermatology referral clinics. Materials and Methods Clinical records of atopic dogs were reviewed to obtain information including the results of the intradermal skin test and/or allergen‐specific immunoglobulin (Ig)E serological results, the allergens included in the ASIT, concurrent symptomatic medications, and ASIT efficacy after at least 9 months. Results Excellent (ASIT alone controlled clinical signs), good (≥50% reduction of clinical signs) and poor (<50% improvement) responses were seen in 31.5%, 28.5% and 40.1% of the dogs, respectively. No significant differences in efficacy were associated with breed, sex, age at initiation of ASIT, type of allergens in ASIT, and between clinics. Dogs re‐examined regularly responded significantly better to ASIT than dogs that did not (>50% improvement in 69.3% and 55.4% of the dogs, respectively). Dogs treated with ASIT and concomitant systemic glucocorticoids showed a significantly poorer response (success rate of >50% improvement of 38.5%). Conclusions and clinical importance In 59.9% of atopic dogs, subcutaneous ASIT can improve clinical signs by ≥50%. The beneficial effect of ASIT is higher if dogs are re‐examined regularly and if systemic long‐term corticosteroids are avoided, at least during the first 9 months of ASIT.
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Affiliation(s)
- Evelien E. M. Fennis
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine Utrecht University Utrecht the Netherlands
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine Utrecht University Utrecht the Netherlands
| | - Catharina M. M. Damme
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine Utrecht University Utrecht the Netherlands
| | - Yvette M. Schlotter
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine Utrecht University Utrecht the Netherlands
| | | | | | | | - Femke Broere
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine Utrecht University Utrecht the Netherlands
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine Utrecht University Utrecht the Netherlands
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Bruet V, Mosca M, Briand A, Bourdeau P, Pin D, Cochet-Faivre N, Cadiergues MC. Clinical Guidelines for the Use of Antipruritic Drugs in the Control of the Most Frequent Pruritic Skin Diseases in Dogs. Vet Sci 2022; 9:vetsci9040149. [PMID: 35448647 PMCID: PMC9030482 DOI: 10.3390/vetsci9040149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Pruritus is a common clinical sign in many skin disorders and is currently the main complaint in canine dermatology. Pruritic skin diseases can affect the quality of life of dogs and their owners. Several families of antipruritic drugs are available to help control pruritus in dogs. The aim of this review is to help practitioners select the most appropriate symptomatic treatment in the most frequent situations of dermatological pruritus in dogs. The molecules reviewed here are systemic and topical glucocorticoids, antihistamines, ciclosporin, oclacitinib and lokivetmab. A level of evidence (1, 2 or 3) has been established according to a detailed algorithm for each individual study in the literature published between 1990 and March 2021. The guidelines result from evidence grading using the strength of recommendation taxonomy (SoRT) and clinical recommendations using a thorough methodology.
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Affiliation(s)
- Vincent Bruet
- Veterinary Dermatology Referral Services, 44100 Nantes, France;
| | - Marion Mosca
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Amaury Briand
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
| | - Patrick Bourdeau
- Department of Clinical Sciences, ENVN (Oniris) Université de Nantes, 44307 Nantes, France;
| | - Didier Pin
- Université de Lyon, VetAgro Sup, Interactions Cells Environment, UPSP 2016.A104, 69280 Marcy l’Etoile, France; (M.M.); (D.P.)
| | - Noëlle Cochet-Faivre
- Department of Dermatology, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France; (A.B.); (N.C.-F.)
- UMR BIPAR, Laboratoire de Santé Animale, 94700 Maisons-Alfort, France
| | - Marie-Christine Cadiergues
- Department of Clinical Sciences, Université de Toulouse, ENVT, 31076 Toulouse, France
- INFINITy, Université de Toulouse, Inserm, CNRS, UPS, 31059 Toulouse, France
- Correspondence: ; Tel.: +33-561-193268
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Ramió-Lluch L, Brazís P, Ferrer L, Puigdemont A. Allergen-specific immunotherapy in dogs with atopic dermatitis: is owner compliance the main success-limiting factor? Vet Rec 2020; 187:493. [PMID: 33082241 DOI: 10.1136/vr.106024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/17/2020] [Accepted: 09/04/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND While the efficacy of allergen-specific immunotherapy (ASIT) to treat canine atopic dermatitis has been well established, it remains unclear why not all dogs show the same response to treatment. The goal of the study was to determine the relationship between duration of ASIT and two measurements of success: disease severity and concomitant medication sparing effect. METHODS Data were retrospectively compiled for 145 dogs with atopic dermatitis treated with ASIT. As a measure of treatment compliance, cases were stratified into dogs treated for less than 12 months or for at least 12 months. Treatment efficacy, defined as a reduction in disease severity score (scale 0-10), was compared between both groups, and correlations between treatment success and several related factors were examined. RESULTS ASIT treatment duration was strongly correlated with treatment efficacy. Animals treated for less than 12 months showed lower efficacy rates (22 per cent) than those treated for at least 12 months (65 per cent). Further, in animals treated for at least 12 months, concomitant medications were reduced more (87 per cent) than in animals treated for less than 12 months (39 per cent). CONCLUSION A lack of owner compliance emerged as the main factor explaining the reduced effectiveness of ASIT. To improve treatment adherence, veterinarians and owners need to be better informed about ASIT mechanisms of action before starting treatment.
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Affiliation(s)
| | - Pilar Brazís
- Animal Health BU, Laboratorios Leti SL, Barcelona, Spain
| | - Luis Ferrer
- Animal Medicine and Surgery, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Anna Puigdemont
- Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
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Herrmann I, Loft KE, Olivry T. Shortened immunotherapy dose-escalation saves time, but is it safe? A case-control study comparing the rates of adverse reactions between conventional and fast-escalation subcutaneous immunotherapy protocols during the induction phase. Vet Dermatol 2020; 31:454-e120. [PMID: 32940395 DOI: 10.1111/vde.12892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Allergen immunotherapy (AIT) is the only intervention believed to change the course of atopic diseases. As dogs appear to have fewer severe adverse events (AEs) compared to people receiving AIT, a prolonged dose-escalation induction phase might not be needed. OBJECTIVES To report the incidence and characteristics of AEs induced by a fast-escalation subcutaneous immunotherapy (f-SCIT) protocol compared to a conventional (c-SCIT) regimen. ANIMALS One hundred dogs treated with either f- SCIT (Centre 1, 50 dogs) or c-SCIT (Centre 2, 50 dogs). METHODS AND MATERIALS A case-control study retrospectively evaluating AEs during the induction of AIT. We determined the incidence and type of AEs in each SCIT group; we also assessed factors such as self-limitation and the need for AE-associated protocol changes. RESULTS Twelve of 100 dogs (12%) developed a SCIT-attributable AE during the induction phase, with one dog having a local and 11 having systemic reactions (nine Grade I, two Grade II, none of grades III or IV). Dogs treated with the f-SCIT had a significantly higher rate of AEs (11 of 50; 22%) compared to those receiving the c-SCIT (one of 50; 2%). Most of the AEs (10 of 11; 91%) in the f-SCIT group were mild and self-limiting. CONCLUSIONS AND CLINICAL IMPORTANCE The induction phase of f-SCIT is simpler, and the maintenance phase is reached faster than that of the c-SCIT. Despite its higher rate of AEs than with the c-SCIT regimen, the majority of f-SCIT-associated AEs were mild and self-limiting. Whether or not this f-SCIT protocol leads to a faster time-to-efficacy needs to be determined.
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Affiliation(s)
- Ina Herrmann
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
| | - Klaus E Loft
- MSPCA Angell Memorial Hospital, 350 South Huntington Avenue, Boston, MA, 02130, USA
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, NC State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
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Flanagan S, Schick A, Lewis TP. A pilot study to identify perceived barrier and motivating factors of primary veterinarians in the USA for specialty referral and management of atopic dermatitis with allergen-specific immunotherapy. Vet Dermatol 2020; 31:371-e98. [PMID: 32416025 DOI: 10.1111/vde.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (ASIT) may decrease clinical signs and potential neosensitization in dogs with canine atopic dermatitis (cAD). Identification of barriers to referral and specialty level case management may improve clinical outcome and satisfaction for both clients and primary veterinarians. HYPOTHESIS/OBJECTIVES The objective of this cross-sectional, descriptive, survey-based pilot study was to identify factors influencing a veterinarian's decision to recommend dermatology referral and prescribe ASIT for management of cAD. METHODS AND MATERIALS An online survey was administered to small animal veterinarians through two veterinary associations in the western United States. Participants were asked to rate factors using Likert scales. RESULTS Of 60 responses, 18 (30%) rarely or never recommended ASIT. The top three factors against recommending ASIT included successful pharmaceutical management (100%), clients' concern for cost (94.4%) and veterinarians' perceptions that immunotherapy is unable to reduce pharmacological dependency (83.4%). The top three motivating factors included concerns for glucocorticoid adverse effects (83.3%), animal/owner quality of life (77.8%) and risk of antimicrobial resistant infection (55.6%). Results of the secondary objective revealed that 19 of 60 (31.7%) respondents rarely or never refer atopic pets to a dermatologist, citing cost of referral, availability of serological testing, and perception of limited benefits as the greatest barriers. CONCLUSIONS AND CLINICAL SIGNIFICANCE Numerous factors appear to influence decisions to recommend referral or ASIT for management of pets with cAD. Further work is needed to determine if these can be generalized to larger populations with a goal of providing suggestions to bridge these gaps and improve outcomes.
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Affiliation(s)
- Sarah Flanagan
- Dermatology for Animals, 86 W. Juniper Ave, Gilbert, AZ, 85233, USA.,Dermatology for Animals, 22595 N. Scottsdale Rd, Scottsdale, AZ, 85255, USA
| | - Anthea Schick
- Dermatology for Animals, 22595 N. Scottsdale Rd, Scottsdale, AZ, 85255, USA
| | - Thomas P Lewis
- Dermatology for Animals, 86 W. Juniper Ave, Gilbert, AZ, 85233, USA
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9
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Fischer NM, Rostaher A, Favrot C. A comparative study of subcutaneous, intralymphatic and sublingual immunotherapy for the long-term control of dogs with nonseasonal atopic dermatitis. Vet Dermatol 2020; 31:365-e96. [PMID: 32537789 DOI: 10.1111/vde.12860] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (ASIT) is the only causative treatment of canine atopic dermatitis (cAD). Different routes for administration of ASIT have been used; however, comparative studies are lacking. HYPOTHESIS/OBJECTIVES The present study compared the efficacy and safety of subcutaneous (SCIT), intralymphatic (ILIT) and sublingual (SLIT) immunotherapy. ANIMALS 30 atopic dogs were included and allocation to three groups (SCIT, n = 8; ILIT, n = 12; SLIT, n = 10) was determined by the owners. METHODS AND MATERIALS ASIT was administered using routine protocols. The pruritus Visual Analog Scale (PVAS), canine atopic dermatitis extent and severity index (CADESI), concurrent medications and adverse events were recorded initially and one, three, six and 12 months later. The main outcome measure was return to a normal status, which included CADESI <12, PVAS <2.5 and medication score <10. RESULTS Drop-outs were distributed evenly and 23 dogs finished the study (SCIT, n = 6; ILIT, n = 10; SLIT, n = 7). Adverse reactions to treatment were rare. At the start of the study, the three groups were homogeneous with respect to clinical signs and concurrent medications. After 12 months of ASIT, the CADESI and PVAS had decreased with a stable medication score in the ILIT and SCIT groups (P < 0.05), while all three scores had increased in the SLIT group. Return to normal state was achieved in one of six (17%) dogs receiving SCIT, in six of 10 (60%) dogs receiving ILIT and in one of seven (14%) dogs receiving SLIT. CONCLUSIONS AND CLINICAL IMPORTANCE These findings suggest that SCIT and ILIT improved clinical signs of cAD, whereas ILIT had a much higher return to normal rate.
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Affiliation(s)
- Nina M Fischer
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Ana Rostaher
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
| | - Claude Favrot
- Dermatology Unit, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
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11
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Chan WY, Selvarajah GT, Ajat M, Suzuki R, Tsukui T. The detection of house dust mite Dermatophagoides farinae, Der f 2 and Zen-1 allergen-specific immunoglobulin E antibodies in dogs with atopic Dermatitis in Malaysia. Vet Immunol Immunopathol 2019; 212:43-9. [PMID: 31213251 DOI: 10.1016/j.vetimm.2019.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 02/05/2019] [Accepted: 05/21/2019] [Indexed: 01/27/2023]
Abstract
Canine atopic dermatitis (AD) is a chronic, inflammatory and pruritic allergic skin disease in dogs. House dust mites such as Dermatophagoides farinae are one of the known causative agents for the induction of canine AD worldwide. D. farinae protein Der f 2 is known as an important allergen involved in canine AD and recently, Zen-1 has also been identified as an allergenic protein. There is limited information on the prevalence and role of allergen sensitization to crude D. farinae extract (CDF), Der f 2 and Zen-1 among dogs diagnosed with AD in Malaysia. The aim of this study was to determine the proportion of CDF-, Der f 2- and Zen-1-specific reactive sera among dogs diagnosed with AD in Malaysia using an enzyme-linked immunosorbent assay (ELISA). Serum samples were collected from dogs diagnosed with AD from several veterinary clinics in Malaysia. The canine case records were retrieved and information on signalment, dermatological and non-dermatological histories, clinical presentation, food allergies, and exclusion of ectoparasitic, microbial and fungal skin infections were obtained through a survey form. All serum samples were evaluated to quantify the CDF-, Der f 2- and Zen-1-specific immunoglobulin E (IgE) levels. A total of 24.6%, 48.4% and 29.8% of dogs diagnosed with AD were positive for CDF-, Der f 2- and Zen-1-specific IgE, respectively. These results suggest that CDF-, Der f 2- and Zen-1 are important allergens that can contribute to AD in dogs in Malaysia, and serological testing can be performed to provide additional treatment options involving specific immunotherapies.
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Abstract
The purpose of this review article is to give an overview of atopic dermatitis in companion animals and of recent developments including knowledge on immunological background, novel treatment options and difficulties in disease management. The prevalence of hypersensitivities seems to be increasing. The pathogenetic mechanisms are not fully understood, yet multiple gene abnormalities and altered immunological processes are involved. In dogs and cats, the diagnosis of atopic dermatitis is based on history, clinical examination and exclusion of other differential diagnoses. Intradermal testing or testing for serum allergen-specific Immunoglobulin E is only used to identify allergens for inclusion in the extract for allergen immunotherapy. Symptomatic therapy includes glucocorticoids, ciclosporin, essential fatty acids and antihistamines. A selective janus kinase 1 inhibitor and a caninized monoclonal interleukin-31 antibody are the newest options for symptomatic treatment, although longterm effects still need to be assessed. The chronic and often severe nature of the disease, the costly diagnostic workup, frequent clinical flares and lifelong treatment are challenging for owners, pets and veterinarians. Patience and excellent communication skills are needed to achieve a good owner compliance and satisfactory clinical outcome for the animal.
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Affiliation(s)
- Natalie Katharina Yvonne Gedon
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstraße 13, 80539 Munich, Germany
| | - Ralf Steffen Mueller
- Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Veterinaerstraße 13, 80539 Munich, Germany
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Mueller RS, Jensen‐Jarolim E, Roth‐Walter F, Marti E, Janda J, Seida AA, DeBoer D. Allergen immunotherapy in people, dogs, cats and horses - differences, similarities and research needs. Allergy 2018; 73:1989-1999. [PMID: 29675865 DOI: 10.1111/all.13464] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 12/28/2022]
Abstract
In human patients with seasonal allergic rhinoconjunctivitis sensitized to grass pollen, the first successful allergen immunotherapy (AIT) was reported in 1911. Today, immunotherapy is an accepted treatment for allergic asthma, allergic rhinitis and hypersensitivities to insect venom. AIT is also used for atopic dermatitis and recently for food allergy. Subcutaneous, epicutaneous, intralymphatic, oral and sublingual protocols of AIT exist. In animals, most data are available in dogs where subcutaneous AIT is an accepted treatment for atopic dermatitis. Initiating a regulatory response and a production of "blocking" IgG antibodies with AIT are similar mechanisms in human beings and dogs with allergic diseases. Although subcutaneous immunotherapy is used for atopic dermatitis in cats, data for its efficacy are sparse. There is some evidence for successful treatment of feline asthma with AIT. In horses, most studies evaluate the effect of AIT on insect hypersensitivity with conflicting results although promising pilot studies have demonstrated the prophylaxis of insect hypersensitivity with recombinant antigens of biting midges (Culicoides spp.). Optimizing AIT using allergoids, peptide immunotherapy, recombinant allergens and new adjuvants with the different administration types of allergen extracts will further improve compliance and efficacy of this proven treatment modality.
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Affiliation(s)
- R. S. Mueller
- Centre for Clinical Veterinary Medicine LMU Munich Munich Germany
| | - E. Jensen‐Jarolim
- The Interuniversity Messerli Research Institute University of Veterinary Medicine Vienna Medical University Vienna Vienna Austria
- Institute of Pathophysiology and Allergy Research Center of Pathophysiology Infectiology and Immunology, Medical University Vienna Austria
| | - F. Roth‐Walter
- The Interuniversity Messerli Research Institute University of Veterinary Medicine Vienna Medical University Vienna Vienna Austria
| | - E. Marti
- Department of Clinical Research and Veterinary Public Health University of Bern Bern Switzerland
| | - J. Janda
- Faculty of Science Charles University Prague Czech Republic
| | - A. A. Seida
- Immunology and Microbiology Department Faculty of Veterinary Medicine Cairo University Giza Egypt
| | - D. DeBoer
- School of Veterinary Medicine University of Wisconsin Madison WI USA
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Kawano K, Mizuno T. A pilot study of the effect of pullulan-conjugated Der f 2 allergen-specific immunotherapy on canine atopic dermatitis. Vet Dermatol 2017; 28:583-e141. [DOI: 10.1111/vde.12470] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Kouji Kawano
- Primo Animal Hospital Tokyo Animal Allergy Medical Center (AAMC); 1-28-7 Shakujiimachi Nerima-Ku Tokyo 177-0041 Japan
- Laboratory of Molecular Diagnostics and Therapeutics; The United Graduate School of Veterinary Science; Yamaguchi University; 1677-1 Yoshida Yamaguchi Yamaguchi 753-8515 Japan
| | - Takuya Mizuno
- Laboratory of Molecular Diagnostics and Therapeutics; The United Graduate School of Veterinary Science; Yamaguchi University; 1677-1 Yoshida Yamaguchi Yamaguchi 753-8515 Japan
- Biomedical Science Center for Translational Research; The United Graduate School of Veterinary Science; Yamaguchi University; 1677-1 Yoshida Yamaguchi Yamaguchi 753-8515 Japan
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Åberg L, Varjonen K, Åhman S. Results of allergen-specific immunotherapy in atopic dogs with Malassezia hypersensitivity: a retrospective study of 16 cases. Vet Dermatol 2017; 28:633-e157. [PMID: 28748560 DOI: 10.1111/vde.12475] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hypersensitivity reactions to Malassezia spp have been shown to occur in dogs with atopic dermatitis (AD) and to cause exacerbation of clinical signs. Improvement of clinical signs following use of antifungal medication is seen with both Malassezia overgrowth or Malassezia hypersensitivity (MHS). Subcutaneous immunotherapy (SCIT) is considered a safe and effective treatment for management of canine AD. Adverse effects are considered rare. OBJECTIVES To report on the use of SCIT with Malassezia extracts in mono-sensitized dogs. ANIMALS Sixteen client owned dogs diagnosed with MHS and treated with SCIT. METHODS A retrospective review of medical records of atopic dogs diagnosed with MHS, mono-sensitized for Malassezia allergens on intradermal test and treated with SCIT for more than 10 months. Efficacy was measured by decreasing use of anti-inflammatory and antifungal medication by ≥50% and by decreasing pruritus by ≥50% as assessed by owners, using a pruritus score. RESULTS Good response to SCIT was seen in nine of 16 cases (56%) with both a reduction in use of anti-inflammatory and antifungal medication as well as a reduction in pruritus scores by ≥50%. No adverse effects were reported. CONCLUSION Allergen-specific immunotherapy was a safe treatment for dogs with Malassezia hypersensitivity. The efficacy of Malassezia immunotherapy corresponds well to the results of previous studies of immunotherapy with other environmental allergens.
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Affiliation(s)
- Liselotte Åberg
- Djurakuten i Stor-Stockholm AB, Kungstensgatan 58, 113 29, Stockholm, Sweden
| | - Katarina Varjonen
- Royal (Dick) School of Veterinary Studies, Small Animal Hospital, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
| | - Susanne Åhman
- Djurakuten i Stor-Stockholm AB, Kungstensgatan 58, 113 29, Stockholm, Sweden
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Wagner I, Geh KJ, Hubert M, Winter G, Weber K, Classen J, Klinger C, Mueller RS. Preliminary evaluation of cytosine-phosphate-guanine oligodeoxynucleotides bound to gelatine nanoparticles as immunotherapy for canine atopic dermatitis. Vet Rec 2017; 181:118. [PMID: 28526774 DOI: 10.1136/vr.104230] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2017] [Indexed: 11/04/2022]
Abstract
Cytosine-phosphate-guanine oligodeoxynucleotides (CpG ODN) are a promising new immunotherapeutic treatment option for canine atopic dermatitis (AD). The aim of this uncontrolled pilot study was to evaluate clinical and immunological effects of gelatine nanoparticle (GNP)-bound CpG ODN (CpG GNP) on atopic dogs. Eighteen dogs with AD were treated for 8 weeks (group 1, n=8) or 18 weeks (group 2, n=10). Before inclusion and after 2 weeks, 4 weeks, 6 weeks (group 1+2), 8 weeks, 12 weeks and 16 weeks (group 2) 75 µg CpG ODN/dog (bound to 1.5 mg GNP) were injected subcutaneously. Pruritus was evaluated daily by the owner. Lesions were evaluated and serum concentrations and mRNA expressions of interferon-γ, tumour necrosis factor-α, transforming growth factor-β, interleukin (IL) 10 and IL-4 (only mRNA expression) were determined at inclusion and after 8 weeks (group 1+2) and 18 weeks (group 2). Lesions and pruritus improved significantly from baseline to week 8. Mean improvements from baseline to week 18 were 23 per cent and 44 per cent for lesions and pruritus, respectively, an improvement of ≥50 per cent was seen in six out of nine and three out of six dogs, respectively. IL-4 mRNA expression decreased significantly. The results of this study show a clinical improvement of canine AD with CpG GNP comparable to allergen immunotherapy. Controlled studies are needed to confirm these findings.
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Affiliation(s)
- I Wagner
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - K J Geh
- Department of Pharmacy, Pharmaceutical Technology & Biopharmaceutics, LMU Munich, Butenandtstrasse 5, 81377 Munich, Germany
| | - M Hubert
- Department of Pharmacy, Pharmaceutical Technology & Biopharmaceutics, LMU Munich, Butenandtstrasse 5, 81377 Munich, Germany
| | - G Winter
- Department of Pharmacy, Pharmaceutical Technology & Biopharmaceutics, LMU Munich, Butenandtstrasse 5, 81377 Munich, Germany
| | - K Weber
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - J Classen
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - C Klinger
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
| | - R S Mueller
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany
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Plant JD, Neradilek MB. Effectiveness of regionally-specific immunotherapy for the management of canine atopic dermatitis. BMC Vet Res 2017; 13:4. [PMID: 28056956 PMCID: PMC5216569 DOI: 10.1186/s12917-016-0917-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/09/2016] [Indexed: 01/08/2023] Open
Abstract
Background Canine atopic dermatitis is a common pruritic skin disease often treated with allergen immunotherapy (AIT). AIT in dogs traditionally begins with attempting to identify clinically relevant environmental allergens. Current allergen testing methodologies and immunotherapy techniques in dogs are not standardized. Immunotherapy with a mixture of allergenic extracts selected based on regional aerobiology rather than intradermal tests or serum IgE assays has been described. The objective of this study was to evaluate the effectiveness of regionally-specific immunotherapy in dogs with atopic dermatitis. The medical records of a veterinary dermatology referral clinic were searched for dogs with atopic dermatitis that began regionally-specific subcutaneous immunotherapy from June, 2010 to May, 2013. An overall assessment of treatment effectiveness (excellent, good, fair, or poor) was assigned based upon changes in pruritus severity, lesion severity, and the reduction in concurrent medication(s) during a follow-up period of at least 270 days. Baseline characteristics that might predict treatment success were analyzed with the Spearman’s correlation and the Kruskal-Wallis tests. Results Of the 286 dogs that began regionally-specific immunotherapy (RESPIT) during a 3 year period, 103 met the inclusion criteria. The overall response to RESPIT was classified as excellent in 19%, good in 38%, fair in 25%, and poor in 18% of dogs. The response classification correlated significantly with a reduction in pruritus severity (r = 0.72, p < 0.001) and lesion severity (r = 0.54, p < 0.001), but not with the dogs’ baseline characteristics. Adverse reactions were reported in 7/286 (2.4%) of treated dogs. Conclusions Under the conditions of this study, RESPIT was safe and effective for the treatment of atopic dermatitis in dogs.
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Affiliation(s)
- Jon D Plant
- SkinVet Clinic, 15800 Upper Boones Ferry Road, Suite 120, Lake Oswego, 97035, OR, USA.
| | - Moni B Neradilek
- The Mountain-Whisper-Light Statistics, 1827 23rd Avenue East, Seattle, 98112, WA, USA
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19
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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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20
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Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. Vet J 2015; 207:29-37. [PMID: 26586215 DOI: 10.1016/j.tvjl.2015.09.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 08/24/2015] [Accepted: 09/11/2015] [Indexed: 01/08/2023]
Abstract
Canine atopic dermatitis is a common skin disease seen in veterinary clinical practice. Several factors appear to contribute to the cutaneous inflammation and pruritus. The therapeutic strategy should focus on control of those factors that can be identified and for which interventional measures are feasible; these include ectoparasites, bacterial/fungal infection and dietary hypersensitivity. Ectoparasites, particularly fleas, are not the cause of atopic dermatitis, but they are a confounding factor, which can exacerbate pruritus, and preventative measures are therefore indicated. Bacterial and yeast infections are frequently associated with atopic dermatitis and initial systemic and/or topical therapy should be considered, followed by regular topical treatment for preventing relapse. Concurrent dietary hypersensitivity should be investigated by undertaking an elimination/provocation trial, followed by feeding of a hypoallergenic diet where appropriate. Depending on the severity of the clinical signs of atopic dermatitis and the willingness and expectations of owners, symptomatic treatment and/or specific interventional therapy for environmental allergy (allergen avoidance, allergen-specific immunotherapy) may be implemented. Symptomatic treatment includes use of glucocorticoids (systemically or topically), ciclosporin and oclacitinib. Other treatment modalities of lower or less proven efficacy include antihistamines, dextromethorphan, fatty acids, feline interferon-omega, misoprostol, pentoxifylline, specific serotonin re-uptake inhibitors and tricyclic antidepressant drugs. The therapeutic approach should be reviewed at regular intervals and tailored to the individual's needs. A successful long-term outcome can usually be achieved by combining the various treatment approaches in a way that maximises their benefits and minimises their drawbacks.
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Affiliation(s)
- Manolis N Saridomichelakis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Trikalon Str. 224, Karditsa GR-43100, Greece.
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA; Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC 27606, USA
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van Beeck FL, Watson A, Bos M, Biourge V, Willemse T. The effect of long-term feeding of skin barrier-fortified diets on the owner-assessed incidence of atopic dermatitis symptoms in Labrador retrievers. J Nutr Sci 2015; 4:e5. [PMID: 26097705 PMCID: PMC4462758 DOI: 10.1017/jns.2014.61] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 10/22/2014] [Accepted: 10/31/2014] [Indexed: 11/06/2022] Open
Abstract
We investigated the effect of feeding a skin barrier function-augmenting diet early in dogs' lives on the appearance of clinical signs associated with canine atopic dermatitis. Pregnant bitches (starting 5 weeks after mating) and their subsequent litters (up to 1 year of age) were fed either supplemented or unsupplemented diets. Nutrients supplemented were nicotinamide, pantothenate, histidine, inositol and choline. Circulating IgE levels to dust mute allergens Der f and Der p were measured when the puppies were 6 and 12 months old. Two owner questionnaires were used to assess the occurrence of typical signs associated with atopic dermatitis when dogs were between the ages of 22 and 36, and 34 and 48 months. Using linear mixed models we observed higher levels of circulating anti-Der f (P = 0·021) and -Der p IgE (P = 0·01) during the first year in the dogs fed the unsupplemented than in those fed the supplemented diet. The owner-assessed incidence of atopic dermatitis signs amongst the dogs was significantly greater in the unsupplemented group at the time of the second follow-up questionnaire (10/33 dogs v. 2/24 dogs). These outcomes suggest that a nutritionally derived improvement to barrier function early in life may reduce the frequency of signs associated with atopic dermatitis. The effect is possibly the result of making the epidermis, now thought to be a major route of environmental allergen exposure, more resistant to penetration.
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Affiliation(s)
- Frank Looringh van Beeck
- Department of Clinical Sciences of Companion Animals
and Division of Immunology, Faculty of Veterinary
Medicine, Utrecht University,
Utrecht, The Netherlands
| | | | | | | | - Ton Willemse
- Department of Clinical Sciences of Companion Animals
and Division of Immunology, Faculty of Veterinary
Medicine, Utrecht University,
Utrecht, The Netherlands
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22
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Kang MH, Kim HJ, Jang HJ, Park HM. Sensitization rates of causative allergens for dogs with atopic dermatitis: detection of canine allergen-specific IgE. J Vet Sci 2014; 15:545-50. [PMID: 24962408 PMCID: PMC4269597 DOI: 10.4142/jvs.2014.15.4.545] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 03/21/2014] [Accepted: 04/27/2014] [Indexed: 11/20/2022] Open
Abstract
Allergen-specific IgE serology tests became commercially available in the 1980s. Since then these tests have been widely used to diagnose and treat allergic skin diseases. However, the relationship between a positive reaction and disease occurrence has been controversial. The purpose of this study was to evaluate allergens using a serologic allergy test in dogs with atopic dermatitis (AD). Dogs clinically diagnosed with AD (n = 101) were tested using an allergen-specific IgE immunoassay. Among the total 92 environmental and food allergens, house dust and house dust mites were the most common. Several allergens including airborne pollens and molds produced positive reactions, and which was considered increasing allergens relating to the climate changes. The presence of antibodies against staphylococci and Malassezia in cases of canine AD was warranted in this study. Additionally, strong (chicken, turkey, brown rice, brewer's yeast, and soybean) and weakly (rabbit, vension, duck, and tuna) positive reactions to food allergens could be used for avoidance and limited-allergen trials.
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Affiliation(s)
- Min-Hee Kang
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 143-701, Korea
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24
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Plant JD, Neradelik MB, Polissar NL, Fadok VA, Scott BA. Agreement between allergen-specific IgE assays and ensuing immunotherapy recommendations from four commercial laboratories in the USA. Vet Dermatol 2014; 25:15-e6. [PMID: 24461034 PMCID: PMC4209119 DOI: 10.1111/vde.12104] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND Canine allergen-specific IgE assays in the USA are not subjected to an independent laboratory reliability monitoring programme. HYPOTHESIS/OBJECTIVES The aim of this study was to evaluate the agreement of diagnostic results and treatment recommendations of four serum IgE assays commercially available in the USA. METHODS Replicate serum samples from 10 atopic dogs were submitted to each of four laboratories for allergen-specific IgE assays (ACTT(®) , VARL Liquid Gold, ALLERCEPT(®) and Greer(®) Aller-g-complete(®) ). The interlaboratory agreement of standard, regional panels and ensuing treatment recommendations were analysed with the kappa statistic (κ) to account for agreement that might occur merely by chance. Six comparisons of pairs of laboratories and overall agreement among laboratories were analysed for ungrouped allergens (as tested) and also with allergens grouped according to reported cross-reactivity and taxonomy. RESULTS The overall chance-corrected agreement of the positive/negative test results for ungrouped and grouped allergens was slight (κ = 0.14 and 0.13, respectively). Subset analysis of the laboratory pair with the highest level of diagnostic agreement (κ = 0.36) found slight agreement (κ = 0.13) for ungrouped plants and fungi, but substantial agreement (κ = 0.71) for ungrouped mites. The overall agreement of the treatment recommendations was slight (κ = 0.11). Altogether, 85.1% of ungrouped allergen treatment recommendations were unique to one laboratory or another. CONCLUSIONS AND CLINICAL IMPORTANCE Our study indicated that the choice of IgE assay may have a major influence on the positive/negative results and ensuing treatment recommendations.
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Affiliation(s)
- Jon D Plant
- SkinVet Clinic, 15800 SW Upper Boones Ferry Road, Suite 120, Lake Oswego, OR, 97035, USA
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Plant JD, Gortel K, Kovalik M, Polissar NL, Neradilek MB. Development and validation of the Canine Atopic Dermatitis Lesion Index, a scale for the rapid scoring of lesion severity in canine atopic dermatitis. Vet Dermatol 2013; 23:515-e103. [PMID: 23140318 DOI: 10.1111/j.1365-3164.2012.01113.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The third iteration of the Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) is the only tool rigorously validated for canine atopic dermatitis (CAD) lesion scoring. The CADESI-03 requires 248 evaluations, limiting its widespread use. HYPOTHESIS/OBJECTIVES The goal of the study was to develop and validate a practical method of grading CAD lesions that requires scoring only the frequently affected body regions. ANIMALS Fifty-seven privately owned atopic dogs were used in the study. METHODS The Canine Atopic Dermatitis Lesion Index (CADLI) was evaluated in an open, multicentre reliability study. Validity was assessed with expert opinion (content validity) and comparison of CADLI with existing disease severity measures (construct and criterion validity). Reliability was evaluated by analysing repeated observations of each dog. Convenience was assessed in terms of the time required to complete the scale. RESULTS The CADLI scores correlated with overall assessment scores (r = 0.60, P < 0.001, linear mixed model) and pruritus severity scores (r = 0.53, P < 0.001, linear mixed model), establishing construct validity. The CADLI was strongly correlated with CADESI-03 (r = 0.84, P < 0.001, linear mixed model), establishing criterion validity. The CADLI values obtained by two observers correlated very strongly (r = 0.91, P < 0.001), as did the repeat values for the same observer (r = 0.98, P < 0.001). The mean time to complete the CADLI was less than that required for CADESI-03 (1.9 and 12.6 min, respectively), a highly significant difference (P < 0.001). CONCLUSION AND CLINICAL IMPORTANCE The CADLI was found to be an effective measure of CAD lesion severity, strongly correlating with CADESI-03. The convenience of CADLI makes it suitable for use in both clinical research and practice.
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Dell DL, Griffin CE, Thompson LA, Griffies JD. Owner assessment of therapeutic interventions for canine atopic dermatitis: a long-term retrospective analysis. Vet Dermatol 2012; 23:228-e47. [DOI: 10.1111/j.1365-3164.2012.01054.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Olivry T, DeBoer DJ, Favrot C, Jackson HA, Mueller RS, Nuttall T, Prélaud P. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol 2010; 21:233-48. [DOI: 10.1111/j.1365-3164.2010.00889.x] [Citation(s) in RCA: 170] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Horvath-Ungerboeck C, Thoday KL, Shaw DJ, van den Broek AHM. Tepoxalin reduces pruritus and modified CADESI-01 scores in dogs with atopic dermatitis: a prospective, randomized, double-blinded, placebo-controlled, cross-over study. Vet Dermatol 2009; 20:233-42. [DOI: 10.1111/j.1365-3164.2009.00739.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Willemse T, Bardagi M, Carlotti D, Ferrer L, Fondati A, Fontaine J, Leistra M, Noli C, Ordeix L, Scarampella F, Schleifer S, Sinke J, Roosje P. Dermatophagoides farinae-specific immunotherapy in atopic dogs with hypersensitivity to multiple allergens: A randomised, double blind, placebo-controlled study. Vet J 2009; 180:337-42. [DOI: 10.1016/j.tvjl.2008.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 12/20/2007] [Accepted: 01/12/2008] [Indexed: 11/18/2022]
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Abstract
This article reviews allergen-specific immunotherapy in human and veterinary medicine. Current hypotheses of possible mechanisms of actions are outlined. Indications, success rates, adverse effects and factors influencing outcome of therapy are discussed in humans, dogs, cats and horses.
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Affiliation(s)
- Christine Loewenstein
- Tierärztliche Klinik für Kleintiere, Bereich Dermatologie, Im Langgewann 9, 65719 Hofheim, Germany
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Merryman-Simpson AE, Wood SH, Fretwell N, Jones PG, McLaren WM, McEwan NA, Clements DN, Carter SD, Ollier WE, Nuttall T. Gene (mRNA) expression in canine atopic dermatitis: microarray analysis. Vet Dermatol 2008; 19:59-66. [DOI: 10.1111/j.1365-3164.2008.00653.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
Atopic dermatitis (AD) is a common chronic inflammatory skin disease that is part of the atopic syndrome and is frequently associated with asthma and allergic rhinoconjunctilitis. Acute eczematous lesions are characterized by erythema, cozing and crusting, whereas chronic lesions show thickened skin and papules. In addition to local and systemic therapy adjusted to the stage of the disease, the search for relevant trigger factors and consecutively their avoidance plays a crucial role in disease management. Aeroallergens like house-dust-mites, pollen and animal epithelia represent important trigger factors in sensitized patients. While allergen-specific immunotherapy (SIT) is widely and most effective used in allergy to insect venoms and allergic rhinitis, its use in AD is still controversial. Double-blind, placebo-controlled clinical trials show that SIT is effective in patients with AD and clinically relevant sensitization to house dust mites and grass pollen and leads to clinical improvement of eczema. Despite these encouraging data, the use of SIT as a routine therapeutic approach in AD requires further evaluation.
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Affiliation(s)
- M Niebuhr
- Klinik und Poliklinik für Dermatologie und Allergologie der Medizinischen Hochschule Hannover, Ricklinger Strasse 5, 30449 Hannover, Deutschland.
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