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- Author or Editor: Ralf S. Mueller x
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Abstract
Canine atopic dermatitis and feline atopic skin syndrome are common presentations in small animal practice. Numerous drugs are used for symptomatic therapy. The only definitive treatment based on the cause of the disease is allergen immunotherapy. Classical allergen immunotherapy (AIT) consists of subcutaneous injections of an extract containing offending allergens, with increasing doses and allergen concentrations at short intervals during the induction phase of several weeks to months followed by a maintenance phase, where a fixed dose is typically given at longer intervals. Dose and interval are tailored to the individual patient. Newer types of AIT include rush immunotherapy, where the induction phase is abbreviated, intralymphatic immunotherapy, and oromucosal or sublingual immunotherapy. AIT aims at inducing a regulatory T-cell response and subsequently downregulating the exaggerated immune response to offending allergens leading to clinical signs. This article reviews the published knowledge about allergen immunotherapy in dogs and cats for small animal practitioners.
Abstract
Objective—To evaluate the safety of an abbreviated course of injections of allergen extracts (rush immunotherapy) for the treatment of dogs with atopic dermatitis.
Animals—30 dogs with atopic dermatitis examined at a veterinary dermatology referral practice for treatment with allergen-specific immunotherapy.
Procedure—A catheter was placed in a vein in each dog. Dogs were constantly observed throughout the procedure. Allergen extracts were administered in increasing concentrations every 30 minutes for 6 hours to a maintenance concentration of 20,000 protein nitrogen units/ml. Epinephrine, oxygen, and emergency treatment were available as needed.
Results—In 22 (73%) dogs, rush immunotherapy safely replaced the prolonged induction period (15 weeks) of weekly injections that consists of increasing concentrations of allergen extract. In 7 (23%) dogs, the induction period was abbreviated to 4 weeks. Of the 8 dogs that developed problems during rush immunotherapy, increased pruritus necessitated premature cessation of rush immunotherapy in 7, and 1 developed generalized wheals. Oral administration of prednisolone (1 mg/kg of body weight) resulted in resolution of adverse effects in all 8 dogs.
Conclusion and Clinical Relevance—Rush immunotherapy performed by personnel at a veterinary hospital is a safe method for treatment of dogs with atopic dermatitis. (Am J Vet Res 2001;62:307–310)
Abstract
Objective—To evaluate the effect of long-term treatment with tetracycline and niacinamide on antibody production in dogs by measuring postvaccinal serum concentrations of antibodies against canine parvovirus and canine distemper virus.
Animals—10 dogs receiving long-term treatment with tetracycline and niacinamide (treatment group) and 10 healthy dogs (control group).
Procedure—The treatment group included 9 dogs with discoid lupus erythematosus and 1 dog with pemphigus foliaceus on long-term treatment (> 12 months) with tetracycline and niacinamide. The control group included 10 healthy dogs with no clinical signs of disease and no administered medications for the past 3 months. Blood samples were obtained from all dogs by jugular venipuncture. Serum antibody titers against canine parvovirus and canine distemper virus antigens were measured, using hemaglutination inhibition and serum neutralization, respectively, and compared between groups.
Results—A significant difference in antibody titers between treatment- and control-group dogs was not found. All dogs had protective antibody titers against canine distemper virus, and 8 of 10 dogs from each group had protective titers against canine parvovirus infection.
Conclusion and Clinical Relevance—These results provide evidence that long-term treatment with tetracycline and niacinamide does not interfere with routine vaccinations and thus does not seem to influence antibody production in dogs. (Am J Vet Res 2002; 63:491–494)
Abstract
Objective—To examine cross-reactivity of aeroallergens in Colorado and surrounding states by evaluating concurrent positive reactions of related and nonrelated allergens of intradermal tests in dogs.
Sample Population—Intradermal test results of 268 atopic dogs.
Procedure—A retrospective evaluation of skin test results for 268 dogs was performed. Pairs of closely related and nonrelated allergens were evaluated. Group 1 consisted of closely related allergens with demonstrated antibody cross-reactivity in humans. In group 2, allergens of the same plant group (ie, trees, grasses, or weeds) that were not closely related were paired. In group 3, allergen pairs were of different plant groups. Plant allergens were paired with dust mite allergens, animal dander, or mold spores in group 4. In the last group, allergens not derived from plants were paired. Data were evaluated twice by use of a different definition of a positive reaction. Significance of the difference between group means of log odds ratios was estimated by use of a bootstrap percentile confidence interval.
Results—Significant differences in the number of concurrent positive reactions were not found between related versus nonrelated grass, weed, or tree allergens. Significant differences in the number of concurrent positive reactions were found between plant allergens of different groups (ie, grasses, weeds, and trees) and plant allergens of the same groups, related or nonrelated , as well as between plant-derived and nonplant-derived allergens. Many dogs reacting to a specific allergen did not react to a closely related allergen at the same time.
Conclusion and Clinical Relevance—These results provide evidence against clinically relevant cross-reactivity and suggest that allergen-specific immunotherapy should be formulated on the basis of single allergen test results. (Am J Vet Res 2002;63:874–879)
Abstract
Objective—To determine essential fatty acid concentrations in plasma and tissue before and after supplementation with n-3 fatty acids in dogs with atopic dermatitis.
Animals—30 dogs with atopic dermatitis.
Procedure—Dogs received supplemental flaxseed oil (200 mg/kg/d), eicosapentaenoic acid (EPA; 50 mg/kg/d)-docosahexaenoic acid (DHA; 35 mg/kg/d), or mineral oil as a placebo in a doubleblind, placebo-controlled, randomized trial. Clinical scores and plasma and cutaneous concentrations of linoleic acid, arachidonic acid, α-linolenic acid (α-LLA), EPA, DHA, prostaglandin E2, and leukotriene B4 were determined.
Results—Total plasma concentrations of α-LLA and EPA increased and those of arachidonic acid decreased significantly with administration of EPADHA, and concentrations of α-LLA increased with flaxseed oil supplementation; nevertheless, there was no significant change in the concentrations of these fatty acids or eicosanoids in the skin. There was no correlation between clinical scores and plasma or cutaneous concentrations for any of the measured fatty acids or eicosanoids.
Conclusion and Clinical Relevance—Results indicated that at the dose used, neither the concentrations of fatty acids in skin or plasma nor a decrease in the production of inflammatory eicosanoids was a major factor involved in the mechanism of action in dogs with atopy that responded to fatty acid supplementation. (Am J Vet Res 2005;66:868–873)
