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Topic:Airway Disease
Airway disease in horses is defined as a respiratory condition marked by inflammation and narrowing of the lower airways, leading to symptoms like coughing, increased mucus production, and reduced performance. This condition, which includes forms such as inflammatory airway disease (IAD) and recurrent airway obstruction (RAO), can significantly impact a horse’s respiratory efficiency and overall health.
This page compiles peer-reviewed research studies and clinical insights that explore the pathophysiology, diagnostic techniques, and effective treatment protocols to manage and improve equine respiratory health.
Modeling the pasture-associated severe equine asthma bronchoalveolar lavage fluid proteome identifies molecular events mediating neutrophilic airway inflammation. Pasture-associated severe equine asthma is a warm season, environmentally-induced respiratory disease characterized by reversible airway obstruction, persistent and non-specific airway hyper-responsiveness, and chronic neutrophilic airway inflammation. During seasonal exacerbation, signs vary from mild to life-threatening episodes of wheezing, coughing, and chronic debilitating labored breathing. In human asthma, neutrophilic airway inflammation is associated with more severe and steroid-refractory asthma phenotypes, highlighting a need to decipher the mechanistic basis of this disease chara...
Alar fold resection in 25 horses: Clinical findings and effect on racing performance and airway mechanics (1998-2013). To report clinical findings and performance in horses in which alar fold collapse (AFC) had been diagnosed and surgically treated and to assess form and degree of respiratory obstruction. Methods: Retrospective case series. Methods: Twenty-one standardbreds, 2 coldblooded trotter racehorses, 1 thoroughbred, and 1 Icelandic horse. Methods: Alar fold collapse was diagnosed on the basis of continuous abnormal expiratory flutter noise coinciding with filling of the false nostrils during exercise on a high-speed treadmill that was alleviated by suturing the alar folds (AF) temporarily in a dorsal p...
Effect of different doses of inhaled ciclesonide on lung function, clinical signs related to airflow limitation and serum cortisol levels in horses with experimentally induced mild to severe airway obstruction. Inhaled corticosteroids are effective for the treatment of equine asthma but they induce cortisol suppression with potential side effects. Objective: To study the efficacy of ciclesonide, an inhaled corticosteroid with an improved safety profile, on lung function, clinical signs related to airway obstruction, and serum cortisol levels in asthmatic horses exposed to a mouldy hay challenge. Methods: Cross-over placebo controlled, blinded, randomised experiment. Methods: Sixteen horses were enrolled in three subsequent dose-titration studies (8 horses/study) to investigate the effects of inhaled ...
Insights into animal models for cell-based therapies in translational studies of lung diseases: Is the horse with naturally occurring asthma the right choice? Human asthma is a widespread disease associated with chronic inflammation of the airways, leading to loss of quality of life, disability and death. Corticosteroid administration is the mainstream treatment for asthmatic patients. Corticosteroids reduce airway obstruction and improve quality of life, although symptoms persist despite treatment in many patients. Moreover, available therapies failed to reverse the lung pathology present in asthma. Animal models, mostly rats and mice, in which the disease is experimentally induced, have been studied to identify new therapeutic targets for human as...
Equine airway inflammation in loose-housing management compared with pasture and conventional stabling. Icelandic horses are often stabled in loose-housing systems, and to date this type of stabling has not been evaluated with regard to its potential impact on respiratory health. The objective was to assess if differences in management systems (eg, conventional stable, loose housing and pasture only) affect the degree of airway inflammation, evaluated by cytology of tracheal aspirate (TA) and bronchoalveolar lavage (BAL) fluid. In total, 84 Icelandic horses (aged 8.1±4.6 years) housed under three different management systems (conventional stables [n=29], loose-house systems [n=29] and pasture [...
Gene set enrichment analysis of the bronchial epithelium implicates contribution of cell cycle and tissue repair processes in equine asthma. Severe equine asthma is a chronic inflammatory condition of the lower airways similar to adult-onset asthma in humans. Exacerbations are characterized by bronchial and bronchiolar neutrophilic inflammation, mucus hypersecretion and airway constriction. In this study we analyzed the gene expression response of the bronchial epithelium within groups of asthmatic and non-asthmatic animals following exposure to a dusty hay challenge. After challenge we identified 2341 and 120 differentially expressed genes in asthmatic and non-asthmatic horses, respectively. Gene set enrichment analysis of changes...
Exercising upper respiratory videoendoscopic findings of 50 competition draught horses with abnormal respiratory noise and/or poor performance. Upper respiratory tract (URT) endoscopy at rest is commonly used to evaluate competition draught horses with URT conditions. Overground endoscopy might be preferred for draught horse URT evaluation as it allows the horses to be driven with harness, overcheck and cart-load under similar conditions to those experienced in the show ring where airway conditions are most prominent. Objective: To describe the exercising URT findings of competition draught horses with abnormal respiratory noise and/or poor performance. Methods: Case series. Methods: Medical records of competition draught horses under...
An observational study of environmental exposures, airway cytology, and performance in racing thoroughbreds. Mild equine asthma is presumed to arise in response to environmental exposures but the relative impact of differing inflammatory phenotypes upon performance are largely unexplored. Objective: Airway inflammation negatively affects performance and cytological phenotype varies with environmental exposure. Methods: Thoroughbred racehorses in active training and racing. Methods: Thoroughbreds were recruited 24-48 hours before racing. Each horse was eligible for re-enrollment with each race entry. Within one hour of race completion, physical examination, respiratory endoscopy, and BAL were performe...
Bronchoalveolar lavage fluid cytology and airway hyper-reactivity in clinically normal horses. To characterise the relationship between bronchoalveolar lavage fluid (BALF) cytology and pulmonary function testing with histamine bronchoprovocation (HBP) methods in a population of clinically normal horses. Methods: Cross-sectional study METHODS: Clinically normal adult horses (n = 33) underwent pulmonary function testing and HBP with a commercial flowmetric plethysmography system. BAL was performed 1-5 days later. Statistical analysis was used to assess associations between BALF cell concentration, relative inflammatory cell percentages and categorisation, and airway hyper-reactivity...
Efficacy of tamoxifen for the treatment of severe equine asthma. Tamoxifen, a selective estrogen receptor modulator, decreased airway neutrophilia and improved clinical signs in an experimental model of equine asthma, and induced neutrophilic apoptosis in vitro. Objective: Tamoxifen reduces airway neutrophilia and improves lung function in severe asthmatic horses. Methods: Twelve severe asthmatic horses from a research herd. Methods: Randomized controlled blinded study design. The effects of a 12-day oral treatment with tamoxifen (0.22 mg/kg, q24h) or dexamethasone (0.06 mg/kg, q24h) on lung function, endoscopic tracheal mucus score and bronchoalveolar ...
Exhaled breath condensate hydrogen peroxide, pH and leukotriene B4 are associated with lower airway inflammation and airway cytology in the horse. Exhaled breath condensate (EBC) analysis is a noninvasive method to assess the lower respiratory tract. In human subjects, EBC hydrogen peroxide (H O ), pH and leukotriene B (LTB ) are useful for detection and monitoring of inflammatory lung diseases, including asthma. Objective: To determine associations between EBC biomarkers and cytological and endoscopic definitions of lower airway inflammation (LAI) while controlling for sampling and environmental variables. Methods: Prospective, cross-sectional study. Methods: Clinical, endoscopic and airway cytological findings from 47 horses were compa...
Lower Airway Disease in the Athletic Horse. The airways are the first part of the pathway in the oxygen transport chain that is critical to excellent athletic performance, and the lower airways are considered the final gatekeeper before oxygen enters the blood and carbon dioxide exits. Horses are blessed with large airways and lungs that allow them to be superb athletes, but the down side of this largesse on the part of evolution is that unless they are truly elite athletes they may withstand noninfectious disease of the lower respiratory tract for months to years before the owner or trainer notices. The two conditions of the lower resp...
Interventional Radiology Management of Tracheal and Bronchial Collapse. Chondromalacia of the tracheal and bronchial cartilages and redundancy of the dorsal tracheal membrane result in collapse of the large airways, leading to coughing and airway obstruction. It most commonly affects small-breed dogs, although larger-breed dogs, cats, and miniature horses are also sporadically reported. Dynamic airway imaging is used to confirm the diagnosis. The primary goal of medical management is to control clinical signs attributable to coughing and airway inflammation. When this is no longer effective, tracheal stents provide a minimally invasive, rapid way to restore airway...
Role of neutrophils in equine asthma. Neutrophilic bronchiolitis is the primary lesion in asthma-affected horses. Neutrophils are key actors in host defense, migrating toward sites of inflammation and infection, where they act as early responder cells toward external insults. However, neutrophils can also mediate tissue damage in various non-infectious inflammatory processes. Within the airways, these cells likely contribute to bronchoconstriction, mucus hypersecretion, and pulmonary remodeling by releasing pro-inflammatory mediators, including the cytokines interleukin (IL)-8 and IL-17, neutrophil elastase, reactive oxygen specie...
Upper Airway Conditions Affecting the Equine Athlete. Many abnormalities of the upper airway that can inhibit performance are determined on a critical resting endoscopic evaluation. Some dynamic abnormalities can only be seen during an exercising endoscopic evaluation, which should be performed whenever the history of abnormal noise or performance limitations is not completely consistent with the resting endoscopic findings. Head and neck position may play a critical role in the evaluation process and the exact position during performance should be reproduced during the clinical examination to definitively define the abnormality. Treatments and p...
The occurrence of dynamic structural disorders in the pharynx and larynx, at rest and during exercise, in horses diagnosed with mild and moderate Equine Asthma (Inflammatory Airway Disease). The goal of the present study was to establish the occurrence of structural disorders in the larynx and pharynx during treadmill exercise tests in horses diagnosed with Equine Asthma (EA). Investigation was performed in 29 horses, patients of the Equine Clinic of the Warsaw University of Life Sciences in Poland, admitted with poor exercise performance. Upper and lower airway examinations were performed in all patients revealing both mild to moderate Equine Asthma (13 horses), and no lower airway abnormalities (16 animals). In the group of horses with EA, 11 did not have structural disorders of...
Combining long-acting bronchodilators with different mechanisms of action: A pharmacological approach to optimize bronchodilation of equine airways. The ultra long-acting β -adrenoceptor agonist olodaterol plus the ultra long-acting muscarinic antagonist tiotropium bromide are known to relax equine airways. In human bronchi combining these drugs elicits a positive interaction, thus we aimed to characterize this information further in equine isolated airways stimulated by electrical field stimulation (EFS) and using the Concentration-Reduction Index (CRI) and Combination Index (CI) equations. The drugs were administered alone and together by reproducing ex vivo the concentration-ratio delivered by the currently available fixed-dose combina...
Influence of bronchoalveolar lavage on thoracic radiography in the horse. Bronchoalveolar lavage (BAL) and thoracic radiography are routinely performed diagnostic procedures. We hypothesized that BAL increases the interstitial opacity of caudoventral and caudodorsal thoracic radiographs. Fifty-three horses, including 8 clinic owned and 45 from a referral hospital population, were classified as healthy controls (n = 12), severe equine asthma (recurrent airway obstruction, n = 12) or mild-to-moderate equine asthma (inflammatory airway disease, n = 21) based on the results of a clinical scoring system. Eight were excluded due to different diagnoses and poor image quali...
Histologic investigation of airway inflammation in postmortem lung samples from racehorses. OBJECTIVE To describe histologic findings in the small airways during postmortem examination of actively racing horses and to quantify the degree of airway inflammation by use of a semiquantitative scoring system. SAMPLE Lung tissues obtained from 95 horses (Thoroughbreds, Standardbreds, and Quarter Horses) that had been actively racing or training. PROCEDURES 10 standardized lung sections were obtained during postmortem examination of 37 horses that had been actively racing or training, and 2 histologic sections of the caudodorsal lung lobes previously collected from each of 58 horses that di...
Modeling asthma: Pitfalls, promises, and the road ahead. Asthma is a chronic, heterogeneous, and recurring inflammatory disease of the lower airways, with exacerbations that feature airway inflammation and bronchial hyperresponsiveness. Asthma has been modeled extensively via disease induction in both wild-type and genetically manipulated laboratory mice (Mus musculus). Antigen sensitization and challenge strategies have reproduced numerous important features of airway inflammation characteristic of human asthma, notably the critical roles of type 2 T helper cell cytokines. Recent models of disease induction have advanced to include physiologic aero...
Bronchoalveolar lavage fluid neutrophilia is associated with the severity of pulmonary lesions during equine asthma exacerbations. The severe form of equine asthma is associated with pathological changes of the peripheral airways and pulmonary parenchyma that are only partly described. Also, the relationship between these structural alterations and the percentage of neutrophils found within the airway lumen, assessed by bronchoalveolar lavage fluid (BALF) cytology, remains ill-defined. Objective: To examine the histological lesions associated with equine asthma during disease exacerbation and remission, and their relationship with lung function and BALF neutrophilia. Methods: Observational retrospective study. Methods: Pe...
Horses With Pasture Asthma Have Airway Remodeling That Is Characteristic of Human Asthma. Severe equine asthma, formerly recurrent airway obstruction (RAO), is the horse counterpart of human asthma, affecting horses maintained indoors in continental climates. Equine pasture asthma, formerly summer pasture RAO, is clinically similar but affects grazing horses during hot, humid conditions in the southeastern United States and United Kingdom. To advance translational relevance of equine pasture asthma to human asthma, histologic features of airway remodeling in human asthma were scored in lung lobes from 15 pasture asthma-affected and 9 control horses of mixed breeds. All noncartilagi...
Neutrophil extracellular traps are downregulated by glucocorticosteroids in lungs in an equine model of asthma. Severe neutrophilic asthma is poorly responsive to glucocorticosteroids (GC). Neutrophil extracellular traps (NETs) within the lungs have been associated with the severity of airway obstruction and inflammation in asthma, and were found to be unaffected by GC in vitro. As IL-17 is overexpressed in neutrophilic asthma and contributes to steroid insensitivity in different cell types, we hypothesized that NETs formation in asthmatic airways would be resistant to GC through an IL-17 mediated pathway. Six neutrophilic severe asthmatic horses and six healthy controls were studied while being treated...
Expression of extracellular matrix metalloproteinase inducer and matrix metalloproteinase-2 and -9 in horses with chronic airway inflammation. OBJECTIVE To examine whether expression of extracellular matrix metalloproteinase inducer (EMMPRIN) can be detected in equine lungs and whether it correlates with matrix metalloproteinase (MMP)-2 and -9 expression in bronchoalveolar lavage fluid (BALF) of horses with chronic inflammation of the lungs (ie, lower airway inflammation [LAI]). ANIMALS 29 horses with signs of chronic respiratory tract disease, which were classified as the LAI (n = 17) and LAI with respiratory distress (RDLAI [12]) groups, and 15 control horses. PROCEDURES BALF, tracheal aspirate, and blood samples were obtained, and...
Upper and lower respiratory tract microbiota in horses: bacterial communities associated with health and mild asthma (inflammatory airway disease) and effects of dexamethasone. The microbial composition of the equine respiratory tract, and differences due to mild equine asthma (also called Inflammatory Airway Disease (IAD)) have not been reported. The primary treatment for control of IAD in horses are corticosteroids. The objectives were to characterize the upper and lower respiratory tract microbiota associated with respiratory health and IAD, and to investigate the effects of dexamethasone on these bacterial communities using high throughput sequencing. Results: The respiratory microbiota of horses was dominated by four major phyla, Proteobacteria (43.85%), Actinob...
Fluticasone/salmeterol reduces remodelling and neutrophilic inflammation in severe equine asthma. Asthmatic airways are inflamed and undergo remodelling. Inhaled corticosteroids and long-acting β2-agonist combinations are more effective than inhaled corticosteroid monotherapy in controlling disease exacerbations, but their effect on airway remodelling and inflammation remains ill-defined. This study evaluates the contribution of inhaled fluticasone and salmeterol, alone or combined, to the reversal of bronchial remodelling and inflammation. Severely asthmatic horses (6 horses/group) were treated with fluticasone, salmeterol, fluticasone/salmeterol, or with antigen avoidance for 12 weeks. ...
Association between exercise-induced pulmonary hemorrhage and inflammatory airway disease in polo ponies. The respiratory system is essential for health and high athletic performance in horses. Respiratory diseases have been recognized as having a major impact on training equine animals and are commonly cited as the second most common cause of wasted training time. Inflammatory airway disease (IAD) is an important cause of poor performance in young racehorses. Exercise-induced pulmonary hemorrhage (EIPH) is considered a major issue for the equine industry because of its high prevalence and association with reduced athletic performance. In Brazil, polo is a growing equestrian sport, but studies on ...
Effect of Dexamethasone and Fluticasone on Airway Hyperresponsiveness in Horses With Inflammatory Airway Disease. Airway hyperresponsiveness (AWHR), expressed as hypersensitivity (PC R ) or hyperreactivity (slope of the histamine dose-response curve), is a feature of inflammatory airway disease (IAD) or mild equine asthma in horses. Glucocorticoids are used empirically to treat IAD. Objective: To determine whether dexamethasone (DEX) (0.05 mg/kg IM q24h) and inhaled fluticasone (FLUT) (3,000 μg q12h) administered by inhalation are effective in decreasing AWHR, lung inflammation, and clinical signs in horses with IAD. Methods: A randomized crossover study design was used. Eight horses with IAD were assign...
