Evaluation of a point-of-care immunodot assay for predicting results of allergen-specific intradermal and immunoglobulin E serological tests.

Immunotherapy to prevent recurrence of clinical signs of atopic dermatitis (AD) is based on intradermal or serological tests that assist in identifying allergen-specific immunoglobulin E hypersensitivities. Unfortunately, the results of such tests can be negatively influenced by several factors, which include the age of the patients, the season of testing and the administration of anti-allergic drugs. Screening to predict when these expensive tests will be useful would benefit owners of dogs with AD. The objectives of this study were to determine whether a point-of-care allergen-specific immunodot assay (Allercept E-Screen, Heska Corp., Ft Collins, CO, USA) could predict results of either intradermal or Allercept full panel serological tests in atopic dogs. Thirty dogs living in the south-eastern USA were diagnosed with AD in accordance with current standards. Allergen-specific intradermal, serological and E-Screen tests were performed in all subjects. For flea, house dust mite and pollen allergens altogether, results of the E-Screen assay agreed with those of intradermal and serological tests in 26/30 dogs (87%) and 25/30 dogs (83%), respectively. In this group of dogs, the probabilities of obtaining intradermal or serological tests positive for these allergens were 70 and 67%, respectively. If either skin or serum tests were performed only in dogs with positive E-Screen tests, the probability of obtaining positive results would be increased from 70 to 95% and from 67 to 90%, respectively. In this population of dogs with AD, results of the E-Screen point-of-care immunodot assay was found to often agree with those of allergen-specific intradermal or Allercept tests for selected allergen groups.

A randomized controlled trial of misoprostol monotherapy for canine atopic dermatitis: effects on dermal cellularity and cutaneous tumour necrosis factor-alpha.

In this blinded randomized placebo-controlled trial, 20 dogs with atopic dermatitis (AD) were given placebo (8 dogs) or misoprostol (12 dogs) at 5 micro g kg-1, orally, three times daily for 3 weeks. Administration of the active drug, but not of placebo, led to a significant decrease in lesional and pruritus scores. The median reduction from baseline of both scores was approximately 30%. Misoprostol therapy did not lead to decreases of dermal cell counts or skin tumour necrosis factor (TNF)alpha mRNA copy numbers that were significantly different from those of placebo. Skin TNFalpha protein production, assessed using indirect immunofluorescence, decreased or remained unchanged in dogs receiving misoprostol. In contrast, post treatment TNFalpha fluorescence scores were higher in all but two dogs given placebo. The changes from baseline of TNFalpha fluorescence scores did not correlate significantly with those of lesional or pruritus indices. These observations confirm the modest efficacy of misoprostol for treatment of canine AD and suggest that its mild anti-allergic effects are not associated with either inhibition of inflammatory cell emigration or TNFalpha production.

Résumé Dans cette étude randomisée en aveugle, 20 chiens présentant une dermatite atopique ont reçu un placebo (8 chiens) ou du misoprostol (12 chiens) à la posologie de 5 µg kg−1 , par voie orale, trois fois par jour pendant 3 semaines. L'administration du misoprostol mais pas du placebo a permis une diminution significative des scores de prurit et lésionnels. La réduction moyenne des 2 scores était d'environ 30%. Le misoprostol n'a pas diminué le nombre de cellules dans le derme ou le nombre de copies d'ARNm du TNF qui étaient significativement différentes du placebo. La production de TNF, determinée par immunofluorescence indirecte a diminué ou n'a pas évolué chez les chiens recevant le misoprostol. Au contraire, les scores de fluorescence pour le TNF étaient plus élevés chez tous les chiens recevant le placebo sauf deux. Les modifications des scores de fluorescence du TNF nétaient pas corrélées aux scores de prurit ou lésionnel. Ces observations confirment l'efficacité modeste du misoprostol pour le traitement de la dermatite atopique canine et suggèrent que ses effets antiallergiques modérés ne sont pas associés à une inhibition de la migration des cellules inflammatoires ou de la production de TNF.

Resumen En este ensayo ciego, al azar y controlado con placebo, a veinte perros con DA se les administró oralmente placebo (8 perros) o misoprostol (12 perros) a una dosis de 5 µg kg−1 tres veces al día durante tres semanas. La administración de la droga activa, pero no la del placebo, dio lugar a una disminución del índice de lesiones y prurito. La reducción media en ambos índices fue de aproximadamente el 30%. La terapia de misoprostol no produjo una disminución del recuento de células dérmicas o del número de copias del ARNm del FNT-α (TNFα), los cuales eran significativamente diferentes del grupo con placebo. La producción de la proteína FNTα, determinada por un método indirecto de immunofluorescencia, disminuyó o permaneció igual en perros que recibieron misoprostol. En cambio, el nivel de fluorescencia del FNTα fue más elevado en el postratamiento en todos los perros, con excepción de dos de ellos en el grupo con placebo. Los cambios en el nivel de fluorescencia, con respecto a la línea basal, no se correlacionaron significativamente con los índices de lesión o prurito. Estas observaciones confirman la modesta eficacia del misoprostol para el tratamiento de las DA caninas y sugiere que sus efectos mínimos antialérgicos no están asociados con la inhibición de la emigración de células inflamatorias o la producción del FNTα.

Cyclosporine decreases skin lesions and pruritus in dogs with atopic dermatitis: a blinded randomized prednisolone-controlled trial.

During the last decade, oral cyclosporin (CsA) has proven to be effective, in randomized controlled trials, for the treatment of atopic dermatitis (AD) in human patients. The purpose of this blinded randomized controlled trial was to test the hypothesis that CsA was successful in reducing the gravity of clinical signs of AD in dogs. Thirty dogs with nonseasonal AD were randomly allocated to receive an oral solution of either NEORAL CsA (5 mg kg-1) or prednisolone (0.5 mg kg-1) once daily for 6 weeks. Before, and 3 and 6 weeks after therapy, skin lesions were graded by clinicians using the Canine AD Extent and Severity Index (CADESI). Pruritus was assessed by the owners using a visual analog scale (PVAS). In both groups, CADESI and PVAS values were significantly lower at 6 weeks post treatment than before the initiation of therapy (Friedman test, P < 0.0004). The percentage reductions in CADESI and PVAS values from baseline were not statistically different between groups (Mann-Whitney test, P > 0.3). In this experiment, the tolerability and safety of oral CsA and prednisolone appeared similar. One-fifth of dogs given oral CsA occasionally developed diarrhoea or soft stools. One dog that was given CsA developed a generalized papillomatous skin eruption during the second half of the trial. Our study provides randomized controlled trial evidence that CsA reduces the severity of clinical signs in dogs with nonseasonal AD. Moreover, the anti-allergic efficacy of CsA appears comparable with that of prednisolone. We propose that oral CsA should be considered as a valuable alternative to glucocorticoid therapy in dogs with AD.