A prospective study on canine atopic dermatitis and food-induced allergic dermatitis in Switzerland

Canine atopic dermatitis sensu stricto and food-induced allergic dermatitis are common canine skin conditions, which are often considered clinically undistinguishable. Several attempts have been made to describe populations of atopic dogs and determine breed predisposition but the results were often biased by the use of hospital populations as control group. The present study aims to describe a population of Swiss atopic and food-allergic dogs and to compare it with a data set representing more than 85% of all Swiss dogs. The study, which was carried out during 1 year in several practices and teaching hospital in Switzerland, describes a group of 259 allergic dogs, determines breed predisposition for atopic dermatitis and food-induced allergic dermatitis, compares the clinical signs and features of both conditions, and outlines the clinical picture of five frequently affected breeds.     

Prevalence and features of canine atopic dermatitis in Hungary

Medical records of 600 dogs diagnosed with atopic dermatitis were reviewed and evaluated with reference to history, geographical distribution, breed predilection, clinical signs and positive reactions to allergens as determined by intradermal skin testing (IDT) manufactured by Artuvetrin Laboratories. In 66.6% of dogs, the age of onset of atopic dermatitis was between 4 months and 3 years. Dogs living in the garden suburb of Budapest were more sensitive to house dust mites, fleas and moulds, and dogs from the western part of Hungary were more sensitive to weeds than to other allergens (p < 0.01). Positive reactions were most common to Dermatophagoides farinae followed by human dander. The breed distribution found in the present study was consistent with that reported in the literature, except for the breeds Hungarian Vizsla, Pumi, French bulldog, Doberman Pinscher and Bobtail which were over-represented among atopic dogs compared to the breed distribution of the general dog population of a large city in Hungary. Breeds with verified adverse reaction to food were Cocker spaniels, French bulldogs, Bullmastiffs, Bull terriers, St. Bernards, Tervurens, West Highland White terriers and American Staffordshire terriers (p < 0.05). The clinical signs of atopic dermatitis and their occurrence are in accordance with the data described in the literature.     

犬特应性皮炎及其治疗药物的研究进展

犬特应性皮炎是一种具有遗传倾向的过敏性皮肤病。由于近年来我国养犬数量不断增加,犬特应性皮炎成为宠物临床上的常见疾病,严重危害了宠物犬的身体健康。该病病因复杂,大致可概括为遗传因素、环境因素、皮肤屏障功能失调、免疫功能失调和微生物菌群失调五个方面,且由于其临床症状与其他过敏反应、炎症反应相似,难以确诊,需要通过多种临床反应共同判定。随着小动物诊疗的不断发展,犬特应性皮炎治疗在以往基础疗法上又增加了使用抗炎止痒药物、JAK通路抑制药物、生物制品药物和PED-4 选择性抑制剂等治疗方式。本文综述了近年来犬特应性皮炎的病因、临床症状、诊断方法和治疗方法方面的研究进展,以期为犬特应性皮炎的治疗提供借鉴和参考。     

The ACVD task force on canine atopic dermatitis (XII): the relationship of cutaneous infections to the pathogenesis and clinical course of canine atopic dermatitis.

Dogs and human beings with atopic dermatitis (AD) frequently exhibit concurrent skin infections with Staphylococcus sp. bacteria or Malassezia yeast, and treatment of such infections is an important facet of managing these patients. Staphylococci appear to colonize atopic skin readily, and bacterial products on the skin could augment cutaneous inflammation via immediate hypersensitivity responses to the bacteria, by superantigen-mediated lymphocyte activation, or other non-specific mechanisms. Similarly, skin colonization by Malassezia yeast could contribute to clinical signs of AD; yeast components could induce inflammation via non-specific mechanisms, such as alteration in mediator release, or via antigen-specific hypersensitivity reactions. Clinical and experimental evidence exists that secondary microbial infections can both initiate and perpetuate episodes of AD in dogs and humans, and could even participate in promotion of pro-allergic immunologic responses. Mechanistic details of these complex interactions are under extensive investigation in human beings; only a few observations have been extended to include dog with AD.     

The study of canine atopic dermatitis involving the isolation of dogs

Twenty-seven pruritic dogs were used in this study. When a hypoallergenic diet was fed to these 27 dogs for six weeks, none of the dogs showed improvement of the pruritus. These dogs had a history and clinical signs of atopic dermatitis (AD) as defined by Prelaud's diagnostic criteria. Subsequently, the 27 dogs were isolated for observation for two weeks in the hospital. In the isolation room in the veterinary clinic, cages and tableware were all stainless steel, and carpet was not used. A hypoallergenic diet was continuously fed to the 27 dogs for two weeks, during which time they were kept in the isolation room. PVAS (Pruritus Visual Analog Scale) was performed prior to starting the isolation, at the start of the study and 2 weeks after starting the isolation. In 17 dogs (63%) the pruritus improved in the isolation room. A statistically significant reduction (p < 0.01) of PLS (Pruritus liners score) was recorded 2 weeks after isolation. It was hypothesized that the 17 dogs whose pruritus improved in the isolation room had AD caused by an environmental antigen that was not present in the isolation room. Pruritus of the remaining 10 dogs (37%) did not improve. For 6/10 dogs, the intradermal allergy testing was positive for an environmental antigen. For 4/10 dogs, the intradermal allergy testing was negative for all environmental antigens. Dogs for which sensitivity to an environmental antigen was not identified were thought to have atopic-like dermatitis.     

益生菌对犬异位性皮炎免疫调节机制的研究

本试验对使用益生菌治疗的21只异位性皮炎犬和9只健康犬进行调查,通过流式细胞术检测其外周血淋巴细胞FoxP3表达(即Treg的生成),ELISA试剂盒检测血清IL-10、TGF-β、IFN-γ和IgE浓度,并比较治疗前后患犬的瘙痒程度。结果表明,服用特殊益生菌使犬外周血淋巴细胞FoxP3表达升高,血清IL-10和IgE浓度分别升高和下降。且通过提高Treg细胞的数量控制异位性皮炎的发病。     

The ACVD task force on canine atopic dermatitis (XV): fundamental concepts in clinical diagnosis.

The clinical signs of atopic dermatitis (AD) in man and in dogs are variable, and there is no single physical or historical feature that, if present, indicates the presence of AD. The initial diagnosis of AD is made clinically with the fulfillment of a combination of criteria that are strongly associated with the disease. Several schemes have been proposed in an attempt to define uniform clinical criteria for diagnosing canine AD, but no system is perfect. Once AD is considered as a possible diagnosis, other important differential diagnoses must be methodically eliminated from consideration. As a final step, once the clinician is certain that AD is probable, "allergy" tests may be conducted to provide additional evidence to "substantiate" the diagnosis. It is important to understand that allergy testing, in whatever form, is not appropriately used early in the patient evaluation as a screening test. Rather, it should be reserved, after a firm clinical diagnosis of AD has been made, to implement allergen avoidance schemes or to select allergens to be incorporated in immunotherapy formulations.     

The ACVD task force on canine atopic dermatitis (III): the role of antibodies in canine atopic dermatitis.

Although an important pathogenic role for IgE is established in the case of allergic asthma and rhinitis in man, its role in atopic dermatitis is less clear. There are many studies where allergists and immunologists have provided evidence in favour of such a role, whereas dermatologists are less than convinced.In dogs, however, there is an abundance of clinical evidence implying that atopic dermatitis is antigen driven, and recent studies suggest that there may be a role for IgE, not only in the effector pathway, but also in antigen capture. Although an IgG response often accompanies an IgE response in dogs with atopic dermatitis, there is little evidence in support of a pathogenic role in respect of the former isotype.     

Masitinib for the treatment of canine atopic dermatitis: a pilot study

There is an on-going need to identify medications suitable for the long-term treatment of canine atopic dermatitis (CAD). Masitinib mesilate is a potent and selective tyrosine kinase inhibitor of the c-KIT receptor. A strong relationship exists between the SCF/c-KIT pathway and pathogenesis of CAD, suggesting that masitinib may potentially fulfil the above role. This study reports on an uncontrolled pilot study of masitinib in CAD. Masitinib was administered orally to 11 dogs at a mean dose of 11.0 ± 1.83 mg/kg/day (free base) for 28 days. Treatment response was assessed by evolution of clinical appearance according to a modified version of the Canine Atopic Dermatitis Extent and Severity Index (mCADESI), pruritus scale and surface area of lesions. Masitinib improved CAD with a mean reduction in mCADESI of 50.7 ± 29.8% (95% C.I. = 29.4–72.0; p = 0.0004) at day 28 relative to baseline, with 8/10, 8/10 and 4/10 dogs showing improvement of ≥33%, ≥40% and ≥50%, respectively. Improvement was further evidenced by a decrease in pruritus score and the surface area of lesions. No serious or severe adverse events occurred during this trial, although 6/11 dogs presented with mild to moderate treatment related adverse events. There is sufficient compelling evidence to warrant further investigation.     

Prediction of future development of canine atopic dermatitis based on examination of clinical history

OBJECTIVES: The aim of this study was to identify clinical features that could be used to identify individual dogs within the Guide Dogs for the Blind Association canine population at risk of being diagnosed as atopic in the future before they had fully developed the condition. METHODS: Clinical histories of atopic and non-atopic dogs from the Guide Dogs for the Blind Association population were analysed and statistically significant differences identified between the two groups. RESULTS: Atopic dogs were consistently affected by skin disease at a younger age than non-atopic dogs and that there was a significant difference in event curves between atopic and non-atopic dogs at 10 months of age. From a predictive point of view, dogs that suffered from four or more episodes of atopic-type skin disease by the age of 15 months were at an increased risk of developing atopic dermatitis. CLINICAL SIGNIFICANCE: It is suggested that the clinical history of all dogs from the Guide Dogs for the Blind Association about to undergo training should be examined for these factors to assess whether or not they should undergo training.     

The effect of nematode administration on canine atopic dermatitis

Canine atopic dermatitis is a common disease and is considered as an animal model of the human disease. Immunomodulation by helminths is reported in several species. The aim of this study was to determine whether nematodes have an immunomodulatory effect on atopic dermatitis in dogs. In the pilot study, 12 atopic dogs were infected with either embryonated eggs of Trichuris vulpis (500 and 2500 eggs in 3 dogs each) or L3 larvae of Uncinaria stenocephala (100, 500 and 2500 eggs in 2 dogs each), respectively, for 3 months. Pruritus was evaluated with visual analogue scales and clinical lesions with the canine atopic dermatitis extent and severity index (CADESI). Skin biopsies were obtained for histopathology at the beginning and end of the study. In the subsequent placebo-controlled, double-blinded, randomised study, 21 dogs received either 2500 embryonated T. vulpis eggs or placebo and were evaluated similarly. In addition, allergen-specific serum IgE concentrations were determined. All dogs in the pilot study improved in their lesion scores, most in their pruritus scores. The cutaneous inflammatory infiltrate did not change significantly. In the subsequent randomised study, there was no significant difference between placebo and Trichuris administration in regard to pruritus or CADESI. IgE concentrations also did not change significantly. Infection with T. vulpis did not significantly change clinical signs of canine atopic dermatitis.     

Characterization of pruritus in canine atopic dermatitis,flea bite hypersensitivity and flea infestation and its role in diagnosis

Background – In dogs, flea infestation (FI), flea bite hypersensitivity (FBH) and canine atopic dermatitis (CAD) have been mainly characterized by their lesions but never by their pruritus. In clinical practice, many of these dogs exhibit only pruritus. Hypothesis/Objectives – The purpose of this study was to evaluate the characteristics of pruritus in these dermatoses and their potential usefulness for diagnosis. Animals – Dogs included were selected from the Oniris clinical data. Cases were selected in which the dogs had only one of the three dermatoses diagnosed. The diagnosis of CAD was based on Prélaud’s criteria and positive intradermal tests except flea; for FBH by compatible clinical signs and a response to an intradermal test with flea allergen; and for FI by the presence of fleas. Moreover, in each group, other primary pruritic skin diseases were excluded. Methods – Location, behavioural manifestations, seasonality and quantification of the pruritus were evaluated. The statistical analysis used chi‐squared test with a P‐value <0.05. Results – Three hundred and forty‐six dogs were analysed, 91 with CAD, 110 FI and 145 FBH. The period (season) of onset was not statistically different either for each dermatosis or among the three dermatoses. Some locations were highly specific for one dermatosis as follows: ventral abdomen/medial surface of thigh (chewing) and radius/carpus/tibia/tarsus (chewing) in FI; back/dorsolumbar area (chewing) and tail (chewing) in FBH; and paws (chewing/licking) and face/neck (rubbing) in CAD. Conclusions and clinical importance – Some features of pruritus could be suggestive of the causal disease, with possible diagnostic value in pruritic dogs.     

Interleukin‐31: its role in canine pruritus and naturally occurring canine atopic dermatitis

Background – Interleukin‐31 (IL‐31) is a member of the gp130/interleukin‐6 cytokine family that is produced by cell types such as T helper 2 lymphocytes and cutaneous lymphocyte antigen positive skin homing T cells. When overexpressed in transgenic mice, IL‐31 induces severe pruritus, alopecia and skin lesions. In humans, IL‐31 serum levels correlate with the severity of atopic dermatitis in adults and children. Hypothesis/Objective – To determine the role of IL‐31 in canine pruritus and naturally occurring canine atopic dermatitis (AD). Animals – Purpose‐bred beagle dogs were used for laboratory studies. Serum samples were obtained from laboratory animals, nondiseased client‐owned dogs and client‐owned dogs diagnosed with naturally occurring AD. Methods – Purpose‐bred beagle dogs were administered canine interleukin‐31 (cIL‐31) via several routes (intravenous, subcutaneous or intradermal), and pruritic behaviour was observed/quantified via video monitoring. Quantitative immunoassay techniques were employed to measure serum levels of cIL‐31 in dogs. Results – Injection of cIL‐31 into laboratory beagle dogs caused transient episodes of pruritic behaviour regardless of the route of administration. When evaluated over a 2 h period, dogs receiving cIL‐31 exhibited a significant increase in pruritic behaviour compared with dogs that received placebo. In addition, cIL‐31 levels were detectable in 57% of dogs with naturally occurring AD (≥13 pg/mL) but were below limits of quantification (<13 pg/mL) in normal, nondiseased laboratory or client‐owned animals. Conclusions – Canine IL‐31 induced pruritic behaviours in dogs. Canine IL‐31 was detected in the majority of dogs with naturally occurring AD, suggesting that this cytokine may play an important role in pruritic allergic skin conditions, such as atopic dermatitis, in this species.