Equine Asthma - Update on terminology, diagnosis and therapy

被引:1
作者
Barton, Ann K. [1 ]
Gehlen, Heidrun [1 ]
机构
[1] Free Univ Berlin, Fachbereich Veterinarmed, Klin Pferde Allgemeine Chirurg & Radiol, Oertzenweg 19b, D-14163 Berlin, Germany
来源
PFERDEHEILKUNDE | 2022年 / 38卷 / 04期
关键词
Equine Asthma; Recurrent Airway Obstruction; Inflammatory Airway Disease; heaves; horse; corticosteroids; diagnostics; therapy; RECURRENT AIRWAY-OBSTRUCTION; BRONCHOALVEOLAR LAVAGE FLUID; RESPIRABLE DUST CONCENTRATIONS; STANDARD-BRED RACEHORSES; BECLOMETHASONE DIPROPIONATE; PULMONARY-DISEASE; AFFECTED HORSES; FLUTICASONE PROPIONATE; MUCUS VISCOELASTICITY; CPG IMMUNOTHERAPY;
D O I
10.21836/PEM20220402
中图分类号
S85 [动物医学(兽医学)];
学科分类号
0906 ;
摘要
Equine asthma is an important disease, known for centuries under various terminologies (heaves, chronic obstructive pulmonary disease, COPD; Recurrent Airway Obstruction, RAO; Inflammatory Airway Disease, IAD). Multiple endotypes exist in human asthma and it becomes more and more obvious that there may exist several subtypes in the horse as well, which may present with various clinical signs and may be associated with different prognoses and require different therapeutic approaches. In mild-moderate equine asthma, three subtypes have been described, characterized by increased percentages of neutrophil granulocytes > 10 %, mast cells > 5 % or eosinophil granulocytes > 5 % in bronchoalveolar lavage fluid (BALF) cytology. A further differentiation in mild (without clinical signs), moderate (with clinical signs, but without dyspnea at rest) and severe equine asthma (dyspnea at rest and severe neutrophilia > 25 % in BALF cytology) was suggested at the last Havemeyer Workshop, which focusses on this disease over the last 20 years on a regular basis, to support the early diagnosis of subclinical cases and initiate early therapy. New therapeutic approaches include inhalative application of glucocorticoids, which reach high concentrations in the lung due to their application as prodrugs and following metabolism in the lung, high lipophilia or low oral bioavailability. Lately, ciclesonide was approved for the German market. Further new approaches include immunostimulatory bacterial plasmids (CpG- ODNs) or the use of combination products.
引用
收藏
页码:320 / 335
页数:15
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